Parents sue docs for deciding gender of intersex child 10 years ago

[K_Z]

In a first of its kind lawsuit, Greenville, S.C., residents Pam and Mark Crawford are suing the doctors who gave their adopted son sex assignment surgery while in foster care. MC, who had been deemed a female by doctors, had surgery at 16 months to “correct” his status as intersex (having both male and female genitalia), but is struggling with this assigned identity now at 10 years old. His parents are grieving that such a decision was made for him before he was able to make it himself.

BuzzFeed reports that after seeing the adorable photo of MC on an adoption website, the Crawfords knew they wanted to adopt him. Understanding the site featured many children with health problems, they decided to contact the South Carolina Department of Social Services to find out what was the matter with MC, who seemed in perfect health. It was then that they were alerted to the fact that he was born intersex; the agency detailed that MC was born with both a penis and vaginal opening, along with an undescended testicle on the left side of his body, and both ovarian and testicular tissue on the right side. Doctors reported MC’s hormone levels were consistent with a male baby at his age.

As for MC, his case is slated to be carried out in November, but has left many talking about this formerly unfamiliar issue.

http://www.msn.com/en-us/health/pre...s-for-deciding-their-kid-is-a-girl/ar-BBlIUDA

The surgery this child underwent 10 years ago, while in the foster care system, was entirely within medical standards for care of these children at the time (approximately 2005). "Doing nothing" would likely not have been a realistic option, IMO, for many reasons. (Some of them medical-- depending on the child's particular anatomy.)

I think it's unfortunate the child identifies with the opposite sex than the one determined by the team of docs, but don't see where anything that was done medically for the child was inappropriate. I think the parent's lawsuit is profoundly inappropriate. They knew the child had had surgery before they adopted her. Remember-- the infant care this child received was 10 years ago.

What do posters think?

 

[sonjay]

I don't even know what to think.

That poor kid.

 

[Donjeta]

Doctors reported MC’s hormone levels were consistent with a male baby at his age.

I wonder what the stats are regarding the child's hormone levels and the later identification... I'm just talking out of my hat here but it seems to me that if surgery is necessary, going with the gender that is consistent with the child's hormones might be a better bet.

 

[gxm]

I don't think doctors should "correct" intersex children. IMO, surgery is a decision that should be made by the intersex person when they are an adult.

 

[4senthia]

I have no idea about such things, but was it easier for the doctors to "make" this child a female rather than a male?
From your link above:
"Pam Crawford’s first thought was that she hoped MC had not undergone a surgery, but much to their dismay, they found he had, being officially assigned the gender of female."
Poor kid.
jmo

 

[Margo/Mom]

http://www.msn.com/en-us/health/pre...s-for-deciding-their-kid-is-a-girl/ar-BBlIUDA

The surgery this child underwent 10 years ago, while in the foster care system, was entirely within medical standards for care of these children at the time (approximately 2005). "Doing nothing" would likely not have been a realistic option, IMO, for many reasons. (Some of them medical-- depending on the child's particular anatomy.)

I think it's unfortunate the child identifies with the opposite sex than the one determined by the team of docs, but don't see where anything that was done medically for the child was inappropriate. I think the parent's lawsuit is profoundly inappropriate. They knew the child had had surgery before they adopted her. Remember-- the infant care this child received was 10 years ago.

What do posters think?

I agree, it has been fairly recently that procedural recommendations have moved away early from early surgical assignment. I am not certain where things stood in 2005, but I do know that this has been an evolving area. A scant generation back it was felt (and professionally recommended) that the combination of physical genitalia, hormones and parental nurture were the key ingredients in setting gender. As a result there were some truly tragic cases of assignment in which parents strove mightily to raise a child in an assigned gender that never fit. There was a classic case of a boy whose penis was tragically destroyed due to a surgical accident during circumcision. The belief in the role of nurture, plus outward appearance was so strong that the parents were advised to have the child undergo surgery to become a girl and to raise him as such. This included never telling the child what had happened and hiding a regimen of hormone therapy at adolescence under the ruse of being vitamins.

At some point during this unhappy person's life the truth had to be revealed, which brought some measure of relief and a choice to return to the gender of birth. However, he ultimately committed suicide. There are other cases with similar ends.

So--with all that said, I would really have to delve further into the information that was available in 2005 and the diligence with which it was researched prior to making such an important decision on a child's behalf. The fact that this happened while the child was a ward of the state certainly adds additional cautions about due diligence.

 

[Margo/Mom]

I have no idea about such things, but was it easier for the doctors to "make" this child a female rather than a male?
From your link above:
"Pam Crawford’s first thought was that she hoped MC had not undergone a surgery, but much to their dismay, they found he had, being officially assigned the gender of female."
Poor kid.
jmo

I know that at one point in time it WAS in fact easier to "make" females--and coupled with a strong belief that it was nurturance that weighed next most heavily, I belief that the SOP was to change intersex infants into girls.

 

[katydid23]

I don't think doctors should "correct" intersex children. IMO, surgery is a decision that should be made by the intersex person when they are an adult.

So in that case, ALL intersex children would go through their social teen years having two genders represented by dual sexual organs? That sounds very difficult for anyone to endure, imo. I would rather have only one gender and then if I thought it was the wrong one, I would reassign, if necessary. JMO

 

[bluesneakers]

I agree, it has been fairly recently that procedural recommendations have moved away early from early surgical assignment. I am not certain where things stood in 2005, but I do know that this has been an evolving area. A scant generation back it was felt (and professionally recommended) that the combination of physical genitalia, hormones and parental nurture were the key ingredients in setting gender. As a result there were some truly tragic cases of assignment in which parents strove mightily to raise a child in an assigned gender that never fit. There was a classic case of a boy whose penis was tragically destroyed due to a surgical accident during circumcision. The belief in the role of nurture, plus outward appearance was so strong that the parents were advised to have the child undergo surgery to become a girl and to raise him as such. This included never telling the child what had happened and hiding a regimen of hormone therapy at adolescence under the ruse of being vitamins.

At some point during this unhappy person's life the truth had to be revealed, which brought some measure of relief and a choice to return to the gender of birth. However, he ultimately committed suicide. There are other cases with similar ends.

So--with all that said, I would really have to delve further into the information that was available in 2005 and the diligence with which it was researched prior to making such an important decision on a child's behalf. The fact that this happened while the child was a ward of the state certainly adds additional cautions about due diligence.

If you're referring to David Reimer here's an article about him:

David Reimer, 38; After Botched Surgery, He Was Raised as a Girl in Gender Experiment
http://articles.latimes.com/2004/may/13/local/me-reimer13

And there's an excellent book about his story:

As Nature Made Him: The Boy Who Was Raised as a Girl

 

[Donjeta]

So in that case, ALL intersex children would go through their social teen years having two genders represented by dual sexual organs? That sounds very difficult for anyone to endure, imo. I would rather have only one gender and then if I thought it was the wrong one, I would reassign, if necessary. JMO

I think I would find it hard to cope with the thought that someone took it upon themselves to decide it for me... Also in many cases reassigning surgery would be vastly more difficult than waiting for a while to see what the child feels more comfortable with. Sometimes it might be clear in the early childhood - but you can't ask a baby how they feel.

Some of the problems intersex children face are created by their environment and might be alleviated in less invasive and less final ways by educating the people around the child.

 

[katydid23]

I think I would find it hard to cope with the thought that someone took it upon themselves to decide it for me... Also in many cases reassigning surgery would be vastly more difficult than waiting for a while to see what the child feels more comfortable with. Sometimes it might be clear in the early childhood - but you can't ask a baby how they feel.

Some of the problems intersex children face are created by their environment and might be alleviated in less invasive and less final ways by educating the people around the child.

So maybe deciding to do surgery to a baby is unfair. But I think waiting until adulthood is also unfair. Maybe deciding to do the surgery at 6 or 7 makes more sense. because many children seem to 'understand' which gender they identify with by then. IDK

 

[gxm]

So in that case, ALL intersex children would go through their social teen years having two genders represented by dual sexual organs? That sounds very difficult for anyone to endure, imo. I would rather have only one gender and then if I thought it was the wrong one, I would reassign, if necessary. JMO

Adolescence is hard for everyone, especially those who are different or don't fit into one of our neat and tidy cultural boxes. But I think our culture should change to accept intersex children instead of the other way around.

http://www.pbs.org/wgbh/nova/body/intersexual-life.html

 

[cocomod]

http://www.msn.com/en-us/health/pre...s-for-deciding-their-kid-is-a-girl/ar-BBlIUDA

The surgery this child underwent 10 years ago, while in the foster care system, was entirely within medical standards for care of these children at the time (approximately 2005). "Doing nothing" would likely not have been a realistic option, IMO, for many reasons. (Some of them medical-- depending on the child's particular anatomy.)

I think it's unfortunate the child identifies with the opposite sex than the one determined by the team of docs, but don't see where anything that was done medically for the child was inappropriate. I think the parent's lawsuit is profoundly inappropriate. They knew the child had had surgery before they adopted her. Remember-- the infant care this child received was 10 years ago.

What do posters think?

I agree with others that say - 10 years ago, things were perceived differently than they are today. I do not think that the doctors did this in neglect or in a way to hurt this child. I think that their efforts would be better in educating the public and possibly doctors on their plight. Figure out the best solution for future children so that they are not faced with the same outcome.

I do not like that society thinks that everything should be brought in to a court of law. Sue happy people cause prices to go up for all of society. To me, I hope that this case is thrown out and doesn't go anywhere. I am sorry for this child that feels like this, but I think the parents are doing a disservice by blaming the doctors for something that is hard for anyone to understand or go through. JMHO

 

[gxm]

BBM

Following diagnostic work-up, newborns with intersex should be given a gender assignment as boy or girl, depending on which of those genders the child is more likely to feel as she or he grows up. Note that gender assignment does not involve surgery; it involves assigning a label as boy or girl to a child. (Genital “normalizing” surgery does not create or cement a gender identity; it just takes tissue away that they patient may want later.)

http://www.isna.org/faq/patient-centered

 

[SophieRose]

I agree with others that say - 10 years ago, things were perceived differently than they are today. I do not think that the doctors did this in neglect or in a way to hurt this child. I think that their efforts would be better in educating the public and possibly doctors on their plight. Figure out the best solution for future children so that they are not faced with the same outcome.

I do not like that society thinks that everything should be brought in to a court of law. Sue happy people cause prices to go up for all of society. To me, I hope that this case is thrown out and doesn't go anywhere. I am sorry for this child that feels like this, but I think the parents are doing a disservice by blaming the doctors for something that is hard for anyone to understand or go through. JMHO

The case has been around since 2013 so apparently it hasn't been thrown out of the courts. He had the surgery at 16 months, couple gained custody of the child at 20 months.

http://www.dailymail.co.uk/news/art...spital-mutilating-sex-assignment-surgery.html

But they said they soon noticed M.C. tended toward interests typically associated with males and preferred boys' clothing. As he grew older, he asked for his hair to be cut short like his father's and wanted to join a gymnastics class as a boy, they said.

'He's always been able to amuse himself with a toolkit,' Mark Crawford said. 'He's more likely than any of our other children to be climbing trees, wanting to ride bikes, flying model airplanes.'

A couple of months ago, in consultation with their pediatrician, the Crawfords said their son made the transition to live as a boy and has been accepted as one by his friends.

 

[gxm]

I am glad that the parents are suing. Hopefully, it will raise awareness and bring about an end to doctors operating on intersex babies to make their genitals look "normal." Surgery should only be done if necessary for the physical health of the child.

 

[al66pine]

From OP's link to msn: "According to the Intersex Society of North America..."

Seems ^ reference to ISNA* is at best a historical reference, or perhaps stale, as it folded in 2008. The Accord Alliance is successor organization to ISNA, per below. "Their stated mission is to promote comprehensive and integrated approaches to care that enhance the health and well-being of people and families affected by disorders of sex development (DSD, which includes some conditions referred to as "intersex").[SUP]"

[/SUP]No reflection on K-Z, only on msn and reporter's source or research.

________________________________________________________________
* FWIW, per wiki:
"ISNA closes.
By 2008, even though ISNA felt that they were able to come to a “consensus on improvements to [medical] care” for people born intersex with a large amount of the medical community, they ran into many problems in implementing these ideas.... The ISNA decided its best course of action was to “support a new organization with a mission to promote integrated, comprehensive approaches to care that enhance the overall health and well-being of persons [who are intersex] and their families.” The ISNA transferred all of its remaining funds, assets, and copyrights to Accord Alliance and then closed." bbm

"Successor organizations
Main article: List of intersex organizations
The Accord Alliance, which opened in April 2008, is a direct successor to ISNA. Its goal is to “improve the way health care is made available” to people born intersex.[SUP][6]. ....[/SUP] OII continues today with affiliates in many countries. Other intersex and DSD activist and advocacy organisations also continue their work around the world. Many of those organizations participate in the International Intersex Forum." bbm

ETA:
* also
"Please note that ISNA is closed. If you need to talk to us about legal or accounting issues, please use the fax or email addresses below."
http://www.isna.org/about/contact

 

[Margo/Mom]

If you're referring to David Reimer here's an article about him:

David Reimer, 38; After Botched Surgery, He Was Raised as a Girl in Gender Experiment
http://articles.latimes.com/2004/may/13/local/me-reimer13

And there's an excellent book about his story:

As Nature Made Him: The Boy Who Was Raised as a Girl

I read the book and it is very sad.

 

[Margo/Mom]

So in that case, ALL intersex children would go through their social teen years having two genders represented by dual sexual organs? That sounds very difficult for anyone to endure, imo. I would rather have only one gender and then if I thought it was the wrong one, I would reassign, if necessary. JMO

I think that there are a lot of misunderstandings about gender and assignment. Gender is pretty much innate and possibly inalterable. For most humans there is a match-up between gender, sexuality and sex. But not all. Many regard surgery altering physical manifestations of sex to be determinative, but it is not. Not all gender atypical persons elect surgery or medical treatments for many reasons. The choices are really intensely personal. Certainly in cases of ambiguity at birth, it is presumptive and wrong for adults to elect surgical changes on behalf of an infant. I don't know that it is always approptiate to wait until the age of majority either. Sometimes puberty can be delayed to allow more time for decision-making.

 

[al66pine]

Buzzfeed article* linked in OP's link to msn has much more info than msn article (sorry if already posted) but also raises more questions in my mind. From the little I've read so far, my thought: alleged wrongdoing was not to Pam & Mark, but, if anyone, was to MC.

"By February 2005, when M.C. was 3 months old, his biological father abandoned the family. Shortly after, the state of South Carolina determined that his mother was an unfit parent, and he was taken into state custody. Decisions about M.C.’s medical care from there on out were supposed to be made by social workers as well as his biological mother, whose parental rights had not yet been formally terminated."

"In January 2006, M.C.’s case was referred to two doctors at the Medical University of South Carolina (MUSC)..."
"M.C.’s biological mother signed the consent form .... Social services signed off as well."
Puzzling to me: if SC SS was MC's legal guardian and MC's bio-moms parental rights had not been terminated, why did SC have bio-mom sign to consent? Belt & suspenders, or something else?

After seeing MC's pic on website, then learning of MC's condition, Pam said: "... the first thing she remembers saying was, “Oh, I hope they haven’t done a surgery!” But they had. Just two months before she saw that first photo, surgeons had removed all of M.C.’s male anatomy. “We were just like, OK, let’s deal — we’ll deal with what we gotta deal with,” Pam said. Two months later, they brought home a baby girl."
Puzzling to me: Can bringing home happen this ^ fast, two months? Were they already in process to adopt (non-specified child?)? W MC, were they initially foster parents (or equiv?) and adoption proceedings came months or yrs later?

"A psychiatrist by profession, Pam ...; Mark a timid and self-deprecating stay-at-home dad to their five kids. They met in California in the ’90s, while Mark was studying law at Stanford University and Pam was in the Air Force..." sbm
Not an uneducated pair buffaloed into adopting child w no background or condition info, imo.

"....the legal complaint filed on behalf of Pam and Mark by the intersex advocacy group Advocates for Informed Choice and the Southern Poverty Law Center."
Puzzling to me: did ^ groups actually file complaint on their behalf or file an amicus brief?

"The state case ... hinges on ...: informed consent. A jury will decide whether M.C.’s doctors did enough to convey the risks of surgery, and whether South Carolina’s social services failed to act in M.C.’s best interest while serving as his legal guardians...."

The lawsuit claims pre-adoption wrongdoing by doctors (failing to convey risks, presumably to bio-mom & to SC SocServ) and apparently SC SS (for not acting in tot's best interest) but seems, imo, Pam & Mark were aware of alleged wrongdoing before adoption and adopted anyway. Alternatively, if they were not aware of wrongdoing, it was not to them. To my thinking, alleged wrongdoing was to MC, if anyone. I'd like to know more re state of medical sci on this issue was in ~2006.

And Pam's stmt: "... that she and Mark would have sued regardless of whether M.C. had turned out to be a boy or a girl.”
Does this ^ weigh in favor of parents' lawsuit or against it?

* http://www.buzzfeed.com/azeenghoray... decide what sex a child should be#.ju0vBrlKw Aug.5