A Child’s Right to Choose: Intersex Dilemmas and Consent

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A construction sign pointing left and right

Last week I talked about consent in the context of sex. This week I want to take a closer look at consent and see the environments where consent operates, outside of sex. One of those environments is for individuals that are intersex. According to the Intersex Society of North America (ISNA), “‘Intersex’ is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy that doesn’t seem to fit the typical definitions of female or male.” As ISNA expands their definition, they emphasize that the term “Intersex” is a “socially-constructed” category that comes from our society’s ideas about gender and sex and what it means to be normal.

 

In these two videos (Part One and Part Two) Eden Atwood explains her intersex journey. While every person experiences being intersex differently, it is important to point out that many individuals have had similar experiences as her when it comes to the lies that she was told and the shame that she felt for a long time.

When a child is conceived, they are randomly assigned sex chromosomes from both of their parents; usually, they either have XX or XY. XX chromosomes typically produce a female infant and XY chromosomes typically produces a male infant, but not every time. Despite what we like to think, a person’s sex and gender isn’t black and white and is influenced by multiple factors such as their chromosomes, sex hormones both prenatally and during puberty, their internal genitals, external genitals, brain structures, assigned gender, and gender identity. The sex chromosomes tell the gonads to begin differentiation around week seven of conception, either producing testes or ovaries. These organs then begin producing hormones to continue the sex differentiation process, creating internal organs and external genitalia as well as making changes in the brain. This process will take about 12 weeks, but after that the differentiation is complete and the child develops further in the womb.

Sometimes over the course of sexual differentiation, there are contradictions between the factors of sex and gender that I described above. This is what leads to a person being intersex. One of the most common intersex syndromes is congenital adrenal hyperplasia (CAH). While an infant with CAH develops, they have XX chromosomes, which means ovaries are developed, but they produce an excess amount of androgens (male sex hormones like testosterone) which results in the creation of genitals that are male in appearance. Usually, these infants will have an assigned gender of male (even though they have female sex chromosomes and ovaries) but a gender identity of female. The other most common intersex syndrome is androgen-insensitivity syndrome (AIS). In this condition, an embryo with male chromosomes and testes that produce normal levels of testosterone develops female genitalia because their body fails to recognize testosterone. Individuals with this syndrome typically have the assigned gender of female (even though they have male chromosomes and testes) and they have a gender identity of female.

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A ruler used to measure an infant’s genitalia to determine if they are a boy or a girl

So what does this have to do with consent? Many infants who are intersex are born with ambiguous genitals, for example a penis that is shorter than normal or a clitoris that is longer than normal, as determined by the Phall-O-Meter. Cheryl Chase was born with a clitoris that was approximately .67 inches long, or about .3 inches longer than the average clitoris, but about .3 inches shorter than a small penis. Her parents, after consulting the doctor, decided to put Cheryl through surgery to shorten her clitoris. Now, as an adult, Cheryl is outraged at what she feels was a mutilation of her body and she is unable to orgasm. This raises a question: Do parents have the right to make permanent changes to their child’s body without their consent? In their decision, Cheryl’s parents were hoping to give their daughter a normal body so that she could have a normal life. But, the repercussions of that decision are unalterable and they will last for the rest of Cheryl’s life. This is just one example of a phenomenon that has lasted decades, affecting many people’s lives.

This surgery doesn’t have to be performed when the individual is an infant or a child. Instead, parents can allow their child to grow up and choose where on the gender spectrum they want to identify themselves, and then decide what changes, if any, they want to make to their body. I would argue that it would be better to let the person make the decision for themselves because it is so catastrophic when their parents or doctors make the wrong decision. Not only that, but I firmly believe that everyone should have a right to decide what happens to their body, no matter what. That is what consent is about. 

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