April 2010, revised November 2011
My attention was brought to a blog by Suzan Cooke on Woman Born Transsexual, and it made me think.
I have plagiarised her original in part response, homage, tongue-in-cheek… all of these things.
Q: What is wrong with being intersex?
Q: Or in the case of people who identify as male or female, what is wrong with having been intersex?
Q: What makes you say you are intersex?
A: Because I appear to have an intersex history.
Q: Does this mean you are still intersex?
A: Yes. However, the way specialists have seen this is that once a child has been treated for intersex and discharged from their care, the intersex has been cured, and they are no longer described as being intersex. However, despite such operations and subsequent psycho-social gender reinforcement, I never felt comfortable in my assigned sex, I found I felt uncomfortable living as either sex. Even though I was discharged as a teenager, and my medical records restarted from that point with just a letter covering the previous 15 years of medical treatment, my body did not appear nor function in the same way as those of my peers.
Q: But you have to be one sex or the other, you can’t change that.
A: Arguably you can, but I would argue that this is what the original operations that some intersex people had tried to enforce: to make people conform to other people’s expectations of what one sex or the other should be like, conforming to certain criteria of determining the sex of an individual. Not some ideological test, or test different to that which non-intersex people are subjected to. If one uses the usual test of sex determination, a visual examination based on whether one has a vagina or penis, I guess it would be true to say I was male after surgery, just as I was not clearly male prior to surgery (hence the need for surgery). This means that no matter what sugar-coated words one uses as a euphemism for the operations intersex children have, by common criteria it either changes or reinforces the sex assigned to the individual it is performed upon. It is either a sex change operation, or a sex reinforcement operation.
Q: So are you a transgender?
A: No I am not. The word, or the social construct, did not exist when I had my sex reinforcement operations. By the time it had been, the intersex part of me was part of my life history, and I had been raised believing that I was male. I doubt I would have embraced such a term even if I had heard when I grew up. I have found the thinking of the Gay Liberation Front much more appealing than either transsexual or transgender ideologies. Later, I tried identifying as ‘trans’, but it doesn’t make sense to me, personally.
Q: You mentioned that you viewed being intersex as a part of life history and as an identity…
A: Maybe it is a bit of both. Many intersex people had sex change/reinforcement operations and then experienced years of psycho-social gender reinforcement; as adults they try to get on with their lives as the men and women they believe themselves to be. But it is very difficult to escape such a history, although it is possible for people to deny it. Some go as far as to create a false history, and while that may work with the outside world, I would have a hard time extending that exercise to my interior world as it would mean denying so much that shaped me into the person I am today. Part of my personal development was my involvement in a range of political and religious campaigns addressing issues of social justice and bigotry which took place before I tried to transition from what I thought was male, and that is still an important part of who I am (although I have little faith in religion any more).
Q: Why do you hate ‘trans’? You are part of the transgender umbrella.
A: I don’t hate ‘trans’. I am quite willing to support transsexual and transgender rights and campaigns to ensure the civil rights protections of transsexual and transgender people. Perhaps it would be good for those espousing transgender as umbrella to study the history of the gay and lesbian movements of the 1960s and 70s. The GLF got a lot right, only were too radical for their own time – we need to revisit their ideas, at the time before the movement fragmented when the women went their own way, the trans folk found themselves left out in the cold, and what was left was a gay movement that became increasingly commercialised. I try to avoid ‘trans’ discussions, because I find the discourse is often vitriolic, and I cannot relate to much of the content.
Q: It’s all about gender…
A: Gender… I have a hard time with this word, and prefer ‘sex’ to signify male/female. There were two streams that led to gender becoming so dominant in the second half of the 20th century, one was feminism, the other was John Money. Money developed the idea of gender identity, while gender roles were what those of us who supported feminism critiqued way back in the 1970s. Contrary to what a lot of intersex people are supposed to believe, Money did some good work – he completely revolutionised our understanding of the medical intersex conditions; he also provided a conceptual system that helped legitimise and gain acceptance for transsexual surgeries. However, the system he developed also legitimised the aribtrary assignment of sex for intersex neonates, surgery to reinforce that assignment, and subsequent psycho-social reinforcement of the surgical assignment. This has been very problematic for many who experienced this.
Q: Are you tanssexual?
A: I have tried to think of myself that way, and to live up to that standard; I tried to see if that might solve my dilemma, but swapping one oppressive gender role for another did not seem to be the solution to my problems. Neither would further surgery, because the genitals I would want were not those of a man or a woman, but my own; there is no operation to put genitals back the way they were before they were operated on. So, I put up with the genitals the surgeons left me with as a child, and at best feel ambivolent about them. So, no I am not transsexual, I am intersex. However, despite sometimes making glib throw-away comments from time to time, having experienced some of what transsexuals have to do, what they have to go through, and how they can be treated, I have to respect their decision and their achievement. To me, to achieve a successful transition is precisely that – an achievement. The problem for me, and I must admit to being aware of this from when I first began to research what was ‘wrong’ with me over 25 years ago, was that I did not fit the transsexual narrative. There were points of similarity, but there was also considerable divergence. Some of those points I would now identify as parts of that intersex history I describe.
Q: Focus on the Family and all those other right wing hate groups hate us because we use a word that has sexual connotations?
A: No we discomfort them, because by our existence we challenge their belief that there are only two immutable ways that humans can be, male and female, which for them is divinely ordained. This is part of the reason that people experience surgeries in childhood which try to erase our apparent difference. This is why, as adults, those who reject that assignment are pushed through the same sausage machine that is designed for transsexuals, which is meant to turn what were biological men and women into phenotypic women and men. In that process, the existence of intersex as adults is erased, just as much as it is erased in childhood through intersex surgeries; intersex is erased in adulthood through transsexual surgeries carried out on intersex people who reject their earlier assignment.
Q: But isn’t it about gender and gender identity?
A: Intersex is about the sex that is assigned, the sex identified with, the surgeries that change/reinforce the assigned sex in childhood, the sometimes serious health issues that affect intersex people because they are intersex, and how they identify. For some, gender and gender identity will be an issue, for others not. I do not see myself as having a specific gender identity, if anything I have a non-gender identity, and a gender-role that involves integrating masculine and feminine aspects of my personality.
It infuriates intersex-identified people with an intersex history no end to have their life experiences dismissed by people who have not gone through the same process, and yet who themselves expect to be seen as women or men. Being human is the basis for having human rights and equality, not being male or female from birth and remaining that way. It is important to appreciate that many intersex people are ‘post-op’, although the operation may have happened in childhood. So, some of us do know what it is like to be in the position post-ops are in to some extent, but they do not know what it is like to be a person who had these sorts of operations not out of choice.
That is a physical reality that separates intersex people from transsexuals – usually we had no choice, and attempts at changing things is sometimes about rejecting decisions made for us. Intersexphobia (or the fear of it) is as much of a factor in intersex people’s lives as transphobia, homophobia or misogyny – especially those who live in situations where they are not involved with people who change sex or are homosexual. Intersexphobia is only knowingly encountered when one is ‘out’, because many people will not realise that an intersex person is so; what may be experienced can seem like transphobia, homophobia or misogyny. However, this is intersexphobia. Just as with being lesbian, gay, or trans, there is no pressure to be out, and as with most lesbian, gay and trans people, in a heteronormative world, people generally assume intersex people are just as they appear to them. That is, it is generally assumed people are non-transsexual, heterosexual, men and women unless they are told (or find out) otherwise.
One form of intersexphobia is the people feeling they have some right to demand ‘proof’ that the other person is actually intersex. So, interrogators will ask about diagnosis, details of private medical histories relating to genital surgeries, or chromosomes, etc. These things are usually regarded as confidential in any other circumstance, so the interrogator has no right to demand to know about these things; but when people are open about their being intersex, some feel they have some right to demand evidence that they are so. This in itself is part of an oppressive process that can prevent intersex people coming out about themselves. Intersexphobia also involves not believing people when they do choose to disclose these things. Intersexphobia is widespread, and is found amongst heterosexual, lesbian, gay, transsexual and transgender people – and even people who claim to have an intersex history themselves. People don’t usually demand that a transsexual proves their post-op status in social discourse, nor that a gay man proves he prefers men to women as sexual partners; nobody expects a heterosexual woman to start giving private details about a hysterectomy, or a man a vasectomy. Yet intersex people seem to be expected to go into quite personal details, and the experiences involved are often very traumatic and these recollections can be triggers. Some intersex people have reached a point where they can discuss these things, but some prefer not to, or cannot because they simply don’t really know what happened and their records have been lost/destroyed, and some will remain traumatised for the rest of their lives.
I think it is more an existentialist matter than an essentialist matter, in that having had a body and/or genitalia that are in some way different, or which have been modified without consent to make them conform, results in qualitatively different life experience than does living as a woman or a man who has not had that experience – or as one who has had sex change surgery they consented to.
It will not always be the case that somebody with such a history will want to identify as intersex, but in those cases where people find it helpful, I am all in favour of them identifying as intersex. Even more so since the development of the nomenclature referred to as ‘DSD’. This could signify a real opportunity for intersex liberation. I do not like the ‘disorder’ in DSD, as I feel it is derogatory and has a number of problems (which I have gone into detail elsewhere), and prefer ‘variation’ or ‘difference’ – so I use ‘dSD’ to signify difference with a small ‘d’; it appears that there are those with medical conditions formerly referred to as intersex, who prefer not to be identified as intersex, and who prefer to be thought of simply as men and women with a medical disorder or condition. I cannot deny people’s wish to identify as they choose, and have to support their choice to do that. I do find it sad, though, and I wish they would feel comfortable supporting those who do not wish to be identified as having a disorder, and who positively identify as intersex. But, this shift in the discourse also signals an opportunity for progress for those of us who do identify as intersex, because by disconnecting it from pathology (in a way that intersex once stood for ‘intersex disorders’), we are more free to talk about our aspirations than ever before. We are in a position to choose something we were always denied before – intersex people can choose to be intersex, giving us a similar agency to that which transsexual, lesbian and gay people can achieve (or have done).
Q: Can people be transsexual and intersex?
This is a very difficult question, because transsexual means somebody who was one type of human (male/female), and has surgery as part of becoming another type of human (female/male). It is important to be clear what we are talking about here.
1. The most well-known version is that transsexualism is congenital, as supported by Diamond and others, who often cite Swaab, and that is that transsexualism is a sort of intersex of the brain; there is a mismatch between phenotype and psychology/emotion/will.
2. Another is a form of ‘intersex by design’. Whatever the motivation/cause behind transsexual reasignment, the result is that transsexuals become intersex, as they have XY chromosomes with a female phenotype or XX chromosomes with a male phenotype. This mismatch may even be more pronounced than for most intersex people.
3. There is the issue that some people with a clear intersex history seek reassignment, because they are unhappy in their assigned gender.
4. There are people who discover some form of intersex history or diagnosis, or its relevance, as they pursue transsexual treatment.
No.1 and No.2 do not reflect my understanding of intersex. Whether transsexual brains are wired up in certain ways (No.1) is not important to me, and I resist the determinism that is associated with this idea. It may be true, I do not know, but I don’t think we need to know this in order to ‘justify’ transsexual reassignment. It is justified on other grounds – perceived need and outcome. I am in favour people making a positive choice to be what they will be, rather than feeling it is something they have to do – it is about agency. No.2 is an interesting argument, but not one I am able to reply to politely.
In relation to No.3 and No.4, I am sure that there are trans people who have intersex histories (No.4), just as there are intersex people who have sought to change the sex they were originally assigned. As many as 10% of people who had interventions for intersex in childhood grow up unhappy with their assignment; that is a much higher ratio than the general population. The main difference between No.3 is one moves from an awareness of being intersex to choosing reassignment as a solution, while No.4 moves from an awareness of being transsexual who seeks reassignment to an awareness of the significance of an earlier medical history. It is hard to say much about No.4, because in an ideal world, we would all be party to a full disclosure about our histories; however, we know that having an intersex history was kept secret from most people. In the case of No.3, I am not clear that reassignment is necessarily the best approach, but it depends on the individual. When it comes to being uncomfortable about their assignment, intersex people are between a rock and a hard place. Personally, I find the whole surgical approach intensely disturbing, and I am sure that my own experience has contributed to this feeling.
I am unclear how it is possible to be both intersex and transsexual, in terms of identity; I tried, but I could not find a way for these to co-exist within myself. Affirming one seemed to entail denying the other, to myself, my peers, and to caregivers. Maybe dSD will help with this, and the proposals for DSM5 seem to be trying to accommodate this; that there are people with dSD who seek help with what it calls ‘gender incongruence’. So, the question of trans people who claim intersex will become redundant – because there will be trans people without a dSD, and go through the diagnostic sausage-machine one way, there will be trans people with a dSD, who go through the diagnostic sausage-machine another way, and there will be intersex people with a dSD who have no desire to go through the same sausage-machine as transsexuals, but who are unhappy with their assignment. The proposed revisions in DSM5 appear to be making a space for people, including those with dSD, who seek help establishing an identity that is neither male nor female. It would be very ironic if it turned out that DSM5 ends up supporting those with dSD who simply want to identify as ‘intersex’, rather than male, female or transsexual, although many like myself have had a belly-full of diagnoses, particularly inadequate ones and ones that identify us as disordered in some way because we aren’t like most men and women, and spectacularly failed in making all of us like most men or women, originally.
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