Intersexuality: What to do when babies are born with sexually ambiguous traits?
Last week, my local Mormon study group discussed the topic of the body. We read in the Proclamation about how gender was eternal, and the question that popped into my mind immediately was “Well what do we as Mormons then do with babies that are born with both male and female sexual organs?”
I suppose I’m particularly intrigued by this since I’m about to give birth any day now – probably to a boy, since that what the ultrasound seemed to indicate. But I can’t help wondering what Mike and I would do if we did have a baby whose sex was ambiguous.
I think this happens a lot more than a lot of us talk about. According to Wikipedia (o great source of knowledge), as many as 1% of live births involve a baby that is born with sexually ambiguous traits. (Though other studies say it’s more like .1%) There are a lot of ways these babies might exhibit intersexual traits. Take a look at this picture which shows the anatomy of a person with XXY chromosomes. Wikipedia talks about how this is only the tip of the ice berg when it comes to chromosomal abnormalities which lead to ambiguous sex. There’s “Turner syndrome XO, Triple X syndrome XXX, Klinefelter syndrome XXY, XYY syndrome XYY, Mosaicism XO/XY, de la Chapelle syndrome XX male, Swyer syndrome XY female, and there are many other individuals who do not follow the typical patterns (such as individuals with four or even more sex chromosomes).”
Often parents and doctors simply have to choose what gender to make these kids, and then give them surgery and hormones. But some people who have these conditions are arguing that there should be a space for a third sex, that society shouldn’t tamper with this naturally occurring phenomenon of intersexuality.
Anyway, I’m intrigued by this occurrence of “intersexuality” and wonder how it fits into our Mormon mind frame. I’d love to know if you have any experience with situations like these.
*Do you know of any babies born with sexually ambiguous traits? What did the parents decide to do?
*If you had a child who was born with this condition, do you have any idea of how you’d handle it? Would you talk with church leaders to have them help you decide what to do?
*What is the church’s stance on people who exhibit both sex characteristics? Do they advocate parents choosing a sex? Would they let a person who had both sex characteristics get the priesthood?
*What are the implications of this “third sex” on Mormon doctrine, which specifically states that gender (and I assume they also mean sex here) is eternal?
Gender is eternal, but why are you assuming there are only 2 genders?
My husband’s cousin was born with ambiguous sexual characteristics. She was closer to female than male and that’s the way her parents went. She will require at least one surgery to ‘assist’ puberty in the next few years.
I am very impressed with her parents for not overcompensating for her physical ambiguity with oppressive requirements of femininity and not being afraid of her tomboyishness.
I would have the genetic test that is supposed to show what a person is genetically. Then I would watch very carefully for a few years, re-test, discuss it with my child (even if the child is only 3) and go with it.
I thik your husband’s cousins family was very wise, Starfoxy. I’ve heard of people who have not been that wise and the children suffer.
Without really knowing the details and ramifications at this point, what I think I would do is leave the child as they are. I imagine there is a good chance they will identify more with one gender, and they could make the choice when old enough to do so.
Not too long ago I read a great book called “Middlesex” by Jeffrey Eugenides. It won a Pullitzer in 2003. Here is the synopsis:
Raised as a girl by her second-generation Greek-American family, Calliope (now Cal) Stephanides is physiologically a hermaphrodite and is more male than female. That’s not giving away much — Cal explains it on the first page. What’s remarkable is that a book can start with such a revelation and still manage to be full of surprises. Narrated by Cal, the story also shares the thoughts, feelings, and intimate details of the lives of Cal’s grandparents, parents, and other family members. In this omniscient first-person mode, we get an epic family saga, a journey from 1920s Greece to 1960s Detroit to contemporary Europe — one that leads to a remarkably satisfying conclusion. To understand anyone, Eugenides seems to be implying, we need to know not only his or her (or in this case, “his/her”) inner thoughts, but also those of all the ancestors whose DNA has contributed to the mix that created him/her.
I would recommend it to anyone interested in the topic or if you just want a compelling read.
I don’t know what the implications are for an intersex person in the church. I’m not sure that the institution can cope very well with ambiguities like that.
Probably the most progressive ideas I have heard on this were from one of the most conservative members of the Church’s presiding councils. In a training session he basically said (in regards to gender assignment and priesthood ordination): pray about it and do what is best.
annegb
The genetic makeup does not necessarily determine the sex. There are syndromes with opposite results to what we usually think.
One common one is testicular feminization (now called androgen insensitivity syndrome). Here a child is born XY (usually associated with a male), but developed insensitive to male hormones. In the absence of the male hormone effect the fetus develops externally as a female (in spite of being XY).
The testes determining gene can be translocated from the Y chromosome to the X chromosome as well, and this would cause male development (although probably with mental developmental delay).
XX fetuses with congenital adrenal hyperplasia will develop with more external male sex characteristic than female. (The current recommendation is to raise these as females even with complete male external development).
The result of gender assignment and later which gender the person chooses is mixed. In one study with XY babies with ambiguous genitalia, both groups of gender assignment (male or female) had a majority satisfied with their assignment, but a significant minority wanted the opposite gender.
The current medical recommendation I found was “no surgery should be performed for cosmetic reasons alone until the intersex individual is capable of making the decision for surgery autonomously”
I agree it would be wise to wait and use the genetics, the external genitalia, but mostly what the person chooses for gender (unfortunately this can take more than 20 years in some cases).
I have no direct experience with this issue, but it’s something I’ve spent some time thinking about (a lot of the theoretical/philosophical reading I do for school is on gender and the body).
If faced with this decision, I would do a whole lot of praying. But my initial inclination would be to leave things be and let my child decide what they wanted to do when they were old enough. I’ve read quite a few stories by intersex individuals who ended up having a difficult time later on in life when parents/doctors make this decision for them when they are babies. Though I guess other difficulties arise if you make the choice to wait and let the child decide (children who have not been assigned to our strict sex/gender categories are not going to have an easy time of it).
As for the theological implications, I have to say that I’m pretty stumped on this one. I have a hard time with the whole “gender is eternal” statement (how can something that is generally defined as being a social construct be eternal?), and tend to accept it better when I replace “gender” with “sex,” but this whole intersex issue makes the idea “sex is eternal” more complicated.
Anyway, thanks for this post, Caroline. You’ve asked some good questions.
Caroline:
How would *you* answer your four questions, especially question #4?
As a parent, I’d like to think that I’d let life play out naturally, that I’d try to leave as much of the gender decision to my child as possible. But such sentiments are easier said than done. How do you sit back and let nature run its course when gender is inextricably tied to everything we are, almost from Day 1? What do you name the baby? How do you cut the baby’s hair? What color clothes do you buy? What kinds of toys? How do you refer to the baby in the third person to other people: he or she, him or her?
And how long will it take until the child determines its own gender? In the meantime, how does the child relate to his/her playmates? Which bathroom do you tell him/her to go into?
I realize many of these questions seem superficial, but as a young child, just learning to negotiate one’s way through the world is difficult enough without the enormous added weight of gender ambiguity.
Anyone familiar with the urban legend regarding Jamie Lee Curtis’s supposed intersexuality?
See Snopes: http://www.snopes.com/movies/actors/jamie.htm
Starfoxy,
It does sound like your cousin is being wise and sensitive with their child.
Annegb,
I also would definitely look into genetic testing. But as someone later pointed out, unfortunately that sometimes that doesn’t clear anything up when it comes to assigning gender.
Amyb,
That book sounds great. I’m going to check it out.
J.Stapley,
That does sound like wise advice. I hope he also would advise the bishops to consider the family’s desire on the matter.
S and Matt,
My inclination is to do what you suggest as well, S. Let the kid decide when he/she’s old enough. But as Matt points out, I understand how unbelievably hard that would be on everyone. I don’t know how the child would survive school if people couldn’t categorize it. However, I would just be terrified of assigning the wrong gender, so I think I would be more comfortable waiting as long as possible and listening to the child’s wishes.
I think this is a very important point that has very serious implications for our attitudes in the church.
The existence of people of indeterminate gender proves that, even if gender is an eternal trait, eternal gender is not perfectly reflected in physical gender. We can’t even always accurately identify what gender someone is.
This means that we need to be humble and non-judgemental in our relationships with others. For example, if there is a man who feels inside that he is really a woman, how do we know that he’s wrong? Currently common church rhetoric is to condemn him for having “gender confusion.” But maybe it’s we who are confused.
It’s only a short leap from there to say that we should be less judgemental with all people who have unusual gender-based traits, even if they don’t have XXY chromosomes or any similar genetic abnormality. This would include homosexuals, effeminate males, etc.
Re third question on the list:
I do not think the church has a stance on ambiguous genetalia, except to say that non-elective surgery is the only kind of gender surgery allowable for full membership (Persons who have already undergone an elective transsexual operation may be baptized if they are found worthy, but they may not receive the priesthood or a temple recommend. If a person is excommunicated for an elective transsexual operation they must apply to the first presidency for approval of reinstatement of prior blessings. The handbook does not specify that a person who has a transsexual operation must be excommunicated, but the counsel is against elective transsexual operations and that the surgery may be cause for formal Church discipline. Bishops are to refer questions on cases to the stake president who may direct questions to the First Presidency if necessary.). This to me implies surgery near the time of birth is OK, but the referral to higher authorities makes me think there is some wiggle room for doing the gender assignment surgery later in life for these children/adolescents.
I fear if a member couple had a child with ambiguous genetalia, some church authorities would be against waiting for the child to decide (as this might be seen as non-elective). I hope the bishop/SP of a family in such a case would see the later surgery as preferable to surgery close after birth.
What makes me struggle with this whole issue of eternal gender is that one small decision potentially is the difference between this person holding the priesthood or not (or in essence having one gender or the other). If a parent chooses female, they cannot, if they choose male, they can. It could go either way. How can both be correct? It seems quite arbitrary to me.
My gut reaction would also be to let my child decide, but Matt’s questions make me think that would be really hard. How could I try and keep everything gender neutral for years? And, how many years before my kid came up with her/his final decision?
It’s interesting to see what the handbook has to say on the matter.
Thanks for a thought-provoking post!
Reading those comments about church discipline for people who undergo sex change operations made me sad. I can understand that it doesn’t match with church doctrines, but it still makes me sad. I think people with gender dysphoria have to be some of the most tortured people there are, and to add stigma and shame from the church onto their burden seems especially cruel. I hope that one day the church can be a safe place for all people.
A professor of mine has several intersexed friends. She said they had a lot of hostility toward beig unable to make the decision for themselves. The surgery left them unable to experince orgasm. They said “ok, so it was not pretty to look at but at last it worked!”
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I know no one who’s intersexual, but I’ve been researching it for quite some time now (which was how I found this blog).
Oh, it will be hard raising your child with a neutral gender, but if it was me, I’d take it upon myself to do just that. I’d raise my child as an intersexual so he can choose for himself later, basically because, I, myself, hate having decisions made for me.
The issue about what color of clothes to wear, what haircut should be done and that stuff are all important, true, but too trivial for me to be worried about. During an infant’s birth, a sex would be determined for the baby and the society would know my child as such. Let them call my child “him” or “her” depending on the birth certificate, I don’t care. However, I will educate my child on what he really is, and if it’s possible, educate my community too. I might even go to my church for help on spreading the word.
Hermaphroditism is not a gender, it’s a mutation.
Well, I’m 1 in 20,000. I was born with xx male syndrome.
and I can tell you for my case it was not a very easy life.
There are many conditions within this sector.
Some males will look like like normal males and some
will be small and girlish looking.
For my case I had gender issues as a child and later
this was make more of a problem by my delayed or almost
non coming of age. At 22 I looked like a small 13 boy, I could not
grow a beard and had fine facial hair. My build was tiny and my
hands and feet were small. I tried to go out with woman and
had problems. I could go on but I’m running out of room
I am 28 years old and been raised as a female. when I was 20 I took myself to my doctor as I had never had a period. She examined me then and I could tell she was puzzled and she referred me to a clinical specialist who months later, sat me down and told me I had AIS (androgen insensitivity syndrome). They said that making a human was like a cake recipe, lots of different ingrediants go into the bowl and sometimes the outcome is not what you expect. I have male chromosomes and had my testes removed shortly afer this at age 20. Outwardly I look like a woman. My parents do not know. I got married, sealed in the temple and my husband does not know. He knows I am infertile but he does not want kids anyway so he never questioned me why. I struggle with the family proc and church doctrine that teaches about gender as I do not feel I fit in anywhere. I know I am meant to be a woman, I do not feel attracted to women, but at the same time I do not understand how Heavenly Father has a place for me in the eternities. I am biologically neither male or female. I am both.
A blessing I suppose is I am tall and, even if I do say so, good looking. I have lovely thick glossy hair, clear skin and an athletic frame. People always tell me how lucky I am to be so pretty but inside I feel dirty and fake and am terrified of people at church finding out and what they will say and think.
President Packer’s talk this last week didn’t little to make me feel any better.
JustaGirl:
I can only imagine the weight of carrying this as a secret from those closest to you . . . and THEN trying to figure out what it all means emotionally, rationally, theologically. That can’t be easy.
Of all the (many) changes made to President Packer’s talk after he delivered it, these two were the most hopeful for me:
1) Changing the classification of the Proclamation on the Family from “revelation” to “guide”
2) The striking of the rhetorical question, “Why would would our Heavenly Father do that to anyone?”
Because we are born with all kinds of ambiguities and theologically confounding traits and situations. If we extend the reasoning behind the original question, Why would anyone be born with anything but “perfect” (defined narrowly as able to grow up physically and mentally healthy, grow up attracted to the opposite gender, grow up able to conceive and bear children)? And yet reality of life — from birth — of untold millions of people confounds that question. My favorite reading of “In my father’s house there are many mansions” = heaven is an expansive place, diverse enough to hold and heal us all.
I think this is a timely question given Elder Packer’s talk at conference. He would have us believe that such abberations are not part of Heavenly Father’s plan and he wouldn’t do such a thing to us. But we can’t deny that it happens. He’s raised the question then, if Heavenly Father didn’t do it to us, why does it happen?
I agree with him that Heavenly Father doesn’t say “My will for this child is to be born [insert XXY, homosexual, bipolar, etc here].” But obviously based on our observations has humans it happens which we could then infer that he lets it happen. Why then? Why does he let these things happen?
A good book on that question is written by a Jewish rabbi which in entitled “Why Do Good Things Happen to Good People?” Its my personal belief that physical traits or physiological characteristics happen because God is subject to natural laws and except for cases that are only fully understood by our heavenly parents, they are bound to allow nature to take its course. Genetics, biological and which traits are expressed is a very delicate process where many millions of things can go wrong creating a billion various traits or “aberrations from normal.” Its my personal belief that our heavenly parents know what is ultimately intended for a person who is born with a certain trait and it will be healed or taken from them in the afterlife.
I compare it to bipolar (which my dad struggled with until his death). I truly believe that he is healed from his condition. Being saddled with that affliction was not his choice, though he had choices in how he was going to life with/in spite of it. And now he is dead, it is taken from him. I believe that too will happen with those who are homosexual or sexually ambiguous. And us people need to get out of the way and stop making it harder for people facing these realities.
Justagirl –
I’ve thought long and hard about what we believe by gender being eternal. The fact that there are people who truly feel they are in the wrong body (even if this is not how you feel) tells me that our earthly view of gender is not all there is to know about it. I believe that we all have each of the traits that can be attributed to gender, and we express them disproportionately either due to cultural or biological reasons (or both). Similar to the belief that we all contain the capacity for either good or evil – we’re not born good or bad, and maybe we’re not born “girly” or “manly”.
Of course, it’s easy to look around and see “evidence” that makes this seem untrue, but if we keep our perspective open, it allows for a much greater variation of “normal”. It must seem unbearably hard to accept that reality is not what you grew up believing, but you literally contain physical traits of both sides, and you have the freedom to be what you want and what makes you happy. I’m not sure that “sex” in the way we think of it is as eternally important as we like to believe. Trust yourself to find harmony with your body – and don’t get stuck feeling trapped by your genetics. New cellular biology research is showing that our environment and our perceptions have more of an impact on our genetic expression than our DNA – which means that we have more control over our bodies than we ever believed. Have faith in your abilities, and know that God gives us life – but allows us to use it and mold it.
I hope you find hope and understanding with your new perspective and that God gives you peace.
Justagirl –
I’m so impressed with your courage. You indicated that you “know that you are meant to be a woman”. I hope that you can find peace in that. You’ve reminded me that there are a long list of mysteries in this life, of things that we don’t fully understand. We need to be so careful about judging each other. Thanks so much for sharing your story. I hope you feel the love of your sisters here at Exponent. If I were your mother, I’d be so proud that you had the courage to go ahead and marry, move forward with your life, and live your truth.
I am a “male” who suffers from lifelong gender dysphoria (it may or may not have a biological basis to it) and just wanted to clear up that President Packer’s talk last October was not about gender identity, at least not that I could tell. Our spirits are only male or only female. In mortality some of us may have bodies that don’t accurately represent our spirit’s gender but that doesn’t mean we should be concerned when the Church strives to keep the legal definition of marriage as being only between a man and a woman. On the other hand I still hope for greater understanding in and out of the Church on the issue of those who have gender identity struggles. And, yes, some people in the Church have been allowed to transition their physical appearance to that of the gender they feel they really are.
I as an intersex person had a really bad experience with the church. I have a mix of both make and female anatomy and parts. I have facial hair, breasts, a deep voice, a vagina, a penis, a menstual cycle, and a physically large frame.
My younger brother is also intersex and my baby sister is a lesbian. There are several other cases of homosexuality, transgenderism, and intersex birth on my moms side of the family. I strongly believe it’s a genetic thing and not a choice as some people claim it is.
Growing up in the church was really hard. I wasn’t allowed to bless the sacriment nor hold the priesthood because I was part female. And I wasn’t allowed into young women’s nor the relief society because I’m part male. I had absolutely no function or purpose in the church.
I wasn’t allowed to use the mens or women’s restrooms at church. At youth dances, I wasn’t allowed to dance with anyone because either gender I danced with is considered both homosexual and heterosexual. I wasn’t allowed to do temple work of any kind. I wasn’t allowed to go on a mission. I wasn’t allowed to participate in just about every church event or gathering.
I was expected to sit in the back, remain quiet, remain celebate for life, make myself small and invisible to others, don’t talk to and/or form relationships with anyone, and to quietly wait to die. Then “maybe” I’ll get into heaven. Maybe. No guarantees.
I left the church and officially resigned. Can you blame me? Going to church left a pit of anxiety in my stomach. Rather than feeling comforted in the house of the lord, I dreaded going there. Not from any divine reasons, I just couldn’t stand the negative attitude everyone held against me. I left, my intersex brother left, lesbian sister left, and pretty much everyone else in the family left the church for good except two: my mom and one of my sisters. And my mom still sorta believes but doesn’t attend church anymore. She doesn’t pay tithing and she doesn’t help the church in any way. The members verbally attacked a couple of their children and she couldn’t stand it anymore.
I personally will never go back. Rather than making amends and making things right, church leaders dug in their heels and started going after LGBT people with a vengeance. There’s Prop 8 and Utah leads the country in youth suicides by a mile. Over 40% of Utah’s homeless youth are LGBT, much much higher than any other state and that’s no coincidence.