PHIL 2805- Essay 2 - Grade: A+ PDF

Preview

Summary

Second major essay....

Description

Intersexual people are individuals born with several potential variations in sex characteristics including chromosomes, sex hormones, or genitals, that fail to comply with traditional, socially prescribed definitions of male and female bodies. The practice of performing gendered ‘normalizing’ surgeries, whereby surgeons reconstruct the gentiles of newborns to satisfy predisposed gender expectations, is largely controversial. The procedure is definite, altering the identity of the patient for the rest of their lives, and requires consistent hormone treatments and regular check-ups to ensure accuracy (Dreger, 2011). Since babies lack the ability to adequately consent, parents are responsible for approving such surgeries, and deciding the sex of their child. Post-surgery practices usually require psychiatric counselling to ensure both children, and their respective parents effectively adapt to the child’s newfound identity. The practice of ‘normalizing’ surgeries is complex and does not come without complications. I argue that ‘normalizing’ surgeries performed at birth are detrimental to the psychiatric health of the patient, are both morally and ethically impermissible, lack progressive understanding, and should not be practiced. Such practices result in misconstrued conceptions of identity; oftentimes lack the necessary consent to be performed; infringe on fundamental parental and individual legal rights; lack an adequate risk-reward incentive; and are arbitrary, perpetuating heteronormative social standards. One might posit that ‘normalizing’ surgeries are advantageous as they prevent future identity complications and extraneous harm inflicted from public perceptions. Immediate decisions could be made based on the presumption that the child will be confused and incapable of comprehending their ambiguous genitals. Additionally, parents may fear the inevitable

pressure placed on their child in regards to their personal choices, and the social responses correlated to such circumstances. Many intersexual persons believe they are, “subject, out of "compassion," to “normalizing" surgeries on an emergency basis without their personal consent…” (Dreger, 1998). I do not believe parents should be able to make life-altering decisions based on the inclination that their child will somehow be deemed insufficient because of their ambiguous genitals. Who are they to assume their child will not be content with what they were born with? It has been scientifically proven that intersexual individuals, with proper psychiatric therapy and counselling, often learn to accept their disposition and are comfortable contriving their identity, regardless of its inconsistency with social definitions (Dreger, 1998). With this in mind, we must ask why such surgeries are often deemed a necessity. Is it safe to presume that parents are attempting to satisfy their own, selfish desires when approving such practices? It appears parents are reflecting their insecurities onto their child. Their decision is made to prevent the possibility of embarrassment for their child’s inability to comply with social norms, and the negative treatment they may receive for raising an ambiguously gendered child. This is both immoral and unethical. Continually, “intersex individuals are often not told the whole truth about their anatomical conditions and anatomical histories.” (Dreger, 1998). Parents green-light ‘normalizing’ surgeries and proceed in life withholding the true identity of their child. This choice usually results in more detrimental effects than if they were to keep their child’s genitals intact. The concealment of information oftentimes implies that intersex children have something to be ashamed of, resulting in the adoption of unhealthy conceptions of themselves and their identities (Dreger, 1998). Furthermore, withholding or misconstruing information can result in

immense trust issues. When intersex people do find out about their disposition (usually due to future identity complications/confusion), they believe they have been deceived their entire lives, resulting in resentment and distrust in doctors and parents (Dreger, 1998). This can negatively influence their future medical and social relationships. Therefore, ‘normalizing’ surgeries further complicate gender identities, perpetuating insecurities as a means to prevent social backlash, and thus should not be performed. One may also be in favour of ‘normalizing’ surgeries at birth as they believe they are acting in the best interest of the child by simply assigning them to their “true” gender. They may believe that they have the right to choose the gender of their child based on their subjective interpretations. Doctors assess the genitals of the intersexual baby and determine its “true” gender based on the prevalence of teste tissue and/or ovary tissue. For example, in some instances, if the doctor deems the phallus to be of inadequate size (based on their subjective measurement of penis functionality), they will assign a “female” gender (Dreger, 1998). Continually, as proclaimed by Alice Dreger, the “monster approach,” whereby doctors perform ‘normalizing’ surgeries through the justification that said surgery is required to render the unfortunate disposition of the individual, is still practiced (Dreger, 2011). These aforementioned practices inherently infringe on human rights and unjustly allot parents the capacity to make absolute medical decisions on their child’s behalf. Section 7 of the Canadian Charter of Rights and Freedoms ensures the right to life, liberty, and security of the person, preserving the autonomy and personal legal rights of citizens. Such rights are impeded on when parents decide to perform ‘normalizing’ surgeries without legitimate medical incentives. When such surgeries are performed for cosmetic purposes, the child faces life-altering reproductive and identity complications without their discretion or proper

justification, revoking their inherent right to autonomy. Our laws are established to deter such right infringements. Every individual has the right to protection from unnecessary harm and the autonomy to make medical decisions with adequate informed consent. In instances whereby the ‘normalizing’ surgery is not medically necessary, parents and doctors are not legally justified in their decisions and should wait until the child can comply with informed consent laws—through ensuring competence (of patient), providing sufficient disclosure (extent of revenant information regarding practice), actions to promote understanding, and voluntariness (preventing coercion) (Brody, 1989). When considering cosmetic circumstances, an individual’s discretion should never be entirely null and void. Why is their autonomy and human rights deemed less important simply because they are not able to contest for themselves at that specific time? Furthermore, legalities determining the breadth of discretion parents have when making medical decisions on behalf of their child is not meant to be absolute or unlimited. In the case of ‘normalizing’ surgeries, parents' need for comfort is often cited as the primary justification for the surgical intervention at the earliest stage of the child's life. Rather than considering the child's long-term quality of life, including her or his adult sexual functioning, they make decisions based on their own subjectivity, which is essentially arbitrary. This is not ethically or morally permissible as parents do not have the legal right to approve extensive, life-altering cosmetic procedures on their children without the necessary incentive or medical justification. A doctor’s subjective determination of adequate aesthetics or functionality of male and female reproductive organs is not sufficient enough (e.g. penis size). Hypothetically, if a doctor or parent believed that their child’s nose was too long, potentially impeding on the baby’s future sexual attractiveness, they would not be able to perform cosmetic surgery on said individual. This is because they are unable to determine what is, or is not, aesthetically pleasing, and such

determinations are irrelevant—just as they are for ‘normalizing’ surgery justifications. To allow such surgeries, operationalized definitions of male and female sexual organ functionality should be implemented. Surgeries should only be performed if completely necessary for future reproductive capabilities, not based on social standards of sexual performance considerations. Lastly, parents and doctors may perform ‘normalizing’ surgeries as they believe that the gender of their child must satisfy socially formulated definitions of “male” or “female.” They may believe there are, or should be, only two respective genders and that their child needs to be “fixed.” This positions lacks objectivity and progressive thought. There remains an implication that intersex peoples need to be “fixed.” This idea derives from the perpetuation of social expectations and gender norms that lack scientific evidence. Why should children be ‘normalized’ when the definition of ‘normal’ is forever evolving with increased progressive thought and a continued understanding of diversity? Similar to our society’s understanding of sexual identities, gender identities are constrained by socially prescribed definitions of acceptability. One must comply with the fixed categories of “male” and “female.” However, who’s to say these are the only possible genders? Just because we don’t fully comprehend or accept the possibility of diverse genders, as our society has constructed itself based on gender roles (e.g. male and female material goods, familial expectations, job expectations, etc.), it does not mean that they are any less human. As society evolved and progressive thinking began to influence societal behaviours, sexual identities that failed to comply with heteronormative expectations were acknowledged and accepted. We now recognize an extensive breadth of sexual identities and consider traditional prescriptions to be constraining and an inadequate representation of human diversity. Just like those identities, we are beginning to understand that ‘normalizing’ surgeries are not pivotal to the health of the individual and there

are multiples variations of genders (Dreger, 2011). If we perform ‘normalizing’ surgeries simply because we don’t yet acknowledge or accept this inevitable diversity, we are ignorantly enforcing harm onto children simply because of our lack of progressive thinking and our society’s inability to deconstruct or expand traditional gender definitions. Therefore, the only thing that needs to be ‘fixed’ is our society, and thus ‘normalizing’ surgeries should be reconsidered. In conclusion, the regulatory practice of ‘normalizing’ surgeries on intersex babies is wrong and should not be performed. It is detrimental to identity formation, infringes on legal rights, and is indicative of a lack of social evolution. Such practices are representative of the paternalistic model in healthcare, whereby medical action restricts the autonomy and liberty of an individual based on another’s consideration for what they deem to be in the best interest of said individual (Zembaty, 1979). ‘Normalizing’ procedures are barbaric and unjustifiable, relying on heteronormative perceptions of acceptability that lack the acknowledgement of inevitable human diversity. One cannot predict the future desires of their child, and since there are multiple alternatives to such surgeries (e.g. psychiatric counselling until the child is of age/maturity to make their own decision, hormone and surgery at a later date, etc.), the performance should be considered medical malpractice when not entirely necessary.

References

Brody, H. “Transparency: Informed Consent in Primary Care,” Hastings Center Report19 5 (1989): 5-9.

Charter of Rights and Freedoms, Part 1 of the Constitution Act, 1982, being Schedule B to the Canada Act 1982 (UK), 1982, c 11.

Dreger, A. “‘Ambiguous Sex’ or Ambivalent Medicine?” Hastings Center Report28 3 (1998): 2435.

Dreger, A. “Epilogue,” In Health Care Ethics in Canada, 3rdEdition. Edited by Baylis, F., Hoffmaster, B., Sherwin, S., Borgerson, K., Toronto: Nelson (2012):489-492.

Zembaty, J. “A limited defense of paternalism in medicine,” Proceedings of the 13thConference on Value Inquiry: The Life Sciences and Human Values, State University of New York College at Geneseo (1979): 145-158....