5 Assignment 03

Suzanne Kessler, in her essay ” The Medical Construction of Gender, describes how the condition of intersexuality is handled from a medical and cultural standpoint. She provides many examples of how doctors and parents of intersex children go about dealing with children that are intersex. The main point of her text seems to be that in order for doctors and parents of intersex children to deal with an intersex child, a gender must be determined whether or not at a later time the assigned gender would not make sense. She finds this to be a problem because the concept of changing the genitals of a child to what sex a person deems the child to be  goes against her belief that there can only be two concrete genders. Doctors have several protocols when it comes to dealing with intersex children. Kessler describes the complications of how certain sets of chromosomes can affect surgery that is undergone to make a child the gender they are seen as. When children are born with XX chromosomes, surgery can be preformed almost immediately to reduce the phallus size. In cases of XY chromosomes the process of reassignment is much more complicated. These cases require tests to be taken, for example if the child can produce testosterone and whether the phallus can respond to testosterone. Results from these tests can come back negative and the child cannot be seen as officially male. When parents have intersex children, determining the gender of the child can be a major factor in coming times. A common problem with solidifying the sex of an intersex child is described by one of the doctors Kessler interviewed. They explain that when an obstetrician is inexperienced it can lead to miss-gendering children and affect how that child is raised once the parents are told the gender of the child. Parents will commonly go about naming and raising the child as if they are a certain gender far before any conclusive results are made on the official gender of the child. These examples of handling cases of intersex children may be the most important factor as to how the child is dealt with later in their life. At the time of adolescence the child may not go through normal puberty for a girl or boy of their gender which could easily lead to the child having an identity crises. This would no doubt require counseling for the child. Kessler recounts that in order to avoid this physicians would have to lie to the child which in its own way may be the correct thing to do.

In Suzanne Kessler’s essay, “The Medical Construction of Gender,” inter sexuality is described to be when a baby is born with genitals that aren’t specifically male or female. Members of medical teams have practices when it comes to managing this issue. Such as announcing the babies gender during delivery, discussions with the parents after the baby is born, and discussions with the patient during its teenage years is only apart of the outside of the medical issues. It relies on the cultural comprehension of gender it self. According to the article their are different categories for this deformation, for example the “true inter-sexed” is where ovarian and testicular tissue are present in the same or opposite gonad, or if the infant has two ovaries/testes, this goes by female or male   pseudohermaphroditism.

Physicians understand inter-sexuality in 3 different concepts. One would be how it is surgically taken care of , some smaller male genitals that may not be clearly recognizable could be enlarged, or a female’s genitals could be constructed to be different in appearance from normal ones. As well as gender identity, physicians believe in order for this perception of belonging to the female or male category to happen successfully that gender must be assigned as early as possible, between 18 months and no later than 2 years of age. Experts must be sure that parents don’t have any doubts about whether their child is female or male, gender hormones must be given during puberty, and patient should eventually become informed about this situation during appropriate timing, therefore the child will not question his or her identity later on. Physicians also inform parents not to identify the child’s gender until it has been specifically allocated. Different methods to handle this situation are also given to the parents of these intersex children, physicians give parents ways to deal with other people who might not exactly understand the situation, “Why dont you just tell them that the baby is having problems and as soon as the problems are resolved we’ll get back to you” ( Kessler, 13). Or until the problem is resolved choose not to speak about it to others has been suggested. These are some factors that impact the way physicians, parents, and patients understand and manage the medical condition as inter-sexuality.

Intersexuality is a condition where an individual is born with both male and female features such as reproductive organs or indistinguishable genitals. Throughout the course of history and presently many children have been diagnosed as being intersexed. As society and technology have evolved our understanding of intersexuality has been broadened. Many physicians, patients, and parents of intersexed children similarly understand what intersexuality is and how an individual can develop this condition. Both understand intersexuality as a fetus that goes through development just like any other fetus but with one discrepancy. A fetus can begin to go through intersexuality when it’s reproductive systems do not mature properly or irregularly. In some cases, a child is born with genitalia that resembles neither male of female genitals and in other cases a child can develop both male and female reproductive organs.

As the medical field has evolved there have been many developments in the surgical techniques and in the field of endocrinology. Much of the knowledge on how to deal with intersexuality cases both surgically and psychologically was given to the field by John Money, J.G. Hampson, and J.L. Hampson (Kessler, 1990). Physicians are more knowledgeable on what intersexuality is and how to assist children born with this condition. Presently intersexuality is corrected by physicians through surgery where they determine the sex of the child and perform alterations to make their reproductive organs match their determined sex. Many tests like cytologic screening, chromosomal analysis, assessing serum electrolytes, the evaluation of hormones, steroids, and gonadotropin, and radiographic genitography are used to help physicians better identify which gender an intersexed child is (Kessler, 1990). The medical advancements have granted doctors the ability to construct immature genitalia into fully developed male or female genitalia that greatly resembles natural ones.

The medical field has gone through many advancements in surgical techniques, technology, and in the field of endocrinology. Two factors that have greatly influenced its growth are society itself and the theories of John Money, J.G. Hampson, and J.L. Hampson (Kessler, 1990). It is believed by many that there are only two genders in the world; male or female. This belief has influenced both physicians and parents to deal with intersexed children with haste. Both society and the theorists have put a great pressure on these people to determine a child’s sex and immediately operate. Following surgery, parents are to begin raising the child with social interactions that reinforce their gender upon them. It is believed by many that the sooner you resolve the “issue” of intersexuality, the sooner a child can understand what gender they are. They will learn how people who are that gender are to conduct themselves and act accordingly. These influences have resulted in people interpreting intersexuality as abnormal and as a condition that needs to be corrected. Most importantly, society has impacted physicians, leading them to impose their assumptions regarding gender on their patients.

Kessler, S. J. (1990). The Medical Construction of Gender: Case management of Intersexed         Infants. The University of Chicago Press, 3-26.

At birth, infants are given certain guidelines on how they should be raised based on genitalia. They are given either a pink or blue cap, and this cap comes with certain rules that the parents follow in order to give them a “normal” childhood; but what happens when a child is born with ambiguous genitalia? Intersexuality is something that is often ignored by society, and is considered a deformity.
The fact that intersexuality is considered a deformity that must be corrected in order to live a normal life is perpetrated by doctors. These medical professionals believe that they must fix this supposed problem for the parents to raise the child in the proper environment, and the basis for correcting this is not based in biology. Much like the issue of sexism being backed up by science, the cultural construction of gender is being supported by these doctors that say that a child must live as either a male or a female. It is proven that the majority of the time the condition of intersexuality is not life-threatening, but it is practically treated like it is by these doctors, because they want to place them into a box of either female or male.
When a child is intersex, surgery to fix the appearance of their genitals is often performed. A basis for whether or not the doctor assigns this child as either male or female is the child’s penis size. Because of society’s definition of masculinity involves having an average penis, children who are born intersex who have an abnormally small penis are often given hormone treatment first to see if there is a response. If there is no response, the doctor then decides that the child will be a female and gives the child reconstructive surgery, because they believe that the child could not live their life as a normal male with a smaller than average penis. More emphasis is given on making the child into a male, which shows a desire for more male children rather than female by the doctors. A significant factor that contributes to whether or not the child is “fixed” of their intersexuality is how their genitals perform sexually when they are adults; if the male’s penis can satisfy a woman, and that an originally intersex female’s vagina can receive a penis. This not only has implications on the gender roles of masculinity and femininity, but it also implies that being straight is the societal norm.
Doctors treat intersexuality as a deformity that needs to be corrected, and they place this belief on the parents as well. They desire to fix the child’s genitals as soon as possible, to ensure the child grows up without being psychologically damaged from this experience. Doctors often discourage parents from raising their child as either gender when they are unsure, so that when the child is assigned a final gender, their gender identity matches with their sex. Although it is important that these doctors recognize the difference between gender identity and sex, they imply that something is completely wrong when children’s identity and sex do not match up.

Due Monday, February 20th, by midnight. Word count: 300 words. Please make sure everything is in your own words. Absolutely no quotes should be used. If you paraphrase from the text (from Kessler’s work or anywhere else), you must be sure to include the proper citation (either MLA or APA).

In Suzanne Kessler’s essay, “The Medical Construction of Gender,” she claims that cases of intersexuality point to a lack of imagination on the part of physicians and Western society: a failure to understand how each of the “management decisions” described constitute a moment when “biological sex” is transformed into a “culturally constructed gender” (1990:26). Drawing on the examples in Kessler’s work, describe the factors that impact the way physicians, parents, and patients understand and / or manage the medical condition referred to as intersexuality.