Rhetoric of the
Medical Management of the Intersexed

J. David Hester
Centre for Rhetorics & Hermeneutics

 

A child is born. Healthy, alive, responsive. Only, the genitalia of the child seem strange, somehow unexpected. Maybe the child's penis is very short and the scrotal sac underdeveloped. Maybe the urethra is at the base of what appears to be a very large clitoris. Maybe there is no vaginal opening. At this point the attending physician declares a psychosocial emergency and pulls together a team, usually consisting of a geneticist, a pediatric endocrinologist and a pediatric urologist. The parents are told to wait before telling anybody about the situation, to only say that the child is healthy but needs to stay in the hospital longer, and to postpone naming the child, who is put in an NICU. Tests are run in order to ascertain the "true sex" of the child. Sexual function in genetic "males" and fertility in genetic "females" are considered, as are normative standards of penile/clitoral length. A decision is made regarding which gender to rear the child (the "optimum sex of rearing"). The parents are asked to adopt the new gender wholesale, to never display any ambiguity regarding the gendered identification and rearing of the child. Surgical reconstruction is employed, hormonal treatments planned. Throughout the child's life, s/he is kept in the dark as to the purpose for the continuing surgeries and treaments.

The purpose of this presentation is to begin an exploration into the rhetorics of gender formation through what I have elsewhere described as a rhetoric of power. Third sexes provide an important trope of gender formation, exposing the limits of identity and the strategies of power to reinforce gender. Intersexed children are an important example of the ways in which bodies are shaped to conform to gendered assignment and roles. Approaching the decision-making process in cases of gender ambiguity by means of a rhetoric of power helps us to see the ways in which "curing" and "illness" work at crossed purposes in the lives of the intersexed. Listening to the stories of the intersexed helps us see possibilities in other approaches to shaping identities.

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