SWITZER, continued

Most Famous Gender Assignment Case

Early gender assignments should never have become the standard procedure for infants with injured or abnormal genitals because the case that set the precedent for sex reassignment turned out to be a failure from the outset. The case began in 1965 with the birth of two identical twin boys, Bruce and Brian (Colapinto, 1997). Because of a condition known as phimosis, the twins’ foreskins began to close, making it difficult for them to urinate. However, their pediatrician explained to the parents that the situation could easily be remedied by circumcision. What should have been a simple procedure turned out to be a life-altering experience for one of the babies. During the circumcision, little Bruce suffered a burn that spread from the tip of his penis to the base. His penis was blackened like charcoal and over the next few days, the burnt tissue dried and broke away in pieces until there was nothing remaining. Because phallic reconstruction was in its infancy in the 1960s, doctors would never have been able to reconstruct a functioning penis, only a conduit for urine. Therefore, Dr. John Money assured them that gender transformation was indeed the best option for little Bruce. The baby boy underwent surgical castration, which included the removal of the testes, reformation of the scrotal tissue to resemble labia, and the lowering of the urethra. The decision had been made to raise the little boy as a girl and her parents changed her name from Bruce to Brenda. However, Brenda struggled against her girlhood from the start. Her mother Linda recalls putting Brenda in her first dress shortly before her second birthday. “She was ripping at it, trying to tear it off. I remember thinking, ‘Oh my God, she knows she’s a boy and she doesn’t want girls’ clothing. She doesn’t want to be a girl’” (Colapinto, 2000, p. 9). Nothing could have been closer to the truth. Brenda never acted like a girl, never played with girl toys, was never interested in “girlie” things, and as she grew older, there was nothing feminine about the way she moved, spoke, walked or gestured. As a result of the nature vs. nurture clash and the constant teasing she was subjected to from her peers, Brenda knew she was different and instead of feeling like a girl or a boy, she felt like an “it,” and the situation began to affect her psychologically.

What made this case so famous was the fact that this was the first infant gender assignment that had been done on a male who was born with normal genitalia. For Dr. John Money, this case was supposed to serve as the ultimate proof that babies are psychosexually neutral at birth, and that it is environmental rearing that forces us to identify with one gender or another, but instead it proved the opposite. This was the case that Dr. Money had been waiting for his entire career, so it comes as no surprise that in his books, reports, articles, and even pediatric textbooks, the experiment was portrayed as a huge success. Although he made note of a few “tomboyish characteristics,” he overshadowed it by stating all of her “non-existent” feminine qualities. In the 25 – 30 years since this case was first published, over 15,000 similar sex reassignments have been performed on babies with abnormal genitalia based on these false results. Instead of proving what John Money wanted it to prove, this case further proved that biology holds much greater weight than environmental rearing, which is why genital-altering surgery should not be performed on infants.

Unhappy Adults

Not all those who were born with ambiguous genitalia are happy about the early surgery that altered their gender. Affected adults have been increasingly vocal about their dissatisfaction with clinical decisions made on their behalf during childhood or adolescence. Many adult intersexuals have had to discover their history and status independently, without having any emotional support. As a result, more than a few have become estranged from their families. An organization was formed and is known as the Intersex Society of North America (ISNA). These intersex individuals are challenging the current practice of irreversible sex reassignment surgery for infants. The group contends that this genital-altering surgery can damage a person’s sexual function for life due to loss of feeling, painful sex because of scar tissue, or complete lack of sexual response. The damage done from this process, which some intersexes refer to as “mutilation,” can result in the inability to have normal sexual relations. The ISNA recommendation is to wait until the child is old enough to make his or her own decision as to whether or not to have the surgery. “We’ve heard more and more people, coming forward saying, this hurt me, either physically, psychologically or both,’ says Dr. Bruce Wilson, a pediatric endocrinologist at Michigan State University. One of the people to come forward was Cheryl Chase, who at age of 18 months underwent a clitorectomy to remove her enlarged, almost penis-sized clitoris. ‘I can’t have an orgasm,’ says Chase, who believes her inability is due to the surgery” (Colapinto, 2000, p. 24). On the other hand, one woman, who chooses to remain anonymous, wishes she were given the opportunity to have clitoral surgery when she was a child. “She recalls how embarrassed she felt about her enlarged clitoris, how it showed through her bathers and was uncomfortable for her when she was wearing jeans” (Zucker, 2002, p. 272). Many physicians agree with this woman in believing that it would be more harmful to wait for this surgery than to do it during childhood. However, after careful analysis of various data, I find that it is indeed more suitable and appropriate for surgery to be delayed until the child is old enough to give consent. Everyone should be given the right to control what happens to their body, especially with respect to a part as intimate and personal as the genitalia.

Most of us are agreed that one of the basic requirements for a happy life is a sense of harmony between gender identity, functional sexual ability and reproduction. Unless experienced firsthand, one can only imagine being subjected to this traumatic, life-altering surgery with an outcome that is in most cases uncertain. Worst of all, this gender decision is made and executed without consent, or any form of input being given by the person it will affect the most. It almost seems like a violation of human rights, and I’m sure that many angry intersexuals would agree. Everyone should be given the opportunity to choose how he or she should live, and should not be forced into a life of psychological turmoil because of some clinical decision that was made on his or her behalf when they were to young to speak for themselves. Gender-assigning surgery should involve much more input from the children themselves, whether through voiced opinions or observation of actions. Too much uncertainty lies in performing early surgery on intersexual infants - not even people of the medical profession should have that much control over a young patient’s life.

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