Intersex powerpoint

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Intersex powerpoint

  1. 1. Tiffany Dzioba and Melissa Haupt
  2. 2.  Attributed to more than 70 atypical chromosomal & hormonal conditions APA defines intersex as the atypical development of physical sex characteristics including  Ambiguous external genitalia  Incomplete or unusual development of reproductive organs  Discrepancy between the external genitalia and internal reproductive organs  Abnormality of sex-related chromosomesAmerican Psychological Association (2012). Answers to questions about individuals with intersex conditions. Retrieved from http://www.apa.org/topics/sexuality/intersex.aspx
  3. 3.  Condition was historically referred to as ‘hermaphrodite’ and continues to be used by some medical personnel that perpetuates stigmatization and misconception. The term implies a person is both fully male & fully female which is not physiologically possible. Difficult condition to define due to being socially constructed. Intersex reflects variation in sexual and reproductive anatomy that does not adhere to typical male or female development. “Masculinity” and “femininity” more shaped by expectations about abilities and perceptual bias rather than influenced by hormone levels in the brain, and are not stable constructs over time and across culturesJordan-Young, R. (2010). Brain Storm: The flaws in the science of Sex Differences. Harvard University Press. Cambridge, MAIntersex Society of North America (2008). Frequently asked questions. Retrieved from http://www.isna.org/faq/
  4. 4.  New Guinea: Kwolu-Aatmwol  Navajo Culture: Berdache  Thought to have spiritual  Socially accepted abilities  Societal prestige; considered Turkey holy & sacred  Demand social recognition  India: Hijra Africa: Serrer  Low social status  Killed after birth  Excluded from society  If survived, they are subject to  Siberia: Shamans ridicule & mockery  High spiritual power  Not permitted to marry or  High social status & great adopt children influence  Barely tolerated in society Lang, C. & Kuhnle, U. (2008). Intersexuality and alternative gender categories in non-western cultures. Hormone Research, 69, 240-250. doi: 10.11591000113025
  5. 5.  1 in 2000 babies born possess ambiguous genitalia 1-4% of the population are impacted by ambiguous genitalia 0.1% of the population indicate that their lives are strongly affected by intersex condition May be underreported due to intersex conditions that are not identified until later in lifeLev, A. (2004). Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People and Their Families. New York, NY: The Hawthorn Press, Inc.
  6. 6.  Ambiguous genitalia at  Misplaced urethra birth opening of the penis Micropenis  Electrolyte abnormalities Enlarged clitoris  Delayed puberty Partial labial fusion  Absent puberty Undescended testes  Unexpected pubertal Masses on the changes labia/groin Intersex Society of North America (2008). Frequently asked questions. Retrieved from http://www.isna.org/faq/
  7. 7.  Congenital Adrenal Hyperplasia 5-alpha reductase deficiency Partial/complete androgen insensitivity Penile agenesis Klinefelter Syndrome Turner Syndrome Swyer Syndrome Progestin-Induced SyndromeIntersex Society of North America (2008). Frequently asked questions. Retrieved from http://www.isna.org/faq/
  8. 8.  Condition is usually recognized at birth Intersex conditions associated with complete androgen insensitivity, Klinefelter Syndrome, & Turner Syndrome may not be recognized until adolescence as evidenced by delayed or absent pubertal changes. Late discovery is correlated with reduced or complete infertility & increased emotional distress.American Psychological Association (2012). Answers to questions about individuals with intersex conditions. Retrieved from http://www.apa.org/topics/sexuality/intersex.aspx
  9. 9.  Havelock Ellis (1945)  With early intervention, gender can be nurtured John Money (1950s), Theory of Gender  Infant is psychosexually neutral at birth & can develop as either gender, regardless of biological sex, as long as child rearing is consistent with sex assignment  Sex assignment and surgical intervention will avert psychological disturbance associated with intersex conditionFeder, E. (2011). Tilting the ethical lens: Shame, disgust, and the body in question. Hypathia, 26, 632-650.
  10. 10.  Considered a “medical & psychosocial emergency” although nearly all surgeries are performed for cosmetic purposes. Immediate sex assignment & surgery to create genitalia that are consistent with one another. Surgical protocol based on the premise that infants are psychosexually neutral at birth & healthy gender identity is dependent on the appearance of the genitals Surgical protocol has been the prominent treatment for the past 30 years.Feder, E. (2011). Tilting the ethical lens: Shame, disgust, and the body in question. Hypathia, 26, 632-650.
  11. 11.  Physician deception endorsed by medical textbooks  Providers encouraged to withhold information and medical history when requested Focus of surgical treatment has been on alleviating parental distress Parents counseled to maintain secrecy and encourage that secrecy is maintained by child into adulthoodFeder, E. (2011). Tilting the ethical lens: Shame, disgust, and the body in question. Hypathia, 26, 632-650.
  12. 12.  Physicians to assume moral responsibility to surgically correct ambiguous genitalia in an effort to preclude social ostracism & suffering. Intersex Society of North America argue that intersex genital surgeries constitute a human rights issue.Moreland, I. (2012). The injured world: Intersex and the phenomenology of feeling. A Journal of Feminist Cultural Studies, 23, 20-41.
  13. 13.  Is not curative and does not improve functioning Performed without properly informed consent  Patients are too young to provide informed consent  Parents not informed of the associated risks Risk of injury & damage to sexual functioning  Trading function for appearance as reinforced by cultural norms Morally injurious  Suggests that the child is not acceptable as he/she is  Potential for incorrect sexual assignmentLev, A. (2004). Transgender Emergence: Therapeutic Guidelines for Working With Gender-Variant People and Their Families. New York, NY: The Hawthorn Press, Inc.Moreland, I. (2012). The injured world: Intersex and the phenomenology of feeling. A Journal of Feminist Cultural Studies, 23, 20-41.
  14. 14.  Need for ongoing,  Infertility invasive treatment &  Trauma repeated surgeries  Mistrust in adults & Scarring medical professionals; Genital pain subsequent avoidance of Nerve damage & loss of helping professionals sensation  Psychosocial difficulties Impairment in sexual  Psychological distress functioning Murray, S. (2009). Within or beyond the binary or boundary?: Intersex infants and parental decisions. Australian Feminist Studies, 24, 265-274. doi: 10.1080108164640902852464
  15. 15. Considerations when determining sex assignment: 1. Preservation of fertility 2. Preservation of genital sensation 3. Maximizing later satisfaction with sex assignmentAmerican Psychological Association (2012). Answers to questions about individuals with intersex conditions. Retrieved from http://www.apa.org/topics/sexuality/intersex.aspx
  16. 16.  Disorientation and confusion Shock, grief, anger, and shame Looking to doctors for answers (as “all knowing”) with little communication Doctors frequently change their minds about the “proper sex,” and different doctors will make different recommendations Parents trust medical experts and believe that not undergoing surgery will add to the child’s gender identity confusion
  17. 17.  No language for what to call the baby Baby seems “sub-human,” as “something” until there is a sex to “humanize” it Not sure whether to focus on genitals, chromosomes, or internal sex organs when deciding sex Parents often are not aware of any choice or alternatives other than sex assignment procedures, they look to the doctors for guidanceGough, B., Weyman, N., Alderson, J., Butler, G., & Stoner, M. (2008). They did not have a word: The parental quest to locate a true sex for their intersex children. Psychology & Health, 23(4), 493-507. doi:10.1080/14768320601176170Zeiler, K. & Wickström, A., 2009. Why do “we” perform surgery on newborn intersexed children? The phenomenology of the parental experience of having a child with intersex anatomies.   Feminist Theory, vol. 10(3): 359– 377.1464– 7001 DOI: 10.1177/1464700109343258 
  18. 18.  The development of genitals and sex characteristics change over time and with puberty Doctors may change recommendations as an intersex child develops and hormones change Some children/adolescents may experience incongruence between their sense of gender identity and their sex following sex assignment surgeries and procedures Female becomes the “default” gender when it is determined that male genitals won’t meet strict norms for appearance and function, despite chromosomes and hormones that indicate male dominance
  19. 19. YouTube video: Intersex Genital Mutilationhttp://www.youtube.com/watch? v=Twe8p0R8tms&feature=em- share_video_user
  20. 20.  Childhood was experienced as difficult for intersex individuals who both had surgery and did not have surgery: secrecy and shame made it more difficult regardless of genitals and sex characteristics Most intersex participants indicated that they were not supportive of surgery Surgery reinforces stigma through degradation and shame Surgery without the consent of the intersex individual can often lead to sex assignment that is not congruent with the individual’s internal identityGough, B., Weyman, N., Alderson, J., Butler, G., & Stoner, M. (2008). They did not have a word: The parental quest to locate a true sex for their intersex children. Psychology & Health, 23(4), 493-507. doi:10.1080/14768320601176170MacKenzie, D., Huntington, A., & Gilmour, J. A. (2009). The experiences of people with an intersex condition: A journey from silence to voice. Journal Of Clinical Nursing, 18(12), 1775-1783. doi:10.1111/j.1365-2702.2008.02710.x
  21. 21.  Guth et al. (2006) study with intersex women who had undergone genital surgery as children reported the following:  Lack of understanding of the condition as an adult  Discomfort & embarrassment with continued medical treatment  Inability to communicate with others regarding their condition  Maintenance of confused concepts from childhood  Concerns regarding fertility and masculine character developmentOverall, women were satisfied with the outcome but participants varied with regard to gender identity and gender role.Guth, L., Witchel, R., & Lee, P. (2006). Gender roles and self-concept of individuals who have congenital adrenal hyperplasia: A Qualitative Investigation. Journal of Gay & Lesbian Psychotherapy, 10 57-75. doi: 10.1300IJ236v10n02_04
  22. 22.  Intersex individuals report finding acceptance after they were able to break the silence Being connected with other intersex individuals made them feel empowered and normal Forming an identity outside of the gender binary helps with acceptance There are more intersex children born than those born with Down’s Syndrome, yet less awareness… Increased awareness can lead to decreased shame and secrecy Parents believe that if the silence and shame were broken, then people could talk more freely about different possibilities and options for intersex children
  23. 23.  Obtain ongoing training and education regarding intersex conditions & implications. Recognize one’s own attitudes about intersex conditions & how those may influence treatment. Assist the client in exploration of gender identity & sexuality with a focus on the societal influence. Strive to understand the challenges experienced by intersex individuals & their families. Recognize the influence of social stigma & how it inhibits disclosures & willingness to seek treatment. Connect intersex individuals and families to community based resources and educational materials regarding the intersex condition & treatment options. Encourage intersex individuals and families to advocate for themselves with regard to medical professionals. Be an advocate for the rights of children with intersex conditions.Guth, L., Witchel, R., & Lee, P. (2006). Gender roles and self-concept of individuals who have congenital adrenal hyperplasia: A Qualitative Investigation. Journal of Gay & Lesbian Psychotherapy, 10 57-75. doi: 10.1300IJ236v10n02_04

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