Is the Body Natural? Intersexuality and ‘Corrective’ Genital Surgery

baby_hand_family_newborn_feet-38666-jpgd.jpegTo cite this article: Sturt-Schmidt, James (2015). Is the Body Natural? Intersexuality and ‘Corrective’ Genital Surgery, The Millennial [Online], Available at: (this page URL).

Intersexuality, its social construction and its management are subjects increasingly present in contemporary research that intersect intriguingly with theories of embodiment, performativity (Judith Butler) and bio-power (Foucault). This essay will compare the arguments put forward by Anne Fausto-Sterling (1993) in her article The Five Sexes and Iain Morland’s article Is Intersexuality Real?, exploring their theories of intersexuality and critical analysis of current medical discourse and procedures.

In Anne Fausto-Sterling’s article, ‘The Five Sexes’ (1993), Fausto-Sterling critically explores Western culture’s commitment to the idea that there only exist two sexes, particularly focusing on the medical practice of ‘correctional’ genital surgery. She begins by telling the story of Levi Suydam, who in 1843 was denied the vote due to being “more female than male” (1993: p20), was given the vote after being declared male by a physician (presumably due to the presence of a penis), and was later found to regularly menstruate and to have a vaginal opening. This clearly demonstrates the confusion intersex people are often met with due to the socially (and linguistically) accepted dichotomy of sex, which Fausto-Sterling explores thoroughly in her article. She argues that, despite there being such a social and legal importance placed on one’s being either male or female, biologically there exists a spectrum containing at least five sexes. She explains that the three ‘intersex’ subgroups consist of ‘true hermaphrodites’ (who have a testis and an ovary), ‘male pseudo-hermaphrodites’ (who have testes and aspects of female genitalia) and ‘female pseudo-hermaphrodites’ (who have ovaries and aspects of male genitalia). Having listed these categories, Fausto-Sterling argues that sex is an “infinitely malleable continuum” (1993: p21), examines the many differing historical perspectives on intersexuality, and contests what she describes as “scientific dogma” (1993: p23) which assumes “without medical care hermaphrodites are doomed to a life of misery” (ibid.). Citing Foucault’s concept of bio-power, “the taking charge of life, more than the threat of death” (Foucault, 1979: p143), Fausto-Sterling argues that the ‘expert’ knowledge developed by the various medical disciplines has given physicians the power to “control the very sex of the human body” (1993: p23). This deployment of the Foucauldian concept of bio-power to understand the regulation (and eradication) of intersexual embodiment echoes broader theories of how social bodies are constructed through normalising discourses, ‘regulative apparatuses’ (which Foucault called ‘apparatuses of knowledge’) and institutions (Foster, 2013). In this case, intersexuality is controlled by confusing medical discourse, androcentric, heteronormative medical “state informed expert knowledge” (Roach, 2009: p157) and clinical institutions.

Complementary to Fausto-Sterling’s (1993) enlightening article, Iain Morland (2001) offers an extremely comprehensive (and at times particularly abstract) exploration of intersexuality’s social construction and sex’s performative nature. Writing as an individual who has personally undergone “fourteen unsuccessful and dilapidating surgeries […] for intersexuality” (2001: 529), his starting point is where Fausto-Sterling finished eight years earlier: surgical protocol has to change. Echoing Fausto-Sterling’s engagement with bio-power, Morland argues that children born in Western culture with ambiguous genitalia are “subjected to a programme of medical ‘management’” (ibid.). He engages with Suzanne Kessler and Wendy McKenna’s concept of ‘cultural genitals’ (which are the genitals one is assumed to possess) to argue that sex and sexual difference is performative, and argues that ‘corrective’ surgery aims to “create sexual difference out of intersexed flesh” (2001: p529). In greater detail than Fausto-Sterling, Morland explains the confusing and paradoxical ways in which medical science outlines what constitutes or defines sex, and examines the implications of Judith Butler’s theory of performativity that “science […] actually produces sex by its discursive repetition of sexual difference”. He draws upon Kessler’s theory, arguing that intersexual genitals pose no threat to life, but rather threaten heteronormative culture.

Morland’s (2001) article poses many questions which expose the fragility and paradigmatic nature of medical knowledge, for example he asks if “differentiated features occur because an embryo is male or female, or [if] they actually make it male or female” (p442, italics in original), and “do sexed features signify a body’s sex, or do they instead constitute its sex?” (p543). He proceeds to highlight the many contradictions found in medical literature, concluding from the lack of answers to these questions that, as Butler believes, sex is performative – even in scientific terms. Regarding embodiment theory, Morland emphasises that intersexuals’ personhood is limited to medical terminology and what they embody is not a person but an object of medical knowledge. He depicts a reality in which intersexual people could assert their personhood and utilise language “to illustrate what their bodies already prove – […] that maleness and femaleness are not monumental, discrete categories” (2001: p536). Similarly, Fausto-Sterling (1993) invites the reader to imagine a world of “shared powers” (p23) where medical knowledge which has fuelled intervention is instead used to preserve life and enable hermaphrodites to worry about the potentially life-threatening conditions which can accompany their development, rather than conforming to social norms. She envisages treatment as a “cooperative venture between physician, patient and other advisors trained in […] gender multiplicity” (ibid.). These visions of the future are reflected in Katrina Roen’s (2008) analysis of medical literature in her belief that “by conceptualising the atypically sexed child as a whole, agentic subject and thinking of his/her embodiment as a process” (p63) there is an opportunity to reshape clinical practice.

To conclude, Morland appears to offer a deeper and more comprehensive exploration of each of the subjects raised by Fausto-Sterling. They both emphasise the need for change in the surgical management of intersex children, demonstrate their robust knowledge of medical discourse in their undoing of it, and argue that sex is performative. They appear to share many of the same optimisms, offering a hopeful vision of a future where intersex people can embody something more than medical terminology, and where children born with intersex genitalia are able to decide later for themselves what they would like to embody. Although language is still restricted to the dichotomy of male and female sexes, the optimisms of Fausto-Sterling and Morland are already beginning to enter reality as clinicians, intersex people and their families are exploring non-surgical possibilities and “disrupting the assumptions upon which the routine practice of early cosmetic genital surgery is based” (Roen, 2008: p63). Indeed, these texts and others of their kind have played a key part in this advancement.

James

References

Fausto-Sterling, A. (1993) ‘The Five Sexes: Why Male and Female Are Not Enough’, The Sciences, March/April 1993: 20-24

Foster, E. A. (2013). ‘International sustainable development policy: (re)producing sexual norms through eco-discipline’. Gender, Place & Culture: A Journal of Feminist Geography. July, 2013, Vol 21 Issue 8, p1029-1044.

Foucault, M. (1979). The History of Sexuality, Volume One: An Introduction. London: Allen Lane. [Fr 1976]

Morland, I. (2001) ‘Is intersexuality real?’, Textual Practice, 15(3): 527-547

Roach, T.J (2009). ‘Sense and sexuality: Foucault, Wojnarowicz, and biopower.’ Nebula. Sept, 2009, Vol. 6 Issue 3, p155, 19p.

Roen, K. (2008) ‘‘But We Have to Do Something’: Surgical ‘Correction’ of Atypical Genitalia’, Body & Society, 14(1): 47-66

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