Tuesday, April 10, 2012

Binary Gender, and Dimorphic Sexed Bodies; A Critique of the Natural

“In our everyday lives we do not treat gender as problematic, do not treat biology as constructed, and sometimes even continue to believe in genitals as essential defining feature. In other words the natural attitude has not changed.” - Kessler, 2000

    Post-structural feminist theory proposed the now-accepted differentiation between sex and gender, both having traditionally dichotomous associations. The assumption being that the binary structure of gender (although socially constructed,) mimics that of sex and thusly nature. Is sex naturally dualistic, or is that assumption socially constructed as well? Why do we feel the need for sex and gender to have such an impact on the construction of our identities? If neither sex nor gender are dichotomous, could there be a genderless society?

      Sex and gender are both terms that have a long history of dualistic and binary associations, and at one time both were thought to be biological certainties. According to this concept, each human was born either man or women and therefore would embody the hetero-normative essence of either masculine or feminine. However, post-sctructurlist theory questions these binaries; in her essay Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory, Judith Butler asserts that “...gender is instituted through the stylization of the body, and hence, must be understood as the mundane way in which bodily gestures, movements, and enactments of various kinds constitute the illusion of an abiding gendered self.“ (Butler, 1)
      These bodily gestures, movements and enactments that she refers to are a performance caused by the ideology of hetero-normative. They are the only socially acceptable sexual orientation and “lifestyle.” In The Second Sex, Simone de Beauvoir argues “one is not born, but rather, becomes a
women,” (De Beauvoir 4)  she is arguing the idea that gender is not a solid part in the construction of one’s identity, but rather a socially constructed way of identifying people. Gender is not something you are born with as an inner essence; gender is a condition learned through social construction and tradition. 
        Sex on the other hand is biological. Sex is how we describe the biological reproductive structure of a human being. In society today we see sex as a binary that is undoubtedly natural. This dualistic idea of male and female is often used as the excuse for the creation of  the socially constructed gender binaries. But the assumption that sex is dimorphic proves false, as is the idea of “normal” physical attributes as the descriptive feature of female and male. 

    The genetic structure of a human being is made up of chromosome pairings, theoretically one from each parent. The mother provides an X chromosome, where as the father provides either an X or a Y chromosome. An XY chromosome pairing resulting an a male, and an XX chromosome pairing resulting in a female. However abnormalities exist in which an extra chromosome is present, resulting in either an XXX, XXY, or XYY chromosome combination. The percentages of people born with this third chromosome is higher than one might expect; 1 in 2000 people is born with the extra chromosome, making them intersex; the same amount of people born with red hair and freckles.
    The reproductive organs of intersex people vary greatly. On one end of the spectrum there are intersexual people whose genitals and reproductive organs resemble that of a medically deemed “normal” male or female, to mosaic hermaphrodites who have fully functioning reproductive organs and genitals of both males and females, and everything in between. The category of intersexual goes beyond chromosomes, for example, children born with XY chromosomes and complete androgen insensitivity syndrome have genitals that look pretty typically female, and some children born with XX chromosomes and congenital adrenal hyperplasia are born with genitals that look thoroughly male. Yet nearly all medical professionals agree that these kinds of conditions are also intersex. 

    Intersex is a socially constructed category that reflects real biological variation. The differentiation between male, intersex, and female is not however biologically given, or obvious. What defines intersex is not natural, it is also socially constructed in my research I have found that doctors’ opinions about what should count as “intersex” vary substantially. Some propose you must have “ambiguous genitalia” to count as intersex; some think your brain has to be exposed to an unusual mix of hormones prenatally to count as intersex—so that even if you’re born with atypical genitalia; you’re not intersex unless your brain experienced atypical development; and some believe you have to have both ovarian and testicular tissue to count as intersex.

    Virtually all academic writing on sex and gender refers to a case first described by sexologist John Money in 1972. John Money’s argument was that gender is a social construct, and therefore can be constructed by human intervention. He saw intersexed children as perfect test subjects for his theories. John Money and Anke Ehrhard published their research paper in 1972, which outlined a generic medical protocol for the treatment of infants who displayed sexual ambiguity. A general protocol which many surgeons still adhere to. Money’s argument is filled with many unexamined, and deeply conservative underlying assumptions.  In Suzanne Kessler’s book Lessons From the Intersex she outlines the assumptions in Money’s argument:

1 Genitals are naturally dimorphic; there is nothing socially constructed about the two categories.

2 Those genitals that blur the dimorphism belonging to the occasion intersexed person can be and should be successfully altered by surgery.

3 Gender is necessarily dichotomous (even if socially constructed) because genitals are dimorphic.

4 Dimorphic Genitals are the essential markers of dichotomous gender.

5 Physicians and psychologists have legitimate authority to define the relationship between gender, and genitals.
 (Kessler 9)

    Money also had an extreme belief in the necessity of any human being to be assigned their gender role of male or female within their first 18 months of infancy, in order to develop a psychologically healthy identity. Money proposed in order to achieve this, children born with ambiguous genitalia should be deemed “a medical emergency” (Money & Ehrhardt, 1972) and aesthetically “perfect” genitalia was said to be achievable with little scar tissue if performed as early as possible. This treatment protocol supported his rationale that there was a need for an infant’s gender identity to be fixed as male or female very early in there life, and was malleable in these early stages. He also believed however that ambiguity later in life was pathological. Money also suggested that it was just as important for the parents to believe in this fixed identity of their child in order to validate their child’s identity. (Money 148)

    Money’s recommendation of sexual-reassignment surgery was a dangerous one; it presumes that intersexuality is an abnormality and these individual should have become either male or female. Even though Money and Ehrhardt studied hermaphrodites, they only did it in order to prove their ideas on “normal development” (Kessler, 46) They never once questioned their fundamental assumption that there are only two sexes.

    All of Money’s research was greatly supported by his famous case study of two twins born biologically male, often referred to as the Joan/ John case. John was born male and lost his penis at 7 month of age after a circumcision accident. Using his theory of intersexuality John Money suggested the child should be raised a female and surgically altered to fit this new status. Now referred to as Joan, Money asserted that Joan’s twin brother would be a great control of this study.

    Money’s hypothesis was that if Joan and her brother each achieved their gender identification successfully, and became happy “normal” adults, then his protocol for inetersexualy could be deemed as moral and successful. He famously quoted the twins’ mother in support that Joan embraced her femininity “she just loves to have her hair set.” (Money, 144) This quote enforced his theory that ‘nurture’ can overcome ‘nature.’ He deemed this study as a success and it began being cited as such extensively throughout subsequent decades.

    However, contrary to the evidence Money presented, it transpired thirty years later that this was not the case. Joan/John himself made public his discontentment about the entire process of sex-reassignment. His real name was David Reimer, born Bruce Reimer, and at the age of 21 months after his testicles were removed, they changed his name to Brenda. They enforced a hyper-feminine stereotype upon their now-daughter , Brenda, as well as a hyper-masculine role projected on Bryan, her twin brother.
    Brenda did not however, enjoy her hair set. He mother recalls her ripping off her frilly dresses, and often getting angry and violent when unable to play outside with her brother. By the time Brenda turned nine, the Reimer family was having serious doubts about their decision. It was around this time that Money published this study claiming it’s resounding success. Money even wrote “The child’s behavior is so clearly that of an active little girl and so different from the boyish ways of her twin brother”

    By the time Brenda reached puberty it became increasingly clear that Money’s experiment was not working. Brenda started developing male-associated physical attributes. It was during this time Money was pressuring Brenda and the Reimers to follow though with the final step and create a vagina for Brenda.

    Brenda protested this greatly, and went as far as threatening suicide if she was forced to see Money again. This cry for help is when Brenda’s parents revealed everything to her. After finding out the truth Brenda tried to commit suicide several times, the third, an overdose of pills, leaving her in a coma. But after recovering she decided the only way to be happy was to become a man. Leaving his Brenda identity behind, Bruce Reimer decided to identify once again as male and changed his name David Reimer. This loss of identity perpetuated by this life change in his brother’s life, caused David’s twin brother Brian to become very angry. He became depressed in his adult life and, unable to cope with this situation and eventually committed suicide. Within two years of his brothers suicide, David also ended his life.

    Meanwhile Money continued to deem his study as a success and the idea of enforced gender by human intervention was being practiced widespread on intersexed individuals and individuals with ambiguous genitalia. But what is really at risk in pursuit of aesthetically normal genitalia?

    Aside from the psychological effects of sexual reassignment surgery the physical effects are often horrendous. Many children have to go through years of rigorous evasive surgery, often to have genitalia that is built up of scar tissue, and lacks proper function. Many are unable to achieve orgasm, due to their mutilation, and many have had to have reconstructive surgery as adults. Some patients were uninformed about their own medical care, there are several cases of patients who were depressed from their repeated surgical procedures and stopped taking hormone replacement therapy—critical after gonadectomy—and wound up with life-threatening osteoporosis at an early age. (ISNA)

    When a child is born with ambiguous genitalia the process of their sexual reassignment is one often forced on to parents, and in some cases not even discussed with the parents. Parents are not fully informed about the evidence of alternatives theories available to them, about the risks associated with surgeries, or about the theoretical problems underlying the “optimum gender of rearing” approach. For example, they are typically not told the theories that gender identity may emerge to an important degree from prenatal hormonal actions on the brain—and thus, that you can’t enforce a child to maintain a particular gender identity in the long term by doing surgery on him or her in infancy.  This process is a lengthy commitment for the parents, as it involves years of hormone therapy and often counseling, as well as a strict regiment for them to follow when raising their child, in order to convince them of their gender. 

    Many doctors and surgeons believe(d) that this was a moral act. They felt that by helping the child appear more like their peers they were allowing them fit in, be socially acceptable and thus, happier. Money believed that sexual gendered identity of either man or women was an integral part of identity and any ambiguity would be incredibly detrimental. This commitment to a standardized binary of sex model that underlies any medical intervention is still in existence despite recent studies suggesting there are as many as 1.7% of intersexed births. (ISNA)

     Kessler questions this practice with a outlined critique:

1 How dimorphic are genitals?

2 How successful are genital surgeries?

3 Is gender necessarily dichotomous; should it be socially constructed to be trichotomous at least?

4 Must genitals be the marker of gender?

5 How does the medical profession use its authority to manage a particular version of gender? (Kessler 7)

    In recent decades there has been a backlash from intersex adults who had surgery performed on them as infants, referring to it as Infant Genital Mutilation or IGM. They have formed very outspoken support groups pleading with medical professionals to reconsider this procedure. Cheryl Chase, founder and long-time president of the Intersex Society of North America, propositioned for the medical community to produce even one case of a happy successful adult who had had this treatment, and they did not comply by finding even one, or at least one who was willing to speak on their behalf even anonymously. 

    The ISNA and similar organizations propose that the surgery not be performed on infants, and if a child is born intersex to be raised as such. Then when he child is older they decide for themselves how they want to identify and if they want surgery. According to the INSA website “There is no evidence that children who grow up with intersex genitals are worse off psychologically than those who are altered. In fact, there is evidence that children who grow up with intersex genitals do well psychologically. In other words, these surgeries happen before the age of assent or consent without real cause. “Ambiguous” genitalia are not diseased, nor do they cause disease; they just look funny to some people” (ISNA)
   They even go as far to say, that if you feel the necessity to assign a gender to the child, this does not mean you must perform evasive surgery or hormone treatments until the child is old enough to decide for themselves. (ISNA) But is gender dichotomous?
    Kessler proposes it could be made trichotomous, but grouping the entire spectrum of sexes into man, women, and intersex has its own issues. In this grouping is is creating a groups of “normative male” and “normative female” causing all others to fall into the category of intersex, as means of “othering” them. Not to mention the confusion of where the boundaries exist between female, intersex and male.
    In her essay Cyborg Manifesto Donna Haraway describes “imagining a world without gender, which is perhaps a world without genesis, but maybe also a world without end. The cyborg incarnation is outside salvation history.” (Haraway 150) She uses the metaphor of the cyborg to describe the paradigm shifts that are occurring due to advancements in technology. 

    In Rosi Braidotti’s Essay Body-Images and the Pornography of Representation, she discusses philosopher Michael Foucault and his writings about “...the medicalization process, or rather of the simultaneous objectivity and the knowing subject sexualization and medicalization of the body, in a new configuration of power which he describes as ‘bio-power’ —the power of normativity over the living organism.” (Braidotti, 17) She relates this to feminism in her discussion of the fantasy of self generation and the paradigm shift “...the split between sexuality and reproduction, as far as women are concerned, has quite a history. I would sum it up by saying that, with chemical contraceptive techniques (the pill) we could have sexuality without reproduction— sex without babies. With the latest reproductive techniques, especially in vitro fertilization, we can have reproduction without sexuality—babies without sex.” (Braidotti, 19)

    This paradigm shift also fits into Haraway’s metaphor of the cyborg. The use of technology as an extension of our lives in way that it greatly alters our lives. The creation of this paradigm shift of the split between sexuality and reproduction marks the possibility of a genderless society. 

    In Judith Butler’s work Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory, she discusses the idea of hetero-compulsion. The idea of “an ostensibly “natural” attraction to the opposing sex/gender..” as an “...unnatural conjection of cultural constructs in the service of reproductive interests.” (Butler 5) She asserts that “it is primarily political interests which create the social phenomena of gender itself, and that without radical critique of gender constitution feminist theory fails to take stock of the way in which oppression structures the ontological categories in which gender is conceived.” (Butler, 8)

    This social construction of our gender is interpellated in though everything from media, to fiction, to children's toys. We have created a world that equates gender strongly with identity, and traditional nuclear family values. This binary version of gender and hetero-compulsion aids greatly in the continued tradition of the patriarchal social structures.
    So in a world where sex and reproduction are no longer synonymous, the idea of this hetero-compulsion is less practical. The advancements in technology from bio-medical, to social-networking have allowed these concepts of gender and sex binaries to be critiqued and discussed on a vast level. Haraway believes that technology is a necessary part in the advancement of humanity and breaking down binary thinking of all kinds is an integral part of this advancement.
    However the utopian concept of a genderless society, or at least one in which gender is irrelevant is a radical one.  A more obtainable goal is the constant and persistent critique, evaluation and revaluation of the set structures, as well as acknowledging the complexities that exists within society and culture.
    In regards to gender and sexual binaries, we are already on he road of progress; in September of this year Australia was the first country to add a box for intersexual on their government documents including passports, and the Olympic Committee in 2008 changed their  requirements to allow for transgendered and intersexual people to take part in their games, but only under strict regulations.
    The social construct of gender binaries is one that is assumed to be natural; not only is it socially constructed but it does not actually reflect nature. Nature is complex, and there is an entire spectrum of variations within nature, including natural sexed bodies. The assiduous critique and examination of preexisting structures and their origins and histories, is the only way to break down dualistic thinking and opposed binaries that are dangerous to human society. Sexuality are gender do not have a dimorphic existence , they are immensely complex and should be treated as such.

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