As a pediatrician and urologist specifically concentrating on disorders of sexual development (DSD)- “congenital conditions in which the development of chromosomal, gonadal, or anatomical sex is atypical” (Arnold/Saguy, Lecture 11)- every once in a while, a pregnant woman, whose first child is born with congenital androgen hyperplasia (CAH), comes to my office asking for a medicinal point of view on the biological, psychological, and ethical methods of treatment of her second child. Since recent advancements in research on ambiguous genitalia has uncovered several treatments that attempt to prevent certain disorders of sexual development in children, the woman comes in for insight on a steroid treatment specifically to avoid her second child developing ambiguous genitalia.
As a doctor, I simply cannot allow for a pregnant patient to jump into a treatment, which in this case would be the prenatal dexamethasone treatment, without properly educating her on the benefits versus the risks. Though the dexamethasone treatment can help prevent ambiguous genitalia, there are slim chances and several factors that go into the treatment therapy working out successfully, there are ethical questions posed that require thorough consideration in order to achieve an ideal lifetime of fewer medical concerns for the parents of children with disorders of sexual development and the children with disorders of sexual development, there are concerns from a sociological standpoint, which lend to the ultimate decision to go in a different direction from the prenatal dexamethasone treatment, and there are the complexities of a sexual development disorder such as congenital adrenal hyperplasia.
Because the mother came in requesting a specific steroid treatme...
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...with the ambiguous genitalia (Vilain, Lecture 12).”
If in the end, neither going with the prenatal dexamethasone treatment nor choosing to challenge the gender binary prove to be a stronger choice than the other to provide a stable life for parents of children with disorders of sexual development and children with disorders of sexual development, then I would, as both a pediatrician and a sociologist, recommend that the mother and her partner seriously consider adoption to provide stability in the life and future of a less fortunate child, since the mother cannot handle the idea of having another extraordinary child- which to others beings often considered unconventional, would be a blessing, ‘disorder’ of sexual development or not. The most important aspect of this case is that the child is raised to live a fulfilling life, emotionally, despite physical variations.
A gynaecologist can easily perform an ultrasound and tell parents what gender to expect their child to be. Reasonably, parents have the choice to learn the gender or to keep it a surprise. However, For parents to know they are expecting a daughter by chance or for them to choose that they want a daughter are two different cases. There are a variety of methods that allow parents to choose the gender of their child. In some cases, there may be fear of passing down a sex-linked genetic disease and so a certain gender may be preferred to protect the child’s health. However, a contentious issue is whether or not gender selection for non-medical reasons is ethically defensible. There are three positions that one could take: gender selection can never, sometimes, or always be ethically defended. In this paper, I intend to argue that gender selection is always permissible.
The first category of Dr. Bushong's theory is genetics. Due to defects in fertilization, fetuses can have a chromosomal pattern of XXXY (mosaic hermaphrodite), XXY, or XYY. These abnormalities result in deformed genitalia, sterility, or an individual whose physical appearance as one sex does not match their genetic makeup as a member of the other...
Initially the individual was described as having a large penis and elevated testosterone levels, he was also labeled as having confusing genitalia—the individual was intersex. There was a vaginal opening and ovarian tissue, which is why the doctors and parents took four months to do the surgery and the individual was 16 months old when the surgery happened. Similar to David, this person also identified as male despite being raised female for five and a half years. Also similar to David, this person expressed differentiating behaviors from their assigned SRS; however, in contrast this person came out earlier, at the age of seven. The unidentified person’s parents sued the medical facility that carried out the SRS for malpractice.
According to the textbook, the term Gender Dysphoria means “biological sex and gender identity do not match, thus leading to distress and impairment” (Chapter 8, pg.279). The textbook also discusses how “children with Gender Dysphoria is apparent in repeated statements that the child wants to be the opposite sex or is the opposite sex; cross-dressing in clothing stereotypical of the other sex and how the child has persistent fantasies of being the opposite sex such as; pretend play or activities associated with the opposite sex” (Chapter 8, pg. 279). However; the textbook also mentions how “people with gender dysphoria have persisted discomfort with their own sex” (Chapter 8, pg. 279).
The androgenic effects of AAS are numerous. Depending on the length of use, the side effects of the steroid can be irreversible. Processes affected include pubertal growth, sebaceous gland oil production, and sexuality. Some examples of effects are growth of the clitoris in females and the penis in male children, increased vocal cord size, increased libido, suppression of natural sex hormones, and impaired production of sperm. Effects on women include deepening of the voice, facial hair growth, and possibly a decrease in breast size. Men may develop an enlargement of breast tissue, known as gynecomastia, testicular atrophy, and a reduced sperm count.
"Chemical Castration: The Benefits and Disadvantages Intrinsic to Injecting Male Pedophiliacs with Depo-Provera." Serendip's Exchange. Web. 23 June 2010. .
Gibson, B., & Catlin, A.J. (2011). Care of the Child with the Desire to Change Gender-Part 1.
In the past Johns Hopkins was a center for patients with a gender disorder. John Money, PhD worked in the Psycho-hormonal Group as a head. He had a very strange theory. He would apply his theory to actual patients, not knowing or expecting what would happen. The experiments he attempted on children and adult literally had no boundaries. One of well-known cases of gender identity disorder was about a boy. He was inducted into the Johns Hopkins center because of what happened during a normal ‘surgery’. The boy’s penis was accidently burnt during the circumcision. He underwent a surgery that made him have female body part. The little boy was raised as a girl. The boy raised as a girl felt as if he was a boy. When the family decided he was old enough to know they told him about what had happened during his circumcision. Once he had heard of this he decided to not be living as a female anymore. He later committed suicide. What we have learned from this experiment is that it comes with a lot of depression. Van Meter stated, “Because of the failures that began to materialize from Money’s ideology, the Psycho-hormonal group was abolished and Money was forced into retirement.” (239.) They are steps being taken to provide the best medical treatment and social environment with those who are suffering GID. I added this piece of information because I thought it was something we all show know about how the past has
When one’s biological sex and one’s internal gender are the same (a female with a vagina or a male with a penis), one is cissexual, or non-transgender. However, when one is born with the inappropriate sexual equipment, one is transgender, or one who feels one gender but has the sex organs of the other. The misalignment of sexual and gender identities raises a puzzling question. If gender is solely based on one’s genitalia, as biological determi...
Slaughenhoupt, Bruce L. "Diagnostic Evaluation and Management of the Child With Ambiguous Genitalia." KMA Journal 95 (1997): 135-141.
As a young adult, it may seem foolish to predict what your future family life will look like, especially in regards to children. Often times this reality is forced upon a select few, particularly homosexual couples; however, with the innovation of in vitro fertilization (IVF), a couple is met with promise and the hope of a successful family life. IVF can be described as a process by which a fetus is genetically formed in a laboratory setting. Though this process may seem unnatural in essence, it allows for a more diverse family arrangement through medical innovation. This procedure, though controversial, is seen by many as an advancement in the medical field and can be accredited to procuring a healthy child for an unfortunate family, whether
Practicing sex selection prior to conception is viewed as a more natural and more of a safe way to conceive a child of a desired gender. “The trouble is that society as a whole is not capable of handling Sex Selection without terrible results” (Dixon). The most practiced pre-selection is the laboratory. Here urine specimens are used to monitor ovarian steroid changes during ovulation. “Although methods of selecting sex before conception are not entirely reliable […]” (British Medical Journal), it is obviously the practical route to go. A response to either practice of sex selection merely depends on the factor of cost and ease of access.
Anti-androgen medications such as medroxyprogesterone acetate decrease testosterone levels and can reduce deviant sexual perversions in individuals having various paraphilia’s.
Part Two of Kartina Karkazis’ novel Fixing Sex focuses on the reality parents face when their child receives an intersex diagnosis. Karkazis illustrates what a couple experiences when they discovered their baby girl was not in fact a girl, in accordance to the socially constructed understanding of a female. She also covers the importance of choosing a sex with an intersexual baby when society is involved. A great example from the text is, “Bodies with atypical or conflicting biological markers of gender are troublesome because they disturb the social body; they also disrupt the process if determining an infant’s place in the world” (96). It ties in perfectly to the purpose of paragraphs four, five and six: The Ramifications of Corrective Surgery (Good and Bad). The quote highlights one of the “bad” ramifications of intersexual corrective surgery. It has progressed to the point where society has such a large impact on what is classified as a “proper girl” or “proper boy” that if a baby does not classify into one of those categories, then the child is no longer accepted.
One of the major biological differences between males and females are hormones. Hormones that were once thought to only be important for pregnancy and sexual drive are now shown to have profound effects on just about every organ in the body.(*) Some researchers believe that higher exposure to estrogen, in females, or androgens, in males, during fetal development not only causes the sex organs to form but also predisposes the infant to behavior that is typically associated with one gender or the other. (*) For example, girls that were exposed to higher than normal prenatal levels of androgens were more likely than other females to engage in “boy-like” behavior and to play with boy’s toys eve...