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Unformatted text preview: n some ways forever separates parents from their child. Still, in the end they accept the
reality of the situation and move on. Beyond the transvestite ceremony
they make no further effort to force their child into the mold of a boy.
From then on, everyone agrees things will be different.
how Our Past Becomes Our Future
There has never been a large-scale study that investigated the effects of
our cultural heritage on the decisions we make when one of our children doesn’t fit with what we’ve seen on TV, in magazines and motion
pictures, in showers and schools. Nor has there been a broad study of
what might happen if we made no decision at all. But there has been
one rather small study that produced some provocative results.8
Ursula Kuhnle and Wolfgang Krahl carried out this study at Malaysia’s largest children’s hospital at the University of Malaysia. The people
of Malaysia mostly comprise three ethnic groups; about 60 percent are
Malays, about 30 percent are Chinese, and about 10 percent are East
Indians. The Malays are Muslims, the Chinese are Buddhists or Taoists,
and the Indians are Hindus. The social roles of men and women, as well
as the structure of the nuclear family, differ significantly among these
peoples. The purpose of this study was to try to determine if these differences affected the way parents responded to the birth of an intersex
child and the choices that birth necessitated. 152 Between XX and XY Muslim women in Malaysia have roles in religious and public life
similar to those of Christian and Jewish women, including the right to
control their own money and, in the event of the death of their husband
or divorce, to inherit their own money. The roles of women in Chinese
and Indian societies are much more restricted. As we have seen, the
birth of a girl is often perceived as a burden by an Indian family. And
in China, men are both the head of their families and the ones who,
through their work and fortune, can ensure that families will persist.
The authors’ roles at the hospital in Malaysia were to attend to the
births and management of intersex children. During their time at the
hospital, they found it “was never difficult to convince a Muslim family
to assign a severely virilized girl or undervirilized boy to the female gender. This was not the case for Chinese or Indian parents, who on several
occasions took off with their ambiguously born child when female sex
assignment (or reassignment) was suggested.”9 Just the idea of another
daughter was enough to make the parents bolt.
The authors point out, though, that, while it was easier to work
with Muslim parents, these people still took a diagnosis of intersex very
seriously. And a few of the Muslim parents chose not to follow the doctors’ recommendations at all.
In one case, a child by the name of Fatimah was born with congenital adrenal hyperplasia. At her birth, the doctors assigned Fatimah as
a girl. For that assignment to work, any child needs to strictly follow a
course of medications to control her overactive adrenal glands.
Fatimah’s parents didn’t think the medicines were so very important. So, at puberty, Fatimah further virilized. Her facial hair, body
shape, and voice all became more like those of a boy. In addition, she
preferred the company of boys and was accepted among them as a peer,
“not as a tomboy who likes to play with boys.”
Often parents like Fatimah’s, who failed to comply with the doctors’
instructions, saw the changes that occurred at puberty as proof that the
doctors had got it all wrong—an affirmation of the parents’ suspicions
and a reason to go forward as they had originally planned.
Fatimah took up the normal roles of a boy in her religious practice,
and at the appropriate age she was circumcised. Her acceptance as a Alternatives 153 boy was complete. The only reason the authors ever saw her again was
because she later applied for an identity card, and the official in charge
questioned the name Fatimah for a male and requested the doctors’
But things don’t always turn out like that. In a second case, a child
named Diana was referred to the authors at the hospital in Malaysia
because of her mother’s concern about the child’s abnormal genitalia.
The primary care physician had agreed with the mother that Diana’s
genitals were abnormal, but he said he couldn’t tell if she should be a
boy or a girl. So he suggested that Diana and her mother return when
Diana was twelve or so years old, and they would go from there. Diana
and her parents were of Chinese ancestry.
At home, Diana’s behavior was much more like that of a Chinese
boy than a girl. She wore shorts and T-shirts and played in many of
the games with the boys. When the authors first saw Diana (at age
twelve) she seemed built like and carried herself more like a boy than a
girl. When the doctors examined Diana they found “a phallus of about
5 cm [approximately 2 inches] in length with significant erectile tissue, severe hypospadias [the openi...
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This document was uploaded on 02/04/2014.
- Spring '14