Monday, February 3, 2014

Consent Children VS Adults

In the book Bodies in Doubt by Elizabeth Reis, there is a lot of historical accounts of sexual reconstruction surgery. These accounts depict people who have divergence in sex development (intersex people) undergoing painful, unnecessary procedures that result in sometimes non-functional genitals. On Page 75, Reis discusses the case of one person who was thirty-four years old and was undergoing a surgery for a “curved penis.”  The patient declined the surgery that the doctor had mandated, but the doctor went through with the surgery anyway. In the text it states, “For this particular person, considerations of practicality, convenience, and the possibility of surgical damage merged with the sheer illogic, for her, of switching genders at age thirty-four.” This exemplifies the utter ridiculousness that the surgery would even be deemed necessary let alone done against a patient’s will. Reis states on page 76 that,  “Patients could sometimes defy doctor’s suggestions, but doctors often reassigned them anyway, even if only pronominally. “
This made me think a lot about the nature of consent and how people understand it. Within the medical profession there seems to be some fine print somewhere that says, “Do no harm (unless it is for the ‘greater good’)”. It seems like if a situation were to arise where a person needed a vital surgery and declined it, it would be okay, but if a person declines a surgery with sociocultural implications, then it is really up to the doctors who somehow speak for society about what is best. 
This carries over from the historical context of the book. In the book, many of the sex reassignment surgeries were preformed on people past the age of puberty. This is the age when difference becomes more pronounced. The medical profession and the church’s idea of what was right or just for society to understand or see clouded the ethics of these physicians. The more I consider this in the context of today, the more I wonder if performing elective surgery on a child is just as unethical as performing elective surgery on an adult that doesn’t consent. When intersex babies are born today, I have no doubts that (although the methods are much safer and more advanced) the doctors identify what sex the baby “should” be or would be most “successful” in, and suggest to the parents of that child that the surgery is necessary. If my child’s doctor (assuming that I had a child) had told me that before I read this book, I would have agreed to it.
Doctors obviously can’t perform these surgeries on non-consenting adults anymore, but they wont have to if they catch it before the intersex individual reaches adulthood. When the parents make a decision about their child’s body that will stay with them for the rest of their life, the child loses his/her voice in the matter. When the child reaches an appropriate age, it is too late.
Parents and doctors use the justifications that the child will be better socialized if they stay in one gender category. They believe they are saving their child from a lifetime of bullying and abuse, but they are taking it upon themselves to make a life long decision for their child based on bullying that will only last until they are an adult. Once they hit adulthood, and wish they could have made their own decision, was it really worth it to take a way the choice that lasts a lifetime (80-100 years) in exchange for 18-20 years of not being made to feel different? I don’t mean to trivialize bullying, but it seems that parents think in the short term when it comes to these issues. Doctors and religious leaders on the other hand (more so in the historical context) seemed to look at this from a sociocultural perspective. They knew how intersex people would affect our lives if they were not altered to fit our binaries, so they contained that “problem”.
This struggle of whether it is ethical to perform an elective surgery on a baby made me think of circumcision. This is a much more common and widely accepted form of this struggle, but to most of us, this seems like a no brainer. Our kids will probably be circumcised. It’s just something that we do. The doctors will tell the parents that it is safe and beneficial to the child, and walking out of the hospital with a circumcised baby is not taboo. This all seems pretty normal, but while watching a documentary I found out about a man who runs an organization that pushes for not circumcising children. The reasoning was that foreskin aids sexual pleasure, and that it is disempowering to have our choices taken away from you when you can’t fight for them on your own.  Also an argument that was made, which draws parallels to the subject of intersex, was that if something was naturally occurring, then it couldn’t possibly be bad. There are many benefits to not circumcising a boy, and it is slowly becoming more acceptable in society. The man in the documentary I watched owned a company that sold devices for people to attach to their penis that would stretch the skin, thus “restoring” foreskin.
These comparisons have really made me rethink the way society trusts medicine without question. People usually don’t consider that doctors can be under the same cultural influence as the rest of us. It has also made me rethink my own future life decisions about the consent of children and what that means outside of the legal definition. It may be legal to make permanent choices for people who are only temporarily unable to make them, but is it ethical? I have attached a link of a sex positive Youtube show that discusses the non-consensual nature of circumcision. She doesn’t discuss this in relation to intersex, but the connection is still there.
http://www.youtube.com/watch?v=JbTdkWV89Ak

Also, I have included a diagram of the device used to restore foreskin in circumcised males.


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