Pink Blanket, Blue Blanket, Other Blanket? Intersex Infants and Consent for Surgery

While reading “Bodies in Doubt: An American History of Intersex” by Elizabeth Reis (Reis, 2009), I began to realize how gender and sex is politicalized and socialized from the moment an infant is born. Although I knew that this happened by the colors chosen for the infant’s blanket (pink for female, blue for male), I was not familiarized with the statistics of intersex individuals until I began reading “Bodies in Doubt.”  One of 2,000 babies are born with ambiguous genitalia, in which there are 60 conditions that are under the term disorders of sexual development (or DSD for short).  This means that an infant has atypical chromosomes, gonads, or genitalia that does not develop “normally.”

“Bodies in Doubt” explores the history of Intersex in America, specifically, the mindsets from a social and medical perspective by beginning in the mid-eighteenth century and progressing throughout the 19^th and 20^th centuries.  The book provided some answers and brings up a lot of questions, especially when in reference to infants, consent, and what age can a person give consent to surgery that will change their life (140).

I did not know what the age of consent was for children and sex reassignment surgery, so I began looking on the interweb for some sort of standard.  I thought I would find something like the age for consensual sex; complicated and different from state to state.  In fact, I found a court case regarding a child whose parent(s) chose to have an unnecessary surgery done on their child, which sterilized the child. This court case ignited many questions regarding sex reassignment surgery and surgery on intersex children.  What I discovered was that the overall consensus was a person must be 16 years of age to consent without an adult (Parlett, K. & Weston-Scheuber, K.).  The argument was that the person would not have the intelligence level, maturity, or life experience to make such a life changing decision.  Others disagreed and there may be a level of intelligence and rationality to medical treatment, but overall the parents are the “keyholders” and they are able to “unlock the doors” of medical treatment. 

Although I do believe that parents makes decisions in their child’s best interest, this is not a foolproof and clean cut option when it comes to consent for those who are giving an infant a gender.  Parents may be thinking that the choice is what is best because it allows the child to have a “normal” life, but they may not be taking in all the irreversible consequences by making such a large decision for their child. Assignment surgery is not a necessary procedure for the function of a human life – wouldn’t it be easier to allow the intersex individual make that choice later in life?  Socially, there are repercussions and that is what doctors and parents are afraid of. 

There has been much debate lately regarding whether parents should make the decision to put their infant through sex assignment surgery or to wait and possibly watch their children go through social situations that may negatively impact their well being.  According to ABC news, a German Law has been put into action where parents have the choice to pick a third gender, otherwise known as “undetermined” or “unspecified” on birth certificates (S. D. James, 2013).  There has been some discussion on whether this is going to stigmatize the child even more by putting a label on their unknown gender or if it is more empowering so that when the child reaches an age to make a decision about their gender, they may do so without interference from parents or doctors.

I believe this option could become empowering for individuals, yet there will be stigmatization regardless because intersex individuals will still be labeled as “other.”  In Reis’ epilogue, she dives into the notion that by allowing the undetermined gender, it could create more issues socially for the child and can negatively impact the child.  Although this may be the situation, there is a social expectation that there must be a gender, specifically male or female.  The binary system does not work for the 1 in every 2,000 infants who are born with ambiguous genitalia.  The binary system wants females to have certain characteristics, whereas males take on the reversal.  For example, in class we listed what stereotypical characteristics are a representation of women and men.  Women are expected to be passive and men are supposed to have leadership roles and show assertiveness.  When an individual threatens to blend feminine and masculine characteristics, which disrupts the binary system, this causes stigmatization. 

This is what “Bodies in Doubt” provided extensively.  Making a choice of an infant’s identity is unsound since the infant is unable to consent to pick a gender or commit to assignment surgery. 

Activists believe that the wisest choice for parents and medical practitioners is to wait it out.  Give the infant time to grow and have the ability to make informed decisions with intelligence and full understanding of what surgery means.  Keep the options open; some people do not want surgery.

I personally agree that people should be given the rights to consent fully and making decisions with the knowledge given to them. What I am not so sure about is the German Law that I mentioned before. Although this allows parents to become knowledgeable and to give opportunity for the individual to choose to have surgery or to not accept the binary system, but by creating a third gender and calling it “undetermined” or “unspecified,” this just continues the idea of separating individuals with ambiguous genitalia. 

This brings up even more questions, such as: what if people decide not to commit to surgery and are considered “undetermined?”  How is this going to negatively impact individuals? How is this going to change the political arena, such as government documents that ask for gender?  Perhaps this German Law will begin conversation and change the binary system, or at least question the system already in place.

James, S. D. (2013). German Law: Parents of intersex kids can pick 'Gender Undetermined.’ ABC News. (pp. 1-2)

Reis, E. (2009). Hermaphrodites, monstrous births, and same-sex intimacy. In E. Reis (Eds.),  Bodies in doubt: an American history of intersex (pp. 1-21). Baltimore, MD: Johns Hopkins University Press

Parlett, K. and Weston-Scheuber, K. (2004). Consent to treatment for transgender and intersex children (2004).  Deakin Law Review, 9, 2. 376-397.