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Genital Cutting the Intersex Movement Chase

Genital Cutting the Intersex Movement Chase

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Published by: Biz Tutarız Bırak Atsın on Mar 17, 2011
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GenitalCuttingand Sisterhood Transnational



Univcrsityof lllinois Press
IJ III' NA N I) ( ]}I I C AG O


rtrttlI rI Ii II rr|.rt i rr l)rologuc:PositionPaperon Clitoritlcctortry Assttcirttiott t Wonrcn'sCaucusof the African Sttttlics lnlr o( luct ion: Reilnagingliansnr t ionlt lSist cr 'lr r xr r lr St,tttlttM lntnt:s atd CItirc C llob':ttsott Fct , Sc. r lclt ir tlir r "Voices": t t inisntAt r t hropology,, t t r r lt lr t g (; t ilr r b. r l) cb|t c'ovcr F- enr alcenil0l ( ) pclir lior r s t i l t ln istirtL \Mrllty l ( i( l t ir r gl) cyon( l hc Ewl liict or llct hinkir r gL, l. S. /"1 n t ( lcr ,,1 Allit . r r r lr cr r r lr lc lit al( ht t ing 54
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o 2oo2by the BoardofTrustees of thc University oflllinois All rightsreserved Manufactured the United States in ofAmerica c5432t ,rn p.rper. @ Thisbookis prirrted .rrid-lree Libr,rryof Congress CataLoging-in-Publication Data Genrl1rl cutting and transnatioDal sisterbood dlsputingU.S.polemics : / editedby Starlie M. James and ClaireC. Robertson. p, cnl. InchLdes bibliographical rcferences index. and (cloth rsBN 0-252-02741-8 : alk.paper) r. Femxle circu rcision.:. Infibulation. Olitoritlccrorny. r. theory-Africir. I;crrrir)isl ll)cory tJnitr(l Slll(.s 5. 4. Fenrurist I. l. r nlc s , St aDlic( St anlic y r is c ) I{o b c r t s o n , t i l a i r t . {ie , 1 , ; M M ll. r,
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l , r r r ,r l r( i t r r i tr l Str r 'l i ctr cs:r ,r a cl i cu l i o r M e i tstr r cs.tl l l tt' ' l r \'Vr '.l l r r r l o r .r l l .cvcl l \tl \ l h l l t;r r u n tl 2 ''t r r l tr r r ,r l l 'r ,r r l r tt," o r "l ( r 'r o ttsl t ttt l i vc Sttt lilt y ( ;{ n i l ,r l ( l l r l l i r ) l l , l l r ( l r r l cr s( r M r r vcl l tcttl ,.r r r r l J\'l .r l i r .r l I " ' I l r ,,r r l ,l , \t,r r r ,l ,r r r l s t.r r , l
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TheIntersex Moyement and Mediml DoubleStandards

t2 7

or 5. "Cultural Practice" "Reconstructive Surgery"? U.S.GenitalCutting,the Intersex Movement,and MedicalDouble Standards

ONEoF rHE FoRMS powerthatmaintains of gender boundaries inthedited States the surgical"correction" of infantswhosegenitalsaredeemed is by medicalprofessionals be sociallyunacceptable. to Media and scholarly discourses "femalegenitalmutilation," however, on havenot engaged these surgeries, instead servingup only representations ofAfrican women.These discourses continue a long tradition of making Africansinto the "other," suggesting ethnocentrism a key factor in the sometimes that is purposeful maintenance ofignoranceaboutcontemporary U.S.genitalsurgeries. This essay describe will howAmericans participatein the productionof normatively sexed bodiesfrom thoseborn intersexed, consequences such the of genitalsurgeries thosesubjected them,the effortsof intersex for to people to organizeto eliminatepediatric genitalsurgeries and how thoseefforts have beentreated manyfeminists, the doublestandard by and regarding representations genitalcutting, depending of upon who is cutting and where in the world the cutting is done. , "NewLawBansGenitalCuttingin UnitedStates" readthe headline the on front pageof the New YorkTimes.t The law seems clearenough:"Whoever knowingly circumcises, excises, infibulatesthe whole or any part of the or labiamajora or labiaminora or clitoris of anotherpersonwho hasnot attainedthe ageof eighteen years shallbe finedunder this title or imprisoned not more than five years, both."'?Yet law wasnot intendedand has or this not beeninterpreted protectthe approximately childrenper dayin the to five UnitedStates who aresubjected excision part or all oftheir clitorisand to of inner labiasimplybecause doctorsbelieve their clitoris is too big.l Sexual anatomies, genitals particular, in conre manysizes shapes. in and

U.S.doctorsIabelchildrenwhosesexual anatomies differ significantlyliorrr the cultural ideal "intersexuals" "hermaphrodites"(a misleadingtclrrr or because thesechildren are born with intermediategenitals, two scls). not Medicalpracticetoday holds that possession a largeclitoris, or a snrirll of penis,or a penisthat hasthe urethra placedother than at its tip is a "psy. chosocial emergency."a childwouldnot be accepted themother,wortltl The by peers, be teased by and would not be ableto developinto an ernotionally problemis sLrrllcly healthyadult. medical The solutionto thispsychosocial -' beforethe child reaches threemonths of ageor evenbeforethe newburn is discharged from hospital.Although parentalemotionaldistress nd rcjce. tion of the child and peerharassment citedasthe primary justificllions are for cosmetic genitalsurgerytherehasneverbeenan investigation nonof surgical means-suchasprofessional counseling peersupport-kr ttdrlt'ttss or theseissues. girls The federal Lawto BanFemale GenitalMutilation notwithstandinll, are pnrts born with largeclitorises todayroutinely"normalized"by excising ofthe clitorisandburyingtheremainder deep within thegenitalrcgion.IArttl boyswith smallpenises? Current medicalpracticeholds that intclscx children "can be raisedsuccessfully members eithersexif tlre proccss as of bcgins beforezY.years."5 Because surgeons cannot createa largcpcnis frrrr a smallone,the policyis to remove testes raise and these childrcnrs girls, This is accomplished "carvIing] a largephallusdown into rr clilori$, by creatIing] vagina a usinga piece Ithechild's]colon,"nrarvclcd seicrtcc of u writer who spokeonly to physicians parents, to anyol'thc inlu and not sexpeoplesubjected this miracletechnology.T to Effortsto creatc cxlurtl or a penileurethrain boyswhoseurethraexitsother than at thc lip ol lhc penis-a conditioncalledhypospadias-frequently to rrrulliplc lead srrr' geries, each compounding harm.3 the Heart-rending storics physical ol rrnd emotional carnage related are byvictimsofthese surgerics "(irowirtgLrp in in the Surgical Maelstrom"and, with blackhumor, in "'l'akcOhulgcr A Guide to Home Catheterization."n "Reconstructive" for infant genitals clnrc into wirlc. surgeries intersex 6rst practice the195os. was spread in Because intersexuality treated shunrclirl as irrrrl physicians actively discouraged open discussion their paticnts-irrdcctl, by recommended lying to parents to adult intersex and patients-urltil rccrnlly mostvictimsofthese interventions suffered alone shantc silcncc.r" iu ancl By1993 accomplishments progression the ofa ofsocialjusticc rnovcnlcnls civil rights, feminism, andlesbian, gay bisexual transgcncicr-hclpcd ancl rrrukc it possible interscx for people speak I nitially, out. physicia scollirluI llrcir' to ns that was rntl assertior'rs intcrscxuality nol shrnrclirl thatnrcdicirlly rrrrrrcces



TheIntersexMovementand Medical DoubleStandads

weremutilating and shouldbe halted.Onesurgeonfrom sarygenitalsurgeries the for Hopkins,the institutionprimarily responsible developing curJohns patient-adyocates"zealots."tt intersex as Othrent medical model,dismissed "don't reallyhavea choice" imperative. Doctors erscitedthe technological insists George aboutwhetheror not to performsurgery Szasz.r'? gathered enough strength visit Conto By 1992 intersex the movementhad to gress askthat the Law to Ban Female GenitalMutilation be enforced and practices but protectchildrennot only against importedfrom othercultures this uniquelyAmericanmedicalized form of mutilation.Their alsoagainst work won coverage the NewYorkTimesand. Dateline NBC, and by the n on wasreporting a smallbut growing"new tidal following yearthe UrologyTimes and supportingthe actrvwaveof opinion" ftom physicians sexresearchers activists against Arnerican medists.13 to report,the struggle intersex of Sad genitalmutilation hasyet to attractsignificant supportor evennoicalized outrageoverAfrican genital tice ftom feminists and joumaliss who express cutting.

Hermaphrodites:Medical Authority and Cultural Invisibility
not Many peoplefamiliarwith the ideasthat genderis a phenomenon adeof quately dimorphismandthat the interpretation described male/female by physicalsexdifferences culturally constructed remainsurprisedto learnhow is Althoughthe male/female binary is constructvariablesexual anatomyis.ra presumably the of ed asnaturaland therefore immutable, phenomenon inoffers clearevidencethat physicalsexis not binary. Intersexualitersexuality as furnishes opportunityto deploy"the natural"strategically an ty therefore The systems ofp€x/gender/sexuality. a means disruptingheteronormative for inrefers rriultiplecharacteristics, to concept ofbodilysex,in popularusage, gonadal differentiaof cludingkaryotype(organization sexchromosomes); genitalmorphology; configuration ofintertion (e.g., ovarianor testicular); such and nal reproductive organs; pubertalsexcharacteristics asbreasts and are and to facialhair.These characteristics assumed expected be concordant in eachindividual-either all-maleor all-female. quickly in intersex births to change inthe Because medicineintervenes largely fant's body,the phenomenonof intersexualityhasbeen,until recently, practices. publicawareness of medical General unknownoutsidespecialized as intersexbodiesslowlyvanishedin modern WesternEuropeansociettes gradually to medicine appropriated itselfthe authorityto interpret-and of Viceventually manage-themucholdercategory "lrcrnraphroditism."

torian medicaltaxonomybeganto efface hermaphroditism a lcgilirrlrt as 'l'hc V status settlingon gonadal by histologyasthe arbiterof "true sex."r, torian taxonomy(still in useby medicalspecialists) requiredboth ovrlri andtesticular tissue types, microscopically confirmed, bepreseDt rl "tr to in hermaphrodite-" giventhe limitationsofVictoriansur6cry Conveniendy, u anesthesia, suchconfirmationwasimpossible a living patient,All otl, in anomalies werereclassified "pseudo-hermaphroditisms" as rrrasking "lr. rr sex"determined the gonads.16 by With advances anesthesia, in surgery,embryology, and cndocrirrolo however, twentieth-century medicine movedfiom merelylabclingirrtcrsc bodiesto the far more invasivepracticeof "fixing" them-altcring thr physicalappearance conform with a diagnosed to true sex.'l'hctcchniqr andprotocols physically for transformingintersexed bodieswcrcrlcvclop primarily at fohns Hopkins Universityin Baltimoreduring thc rgronlr r93os "Only drrri underthe guidance urologistHugh HamptonYoung. of the lastfewyears," Youngenthused the preface his pionccringtcxtb(x in to GenitalAbnormalifles, havewe begun"to get somewhcre ncilr lltc cxpLln tion ofthe rnarvels anatomicabnormalitythat maybc portraycdby tlrc of amazingindividuals.But the surgeryof the hermaphroditchasrcrnliltcd terra incognito."The "sadstateofthese unfortunates"prontptcdYrrrrrr devise"a greatvariety of surgicalprocedures"by which hc rltcnrptctl normalizethe their bodily appearances the greatest to extcnl possiblc.r/ 'l'., a few ofYoung'spatientsresisted efforts.Enrr:ra l "'snrrpp his Quite young negrowomanwith a good figure" and a largeclitoris,hatl nrrrrric man but found her passion only with women.Emmarefuscd strrgcry "l lo madeinto a man" because removalofher vagina would nrcanthc lossol lt "mealticket"(i.e., husband).'3 the 195os, principlc lrrpidpos her By the ol nataldetectionand interventionfor intersex infantslradbcclrrlcvckrncd cirrlycnorrghr JohnsHopkins,with the statedgoalof completingsr.rrgcry the child would haveno memoryof it.reOnewonders whelhcr(ltc insistcl on earlyinterventionwasnot at leastpartly motivatedlty tlrc rcsislirnce o feredby adultintersex people "normalization" to throughsrrrgcry. |rightclrt parents ambiguously of sexed infantsweremuch more opcn k) sugllcstir of normalizingsurgery than wereintersex adults, and thc irrfarrlstlrclrsclv could,of course, offer no resistance whatsoever. justifringthese Mostofthe theoretical foundations intcrvcnlions rc ltlil il utableto psychologist a invitccito lohnsI lopkir )ohn Money, sexresearcher by Lawson Wilkins, founder pediatric ndocrinology.r" of e Wilkils's nrlrrt ousstudents subseqr.rcnlly protocols carricd thcsc [r<lrn lopkins lrospit I to throughout Unitccl lcsi rd irllftrd,rrIrrr99ll thc Sl Srrzarrnc Kcsslcr lrotcrl tlr



TheIntersex Movement MedicalDoubleStqndards and


Money'sideasenjoyed "consensus approvalrarelyencountered scia of in ence.""But therevelation zooothatMoneyhadgrossly in misrepresented and mishandled famous"John/Joan" the (in case which an infant wascastrated and raisedasa girl after his peniswasdestroyedin a circumcision accident) sentMoney'sstockinto a steep decline.2r In keepingwith the Hopkinsmodel,the birth of an intersex infant rs today deemeda "psychosocial emergency" that prope.ls multi-disciplinary a teamofintersexspecialists action.Significantly, into they aresurgeons and endocrinologists rather than psychologists, bioethicists, intersex peer sup_ port organizations, parents intersexchildren.The teamexamines or of the infant and chooses eithermaleor femaleasa "sexof assignment,', then in_ formstheparents that this is the child'struesex. Medicaltechnology, including surgeryand hormones,is then usedto makethe child'sbody conform asclosely possible the assigned as to sex.

atic_the question,Is it a boy or a girl?,7 Sincethe earlyt96os,nearly cvery medium-sized largercity in the UnitedStates had at leastonc hosr)i_ or has tal with a standingteamof medicalexperts who intervenein thesecuscs ro 'assign"-through drasticsurgical means-a maleor female statuslo intcrsexinfants.The factthat this system enforcing boundaries thc cut_ for the of "male" and "female"existed so long without drawingcriticisll egories for or scrutinyfrorn anyquarteris an indicationof tle extreme disconrforrtnirl

sexpeoplehavebegunto politicizeintersexsubiectivity, s tr.lnsli)nnilll{ th intensely personal experiences ofviolationinto collective opposilion lhc to medical regulation ofbodiesthat queers foundation, the ,rf'h.1"r,,,,.,r,,,u, tive genderidentifications and sexual orientations.

the phallustrimmed to an acceptable The only exception this sort_ size. to ing rule is thatevena hypothetical possibility female of feriiliry mustbepreserved assigning infant asfemale, by the disregarding masculine genitals and a phalluslongerthan one inch.ra The sort of deviationfrom sexnorms exhibitedby intersexpeopiers so higl y stigmatized that emotionalharm dueto likelyparentalrejectionand community stigmatizationofthe intersexchild providesphysicians with their most compellingargurnent justify medicallyunnecessary to surgical interventions. Intersex status considered be soincompatible is to with emotional healththat misrepresentation, concealment fac\and outrightlying (both of to parentsand later to the inters€xperson)are unabashedly advocated in professional medicalliterature.rs

ment ripple out everafterward. The emotionalimpact of this trc tlrcnt ls sodevastating until the middleofthe r99os that peoile whosclivcshavcbccn

The Impact of "Reconstructive"Surgeries
The insistence two clearlydistinguished on sexes calamitous has personal consequences the manyindividualswho arrivein the world with sexual for anatomythat failsto be easily distinguished maleor female, as who are labeled'intersexuals"or "hermaphrodites" modern medicaldiscourse.16 by About one in onehundredbirths exhibitssomeanomalyin sexdifferentia_ tion, and aboutonein two thousand differentenoughto renderprooremis

original).'z8 The tragic irony in all this is that while intersexual anakrnry occnsiorrirlly indicates underlying an medical problem suchasadrenal disordcr, ultrbigrrousgenitals in andofthemselves, are, neither painfulnor harnrfirl hclltlt. to Theoftendebilitating pediatric genital surgeries entirclycosnrctic lurrc. are in tion.Surgery essentially is a destructive process. crDrentovc It tissUC lo il itrr(t limitedextent relocate but it cannot it, create newstructtrrcs.,l.lris tcchrrieal limitation,takentogether with theframingof the feminincasa corrdit ol. iorr lack,leads physicians assign percent irnatomically to of anrbiguous 9o irrtitrrts asfemale excising by genital justi$,fenralc tissue. Surgeons assigrrrrrcrrt he "you canmakea hole,but you can'tlruild a pole."]., cause Hcroiccllirts slrolc up a tenuous masculine status theone-tcnth for assigncd trlillc, wllo ilt.c sut,. jectedto multipleoperatiolls-twenty-lwo onc clsc-with thc ir.t *oll ol straighterring tht'pcrris const irrrd r.r.rclir rtrclhra ct)itblc tg l() stlrrrlin6 rrlilral,y



TheIntersex Moyement MedicalDoubleStandqrds and

I l.i

posture.ro some, surgeries onlywhenthe child growsold enough For the end to resist.rr the femalearesubjected surgery to that removes trouChildrenassigned (i.e.,large) ditoris.Thisis thesame tissue that wouldhave hypertrophic bling beena troubling micropenis(i.e.,smallpenis)had the child beenassigned male.Through the r96os,feminizingpediatricgenitalsurgerywasopenly favorablyto the Afiican praclabeled"clitoridectomy"and wascompared ticesthat havenow becometJrefocusof such intensescrutiny.As three Harfor noted,"Evidence that the clitoris is not essential normal vard surgeons it data.For instance, is the coitusmay be gainedfrom certainsociological the customofa numberofAfrican tribesto excise clitorisandotherpartsof Yet the externalgenitals. normal sexualfunction is observedin thesefemales."r': Authors Robert E. Gross,JudsonRandolph,and John F. Crigler penenormal femalesexual function only aspassive apparently understand most ofthe clitoris tration and fertiiity.A modifiedoperationthat removes calledclitoroandrelocates bit ofits tip is variously(andeuphemistically) a plasty, and as clitoralreduction, clitoralrecession described a simplecosor it clitorimeticprocedure order to differentiate from the now-infamous in dectomy. The operation,however, far from benign. is E. )ohnsHopkins surgeons Joseph Oesterling,IohnP.Gearhart,and Robert They makean incisionaroundthe their technique.r3 D. )effshavedescribed Next they the clitoris, at the corona,then dissect skin awayfiom its underside. dissect skin awayfrom the upper sideand removeasmuch of the clitothe an size ral shaftasnecessaryto create "appropriate clitoris."Thentheyplace from the pubic areaalongboth sidesof the entire length of what stitches the folds,like stitches, tissue remahs ofthe clitoriq whentheytightenthese into position behind the pubic pleatsin a skirt, and recesses a concealed the mound. If they think the resultstill "too large,''tlreyfurther reduce tip wedge. of the clitoris by cutting awaya pie-shaped For manyintersexpeople, sort ofarcane, this dehi:manized medicalliterof ature,illustratedwith close-ups genitalsurgeryabd nakedchildrenwith Thts, is versionof Our Bodies, Ourselves. blacked-outeyes, the only available genderrole development,and evenasfierceargumentsover genderidentity, feminism,and queerthesocialconstructionof genderragein psychology, to ory we haveliterally delegated medicinethe authority to police the boundintersex peopleto recover besttheycan, as ariesof maleand female,leaving aloneand silent,from violent normalization. as My own case, it turns out, wasnot unusual.I wasborn with ambiguin ous genitals. doctor specializing intersexualitydeliberatedfor three A whatwaswrongwith her mv davs-and sedated mothereachtime sheasked

baby-before concludingthat I wasmale,with micropenis,complclc hypospadias, undescended testes, a strange and extraopeningbehind thc urcthra.A malebirth certificate wascompleted me, and my parentslrcgarr for raisingme asa boy.When I wasa yearand a half old, my parents consullc(l a differentset of intersexexperts, who admittedme to a hospital for "scx determination." "Determine"is a remarkably word in thiscontext, apt nrcrningbothto ascertain investigation to c44se cometo a resolution, by and to lt perfectlydescribes two-levelprocess whereby the science produces througlr a series masked of operations what it claimsmerelyto observe. I)ockrrstokl my parentsthat a thorough medicalinvestigation, including cxplolrtlrtry surgery, would be necessary determine(that is, ascertain) to what nty "l tuc judgedmy genitalappendage be inadequate a pcrri$: sex"was.They to as too short to effectively mark masculine statusor to penetrate femalcs. n lcAs male,howevel I would be penetrable and potentiallyfertile. My anulonty havingnow beenre-labeled vagina,urethra,labia,and outsizcdclitoris, as my sexwasnext determined(in the second sense) amputatingIny gcniby Followingdoctors'orders,my prrcnls lhcn tal appendage-clitoridectomy. my changed name;cornbed their house eliminate traces my cxislcncc to all of asa boy (photographs, birthday cards, etc.);engaged lawyerto changcrny a birth certificate; movedto a differenttown; instructed extended fanrilynrcnr. bersto no longerreferto me asa boy; and nevertold anyone elsc-includ. ing me-just what hadhappened. intersexuality changc' scxwcrc My and ol the family'sdirty little secrets. At ageeight, I wasreturned to the hospitalfor abdominalsurgcrythirl portion of my gonads, trimmed awayth€ testicular eachof which wrrsprrrt Iy ovarianand partly testicular character. explanation givcnlo ntc in No was then for the long hospitalstayor the abdominalsurgery, f<rrthc rcguku nor which doctorsphotographed gcnitals hospital visitsafterward in rny arrd inserted fingers andinstruments into my vagina andanus. Thesc visi(sccitsctl assoonasI began menstruate. thetime ofthe sexchange, At to tloctors hatl assured parentsthat their once-son/now-daughter my would grow into ir womanwho couldhave normalsexlifeandbabies. a With theconlirrrrirt iorr ofmenstruation, myparents apparently concluded thatprctlictiorr rl that h borne out and their ordealwasbehind them.For me, the wor$t p rt ol tllc nightmarewasjust beginning. As an adolescent, I became aware that I hadno clitoris inncrllbia arrtl or wasunableto experience orgasm. the endof my tcens, beganto rcsclrclt By I in medical libraries, trying to discover what might havehappcncd nrc. to When I finallydeternrined obtainmy personal to rrcclical rccorrls, took il thr€e years overcomc obst ruction thccloctors to thc ol whonrI askc<l hclp. lirr


TheIntersex Moyement MedicalDoubleStandards and


When I did obtain a scantthreepages fiorn my medicalfiles,I learnedfor the first time that I wasa "true hermaphrodite" who had beenmy parents' sonfor a yearanda half,with a namethat wasunfamiliarto me.The records my This wasthe middle r97os, whenI was alsodocumented clitoridectomy. I in my earlytwenties. had cometo identifr myselfaslesbian a time when at lesbianismand a biologically basedgenderessentialismwerevirtually synwar and environmentaldestruction; on1'rnous. Men wererapistswho caused werea supewomenwereloving beingswho would healthe earth;lesbians rior form ofbeing uncontaminated "men'senergy." sucha world, how by In possessed dreaded "phallus"? was couldI tell anyone that I hadactually the I an impostor,not reallya womanbut rathera monstrousandmythicalcreamy and ture.And because hermaphroditism long-buriedboyhoodwerethe history that underlay the clitoridectomy, I could never speakopenly about that either,or about my consequent inability to orgasm.I wassotraumatized my thatI could by discovering circumstances produced embodiment the that not speak ofthese matterswith anyone. Nearlyfifteenyearslater,in my middle thirties,I sufferedan emotional meltdown.In the eyes the world I wasa highly successful of businesswoman,a principal in an international high-techcornpany. mysel( I wasa fteak, To incapable loving or being loved,filled witi shameabout my statusasa of hermaphrodite, about the imaginedappearance my genitals of beforesurgery (I thought "true hermaphrodite"meantthat I had beenborn with a penis),and about my sexualdysfunction. Unableto makepeace with these only factsaboutmyself,I finally soughthelp from a professional therapist, to find my experience denied.Shereacted eachrevelation to aboul my history and predicament with someversionof "no it's not" or "so what?"I'd "I'm not reallya woman." Shewould say, "Of courseyou are.Youlook say, "My completewithdrawal fiom sexuality hasdestroyedevfemale." I'd say, "E.er-itody hastheir ups I've ery relationship everentered." would say, She and downs."I tried anothertherapistand met with a similarresponse. Infriendswho shrankaway creasingly desperate,I confidedmy storyto several in embarrassed I silence. wasin emotionalagonyand found myselfutterly alone,with no possibleway out. I decidedto kili myself. Confronting suicide asa real possibility proved to be my personalepiphany.In contemplating my own death,I fantasized killing myself quite messily anddramatically the officeofthe surgeon in who had sliced my clitoout ris,forciblyconfrontinghim with the horror he hadimposedon mylife. But that to in acknowledging desire put my pain to someuse,not to wastemy finding a wayto directmy rage prolife completely,turned a crucialcorner, I at ductivelyout into the world rather than aim it destructively myselflMy

breakdown became breakthough, my and I vowedthat, whateverit ttxrk, I would healmyself.Still, I had no conceptualframework for developinga ntor.c positiveself-consciousness. I klew only that I felt mutilated,not fully wonran,Iess than fully human even, I wasdetermined heal.I struggledlirr but to weeks emotionalchaos, in unableto eator sleep work. I could not acccpl or my imageofa hermaphroditic bodyanyrnorethan I couldaccept [.rutchthe eredoneleft me by the surgeons. Thoughts myselfasa Frankenstein of prtchwork alternated with longings escape death, for by only to be followcdby outrage,anger, and determination survive.I couldnot accept to that it w s iust or right or goodto treatanypersonasI had beentreated-my sexchlngcrl, my genitals up, my experience cut silenced and rendered invisible.I borc u privatehell within me,wretchedly alonein my condition without cvcn rrry tormentorsfor company. Finally,I beganto envisionmyselfstandingin rl driving rain storm but with clearskies and a rainbowvisiblein thc'distrrncc, I wasstill in agony, alone,but I wasbeginningto see painful proccss still the in which I wascaughtup in termsof revitalization and rebirth,a nrcirns ol' investing life with a new sense authenticitypossessing potcntiuls rny of vast for further transformation. then I haveseen Since this experiencc dcscribcrl by other intersex and transsexual activists.ra I slowlydeveloped newly politicizedand critically awarefornr ol sclla understanding. had beenthe kind oflesbian who at timeshad a girlfricntl I but who had neverreallyparticipated the life of a lesbianconrntLrnity. in I felt almostcompletely isolatedfrom gaypolitics,feminism,and quco. rltl(l gender theory. did possess rudimentary I the knowledge thc grry that civil rights movementhad gathered momentum only when it could cffcctivcly denythat homosexuality sickor inferior and assert thc contritry lllill was to "gayis good."As impossible it then seemed, pledged as I similarlyto aflirrtr that'intersexis good"and that the body I wasborn with wasnol sickor shameful, only different.I vowedto embrace sense being" rrota worrrthe of an" that I had initially beenso terrified to discover. I began search communitythatbroughtnreto SanFrancisco thc a for irr fall of rygzon the theorythat peopleliving in the "queerMccca"worrkl havethemostconceptually sophisticated, lly rolera t, al d politicl lly socia n astuteanalysis sexed of and gendered embodiment. fourrcl I whirt I was lookingfor, in part because arrivalin the BayAreacorrespondccl my witlr the rathersudden emergence ofan energetic trat)sgcnder polilicitlnrovc. ment.At the sametime,a vigorous new waveof gcudcrscholarship hrttl emerged theacadenty. thiscontext, in ln Morgiur Holrlescouldanalyzc hcr own clitoridectonty hcr master's for thcsis antl hlvc hcr sttr<ly llkcrr scliouslyasacadc'nric work.'"()pcnlytrarrsscxrral scholrrs, irrclu<lirrg Srrsurr



Movement MedicalDoubleStandarcls and TheIntersex


Strykerand SandyStone, werevisiblein responsible academic positionsat major universities.36 Into this headyatmosphere, brought my own experience. startedtellI I ing my story to everyone met. Beforelong I learnedof six other intersex I people-including two who had beenfortunateenoughto escape medical attention.Realizingthat intersexuality, rather than beingextremelyrare,must be relatively common,I decided create supportnetlvork.SoonI wasreto a ceiving severalletters per weekftom intersexpeoplethroughout the United States and Canadaand a few ftom further afield.Although detailsvaried,the letters gave remarkably pictureof the emotionalconsequences a coherent of medicalintervention: All thethingsmy bodymighthave growato do,allthepossibilities, down went thehallwith my amputated clitods thepathology to department. restof The mewentto therecovery room-I'm stillrecoverhg. -Morgan Holmes I amhorrified whathas by be€n done meandby theconspiracy silence to of andlies.I am filledwith griefandrage, alsorelieffinallyto believe but that maybe amnot theonlyone. I
-Angela Moreno As soon asI sawthe tiie Hermaphroditeswith Attitude 1 Clied aloud for sheer joy. . , . Iinally I cansay,'I'm hermaphrodite,I'm intersex,I'm transgender, I'm queerand damn proud,' astearsof joy and belongingstreamdown my face. _Lee Doctorsneverconsulted me. . . . [T]he idea of askingfor my opinion about having my penis surgically alteredapparendynever occurred to them. . . . Far too many peopleallow socialstigmato cloud thet judgment.It's OK to be different,

The peersupport network that I formed grewinto the IntersexSociety of North America(ISNA).ISNA'slong-termandfundamental goalis to change the way intersexinfants are treated. advocate We that surgerynot be performed on childrenborn with ambiguous genitals unless thereis a medical

be reason(to preventphysicalpain or illness)and that Parents given the their children'sphysical conceptual tools and emotionalsupport to accept that childrenbe raisedeitherasboysor girls, We differences. alsoadvocate seems lilely to offer the child the greatest to according which designation without resorting to of future sense comfort. Advocatinggenderassignment normalizing surgeryis a radicalposition giventhat it requiresthe willful concordance betweenbody shapeand gender disruption of the assumed category.However,this is the only position that Preventsirreversiblephysiperson's the person's body,that preserves intersex caldamage the intersex to and genitalsensation their own flesh,and that recognizes agency regarding erotic functioning to be at leastasimportant asreproductive capacity.If an genderor to underSosurgicalor to intersexchild or adult decides change hormonal alterationof his/herbody,that decisionshould alsobe fully reshouldnot be subjects The keypoint is that intersex spected facilitated. and of violatedfor the comfort and convenience others. One part of reachingISNA'slong-terrngoal hasbeento docurnentthe As resultingftom medicalinterventions. a emotionaland physicalcarnage <http:// rapidly growingliterature (seethe bibliographyon our Web-site, www.isna.org>) makesabundantly clear,the rnedicalmanagementof intersexualityhaschangedshockinglylittle in the more than forty yearssincemy fust surgery-doctors still cut up children's genitalsand still perpetuateinsurprisethat "in expresses visibility and silencearound intersexlives.Kessler thereare performedeveryyear, of of the thousands genitaloperations spite success."37 ftom within the medicalcommunity on levelsof no meta-analyses admit to not knowing whether their former patientsare "silent and Surgeons eroteffort to improYe Thereis no research happyor silentandunhappy."38 for adult intersexpeoplewhosegenitalshavebeencut, nor are ic functioning in who specialize working with adult intersexclients there psychotherapists trying to heal frorn the trauma of medical intervention. To provide a couninmedicalliteraturethat neglect terpoint to the mountainsofprofessional accountof that and tersexexperience to begin cornpilingan ethnographic experience, ISNA hasworked to rnakepublic the livesof intersexpeople Speak!) through our own publications (includ tng our ideo, Hermaphrodites and and by working with scholars the popular media.3'g It has ISNAs presence begunto be effective. hashelpedpoliticize the growing number of intersexorganizationsaswell asintersexidentities themselves. ofthe Turner'sS1'ndrome ISNA,I met leaders When I firstbeganorganizing differthe Society, oldestknown supportgroup focusingon atypicalsexual (Turner'sSyndrome definedby an XO genetic is entiationfoundedin 1987. karyot)?e that resultsin a femalebody morphologywith nonfunctioning



( ;tl ll.l tYt. (i ^stl

TheIntersex and Movement MedicalDoubleStandards


ovarics, cxtrcrrely shortstaturc,nd,variably, valicty r ofothervisible physical differences described the ureclical still in literaturcwith suchstigmatizing labels "web-necked" "fish-mouthed.")Eachof these as and womentold me what a profound,life-changing experience had beensimply to meet it (theyare anotherperson herself.I inspired their accomplishments like was by a nationalorganization serving thousands members) wantedISNA to of but havea different focus-less willing to think of intersexuality asa pathology or disability, moreinterested challenging medicalization sexual in the of difference entirelSand more interested politicizinga pan-intersexual in revolt the across divisions ofparticularetiologies orderto destabilize heteroin the normativeassumptions underliethe violence that directed our bodres. at

Public Discourseon PediatricGenital Surgeries
Because politicizedintersexcommunity is still quite young,and most the intersexpeopleremaintoo burdenedby the crippling emotionalconsequences of what hasbeendoneto them to comeout publidp ISNA hasdeliberately cultivated networkof non-intersexed a advocates commanda measure who of sociallegitimacy and can speak contexts in whereuninterpreted intersex voices will not be heard. Because thereis a strongimpulseto discountwhat (as peoplehaveto sayaboutthemselves if we aretoo close the isintersex to sues offerobjective to opinions),this sort of sympathetic representation has beenwelcome-especially helpingintersex in peoplereftameintersexuality in nonmedical terms.ao Somegendertheoryscholars, feministcriticsof science, medical historians, anthropologists beenquickto understand and have andsupportintersex activism. Feminist biologistandscience studies scholar Anne Fausto-Sterling-whowrote,years beforeISNA cameinto existence, aboutintersexualitf in relation to intellectuallysuspect scientificpractices that perpetuate masculinist constructs gender-becamean earlyISNA ally.ar of Likewise, socialpsychologist Suzanne Kessler wrote a brilliant ethnography of surgeons who specialize treatfngintersex. in After speaking with a num"products"of these ber ofthe normalized medical programs, she,too,became a strongsupporterof intersex AJice Drege6 activism.{'Historianof science whosework focuses only on hermaphroditism alsoon other forms not but of atlpical embodimentthat becomesubiectto destructively normalizing (as medicalinterventions in her discussion ofconjoined twins in "Limits of Individuality" hasbeenespecially supportive.4r Fausto-Sterling, Kessler, and ), Dregerhaveeachwritten booksthat analyze medical the treatmentof intersexuality beingculturallymotivatedand criticizeit asoftenharmful to its as patients.* ostensible

Allieswho help contest medicalization intersexuality the of havebecncspecially important,because ISNA initially found direct,nonconfrontationrrl interactions with medicalspecialists determine who policy on the treatntcnl of intersexinfants and actuallycarry out the surgeries be both difficu lt l nd to ineffective.loycelyn Elders, Clinton administration's surgeon the gcncrfirst al,is a pediatricendocrinologist with manyyears ofexperience mannging in intersex infants.In spiteof a generally feministapproach healthc rc rln(l to frequentovertures from ISNA,sherejected concerns interscxpcoplc the of themselves.a5 Surgeon RichardSchlussel, a pediatric plasticsurgerysymposiunr(wh ich at had reiected ISNA'sofferto providea patients'panel)at Mount SirrniMcdi. calCenter NewYorkCity in 1990 in proclaimed, "The parents ofchildrcn wilh ambiguous genitals more gratefulto tle surgeon are than any-morc gnltcfirl eventhan parents whosechildren'sliveshavebeensaved througlr opcn heartsurgery."a6 Anotherpediatricianremarkedin an Internetdiscussion intcrscxrrul. on ity, "I think this whole issueis preposterous. . . To suggest . that Inrcdicll decisions about the treatmentof intersex]aresomehow cruelor arbitrrrryis insulting,ignorant and rnisguided. . . To spread claimsthat I ISNAI it . the makingis just plain wrong,and I hope that this [on-line group of dockrrs I will not blindlyaccept physician participating th tsrlntc them."Yetanother in chat,in a marvelous example ofthe degree which practitioncrs scicncc to of canbe blind to their complicityin constructing obiects the rskc(l theystu(ly, "Who is thc cncrrry? lcwhat wasfor him obviouslya rhetoricalquestion: I ally don't think it's the medicalestablishment. Sincewhen did wc cstablish the male/female hegemony?" Gearhart, <luotcdirr rr lohns Hopkinssurgeon New YorkTimesarticleon ISNA,summarilydismissed as "zcalots,"but us professional meetings the fieldsofpediatrics,urology, in genit lltllsticsurgery and endocrinology abuzzwith anxiousand defensivc are cliscussions protestby Hermaphrod with of intersex activism.aT response a r996 In to itcs Attitude at the AmericanAcademy Pediatrics of annualnrceting, tlrirt()rgrlnizationfelt compelled hold a press to conference issue statcntcnt: and a "'l'hc Academy deeplyconcerned is aboutthe emotional,cognitive, anrl lrodyinragedevelopment intersexuals, believes of and that successful carly gcnittl surgery mhimizesthese issues." academy The refused, howcvcr, spclk with to intersexpeoplepicketingits meeting. Theroots ofresistance themedical in establishnrerlt truth-cLlinls k) thc ol people deep. onlydocsISNA's intersex run Not cxistcncc inrplyI crititlrrc ol' the normativistic biases couchcd within mostscicntilic Lrrrcticc it irlso btrt protocol inlcrscx advocates a treatrncrrt lirr irrlitnls disrupts thrrt convcntiorr-



\ TheIntersex Movement MedicalDoubleStandqrAg and

l .l I

al understandings ofthe relationship between bodiesandgenders. a level On more personallythreateningto medicalpractitioners,ISNA'sposition implies that theyhave-unwittingly at bestandthrough willfirl denialat worst-spent their careers inflicting a profound harm from which their patientswill never fully recover. ISNA'spositionthreatens destroy foundational to the assumptionsmotivatingan entiremedicalsubspecialty, jeopardizing thus their continued ability to perform what surgeons find to be technically fascinating work. Science writer Melissa Hendricks notesthat Gearhart known to colis leagues an "artist"who can"carvealarge as phallusdowninto a clitoris"with consummateskill.a8 Given thesedeep and mutually reinforcing reasonsfor opposing ISNA'sposition,it is hardly surprisingthat medicalintersexspecialists have, the mostpart, turned at deafeartowardus.ae for Thus,the mostimportant aspect ofour currentactivities the struggle is to public perceptions. usingthe massmedia,the Internet,and our change By growing network of alliesand sympathizers makethe general to public aware of the frequencyof intersexuality and of the intensesuffering that medical we treatmenthascaused, seek create environment which manyparto an in entswill havealreadyheard about the intersexmovementwhen their intersexchild is born. Suchinformed parentshaveprovedbetter ableto resist medical pressure unnecessary for genital surgery secrecyandto their and find wayto a peer-support groupandcounseling ratherthan to a surgical theater.

The Double Standard:First-World Feminism, African Clitoridectomy and IntersexGenital Mutilation, and the Media
African practices that remove clitorisand other partsof femalegenitals the havelatelybeena targetof intense mediacoverage feministactivismin and the UnitedStates otherindustrialized and Western societies, the eupheand mismfemalecircumcision beenlargelysupplantedby the politicized term has medical(ratherthan folk) opfemalegeninl mutilation(FGM). Analogous erations performedon intersexpeople the UnitedStates in havenotbeenthe focusof similar attention-indeed, attempts link the two forms of genito tal cutting havemet with multiform resistance. Examining the waythat firstworld feminists andmainstream mediatreatAftican practices comparand ing that treatmentwith their respanse intersex to genitalmutilation (lGM) in North Americaexposes someofthe complexinteractions between ideologiesof race,gender, colonialism,and science that effectively silenceand renderinvisibleintersex experience first-worldcontexts. in Cutting intersex

genitalsbecomes anotherhidden rnechanism imposing norn\(clt yet for upon unruly flesh, means a ofcontairing thepotentialanarchy ofdesircs arrd identifications within oppressive heteronormative structures. In ry94theNewEngland pairedan artrcle thc physon loumal of Metlicine ical harm resultingfiom African genitalcutting with an editorialdenouncing clitoridectomy a violation of human rights but declinedto run ir rc" as ply draftedby Universityof Californiaat Berkeley medicalanthropologirit Lawrence Cohenandtwo ISNAmembers detailingthe harm caused nrctllry icalized Americanclitoridectomies.soresponse growingmediaattcntion, In to passed Federal Congress the Prohibition of Fernale GenitalMutil tiot) Acl in Octoberr996.s' That actspecifically exempted from prohibitiou nrc<licnl'l'hc izedclitoridectomies ofthe sort perform€dto "correct"intersex bodics. bill's principal author, feminist Congresswoman Schroedcr, Pat ignorcd multiple lettersfrom ISNA membersand Brown University professorol' medicalscienceAnne Fausto-Sterling askingher to recast [rill'slrrngulgc. the "New Law BansGenitalCutting," the New YorkTimesproclained aud rclincd to address docurnentation fiom ISNAandMichiganState Universityprolcssor Alice Dregerpointing out that genitalcutting continues be st ndflrd to medicalpracticein the United States.s'? The Boston Globe's s1-ndicated columnistEllenGoodmanhaslrccnonc ol' the fewjournalistscoveringAfticangenitalcutting to makeany responsc lo "I ISNA overtures. must admit I wasnot aware this situation,"shewrolc of "I to me in 1994. admireyour courage." Shecontinued,howevcr, tliscr.rss to Africangenitalcuttingin her columnwithout mentioningsimilarAnrcricrrn practices. Ironically, Goodman based Boston, Mecca is in a ofsortsaftcr lohrrs Hopkinsfor the surgical rnanagement intersex of children,witlr prorrrinclrl specialists operatingat Harvard,Massachusetts GeneralHospit l, and ltoston Children's Hospital.An October 1995 Goodman columnon gcnital crrtting waspromisinglyentided"We Don't Want to Believe Happelrs lcrc" It I but discussed only practices imported to the United States inrnrigrrrrrts by from third-world countries. While anti-excision African immigrant womenwithin the Unitcd St tcs havebeenreceptive the claimsmadeby intersexopponentsto nrcrlicrrlto ized clitoridectomies, first-world feministsand organizations working on genitalcutting havetotally ignoredus. Only two of thc r arryarrtiAfrican genital-cutting groupscontacted activist havebothered respond rcpcrrtto kr ed overtures from intersex activists. Fran Hosken, who sincctgtiz lraslcgtr. larly published catalog statistics female a of on genital cuttingworklwirlc, "wc arcnot conccrncd wroteme a terse notesaying that with biologicllcxceotions."sr



Thelntersex Moyement and MerliculI)ortltlt Stturlrnls

r4 |

Forward International, London-based, a anti-female-genital-cutting organization, replied to Germanintersexactivist Heike Spreitzerthat her letter of inquiry was "most interesting" but they could not help because their work focuses only on genitalcutting "that is performed asa harmfirl cultural or traditional practice younggirls." on As ForwardInternational's reply to Spreitzer demonstrates, many firstworld, antiFGM activists seerningly considerAfticans have,.harmfirlculto tural or traditional practices,"whereas in the modern industrializedWest we presumablyhavesomethingbetter.We havescience, and science linked to is the meta-narratives enlightenment, of progress, truth. Genitalcuttingis and condoned the extentthat it supportsthese to culturalself-conceptions. RobinMorganandGloriaSteinem the tonefor much ofthe first-world set feminist analysisofAfrican genital cutting with their pathbreakingarticle in the March r98o issueof Ms. magazine,"The International Crime of Genital Mutilation." A disclaimer atop the first page warns,"Thesewordsareparnful to read.They describe factsof life asfar awayasour mostfearfulimagination-and ascloseasany denialof women'ssexualfreedom.,,5a Ms. For readers, whorn the editorsapparently imaginearemore likelyto experience the pain of genitalmutilation betweenthe coversof their masazinethan betweentJreirown thighs, clitoridectomy is presentedasa fact oiforeign life whoseprincipal relevanceto their readershipis that it exemplifiesa loss of "freedorn," that mostcherished possession ofliberal Western subjects. Onehalf of the article'sfirst pageis filled with a photographof an African girl seated the ground,her legsheldopenby the arm ofan unseen on womanto her right. To her left is the disembodied hand of the midwife,holding the razorbladewith which shehasjust performeda ritual clitoridectomy. The girl's faceis a rnaskofpain, her mouth open,her eyes bulging. In sometwenty yearsof coverage, WesternimagesofA_frican practices have changed little althoughthey havefound their way into more mainstream publications. "Americans madea horrifring discovery year,,' Januthis the ary 997 issteof Lifesoberly informedreaders.ss two-page The photo spread showsa Kenyangirl held ftorn behind, a hand clampedover her mouth, her facecontorted in pain asunseenhandscut her genitals.Interestingly,the girl in this photo is adolescent, breasts shown,covered her are with rivuletsof sweat, and thereis a definiteair of sensuality the presentation. 1996 in The Pulitzerprize for featurephotographywent to yet anotherportrayal of a KenAnd, in the wake of FauziyaKassindja's 1an clitoridectomy.56 successful bid for asylumin the UnitedStates afterfleeing clitoridectomy Togo, numin the ber of related images from her countryskyrocketed. wonders Wesrern One if

photojournalists search sensational in of clitoridcctomyphotos(lo Iol I('lr a tourism boom for a country thc sizcof WcslVir'11irrirr, resent yeritable manifesta profound act of "otlrcrin11" Aliicurr eli Theserepresentations to surrounding sinrililr nlc(licu lizc(l toridectomythat contributes the silence "Their" gcnitrl cllltirll is practices the "modern,"industrialized West. in ours nornrnlizcs lhc barbaricritual;"ours" is scientific. Theirsdisfigures; representatiorrs gcrt cutof ilrtl implicationsof these deviant.The colonialist inragcs inol ting areeyenmoreglaringlyobviouswhencontemporaneous Mcdicrtl tersexsurgeries juxtaposedwith imagesof African practiccs. are how to perform clitoral surgeryon interscxchiklrcn rtrc books describing disconncctin$ thc almostalways illustratedwith extremegenitalclose-ups, personbut also lrotn llrc genitalsnot only ftom the individual intersexed eyes blackcdout. Why body itself.Full body shotsalways havethe subject's polite-to blackout thc cycsol Antcris it considered necessary-orat least ican girls but not tle eyes the African girls usedto illustr tc Stcinc|ll'!r of "InternationalCrime" or Life'smore recent"Ritual Agony"?| suspccl rtnc reason that a Western is readeris likely to identifowith an Anrcricut bul rtot an African girl. Blackingout the Americangirl's eyesallowsthc rcrttlcrtrt rernainsafely this sideof the camera. on locates clitoridectomynot only clscwhctc First-worldfeministdiscourse An in Afiica but also"elsewhen." Atlantic Monthly articleon Alrican clikrproltssion ridectomy, example, for asserted the "Americanmcclical that performing nl glzinc (lc' clitoridectomies decades ago,"and thc stopped Acrtdctttie that clinedto publisha letterfrom ISNAcontradicting clairrr.tT prcss. publications asproneto thisattitude thepopular as Fcnrinist Mrtt are " ll' acknowlctlgcs, thaNussbaum, a discussion in ofjudgingothercultures, two abuses morallythe sameandwe havebetterlocalinfirrnralirtttitlrottl are placed politically do something to aboutit, lhatrtncsccttts oneandarebetter hercartdnow."llul thctt to be a sensible choice focuson in our actions to solely thc plst: "A$ rcin locates genital U.S. surgeries shecounter-factually wereperformed U.S. by and llritish centlyasthe r94os, surgeries] [genital "'l 'problems' artd n to suchasmasturbation lcsbirtisnt. doctors treatfemale genital surgcrics, Nussbittttt By collaborating the silence in aboutintersex first-worldfeminists from anyobligationto challengc thcir own ctrl excuses tural practices rigorouslyasthey do that of others.s' as D anthology, visuallrtist Susirn In the influential eviantBodies Iilho(lrr'r "Theatres Madness" nineteenth- twentielh-ccntury and nlu of .juxtaposes " intcrdependencescxualit rcprotlucl of y, iott, terialdepicting theconceptual familylife,and'fernaledisordcrs."'Ii)rcprcsenttwcnticth-ccnlur


TheIntersexMovementand Medical Double Standards

I 45

clitoridectomypractices, Jahodaquotesa r98o letter to the editor of Ms. prompt€dbytheSteinem Morganarticle. magazine and Thewriter,a nurse's aid in a geriatrichome,says had beenpuzzledby the strange she scars she sawon the genitals fiveofthe forty womenin her care:"Then I readyour of article.. . . My God!Why?Who decided denythem orgasm? to Who made them go through sucha procedure? want to know.Wasit fashionable? I Or wasit to correct'a condition?'I'd like to know what this so-called civilized country usedasits criteriafor sucha procedure. And how widespread it is here in the United States?"o While Jahoda'sselectionof this letter doesraisethe issueof medicalized American clitoridectomies, it again safelylocat€sthe cutting in the past,as something experienced long time agoby womennow in their later stages a oflife. Significantly, overan excellent opportunity to fahodaliterallypasses commenton the continuingpractice clitoridectomy thecontemporary of in UnitedStates. monthsearlier, theApril r98oissue Ms.,notedfemTwo in of inist biologistsPatriciaFarnes(a medicaldoctor) and Ruth Hubbard also repliedto Morgan and Steinem: Wer^,ant drawthe attentionof your readers tie practice clitoddectoto to of my not only in th€Third World . . . but righr herein theUnitedStates, where it is used part of a procedure 'repair" by 'plastic surgery'' as to genso-ca.lled ital ambiguities. people Few realize this procedure routinelyinvolved that has removal theentireclitorisandits nerve of supply-in otherwords, total clitoridectomy.. . In alengthy . article, Hopkins intersex expert [Johns ]ohnl Money andtwocolleagues "There been evidence a deleterious write, has no of effect ofclitoridectomy. of thewomen None practices.reportexperiencedgenital in edaloss oforgasm clitoridectomy." article advises "athreeafter The also that yearold girl aboutto beclitoridectomized. , should wellinformed tlle . be tlat doctots make looklike other andwomen" emphasis), (our will her all girh which is not unlike whatNorthAfticangirlsareoft€ntold abouttheirclitoridectomies.. . . But to date, neitier Moneynor hiscriticshav€ investigated effect tJIe of clitoridectomies thegirls'development. onewouldsurely on Yet expect this to affect theirpsychosexual development theirfeelings and ofidentity asyoung

juswork for social meddlingin the socialaffairsof otherswhile hamPering tice at home,62

thrtt in the itselfasbeinginterested unmasking silence Feminismrepresents thc womenandin providingtoolsto understand against violence surrounds is intersexmanagement a form of viopersonalas political.Most rnedical l)ocdevaluing femalepain and femalesexuality: of lencebased a sexist on tors considerthe prospectof growing up malewith a small penisto be a worsc gr0ti6sexual without a clitoris,ovaries,or than living asa female altemative bodiesinto transgressive cation.Medicalinterventionliterally transforms to be onesthat can safely labeledfemaleand subjected the many forms of Why then bavemost lbnrsocialcontrol with which womenmust contend. people? of of the inistsfailedto engage issue medicalabuse intersex mllinpeoplehavehad suchdifficulty generating I suggest that intersex frornc' ofthe racistandcolonialist feministsupportnot only because stream with' as foreignto propersubjects clitoridectomy apractice worksthat situate the intersexuality undermines stabilityof in the first world but alsobecause "woman" that undergirds much first-worldfeministdiscoursc. the category genders bodics0nd and relationbetween the We call into question assumed dichotomics. do bodies not fiteasilyintomale/female how demonstrate some the Weembodyviscerally truth ofJudith Butler'sdictum that "sex,"thc conof and naturalization culturnlly the ceptthat accomplishes materialization all gender has differences, reallybeen"gender along."'rlly rcfits' constructed not upon whichdepend only the we ing to remainsilenced, queer foundations feministassurrrp' of management bodiesbut alsowidelyshared the medical femalesubjectivity. tions of properlyembodied transfor Kessler noted,"IT]he possibilities realsocietal In r99oSuzanne in specializing and formationswould be unlimited [if physicians scientists pcoplc thatl finally,and always, the management ofgendercould recognize that are groulrdedin genderconstructgenderaswell asthe socialsystems genitalambiguityasa naturaloption woukl . based concepts. . . Accepting that also requirethat physicians acknowledge genitalambiguityis 'corrcctit to it is threatening the infant'slife but because is threatclred' not because ing to the infant'sculture."6n To the extentthat we arenot normativelyfemaleor nornlativelywolrlcll, hts Western fenrirrism concern, of we arenot the propersubjects feminist harnrfitl, itlttl Africangenitalcuttingas primitive,irratiorral, represented

AlthoughFarnes Hubbard's and prescient feministexpos6 medicalized of clitoridectomies the contemporaryUnited States in sankwithout a trace, therehasbeena veritableexplosionof work like Nussbaurn's Jahoda's and "domestic"clitoridectomy a safedistance. that keeps at Suchconceptualizations of clitoridectomy's cultural remoteness-both geographically temancl porally-allow feminist outrageto be divertedinto potentiallycolonialist



cHBnvl. cHAtt

Movcmfit ffit lfrttlael lrou,tc standofit The Intersctt


tlcscrving contlcnr lion.'l'hcWcslcrn ol nl trrcrlierrl colrrrrrtrnily rcprcscnt_ h.ts editsgenital cuttiug nroclern, as scicnlilic, hcnlirrg, ah,,u. irntl ,.prno.h. W},"n will Western feminists realize that their lhilurckr cxanrine eitherof these claims"others" African womenand allowsthe violerrtnredicaloppression of intersex peopleto continueunimpeded? Notes
of this essay. earlier version appeared as ,,Hermaphrodites with Attitudq Mapping the An Emergenceof In tersexPolitical Activism," Gl e: A lournal of Gayand LesbianStircs 4 no. 2 (1998):r8F2rr. @1998. rights reserved.Us€d by permission of Duke University prcss. All

r{}.,AnilrNllulrjnrr,"N4etlirlllllhlt r ,ttlrl'll rtllr'li'lllrll lrl tltct irr'col All(ll('8cllllli(ll ()u hu Mtrlh Astrtrinlh httttttd t14,tto4 (1996):561t Trt,rlvrrll sitivitvSvr)(fronrc," ll''lfr' l)tcgcr',cd,lt,/t'trtxi'l 154/{15('ltc.llltll <lrttp://www.cnl0.c$/ctul)/vol ablefrorrr 'i oI Ethics. "lntcrscxurlllcrtling: Attotttllylintls I ( iroup,"Ncw Yrrrl'lirrtrt' Att Angicr, u. Natalie Er4. Feb,4,1996, rz. Ian Mulgrew, "Controversyover Intcrscxl'reatment," ydrc0tlvcrSkr, AFril 7' 1997, "Spare thc Knife, Spoil thc Child"' Gklrc aul Mtll' u Edna Durbach and GeorgeSzasz, Feb.27, 1996, 76. york ?inrcs' Moy t1' r3. Natalie Angier, "New Debateover Surgeryon Genitals," Nsla " Anne Scheck, lntcr$cxu0lityl\kcr Limbo," DatelineNBC,lune l7' 1997; 1997,87:"Getdet Turn," lJrologyTimes26,no.r (1998):l'32-ll. a Conservative er'llrouble:Feminismand the Subwrsionof ldettritl (Ncw Y(rrkl r+. Iudith Butler, Gend Body and Gender[ron the Orutksk' I]ftu Making Sex: Routledge, r99o); Tho masLaquLeu4 (Cambridge: Harvald University Press, r99o). 15."Histology" lefers to the structure ofthe tissueof the sexglandswhon 0 $0nlPlclil surgicallyremoved,stained,and observedunder a microscope. 16.Alice Domurat Dre ger,Hermaphroditesand the Medical lnventio o/.S.'x ((hnl" bridge Harvard University Press,r99E). Heftndphroditism,/,,rrlRchtl l Al17.Hugh Hampton Yotng,Genital Abnormalities, xxxix-xl. (Baltimore:Williams and Wilkins' 1937), rcflal Diseases rE.Young,"Genital Abnormalities," 139-42. 19.Howard W Jones, andWilliam WallaceScott,HermoPhrcditit,rt,Gc,tilil A,ttxttJr, Disorders(Baltimore:williams and wilkin$' 1958)'269' Endocrine aliesand Related 20. John Money,)oan G. HamPson,and John L. HamPson,"An Exonrinltion ofsrxnc The Evidenceof Human Hermaphroditism," llullclitt ol tlt( h'lntr BasicSexualConcepts: Hospital gT, Hopkins 3or-r9; John Money, loan G Hanlpson, 0nd ,t)hn l,' + (1955): ^o. (:hfl 18( ()f ConcerningAssignmcnt Sex, Hampson,"Hermaphroditism:Recommendations Management,"Brlletitl of lohns HopkinsHospilalgT' tto, 4 \t911ll of Sex,and Psychologic and Exigc,lcy'l'htoty lllttll\tSexosophy, Penuses:Sexology, 2E4-3oo; John Money, Venuses 1986 lo: PrometheusPublishers, ). a zr. Robert M. Blizzard,'Iawson Wilkins," in Wllkins the Diagnosis l'lltrtl tt'ttl ol ed.,ed. Michael S. Knppy' ltobcrl Dkorders in Chitdhoodand Adolescerce, +th Endocrine M. Blizzard,and Claudef. Migeon (Springfield:CharlesC Thomas' t994), xiii "The Medical Construction ofGender: CaseManlScmcnt ol lll22. SuzanneKessler, J-26' s: lnfants," Sigt, Joumal ofWomen in C hure afid Society16,no l (1991')i tersexual

My appreciation to Susan goes Stryker herextensive for contribution thedevelopment to

r. CeliaDuggen"New Law BansGeniralCutting in the United State NewyorkTimes, s,,, O.t. 12,7996, r. 2. Departm€nt of Defense Appropriations Act, public Law to4_20E, Sept.30,1996, 3. Alice Domurat Dreger, "'Ambiguous Sex,----orAmbivalent Medicine? Ethical Issues intheMedicalTreatmentoflntersexuality,,'HastingsCefitetReport2S,rro-3O99a\24_ 35,available from <http://www.isna.org/articles/dregerart.htrnl>. 4. American Academy of Pediatrics Section on Endocrinology and Section on Urclo_ gy Committee on Genetics, "E]"luation ofthe Newbom with DevelopmentalAaomalies of the External Genitalia," Pediatricsto6, no. 1 (2oooj: 138-42,availableftom <httpr// wwwaap.orglpolic/le9gsE.html>; Clttthia H. Meyers-seifer and NancyJ.Charest,,.Di_ agnosisand ManagementofPatients with Ambiguous Genitalia,,, minars in perinatol_ Se ogy 6,rto. 5 (tggz): yz-39; American Academy of pediatrics Section on Urology, .Timing of Elective Surgery on the Genitalia ofMale ChilcLen with particular Reference the Risls. to Benefits, and Psychological Effects of Surgery and Anesthesia,. pedia trics g\,no. 4 \1996)l from <http://www.aap.orglpolicy/0l306.htnl>; LeslieA. parker,,,Anbis_ 59o,available uous Genitalia: Etiology, Treatmenr,and Nursirg Implications,,' lournal of Obstetric, Gynecologicand Neonatal Nursing 27, rro. | (\ggE)t rS-22. E, 5. Joseph Oesterling,John P Gearhart,and Robert D.leffs,,,A UnifiedApproach to Early Reconstructive Surgery of the Child with tunbiguous cenital ia,,,joum)i of Wolo_ ro79 84.The following video trains surgeonsin the procedure: &r'r3E,no. 4 pt. 2 (1987): fuchard Hurwitz, H. Applebaum, and S. Mu enchow,Surgical ReconstructionofAmbigu_ ous Genitolia in FemaleChildren, CinC-Med Inc,, r99o (the video can be ordered from CinC-Med at MACROBUTTON HtmlResAnchor <htrp://www.cine-med,com>as vid_ eo number ACS-16r3). 6. American Academy of pediatric$Section on Urology, "Timing ofEleaive Surgery" 59o. z. Melisa Hendricks,'Is it a Boy or a Girl?,'ro hnsHopkins Magazine 45,no. 5 (1993):ro. 8. John F. Stecker,Charles E. Horton, Charles J. Devine, and John B. McCraq .Hypo_ spadias Cripples," Urohgic Clinics of North Americo: Symposiurn on HypoEadios 8, no,3 \r98r)t $9 44. 9. Howard Devore, "Growing up in the Surgical Maelstrom,,, and SvenNicholson, "Take Charge: A Guide to Home Catheteriz atiorr,', both jn Inte$er in the Age of Ethics, ed.Alice Domurat Dleger (Hagentown: University publishing Group, 1999), 78_8r.

quotation on 7. r as 23.Johr Colapinto,As NqtureMade Him: TheBoy Who WasRaised a (iiri ( Ncw Yr lk: Harpercollins, 2ooo). zq. American Academyof PediatricsS€ctionon Endocrinology and Sccti(nroll IJr(rl ogy Committee on Genetics,"Evalution of the Newborn"; Gerardo lzquicrdo nrl(l Kcn "Gender Assignmentand Genderldentityin Patientswith AnrltiSurrtlr neth I. Glassberg, Urology 42,no,3 G9y): z3z-42;SuzanneKe sslet Lessons Genitalia," ltont thr' ltrt,.rtr'nI r9p8);BarbaraC McGillivray,"'l'hc Ncwlrolrr (New Brunswick:RutgersUniversityPress,

1 4u


DoubleStandards Mot ementand Medic&l Thelntersex


with Ambiguous Genitaha," Semifiafi in Perinatolog)/ no. 6 (1992):365-68;Meyers16, Seifer,"Diagnosisand Management." 25,The best sourceto view the dgramics ofthe medicalrelianceon prevaricationis B. Diane Kemp, Sherri A. Groveman,Anonymous, H. Deni Tako,and Karl M. Irwin, "Sex, Lies and Androgen lnsensitivity S),ndrome,"CanadianMedicalAssociaion]ournal84, no. u (1996): r8z9-33, available from MACROBUTTON HrmlResAnchor <http:// www.cma.calcmaj/vol-154/1829e.htm>. evidence For that the practiceofwithholding the diagnosis from intersex patients is still common, seeRobert Marion, "The Cr_rrse of the Garcias," Discover zt, no. r (zooo): 4z-44, available from MACROBUTTON HtmlResAnchor<http://www.findarticles.com/cf0/m I51l/t 2 211671852941pl1 article.jhtmb. Representative older work recornmendingwithholding the diagnosis include Tom Mazur, "Ambiguous Genitalia:Deiection and Counseling," PediatricNutsing 9,no.6 (D83):4\7-22. 43r;l. Dewhurst and D. B. Gnnt, "lntersex P toblems,"Archittes of DiseaseinChildhood 59,no. D (r9E4)iu9r-r94; Froukje M, E. Slijper,StenvertL. S.Drop, fan C. Molenaar,and R.I. Scholtmeijer,"Neonateswith Abnormal Genital Development Assignedthe FemaleSe* ParentCounseling,"lournal of Sex Educaion and Therary 20, no. r (r994l:9-17. 26. Claudel. Migeon, GaryD. Berkovitz,and Terry R. Brown, "SexualDifferentiation and Ambiguity," in Mrftins the Diagnosis andTreahnent of Endocrine Disorders in Aildhoorlanil Ailolescence,4th ed. Michael S. Kappy, Roberr M. Blizzard,and Claude J. ed., Migeon (Springfield:CharlesC Thomas,1994), 573 7r5. 27. Lalitha Raman-WiLns,Alice Lin-in Tseng,SuzanneWighardt, Thomas R. Einarson, and Gideon Koren, "Fetal Genital Effects of First-Trimester Sex Hormone Exposure: A Meta-Analysis,"Obsterics and Gynecology no. I (1995): 85. 141-48;J. Fichtner,D. Filipas, A. M. Mottrie, G. E. Voges,and R. Hohenfelher "Analysis of Meatal Location in Five Hundred Men: Wide Variation QuestionsNeed for MeatalAdvancementin All Pediatric Anterior H)?ospadiasCases," nal ofUrology r54,no.2 (r9g5):A3;-14;Melanie B|ackJo less, Anthony Charuvastra, Amanda Detryck, Anne Fausto-Sterling, Karl Lauzanne, and Ellen Lee,"How SexuallyDimorphic Are We?Reviewand Synthesis," AmericanJounal of Human Biologytz,no.2 (20oo):151-66;AnneFausto-sterling, SeringtheBody: Gendet Politicsand the Consttuctionof Humafl Sealtallry(New York BasicBooks,zooo). 28. Milton T. Edgerton,"Discussion:Clitoroplasryfor Clitoromegalydue to Adrenogenital S;.ndromewithout Lossof Sensitivity,"Plasic and Reconsttu.til,e Surgerygr,rlo.

Intersexualitybeyond 35.Morgan Holmes,"Medical Politicsand Cultural Imperatives: 1994. Pathologyand Erasure,"master'sthesis,YorkUniversiry, Manifesto," i|r lror'l/ 36. Sandy Stone, "The Empire Strikes Back A Posttranssexual Ambiguitl,, ed. Julia Epstein and Kristina Strnuh Guards:The Cubutal Politicsof Gender (New York: Routledge,rggr). 37. Kessler,Lessons from the Interse\ted, 53. 1996, stylc sccofAmbiguity," BostonPhoenia,No't.22, 38. Ellen Barry, "United States tion, 6-8. SPeak! thirty-minute videotape(SanFrancisco:InHsrnxaphrodites 39. Cheryl Chase, tersexSocietyof North America, r99Z),availableftom <httP://www.isna org>; Kcsslcr, Intersex ik the Age of Ethics; Angiet " l n tcrscx tril I Lessons from the Intersexed; Dreger, ed.., Healin1"; Is It a Boy or a Gii? d:ie.tedby Phyllis Ward, DiscoveryChannel, March 26, from <http://www.isna.org>;Ruth G. Davis,"Was I Meant to Bc a Milr?" zooo,available tan 2oo-zoj. Cosffi opoli zz9.no. 4 (2ooo): 40. Similarly,some Westernfeminist opponents ofAfiican genital cutting hlvc llkcn to it upon themselves speakfor thoseaffected,under the assumptionthat they.rrc cilhcr too ignomnt or too vestedin the practicesto make any valid contributions ((ilxitc (l Robertson,"Getting beyond the Ew! Factor: Rethinking U.S.Approachesto Africitn lcmale Genital Cutting," chapte.2 in this volume). why Male and FemaleAre Not lix)tr8h," 4r. Anne Fausto-sterling,"The Five Sexes: M/ffis ol Gendct: Ilidolii me Sciences no. 2 (1993):20-25; Anne Fausto-SterliDg, 33, t34-4t meoties about women and Men, zd ed-(New Yorlc BasicBooks,1985), 42. Kessler"Medical Construction ofGender." irt 43.Alice Domurat Dreger,'The Limits ofIndividuality: Ritualand Sacrificc thc Livr'n nl in and Medical TreatmenrofConioined Twins," Studies History atld Philosoqhy llidn(rgg8\ r-29; Alice Domurat Dreger,"l)oul)tltll Scxi 29, gy and BiomedicalScience no. a The Fateof the Hermaphrodite inVictorian Medicire," Victorian Sturriss rlo. I ( |995)l 3{i, (l(trl ds," in 336-70;Alice Domurat Dreg€r,"H€rmaphrodites in Love:The Truth of thc ahd Science Hofiosexual;fiet ed.Veinon A. Rosario(NewYork: Routledge,1997), 46-66; Alice Domurat Dreget "Doctors Containing Hermaphrodites:The Victorirrl l,c8ir(y,' GenderIdentities2, no. 5 \rgg7). 15-2.2.. Chrysalis: The lournal ofTrahsgressh/e Lessons Sexingthe Body; Kessler, 44. Fausto-Sterling, from the I tcrstxc.l;l)rcgcr, c(1., and the Medical Invurtiut ol Stx Intersexin theAge of Ethics;Dreger,Hermaphrodites Daughtcr to St,rgro (;[ 45. ]oycelynEldersand David Chanoff,From ShareuoPPer's the united States America (NewYork: William Morrow, 1996),t5o-54i "l )r. lllof enl of Sept.26, rgg4,45 46. ders' Medical History," The New Yorker, Mt. Sinai SchoolofMedicine, Conferenceon PediatricPlasticand Roconstrlrclivc 46. Surgery,New York City, May 16,1996. 47. Angier, "lntersexual Healing." 4E.Hendricks,"ls It a Boy or a Girl?" More than one ISNA membcr hasdiscov(rr(l thrtl ncwstlrtielc A wirc scrvicc the surgeons who operated them did so at no charge, 1994 on (Tom Majeski, "Surgery ChangesRussianChild's Sex,"Sa Josc Mtr.ury Ntwllrtly )5, of by family, clrivcn thouShts murdcr-suiciclc tht'ironc to Au) relates how a Moscow r994, wilh sc;rrchcd high ancllow ttntil thcyconrrcctc(l nn Anlcr year-old Misha's anatonry, son (lon lc(l ils sefvi(('s, thc l o|crirtctllirr'lr-ec, hrtsl)itirl icanpcdiatricLlrologisl. hc Llrologisl


"ls It a Boy or a Girl?" Quotation on 15. "HlryospadiasCripples." 3o. Stecker, 3r. Devore,"SurgicalMaelstrom." 32.Robert E. Gross,JudsonRandolph, and lohn F. Crigler, "Clitorectomy for Sexual Abnormalities:Indications and Technique,"Surgery59,r'o.2 (1966):3oo-30E,quotation on 3o7. 33.Oesterling,"Uni6ed Approach." v,ith Attitude (Winter 1994-95):r, 34. Kiira Triea, "The Awaketing," Hermaphrodites available ftom <hftp://www.isna.org/hwa/winter94-95/winrer94-95.html>; Susan Stryket "MyWords to Victot FrankensteinabovetheVillage of Chamounix," GLQ: A Joumal ofGay and LesbianStltdies 1no.3 j994):47 54.

s56. '9ca\ 29. Hendricks,


c t |I RYL ( j l t ^ s t l

'l'fuI lrsu Movt','|trtl Mttlitnll)othlr Stnnltnls tttttl


and an airline footed the expcnses a round trip to Sr. Paultirr thc cntirc lhnrily. Docfor tors removed Misha's penis, testis,and ovary and irrstructedtlrc family to rcname him and to move,The family plans neverto revealanypart ofthe story to relatives to their or now-daughter Masha.The medical establishment's fascinationwith its power to change sex and its drive to rescueparents from intersex children are so strong that intervention can be delivered acrossnational borders and without regard to the commercial model that ordinarily governsU.S.medical services, 49. The first exception was ulologist Justine Schober,who, after watching a videotape made at the 1996 ISNA retreat and receiving other input fiom various intersex groups, suggestedin a new textbook on pediatric surgery that altho ugh technology has advanced to thepointthat "our needs[assurgeons]and the needsofparents to havea plesentable child can be satisfied," il is time to acknowledge that there are problems that "we as surgeons,despite the most technically perfect surg€ries,cannot address." She then called for a thorough reevaluationoftheprotocols surrounding medical managehent of intercexuality: "Surgery makesparents and doctors comfortable, but counselingmakespeople comfortable too, and is not irreversible." Justine M. Schober, "Ferninizing Genitoplasty for Intersex," in Pediatric Surgery and Urclogy: Long'lerm O tcotnes,ed. M. D Stringer et al. (London: W. B. Sar:nders, r99E),j49-58. By eally 2oo1,there was finally growing acknowledgment within the medical community that a.llis not well. Surgeon lan Aaronson, in forming a "North American Task Force on Intersex' in zooo, acknowledged that "long-term outcome data lon intersexgenitalsurgeries]is r.erysparse and selective, and this puts surgeonson tenuous ethical grouflds." The july zooo issueof the Amerrcan Academy of Pediatric s' journal Pediatrics carried an article that called for a moratorium on pediatric geoital surgeries: Chanika Phornphutkul, Anne Fausto-Sterling, and Philip A. Gruppuso, "Gender Self-Reassignment an XY Adolescentlemale Born with Amin biguous Genitalia," Pediatricsro6,no. | (zooo): 135-37. Unfortunately,it also carried an arnouncement of a newly adopted poliry of the academy calling for continued pediatric genital surgeries as standard practice (Arnerican Academy of Pediatrics Section on Endocrinology and Section on Urology Committee on Genetics,"Evaluation.ofthe Newborn"), 5o. Patricia Schroeder, "Female Genital Mutil aion," New England loumal of Medicine 94 no. t (1994): 79-4o; Nahid Toubia, 'Female Circumcision asa Public Health Issue," New England Journal d Med icine 33t, no. \ (1994)t 7 12-16. EradicationMeasures the West5r, IsabelleR. Gunning, "FemaleGenital Surgeries: at ern Local Lwel-A C,autionary Tale" (chapter 4 in this volume). 5r. Dugger,"New Law Bans Genital Cutting." 53. Fran P, Hosken, ?}e Hoskeh Report: Genital afid Sexual Mutilation of Ferndles,4th iev. ed. (Lexingtonr Women's International Network News, 1994). 54. Robin Morgan and Gloria Steinem,"The International Crime ofGenital Mutilation," Mr 8, no.9 (r98o): 65-67,98,quotation on 65. 55. Mariella Furrer, "Rit:ual Agony," Life zo, rlo. 1 (1992):38-39. 56. Robertson, "Getting beyond the Ew! Factor"; seealso Pulitzer PrizeBoard, Featute Photography: Stephanie Wehh (t996), available from MACROBUTTON Hrn ResAnchor <hft p://www.pulitzerorg/1.ear/996/feature-photography/>. I

(:{tlrl('s All(.ri(i|," n I lNJttit Monthly t7t', lo "Icnrnlo(liJcllnlcisioll llttrstyrr, 57.Lin<fir quol.r(ron 3l on 28-35, no.4 (r995): :urn,Sexa d soci l lusllu' (Ncw Yrrk: Oxfor(l Ljlivcrsity l)rcilil, 58.Martha C. Nussba rggg), r22-2j, would do lhcir ht'lllc' criticsofAfrican Benitalcutting that first-world 59.One wishes (and ftee) to perform an Internct searchof the Nationnl Librnry ol Mc(lwork. lt is easy of icine's database medicalPublications.Searchingfor "clitoris" and "surgcry" iln(l th(ll animals,and bladder cxstrophy Pto(ltlccd transsexuals, to eliminating references cancer, 196citations in April 2ooo.Of these,3l relat€to folk genital cutting prilcliccs,wlrilc l1i relateto genital surgery for transforming intersex genitalsinto nornriltivc fcnrlllc onc{' M Many ofth€ titlesshould draw immediatefeminist suspicion:"The SurSical n0g0tllcnl "A Ncw tntlSlttl' ofthe EnlargedClitoris," "surgical Techniquefor Clitoral Reduction," plified Method for Concealingthe HyPertrophied Clitoris," "Clitori(lcclonry or l'lrrll( Reduction of the Clitoris in the AdrenogenitalSyndrome," "Opera(ivc llcdtlctioll tll thc EnlargedClitoris," "TechniqueofVaginoplastyand clitoridectomy in I hc A(lrcnol|ctlltnl Syndrome," "A Simple Technic for Shortening the clitoris without AnlPul$ti(|n"' nlld Indications and Techniquc."NcIrly lll thc lrtl' "Clitorectomy for SexualAbnormalities: cleson folk genital cutting use condemnatory language'while thosc on in(cricx l{cllll0l all surgeries representit astheraPeutic. 60. Susanlahoda, "Theatresof Madness," in Detianl Bodies:Criliul l\nlla(livat o and Dffirence in Science Popular Cuhure, ed. JenniferTerry and lacquclinc Urlo (llhtrt' Letter to the Editor, Mi lt, no,lo (lgtlr)): l2' t995),273; mington: Indiana UniversityPress, Farnesand Ruth Hubbard, Letter to the Edibr, MJ, lt, no. lo(l9lt(')i9 l('' 6r. Patricia. Dawit and SalemMekuria, "TheWest,ust Docsn't(;ct lt," M'l9 l'1'rl 62 Crmpare Seble Az7. Times, Dec. 7, 1993, g. Blutler, Gender Tlouble, 8. "Medical Construction ofGender," 25. 64. Kessler,

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