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Assignment 03

In order to understand how physicians, parents, and patients manage the medical condition called intersexuality, Kessler conducted several interviews with medical experts who deal directly with pediatric intersexuality. All of these physicians agreed that the way in which they manage cases of intersexed children generally comes from theories on gender from John Money and Anke Ehrhardt which state that “gender and children are malleable; psychology and medicine are the tools used to transform them” (8). Doctors believe that the decision on whether a newborn’s gender is male or female must be made as soon as possible. They base their decisions off of chromosomal makeup (or biology), whether or not the genitals will be able to grow to perform adequately and whether or not hormones can help match their gender identities. However, Kessler notes that these physicians fail to imagine a culture that could possibly have more than two genders, and that their decisions are influenced by both medicine and societal factors.

Parents have a certain amount of expectations on sex and gender when their baby is born which translates to pressure on physicians. However, with intersexed cases, physicians have to be very careful as to what they say to parents. Educating the parents on the intricacies of intersexuality and making sure they understand the reasons why their child was born with incomplete genitalia is crucial. Doctors stress that they are not choosing the child’s gender, but are merely completing their sexuality by “reconstructing” their sex organs and genitalia. Interestingly, doctors also inform the parents that “social factors are more important in gender development than biological ones” (16). In other words, as soon as parents are told what sex their child is, it is up to them to raise their intersexed child as male or female according to societal norms.

While Kessler does not speak much about the patient’s point of view (presumably because she focuses on infants), she does give examples of how an intersexed patient may feel based on discourse with the experts. They seem to think that having “normal-looking” genitals is important when dealing with gender identity. It made me think of the phrase “if it looks like a duck, swims like a duck and quacks like a duck, then it is a duck”. Doctors would argue that if a once-intersexed male teenager has a “normal” sized, functioning penis after puberty, it is likely he will “feel” like his gender, even if he has had to take testosterone his whole life in order to make this possible.