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January 29, 2004 edition of the science journal Nature has a feature story titled "The most important sexual organ" that explores the implication of the recent findings regarding the brain sex differentiation and other researches. While the article mostly focuses on the science of sex differentiation and the development of gender identity, it also addresses how the new discoveries will impact the controversy over intersex treatment.
Garry Warne from the Royal Children's Hospital of Melbonrne is an expert with the history of involvement with intersex-related support groups (AISSG-Australia, CARES Foundation, etc.) but appear most conservative of the physicians interviewed, insisting that the vast majority of his patients are "satisfied with their assigned gender... in less than 8% of cases is the outcome bad." It is not surprising that most people are content with the gender in which one is raised, but being satisfied with the gender assignment does not necessarily mean that the surgery is warranted if it caused physical, emotional and sexual problems for the patient. He also claims that in his survey of intersex individuals in Vietnam and India who did not receive genital surgeries, "most wished they had been operated on as infants." We are curious about how this survey was conducted and what questions were asked, but Dr. Warne has not published a report on this research anywhere.
On the other hand, Eric Vilain of UCLA calls for a moratorium on the cosmetic genital surgeries on intersex children, but only because it's impossible at this point to accurately predict the child's gender identity, it appears. According to the article, "Vilain suggests that any surgery should be delayed until the child can offer consent and has started displaying gender-specific behaviour. But he hopes that it may one day become possible to use genetic tests to allow decisions about gender assignment to be taken with more confidence at an earlier age."
We believe, as does the intersex activist Tony Briffa of AISSG who is quoted in the news, that being able to better predict the appropriate gender of rearing for a child is a good thing, but whether or not to perform surgery is entirely another question. In our society, gender assignment happens to every child, intersex or not, and there will always be a possibility that the assigned gender turns out to be "wrong"; instead of attempting to eliminate this possibility through genetic testing, we as the society should become more accepting of our children who may be transgender or transsexual. Genital cosmetic surgeries should be stopped because it is harmful to the child's well-being and also because it violates the basic tenets of medical ethics--and not because of the fear that the child might end up with the "wrong sex."
We wish that the article addressed more about the potential risks of surgery beside the "wrong gender" problem, but we applaud writer Carina Dennis for including a patient/activist's point of view in a science magazine.
Source:
Dennis C (2004). "The most important sexual organ." Nature. 427: 390-392.
Posted by Emi on Feb 6, 2004