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Do No Harm: Intersex Surgeries and the Limits of Certainty

in UNITED STATES, 21/05/2013

The Southern Poverty Law Center and Advocates for Informed Choice have filed a lawsuit against the South Carolina Department of Social Services (SCDSS), Greenville Hospital System, the Medical University of South Carolina, and several medical personnel for allowing physicians to remove the atypical genitals of a 16-month-old toddler because that child, in the state’s custody at the time, was born with an intersex condition.

M.C. had been identified male at birth, but his genitals were sufficiently indeterminate that surgeons removed his ambiguous phallus, a testis, and testicular tissue on one gonad, and surgically created an ostensible approximation of female genitals. The suit asserts that there was no medical need for this surgery, which was meant to permanently “fix” this child and turn him into an unequivocal girl, but it did him more harm than good. M.C., now eight years old, feels more like a boy, lives as a boy, and heartbreakingly has asked his mother, “When will I get my penis?”

This sad situation is reminiscent of another case in which the patient, also an orphan, had no parents to advocate on his behalf and underwent similar genital surgery for no medical reason. Frank, a seven-year-old boy was admitted to the Johns Hopkins Hospital in October 1925, diagnosed with undescended testicles and hypospadias, a condition where the urinary opening is underneath rather than at the tip of the penis. In addition, Frank had a short vagina, leading physicians to believe that he was actually a girl. When they did exploratory surgery they found an ovary on one side, confirming their suspicions. What was once seen as a boy’s penis was now seen as an enlarged clitoris. Doctors now considered Frank to be a girl, and they advised the orphanage to change his name from Frank to Frances and rear him as female. The fact that the child was an orphan probably made it easier for the doctors to convince his guardians that surgery was necessary, but even parents face overwhelming pressure when confronted with physicians’ seeming certainty over the correct course of action.

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