Book Review–Sex/Gender: Biology in a Social World

From our earliest memories are told there are only genders, boys are certain way, girls are a certain way, and these differences can be explained with biology. Girls produce estrogen, which makes them emotional and gives them breasts when they grow up. Boys produce testosterone, which gives them lots of energy and muscles when they grow up. These sorts of message are so ubiquitous we never question them even as adults. We take it for grant that boys have a certain biology, girls have another, and that is what accounts for the differences we see in how women and men interact are treated in society. It is a kind of biological essentialist thinking many have used to justify sexism, cissesexism, heterosexism, and various other forms of oppression for millennia.

Alternatively, many feminists and others  have countered biological essentialism in asserting gender is socially constructed and making a distinction between gender and biological sex. In other words, gender is a social category while sex is a biological. From this standpoint these feminists were able to successfully debunk the myth that sexism is the inevitable result of unchangeable biology and assert gender oppression is the result of social forces and, therefore, changeable. However, such theories neglect to account for much of people’s lived, bodily experiences of gender.

Then there are those who assert the typical nature vs. nurture that often rages around sex and gender misses the mark. Humans are complicated social and biological beings, nature does not exist apart from nurture, and nurture does exist apart from nature. Any theory that ignores one or the other will be inadequate. To address these issues feminist and biologist Anne Fausto-Sterling in Sex/Gender: Biology in a Social World debunks many of the myths about the scientific study of sex differences and offers possible alternative developmental theories on gender and sexual identities. This is all done in an interdisciplinary approach. Not only does Fausto-Sterling draw insights from biology, she also brings insights from other fields such as anthropology, sociology, and even history to the table as well.

The topics Fausto-Sterling covers range from the development of primary sex characteristics, intersex conditions and what they can and cannot tell us about gender, the development of gender identity in early childhood, and the theory of brain sex. In doing so she manages to address the misconception that sex as a biological category is strictly binary as well as the limitations of current research and theories on sex, gender, and the brain. Beyond issues of sex and gender Fausto-Sterling also addresses the history of sexual identity as a concept and its complex relationship to gender and gender expression.

With Fausto-Sterling’s interdisciplinary approach and easy-to understand style, I would recommend Sex/Gender: Biology in a Social World to anyone who is new to the field biology or gender studies as well as to more experienced scholars. In a world where there is a divide between the sciences and humanities and misconceptions concerning gender and science run rampant, more interdisciplinary works like Fausto-Sterling addressing issues of science and gender are most welcome.

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Life Updates: Starting Graduate School and Experimenting with Gender Identity and Expression

About a week ago I started graduate school and it is already proving to be a hectic ride with full time Teacher Assistant responsibilities on top of my studies. I may not have as much time to blog as I did before, but I am certainly finding more opportunities to explore my gender identity and reinvent myself.

Just this weekend I went to a local Pride festival and, sensing I was having one of my more nonbinary days coming on, decided to experiment with my name and pronouns. When I picked up a name tag at one of the booths at the beginning of the festival, instead of writing my birth name and assigned pronouns like I usually would, I wrote Quincy and ze/hir/hirs. It felt strange at first, but I actually liked being called Quincy and using ze/hir/hirs pronouns in that particular setting surrounded by a whole host of my fellow nonbinary, genderqueer, and gender nonconforming siblings. It was awesome!

While I was there I also purchased my first bowtie. It was rainbow for the occasion and I wore all through the evening. When I returned home and finally saw myself in the mirror wearing my purple “This is What a Feminist Looks Like” t-shit, sporting rainbow face paint, and dawning a matching rainbow bow-tie I really understood for the first time what many in trans communities call gender euphoria. I felt empowered. I felt seen. I felt liberated. I felt happy in my expression in a way I hadn’t before that’s hard to describe. I felt all of this just because of a bowtie. It is amazing what such small changes in self-expression can do for a person psychologically. Now I can’t wait to see what comes next!

Book Review–Gender Outlaw: On Men, Women, and the Rest of Us by Kate Bornstein

What’s your gender? When did you decide it? How much say do you have in your gender? Is there is anything about your gender or gender role that gets in your way? What would happen if you transgressed those roles? These are the sorts of questions Kate Bornstein asks as a self-described nonbinary transfeminine diesel femme dyke in hir part coming-of-age, part mind bending manifesto on gender and sexuality, Gender Outlaw: On Men, Women, and the Rest of Us.

Published in 1994, Gender Outlaw was years ahead of its time. Now, a little over twenty years later, it is a recognized classic in the world of gender and queer theory that continues to expose new readers to a daring world of gender anarchy, rebellion, fluidity, and creativity; a world where gender ambiguity can and should be explored and everything everyone is supposed to just know about gender is brought into question. This world of gender outlaws comes alive through Bornstein’s fun, quirky, personal style with a combination of cultural criticism, autobiography, and dramatic writing.

As a cultural critic Bornstein tackles many common assumptions about sex, gender, and sexuality from the idea sex and gender are the same and gender and sexuality are interdependent traits. The main assertions Bornstein makes include gender is a cultural rather a cultural phenomenon distinct from biological sex and it does not determine sexual orientation. If it did what that make someone who is attracted to someone who is nonbinary?

Bornstein enhances hir cultural criticism with autobiographical content that gives readers a window (or, perhaps, a mirror) into the experiences of someone who does not live outside of the gender binary most of the population takes for granted. As someone who is neither a man or a woman, has experienced a gender transition from male to female, and is a trans elder Bornstein through means of autobiography manages to make hir theories speak to lived experience and come alive.

Also eaders who are interested in queer theater will appreciate the inclusion of Bornstein’s play, Hidden: A Gender, and its creative exploration of gender ambiguity and fluidity. By the end many readers and audiences will be left with new questions to examine and new gender possibilities to see.

While Gender Outlaw may not be for  the feint of heart, I would recommend it to anyone who wishes to gain a better understanding of gender and sexuality. Some, in the process of exploration, may find the issues of gender, sexuality, and desire Bornstein addresses speak to them more than they expected.

Intersex People in History: Who is Cheryl Chase (Bo Laurent)?

While intersex people have existed for as long as humanity has existed, we are often left out of the historical narrative. This series of posts seeks to address this gap in showcases important figures in intersex history. To begin let’s focus on the pivotal leaders of the early intersex rights movement, Bo Laurent, better known by her pseudonym Cheryl Chase.

Cheryl Chase (August 14, 1956) is an American intersex activist who is best known as the founder of the Intersex Society of North America (ISNA). At birth Chase was assigned a male sex and given the name Brian. At the age of eighteen months it was discovered she had ovaries and a uterus. A clitoridectomy was performed, her parents obtained a new birth certificate, changed the child’s name to Bonnie Sullivan, moved to a new town, and began raising their child as a girl all under the advise of medical professionals. Chase did not discover what had been done to her until the age of ten and did not gain access to her medical records until the age of twenty-one. What she found shocked her. At the age of thirty Chase had a nervous break-down that prompted her to research intersexuality. This time what she found left her feeling less alone and determined to spare others from what she had experienced.

In 1993 Chase founded ISNA in an effort to increase intersex visibility, oppose medically unnecessary and irreversible interventions like early genital surgeries like the one Chase herself was subjected to as a child, and improve intersex health care. The organization was the first of its kind in the United States and played a major role in launching the intersex rights movement.

Along with founding ISNA, Chase also produced Hermaphrodites Speak! in 1997. The piece broke new ground as the first documentary to feature intersex people speaking openly about their experiences. It has been shown in dozens of film festivals worldwide as well as in university classrooms, medical school grand rounds, and professional conferences in a variety of fields such as medicine, psychology, and history.

As a patient advocate Chase has delivered Grand Round presentations at Stanford University, UCSF, UCLA, Albert Einstein College of Medicine, Michigan State University, University of Michigan, and others. Her presentation Sex Ambiguity: The Patient Centered Approach at the 2000 meeting of the Lawson Wilkins Pediatric Endocrine Society is considered to be a major patient-led breakthrough in medical reform.

As a scholar Chase’s work has been published in the Journal of Urology, Journal of Medical Ethics, and Pediatric Nursing. The historic 1999 Supreme Court of Columbia decision establishing human rights protections for intersex people relied heavily on Chase’s 10,000 word amicus.

Over the course of her career Chase’s work as an activist has been recognized the year 2000 Felipa de Souza Human Rights Award as well as in numerous publications. These publications include News Week, the New York Times, NPR’s Fresh Air, NBC’s Dateline, ethicist Alex Dreger’s Intersex in the Age of Ethics, social psychologist Suzanne Kessler’s Lessons from the Intersexed, and molecular biologist Anne Fausto-Sterling’s Sexing the Body, and medical writer Natalie Angier’s Woman: An Intimate Geography.

More recently, in 2005 Chase participated in the Intersex Consensus Conference, which culminated in the 2006 Consensus Statement on Disorders. The statement mainly a change in language within the medical community from terms many within the intersex community considered to be misleading and offensive such as “sex reversal,” “hermaphroditism,” and “pseudo-hermaphroditism.” Chase and allies believed medical professionals needed new, less offensive nomenclature in their work with intersex patients. They also believed the new terminology needed to be palatable to said medical professionals. Eventually the term Disorders of Sex Development (DSD) was agreed upon and is used in virtually all medical settings today and even among many intersex people themselves.

This change in language sparked a major debate over terminology within intersex communities that continues to this day. Some reject DSD terminology in favor of intersex language on the grounds the term “disorder” is unnecessarily pathologizing and reasserts medical authority over intersex bodies. For example, it is much easier for medical professionals to justify treating a “disorder of sex development” with corrective surgery than to perform irreversible surgery on an intersex person whose body is simply different from the average. Others embrace DSD nomenclature as a pragmatic, less confusing, and less politicized alternative to terms like intersex. For instance, many medical professionals find the term intersex to be abrasive with political connotations and it is much easier to persuade them to listen while using DSD nomenclature instead.

Ultimately, this shift in language represented the start of a larger shift within the mainstream intersex rights movement from utilizing methods that collectively confronted the medical establishment to taking collaborative approaches to achieving social change. The mainstream intersex rights movement continued to move in this new direction when Chase left ISNA in 2008 to work on the Advisory Committee of Accord Alliance, an advocacy group that was formed to work in collaboration with medical professionals to promote comprehensive and integrated approaches to intersex care. It is also during this time that Chase changed her legal name, Bonnie Sullivan, and started going by the name Bo Laurent in all aspects of her life.

Today, roughly a decade after the closing of ISNA and the founding of Accord Alliance, there is extensive debate within intersex communities over activist strategies. Some have embraced organization Accord Alliance and their collaborative strategies while others continue to favor more radical approaches in their activism. It is likely both of these methods will be necessary for creating social change into the future. Yet, no matter what the mainstream intersex rights movement will look like in the decades to come, Bo Laurent will always have an indispensable place in intersex history.

Sources and Further Reading

  1. Contesting Intersex: The Dubious Diagnosis by the Georgiann Davis
  2. http://www.isna.org/about/chase
  3. http://bilerico.lgbtqnation.com/2008/03/womens_history_month_cheryl_chase.php
  4. http://www.sfgate.com/living/article/PROFILE-Cheryl-Chase-Medical-Activist-Boy-or-2815701.php

“Is it a Boy or a Girl?”: Birth and Gender in Twenty-First Century America and Beyond

It is the third word said about each of us and the answer to the first question ever asked about all of us: boy or girl. When a baby is born a doctor looks at their genitals. If the doctor sees a penis they declare, “Its a boy!” If the doctor does not see a penis they declare, “Its a girl!” Then a permanent “M” or “F” is inscribed on the infant’s birth certificate that will follow them for the rest of their life. The new arrival’s gender becomes government record before the child even knows what gender is let alone their place in it.

When new parents announce a birth the first question on everyone’s mind is, “Is it a boy or a girl?” Then the parents dress the newborn in either pink or blue to make sure there is no confusion over the appearance of the child’s genitals and, by extension, which gender within the binary they are raising the child to be for the rest of their life. If the parents inquired what their expected child’s reproductive anatomy looked like on a prenatal ultrasound they begin to gender the coming baby before the child even comes out of the womb. This early gendering sets into a motion an array of behaviors from buying certain toys, clothes, and decorations to choosing from only certain names, throwing “gender reveal” parties, and forming strong expectations regarding the infant’s future. These expectations are oftentimes so strong any break with them is met with pain, grief, distress, fear, anger, and violence.

For those of us who are intersex, being assigned a gender can be a source of great pain. When doctors cannot determine a baby’s sex immediately a medical emergency is set in motion. Surgeons are called in, endocrinologists are consulted, whole medical teams are formed, tests are administered, and the offending ambiguous body parts are surgically modified to fit into what the wider society has deemed to be standard for male or female. In most cases parents are not even consulted on these decisions and if they are consulted they are usually pressured into going along with normalizing procedures regardless of medical necessity or the serious life long consequences for the child, which often include sterility and lose of genital feeling. Not to mention all of the ethical issues surrounding the hormonal treatments many intersex people go through in adolescence in an effort to keep shoe horning them into the side of the gender binary to which they were assigned regardless of their actual sense of self.

Then there are those of us who are trans and do not identify with the gender we were assigned at birth. Such an early misidentification often leads to a great deal of distress and struggle in a society built on a strict binary. Trans people are more likely to attempt suicide, face violence, be denied health care, and experience poverty as a result of institutionalized cissexism and transphobia with trans women of color being particularly vulnerable. For many of us in the trans community our birth assigned genders are horrible mistakes we spend a lifetime correcting at great personal risk.

In many ways the different experiences of interphobia and transphobia intersect in how the medical gaze aggressively genders bodies from birth to death with no room for variation even in newborns. The surgeries many trans people elect to undergo in the process of affirming their gender identities had their start being performed on intersex infants and children who could not consent to such procedures. The same hormonal treatments trans people have to go through all kinds of hoops to gain access to are given without any question to intersex children. Both intersex and trans people find themselves having to educate medical professionals about their bodies in ways their non-intersex and cisgender counterparts never do. Those of us who live at the intersections of intersexuality and transness find our experiences are incoherent even within trans and intersex communities. All of this has at least some roots in deeply entrenched cultural beliefs that gender is easily recognizable at birth, binary, natural, biologically determined, and fixed. These are the cultural beliefs that make grown people think they know who a child is based on their genitalia and lead them to be fearful whenever faced with any challenge to those beliefs, even when said challenge comes in the form of a helpless baby.

This is the reality of birth and gender in twenty-first century America, where a simple “M” or “F” plays a role in determining the civil rights and privileges a person is afforded in important areas of life and being intersex or trans is met with oppression. Fortunately there are signs these practices are changing for the better. Transgender adults and children, in particular, are gaining visibility. Nonbinary identities are becoming better known to the general public. Intersex activists have made strides in raising awareness and working toward changing intersex health care. More parents are questioning and even out right resisting societal pressures to impose a particular gender on their children based solely on genitalia, especially when they are only infants.

I dream of a day when we put our babies in rainbow hats and are not so quick to assign gender to infants, or at least learn to take such assignments with a grain of salt. Besides a gender assignment at birth doesn’t yield all the information we are told it does even when it comes to biology. No one is testing the karyotypes of babies or conducting ultrasounds of their internal reproductive systems let alone thinking of the possibility the child may be trans. For all anyone knows in those first moments of life the healthy newborn everyone assumes has ovaries, a uterus, and XX chromosomes because the doctor said its a girl actually has internal testes and  XY chromosomes or the baby the doctor so confidently declared to be a boy due to the presence of a penis may one day disagree with that doctor’s assessment and grow up to be a woman.

So the next time someone you know has a baby maybe just ask if the baby is healthy rather than the classic, “Is it a boy or a girl?” Afterall you’re asking about a baby. No one knows who they are yet.

Introductions to Intersex Traits: What is Klinefelter Syndrome?

This is the third in a series of posts in which I cover the basics of a particular intersex trait. For the purposes of this blog an intersex trait is defined as a bodily characteristic or set of bodily characteristics that have been determined to not be standard for male or female. This determination can be primarily chromosomal, hormonal, gonadal, and/or genital. Some examples include Androgen Insensitivity Syndrome, Congenital Androgen Hyperplasia, and cliormegaly. Here the focus will be on Klinefelter syndrome.

Klinefelter syndrome is a genetic condition in which a person is born with a 47XXY karyotype or a 47XXY/46XY karyotype instead of a typical 46XX karyotype or 46XY karyotype. This particular syndrome occurs in 1 out of 500 to 1 in 1,000 live male assigned births and manifests in a variety of ways that range from the mild to the severe. No two cases are the same and it is likely any one individual will only experience a hand full of symptoms in their lifetime.

At birth Klinefelter syndrome commonly results in genitals that are considered typical for males and most are not diagnosed until later. A diagnosis is usually made when puberty is not be progressing as expected during adolescence or issues of infertility arise in adulthood, although some are diagnosed before birth through prenatal genetic testing. Common physical signs of Klinefelter syndrome include tall stature, long legs, small, firm testes, small penis, enlarged breasts, and little to no body and facial growth.

Beyond the aforementioned physical signs, Klinefelter syndrome is also associated with various learning difficulties including difficulties with memory, attention, verbal communication, and social skills. When present, these difficulties can be overcome with appropriate accommodations in school and support from family and friends as well as others in Klinefelter community.

In adulthood the most common issue associated with Klinefelter syndrome is infertility due to a lack of testiculuar development. In short, the testes do not produce sperm and even in cases when sperm is produce they often die off. Today there are options for those who do wish to have children including adoption and, in some cases, sperm extraction, freezing, and In Vitro Fertilization (IVF) with Intra-clytoplasmic sperm injection (ICSI).

Along with infertility, adults with Klinefelter syndrome also have an increased risk for osteoporosis, breast cancer, varicose veins, and autoimmune disorders than their XY counterparts. These increased risks is often attributed to low testosterone levels or the presence of the second chromosome. There is also an increased risk for diabetes, lung disease, taurodontism, sleep apnoea, essential tremor and unbalanced gait than the general population. While this list of possible health issues may look intimidating, it is important Klinefelter syndrome presents in a wide range of ways and it is highly unlikely any one individual will have experience all of these health issues over their lifetime. Although it is important all of these health risks be taken into account when receiving health care.

Beyond monitoring for potential health and fertility issues associated with Klinefelter syndrome, other conventional medical interventions to a diagnosis of Klinefelter syndrome in adolescence and beyond often include testosterone replacement therapy and surgical removal of breast tissue in the interest of promoting a more conventional adult male appearance. While it is true the majority do grow up to live comfortably as men and benefit from such treatment plans, this is not the case for everyone. It is important to recognize people with Klinfelter syndrome come in all genders, gender expressions, and sexualities and with diversity of identities comes diversity in medical and psychological needs.

In the end informed consent in intersex health care is paramount and everyone has the right to bodily integrity. For more information on Klinfelter syndrome, informed consent, bodily integrity and personal narratives from within the Klinfelter community please visit the resources below.

Sources and Further Reading

  1. http://www.isna.org/faq/conditions/klinefelter
  2. https://www.genome.gov/19519068/
  3. http://www.ksa-uk.net/
  4. http://www.aaksis.org/
  5. http://klinefeltersyndrome.org/Stefan.htm

Book Review–Standing Tall with Turner Syndrome edited by Claudette Aharon

In a highly medicalized world it is important for those of us who are intersex to exchange in personal narratives centered on our experiences living in our particular bodies beyond clinics, charts, test results, treatment plans, procedures, lists of symptoms, diagnostic nomenclature, and normalization. When we share stories and information with one another we can empower each other. Just the act of sharing stories in community allows us to learn from one another away from the constraints of doctors’ offices. It makes us feel less alone and deepens our sense of community. When medical professionals hear our stories it gives them a chance to improve the care they provide and see us more as human beings and not just patients or issues to be managed or fixed. That is why the autobiographical essays like the ones collected in Standing Tall with Turner Syndrome are so important for the Turners community.

The essays cover a wide range topics including sexuality, hormone replacement therapy, interactions with medical professionals, gender expression, relationships, family life, and more. Turners women and girls in particular are given opportunities to see themselves accurately portrayed in the stories the contributors share. The essayists themselves are of ages from older women to young adults and a few are even people of color. This helps to expand representation for the Turners community beyond the usual focus on white girls and hormonal treatments. However diverse representation in terms of gender identity and sexual orientation is limited with only a brief acknowledgement lesbian with Turner syndrome exist. Otherwise the assumption everyone with Turner syndrome is a feminine, heterosexual, female, and cisgender are left unchallenged. Unfortunately such a lack of LGBTQ+ is unfortunately quite common within the wider Turners community. Hopefully this will change as visibility increases for LGBTQ+ and Turners communities including those of us who live at the intersection of these experiences.

Readers who do not have Turner syndrome are given a window into what it is like to live with the condition and what it means on a personal as well as a medical level. The sections on the biology of Turner syndrome are straight forward, easy to understand, and effective for teaching the basics of the condition. It avoids the common pit falls sources on Turner syndrome fall into like just giving a long of symptoms or using confusing medical jargon. All of this makes it an excellent educational resource.

In the end I would recommend this book to anyone who wants to learn more about Turner syndrome, especially to those who are newly diagnosed and their families and friends. It is the kind of book I wish was in existence when I was diagnosed and I think it  also would have been really helpful to my family during that difficult time.

From a Drag Queen Sea Witch to a Misunderstood Ice Queen: The Evolution of Queerness, Femininity, and Villainy in Disney Movies

If you live in the United States odds are you have been exposed to Disney at some point in your life. As for me, my very first memory is watching The Lion King when I was a little over one year old. As a toddler I was obsessed with Mary Poppins and watched it on repeat. Like any true ’90s kid I was raised on Disney animated movies like The Little Mermaid, Aladdin, and Mulan. Even as I grew older I continued to see the latest Disney animated movies in theaters and enjoyed family vacations to Disney World and Disney Land. Now as a young adult I still watch Disney movies and I have just returned from my thirteenth Disney theme parks vacation. Over time the way I consume Disney theme parks and movies has evolved as I begin to notice details I had missed when I was a child. Among these details is the surprising amount of queerness for a film company built on a reputation for being good, wholesome, (straight) family fun.

It can take a few viewings to pick up on the subtle undertones of queerness in the flavor of various Disney animated films, but once noticed it cannot be ignored regardless if the filmmakers intended to code these characters as queer or not. An excellent example of this can be found in Ursula from The Little Mermaid. The powerful sea witch is based on the drag queen Divine (a fact that will come as no surprise to anyone familiar with drag queen performances). Many fans view The Lion King‘s fratricidal villain, Scar, as gay. Some have asserted Aladdin’s Jafar is arguably more interested in Aladdin than he is with Jasmine. Lyricist Howard Ashman saw himself as a gay man with AIDS in the beast. He publicly interpreted the curse in Beauty and the Beast as a metaphor for what its like to live with the AIDs. More recently many in gay and lesbian communities in particular have cited Elsa’s ice powers as a metaphor for queerness and think of the ice queen’s show stopping number “Let It Go” as a coming out anthem. So the next time you hear someone complain about the new Beauty and the Beast‘s “exclusively gay moment” just remind them Disney has been having queer “moments” for quite some time.

Now it must be acknowledged the majority of the characters mentioned are villains and femme or effeminate. In many ways these characters fit into a long tradition of vilifying queerness and femininity that is far larger and older than Disney. For this reason these films must be consumed with caution and a healthy amount of suspicion lest they contribute to the internalization of the idea queerness and femininity are evil. Yet in a world where queer representations are few and far between some queer viewers find mirrors in the drag-esque stylings of Ursula and the flamboyance of Scar and Jafar. Oftentimes the villains are more compelling than the oftentimes bland hero and heroines that populate Disney films. They drive the major external conflicts their respective hero(ines) must face and in doing so give the stories they inhabit life. After all, what would Ariel, Aladdin, and Simba have to do without Ursula, Jafar, and Scar plotting and scheming in their way? However, as fun as these characters may be, a list filled with villains who are not even explicitly queer and play into a long tradition of heterosexism and misogyny isn’t very satisfying media representation.

Fortunately, over the past few decades queer representations in Disney movies have evolved from the subtly coded queerness of the villainous sea witch Ursula. Now queer viewers can find a mirror for themselves in Elsa the misunderstood ice queen who lets her freak flag fly and whose primary relationship in life is with another woman, albeit her sister. Many fans are hoping for more explicit and intentional queer representation in Frozen 2 with Elsa at the heart of a lesbian love story.

Only time will tell if same gender love stories from Disney will ever brace the world’s multitude of screens. In the meantime we can be mindful of what we consume, take whatever pleasure we can in the media representation available, and encourage better representations with our views and our wallets.

Sources and Further Reading 

  1. https://mic.com/articles/170056/the-original-beauty-and-the-beast-cartoon-was-a-metaphor-for-aids#.fXEYfa0qO
  2. https://tjwest3.com/2013/11/13/the-queer-pleasures-of-disney-villains/

 

The “I” Does Not Stand for Invisible: Intersex Pride and Remembering Queer History in the Trump Era

It’s that time of year again. It’s Pride Month, a time when the LGBTQIA+ community gathers to celebrate our history and the many ways there are to be queer with parades, festivals, music, and, of course, lots of rainbows. What a better time to spread some love and intersex pride?

For those who may not know intersex refers to those who were born to bodies considered non-standard for male or female in terms of chromosomes, hormones, gonads, and/or genitals and is the “I” in LGBTQIA+. Since intersexuality comes in a variety of manifestations we be can found in every gender, sexuality, class, race, ethnicity, religion, culture, region, and time period. Some of us are straight. Some of us are queer. Yet all of us have a stake in LGBTQIA+ liberation in a world where interphobia, transphobia, femmephobia, homophobia, biphobia, and acephobia form interlocking systems of subjugation in which any deviation from the gender binary in body, sexuality, expression, or identity is met with cruelty, abuse, violence, and erasure. There can be no intersex liberation without trans, gay, lesbian, bisexual, queer, and asexual liberation and vise versa. That is why intersex presence at Pride is critical. It is high time people learned the “I” does not stand for “Invisible.” We exist. We are not impossible. We are not disordered. We are not aberrations. We are here. We are everywhere.

So many of us have experienced shame, stigma, secrecy, and erasure living in a binary gender caste system that deems us to be impossible. Still we survive and even thrive. Yes, many of us have stories of pain, trauma, and shame that need to be shared, but we also have stories of joy, hope, and pride. Those are the stories we need to tell: stories of love and acceptance; stories of courage and hope; stories of wellbeing and vitality; stories of healing and perseverance; stories of pride. Let’s tell more of those stories for Pride month and all year round. The world definitely needs such stories, especially in the current political climate.

In the United States we are now living under an administration with a dangerous anti-LGBTQIA+, anti-woman, anti-immigrant, basically anti-every-minority-group, “America first” agenda. Every day brings new shockwaves. Federal bathroom protections for trans schoolchildren have been rolled back. Multiple attempts at a Muslim travel ban have happened. Deportations have increased. Threats to women’s healthcare and reproductive rights have multiplied. Environmental protections are coming under attack. The list goes on and on. At the same time many Pride events and the larger LGBT+ movement are being coopted by dominant capitalist, colonial, white supremacist, heteronormative, and patriarchal traditions in the form corporate, military, and police sponsorships. A good example of this form of cooption is Well Fargo’s sponsoring of Capital Pride while continuing  to invest in the private prison industry that harms so many queer and trans lives. Not to mention the respectability politics, biphobia, and transphobia that infects much of the mainstream gay (and sometimes lesbian) movement, which tends to focus only on privileged, cis, white, gay men and leave out women, trans people, gender nonconforming people, multisexual people, and people of color.

In the midst of the current administration’s dangerous agenda and the trends of cooption at many Pride events we must come together across our differences and remember the radical roots of Pride. The reason why we have Pride in June is to commemorate the Stone Wall riots. The first Pride was literally a riot. And it wasn’t just any riot. It was a riot with trans women of color at the forefront who sparked revolutions. We must remember this history and own it. After all, this is protest; not a parade. In our activism we must remember there can be no sexual or gender justice without ability, racial, economic, and environmental justice and recognize the necessity of intersectional praxis that centers the most vulnerable in our society.

That is why this Pride month I am recommitting myself to love and social justice work that is truly intersectional within my communities. I will tell share my story as an intersex person openly and honestly. I will enjoy the celebrations and wave my rainbow, nonbinary, bisexual, and intersex flags proudly. I will remember those have gone before me and resist injustice like they did at Stone Wall and beyond.

Introductions to Intersex Traits: What is Androgen Insensitivity Syndrome?

This is the second in a series of posts in which I cover the basics of a particular intersex trait. For the purposes of this blog an intersex trait is defined as a bodily characteristic or set of bodily characteristic that have been determined to not be standard for male or female. This determination can be primarily chromosomal, hormonal, gonadal, and/or genital. Some examples include Turner syndrome, Congenital Androgen Hyperplasia, and cliormegaly. In this post I will focus on Androgen Insensitivity Syndrome (AIS).

AIS is an inherited intersex condition (expect for the occasional spontaneous mutation) that occurs in approximately 1 in 20,000 live births and results in partial to complete inability of the body’s cells to respond to androgens, which are the hormones commonly associated with male physiological development. Depending on the extent of the insensitivity, AIS can present in a variety of ways. Complete Androgen Insensitivity Syndrome (CAIS) in most cases results in a 46XY karyotype, undescended or partially descended testes, a short vagina without a cervix and no uterus or fallopian tubes. In some cases infants born with CAIS do not show obvious signs of the condition until puberty and are assigned female at birth without any question. In other cases the signs of the condition are obvious from birth. During puberty those with complete CAIS develop breasts as the body converts some testosterone into estrogen. However, they do not start a menstrual cycle without a uterus. Also, due to their insensitivity to testosterone, they grow little to no armpit and pubic and do not have any acne. Partial Androgen Insensitivity (PAIS) often results in an individual with a 46XY karyotype and ambiguous genitalia that can either be described as a large clitoris or a small penis. Here it is also important to note PAIS may actually be quite common and has been suggested to be the cause of infertility in many men whose genitals are typical in appearance.

Some of the most common medical responses to AIS involve medically unnecessary surgical interventions. These procedures involve removing internal testes and/or modifying genitals to appear more male or female. Along with these surgical interventions, there is also a history of parents and medical professionals refusing to disclose an AIS diagnosis to affected individuals. As well-intentioned as these responses may be they are actually problematic for many reasons, the most obvious being the fact these surgical interventions are mostly performed on infants and children who cannot consent. While it is true removal of internal testes is advisable in some instances due to cancer risks, cases of testicular cancer before puberty are extremely rare and there is no reason why such surgeries cannot be delayed until the individual is an adult with the ability to make an informed decision. As for genital surgeries, being born with genitals deemed to be ambiguous does not pose any physical dangers in and of itself. Unless the genitals in question have formed in such a way that bodily functions like urination are disrupted and the child’s life is threatened there is no medical reason to modify an infant’s genitals. Thus the reasons behind the surgeries performed on infants and children with AIS and other intersex conditions are purely cosmetic and often rooted in cisheteropartriarchy. A good example of this is the practice of lengthening the vaginas of infants and children with CAIS. The most commonly cited reason for vaginoplasty in these cases is to enable the female-assigned infant to one day have cis/heteronormative, penetrative sex as an adult. Under this line of reasoning there is absolutely no consideration of the various ways the individual’s gender and sexuality may develop over time let alone any concern for their future sexual pleasure should the procedure fail. After all she’s going to grow up to be a married woman and it’s all about her future husband’s pleasure, right? Once again such surgeries should not be imposed on anyone. Instead they should be offered later when the person is able to make an informed decision.

Beyond the physical and mental repercussions of nonconsensual surgeries there are the psychological consequences of secrecy regarding a diagnosis of AIS. While nondisclosure is done in the interest of sparing the individual unnecessary upset and confusion the actual lived experiences of those in the AIS community indicate such secrecy is actually harmful. Most people diagnosed with AIS who were not told of their condition have reported feelings of shame and confusion upon discovering they have AIS and advise full and complete disclosure from the beginning. A prominent example of this can be found in the narrative of Georgiann Davis, who tells of her experiences with AIS, nonconsensual childhood surgeries, and nondisclosure in Contesting Intersex: The Dubious Diagnosis as part of her investigation into intersexuality, intersex rights movements, and current diagnostic nomenclature. Along with her own story Davis also includes insights from interviews she conducted with intersex people on their experiences with medical terminology and practices.

Rather than approach AIS with secrecy and nonconsensual, medically unnecessary surgeries medical professionals, families, and individuals with AIS should work together for the well-being of those diagnosed with AIS in ways that respect their bodily autonomy and humanity. This means ending the imposition of medically unnecessary surgeries on infants and children and creating supportive environments free of shame, stigma, and secrecy. Above all individuals with AIS should take the lead in these efforts, challenging abuses of medical authority as necessary and supporting one another.

Access to support groups has also proven to be helpful for many individuals with AIS and their families, especially when first adjusting to a new diagnosis. An excellent example of such a group working today is the DSD-AIS Support Group. In this case DSD stands for Differences in Sex Development as opposed to the highly medicalized Disorders of Sex Development terminology that has been highly debated within the intersex community over the past decade. The group started out as a support group for women with AIS, but recent decades has branched out into a larger support group with a mission of, “Promoting support, education, and outreach to foster healthy outcomes for adults, youth, children, and families affected by Intersex/Differences of Sex Development.” This includes not only intersex women with AIS, but also intersex men, transgender, and nonbinary people with AIS and anyone else with an intersex trait and their families. Such support groups help individuals and families realize they are not alone, find resources, and exchange information. They can also be valuable educational spaces for medical professionals and others who wish to be allies to the intersex community.

Sources and Further Reading 

  1. http://www.isna.org/faq/conditions/ais
  2. http://www.isna.org/faq/conditions/pais
  3. https://www.childrens.com/specialties-services/specialty-centers-and-programs/gynecology/what-we-treat/androgen-insensitivity-syndrome
  4. http://aisdsd.org/
  5. Contesting Intersex: The Dubious Diagnosis Georgiann Davis