“normalizing” surgeries
o Since 1950’s, children have been “treated”
 Intersex conditions
 Physiological anomalies of the reproductive sexual organs
o Has been damaging
 Sexual well-being
 Emotional well-being
o No long-term study to show outcome of surgeries
Some intersex individuals have been subjects to experiments on whether gender is
determined by nature or nurture.
In the past
o Prevailing opinion was to assign gender quickly and act accordingly
 Surgery no later than 24 months
 Usually just looked at external genitals rather than chromosomal gender.
o It was easier to reconstruct female genitalia.
 Often if gender could not be easily determined, female was chosen.
o Genital tissue of the “other” sex is removed.
o Hormone therapy
More recently
o Rethinking defaulting to female genitalia
o Looking more at chromosomal, neural, hormonal, physiological and behavioral
factors that influence gender identity.
o Where previously it was thought best to jump into surgery very soon after birth,
many now wait until the child can actually make the decision.
Over the course of the years, gender assignment surgery hasn’t been found to be
congruent with the individual’s gender identity.
o Some of the times
There have been mainly two different models of intersex treatments.
o Information from Intersex Society of North America (ISNA)
o Concealment-Centered model
 Includes many of the older ideas
o Patient-Centered model
 More modern
 Focuses more on wellbeing of intersex individuals
o View of intersex
 Anatomical abnormality
 Can cause problems and distress in family and for intersex individual
 Requires immediate medical attention
 “Normalize”
o Is gender nature or nurture?
 Nurture
 Convincing genitals and sometimes hormone therapy

When “normalizing” surgery should be performed?  As soon as possible  Before long-term memory kicks in  Less scarring  Overall less trauma o Why the children should be “normalized”  Avoid ridicule. family. being ostracized. and many gynecologists and other health care practitioners. genetic. etc) should be treated medically.  Non-essential treatments should be done until the patient’s consent can be given. o When “normalizing” surgery should be done?  Only when and if the individual requests the surgery  After being informed of risks and outcomes  Those with intersex condition should be able to talk to others who have undergone treatment and make an informed decision. Patient-centered model o View of intersex  Common anatomical variation  Not a medical problem in itself o Is gender identity determined by nature or nurture  Both o What should be the medical response?  True medical problems (urinary infections or metabolic disorders. and diagnostic tests have been administered  Parents should be well-informed  Talk with other families with similar circumstances o  . most pediatric urologists and pediatric endocrinologists. o How gender is decided for infants  After hormonal. and society o How is gender decided?  Y chromosome and adequate penis – Male  Penis of 1” or longer  Y chromosome and inadequate penis – Female  Reconstruction surgery  No Y chromosome – usually Female o What should the child be told and when?  Very little  Could lead to gender confusion  Vague answers are recommended o Ideal future of intersex  Elimination via improved scientific and medical technologies o Proponents of this model  John Money and his followers. and rejected by friends.

 Secrecy can be damaging. and can leave the individual feeling shameful. feminists. and is subject to change in later years according to the child’s wishes. o Surgically constructed genitals are extremely difficult to undo.  Child may later want different genitals from what was assigned earlier in life. embarrassing. LGBT activists. ethicists. medical historians. some legal scholars. and a growing number of clinicians.org/compare     Introduction Methods for “correcting” intersex o Old method o New method Ideas on the whole thing o Old o New Closing statements o . http://www.  Ending thoughts Throughout the years.Keep in mind any gender assignment for infants is preliminary. o Ideal future for intersex  Social acceptance of human diversity  End the misconception that intersex is a disease o Proponents of this Patient-Centered Model  Intersex activists and their supporters. o Can cause them to avoid further health care  Such as hormone therapy.isna. so oftentimes the children are stuck with what the doctors give them.  What should be told and when?  Everything and when they’re old enough to understand.  Unnecessary surgeries should not be done without patient’s consent.