I’m so relying on this in my criminal trial.

ALSO: my second-best ever.

Alice Dreger, Ellen Feder and Hilde Lindemann have published an update to their article, “Fetal Cosmetology,” in Bioethics Forum that comment on the “responses” to that article, including to my own contribution to the conversation. I am generally in agreement with Dreger et al., but I want to comment on how they respond to my concerns. In the article, “Prenatal Dex: Update and Omnibus Reply,” they state:

First of all, my essay was not a response to their piece in Bioethics Forum; it was a response to the “letter of concern from bioethicists” posted on Dreger’s site. In fact, I was not even aware of their Bioethics Forum piece until after I submitted the first draft of the essay, and reference to their article was added by the editor of Bioethics Forum to give readers further context.

I am castigating not just bioethicists’ inaction on behalf of vulnerable populations, but also the limitations bioethics as a field has imposed on itself on the scope of their philosophical and ethical inquiry, obsessing over policies and procedures rather than sociopolitical implication of the increasing role and authority of medicine. I did express my appreciation for the “action” of the bioethicists and other scholars responsible for the “letter of concern,” and at the same time I explained why it had the danger of backfiring, like it did on the controversy surrounding growth attenuation, because they continue to operate within the confines of the field of bioethics as it is today.

Further, I resent their dismissive characterisation of my essay as written in “postmodern feminist language” and the patronising statement, “Pardon our pragmatism.” I would concede that voices of concern from among disability rights and women’s health movements are often ineffective at changing the problematic medical practices by themselves, and we often need certain spokespersons and “experts” that transform these voices into pragmatic strategies, these spokespersons and “experts” must be held accountable to the movements which they represent. Thus, the need for pragmatic strategies is in no way an excuse for dismissing activists’ and impacted communities’ concerns as mere “postmodern” intellectual exercise.

Dreger herself has been labeled “postmodernist” by the critics of her work, and she resists this. On her website, she wrote: “Although I sometimes get labeled a ‘postmodernist’ because I write and speak about the social complexities of science and medicine, in fact I would have to label myself a raving modernist. I really believe in the power of science to improve our knowledge and our lives.” I also write and speak about the social complexities of science and medicine, including the field of bioethics, and somehow she finds it convenient to label me “postmodernist” in a dismissive way.

Finally, I find the suggestion that my “postmodern feminist language” is what prevents me from being able to “move the feds the way [Dreger et al.] have moved, as if we live in a society in which everyone’s opinions are equally respected and judged solely by their content, offensive. There is no question that their success (so far) has been made possible by the number of Ph.Ds and MDs on the “letter of concern” as well as by Dreger’s and others’ officially sanctioned academic and medical authority and connections that arose from these positions, which have been heavily influenced by their class backgrounds, educational and professional opportunities, and other social conditions. These factors inform our political sensibilities and sometimes open or close certain venues of social change.

I am a pragmatic person, and a pragmatic activist. As a pragmatist, I really don’t see any benefit from Dreger et al. and I continuing to communicate this way publicly. But I reject the idea that pragmatism is a justification for dismissing the sometimes inflexible and unpragmatic but principled work of the disability rights and women’s health movements; in fact, pragmatism and idealism are both essential elements of a successful social change movements, and even that of a successful activist.

I just came home from my trip to Providence to speak at Brown University for the second time. My last visit there was in April 2007, which you can read about here.

The title of my presentation (workshop) was “Transgender Inclusion, or Demilitarizing the Borderlands of Binary Gender System.” It is a critique of “inclusion” model of transgender activism, which promotes individuals’ rights to self-define who they are while leaving the larger structure of binary gender system mostly intact, only creating rooms for minor “exceptions.” While self-determination is an important goal, the promotion of individual choice and responsibility in the absence of justice and equity is the hallmark of the neoliberal ideology and needs to be challenged.

As the title suggests, the workshop also introduced the concept of borderlands, which Gloria Anzaldúa describes as “vague and undetermined place created by the emotional residue of an unnatural boundary.” In the book Borderlands/La Frontera: The New Mestiza, Anzaldúa presents a parallel view of borderlands in the U.S.-Mexico border as well as the borderlands created by the boundaries of race, gender and sexuality. I’ve been using the metaphor of borderlands to talk about transgender issues for a long time, but I have not been able to present it in a way that was easy for people to understand, but preparing for this workshop helped me to think through how to go about writing a piece that centers on this idea. In other words: stay tuned.

I actually did this workshop at the National MEChA conference at University of Oregon a while back, but that was an audience that was already familiar with issues around borders, borderlands, and immigration. But the highly privileged Brown University crowd would have a very different backgrounds, and I worried that I might not be able to convey my ideas very well.

To my surprise, though, everything went fine. In fact, it turned out great. I have given workshops and lectures at many universities around the country, but speaking at an elite school like Brown (other schools in this category that I’ve visited include University of Chicago, Cornell, Columbia, and Yale) is actually very enjoyable and stimulating for me. Students are bright, of course, but they also possess the cultural capital that affords them the luxury of abstract critical thinking and complexity. And at the same time, I feel certain level of resentment at their highly privileged existence and prospect–these are the people who would join companies like Goldman Sachs and get huge bonuses while the rest of us suffer from unemployment and increasingly hostile labour market.

When talking about the binary gender system, people sometimes jump to the conclusion that we should simply “deconstruct” genders so that everyone is free to be who they are. I’ve been told over and over (by bunch of graduate students, scholars, and some highly educated trans activists) that the intersex movement should work on challenging the binary gender system because that is where the oppression of intersex people stem from. I have nothing against that proposal, except for the fact that intersex children are being harmed by the society’s intolerance of their variance every day and need more immediate, practical help now.

I did not want Brown students to go home only with the critique of identity-based argument for transgender “inclusion,” or with a simple understanding that “deconstructing” binary gender system (however long it would take, and however many trans and intersex people would continue to suffer until that magical day) was the way to go. My call for “demilitarizing the borderlands of binary gender system” is distinct from simply “deconstructing” the binary: it starts with an acknowledgement that trans and intersex people live in the borderlands, and take concrete steps to demilitarise their environment that is the consequences of the society’s attempt to draw a clear and unambiguous boundaries where none naturally exists.

More on that coming soon…

By the way, out of 16-18 students who came to my presentation, not one of them has ever read anything by Gloria Anzaldúa! WTF!?

This past week, I attended the 29th Annual Gender Studies Symposium at Lewis & Clark College. Since I am local and available, I seem to get invited just about every single year on various panels, but this year I was invited to speak on the topic of disability and sexuality.

There is also a dinner reception on the first day of this conference for organizers, college staff, and presenters each year. I’ve never actually attended the dinner in all those years I’ve been part of the conference, but this year I thought I’d check it out. So I walked into a room full of people I didn’t recognize, and picked a table to join.

It turned out that all four people sitting at the table I picked were administrators at Lewis & Clark who had something to do with the conference. After a quick introduction, they went back to the conversation they were having before I joined the table, which was about the small swastika drawing inside men’s bathroom at the said campus.

To summarize their conversation, they were talking about how students initially did not take the issue seriously, dismissing the drawing as an isolated incident that didn’t mean anything. But the school took time holding campus-wide conversations about the incident and how it might affect Jewish students, students of color and others targeted by the Neo-Nazis and other white supremacy groups, and many white non-Jewish students began to understand that it meant something to some students and should not be tolerated.

“Can I ask a question?” I asked. “Well I was reading the program for this year’s conference, and correct me if I’m wrong, but it seems that all main speakers and performers seem to be white this year. I don’t think this conference was like that in other years I came. Has there been any conversations about that?”

Immediately, a couple of the administrators started stressing, “it was not intentional!” “We noticed that after we planned all the main speakers, but we didn’t do that on purpose. We picked our speakers according to their expertise in this year’s theme, and it was a coincidence that they were all white.”

It wasn’t on purpose? Of course it wasn’t! If I thought it was on purpose, there is no way I would step a foot on this campus ever again (and while this isn’t the main point of this blog post, WTF is up with the name of this school anyway?). And am I supposed to feel comforted because even though all of the main speakers and performers in this conference are white, it was not intentional?

The problem, of course, is not the presence of malicious intent, but the absence of anti-white supremacy intent to create a conference whose speakers and performers are not just competent, but also diverse. It is about the lack of willingness on the part of organizers to go a little bit deeper to find and invite researchers and speakers of color with equal level of expertise and knowledge who are not receiving fair share of attention or status either because of their background or because of the focus of research that white academia deems unimportant.

And if the college is not interested in making an effort to not let very predictable “coincidence” after “coincidence” take place not just in terms of the racial breakdown of the main speakers, but in other aspects as well, what’s the point of hosting Gender Studies Symposium anyway? Besides, how did the administrators fail to see the parallel between the defensiveness of Lewis & Clark College students over the swastika drawing on the urinal and their own defensiveness in response to my query?

After a month or two of scholars and intersex activists challenging the prenatal dexamethasone treatment on fetuses suspected of having congenital adrenal hyperplasia (CAH) designed to prevent the virilization of clitoris, the pro-dex doctors are starting to publicly defend the controversial treatment.

In Bioethics Forum, a blog published by Hastings Center and where Hilde Lindenmann, Ellen Feder, and Alice Dreger have previously published a piece criticizing the treatment, two articles defending the treatment have been published.

• Ambiguous Genitalia: To Treat or Not by John Lantos
• Not Fetal Cosmetology by David A Diamond, Jeffrey Ecker, Ingrid Holm, Susan Kornetsky, Christine Mitchell, and Norman Spack

In addition, there is a research review paper in the current issue of Obstetrics and Gynecology Survey which apparently suggests that the dexamethasone treatment has benefits (But what is the “benefit” they are talking about? Not being born intersex?).

I had also written my own response, which was posted on Bioethics Forum, to the scholars’ letter of concern about dexamethasone treatment (“letter of concern from bioethicists”) to express my broader concern about the field of bioethics and role it plays in legitimizing ethically troubling medical treatments designed to address social problems.

While I haven’t been able to read the Obstetrics and Gynecology Survey piece yet (although it seems to be a straightforward review paper), both of the responses in Bioethics Forum seem to be exactly the examples of the problems with the field of bioethics that I was trying to address in my own piece.

Lantos epitomizes the tendency for pediatric bioethicists to endorse “let the parents decide” model whenever an ethical question is raised about any particular treatment, rather than seriously considering social and ethical implications of such treatment. It’s interesting that he calls for the “marketplace of ideas and marketplace of medical treatment” to sort it out, as it apparently would mean that bioethicists should have an opinion one way or another only when evidence is completely on one side of the debate, a scenario that does not require bioethicists in the first place. Who needs bioethicists if marketplace is competently guided by the invisible hands of God?

Diamond et al. (I only recognize the names of Diamond and Spack among them) embodies another problem with the bioethics, that is the main concern of my essay: bioethics’ obsession with regulatory mechanisms and procedures rather than the actual ethical considerations. I feared that Alice Dreger’s and others’ critique of Maria New’s practice as an un-authorized, un-supervised human subject research involving off-lable medication would only lead to a kinder, gentler version of the same practice under full IRB review, and that appears to be precisely what Diamond et al. are calling for. That is definitely an improvement over the current situation, and perhaps it’s a step we must go through, but I really don’t want to wait for ten or more years before the registry begins to produce useful information.

I want to write more, but I have to finish writing grant proposal to get a new group for queer people with developmental disabilities funded due Monday (and it’s 12:30am on Monday) and get ready to fly out to the East Coast in less than 24 hours…

By the way, if you happen to be near Providence, I’m presenting a workshop at Brown University on Wednesday, March 17th as part of Brown’s Pride Series 2010. The workshop is titled “Transgender inclusion, or Demilitarizing the Borderlands of Binary Gender System.” See their site for more info.