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Doctors "should stand in shame" at the lack of follow-up studies on the cosmetic genital surgeries on intersex children they have been performing for decades, proclaimed Dr. Ian Aaronson of the Medical University of South Carolina. The strong words came during a presentation titled "Gender Reassignment: Yea or Nay?" at the American Urological Association conference currently being held in San Francisco. This is an interesting change of heart for a doctor who stated "to advocate nonintervention in intersex infants until they are old enough to make up their own minds about what gender they want to be signifies a return to the 'dark ages' of intersex management, which has given rise to a host of psychological cripples" in 1999. Perhaps the "dark ages" wasn't so bad after all.
However, in the discussion of available follow-up studies, Aaronson seemed to solely focus on defining a "success" as a "correct" gender assignment, in that the person maintained her or his gender identity over the period studied--an incredibly narrow way to measure success, and certainly not the most important factor impacting the person's overall quality of life. This is concerning, considering the fact that Aaronson is in charge of the largest follow-up study currently being conducted on the intersex patients' psychological and sexual well-being after surgery.
From the activist point of view, the title "Gender Reassignment: Yea or Nay?" is a very limited way to frame the question. What is important here is not whether or not surgery should be performed, but what the overall treatment strategy should be in order to allow maximum participation of the patient and to reduce shame, secrecy and isolation. Activists do not argue for simply eradicating surgeries; we want full disclosure, counseling, peer support, true informed consent, and education.
Also of interest to intersex activists and allies: In an earlier presentation at the same panel, Dr. George Kaplan from University of California San Diego gave a lecture titled "Complications of Neonatal Circumcision." In this talk, Kaplan discussed "mistakes" that can occur in routine circumcision and how to resolve them. One of the points he made was that it is now very clear that reassigning boys who are victims of botched circumcision to be raised as girls is a really bad idea. Coming only few days after the death of David Reimer, the subject from John Money's infamous "john/joan" experiment, we can't be more thrilled that they finally got the lesson that had been obvious to many from the beginning.
J Sevelius contributed to this report.
Posted by Emi on May 10, 2004