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=JbTdkWV89AkAlso, I have included a diagram of the device used to restore foreskin in circumcised males.
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