Body Image / intersex / Penis Size

Neither Innie nor Outie?

ya'll ever heard of hermaphrodites?

ya

This classic column originally appeared at the barbershop notebooks where Sex with Timaree runs every Monday.

Question to the Sexpert: 

“My sister and her husband just had a baby and the doctors are saying it’s intersex. My brother-in-law is freaking out and wants the doctors to do a surgery on the baby (whom they have yet to name). The doctor says they used to do surgeries to fix this all the time but that there is really no need. But how will the kid be raised? Won’t the other kids be really mean? Shouldn’t they fix it if they can?”

You and your brother-in-law are certainly not alone in your perception. You have yourself a baby, you are told it has some diagnosis but that, “it’s cool though; no worries, mate.” Clearly if a baby gets labeled with some random word describing a condition that will differentiate it from all other kiddos for the rest of its days, you want to do all you can to give it a chance at a “normal” life.

Actually, you should consider your family lucky for coming across a doctor with such a progressive perspective on intersexuality, the state of having genitalia, chromosomes or other secondary sex characteristics that don’t make it exclusively male or female. There are a number of types of intersexuality, which is sometimes generally called hermaphrodism or disorders of sexual development, resulting in a variety of possible combinations of chromosomes, external characteristics and internal organs.

It is estimated that somewhere around 1% of live births are intersex in some way. Weirdly enough, a fair percentage of people with some sort of sexual development disorder don’t know about it because their bodies look relatively “normal.” It’s just that their chromosomes or internal goodies are inconsistent with the outside bits.

For many years (and to a great extent still to this day) the opinion of the western medical community was that any ambiguous genitalia were to be, using your words, “fixed.” The doctors thought that the children would be confused or unable to function in society if they did not have a specific, clearly delineated gender and genitals that looked like everybody else’s.

Generally the decision was based on the length of the penis/clitoris. As is the rule with all genital modification surgeries, it’s easier to make a hole than a pole. Operating as though females are just castrated males, doctors would remove the micropenis and suggest the parents go get a bunch of pink frilly dresses and never speak of the whole sordid thing ever again.

Unfortunately, as you might imagine, not having the pleasant little bundle of nerves that forms either the glans of the penis or the clitoris (they’re the same tissue basically, since we all start out identical) can be a real buzzkill for the ole’ sex life. It’s tantamount to what happens during female genital mutilation. On top of that, these kids were growing up feeling all out of sorts about themselves, since in our society gender= identity. They’d think to themselves, “I’ve got these parts but I don’t feel like I’m supposed to at all.” Many ironically went on to have sexual reassignment surgery to make the outside better match the inside.

So here are some considerations about this surgery on your little relative:

PROS OF SURGERY
- ease/convenience of terminology, clothing, registrations, etc
- strict gender dichotomy: men are one way and women are another and that’s that
- parental comfort
- aesthetics
- sometimes there are medical considerations, related to urinary function
- save the child the possibility of embarrassment or feeling abnormal

CONS OF SURGERY
- dramatic reduction of sexual function, possible inability to orgasm
- strict gender dichotomy: men are one way and women are another and that’s that
- it’s often medically unnecessary but merely for aesthetics and parental comfort
- essentially irreversible
- on infants it is performed without consent; but there’s no reason it can’t be done later on a consenting adult (although it may be more painful and recovery will take longer )
- parents and doctors have more often than not picked wrongly about the gender the child later prefers and identifies with

Bear in mind that just because there is no surgery doesn’t mean the child can’t be raised as one particular gender. No one is asking your family to make it everyone’s business and start doing introductions like, “here is Idris, our son, Shira, our daughter and Tyler, our gender non-specific child.” Remember also, that by avoiding surgery as an infant does not rule out the possibility of surgery later, but it at least makes it the individual’s choice.

So, in my sexpert opinion, I’d say listen to your surprisingly enlightened doctor and hold off on “fixing” this otherwise healthy kid. Consider it merely the first in a long series of times parents have to deal with things being different than they’d hoped and an opportunity to view variety and diversity as something positive. And check out the great resources available to families such as yours: Intersex Society of North America , Bodies Like Ours, and Intersex Initiative .

Do you have a question or comment? Please email Timaree directly at sexpert@MarcLamontHill.com

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