What Child is this?
Making Room for Intersexuality
Amanda Riley Smith
April 1, 2002
At approximately one of every fifteen hundred births in the United States, no one says, "It's a boy"-or "It's girl." Instead, under guidelines issued by the American Academy of Pediatrics (AAP) in 2000, the medical professionals attending the birth refer to the infant as "your baby," rather than "he," "she," or "it." The baby's genitalia are ambiguous-neither clearly male nor female-and another intersexual child has come into the world. Doctors and medical ethicists have discussed intersexuality for several decades. But interest has grown in the past ten years, as the first generation has come of age that benefited from-or suffered from-surgical intervention to "assign" sex. Intersexuality appears in varying forms, and it can be caused by a number of hormonal and genetic disorders. Typically, a team of specialists determines which sex to assign, basing their decision on genetic and chromosomal information, along with external and internal duct structures, and surgically conforms the child's genitalia to that sex. About 90 percent of children born with ambiguous genitalia are assigned to the female sex, largely because surgery to reduce the size of the clitoris or create a vaginal canal is considered less risky for the infant. The AAP recommends that such surgery be performed between 6 weeks and 15 months of age to minimize social problems and urological difficulties. Some doctors advocate surgery even earlier, before eight weeks of age. Nearly all patients must take hormones for the rest of their lives so that their bodies will develop into the sex that they have been assigned. Nowhere is the distinction between sex and gender-nature and nurture-more vital, and nowhere is it more contested, than in speaking of intersexuality. ...
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