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Only If They Admitted that They Didn't Know

reviewer underestimates the dishonesty in intersex medicine

Forum: Letter to Dr. Andrew Hacker
Date: 03/10/2003

Hello Dr. Hacker,

My name is Emi Koyama and I am the director of Intersex Initiative Portland, a new (since January) intersex activist group in Oregon. I have also worked for Intersex Society of North America from 2001-2002 as the program assistant.

I am writing in response to the review in The New York Review of Books (March 27) which you wrote. I'm writing to provide you with a couple of clarifications on the topic you briefly touched, that is intersexuality. The online address for the review in question is Since I haven't actually read "Normal," I'm not sure if these comments are attributable to her or to you, so forgive me if some of them had nothing to do with you...

You wrote:

After about one of every two thousand births, the parents hear a physician saying something like "Somehow your baby's genitals haven't finished developing, so we don't quite know right now what sex it is."

I wish this was true! However, physicians rarely admit to the parents of intersex babies that they *do not know*. In fact, the current medical standard *encourages* physicians to act confident that they *know*, or else parents would not be able to raise the child appropriately to his/her assigned gender.

Medical ethicist Alice Dreger from Michigan State University wrote in 1998: "Since the overarching rule of this system is 'avoid psychological confusion about the patient's gender identity,' doctors often do not tell intersexuals and their parents all that the doctors know, lest information about intersexuality confuse or complicate the family's understanding of gender." She further states, "in no other realm in medicine do doctors regularly argue for active, nearly wholesale deception." (Quotes are from the introductory chapter of "Intersex in the Age of Ethics" ed. by Alice Dreger).

One who is known is John Colapinto, who was made into a Joan shortly after being born, and decided in his teens that he really was a boy.

Actually, John Colapinto is the author of the book *about* the child who has been referred to as "John/Joan," and not the "John/Joan" himself. Colapinto is a freelance writer living in New York.

ALSO, "John/Joan" was *not* intersex; he was born with "normal" male genitals, then was turned into a girl after an accident during the circumcision. Sure, the way he was treated by the medical system was similar to how intersex children are being treated, but if you are talking abut intersex, you should probably mention people who are actually intersex.

I hope this information would help with your future projects.

Emi Koyama
Intersex Initiative Portland
PO Box 40664
Portland OR 97240