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May 31, 2005 edition of The New York Times featured an interview with Dr. William Reiner, who is known for the long-term follow-up study of genetic males born with cloacal exstrophy and reassigned to female during infancy. His study debunked John Money's theory that gender identity can be readily manipulated as long as sex reassignment surgery is performed early enough. Reiner's findings were reported in the New England Journal of Medicine last year, sending a wave of caution against surgically reassigning genetically and hormonally "normal" boys with genital anomalies into female simply because feminizing surgeries are easier than masculinizing ones.
However, in reporting of his findings, media often over-simplify the mechanism of gender identity development, focusing too much on the influence of the male gene. For example, Reiner is quoted as saying: "As part of a research study, I've personally seen and assessed 400 children with major anomalies of the genitals. Of those, approximately 100 might be called 'intersex.' Our findings have been many and complex. The most important is that about 60 percent of the genetic male children raised as female have retransitioned into males."
Unfortunately, Dr. Reiner does not seem to make a distinction between genetic males who are hormonally male and those who are genetically male but do not respond to androgen due to complete androgen insensitivity syndrome. To most readers, Reiner's statement seems to say that a large portion of phenotypic females with CAIS (genetic males) grow up to become men, which is absolutely not true (CAIS women are not known to be any more likely to transition to live as men than XX women).
Here, Reiner is only discussing his clinical sample, which happens to involve ten times as many cloacal exstrophy patients than CAIS ones, so when their numbers are combined CAIS women's presence is statistically erased. Unfortunately, stories like this in a major newspaper mislead the readers about the lives of women with AIS.
And it is not just the readers who are confused. The May/June issue of Science & Spirit magazine has a short article about gender, which includes a sentence that goes like this: "Genetic males with Androgen Insensitivity Syndrome, for instance, may fail to develop penises, yet even those who undergo surgical reassignment and are raised as girls tend to identify themselves as male."
Of course it's not true that girls (genetic males) with AIS "tend to identify themselves as male." Yes, a small number of them might, but for the most part girls with AIS tend to grow up to identify themselves as female. It's too bad that writers are misled in such a way, especially when they also quote Eric Vilain as saying "the biology of gender is far more complicated than XX or XY chromosomes."
Posted by Emi on Jun 2, 2005