Friday , 20 September 2019

Intersex Musing on Binary Essentialism

Intersex flag
Intersex flag

There’s definitely something stirring in the ether.

Claire Ainsworth was first out of the traps with their article in Nature, openly stating that science has known for years that sex is a spectrum, and nothing like the immutable binary that everyone is told about in class, all the way from primary school thru to med. school.

You will search in vain in this article for any acknowledgement of the validity of intersex embodiment, or that anyone born so is entitled to bodily integrity and personal autonomy. Indeed the framing of the narrative is made plain when CA describes X and Y chromosomes as sex specific identifiers, intersex as a condition, and the onus being on parents having to make difficult decisions in the situation of giving birth to an intersex child, whereas in fact it will almost always be clinicians who tell parents what they ought to do.

It is left to Anne Fausto-Sterling, whose work is cited in this piece, to point out in the comments that CA has completely failed to acknowledge the groundwork that intersex advocates have made in establishing these ideas, and the fact that some of the cited clinicians actually know, and have worked with, those same people.

“Giving credit and showing chains of knowledge are part of doing science journalism in an ethical and professional manner. It does a disservice to science to pretend that all the ideas come from scientists in the current moment. The ideas in this article come from intersex activists (many of whom some of the scientists you do cite knew and worked with) as well as historians of science and biologists such as myself. Feminist theory also contributed to the growth of these ideas. Biology is not an island divorced from the rest of academia or society. It is not great journalism to pretend otherwise.”

Intersex erasure takes many forms, and one of the more egregious is to deny the body of work that intersex activists have contributed to scientific thinking in the arena of sex differentiation. Rather than being read as a willingness to acknowledge the breadth of human variation, Ainsworth’s article ought to be more readily seen as a determined effort to retain control of how the binary narrative is interpreted.

Another long-read item that has just popped up on the radar can be found in the New Statesman.

This article waxes lyrical about the essentialist thinking that has driven reliance of the belief that XX and XY define men and women. It is a long read, and quotes Ainsworth at some length, if only to reify the idea that intersex variation is   *something that has to be addressed*. The New Statesman article is a longform review of Sarah Richardson’s Sex Itself: The Search for Male and Female in the Human Genome

Human genomes are 99.9 percent identical—with one prominent exception. Instead of a matching pair of X chromosomes, men carry a single X, coupled with a tiny chromosome called the Y. Tracking the emergence of a new and distinctive way of thinking about sex represented by the unalterable, simple, and visually compelling binary of the X and Y chromosomes, Sex Itself examines the interaction between cultural gender norms and genetic theories of sex from the beginning of the twentieth century to the present, post-genomic age.

As it continues, the NS article veers away from discussing genetics to touch on the equally problematic area of endocrinology. The early 20th century was an era when scientists really believed they could refashion humanity. Eugenics was highly regarded, and openly discussed. In their striving for knowledge, scientists took some very dark turns in the search to describe what exactly defined a man or a woman.

It was in 1905 that Ernest Stirling, a British physiologist, gave the name *hormones* to the chemical secretions that govern much of human development. Stirling had a classical education, as did most of the predominantly male medical establishment, and he took his inspiration from the Greek word hormõn – meaning exciting/arousing.

Much of the early research into the properties of testosterone was conducted by vivisecting animals and transplanting their organs, or the testicular extracts, into men as a restorative. In doing so these early years scientists adhered to the gender essentialism we still know today, and named testosterone a male hormone. Today we know that both men and women produce testosterone, and there is no empirical data available for differentiating what the blood-t level is in a healthy man or woman; there are only averages. It is this that is about to be tested in the International Athletics Court in Lausanne after the IAAF/IOC introduced arbitrary rules about the blood-t levels for female athletes, without the concomitant evidence to enable them to uphold it.

Medicine has long known about variations of the human form. It has a shockingly poor record of accepting such differences as valid; as representing the continuum of human diversity. Medicine has taken upon itself to be the arbiter of who and what is a ‘proper’ male or female: delineating two discrete forms of human being, as complimentary but opposite to one another. In recent times medicine has aggressively sought the erasure of intersex embodiment by surgery and assimilation. The justification for this has always been the well-being of those born intersex, but is more comprehensible if viewed as a mechanism to assuage parental and societal unease at intersex embodiment.

Medicine continues to adopt a self-referential and paternalistic attitude to intersex, and has conferred on itself the right to pathologise those variations. It is unquestioning in its right to signify intersex variations as abnormalities, as disorders. In doing so, medicine has determinedly sought to reinforce social and cultural norms of sex and gender identity, primarily by the use of surgery and hormone interventions: itself a legacy that reaches back to medicine’s earliest attempts to identify, categorize and delimit an acceptable portrayal of human beings.

To be borne intersex is to be codified by clinical language. Onto which are imputed alleged developmental and psychological dysfunctions, without any proper evidence provided to support those assumptions. The assumptions are enough in intersex medicine.

Intersex interventions presume  heterosexuality as the expected orientation after surgical procedures. As if the shape and form of one’s genitals is a predictor of sexual identity. Sexual orientation is definitely not a personal quality appropriate for medical intervention.  A person assigned female who later identifies as gay is not a failure of treatment values. Normality is the non-sequitur that describes many parents fear that their child will grow up a lesbian without surgery; they want their child to conform to their expectations of a female child. And medicine obliges.

Ainsworth’s article finishes with a flourish, quoting a clinician well known in the world of genetics, Eric Vilain:-

“In other words, if you want to know whether someone is male or female, it may be best just to ask.”

In the realm of intersex medical intervention, that is the very last thing anyone ever considers.

And Claire Ainsworth and Eric Vilain both know it.

About Leslie Jaye

Leslie Jaye
Leslie Jaye is an intersex advocate, member of OII - Organisation Intersex International, and chair of OII-UK. Leslie enjoys the company of good friends, film and literature. And red wine. They can often be found negotiating with their cat for enough space to sit comfortably on the sofa.

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