My Position on FGM at Cornell University & Intersex Surgery
The blogosphere is littered with posts about female genital mutilation happening today, right now at Cornell University with boingboing's Female Genital Mutilation at Cornell? It's Complicated leading the charge. This is my official position on intersex surgery and why we must rescue our sex organs from religion, unnecessary medical procedures and institutionalized heterosexuality.
1 in every 2000 babies will be born with ambiguous genitals - 1 in every 2000 babies will be born with red hair. If you've ever met someone with red hair, you've met someone who is intersex.
Dr. Poppas, a pediatric urologist at Cornell University, recently published research dealing with his new technique for modifying the oversized clitorises of baby girls. For these girls- and other children born with a variety of intersex conditions- genital surgery in infancy is standard practice.
The only thing that makes Poppas different is his new technique to preserve sexual sensation later on in life.
He checks to see if the clitoral nerve endings still function by using a vibrating device- a legitimate concern in developing this type of surgery. I believe this seemed scandalous because most people don't know the difference between a vibrator (for the clitoris) and a dildo (for vaginal penetration). Most folks can't imagine testing the female genitals without plunging inside a vagina of a helpless infant. Unfortunately, far too many Americans are unconsciously into kiddy porn i.e., Toddlers and Tiaras. He is simply testing to see if the nerve endings respond by touching the clitoris.
I am already on record when I state that FGM (female genital mutilation) and MGM (male genital mutilation of circumcision) and DSD (disorder of sex development) that leads to any kind of genital surgery must stop- now! That's it, finished! Until a child reaches the age of consent, no religion, doctor or parent has the right to alter any child's sex organ for any reason whatsoever. Period! Added to my list is PGM (psychological genital mutilation) and FSD (female sexual dysfunction). The last two are the result of withholding information that the clitoris is a woman's primary sex organ for pleasure. Not the vagina, nor the G-spot or any other area inside the birth canal. Unless a man has a sizeable penis that can reach the pudendal nerve with deep thrusting and the stamina to continue doing it for at least twenty or more minuets, all other forms of vaginal stimulation can be seen as a secondary form of female sexual arousal. This is my personal experience and professional assessment after forty years of observing and teaching women how to have orgasms.
In the early nineties I had my first intersexed client who hoped I could help her to achieve some kind of sexual feelings. Cheryl Chase had a tragic story. Her over-sized clitoris was surgically removed when she was an infant. As a result, she had never felt any sexual pleasure nor had she ever had an orgasm. Once the internal clitoris is considered, there is more than the glans that is visible at the end of the clitoral shaft covered by a protective hood similar to a man's foreskin. At first, I thought an electric vibrator might stimulate the remaining stem, bulbs and legs of the internal clitoris. Especially if we added vaginal penetration, pelvic floor muscle action with conscious breathing and hip thrusting. Unfortunately, nothing we tried worked.
Cheryl's anger was palpable as it sat just under the surface of her entire being. She was also very bright with a logical mind and impressive schooling. I told her I could identify with her anger and frustration because I felt the same way about women trying to have vaginal orgasms during intercourse with a partner. When we failed, and most of us do, we blamed ourselves for not being able to succeed with the male sexual model of penis/vagina penetration without any direct clitoral stimulation. Sorry, but foreplay just doesn't get it unless manual or oral sex continues all the way through to orgasm. I urged Cheryl to turn her anger into action which is what I had done. It was the best answer for those of us who felt very strongly about any issue dealing with women. Otherwise we might self-destruct if our anger ever got turned inward.
Several yeas later, I was invited to a fund raiser for ISNA, the Intersex Society of North America. Cheryl was the founder. I congratulated her on her success in putting her cause before the public. I had not gotten very far with my masturbation crusade and re-instating the clitoris. After giving her organization my financial and moral support, I asked to be removed from their donor list as I had my own work to do. Until I read the boingboing article, I'd lost track of Cheryl and ISNA that had since closed its doors. For the past week, I've been all over the Internet devouring the available information dealing with intersex which has been extensive. One of the most informative resources was the NY Times article published in 2007 about Cheryl and ISNA.
Next, I discovered OII (Organization International of Intersexuals) with Curtis Hinkel as their founder. The members of OII as well as other intersexed people reject the idea that their sex is a disorder. Intersex is simply a fact of life. The traditional idea that every child must be assigned a gender as soon as possible after birth is at the heart of the controversy. This is done by doctors examining the baby's genes, hormones, genitalia, internal organs (via ultrasound), electrolytes, gonads and urine. The doctors then make their best guess as to whether that child will want to live his or her adult life as a man or a woman. According to Curtis, the first harm done to many intersexed infants is assigning a gender. Yet the same specialists claim there is no clear understanding of how a child develops a "gender identity." The problem is when the intersexed child's identity of male or female is not determined by the child as they mature. Most kids demonstrate their gender preference by the age of two or three.
Once "female" was on my birth certificate, I believe there is a similarity to the societal consensus for the "appropriate behavior" that was supposed to match my gender identity. I was expected to embrace a heterosexual marriage and have a family. During sexual intercourse I was to remain passive and faithful to one male partner. After making my best effort to "fit in" which included my monumental struggle to have vaginal orgasms from position "A" intercourse, I failed miserably. Following a miscarriage and suffering terrible guilt for feeling eternally grateful I'd lost the pregnancy, my nearly sexless seven year marriage finally ended in divorce. Meanwhile I'd become a compulsive guilt-ridden marital masturbator. By 1965, I began questioning the female "sex role" that has since been renamed "gender identity" just to complicate matters. My childhood dream was to be an artist, not a wife and mother and I was determined to follow my dream.
During America's freedom of the sixties counterculture, we had Unisex styles in clothing, men let their hair grow longer and women wore jeans and cut their hair shorter. When I went through my "androgynous phase", I allowed myself access to both male and female sex roles or "gender identity." Like a man, I too could be a bachelor with multiple lovers and determine what we did sexually during partner sex. As a painter of erotic art, I embraced sex parties and shared orgasms with both men and women. Feminists demanded I make up my mind to be either straight or gay so I became a "heterosexual-bisexual-lesbian." Later on I had to add group masturbation as a professional dominatrix to my list of sexual preferences due to the masturbation workshops I ran.
My life was a blank canvas on which I could paint any picture. I did not have to follow anyone's rules but my own so I could let my imagination and creativity flow. On my 44th birthday, I took my androgyny all the way: I shaved my head and kept a buzz cut for several years and passed as a little guy. Cross dressing allowed me to experience the difference in how men and women were treated in society. In restaurants and stores I got better service as a man. I was given more space in social gatherings instead of having some guy get in my face. Random men stopped hitting on me and the cat calls disappeared. When someone wasn't sure of my gender, most freaked out but a few were intrigued- they were always the most interesting. One time an indignant matriarch asked, "Are you a boy or a girl?" With a big grin on my face I answered "both."
This period of enjoying male privileges ended when I became exhausted from always being in control of everything! Was there no middle ground between passive femininity and assertive masculinity? Was it AIDS and Reagan's Moral Majority of the eighties when everyone became obsessed with appropriate behavior and reverted back to the fifties when we all knew our proper place in society? Rosie the Riveter was pregnant and barefoot in the kitchen while Daddy was the primary wage earner! I grew up in the forties and my mother had to work to make ends meet. Today it's taken for granted that both parents work while wives have most of the parenting and housework to juggle job or career. I naively believed the women's movement would open up more options beyond enforced heterosexuality with it's phony monogamy that's primarily practiced by women. All we got was Ms. instead of Mrs. and "serial monogamy" was added to our list of sexual options. A big snore!
The problem that exists within the Intersex community is what many women and men suffer today if we don't fit into societies limited two party system of appropriate sexual behavior. We are all under house arrest of institutionalized heterosexuality that fundamental religions insist upon. The cultural wars in today's political agendas all stem from an enforced binary system of male/female, single/married, straight/gay. It even took gays forever to include bisexuals who are still often seen as unable to make up our minds. Transsexuals only recently made the GLBT list, but Intersexuals are still left out. Gays and lesbians continue to fight for inclusion, for the right to marry, to adopt children and serve in the military. This is also why heterosexual women who step outside of serial monogamy are stigmatized as "sluts" or "whores." This is why sex work is illegal in spite of the fact that it has been part of society before the beginning of recorded history. This is why I say it's organized religions that have to go so people can be free to make their own individual choices.
One of the most telling incidents in Cheryl's story was her mother's response to questions she was asked by her daughter many years later. Her devout Catholic mother admitted she had never actually seen her own sex organ and had never experienced an orgasm. Basically her mother had no idea what a "clitoris" was or that it had anything to do with sexual pleasure and orgasms because both had eluded her. So when the doctor advised the removal of an enlarged clitoris, she gave her ignorant consent. It's similar to a mother who gives a doctor permission to remove her baby boy's foreskin so he will look like his circumcised father. She too has no information that the foreskin contains sensitive and responsive tissue important to the sexual pleasures of both the male and female. My few vaginal orgasms were with intact men, but that's another story.
All of this is surgery is done just so they can choose the sex that corresponds to the "gender identity" that's been assigned so they can put it on he birth certificate and all other documents. It seems the world would come to an end if the sex on the birth certificate read "Intersex."
Following the boingboing article about Dr. Poppas at Cornell, there were many comments. The most insightful one came from an intersexed person speaking from experience. Here comes first person sharing that I trust far more than academic theories although I've fallen prey to many including some I've made up myself. Here is an excerpt:
"Surgically altering the genitalia of an intersex infant is NOT usually medically necessary. But is in-fact, a cosmetic procedure dictated by social rules that change from culture to culture and era to era. There is NO research that demonstrates children brought up with ambiguous genitalia suffer psychologically in later life. There is however, evidence that reveals many of those who have undergone surgery do experience negative medical and psychological consequences. Apart from the fact that any surgery on an infant is a non consensual procedure, we as a society must make sure that the reasons for any surgery are truly medically necessary rather than based on ignorance and prejudice. I approach this from both sides of the fence - I was born with an intersex condition, was surgically 'modified' and have suffered both physically and psychologically all my life.
I am also a professional who has worked with intersex children. Not only did the surgery alter my genitalia, but it also converted my genetically determined sex and subsequent gender role to one with which I could not identify. I had to fight to reclaim the right to live my life commensurate with my gender identity. What the surgery does not do is change the brain and if a child's brain is already hard wired to follow the gender identity opposite to the altered body they are forced to grow up with, the trauma is often too much for many to bear.
The solution is simple- hold back from surgery other than in cases where there is a clear medical need such as a deformed urethra, but consider carefully what gender role to assign to the child. By the age of two or three years most children will start to express their gender identity anyway. When the child is old enough to make informed decisions for themselves, possibly aided by parents, counselors and other intersex people who can offer advice based upon experiences, surgery can be considered. My own training showed me that the human phallus (clitoris or penis) comes in many shapes and sizes, so who can say what is 'normal'?"
While medical professionals claim it's better for the child's mental health with no proof offered, our intersexed counselor made it clear that it was the parents who were the problem, not the child. In the name of giving their child a "better life" their real reasons were "What will the neighbors, family or friends think?" The most telling one was that they'd already painted the nursery.
We must get beyond the limitations of the entire binary system of good and evil, black and white, republican or democrat, straight or gay, vaginal or clitoral orgasms and boy or girl including the compulsive pink and blue color coding that goes with that. On the other side of these limited categories based on conformity that does not exist in nature, we will find blessed diversity. Then personal choice and sexual freedom will naturally follow. Who knows?
Maybe America will stop declaring war on third world countries once sexual pleasure enters the lives of the people in congress- no matter the shape or size of their sex organ or the sexual preference each person pretends to be a married monogamous heterosexual spouse with at least one child. It's such a charade. As my colleague Dr. Mickey Diamond who specializes in transgendered issues said, "Nature loves diversity, society hates it." People hate because they are afraid. Conformity is for those people who are basically uninformed and sexually repressed. They need our compassion and all the help we can give them.