we had the most powerful lecture today by Janet Green, an intersex woman, patient advocate and rockin' activist working with the accord alliance (http://www.accordalliance.org). she spent 2 hours with us sharing her story of multiple surgeries in infancy and childhood trying to sculpt her body, her clitoris, to match an acceptably "female" size and shape. she spoke of her years of secrecy, shame, confusion, and multiple doctors and residents peering between her legs to see how she was different. she held our attention unlike any of our normal lecturers and moved many of us to tears. she is powerful! and she shared with us her story so that we could be powerful and make different choices than her doctors did. so that we could treat our patients and our patient's bodies differently than her doctors did. we are a part of the system that fucked with her body in terrible ways but she stood before us with hope, with expectation that we are a new generation of healthcare practitioners that will think about gender and gendered bodies more openly.
the current pediatric guidelines still suggest performing surgery on infants with congenital sex disorders (the term that the accord alliance coined to replace intersex, but which made many of us uncomfortable in class. does it really need to be called a disorder, implying a need to be "fixed" or "cured"?) the united states condemns female genital mutilation in every country but our own. essentially, this is what is being done on infants whose genitals don't fit into a box stamped "male" or "female". In most cases there is no medical reason to perform surgery - it is purely cosmetic. cosmetic to make the parents comfortable and make the doctors comfortable. cosmetic surgery without the consent of the person whose body is being altered, whose sensitive nerves cut (and sexual function impaired), and who may identify with a different gender than that surgically assigned.
janet asked us to ask questions, to break the silence about this issue, to question our attending doctors. she asked us to think about our patients and leave openness for a wide range of bodies. usually cutting body parts off is not the best solution. i had never really thought about the power the medical community has in defining "normal" sex and gender. how will parents' choices about their child's health differ when the doctor delivers a baby and says "congratulations, you have a healthy baby! we are not sure yet what their sex is, but many babies are born like this and we will figure it out with time" vs. responding with fear, alarm, quickly taking a child away to protect the parents from the shock, and suggesting immediate surgery? Clearly, very differently. what if we regarded the size of babies' clitoris' or penis' as along a spectrum of normal as we do with nose shape or finger length? and if that person wants to have surgery later in life to align their body more closely with their gender identity, they can do that. or perhaps we regard undifferentiated genitals as a disorder, but a disorder can that be dealt with with time, not prematurely sliced into. the child is unique, but healthy. and most importantly, the child is lovable, exactly as they are.
this was what stuck with me the most from janet's talk: model to your patients that every person and every body is lovable as it is. no matter how it looks. the key to achieving health --> being raised with love and acceptance. don't chop it if you don't have to.
i love my classmates. love them for asking such good questions, for pushing the gender binary, and for being so loving. we gave janet a long standing ovation. she was crying. we were crying. we could all feel the love.
