Acclaimed medical scholar speaks about intersex community

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“Sex is crazy complicated,” said visiting scholar Alice Dreger during a lecture on Friday. “They lied to you in school.”

Dreger, a historian of medicine and science and renowned sex researcher, spoke to students and faculty last week at the Wesley Gallery about the past strides and future goals for the intersex community in her talk, “Should We Be Adding ‘I’ to ‘LGBTQ’?”

Intersex individuals are individuals born with reproductive or sexual anatomy that does not fit the biological definition of either male or female. For example, intersex individuals may be born with both ovaries and testes at various stages of development, or they may appear to have female organs but have XY chromosomes.

Dreger has been researching the world of individuals with intersex conditions since she published her first book, “Hermaphrodites and the Medical Invention of Sex,” in 1998. In the book, she examines the history of the term “hermaphrodites,” a word used by scientists at the time to describe these people.

Dreger is also a founding board chair of the Intersex Society of North America and advocates for the fair treatment of children with intersex conditions.

Before the intersex rights movement, treatment for babies born with intersex conditions involved invasive and often unnecessary surgeries to try and make the genitalia traditionally male or female. This practice was especially prominent when dealing with intersex children, who typically underwent surgeries to have female sex organs because they were easier to form than male organs.

In her talk, Dreger explained that the idea for this treatment was developed in the 1940s and 50s by Lawson Wilkins, a pediatric endocrinologist, and was later expanded upon by sexologist John Money, who encouraged sexual correction surgery because he thought it would improve the quality of life for the child.

The surgery was also a method to ensure the child would only have heterosexual relationships. For example, according to Dreger, medical literature of the period said shortening what was considered an overly large clitoris would prevent lesbianism.

However, instead of creating healthier children, the results were often infections and dysfunctions, both sexual and in everyday life. Many who received surgeries as children reported loss of sensation and scarring, and often required many additional surgeries.

The surgeries also left a psychological impact on many, who felt they did not fit with the gender assigned to them as they grew older and that their bodies had been altered without their consent as children.

One famous case was the “John/Joan” case of David Reimer, who was surgically assigned female organs. Later in life, when Reimer was informed of the changes made to him as a child, he readopted his male identity, saying he never felt fully female.

Dreger went over some of the complexities of biological sex. She explained that genitals start out the same in the womb and are then shaped by the hormones the fetus is exposed to in utero. As a result of different levels of hormones, like estrogen and testosterone, the genitals develop in different ways.

Some genitalia appear ambiguous, such as in those with congenital adrenal hyperplasia, which can result in larger than average clitorises or labia that appear like a scrotum. This condition is most common in those with XX chromosomes. Another intersex condition is androgen insensitivity syndrome, when the person has XY chromosomes but their body does not respond to male hormones. This causes the individual to have internal testes but their outward genitalia appears female, yet the individual has no corresponding internal female reproductive organs.

While certain conditions require health intervention, such as certain organs being more likely to develop cancer, people with intersex are usually healthy.

“Normal and healthy are different,” she said. “Normal only becomes a problem when it becomes a health problem.”

The concept of normal sex has changed exponentially over time, Dreger said. For example, bearded women were considered intersex in the past. Scientists have now attributed most cases of facial hair on women as a result of an ovarian condition rather than an intersex one.

It wasn’t until the early 1990s when the intersex rights movement took off. In 1993, the term intersex started being used politically, meaning a body “somebody decided isn’t standard male or female.”

The intersex movement created a universal term for all intersex conditions but also worked to differentiate between intersex as an identity and as biology.

In 2005, the term hermaphrodite was replaced by intersex or disorders of sex development. With the help of Dreger and other advocates, the term intersex and disorders of sexual development (DSD) began to be used by doctors instead.

Intersex rights were also intertwined with the LGBT rights movement. Both groups, sometimes overlapping, were fighting to get equal patient treatment and end discrimination and social stigma. The movements are not only connected through their growth but also by the homophobic stigmas associated with them.

As both communities have grown, the obvious next step for many advocates is to add “I” to LGBTQ. Dreger explained adding on the letter could lead to more awareness about the topic.

However, adding the “I” would also make intersex an identity, reversing the progress made to classify intersex as a medical condition unless otherwise chosen by the individual. Dreger encouraged listeners to reach the conclusion themselves.

As for her role in changing the perception of the intersex community, Dreger said it took speaking out about changes face to face.

“If you want to do a social change work you have to sit with the people in power and treat them as human beings,” she said.

Dreger’s visit to UM was part of the Henry King Stanford Distinguished Professors lecture series sponsored by the College of Arts and Sciences’ Center for the Humanities. Dreger also spoke at two other events on Thursday, including a talk based on ideas from her book, “Galileo’s Middle Finger,” which was published in 2015 and explores the importance of academic freedom in higher education.