A student presentation for WRTG 3020, Spring 2011, based on Sharon Preves' article "Intersex Narratives: Gender, Medicine, and Identity," as well as selections from Cheryl Chase and Riki Wilchins.

1. Understanding Intersexuality via Personal Experience Amy J. Woeste WRTG 3020 April 2011

2. “Intersex Narratives: Gender, Medicine, and Identity” Sharon E. Preves “What Is The Agenda of The Intersex Patient Advocacy Movement?” Cheryl Chase “All Together Now: Intersex Infants and IGM” Riki Wilchins A presentation drawing on

3. Preves was prompted to write the article because she recognized that intersex support groups were being organized, and decided it would be helpful to share their personal stories with people outside the intersex community. This article was specifically written for Sex, Gender, and Sexuality: The New Basics. Target Audience: Academia, Sociology or Gender Studies; Families of Intersexuals Intersex NarrativesGender, Medicine, and Identity

4. Introduction: AuthorsSharon E. Preves Associate Professor and Chair of the Department of Sociology at Hamline University. Education: B.A. 1991, Hamline University Ph.D. 1999, University of Minnesota This article is based on her book Intersex and Identity: The Contested Self

5. What is the agenda of the intersex patient advocacy movement? Chase was prompted to write the article because intersexuals face unfair and traumatizing medical action due to outdated standard medical practices. She provides information to help medical professionals better understand intersexuality, and specific recommendations for patient-centered care. This article was presented orally at First World Congress: Hormonal and Genetic Basis of Sexual Differentiation Disorders, a conference held in May 2002. Target Audience: Conference attendees, specifically standard medical practitioners.

6. Founder of the Intersex Society of North America Co-founder of Hermaphrodites With Attitude with Riki Wilchins Education: B.A.1983, in Mathematics from MIT M.A. 2008, in Organization Development from Sonoma State University Introduction: AuthorsCheryl chase

7. Wilchins was prompted to write the article because every single day, five infants are victims of IGM. She explains and gains support against IGM and GID through the personal experiences of Cheryl Chase. Target Audience: Academia, Queer Theory and Gender Theory Courses All Together Now: Intersex Infants and IGM

8. Founder of GenderPAC Co-founder of Hermaphrodites With Attitude with Cheryl Chase Education: B.A. 1982, Cleveland State University M.A. 1983, in Clinical Psychology at the New School for Social Research Introduction: Authors RikiWilchins

9. By Using first-person experiences and scientific background to describe intersexuals’ lives and challenges they overcome. Introduction: Summary of Presentation These articles explore “what happens to people who, from the time of their birth or early adolescence, inhabit bodies that do not afford them an easy choice between the gender lines.” Preves 33

10. Sex: Determined by biological factors, such as sexual organs. i.e. female or male Gender: Determined by societal or cultural factors, such as characteristics a culture associates with each sex. i.e. woman or man Sex and Gender do not always “line up.” Someone’s sex can differ from their gender. Sex vs. Gender

11. How do you know if you're female or male? How do you know you're a woman or a man? How would you answer those questions if neither option fit you? Beyond Pink and Blue

12. Are there more than two categories? Critical thinking Question

13. Intersexuality Intersexuals are people whose bodies are “in between” the two sexes. In other words, their bodies show signs of both female and male. Terminology Hermaphrodite is an offensive and outdated term. The correct term is intersex.

14. Biological Sex is Based on Biological Factors Such As: Genitalia: External sexual organs; penis and vagina Hormones: Substances transported via the bloodstream Chromosomes: Tiny genetic strands that determine sex Gonads: Sex glands; ovaries and testes Internal Reproductive Organs Overall Body Structure or Physical Characteristics Intersexuality: Biological sex

15. But what if someone possesses female andmale biological factors? Intersexuality: sex-based identity Generally, biological factors like those lead to an established sex of female or male.

16. Prior to the eighth week of pregnancy, whether the fetus is male and female cannot be determined. Around the eighth week of pregnancy, the gonads of an XY embryo begin to form testes. Around the twelfth week of pregnancy, the gonads of an XX embryo begin to form ovaries. The Science of Intersexuality

17. This is why intersexuals are born with signs of being both female and male. The Science of Intersexuality Their gonads do not form only testes or only ovaries.

18. True Hermaphroditism Someone with both female gonadal (ovarian) tissue and male gonadal (testicular) tissue. Cheryl Chase is a “true hermaphrodite.” Pseudo-Hermaphroditism Someone that has only male gonadal tissue or only female gonadal tissue, and whose external genitalia combines features of both sexes. Types of intersexuality Wilchins 72

19. IGM: Intersex Genital Mutilation “Cosmetic genital cutting that is performed solely to make intersex infants resemble normal males and females.” GID: Gender Identity Disorder – The Psychiatric Counterpart “Children as young as 3 and as old as 18 are made to undergo treatment that includes behavioral modification, confinement to psychiatric wards, and psychotropic medication, all because they transcend binary gender norms and/or cross-gender identity.” Intersexuality: igm and gid Wilchins 74, 78

20. Within 2000births, 1 or 2 babies, or about 5 babies per day in the United States, are born with sexually ambiguous anatomy. Sexually Ambiguous Anatomy Genitals that can be surgically altered to create a more distinct female or male genitalia. Large clitoris or small penis can be surgically altered. “The criteria for what counts as female or male, or sexually ambiguous for that matter, are human standards.” Estimates Preves 33

21. Preves’ Research Methods: Interviews March 1997 to September 1998 37 Intersexed Adults Ages 20 to 65 - Average Age of 40 24% lived as a gender different from their sex 6 Transitioning from Female to Male 3 Transitioning from Male to Female 51%with sexually ambiguous anatomy at birth 49% intersexuality was not apparent until puberty

22. Rather, these elaborate, expensive, and risky procedures are performed to maintain the social order for the institutions and adults that surround these children.” Intersex is a Social, Not a Medical, Problem “Medical treatments to create genetically unambiguous children are not performed entirely or even predominately for the sake of preventing stigmatization and trauma to the children. Preves 34

23. Prior to surgery, all of Claire’s biological factors were female, except her larger clitoris. Case Study: Claire “‘I don’t feel that my sex was ambiguous at all. There was never that question. But I’m sure that [clitorec-tomies] have been done forever because parents just [do not] like big clitorises because they look too much like a penis’.” After Claire’s surgery, she “‘was in agony trying to figure out who I was…what sex I was. And feeling like a freak’.” Preves 34-35

24. Was it permissible that Claire’s parentsforced her to undergo a clitorectomy when she was six years old? Critical Thinking Question

25. “If your organ is less than 3/8” long, it’s a clitoris and you’re a baby girl. If it’s longer than 1”, it’s a penis and you’re a baby boy. But if it’s in between, you’re a baby herm: The organ is an enlarged clit, and it gets cut off.” Birth sex is like a menu: Clitorectomy Wilchins 80

26. Critical Thinking Question Does this seem scientific to you?

27. “The pediatrician will apologetically explain to your parents that you were born genetically “deformed,” but through the miracle of modern Science they can make you into a “normal little girl.” Birth sex is like a menu: Clitorectomy Wilchins 80

28. “Of course, this never happens in reverse. No pediatrician will ever apologetically explain to your parents: Birth sex is like a menu:Penectomy ‘I’m afraid your son’s penis is going to be too big, maybe eight or nine inches long. No one will ever be attracted to him but homosexuals and oversexed women. If we operate quickly, we can save him’.” Wilchins 80

29. Why are clitorectomies more common than penectomies? Critical Thinking Question

30. Currently, the rule is 2 standard deviations from the mean. “If pediatricians agreed to increase this rule to, say, 3 standard deviations from the mean, thousands of intersex infants would be instantly “cured.” Birth sex is like a menu: standard deviations On the other hand, if they decided to decrease it to 1½ standard deviations, 1/3 to ½ of the female readers of this book would suddenly find themselves intersexed, and therefore candidates for genital surgery.” Wilchins 80

31. Three Messages Doctors Gave Participants They were objects of medical interest and treatment. They were not to know what was wrong with them or why they were receiving medical treatment. These procedures were in their best interest and should be accepted and kept secret. Medical sex assignment

32. How would you feel being studied like you’re an object without even knowing why? And if you asked, they would only tell you, “Don’t worry, it’s for your own good.” Being an Object of Study

33. “The participants’ experiences with medical attempts to “normalize” their bodies were amazingly consistent, despite the widespread variation of intersex diagnoses.” Medicalization, Stigma, Secrecy, and Shame Preves 36

34. It was the first negative association I’d had, and [I] started [having] this feeling that I wasn’t normal’.” Case Study: Drew “‘When I was twenty, I had my first medical experience as an intersexed person. [The gynecologist] said, ‘Has your clitoris always been this large? I’d like to do some tests ‘cause I think maybe something’s not normal.’ Preves 37

35. ‘Oh boy! I’ll get a whole bunch of answers.’ Case Study: Suegee “‘When I was 16 and I went off to see a gynecologist for the first time, which I was so excited [about]; I was like, And she could just stutter out that she could recommend a good surgeon. And that was about it. She was way too interested in examining my genitals. She was like…got me up in the stirrups and she’s going, ‘Wow. Wow, that’s…that’s big! That’s, that’s real big!’ And she was totally insensitive and completely just mesmerized by what she found’.” Preves 37

36. Drew and Suegee are the only two people who did not undergo surgical or hormonal sex assignment in childhoodin Preves’ study. Drew and Suegee encountered negative attitudes from their gynecologists, women they thought could be trusted because of the authority of the doctors’ medical position. This led to a confusing conflict of prior, positive attitudes and later, isolating attitudes. Drew and suegee

37. may be one of the most harmful and traumatizingaspects of being intersexed in a society that adheres to the medical “correction” of such variation. As a result, the attempt to develop a coherent and positive concept of self amid continuous attempts to “fix” or change one’s sex may be a negative interpretations of self “The inability to deflectnegative interpretations of self project doomed to failure.” Preves 37

38. Have you ever encountered a person in power who makes you feel unaccepted and different? Critical Thinking Question

39. “‘The primary challenge [of being born intersexed] is childhood; Case Study: J8 parents and doctors thinking they should fix you. That can be devastating not just from the perspective of having involuntary surgery, but it’s even more devastating to people’s ability to develop a sense of self. I have heard from people who are really shattered selves, they don’t have a concept of who they are’.” Preves 37

40. “‘The core of their being is shame in their very existence. And that’s what’s been done to them by people thinking that intersexuality is a shameful secret that needs to be fixed. So I think for most people the biggest challenge is not the genital mutilation but the psychic mutilation’.” Case Study: J8 Preves 37

41. “Withholding information from the individuals only compounds their feelings of confusion and shame because they are told that there is something wrong with them, but they cannot and should not know the specific details of their condition.” Fearing the Unknown: “What Kind of Monster Am I?” Preves 38

42. At 19 years old, Carol thought she was going to the hospital for a routine checkup, however, in reality, the doctors had already planned to perform an operation on her to remove her abdominal testicles. Case Study: Carol Because of the secrecy of the hospital staff, Carol thought she had cancer. Preves 38

43. Have you ever believed something just because of others' reactions or influences? Critical Thinking Question

44. “‘They wouldn’t tell me anything…I knew that I wasn’t being told the truth, but there was no way anybody was going to tell me the truth. It was such a mess. Case Study: Sarah There was so much lying and symboling going on that it’s a wonder I ever figured it out’.” Preves 39

45. “‘The cruelest punishment we inflict on prisoners is solitary confinement. Case Study: Sherri And intersex people have lived lives of solitary confinement. And I think that that is such a personal holocaust. Because to be completely separated from others, to not know that a there are others, to only know it intellectually, but not know it viscerally is, without a doubt, solitary confinement’.” Preves 39

46. What other times in history were holocausts happening? What do you think about Sherri comparing intersexuals' feelings to solitary confinement and a personal holocaust? Critical Thinking Questions

47. No matter what it took, the participants tried to find more information about their bodies. However, many encountered difficulties. Medical professionals denied them access to their records. Families didn’t want to talk about it. Seeds of Change Seeking Comprehensive Information and Similar Others

48. After years of trying to gain information, many participants began to find what they were looking for, and this Seeds of Change Changed them forever…

49. “‘Intersexuality is not a disease. I’m not even gonna say it’s an abnormality. I simply say it’s a variation. Case Study: Jana Now I like my body, and I think I would have liked my body when I didn’t like my body if I had known why it was like it is. This is the way I am, and I can accept that now. And I think I could have accepted it then, had I known, but I didn’t know’.” Preves 40

50. My [intersex] has made me feel special, and it finally makes me understand why I am the way I am. It has made a big difference because I feel complete. Case Study: Robin “‘I feel special. I have found a part of myself that was lost’.” Preves 40

51. In what ways have friends or new information helped your understanding of a personal issue? Critical Thinking Question

52. “‘After having lived all my life in isolation with this, suddenly to hear another person speak the words that I have spoken in the past; share the thoughts that I’ve had. Well what it felt like was that I’ve been living on this alien planet, portraying myself, passing myself off as an earthling, and I’ve met someone from, or of my people from this other planet’.” Case Study: Martha Preves 40-41

53. “Having found others with whom to relate, many participants spoke directly to the importance of using A New Life Social visibility as a strategy for destigmatizationand empowerment.” Preves 41

55. Cheryl Chase, Founder and Executive Director Intersex advocacy group Intersex society of north America ISNA’s Mission “The ISNA is devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female.” ISNA.org

56. Riki Wilchins, Founder and Executive Director Gender advocacy and educational group GenderPublic Advocacy Coalition GenderPac GenderPAC’sMission To create "classrooms, communities, and workplaces [that] are safe for everyone to learn, grow, and succeed - whether or not they meet expectations for masculinity and femininity.” genderpac.livejournal.com

57. Intersex protest group First direct action group for intersexuals. Cofounded by Cheryl Chase and Riki Wilchins Also the title for the ISNA’s newsletter. Hermaphrodites With Attitude

58. Intersex Society of North America Director Cheryl Chase chose to title the ISNA’s monthly newsletter “Hermaphrodites with Attitude,” which changed people’s lives. She chose to embrace the alienating and shameful word hermaphrodite. Hermaphrodites with Attitude: Evidence of Intersex Pride Preves 41

59. Hermaphrodites with Attitude: The Reaction “‘I was petrified and traumatized, that word had been so painful and yet, there it was out there. Just out there and then I picked up the newsletter, and it was my story onevery page’.” Preves 41

60. A movement of the ISNA. Criticizes standard medical practice, a goal which is often misunderstood. While the movement criticizes, it also recommends ways to keep patient center care the top priority. Intersex Patient Advocacy Movement

61. Intersex Patient Advocacy Movement Recommendations for Patient-Centered Care Intersexuality is primarily a problem of stigma and trauma, not gender. The child is the patient, not the parents. Professional mental health care is essential. Honest, complete disclosure is good medicine. All children should be assigned as male or female, without surgery. Chase 2

62. “‘I’ll never repay, ever, in this lifetime I will never repay what I’ve been given. After I die, it all goes to the support group. My will is set up so that it all goes to the support group…That’s where I want it to go. That’s all I want it to go for’.” To The Stories One Last Time Preves 42

63. Chase, Cheryl. “What is the agenda of the intersex patient advocacy movement?”First World Congress: Hormonal and Genetic Basis of Sexual Differentiation Disorders, 17-18 May 2002, Tempe, Arizona. Ed. Maria New and Jean Wilson. Chevy Chase, Maryland: The Endocrine Society, 2002. Print. Preves, Sharon E. “Intersex Narratives.” Sex, Gender, and Sexuality: The New Basics. Ed. Abby L. Ferber, Kimberly Holcomb, and TreWentling. New York: Oxford University Press, 2009. 32-43. Print. Wilchins, Riki. “Chapter 7: All Together Now: Intersex Infants and IGM.” Queer Theory, Gender Theory. Los Angeles: Alyson, 2004. Print. Bibliography