Fausto-Sterling opens this chapter by highlighting the roles of the doctors who treat intersex babies. By highlighting previous case studies, Fausto-Sterling illuminates the reader to the lack of guidelines/standards and the strong role that a doctor's personal values play. In many cases the decision rests solely in the hans of a obstetrician or pediatric surgeon who will ultimately decide which sex to promote and which to try to erase. Of course, this can have extraordinarily devastating effects. By trying to make the baby in question "normal" (i.e. fitting into only one category of either "male" or "female") and identifying the "true" sex, the child in question is automatically forced to abandon their natural anatomy and are forced to conform to a doctor's idea of normal. Obviously, this can lead to disaster. If the child in question does not feel connected to the sex which they were prescribed, serious emotional and biological issues can ensue. Fausto-Sterling sites the many different types of genital mutations and their prevalence in society. It is shocking to visualize how common intersex varieties are within the world. By doing so, i think she proves an excellent point that this issue may not be as contained and rare as some people think.
By discussing in depth the methods in which doctors attempt to categorize and "fix" these babies, Fausto-Sterling is inundating the reader with her rhetorical strategy. I myself, a somewhat medically literate person, to struggle with some of her explanations. I think that this is done on purpose. She may be intentionally muddying the medical waters to highlight the ambiguity of the process in its entirety. If the reader finds his/herself challenged just to understand this simplistic overview, they must then get a sense of just how complicated the issues of deciding one's "proper" sex must be. This can also be accomplished by discussing the actual medical procedures which are performed in attempt to make the child "normal." Clitoral reductions, recessions and removals are all examples of such surgeries. By describing them, i think Fausto-Sterling indicated to the readers the pain and suffering that these children are forced to bear (not just as infants, but also later in life) just so they can be categorized according to our dichotomous system.
I thought it was interesting that Fausto-Sterling claimed that the psychological upbringing/understanding of sex was almost as important, if not more so, for the parents not the child. She explains how doctors use "doublespeak" and often to dont fully inform parents of the scenario. I found this both intriguing and horrifying. While i understand the goal of the doctors is to have as "normal" and upbringing as possible, i think that this is atrocious and a very harmful practice. By concealing one's true nature I think it is impossible to have a healthy life. I imagine that as a child grows their body will tell them that they are somehow "different" and by not being open about their experiences i can only imagine that there can be devastating consequences. It also assumes that one is "malleable" to psychological change. Fausto-Sterling, and others, question this assumption.
Should There Only be Two Sexes?:
Fausto-Sterling begins this section by recalling her previous idea to expand the "male" or "female" notion of gender to including a total of five sexes. This idea was met with strong opposition, but as Fausto-Sterling proclaims, it was also a catalyst for future change and understanding. She then goes on to describe her methodology for the proper ways in which to treat a newborn intersex child. First, and probably foremost, she insists that there should be no surgery performed unless necessary for the survival or health of the baby. Here, she cites the story of a young woman who underwent the unnecessary surgery to which Fausto-Sterling protests. The woman, Chase, undergoes a series of doctor visits in her early 20s to try to find the truth about her past. She later suffered from depression and suicidal tendencies. Fausto-Sterling uses cases like Chase to prove that the current system is not beneficial, but rather, causes future hardship.
The second aspect of Fausto-Sterlings proposal is the right of an intersex patient (or h/her family) to refuse. Along with this idea is the set of guidelines proposed by H.E.L.P which include not taking surgical action in the first year, involving family members fully in medical consultations and decisions, etc. For me, one of the most powerful messages of the book thus far is found in this section. Fausto-Sterling debunks the myth that any hermaphrodite who goes without surgery is doomed for a life of misery. I think that once the medical profession, and society as a whole, is capable of grasping this idea the options for intersex children will become more numerous and hopefully more beneficial and accommodating.
The final section of her proposal is probably the most daunting task. Here, Fausto-Sterling proposes her new categorization of sex. She cites how the variability within ones gender is expansive, but with such a narrow focus, people can be ostracized because of their non-gender adherent traits or uncomfortable in their own skin because they feel a separation of sex and gender. She hopes that by extending the categories of sex, and maybe one day making any type of distinction obsolete, the stigma and struggles which are attached to those born of an intersex variety will one day live a life freely, without trying to conform to a category which may or may not apply to them.
Fausto-Sterling clearly states there are problems with the five-sex system she proposed. However, it is clearly a step in the right direction. Although there is no perfect solution offered, Fausto-Sterling encourages people to think about her ideas, and maybe formulate their own, in effort to limit the unnecessary actions and discrimination that is placed on the intersex.
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