ONTD Political

Medical Lawsuit: Stop Wrecking Babies' Genitals

11:24 am - 05/22/2013
A landmark legal case may finally put a stop to almost half a century of bizarre medical procedures in the United States, where children's genitals have been surgically altered to fit a standardized definition of the proper sizes for penises and clitorises.

South Carolina couple Mark and Pam Crawford adopted their son M.C. when he was 19 months old, after he had been the ward of the state for a few months. Before his adoption, M.C.'s doctors and social workers decided that the infant's penis was too small or ambiguous, and determined that the best course of action was plastic surgery that would make his genitals look female. There was absolutely no medical cause for the surgery. It was purely cosmetic. Now, M.C. is 8 years old and has told his parents that he wants to be a boy. But before he was able to make this decision, doctors had surgically altered him in a way that has already caused him grief and confusion.

The Crawfords are suing the South Carolina Department of Social Services, Greenville Hospital, and Medical University of South Carolina for gross negligence and medical malpractice. According to CNN:

The suit says the surgery violated the 14th Amendment, which says that no state shall "deprive any person of life, liberty, or property without due process of law."

The thing that's truly appalling about this case is that M.C.'s experiences are all too common.

According to many doctors during the twentieth century, a medically acceptable clitoris at birth measures .02 to .09 cm, while a medically acceptable penis at birth is 2.5 to 4.5 cm. But there are as many as 1 in 2,000 babies born every year whose genitals exist in that 1.0 to 2.4 cm gray area, or who have ambiguous testicles and labia. These babies are called intersexed. Their ambiguous genitals often result from the fact that clitorises and penises develop from the same tissues in the womb, as do labia and testicles. Plus, there is a lot of natural variation in size and shape anyway.

A note on terminology: Humans cannot be hermaphrodites, which are defined scientifically as animals that are capable of both impregnating and being impregnated.

When intersex babies are born, or when babies' genitals are injured, it has been common medical practice to treat these children as if they have a medical problem that needs fixing. But only a small number of intersex children have medical problems. Most are just slightly outside the range of the typical, no different from kids born with big noses or really short fingers. But in the mid-twentieth century, it became medical "common sense" that children would be traumatized by growing up with genitals that don't match the norm. As a result, girls with large clitorises were given clitoridectomies, and boys with small penises were given reconstructive surgery and raised as girls.

These days, the common sense is changing fast. Now, many doctors would tell parents of intersex children that the child will naturally choose a gender as they grow up (M.C., for example, seems to have chosen his before reaching the age of 8). Parents may choose a temporary gender for the child until he or she is old enough to choose. But mostly, the parents have to be patient and let the kid just be a kid without assigning them a "boy or girl" status — and certainly before giving them life-altering surgery. The Crawfords' lawsuit, if successful, will likely cement this treatment into standard medical practice.

These surgeries are an issue that intersex people have been dealing with for a long time. It has taken decades of activism to reach a point where parents were willing to sue medical professionals for altering their infants' genitals without any medical reason.

On Autostraddle, Claudia writes about why this case is important to intersex people:

Intersex isn't a medical condition . . . It's about bodies that have a combination of sex traits traditionally considered "male" or "female" in the same body. The clinical procedures in question are not those that track health or provide any sort of medical benefit for the child; the genital surgeries, (vaginal) dilation procedures, and other treatments that parents and clinicians give proxy consent to are cosmetic. They're performed to make their child's external genitals look "normal" (as though there is one way genitals should naturally look), to remove internal gonads kids assigned M/F "shouldn't" have, to sculpt intersex bodies into something that more closely approximates societal beauty standards as to what our most private of parts should look like.

This case is really important because it clearly argues that parents and doctors shouldn't get consent proxy to decide whether intersex children should have these cosmetic procedures. Since they're not medically relevant, only intersex persons themselves should decide what we want to do with our bodies.

You can read the tragic story of one boy who was given a sex-reassignment surgery at birth in the incredible book As Nature Made Him: The Boy Who Was Raised as a Girl. In the meantime, if you want to learn more about the lawsuit, you can go to the Advocates for Informed Choice website. They are a legal organization that advocates for intersex children.

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eveofrevolution 22nd-May-2013 03:27 pm (UTC)
I hate humanity sometimes. Good fucking grief.
chaya 22nd-May-2013 03:28 pm (UTC)
If you want to get even more pissed, go look at how many of the comments are like "this is a good time to bring up circumcision, too!"

No. No it's not.
nextdrinksonme TW suicide22nd-May-2013 03:34 pm (UTC)
I can't think of a level where this is not gross.

Seriously, why do we have a standard of 'normal' for genitals anyhow? And who's to say that the kid's bits won't grow or change as they do? What's wrong with a small penis or a large clit as long as it isn't causing the kid physical pain? Ugh. I can't even imagine the shame of knowing "the body you were born in was wrong so we decided to surgically change it to make it more normal" not even on top of the whole gender issue (seriously David Reimer (the boy who was raised as a girl mentioned at the end of the article) killed himself. That really should be enough to tell people that this is not a good idea to do to children).

the_physicist Re: TW suicide22nd-May-2013 03:49 pm (UTC)
There aren't really any statistics on the number of intersex individuals who commit suicide because of stuff like this or other problems faced from being intersex. Simply because no one is monitoring the situation. There are anecdotal accounts though.

One of the arguments for these surgeries was/is that if we aren't surgically altered to fit one idea of how a body should be, then we'll commit suicide later in life. Again. No statistics though.

Doctors don't decide based on evidence or science how to treat us intersex people. Only based on their bigoted feelings.

An intersex woman near where I grew up had her ovaries and uterus removed without her consent by a doctor when she was in for another surgery. Because that doctor saw an M on her documents and when poking around inside her found a female reproductive system. And they saying having an X gender category on birth certificates and passports is not important. Of course it's not. >_> *rage*
gambitia 22nd-May-2013 03:36 pm (UTC)
I truly don't understand the reasoning that "the kid will be traumatized by realizing their genitals are different from others!" Not a child psychologist, but...pretty sure they won't give a damn. And I bet the damage from being misassigned a gender is way worse than the "oh noes! I'm different!" realization that pretty much everyone has for one reason or another.

Good that this practice is being stopped.
the_physicist 22nd-May-2013 03:54 pm (UTC)
pretty sure they won't give a damn.

I gave quite a damn.

edit: but yes, the practice should be stopped. not in a way that doesn't let intersex people have free access to them later on in life though.

Edited at 2013-05-22 03:55 pm (UTC)
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chaya 22nd-May-2013 03:52 pm (UTC)
Lots of very young children have baths together, but nobody's yanking out a ruler and measuring their bath-buddy. There's no expectation to be exactly identical in that area when they already know they're not physically identical otherwise.
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bowling_otaku 22nd-May-2013 04:06 pm (UTC)
I don't understand why being born with a small penis somehow automatically means that a kid has to be raised as female. WTF. This is horrible shit. And who's to say they might not grow into their parts later? And even if they don't, they should be allowed to decide what to do with thier own genitals/gender idenity themselves when they're old enough to know what's what. These are tiny babies that can't even defend themselves. :/
muizenstaartje 22nd-May-2013 04:29 pm (UTC)
I was wondering the same thing. I was taught that penis size doesn't have to say much, because there are "growers" and "showers". The message "Your penis is not big enough for you to be a man. Enjoy your artifical vulva and vagina." is messed up.
From what I read somewhere else about turning baby boys into girls, the criteria for a "sucessfully created vagina" is "does a penis fit?" and not how does it feel or level of sexual pleasure for the patient.
poetic_pixie_13 22nd-May-2013 05:17 pm (UTC)
Thank fucking god.

I hope this starts in Canada, too. I might be remembering this incorrectly (I kind of hope I am) but I believe that there are anti-FGM laws that make it illegal to take your child out of the country for gential reconstructive surguries. Unless your kid is intersex. It's just so disgusting.
the_physicist FGM22nd-May-2013 05:41 pm (UTC)
If they are applied like the ones in the UK, then the Canadian FGM laws probably do fuck all good anyway though -_- . In the UK the stats are:

"The research, which used the 2001 census, found there were at least 66,000 women with FGM estimated to be living in England and Wales.

It identified around 21,000 girls aged eight or younger at high risk of FGM. It also found that more than 11,000 girls aged nine or over had a high probability of already having suffered FGM." ( http://www.guardian.co.uk/society/2013/may/08/female-genital-mutilation-death-intimidation )

For intersex I don't think there are any laws that you can't taken a child out of the country to have the operation though in the UK. The UK is apparently one of the better places currently to be born intersex now I hear.


"British doctors are becoming “world pioneers” in treating children and adults who are born with ambiguous genitals, it has been reported.

According to The Times, the NHS is the first health service in the world to begin treating intersex babies on the assumption that they should not automatically be operated on.

For years, medical opinion has held that it is best to attempt to assign gender at birth where a child is born with an unclear sex. This often led to surgery and distressing results once the child reaches adulthood. [...]"

it's a really new concept not to mess with intersex people. But it not being NHS current practice doesn't make it illegal. that's a different issue.
42months 22nd-May-2013 05:31 pm (UTC)
So... something about all this really confuses me. Sorry if this is a really stupid question, but I didn't realize genitalia is the only thing that determines gender... What about other, er, female traits? What about other traits that only men have? Like let's say there's a child who had genitalia in the grey area, so the doctor decided to assign the child to be a girl... what about the rest of like, being a girl? Will that necessarily develop later on?

I'm not sure if I'm making any sense. Does anyone else understand my confusion? Help?

Edit: Like, how can the doctor be sure that everything else will develop normally later on?

Edited at 2013-05-22 05:34 pm (UTC)
chaya 22nd-May-2013 05:35 pm (UTC)
Are you talking about breasts or hormones? Both will develop (or not develop) as they would have, surgery or not.

edit: actually, if you remove the child's penis you're presumably removing testes as well...? That could have future effects.

Edited at 2013-05-22 05:37 pm (UTC)
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ginger_maya 22nd-May-2013 05:32 pm (UTC)
I was hoping the mutilation of intersex infants is a practice that has slowly been tapering off, but apparently I was wrong. There is absolutely no justification for this. NONE. Once they grow up it'd be up to them, as informed, consenting adults, to decide whether or not they want any sort of surgical interference. But to do it to babies who can't tell you NO is just vile, sick and unspeakably cruel. There should be a law banning this, for crying out loud, it's 2013, not 1013.
cher_arlequin 22nd-May-2013 06:57 pm (UTC)
Well, it's about time. The criteria they use to figure out what "counts" as a penis or clitoris are a lot of arbitrary nonsense, anyway. An "acceptable" penis is "2.5 to 4.5 cm"...please. Just because a lot of alarmist doctors decided at one time that that was "the standard" doesn't make it true.
betray802 23rd-May-2013 03:06 am (UTC)
Goes back to the joke about why women have so much trouble parallel parking. We've been lied to all our lives about what eight inches is.
johnjie 22nd-May-2013 08:39 pm (UTC)
The mutilation of intersex infants is absolutely unacceptable - 'corrective' surgery, if has to happen AT ALL, should at least wait at least until the person in question can articulate exactly what they feel about their gender and what they want done about it, whether that be nothing or hormones or something else.
sio 22nd-May-2013 08:41 pm (UTC)
aside from the disgust at mutilating these poor little babies, i'm baffled. do these doctors think that boy babies' penises won't GROW as they get older? of COURSE they're going to have a tiny one when they're born--they're NEWBORN.
the_physicist 22nd-May-2013 10:10 pm (UTC)
it's really the issues of intersex babies' genitals and reproductive organs. they wouldn't be labelled as such if they fit the check boxes on the F and M forms. so we are talking things like tinier 'penises' (often without urethra grown into them, so then they can't call them penis in medical terminology) and a vagina being present at the same time. testicles might be there, but not descended or there might be ovotestes. like, just as an example. so in that case they might sow up the vagina or they might perform a cliterodectomy. if they decide the baby will grow up to be a woman, their idea is that men don't want to see something scary that resembles a small penis down there. that might make the men feel uncomfortable and the woman won't want such a big clit because of that. and having one might turn her lesbian. literally, i'm not kidding you, these are actual, official arguments for these procedures and why they are necessary.
romp 22nd-May-2013 10:08 pm (UTC)
I understand more and more doctors are educated about this but I'm not surprised this had to go to court to be enforced.

Do people here bring this up with expectant parents? I know it's probably considered odd but there's a real chance their child may be intersexed at birth and they have to be ready to stand up to doctors who want to cut.
the_physicist 22nd-May-2013 10:13 pm (UTC)
doctors might be more and more educated, but there's no laws or rules against any of this, so if parents want their kids operated on... the babies still have no protection.
kittenmommy 22nd-May-2013 11:29 pm (UTC)

But mostly, the parents have to be patient and let the kid just be a kid without assigning them a "boy or girl" status — and certainly before giving them life-altering surgery. The Crawfords' lawsuit, if successful, will likely cement this treatment into standard medical practice.

I hope they win. God, I can't even.
tabaqui 23rd-May-2013 01:00 am (UTC)
This is about the most sick, fucked-up thing i've ever heard. I cannot, as a parent, *imagine* for one second giving consent for this. Hell fucking no.
the_physicist 23rd-May-2013 03:52 am (UTC)
It's very hard I think for parents to go against what doctors say. Take into account also that parents aren't always given the correct information to make an informed choice on the issue. There are also cases where the parents aren't told at all!

And let's not forget the medication pregnant women are given to prevent intersex genital appearance - I say appearance because those drugs don't prevent the actual health issues associated with that intersex condition, only the external masculinisation of the fetid is prevented. These drugs have large side effects, masculinisation only has the side effect to make someone have ambiguous genitals, which is not a health risk.
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ebay313 23rd-May-2013 02:03 am (UTC)
I hope they win their lawsuit and this sort of thing stops.
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