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intersexcat-tboy · 4 days

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Examining Miscalculations and Intersex Definitions Regarding Sax's .018% Claim

The debate surrounding the definition of intersex and their characteristics has been a topic of debate within various professional fields, advocacy organizations, and studies for decades. Amidst this discourse includes a response from Dr. Leonard Sax, who claims to provide a "clinician's standpoint" despite lacking specialized expertise in these conditions, having only served as a primary care physician.

However, his arguments stand in stark contrast to those of Fausto-Sterling, a world-renowned professor of biology and gender studies. Furthermore, they diverge significantly from the consensus among major health associations, medical organizations, intersex rights groups, and human rights organizations.

Leading/Major Health Associations

The definition of intersex is resoundingly clear among leading health associations. The World Health Organization recognizes that intersex individuals are those "born with natural variations in biological or physiological characteristics, including sexual anatomy, reproductive organs, and/or chromosomal patterns that do not fit traditional definitions of male or female." Similarly, the National Institute of Health acknowledges individuals who are "born with, or who develop naturally in puberty, biological sex characteristics that are not typically male or female." The National Health Services emphasizes that intersex "involves genes, hormones, and reproductive organs, including genitals, and a person's physical sex development can differ internally, externally, or both."

Major/Leading Medical Associations

Major medical associations provide crucial insights into the understanding of intersex variations. The The American Medical Association adopts a broader definition, recognizing those with "a congenital condition with inconsistent chromosomal, gonadal, or anatomic sex development." Likewise, the Royal Australasian College of Physicians (PDF - which trains and accredits physicians in Australia and New Zealand) recognizes the significance of "congenital variations in a person's physical, hormonal, or genetic characteristics that do not match strict medical definitions of female or male sex." Additionally, the Center for Disease Control highlights the concept of "variations in physical sex characteristics, including anatomy, hormones, chromosomes, or other traits, that differ from expectations generally associated with male and female bodies." The International Symposium on Disorders of Sex Development notes there to be over 40 conditions

Leading Intersex Rights organizations

Intersex rights organizations, including Intersex Human Rights of Australia and Brújula Intersexual in Mexico, explicitly disagree with Dr. Leonard Sax's narrow definition of intersex individuals. They align themselves with more inclusive perspectives. For instance, Intersex Society of North America (working with) InterACT still use Fausto-Sterling's estimates over a decade later. Intersex Campaign for Equality in the United States also uses Sterling's estimates, believing the figures may even be higher than 2%. Intersex Asia and Intersex Russia both use estimates ranging from 0.5%-1.7%, Russia even including PCOS by name (which would be higher than 1.7%). InterAction from Germany's Intersex Rights suggests a range of 1-2 individuals per 100 births, highlighting how the medical community tries to "keep the frequency as extremely low as possible". Stop Intersex Mutilations from France posits there are over 40 variations and also suggests the prevalence might surpass 1.7%. Additionally, OII Europe presents prevalence estimates of 1:200 and 1.7% in their materials.

These organizations stress that intersex variations encompass a wide spectrum of biological and physiological characteristics beyond chromosomal ambiguity, challenging Sax's limited viewpoint.

Major human rights organizations

unequivocally support intersex individuals. The Office of the High Commissioner for Human Rights emphasizes that intersex individuals are "born with a wide range of natural variations in their sex characteristics that don't fit the typical definition of male or female." Amnesty International notes that intersex encompasses "a wide umbrella of natural variations" (1.7%) and human rights abuses faced by intersex individuals. Human Rights Watch and the Human Rights Campaign underline the broader definition of intersex, acknowledging variations in genitalia, chromosomes, gonads, internal sex organs, hormone production, hormone response, and secondary sex traits, noting 1.7% as a prevalence rate. These human rights organizations underscore the importance of acknowledging intersex variations to ensure the protection of human rights.

Other Medical Orgs

Additional medical organizations like the Société Internationale d'Urologie (PDF) (an international professional organization dedicated to the field of urology), and the National Society of Genetic Counselors (uses 1.7%, says sex is not based on chromosones) adopt definitions that align with broader medical perspectives, they recognize the complexities of intersex conditions and advocate for understanding beyond binary definitions. Furthermore, the Endocrine Society acknowledges CAH to be part of a continuum of disorders, acknowledging the variations in severity.

Examining oversights: Discrepancies in Calculations

What's interesting is that even within Sax's own criteria, defining intersex as when 'the chromosomal sex is inconsistent with phenotypic sex, in which the phenotype is not classifiable as either male or female,' there's an evident inclusion of conditions like 'sex reversals' and ambiguous genitalia. However, Sax overlooks contributors such as mixed gonadal dysgenesis (MGD), as well as Swyer Syndrome and de la Chapelle syndrome, despite the former being the second leading cause of ambiguous genitalia.

Let's do the math

CAH (.0077) + CAIS (.0076) = .0153

+ ovotestes (.0012) + Idiopathic (.0009) = .0174

+ PAIS (.00076) = .01816

Fausto-Sterling includes de la Chapelle syndrome and MGD, although not as separate statistics. MGD is amalgamated with Turner's statistics, and de la Chapelle syndrome is grouped with other sex chromosome variations. However, Sax completely disregards these conditions when he discards several categories from his estimates, effectively throwing out qualifying numbers and ignoring their potential impact on the overall prevalence of intersex conditions.

While newer studies suggest a prevalence of .004 for MGD, we also have to consider that neither study includes Swyer Syndrome (+.00125), and PAIS is now recognized as at least as common as CAIS, with the latter being less likely to cause ambiguous genitalia at birth, and more likely to be identified in childhood.

The leading causes of ambiguous genitalia are CAH (.0077), PAIS (.00076), MGD (.005) and ovotestes (.0012), which places us just below (.01466) the ambiguous genitalia observed at birth from Mothers And Babies Reports from Australia, if we account for 15% (0.0006) of de la Chapelle births having ambiguous genitalia, it brings ambiguous genitalia at birth to a total of .015% found before.

If he includes CAH, PAIS (since CAIS is often not identified until childhood), ovotestes and idiopathic causes under his definition of intersex, it leaves us with .005% of births with ambiguous genitalia without a possible causing condition. This gap can easily be explained by his exclusion of MGD and de la Chapelle syndrome.

If we count only CAIS (.0076) and CAH (.0077), and the newer study estimate of de la Chapelle (.004), it already surpasses Sax's estimate at .0193.

With the addition of ovotestes (.0012) and idiopathic (.0009) we get .0214. With older estimates of PAIS (.00086), .022%; with newer ones (.0076), .029%. Adding in Sawyer syndrome brings us to .03, which is over two thirds an increase of Sax's original estimate.

There is overwhelming support for a more comprehensive understanding of intersex variations that emphasizes the importance of respecting a wide range of biological and physiological characteristics beyond mere genital and chromosomal definitions. This approach is essential in safeguarding human rights and ensuring equitable treatment for all individuals

TLDR;;

The collective stance of experts and organizations, spanning from health associations to human rights advocates, sharply contrasts with the limited definition created by Sax. He claims to know other clinicians' thoughts, without any evidence to back it up. As stated previously, he also lacks education and clinical experience on intersex individuals, he is a family doctor.

#intersex studies #actually intersex #intersex activism #intersex awareness #intersex discussion #intersex issues #intersex erasure #intersex theory #intersex things #intersex #purrspectives #intersex advocacy #queer activism #queer stuff #queer tag #intersex tag

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ipso-faculty · 27 days

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Hello! I’m an intersex literature student in Uni right now looking to write an essay that deals with portrayals of intersex bodies in literature. I was wondering if you/your followers might have any recs on academic books/papers that touch upon this topic? Any help is appreciated. Thank you!

I'd read the last few chapters of Horlacher, S. (2016). Transgender and intersex: Theoretical, practical, and artistic perspectives (pp. 1-27). Palgrave Macmillan US.

As well as the first several chapters of Walker, M. (Ed.). (2022). Interdisciplinary and global perspectives on intersex. Springer Nature.

For the most part these are critiques of intersexist literature like Middlesex (🤮). There is a lot less writing about intersex representation done well, though quality representation does exist (e.g. books by intersex authors like Rivers Solomon and Bogi Takács). Most of that writing isn't peer reviewed - it's book reviews by intersex people, like Bogi's blog and the Intersex Book Club.

If your interpretation of "literature" includes nonfiction, I'd also read:

Ch 1 of Malatino, H. (2019). Queer embodiment: Monstrosity, medical violence, and intersex experience. U of Nebraska Press.

Ch 2 of Rubin, D. A. (2017). Intersex matters: Biomedical embodiment, gender regulation, and transnational activism. Suny Press.

Ch 7 of Horlacher, S. (2016). Transgender and intersex: Theoretical, practical, and artistic perspectives (pp. 1-27). Palgrave Macmillan US.

Hope that helps! I am assuming you have library access to all of these but DM me if you don't. :)

#intersex studies #asks #text #intersex #actually intersex #gender studies #queer theory #intersex literature

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queercripintersex · 1 year

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It was a while ago, but remember that time when I mentioned that it was hard to tell which term to use to mean "not intersex?"

I actually found differences in general attitudes and usage behind terms!

Dyadic is known to be created by an intersex person. Endosex is unknown, and perisex is known to be made by a non-intersex person. Dyadic and endosex are more commonly used in academic literature as well.

Dyadic has a bit of controversy because the implication is that no one else can have differing sex characteristics, but to be fair, bisexual and transgender both have similar issues of the origin of the words aren't completely accurate to the words usage.

I got the information from the book Cripping Intersex by Celeste Orr. If you want to check out the book I'd recommend it!

Thanks! I'll have to check it out.

I've personally been leery of dyadic because to me it implies anybody who isn't is deficient (our bodies weren't made to complete a dyad), but the poll I put out made clear this term is popular.

#intersex #intersex studies #queer theory

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trans-axolotl · 2 years

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one of the reasons I think that intersex people should learn about disability politics and embrace disability justice is because I think it will allow us to make a lot more sense of why intersex medical abuse happens. If you think of the medical system as a system that's functional, has the patient's best interests at heart, and is a place where the first priority of doctors is helping people , instead of their priorities being profit or normalcy, then intersex medical abuse seems shocking and completely unexpected. If you understand the medical industrial complex as a system with many, many moving parts that are shaped by capitalism and oppression, and understand how eradication, eugenics, and violent cure define disabled people's experiences in the medical system, intersex medical abuse is still horrific and shocking but also is less surprising when considering the ways in which the system is set up to support that kind of abuse. Intersex medical abuse is particularly violating and bad, and it exists on a continuum of the many horrible experiences that disabled people go through every day in the medical system. And I think understanding that dynamic is incredibly important when it comes to intersex activism because that needs to shape our tactics. Understanding intersex in the context of disability helps explain why changing terminology to DSD was such a bad strategic move, and explains why that strategy would never have worked to gain any protections from intersex medical abuse. Choosing stigmatizing labels and embracing the medical model is not a stategy that would ever actually help us get protection from medical abuse. Treating the medical system like it's mostly beneficial and pretending that disabled and ill people are respected and receive adequate care from the system is going to fuck us over and prevent us from actually taking steps towards radical change and solidarity.

ok to reblog

#personal #actuallyintersex #intersex #ok to reblog #disability justice #disability studies #actuallydisabled

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ottern0t · 20 days

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I was doing referenced nude studies and i also needed to flesh out my fullbody headcanon design for ten so I decided to kill two birds with one stone

Uncensored version under the cut

Nonsexual nudity my beloved…bodies r beautiful

#doctor who #doctor who fanart #tenth doctor #tenth doctor fanart #doctor who headcanon #nonsexual nudity #nude art study #intersex #trans tenth doctor #Theres the nails again #Top one was a freehand pose actually #Otter-not an art tag 🙄 definently

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gay-ratt · 2 days

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Doodles

I had a lot of fun looking at one peice as mlp and @lazycharmsstuff ‘s gear 5 Luffy ( right)

Luffy with a lot of face piercings , law , and my g5 luffy ( left)

#op #one piece fanart #art #mlp #art study #monkey d. luffy #op sanji #gear 5 luffy #trafalgar law #intersex character #nudity #one piece #one piece mlp

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dakotafoxart · 2 years

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Today is Intersex Awareness Day and with a painting I made, I’d like to introduce my mom!

They are an artist, activist, author, oracle, generally amazing human being—

and they are also Intersex 💛

I made this painting for them because I am so so proud of them, and i wanted to celebrate them today! In the little way i can :] 💛

The intersex community has gone through an immeasurable amount of struggle, a lot of people don’t even know whats going on because its not talked about so I just wanted to use this day to show my mom, a person who lives their life out loud, and has been a light in so many lives, they have helped so many people intersex and otherwise.

They are just a wonderful person and they deserve to be treated with out prejudice.

#intersex #intersex awareness day #IntersexAwarenessDay #intersexpride #nonbinary #art #digitalart #digital artwork #digital art #digital drawing #digital portrait #photo study #illustration #painting #digital portraits #drawing #artwork #lgbtqia #queer

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mrdyketator · 11 months

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there's so many layers to this💀.

#''i hope they fail all their classes'' sorry babe im too smart for that #also im studying to be a doctor not a nurse; feels vaguely misogynist that op would assume that #esp since my pinned post literally says ''aspiring doctor'' and me nor anyone else mentioned ANYTHING abt me being a nurse #AND PLS THE CONSERVATIVE ACCUSATIONS IM DYING bbg u couldn't handle the mildest of my misandrist posts #the sheer amount of stuff op just Made Up is hilarious #the whole ''she doesn't believe in intersex people'' tangent and the nurse tangent and the conservative tangent #op has me blocked & someone from the server @ed me abt this lol #p

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intersexbookclub · 3 months

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Summary: Chapter 4 of Critical Intersex

For many of us, Chapter 4 of Critical Intersex (2009) turned out to be a particularly rich source of information about intersex history. So I (Elizabeth) have decided to give a fairly detailed summary of the chapter because I think it’s important to get that info out there. I’m gonna give a little bit of commentary as I go, and then a summary of our book club discussion of the chapter.

The chapter is titled “(Un)Queering identity: the biosocial production of intersex/DSD” by Alyson K. Spurgas. It is a history of ISNA, the Intersex Society of North America, and how it went from being a force for intersex liberation to selling out the movement in favour of medicalization. (See here for summary of the other chapters we read of the book!)

Our high level reactions:

Elizabeth (@ipso-faculty): Until I read chapter 4, I didn't really realise how reactionary “DSD” was. It hadn't been clear to me how much it was a response to the beginning of an organized intersex advocacy movement in the United States.

Michelle (@scifimagpie): I could feel the fury in the writer's tone. It was a real barn burner.

Also Michelle: the fuckin' respectability politics of DSD really got under my skin, as a term! I know the importance, as a queer person, of not forcing people to ID as queer, but this was a lot.

Introducing the chapter

The introduction sets the tone by talking about how in the Victorian era there was a historical shift from intersex being a religious/juridical issue to a pathology, and how this was intensified in the 1950s with John Money’s invention of the optimal gender rearing model.

Spurgas briefly discusses how the OGR model is harmful to intersex people, and how it iatrogenically produces sexual dysfunction and gender dysphoria. “Iatrogenic” means caused by medicine; iatrogenesis is the production of disease or other side-effects as a result of medical intervention.

This sets scene for why in the early 1990s, Cheryl Chase and other intersex activists founded the Intersex Society of North America (ISNA). It had started as a support group, and morphed significantly over its lifetime. ISNA closed up shop in 2008.

Initially, ISNA was what we’d now call interliberationist. They were anti-pathologization. Their stance was that intersexuality is not itself pathological and the wellbeing of intersex people is endangered by medical intervention. They organized around the abolition of surgical intervention. They also created fora like Hermaphrodites With Attitude for the deconstruction of bodies/sexes/genders and development of an intersex identity that was inherently queer.

The early ISNA activists explicitly aligned intersexuality in solidarity with LGB and transgender organizing. There was a belief that similar to LGBT organizing, once intersex people got enough visibility and consciousness-raising, people would “come out” in greater numbers (p100).

By the end of the 90s, however, many intersex people were actively rejecting being seen as queer and as political subjects/actors. The organization had become instead aligned with surgeons and clinicians, had replaced “intersex” with “DSD” in their language.

By the time ISNA disbanded in 2008 they had leaned in hard on a so-called “pragmatic” / “harm reduction” model / “children’s rights perspective”. The view was that since infants in Western countries are “born medical subjects as it is” (p100)

Where did DSD come from?

In 2005, the term “disorders of sexual differentiation” had been recently coined in an article by Alice Dreger, Cheryl Chase, “and three other clinicians associated with the ISNA… [so as] to ‘label the condition rather than the person’” (p101). Dreger et al thought that intersex was “not medically accurate” (p101) and that the goal should be effective nomenclature to “sort patients into diagnostically meaningful groups” (p101).

Dreger et al argued that the term intersex “attracts the interest of a large number of people whose interest is based on a sexual fetish and people who suffer from delusions about their own medical histories” (Dreger et al quoted on p101)

Per Spurgas, Dreger et al had an explicit agenda of “distancing intersex activism from queer and transgressive sex/gender politics and instead in supporting Western medical productions of intersexuality” (p102). In other words: they were intermedicalists.

According to Dreger et al, an alignment with medicine is strategically important because intersex people often require medical attention, and hence need to be legible to clinicians. “For those in favor of the transition to DSD, intersex is first and foremost a disorder requiring medical treatment” (p102)

Later in 2005 there was a “Intersex Consensus Meeting” organized by a society of paediatricians and endocrinologists. Fifty “experts” were assembled from ten countries (p101)... with a grand total of two actually intersex people in attendance (Cheryl Chase and Barbara Thomas, from XY-Frauen).

At the meeting, they agreed to adopt the term DSD along with a “‘patient-centred’ and ‘evidence-based’ treatment protocol” to replace the OGR treatment model (p101)

In 2006, a consortium of American clinicians and bioethicists was formed and created clinical guidelines for treating DSDs. They defined DSD quite narrowly: if your gonads or genitals don’t match your gender, or you have a sex chromosome anomaly. So no hormonal variations like hyperandrogenism allowed.

The pro-DSD movement: it was mostly doctors

Spurgas quotes the consortium: “note that the term ‘intersex’ is avoided here because of its imprecision” (p102) - our highlight. There’s a lot of doctors hating on intersex for being a category of political organizing that gets encoded as the category is “imprecise” 👀

Spurgas gets into how the doctors dressed up their re-pathologization of intersex as “patient centred” (p103) - remember this is being led by doctors, not patients, and any intersex inclusion was tokenistic. (Elizabeth: it was amazing how much bs this was.)

As Spurgas puts it, the pro-DSD movement “represents an abandonment of the desire for a pan-intersexual/queer identity and an embrace of the complete medicalization of intersex… the intersex individual is now to be understood fundamentally as a patient” (p103)

Around the same time some paediatricians almost came close to publicly advocating against infant genital mutilation by denouoncing some infant surgeries. Spurgas notes they recommended “that intersex individuals be subjected (or self-subject) to extensive psychological/psychiatric, hormonal, steroidal and other medical” interventions for the rest of their lives (p103).

This call to instead focus on non-surgical medical interventions then got amplified by other clinicians and intermedicalist intersex advocacy organizations.

The push for non-surgical pathologization hence wound up as a sort of “compromise” path - it satisfied the intermedicalists and anti-queer intersex activists, and had the allure of collaborating with doctors to end infant surgeries. (Note: It is 2024 and infant surgeries are still a thing 😡.)

The pro-DSD camp within the intersex community

Spurgas then goes on to get into the discursive politics of DSD. There’s some definite transphobia in the push for “people with DSDs are simply men and women who happen to have congenital birth conditions” (p104). (Summarizer’s note: this language is still employed by anti-trans activists.)

The pro-DSD camp claimed that it was “a logical step in the ‘evolution in thinking’” 💩 and that it would be a more “humane” treatment model (p105) 💩

Also that “parents and doctors are not going to want to give a child a label with a politicized meaning” (p104) which really gives the game away doesn’t it? Intersex people have started raising consciousness, demanding their rights, and asserting they are not broken, so now the poor doctors can’t use the label as a diagnosis. 🤮

Spurgas quotes Emi Koyama, an intermedicalist who emphasized how “most intersex people identify as ‘perfectly ordinary, heterosexual, non-trans men and women’” (p104) along with a whole bunch of other quotes that are obviously queerphobic. Note from Elizabeth: I’m not gonna repeat it all because it’s gross. In my kindest reading of this section, it reads like gender dysphoria for being mistaken as genderqueer, but instead of that being a source of solidarity with genderqueers it is used as a form of dual closure (when a minority group goes out of its way to oppress a more marginalized group in order to try and get acceptance with the majority group).

Koyama and Dreger were explicitly anti-trans, and viewed intergender type stuff as “a ‘trans co-optation’ of intersex identity” (p105) 🤮

Most intersex people resisted “DSD” from its creation

On page 106, Spurgas shifts to talking about how a lot intersex people were resistant to the DSD shift. Organization Intersex International (OII) and Bodies Like Ours (BLO) were highly critical of the shift! 💛 BLO in particular noted that 80-90% of their website users were against the DSD term. Note from Elizabeth: indeed, every survey I’ve seen on the subject has been overwhelmingly against DSD - a 2015 IHRA survey found only 3% of intersex Australians favoured the DSD term.

Proponents of “intersex” over “DSD” testified to it being depathologizing. They called out the medicalization as such: that it serves to reinforce that “intersex people don’t exist” (David Cameron, p107), that it is damaging to be “told they have a disorder” (Esther Leidolf, p107), that there is “a purposeful conflation of treatment for ‘health reasons’ and ‘cosmetic reasons’ (Curtis Hinkle, p107), and that it’s being pushed mainly by perisex people as a reactionary, assimilationist endeavour (ibid).

Interliberationism never went away - intersex people kept pushing for 🌈 queer solidarity 🌈 and depathologization - even though ISNA, the largest intersex advocacy organization, had abandoned this position.

Spurgas describes how a lot of criticism of DSD came from non-Anglophone intersex groups, that the term is even worse in a lot of languages - it connotes “disturbed” in German and has an ambiguity with pedophilia and fetishism in French (p111).

The DSD push was basically entirely USA-based, with little international consultation (p111). Spurgas briefly addresses the imperialism inherent in the “DSD” term on pages 118/119.

Other noteworthy positions in the DSD debate

Spurgas gives a well-deserved shout out to the doctors who opposed the push to DSD, who mostly came from psychiatry and opposed it on the grounds that the pathologization would be psychologically damaging and that intersex patients “have taken comfort (and in many cases, pride) in their (pan-)intersex identity” (p108) 🌈 - Elizabeth: yay, psychiatrists doing their job!

Interestingly, both sides of the DSD issue apparently have invoked disability studies/rights for their side: Koyama claimed DSD would herald the beginning of a disability rights based era of intersex activism (p109) while anti-DSDers noted the importance in disability rights in moving away from pathologization (p109).

Those who didn’t like DSD but who saw a strategic purpose for it argued it would “preser[ve] the psychic comfort of parents”, that there is basically a necessity to coddle the parents of intersex children in order to protect the children from their parents. (p110)

Some proposed less pathologizing alternatives like “variations of sex development” and “divergence of sex development” (p110)

The DSD treatment model and the intersex treadmill

Remember all intersex groups were united that sex assignment surgery on infants needs to be abolished. The DSD framework that was sold as a shift away from surgical intervention, but it never actually eradicated it as an option (p112). Indeed, it keeps ambiguous the difference between medically necessary surgical intervention and culturally desired cosmetic surgery (p112). (Note from Elizabeth: funny how *this* ambiguity is acceptable to doctors.)

What DSD really changed was a shift from “fixing” the child with surgery to instead providing “lifelong ‘management’ to continue passing” (p112), resulting in more medical intervention, such as through hormonal and behavioural therapies to “[keep] it in remission” (p113).

Cheryl Chase coined the “intersex treadmill’: the never-ending drive to fit within a normative sex category (p113), which Spurgas deploys to talk about the proliferation of “lifelong treatments” and how it creates the need for constant surveillance of intersex bodies (p114). Medical specialization adds to the proliferation, as one needs increasingly more specialists who have increasingly narrow specialties.

There’s a cruel irony in how the DSD model pushes for lifelong psychiatric and psychological care of intersex patients so as to attend to the PTSD that is caused by medical intervention. (p115) It pushes a capitalistic model where as much money can be milked as possible out of intersex patients (p116).

The DSD treatment model, if it encourages patients to find community at all, hence pushes condition-specific medical support groups rather than pan-intersex advocacy groups (p115)

Other stuff in the chapter

Spurgas does more Foucault-ing at the end of the chapter. Highlight: “The intersex/DSD body is a site of biosocial contestation over which ways of knowing not only truth of sex, but the truth of the self, are fought. Both intelligibility and tangible resources are the prizes accorded to the winner(s) of the battle over truth of sex” (p117)

There’s some stuff on the patient-as-consumer that didn’t really land with anybody at the book club meeting - we’re mostly Canadians and the idea of patient-as-consumer isn’t relatable. Ei noted it isn’t even that relatable from their position as an American.

***

Having now summarized the chapter, here's a summary of our discussion at book club...

Opening reactions

Michelle (M): the way the main lady involved became medicalized really made my heart sink, reading that.

Elizabeth (E): I do remember some discussion of intersex people in the 90s, and it never really grew in the way that other queer identities did! This has kind of helped for me to understand what the fuck happened here.

E: It was definitely a very insightful reading on that part, while being absolutely outraging. I didn't know, but I guess I wasn't surprised at how pivotal US-centrism was. The author was talking about "North American centric" though but always meant the United States!!! Canada was just not part of this! They even make mention of Quebec as separate and one of the opposing regions. I was like, What are you doing here, America? You are not the entirety of our continent!!!

E: The feedback from non-Anglophone intersex advocates that DSD does not translate was something that I was like, "Yes!" For me, when I read the French term - that sounded like something that would include vaginismus, erectile dysfunction - it sounds far more general and negative.

M: the fuckin' respectability politics of DSD really got under my skin, as a term! I know the importance, as a queer person, of not forcing people to ID as queer, but this was a lot.

E: it was very assimilationist in a way that was very upsetting. I knew intellectually that this was going on. There was such a distinct advocacy push for that. The coddling of parents and doctors at the expense of intersex people was such a theme of this chapter, in a way that was very upsetting. They started out with this goal of intersex liberation, and instead, wound up coddling parents and doctors.

Solidarities

M: I feel like there's a real ableist parallel to the autism movement here… It dovetails with how the autism movement was like, "Aww, we're sorry about your emotionless monster baby! This must be so hard for you [parents]!" And it felt like "aw, it's okay, we'll fix your baby so they can interface with heterosexuality!" [Note: both of us are neurodivergent]

E: A lot of intersexism is a fear that you're going to have a queer child, both in terms of orientation and gender.

E: You cannot have intersex liberation without putting an end to homophobia and transphobia.

M: We're such natural allies there!

E: I understand that there are these very dysphoric ipsogender or cisgender people, who don't want to be mistaken as trans, but like it or not, their rights are linked to trans people! When I encounter these people, I don't know how to convey, "whether you like it or not, you're not going to get more rights by doing everything you can to be as distant as possible."

M: it reminds me of the movements by some younger queers to adhere to respectability politics.

E: Oh no. There are younger queers who want respectability politics????

M: well, some younger queers are very reactionary about neopronouns and kink at pride. they don't always know the difference between representation and "imposing" kinks on others. In a way, it reminds me of the more intentional rejection of queer weirdos, or queerdos, if you will, by republican gays.

E: I feel like a lot of anti-queerdom that comes out of the ipso and cisgender intersex community reads as very dysphoric to me. That needs to be acknowledged as gender dysphoria.

M: That resonates to me. When I heard about my own androgen imbalance, I was like, "does that mean I'm not a real woman?" And now I would happily say "fuck that question," but we do need an empathy and sensitivity for that experience. Though not tolerance for people who invalidate others, to be honest.

E: The term "iatrogensis" was new to me. The term refers to a disease caused or aggravated by medical intervention.

M: So like a surgical complication, or gender dysphoria caused by improper medical counselling!

The DSD debate

ei: i think the "disorder" discussion is really interesting. in my opinion, if someone feels their intersex condition is a disorder they have every right to label it that way, but if someone does not feel the same they have every right to reject the disorder label. personally i use the label "condition". i don't agree with forcing labels on anyone or stripping them away from anyone either.

M: for me, it felt like a cautionary tale about which labels to accept.

ei: i'm all around very tired of people label policing others and making blanket statements such as "all people who are this have to use this label”... i also use variation sometimes, i tend to go back and forth between variation and condition. I think it's a delicate balance between being sensitive to people's label preferences vs making space for other definitions/communities.

We then spoke about language for a bunch of communities (Black people, non-binary people) for a while

E: one thing that was very harrowing for me about this chapter is that while there was this push to end coercive infant surgery, they basically ceded all of the ground on "interventions" happening from puberty onward. And as someone who has had to fight off coercive medical interventions in puberty, I have a lot of trauma about violent enforcement of femininity and the medical establishment.

ei: i completely agree that it's psychologically harmful tbh…. i was assigned male at birth and my doctors want me to start testosterone to make me more like a perisex male. which is extremely counterproductive because i'm literally transfem and have expressed this many times

Doctors Doing Harm

M: for me, the validation of how doctors can be harmful in this chapter meant a lot.

E: something that surprised me and made me happy was that there were some psychiatrists who spoke out against the DSD label. As someone who routinely hears a lot of anti-psychiatry stuff - because there's a lot of good reason to be skeptical of psychiatry, as a discipline - it was just nice to see some psychiatrists on the right side of things, doing right by their patients. Psychiatrists were making the argument that DSD would be psychologically harmful to a lot of intersex people.

ei: like. being told that something so inherently you, so inherently linked to your identity and sense of self, is a disorder of sexual development, something to be fixed and corrected. that has to be so harmful

ei: like i won't lie i do have a lot of severe trauma surrounding the way i've been treated due to being intersex. but so much of my negative experiences are repetitive smaller things. Like the way people treat me like my only purpose is to teach them about intersex people …. either that or they get really creepy and gross. I’m lucky in that i'm not visibly intersex, so i do have the privilege of choosing who knows. but there's a reason why i usually don't tell people irl.

M: intersex and autism have overlap again about how like, minor presentation can be? As opposed to the sort of monstrous presentation [Carnival barker impression] "Come see the sensational half-man, half-woman! Behold the h-------dite!" And like - the way nonverbal people are also treated feels relevant to that, because that's how autism is often treated, like a freakshow and a pity party for the parents? And it's so dehumanizing. And as someone who might potentially have a nonverbal child, because my wife is expecting and my husband and she both have ADHD - I'm just very fed up with ableism and the perception of monstrosity.

Overall, this was a chapter that had a lot to talk about! See here for our discussion of Chapters 5-7 from the same volume.

#intersex #intersex studies #queer theory #gender studies #actually intersex #intersex rights #intersex activism #intersex books #book reviews #book summaries #paper summaries #lit review #critical intersex #intersex history

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trans-axolotl2 · 1 year

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"The 'curative' in 'curative violence' foregrounds a tragic paradox: in an effort to 'cure' or 'enable' apparently disabled intersex people, medical professionals subject people with intersex traits to disabling violence that often leads to short- and/or long-term disabilities. Importantly, the term 'curative violence' does not use disability as a symbol but instead emphasizes where blame lies by showing that many intersex people experience body-mind loss due to policies and practices that institutionalize compulsory dyadism and able-bodiedness."

-Celeste E Orr, Cripping Intersex

#actuallyintersex #intersex #disability studies #this book is so fucking good you all!!!#disability justice #intersex studies #cripping intersex #curative violence

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intersexcat-tboy · 2 months

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I have a whole essay disputing Leonard Sax's dumbass "most clinicians don't consider those intersex, so the REAL intersex percentage is .0018%!!!" paper, quoting some of the largest medical organizations and associations regarding their definition of intersex (and how they do consider a larger umbrella under intersex) but I'm not sure if there's like. Any point to it.

Not sure if anyone would read it or care that his appeal to authority was appealed by authorities disagreeing

#actually intersex #intersex #intersex things #intersex discussion #intersex theory #intersexism #intersex studies

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ipso-faculty · 7 months

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Excerpt from Costello (2016) on trans & intersex tensions

As part of the reading I've been doing for tomorrow's @intersexbookclub I read this book chapter "Intersex and Trans* Communities: Commonalities and Tensions" by trans & intersex scholar CG Costello that honestly still feels very relevant in 2023 and I personally found illuminating in understanding interactions I have seen and had on tumblr.

Bit of context: Costello differentiates an identity framework and a disorder framework for both trans and intersex communities, and makes the argument that to understand the relations between trans and intersex communities you need to realize there are four communities at play here, not two:

identity-framework trans people

disorder-oriented trans people (aka truscum aka transmeds)

identity-oriented intersex people, and

disorder-oriented intersex people (who tend to use DSD)

[Excerpt begins, all bolding is by me. A perisex trans person using the h-word is behind cut. A mention is made of rape. Anything in black is my commentary.]

The largest source of tension between intersex and trans* people had its source in the insistence of trans* individuals who framed trans* identity as a disorder that the intersex community should not only be seen as an ally, but really as their home community. [Perisex trans participant] Hazel stated: “I think many [trans*] gurls like me think of ourselves as intersex, and we deserve to be treated respectfully because we’re born with this problem, just like other hermaphrodites.” Stella elaborated,

You should understand where I’m coming from. You’re intersex. Well, being transsexual is really a type of intersexuality. I was born with a female brain in a male body. So I’m intersex, too. My condition is just as real, and needs treatment just as much. It’s unfair, that all these barriers are put in the way of my getting the hormones and surgery I need, because people are treating us like we’re crazy. They need to understand we have a kind of intersexuality. Then they’ll treat us differently.

It is evident that that minority of the trans* community that took a disorder position had a strong agenda: to claim a right to (free) medical treatment by framing trans-identification as akin to, or literally a form of, intersexuality.

This position is received very poorly by intersex people. For intersex people who employ the identity framework, it comes across as an offensive failure to understand intersex experience. Oscar, himself both intersex and trans*, and viewing both through the identity framework, said:

I do think intersex and TG issues are related in many ways. But being TG isn’t an intersex condition. Man, I hate that whole argument, that TG is an intersex brain state that ‘needs’ to be cured with genital surgery. Because that argument is saying that the surgery doctors force on intersex kids is necessary and good. Because it treats intersex people as lucky, not as victims. These people making this argument have no idea what our lives are like, but they’re happy to use us, to say they speak for us. ‘I have an intersex brain, and intersex people have to get genital surgery, which makes everything better.’ Oh, piss off, idiots. The feminizing surgery that was forced on me as a kid mutilated me, but you’re treating it as good. Don’t you dare claim to speak for me.

Intersex people who employ the identity frame have as their goal a civil rights movement aimed at putting an end to the casting of sex variation from binary ideals as a disorder. Trans* people who position themselves as suffering from an intersex disorder are basing their claim to medical treatment on an argument that supports the perpetuation of binary-normalizing infant genital surgery. Thus, these trans* people are viewed very negatively as appropriating intersex identity while acting in total opposition to the goals of the intersex community by those intersex people who employ the identity frame.

In addition to the ‘brain intersex’ argument, a substantial number of trans* people employing the disorder frame suspect or assert that they have a traditional reproductive intersex status. Irene was one such individual:

Well, for me it came together when I learned about Klinefelter’s. That’s when a person has XXY chromosomes—like, between male and female. And they look like boys when they’re born, but they’re really not. And they are tall and unathletic and shy, like me. Their penises are on the small side, like mine, and their testicles can be unusual. I know when I was young, sometimes my testicles would kind of shloop up into my body, and go up like ovaries. So I am pretty sure I have Klinefelter’s, and that explains why I never really felt male. Because I’m not! [footnote 6 which I will summarize as "this does not mean one has Klinefelters"]

The desire on the part of trans* people employing a disorder frame to claim a physiological or anatomic basis for their trans-identification leads to a lot of conflict with intersex people employing the disorder framework. As Anna noted, “These transsexuals act as if people with DSDs all have gender identification problems. Well, the vast majority of us don’t—I’m very happy I was assigned female.” Many intersex people like Anna are concerned that their binary gender identities are not respected. They wish to be treated as ‘real men’ and ‘real women’, and view trans* claims to an intersex status that would justify gender transition as undermining their struggle for legitimacy. Certainly the common experience of a person with Klinefelter’s is to have always identified as male, to receive the diagnosis as a great surprise during medical investigation for fertility problems, and to be uncomfortable applying the term ‘intersex’ to themselves, using the DSD terminology of ‘46, XXY male’ instead.

Another intersex complaint is that trans* people claiming intersex status do active harm to the intersex community. Edith said, “These intersex wannabes made it very difficult for me, an actual intersex person, to get support. I tried using the discussion boards on Bodies Like Ours, but they were just constantly being flooded by transgenders with crazy notions that they wanted validated.” As someone who blogs on intersex issues, I can affirm that I do often receive comments and email queries from trans* people that accord with Edith’s complaint. Some are simple inquiries (“Do you think I could be intersex? I’ve always felt like a boy not a lesbian, and my girlfriend says my clit is enlarged.”), but others assert as factual extremely implausible bodily descriptions. For example, a trans* woman wrote a comment on one of my posts claiming that despite having a normal penis and testes, doctors had found a uterus and ovaries connected to her anus when she was treated after being raped at age ten, and removed them to avoid pregnancy; in another example a trans* man wrote to me asserting that he had been born with a penis as well as a clitoris, but that his mother had caused the penis to retract into his abdomen by giving him birth control pills as a child. Intersex people are angered at encountering such stories that evince a total lack of knowledge of the way the real sex spectrum works. Anna fumed,

These transsexuals who are pretending to have DSDs are out there spreading disinformation and lies. They hurt the DSD community in general by spreading confusion and making us look bizarre. And some of them could wind up killing somebody. They’ll claim to have CAH and start speaking like an expert when they know nothing at all about the many varieties of CAH and the serious health risks associated with some of them.

Intersex people who themselves have gender transitioned also expressed displeasure at the lack of knowledge being displayed by trans* people telling fanciful stories about being intersex. Theta said,

When a trans person bases their claim to a right to gender transition services on some ludicrous story—“I was born with ovaries and testes, but exposure to some Cherenkov radiation caused the ovaries to dissolve in a glorious blue glow”—they are doing no one any favors. Their assumption that an intersex person who is unhappy with the sex zie was assigned at birth is entitled to some sort of ‘free sex change’ is absolutely false. In fact, not only are the gender transitions of intersex people not covered by insurance, but it’s actually harder for us to access transition services, because the diagnostic category used excludes people with intersex conditions. All these people succeed in doing is providing fodder to transphobes in the intersex community who then challenge the legitimacy of the intersex status of any of us who gender transition.

In short, intersex people of all stripes, employing both the disorder and identity frameworks, are repelled by trans* people who seek to position themselves as intersex based upon a false belief that this will protect them from stigma, and grant them access to free gender transition services, which are (mis)framed by these trans* people as appropriately freely provided to intersex children and adults.

[End excerpt]

The inquiries mentioned a few paragraphs above sound like my asks and what I see on #intersex with such regularity, and helped me understand whyyy this keeps happening. 😵‍💫

#intersex #intersex book club #intersex studies #actuallyintersex #actually intersex

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