Thursday, November 20, 2008

Gender Theory - Neither Male Nor Female?

Interesting article on gender theory over at The Smart Set. Jessa Crispin, of Bookslut fame, mentions several interesting books on the topic of intersexuality.

This topic raises many intriguing questions about how we define sexual and gender identity. Very clearly, for some people, even sexual identity is not clear at birth (or later). Without clear biological markers, clear gender identity markers are even harder to take for granted.

We have yet to come to terms with traditional gender identities as a culture, but intersexed people are pushing some of us to think in even less well-defined terms. As much as it sucks for them (sometimes), it is a good thing.
Let's Talk About Sex
For some, neither "male" nor "female" is quite the right fit.

As I was filling out Kate Bornstein’s My Gender Workbook, doodling in the box that says “Draw a perfectly gendered person,” taking the quizzes to find my Gender Aptitude, and learning to adjust my definition of “transgender” to include anyone who breaks with the traditional portrayal of gender, which would include everyone from drag queens to boys in eyeliner, I started wondering how the me of five years ago would answer these questions. Obviously, I would be drawing “my gender” a bit differently. In my present drawing my gender has a cloche and a fur stole. But five years ago I was in the final throes of my Boy Phase (or, giving my current tendency towards glammed-out femininity, what a friend has recently titled my Pre-Op Period), a span of several years of dressing in men’s clothing and cutting my hair short. Even when I was forced to put on a dress for a work function, I was frequently called “sir,” no one noticing the dissonance created by my skirt.

The last century of gender theory has expanded the idea of binary masculine-or-feminine gender: It’s more of a spectrum — not one on which you are assigned a place to occupy for the rest of your life, but one on which you can shift like a be-socked child sliding over a newly waxed floor. From tomboy to cheerleader, from boy drag to girl drag, there are myriad influences on your gender expression, some more socially palatable than others.

But what about the idea of sex itself being a spectrum, rather than the binary of male or female? If you try to write out the criteria for the sexes, it quickly gets complicated. What makes someone male? The first obvious answer is genitalia. But take that away, due to a birth defect or an accident, and is the person still male? Of course, but why? Next answer probably goes to the chromosomes. But there are physical reasons why a child born with XY might have female genitalia and think of herself as female. Is maleness then caused by androgen exposure in the womb? Testosterone production? All fetuses start out as female, and things can happen during the pregnancy that prevent masculinization, or will masculinize a fetus with XX chromosomes. Currently, the word used to describe people born with physical traits both masculine and feminine, or with gender variations like Congenital Adrenal Hyperplasia (CAH) or Partial Androgen Insensitivity Syndrome (PAIS), is “intersex.”

Some, like Thea Hillman, the author of Intersex (For Lack of a Better Word), are not diagnosed until early childhood, some not until puberty. Hillman was four when she began to grow pubic hair. After a battery of tests, she was diagnosed with a mild form of CAH and put on hormonal treatment in an attempt to inhibit the growth of body hair and to allow her to grow to a normal height. The mildness of her CAH means she will not have the infertility, dwarfism, hermaphrodism, or facial hair that can occasionally result. But she is still poked and prodded her entire life, and every doctor’s visit begins with her pulling down her pants. It is a childhood of feeling ashamed of her body, of feeling there is something wrong with her.

In her collection of short autobiographical pieces, Hillman recounts a youth in and out of doctor’s offices, her parents’ acceptance of her coming out as gay, and her later involvement with intersex activism. After a lifetime of regulating her gender with hormones, she begins to wonder, what are the costs, and what are the benefits?

My whole life, my CAH has been discussed as a health problem. But now I realize it’s a sex problem as well. To what degree have I taken medication to maintain girl chemistry, to attain girl attributes and keep boy ones suppressed? To what degree have doctors done this, and in what ways have I become complicit? My medication suppresses the overproduction of 17 hydroxy progesterone, a precursor to testosterone. What else is being suppressed?

For others, these questions are not even possible. Many intersex children are born with ambiguous genitalia, meaning that a doctor cannot visually determine whether a child is a boy or a girl. The labia might be fused, or a baby may be born with a micropenis or an enlarged clitoris. Doctors may do chromosome testing to assign a gender, or they might use the presence or absence of internal sexual organs to make a decision. But the standard for years has been to assign a gender at a very early age with surgical intervention.

It’s a controversial issue. Doctors and parents think they are sparing children embarrassment and pain. But now intersex activists are fighting to create a new protocol, one that waits until the child can participate in “hir” (forgive me — I know the pronoun is a clumsy compromise, but one that comes up a lot when you start reading about gender theory) own treatment.

Katrina A. Karkazis opens her new book Fixing Sex: Intersex, Medical Authority, and Lived Experience at a speech by Intersex Society of North America founder Cheryl Chase. Chase proclaims, “[Early genital surgery] is wrong. It’s torture. These children are subjected to involuntary surgery. Intersex people are not sick, they are not in need of care, but so-called rational medicine is coming after these kids with knives in their hands.” No one is arguing against treating quality-of-life or fertility-affecting maladies like hypospadias, in which the opening of the urethra might be located between the penis and scrotum. But if a child is born with an enlarged clitoris, which might look like a small penis, what exactly is the harm in waiting until puberty to decide whether to operate for cosmetic reasons?

Read the whole article.

No comments: