"Cure" imposed on victims of circumcision accidents

[Hazel]

Last yearl, I was puzzled by media coverage of two Strange Sex Cases.
Apparently, 20-something years ago, in two unrelated incidents, two very
unlucky baby boys had their penises virtually destroyed in circumcision
accidents. In both cases, the doctors sergically removed not only the remains of the penisl, but also the testicles, then created an artificial vagina. The children were raised as girls and, at puberty, given hormones so that they would develop
breasts. One is still female and identifies herself as bisexual; when the other learned the truth, he insisted on switching back to a male identity. (In the latter case, the accident and subsequent surgical "cure" occured later in life then in the former case -- possibly significant.) I've been wondering, weren't those doctors kind of throwing the baby out with the bathwater when they removed the testicles? When you remove the testicles in infancy, you
eliminate the possibility of any real sex life. All that remains is to decide if the individual will look like and live as a male or as a female. Either way, (s)he will never be able to experience sexual pleasure. Wouldn't it have been better to fix the kids up with some sort of artificial extension for the remaining penis stub? Wouldn't that have made possible not only a sex life, but also fatherhood? Weren't both possibilities eliminated not by the accident itself but by the "cure"imposed after the accident?
Granted, their degree of pleasure in sex would probably be reduced by the
absence of a real penis with real nerve endings in the skin -- but surely
something is better then nothing.
Inquiring minds all over the world must be wondering about this. What's the straight dope?

[Kent4mmy]

In at least one of the two cases you
mention, the botched circumcision was done
with the use of a laser. Needless to say
there was next to nothing left of the infants
penis after the initial "slip". The remaining
tissue subsequently died, leaving little
chance for any type if reconstructive
surgery. It might interest you to know that
hundreds of these "boy into girl" procedures
were performed in the United States.

[Nickrz]

I'd like to see some supporting evidence for the "hundreds" of accidents, for the laser "slip," as well as for the original two cases.

I think using a laser to perform this minor surgery easily accomplished with whatever that razor-sharp device is called is like cracking eggs with a nine-pound sledge; can anyone verify these nudnicks actually use them for this? In any event, surgical lasers have power settings, it's not like a guy is waving a light sabre around. I can't imagine a laser used on delicate tissue like this would have the power to do the damage cited.

Please excuse me for being skeptical, but all this sounds apocryphal to me.

[astorian]

The stories are not apocryphal- they have, in fact, received a fair amount of attention in the mainstram press, not just in the "bigfoot-UFO-Loch Ness Monster" tabloids.

As was mentioned earlier, "baby-boy-into-baby-girl" operations are, if not common, far from unheard of. When such operations are performed, it's usually because... how shall I put this... Mother Nature goofed. Sometimes babies are born with ambiguous genitalia, multiple genitalia, or strange combinations of male and female genitalia. In those cases, it's not always clear what the right procedure is, medically or morally.

Suppose you get a baby who is, genetically female, but has testicles, no penis and no vagina. What gender is it? How should it be treated and raised? Frequently, doctors conclude that, since it's impossible to make a functioning penis but rather easy to create a makeshift vagina (and since this kid isn't going to be able to have children of his/her own anyway), the best thing to do is castrate it, create a makeshift vagina, and order the parents to raise the child as a girl. For a long time, the assumption in the psychiatric community was that "gender" is a meaningless concept anyway. "Male" and "female", by this theory, are artificial constructs with no meaning in nature. Under this theory, it's the way we're raised that determines whether we'll be masculine or feminine. Many medical doctors bought into that theory, and figured that these surgically altered babies would be perfectly happy as girls, as long as they were given pink dresses, Barbie dolls, and occasional hormone treatment.

Now, I don't pretend to know if that's the proper way to handle such cases, but I understand the logic perfectly. There may not be ANY ideal way to cope with such babies, and that metjod may be as good as any.

But in a FEW cases. babies that were NOT of ambiguous gender, babies that were purely and simply BOYS, lost their penises due to doctors' errors. In those few cases, doctors decided to treat these babies the way they would a baby hermaphrodite. They decided the best thing would be to remove the testicles and penis entirely, create a vagina, and let hormones/nurturing turn these boys into girls.

In THESE cases, at least, nature beat nurture hands down. The newly created "girls" never behaved like girls, were always extremely masculine, and never took to the female gender roles they were pushed into.

And it's precisely BECAUSE of that perennial "nature vs. nurture" debate that these kids received attention. Several conservative writers (George Will in particular) wrote about these cases, citing them as proof that boys ARE naturally more aggressive and (sorry) masculine than girls, and that traditional sex roles/stereotypes really are hard-wired into our brains genetically.

[Hazel]

Astorian, thanks for all the info. I'm wondering about the ambiguous babies who were turned into girls -- do most of them accept being women; feel it's what they really are? (Assuming there's been any follow up.)

[astorian]

This is not a field in which I'm any kind of expert! I'm not a doctor or a geneticist, and will not attempt to speak with any authority on this subject, which I know of only from coverage in the mainstream press. (In other words, if you read a few back issues of Time or Newsweek, you'll know as much about this as I do).

The short answer is, there's a rather wide range of behaviors and attitudes among children who were born with ambiguous genders. Both nature AND nurture are at work, after all. Bear in mind, that in many cases, the problem is not discovered for several years after birth. Hypothetical example: a new baby has what looks like a penis, so the doctors say, "IT's a boy!" Everybody's happy, cigars are passed out, the baby goes home, the parents name him Henry, and raise him like a boy. Not until Henry is... oh, 3 or 4, do doctors discover he has ovaries!

NOW what do the parents and doctors do? Surgically turn him into a Henrietta? Keep him a boy, and give him lots of testosterone treatments? Very tough call, and there's no predicting how the child will adjust.

Whatever treatment or non-treatment is prescribed, you may wind up with a very maculine girl, a very feminine boy, a rather neuter adult, or someone who conforms to usual gender expectations. There's just no telling.

[SkeptiJess]

There also seems to be an infant movement towards allowing such individuals to be what they are without declaring a gender. A Google search on "intersex" revealed a good deal more than the average person is ever likely to need to know on the subject. Several of these hits, BTW, classified the surgery giving an intersexual a vagina (apparently the most common treatment for this condition in the last few decades) as "genital mutilation."

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Jess
Full of 'satiable curtiosity

[timmar68]

A cousin of mine was born with both male and female organs. The doctors did a very thorough exam and decided that she had more female characteristics than male, so they castrated him (oops, i mean her. This is confusing when you type!) and she was raised as a girl. She led a perfectly normal life. On a sad note, she died young, but that was due to an illness.

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MaryAnn
Sometimes life is so great you just gotta muss up your hair and quack like a duck!

[Hazel]

I can't help wondering if it would not be better to let these children grow up ambiguous. I know this would be difficult, but it might be preferable to making a decision that the child may grow up to bitterly resent. When they are old enough to understand the options, they can make their own decision on what (If anything) to cut off or otherwise alter.

[Hazel]

Astorian, in the example you cite, I'd say the best choice would be to keep him a boy. By a age three, isn't a child well aware of which gender he or she belongs to, and firmly fixed in that gender? Wouldn't a switch at that age be very upsetting for the child? He would not be old enough to understand the reasons; all he'd know would be that the grownups cut off his sex organs and told him he had to be a girl. Talk about a trumatic experience!

[NanoByte]

MaryAnn
Sometimes life is so great you just gotta muss up your hair and quack like a duck!

But if it quacks like a duck, should you raise it as a girl?

Ray

[Manda JO]

Hazel suggested leaving things up in the air until the child was grown. I suspect that the reason they don't do this is because you can't; hormone treatments one way or the other are going to have be administered prior to puberty. And no ten year old is really prepared to make that kind of decision; G-d knows that I wouldn't want to have to live with any decisions I would of made at that age.

[Hazel]

You may be right, Manda Jo, about the reasoning; doctors and parents may well be thinking, re a baby or todler, "let's us adults make the decision now so this child does not have to decide at age ten or so." But this seems to me to be over-protective. At ten, a child should know quite well if he/he IS or IS NOT happy with the prospect of remaining whatever gender he or she has been living as to date.

Consider that small minority of individuals who are distictly unhappy about their gender. Don't they almost always say that they've "always" known that inside, they were "really" the other sex? If not "always," then "since I was six" (or younger).

[TheIncredibleHolg]

Hazel, I have to side with Manda JO. I really don't think a ten-year-old is mature enough to make such a decision. For what it's worth, when I was ten, I thought being a girl would be a lot better. But now I'm a grown-up man, and boy am I glad no fairy granted me that wish! I think before puberty (and often for some time after), a kid does not really know what it means to be a man or a woman. He/she may have observed the social aspects of gender roles, but will have hardly a clue as to the actual sexual issues and what it "feels" like to be one or the other.

As for the unhappy ones "always" having known - it's easy to re-interpret some vague unhappiness you felt as a child. It's like the people who just "knew" their numbers were going to win the lottery.

[PTVroman]

I'd like to see some supporting evidence for the "hundreds" of accidents, for the laser
"slip," as well as for the original two cases.
I think it was last year, one of the cases got a huge write up in Rolling Stone. The patient was a twin. After the accident (but before the castration), the pediatrician on the case referred the parrents to a "specialist" who councelled them to have the sex change done. This man wanted to use the twins as a test case. He ranted and raved and wrote up how successfull the procedure and the hormones were, etc. Guess what? Didn't work. The "girl" was miserable, and has since had some kind of sex change back (don't ask me how).

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"The large print givith, and the small print taketh away."
Tom Waites, "Step Right Up"

IncredibleHolg, almost all transsexuals say they knew from as far back as they could remember that their brain and body did not match. It's not just a matter of "it would be fun to be a boy," but of knowing that you are indeed, a boy. Of course, this is a different case from babies who were "oopsed" at birth.

[TheIncredibleHolg]

Flora, citing myself as an example is, of course, an inadequate comparison. I was trying to point out that a child of ten years has no real idea of what it means to be man or woman, and I stand by that. Children at that age are so easily influenced. They can get the strangest ideas firmly implanted in their heads, and can be talked out of some of the most basic and rational facts. If they are brought up to be ambiguous about their sexual identity (which is likely if their parents refuse to make a decision), they have to make a decision a very weak grounds and will be very unsure of their own opinion. If, on the other hand, their parents sort of nudge them into one direction by treating them as a boy or girl, they are likely to follow that path because it's easier, because it seems to please their parents, or because they just don't know any better. As I said, I don't think they can know what it's like to be a man or woman until they are. Of course, it may be too late then. With the child unable to make an informed decision, the parents just have to do it, whether they like it or not. If the decision is wrong, that's a sad situation, but I don't see any elegant solution.

As for the memories of transsexuals, show me a diary entry of a ten-year-old clearly stating the discrepancy between his body and mind, and maybe I'll change my mind. Until then, read how easily memories can be distorted:
http://skepdic.com/falsememory.html

[Neobican]

The original post was talking about babies that were born clearly boys, and not born with both sets of equipment. However, IF that was the case, being a parent I would want tests done and make a gender decision within 2 years, it would probably be less traumatic than letting them grow up that way I think. In the case(s) of botched circumcision, I would NEVER allow the quack to "fix" his mistake by eliminating it altogether, oh no, I would make sure he never practiced again. I'm talking lawsuit and removing the license. The only way I can think of to fix it would be to wait until he is older for reconstructive surgery, hopefully by then advancements will have been made so as to do a good job. I am in disbelief that the parents allowed that to happen. Do ya think John Bobbit should have been made a woman?? I bet he would have glued it back on if he had to.

[astorian]

I was the one who first brought up the subject of "transgendered" children, beecause, even though that was not the original topic, it seemed relevant. MOST of the time, when doctors perform surgery to remove male genitals and create a makeshift vagina, it's because nature goofed, and the child isn't clearly male or female. As stated earlier, since it's much easier to create a sort-of-functional vagina, and very hard to create a functional treatment, doctors have found it easier to turn cross-gender kids into girls.

In the cases ORIGINALLY brought up, there was no ambiguity: the babies were BOYS, plain and simple. Doctors made a huge mistake, and accidentally removed their penises- they then decided, what the heck! Surgery, hormones and nurtuting will turn them into girls.

This idea was stupid at best, and evil at worst. It was based on two things:

1) Incompetent doctors trying to cover their backsides.

2) Pop psychology. If you buy into the notion that traditional gender roles are STRICTLY a matter of societal pressure, then of course you'll see no problem with turning a baby boy into a girl, and you'll expect him to embrace his newly imposed femininity. WRONG!

"As for the memories of transsexuals, show me a diary entry of a ten-year-old clearly stating the discrepancy between his body and mind, and maybe I'll change my mind."

Actually, I could do just that, but can't scan the text into the computer. There's a book coming out on just this subject in the next six months or so, I'll cite it when it's available.

[Hazel]

I think Astorian has got it. Faced with a baby boy whose penis has somehow been accidently removed, doctors made the (I would say wrongheaded) decision to handle the case with the standard treatment for what is acutally a very different situation, children born with ambiguous genitals.

Does it seem to anyone else that this shows some rather dubious assumptions on the part of the doctors? They were putting a high value on appearence: the baby had to be made to look like a regular guy or gal. And a very low value on sexual pleasure: oh, sure, let's castrate him if that's the easiest way to make him look like a normal person.

I can't help but wonder, did these doctors think that so long as the "woman" they were creating had a vagina, that was all she needed? That sexual pleasure was crucial for a man, unimportant for a woman?

I have read that some adult women have had sex change operations. If they can create some sort of penis for a woman, why can't they create one for a boy?

[AuraSeer]

A penis created through surgery is made of a piece of tissue taken from elsewhere in the body; I seem to remember reading that they use a piece of muscle from the leg, but I'm not at all sure about that detail.

One important reason they can't, or don't, perform this sort of surgery on children is because, to coin a phrase, size matters. An adult man's penis is quite a bit larger than that of a prepubescent boy. A surgically-created phallus does not respond to hormones in the same way that the "original equipment" would; if the surgery were performed before puberty, the organ would have to be recreated years later, at a larger size.

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I'm not a warlock.
I'm a witch with a Y chromosome.

[Hazel]

Found an interesting Salon article, The Sex Police, about the medical treatment of children born with ambiguous genitals.
http://www.salonmagazine.com/health/feature/1999/04/05/sex_police/

Lest this topic get too serious, here's a brief excerpt from the British TV series Blackadder, the Bells episode.

Melchett: Ah well, the whisper on the underground grapevine, ma'm, is that Lord Blackadder is spending all his time with a young boy in his service.
Queen: Oh. Do you think he would spend more time with me if I was a boy?
Melchett: Surely not madam.
Nursie: You almost were a boy, my little cherrypit.
Queen: What?
Nursie: Yeah. Out you popped, out of your mummies pumpkin and everybody shouting: "It's a boy, it's a boy!". And somebody said "but it hasn't got a winkle!". And then I said "A boy without a winkle? God be praised, it is a miracle. A boy without a winkle!" And then Sir Thomas More pointed out that a boy without a winkle is a girl. Anyway, I was really disappointed.
Melchett: Oh yes, well you see, he was a very perceptive man, Sir Thomas More.

[TheIncredibleHolg]

Jeez, Hazel, that article breaks my heart. (Makes my cringe, too, at the thought of such surgery.) Am I glad that my kids are okay!

Still, I'm all the more convinced that it's up to the parents to make a decision in their child's best interest. That decision may be to delay final action in some cases, but as you said yourself, a change at an age when the child is aware of what's happening would be extremely traumatic. And letting him/her grow up ambiguous is problematic at best. What do you say if a kid asks, "Am I a boy or a girl?" "We don't know yet"?! This is such a dramatic situation I'm just glad not to be in...

[Hazel]

Re the Salon article, I was shocked at the arrogance of the doctor who castrated the little boy against the firmly stated wishes of the mother. I think the mother should both sue him and look into going after his license to practice.

I've now read the Salon article, the long story about the identical twin whose penis was destroyed in a circumcision accident (it's on line) and some on line info from people born with ambiguous genitals who are pretty angry about what was done to them, and about having been lied to for years re their situation.

I'd say that the "solutions" medical science has been using for the past 35 years or so are worse then the problem. Almost anything would be better.

[Northern Piper]

oh, and the article does explain how one botches a circumcision:

"Such a simple operation," said David's father, Ron. "I mean, a hangnail is more of a big deal. The doctor used an electronic cauterizing machine and there were two settings. He had it set on the wrong one, or he stepped on the wrong pedal."

David's penis was engulfed in a scorching heat. A few days later, the blackened string that was once his organ fell off his body like a piece of burnt bacon rind.

So, yes Nickrz, it was like they were using a light-sabre. Ick.

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and the stars o'erhead were dancing heel to toe

[Northern Piper]

thanks, manhatten - don't know what went wrong with that link - was it because I got it off of a search function?

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and the stars o'erhead were dancing heel to toe

[manhattan]

I don't think so, jti. UBB seems to have problems when the link is particularly long (all those &21414/ notations and whatnot).

In other words, the link was too long, and I had to snip it. I Only hope I didn't err by snipping too much.

::ducking and running::

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Livin' on Tums, vitamin E and Rogaine

thought you might be interested to know that the boy from one of the most closely-studied cases of botched circumcision has decided to shed anonymity and go public, to try to prevent doctors from doing such surgery in the future. He lives in Winnipeg and a book is coming out about him next month.

I removed a link that was making the page too wide. I've saved it, and if I can figure out how to make it work, I will reinsert it.

--manhattan
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and the stars o'erhead were dancing heel to toe


[Note: This message has been edited by manhattan]

[Northern Piper]

oh, putz!

sorry gang.

the article's in the Globe & Mail - try typing in "circumcision" in the search function at the bottom of this page. It brings up the article, "How David Found His Manhood."

Globe & Mail (http://www.globeandmail.com)

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and the stars o'erhead were dancing heel to toe

[NanoByte]

Try this (http://archives.theglobeandmail.com/search97cgi/s97_cgi?action=View&VdkVgwKey=%2Fchico2%2Fusr%2Flocal%2Fgam%2Fsearch%2Fhtml%2F20000129%2FUREIMN%2Ehtml&DocOffset=1&DocsFound=2 &QueryZip=circumcision&Collection=TGAM&SortField=sortdate&ViewTemplate=GAMDocView%2Ehts&SearchUrl=http%3A%2F%2Farchives%2Etheglobeandmail%2Ecom%2Fsearch97cgi%2Fs97%5Fcgi%3FQueryZip %3Dcircumcision%26ResultTemplate%3DGAMResults%252Ehts%26QueryText%3Dcircumcision%26Collection%3DTGAM %26SortField%3Dsortdate%26ViewTemplate%3DGAMDocView%252Ehts%26ResultStart%3D1%26 ResultCount%3D10&) for that circumcision link.

You do this with HTML thus:

<a href="whatever URL" target="Resource Windows">some designating word or phrase</a>

Ray (Unreliable Bunch o' Baloney)

[NanoByte]

Oh, well. :D At least I got a rise out of it. It always works for long cgi URLs from SF Chronicle searches.

Ray

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LIFE: Those sparse nanoseconds between downloads of software upgrades.