Intersexuality

Intersexuality

* Understanding Intersex
* Gender Identity: Nature vs. Nurture
* The Ethical Questions
* Discussion
* Papers


An advance warning

* For anyone who has done the reading, this will not come as a shock, but we will be discussing sex and gender today.
* Some of the video clips depict surgeries and genitals (sometimes blurred, sometimes not).
Understanding Intersex

* Simplest definition: intersex is a congenital anomaly of the reproductive and sexual system.
* There are many differences between those who are intersexed. It is difficult to point to any set of characteristics of intersexuality, though the most common characteristic is ambiguous genitalia.

A word on language…

* Hermaphrodite vs. Intersex
* “true hermaphrodites” in a medical context

Ambiguous Genitalia

* Generally, this is what tips off medical staff to the possibility of a newborn being intersexed.
* Quite simply, this is when the reproductive organs do not present themselves as they usually do. This can be because of the size or shape of the genitals.

Androgen-Insensitivity syndrome (AIS)

* Also known as “testicular feminization.”
* Though the genes read as XY, the androgen receptors in the body cannot “read” the masculinizing hormones the testes produce. Because of this, these “male” children's anatomy both in utero and after birth develop in a “feminized” manner.
* Often not discovered until puberty, when menstruation does not occur.

Progestin Induced Virilization

* Progestin was a drug administered to women in the 1950s and 60s to help prevent miscarriages.
* The drug would be converted to androgen by the prenatal XX child, which could result in the “masculinization” of the child. Possible side effects are enlarged clitoris, development of a phallus, and/or the fusing of the labia.

Progestin Induced Virilization

* In every case, ovaries and the uterus develop, though in some cases the vagina and cervix do not develop.
* After birth, a normal female puberty occurs.
* While Progestin is no longer used to prevent miscarriages (it was not effective), it along with estrogen is the primary components of birth control pills. Some take progestin-only birth control.

Congenital Adrenal Hyperplasia (CAH)

* An anomaly of adrenal function causes the synthesis and excretion of an androgen precursor, which begins the “masculinization” of an XX person.
* Since this process is metabolic in nature, the masculinizing effects continue after birth.
* Phenotype varies along the whole spectrum.

Klinefelter's syndrome

* Most men inherit a single X chromosome from their mother, and a single Y chromosome from their father.
* Men with Klinefelter syndrome inherit an extra X chromosomes from either father or mother.

A Little on Genetics

* Your DNA is a combination of the DNA of your parents.
* Generally, women receive an “X” chromosome from each parent; this is known as “46 XX”
* Most men receive an “X” from their mother and a “Y” from their father. This is known as “46 XY”

A Little More on Genetics

* Men with Klinefelter, with their “extra” “X” has what is known as “47 XXY.”
* Other variants are “45 XO” (“blank”), “47 XXX” (super-female) and “47 XYY” (super-male)

Hypospadias
For those who wonder if they are intersexed…
The Phall-o-meter
Common Treatments

* Most of the attention in the intersex debate is focused on cases of AIS and CAH.
* Traditionally, the treatment of these forms of intersex was to “correct” the genitals.
* Those with a “micropenis” would be surgically reassigned as females, while those with enlarged clitorises would have a cliterectomy.
* These surgical treatments would really occur in stages. Generally one operation would not be enough to make genitals that appeared normal, so procedures would occur for years.
* Anecdotal evidence supports that most with ambiguous genitals were assigned as females because it is easier to “dig a hole than build a pole.”

Components of a treatment

* Surgery on the genitals (can occur many times) and possibly other body parts (such as breasts after puberty)
* Hormone cocktails
* “Psychosocial” rearing according to norms for the assigned gender.

Gender Identity

* The Case of John/Joan & John Money in general
* Nature vs. Nurture
* What is at stake?

The Ethical Questions

* Involves paternalism, informed consent, and deception
* Also includes societal questions about the nature of gender. Raises issues about our understanding of sexual matters, as well as social conventions such as marriage.

The Readings
Fausto-Sterling

* What is her thesis?
* What do you think about it?

Letters

* Bird’s objection: How would you respond?

Intersexuality.ppt