LETTER- Ethics of intersex surgery

<P>Thank you for covering the important medical ethics and human rights issue of intersex ("Dr. Hook, "Boy, girl, or...? Leave intersex babies alone," April 7, 2005). There are several important expansions we would offer:
<P>First, "intersex" is a general term used for a variety of conditions in which a person is born with a reproductive or sexual anatomy (internally, externally, or genetically) that doesn't seem to fit the typical definitions of female or male. This is different from having a feeling that your identity is different from most women (or men) as in the case of transgender.
<P>Secondly, the statistic "five children a day" refers to the number of children each day in the United States who have their genitals surgically altered to more closely reflect arbitrary and unethical standards. For example, under the "standard of care" from the 1950s until our work started to have an effect, boys born with penises doctors considered small were made into girls– even though other doctors believed (and showed) they could be raised as boys. Still today, girls with clitorises their doctors think are "too big" find themselves in operating theatres with surgeons cutting away at their healthy genital tissue.
<P>The Intersex Society of North America (isna.org), established by Cheryl Chase in 1993, is internationally recognized as the definitive source for all things intersex, and for being a life-saving portal for thousands of people desperate for answers and directions to "their tribe."
<P>We give presentations at hospitals, help with medical school curricular development, and receive emails and phone calls from physicians and parents asking for our advice. We have persuaded hospitals around the world to examine their practices, to find out what has happened to former patients, and to be accountable for the sometimes poor effects of good intentions.
<P><B>Alice Dreger</B><BR>President, ISNA<BR>Michigan State University<BR>East Lansing, MI<BR>dreger@msu.edu
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