YOU KNOW YOU’VE HIT UPON an interesting research topic when in a single week you get interview requests from both Penthouse magazine and Christian Life Radio. And you know you’re doing something promising when both interviewers tell you they agree with your political stance.
That was my life, and this was my stance: Children born with genitals that look funny but work fine should not be surgically altered just because their genital appearance upsets or worries some adult. Big clitorises shouldn’t be shortened, and baby boys with very small penises shouldn’t be sex-changed just because their phalluses induce Freudian crises of confidence in their caregivers. People have the right to grow up with their genitals intact unless there is some dire medical emergency.
Not too surprisingly, the interviewers from Penthouse and from Christian Life Radio didn’t agree with each other on the reasons for backing me up. The Penthouse guy’s attitude was that no one should mess with your sexuality without your consent. He understood that the elective pediatric “normalizing” surgeries in question carry a lot of risk to sexual function and health and that sexual function and health really matter to one’s life. Meanwhile, the Christian radio guy’s position was that God doesn’t make mistakes when he sends babies into the world. He didn’t see the children in question as tragic failures meant to be corrected by some surgeon who apparently thinks he’s more skilled or more compassionate than God.
I liked both their attitudes because, heck, it was 1998, and somebody in the real world was agreeing with me—just what the pediatric surgeons were telling me would never happen. Two somebodies, even! I mean, sure, the surgeons expected my message to be championed by my fellow academic feminists with hair as short and glasses as rectangular as mine, but that, they assured me, would be the limit of the “tolerant” population as far as genital anomalies were concerned.
“Honey,” a very high-up surgeon once said to me right around this time, after hearing one of my talks, “you just don’t understand. The parents in our clinics can’t handle this.” When a baby is born with ambiguous genitalia, he explained to me, the mother cries, and the father gets drunk. If you let a child with ambiguous genitalia grow up without surgery, he went on, the kid will commit suicide at puberty. That’s just the way it is. You can’t change society.
The surgeon telling me this apparently thought that I, a lowly assistant professor not long out of grad school, would simply yield to his authority, as did his medical students and residents and the parents of his patients. But I knew these surgeons’ central argument—you can’t change society—to be simply counterfactual. Here I was, a woman, in pants, with a PhD; my identity had come into existence only because society had been changed—and quite recently, too. But if I tried to tell these surgeons that together we could change society, they would see me as wanting to sacrifice babies on the altar of a radical social agenda. So instead I just took to answering these docs with a joking paraphrase of another uppity historian, Winston Churchill: History will vindicate me, and I will write the history.
I kept reminding myself, you can’t really blame these guys for their myopia. Surgeons are taught to think in terms of days and weeks. They are trained to focus intensely on the surgical field immediately before them. I had an advantage here, being trained in history. Temporal depth perception spanning millennia means you not only can see the potential to enact meaningful social change in terms of identity politics, but also you can see that, no matter what you do, you’ll eventually be forgotten. There’s something really liberating in knowing you don’t matter.
• • •
HUMAN SEX COMES in two big themes—male and female—but nature seems to enjoy composing variations on those themes. Some sex variations occur at the level of sex chromosomes, some at the level of hormones, some at the level of hard-to-detect internal structures, and some at the level of anatomical parts you can see with the naked eye (assuming your eye isn’t the only thing that’s naked). If you call all of these variations intersex, you can then ask how common intersex is. That’s a question people love to ask. The problem is that to answer that question, one has to first decide how subtle a variation to count. How small should a penis be to count as intersex rather than male? How big a clitoris should count? How subtle a difference in hormone receptors? The truth is that human sex isn’t simple. Human sex is practically fractal.
Nevertheless, wherever nature draws unclear boundaries, humans are happy to curate. And the specialist curators of sex tell us this: In America today, about one in two thousand babies is born with genitals so notably intersex that a specialist team is immediately called in. About one in three hundred babies has genitals unusual enough that the average pediatrician will give the parents a referral to a specialist. If you add up all of the dozens of kinds of sex anomalies—including incredibly subtle things you might never know you had without the benefit of a lot of fancy medical scans your insurance company probably doesn’t want to cover—the frequency of intersex in the human population comes to about one in a hundred.
I was twenty-five and in graduate school before I ever learned that sex anomalies happen in humans. Years later, when I had become an assistant professor, I found out that a boy I’d grown up with had been born with ambiguous genitalia. My mother revealed this to me after reading some of my work, and when she revealed it, I asked her where that old friend was now. I told her I wanted to connect him with the support groups that had sprung up.
“Oh no,” she answered, “we never told him.”
This was exactly what I was then documenting in my work—how babies born with sex anomalies were “fixed” and then promptly swaddled in shame, secrecy, and lies.
The topic of hermaphroditism had been suggested to me early in my graduate career by Fred Churchill, the man who became one of my dissertation directors. Fred didn’t understand feminism—I remember that, one day, he admitted, befuddled, “I still don’t get what’s feminine about feminism”—but he believed in supporting students’ interests, and mine was gender. Following Fred’s suggestion, I thought I should look at the history of embryology and Charles Darwin’s study of barnacles. (Those barnacles were hermaphroditic.) But Fred kept saying, “Look at medicine.” Why? I wondered. Hermaphroditism doesn’t happen in humans past the embryonic stage. Then a second graduate advisor who knew I was on to hermaphrodites also said, “Look at medicine.”
So I looked. I went over to the university’s main library and pulled the second H volume of the worldwide index of nineteenth-century medical literature, The Index-Catalogue of the Library of the Surgeon-General’s Office—the comprehensive government-run index of medical reports that eventually came to be known as PubMed. To my shock, there I found pages and pages listing case reports of human hermaphrodites from the 1800s. Hermaphroditism in newborns, in children, in adults, and in dead old people who just happened to get dissected by some lucky anatomist. Cases recorded in England, France, Germany, Poland, the United States, India, and just about every other locale known to Western medicine.
Why had I never heard of this?
I decided then to do my dissertation work on the history in science and medicine of what happened to the people labeled hermaphrodites in late-nineteenth-century Britain and France. These were people who either had mixed-sex anatomy externally or who were found via surgery or autopsy to have one apparent sex on the outside of the body and the other on the inside. There was a nice set of about three hundred papers, mostly medical journal articles, that I could use as my primary sources, and the period was particularly interesting because it was a time when homosexuals and women had started agitating to loosen gender norms. I figured it would be interesting to see what medical and scientific men, who tended to be politically conservative, did when confronted with natural sex blurring, given that their abhorrence of women’s suffrage and men-loving men was based on the “fact” that such things were fundamentally unnatural. Britain and France also made practical sense because they would be nice places to go on dissertation grants, and I could read English and French. Truthfully, the French was sometimes hard, but Fred helpfully suggested that translations often go faster if you drink a bit of wine from the region where your texts originated. (I still can’t drink French wine without thinking about sex.)
During a cold snap in February 1994, I flew to Bethesda, Maryland, to the National Library of Medicine, to collect more material for my work. On the plane, I was seated next to an army doctor who was in charge of HIV management for the military. He asked me what I was working on, and upon hearing me describe my project, he sternly said to me over his reading glasses, “Hermaphrodites are not a marketable skill.” Even so, it was obvious he wanted to hear more.
In history as in science, you look for what changes and what is stable, you look for correlations, and you pray to find evidence of causation. I had a lot of data to work with—more than I could manage with just my brain and marginalia—so I took my three hundred primary sources and created a computer database of their components to see what patterns I could find. I tracked specific patients based on the demographics the medical reporters gave about them, to see if they might pop up more than once in the medical literature. (This enabled me to “watch” one poor nineteenth-century Frenchwoman with a herniated testicle wander from doctor to doctor looking for some productive help.) I cataloged individual scientists and doctors to track who was reporting what when. And then I cataloged each individual article’s specific report, opinion, or theory—if it expressed one—about Adam’s apples, beards, behaviors, breasts, clitorises, erotic orientations, gonads, hair, interests, labia, menstrual signs, penises, prostates, scrotums, skeletal proportions, uteruses, voices, vaginas, and vulvas. Doing this allowed me to sort, for example, by breasts, to see whether there were patterns or shifts in what medical and scientific men thought about the meaning of feminine breasts in a supposed man, or the meaning of perky nipples in a manly woman.
I ended up with notebooks filled with hundreds of dot-matrix-printed, three-hole-punched pages of data—and a growing clarity about what had happened. Over the course of the nineteenth century, there were more and more doctors, more and more people were going to doctors, and the medical profession was enabling and rewarding publication, so the incidence of reports of humans with sex anomalies shot up and up. This alarmed the medical men even as they were tremendously fascinated. After all, social order was based on the presumption that it reflected natural order, yet nature seemed to have a very bad habit of not picking up after herself.
Upon expert examination, a surprising number of people showed obvious external ambiguity in their genitals. Others mixed a masculine chest and beard with feminine genitalia or feminine breasts with a penis. Still others looked all well and good on the outside but were discovered (during surgery or autopsy) to in fact have the other sex’s organs inside. A very few even claimed they were clearly female as children but had become quite manly at puberty.
Notably, most of the people who showed up in the nineteenth-century medical literature with sex anomalies seemed either not to know or not to be terribly bothered. Sometimes a woman wanted an explanation as to why her vagina seemed to be too small to accommodate her husband’s penis. A man and his wife wanted to know why the husband seemed to bleed on a monthly cycle, while a chambermaid in another city wanted to know why she never seemed to menstruate. On rare occasions, a child or an adult was reassigned from one gender role to another after being diagnosed as a victim of “mistaken sex.” (The “mistake” was often blamed on some stupid midwife.) But most often, nineteenth-century patients with such traits just went on with their lives as before their clinical exam, probably never knowing just how high they’d made the doctors’ eyebrows rise.
Late-nineteenth-century medical and scientific men had little interest in changing social mores just because nature was turning out to be a bit churlish where sex was concerned. Instead they opted to impose order on nature as best they could. They came to a consensus by the 1890s that made sex look a lot more organized than it really was. They decided that “true sex” would depend only on the gonads: If you had ovaries, no matter how many manly traits they came with, you were really a female (though perhaps a female pseudohermaphrodite); if you had testes, then you were really a male (though perhaps a male pseudohermaphrodite); and only if you were absolutely positively proven to have both ovarian and testicular tissue were you a “true hermaphrodite.”
Conveniently, because biopsies were not possible at this time, the only people who could be conclusively labeled true hermaphrodites were at least castrated and more often dead. This approach pretty much neutered any threat that hermaphroditism might have posed to the social order. Virtually everybody was really male or female; sex just looked blurry to the untrained eye. Problem solved. As I documented this cleverly constructed solution to blurry sex, I decided to label this period the Age of Gonads.
Of course, not too much later—in the 1910s—biopsies did become possible, and the Age of Gonads had to cease. Suddenly doctors could conclusively diagnose working ovaries in men, working testes in women, and ovotestes in both—not a happy thing unless you’re a gender radical. So again doctors did what they had to do to preserve the two-sex social order. Although they still categorized a patient’s “true sex” according to gonadal tissue, in practice they classified patients according to which gender was most believable. If an attractive housewife happened to have testicles, no one besides her doctor needed to know her diagnosis of male pseudohermaphroditsm. If a man really was menstruating, you just quietly took his ovaries out and hoped no one found out about his insides. Doctors continued to clean up nature’s little indiscretions and thus take care not only of individual bodies, but also the social body.
Given the way intersex could always threaten a sexist two-gender society, this approach of “cleaning up” nature’s sexual “mistakes” persisted in American medicine, leading in the 1950s to the key collaboration at Johns Hopkins University of Lawson Wilkins, the founder of pediatric endocrinology, and the psychologist John Money. Together Wilkins and Money formalized this cleanup approach to sex anomalies. Modern medicine now sought to reinforce the “optimum gender of rearing” by early management of children born with sex anomalies by means of “sex-normalizing” surgeries, hormone treatments, delicate euphemisms, and sometimes lies.
This, then, was the system of concealment that led one day to my mother’s remark to me about my childhood friend: “Oh no, we never told him.” This was also the system that led to a lot of really angry intersex adults who discovered that they had been harmed by the medical care meant to “save” them and who knew the same basic system was still being used on children who would likely grow up as hurt and angry as they were. In the early 1990s, a core group of these people formed the intersex rights movement I eventually joined. Some of these intersex adults had been physically harmed—left with damaged sexual sensation, incontinence, or repetitive infections. Many had been psychologically harmed—left with a sense of having been too monstrous for their parents to accept as they came, of being sexually freakish, of being fountains of familial shame. All were left with a burning desire to try to save others from going through what they had.
I knew about the nascent intersex rights movement as I worked on my dissertation in Bloomington, but I mostly ignored it. My graduate school professors had taught me that history is about the dead. Yet shortly after I started to make public my research findings, I found myself in dialogue with Bo Laurent, the founder of the Intersex Society of North America (ISNA). As I recall, I first talked to Bo by e-mail using her public activist name, Cheryl Chase, a name she had hastily chosen as a nom de guerre early in her activism. As soon as I learned that another intersex activist named Bo Laurent lived in the same region of northern California as Cheryl Chase, I tried to bring Bo and Cheryl together. She politely explained I was trying to introduce her to herself. I easily fell into the habit of publicly referring to my work colleague, the leader of ISNA, as Cheryl, and privately calling my new friend Bo.
Bo was fascinated by my findings and immediately proved herself to be a voracious and intelligent audience of intersex history. Besides being geeks and history buffs, Bo and I shared what I later realized was a rare trait in activists: a belief in evidence even when it challenged our political goals. While it would have been convenient for Bo if I could have told her that no one in the nineteenth century sought surgeries to make their own genitals look or act more normally, she readily accepted my data that a few people did. She also readily accepted my conclusion that we couldn’t know much about why a few people in the 1800s seemed distressed about their own anomalous sex while most seemed fairly unconcerned. The data was incomplete, and rarely could it tell us about something as obscure as the psychological history of an unnamed, one-time patient who probably died before we were born.
I realized as soon as she told me her personal history that in Bo I had met someone who actually represented in the flesh that old Victorian compromise with nature that I had documented in my dissertation. That is to say, because of the fears of my dear Victorian doctors, Bo was to be counted as a true hermaphrodite simply because she had been born with ovotestes. (An ovotestis is usually kind of like an ovary wrapped up in some testicular tissue. And no, even if you have one, you can’t make both viable eggs and sperm.) Even though genetics, endocrinology, and other sciences had traversed a thousand miles from the Age of Gonads to the age of ISNA, that Paleolithic terminology based on gonadal tissue was still in place. (Bo and I later successfully worked to get rid of it once and for all.)
Bo had also been born with ambiguous genitalia. The doctors were so upset when that baby had come out, in 1956, that they kept sedating the mother while they figured out what to do. After three days, they finally let Mrs. Sullivan wake up and go home with the baby the Sullivans decided to call Brian—a boy understood to be healthy but sexually defective. They also sent Mrs. Sullivan home with strict instructions not to let anyone know that this child had a malformed phallus and a vagina. Mrs. Sullivan understood that she had to do all the diaper changes herself, and hide the disaster forever.
When Brian Sullivan was about a year and a half old, a team of doctors at New York–Presbyterian Hospital discovered via exploratory surgery that Brian had a uterus and ovotestes. The doctors realized that these organs might mean that they could turn this genitally unconvincing boy into a fertile girl, so they completely removed the phallus of the child, who at that point, on their strong recommendation, became Bonnie Sullivan. When she was eight, without anyone explaining anything to the bright and perceptive patient, Bonnie Sullivan was sent back to the hospital and her testicular tissue was removed. (This later surgery, removing the testicular portion of the ovotestes, may well have prevented Bonnie from getting a form of testicular cancer. We have never argued against that kind of surgery, which evidence really did show was lifesaving.)
When she became a sexually active lesbian as a teen, Bonnie Sullivan quickly figured out that she was missing a clitoris and, more important, missing sexual function. She could not have an orgasm. To make a harrowing long story short, eventually she sought out people like herself, found them, and marshaled her lesbian feminist political consciousness to fight the system that had taken so much from her. In 1995, as she broke with a past that had never really been under her command, Bonnie Sullivan took on a new name. Bo was a short form of Bonnie. She chose her last name, Laurent, as a tribute to the deaf activist Laurent Clerc and in remembrance of her own grandparents, who had been deaf. Bo understood that intersex had to go where deafness had gone: from the realm of the “defective” to the realm of rights. She started looking for peers and allies anywhere she could find them.
Not long after we started communicating, Bo asked me—as she asked perfect strangers all the time—to help her change the medical system for treating intersex. At first I resisted. As I explained, I was just a historian, somebody who deals with the past, and a newly minted one at that. I also thought it would be a little odd for me to get involved in a movement for rights that did not directly affect me—although having been raised with a brother who is identified as black in an otherwise white family, I did get that civil-rights movements need anyone with the power to help. Hearing Bo’s gentle plea, I also found myself remembering something my mother had said to me before I left for Indiana to study the history and philosophy of science: “I hope you study philosophy, because maybe then you can at least help people think more clearly. History is just about what’s already finished.” The implication: there’s no social good in being a historian.
In any event, Bo pushed me, in her typically blunt yet soft-spoken way, to consider putting my feminist money where my mouth was. Just look, she said, at what today’s medical books say. That was easy enough. Right around the time I had been told hermaphrodites are not a marketable skill, I had fallen in love with a medical student in Bloomington. I had moved in with Aron a few months later, when he had to start his clinical rotations in Indianapolis. As a consequence, my history books were on one side of our little apartment’s living room, and Aron’s medical books were on the other, so, on a break one day, I pulled his books and looked up the standard of care for genital anomalies. This would have been in 1995.
Basically, what Aron and his classmates were being taught, in the latest medical books, was this: If a baby is born with a large clitoris, she might turn out to be a lesbian, so you have to cut down her clitoris. If a boy is born with hypospadias—wherein the opening of his urethra is not at the tip of the penis but on the underside or down near the scrotum—he will not be able to write his name in the snow next to other little boys, and then he might turn out gay. Therefore you have to do a “corrective” surgery to make sure he can pee standing up. Mind you, this surgery failed so often that doctors had a special term for the men in whom it failed. They were called hypospadias cripples, because life is tough with a surgically scarred, infection-prone penis, but, the urologists insisted, you had to try to get that boy to pee standing up. Or else.
Huh?
When Aron got home from the hospital that day, I showed him the relevant passages in his books. I then asked him if he had written his name in the snow next to other little boys. “No,” he said, putting both his hands to his cheeks in a mockery of the book. “Do you think I might be gay?”
We were both pretty stunned. OK, I thought, I’ll help Bo. I’ll go to these doctors with her, and we’ll reason with them. We’ll use data from history and medicine. We’ll say, Look, this system was developed before gay and lesbian rights, before an appreciation for women’s sexual health, before modern medical ethics. There’s no evidence to support this heterosexist system of shame and secrecy as good for the patients, and there is evidence, albeit anecdotal, that this approach is unnecessary, unsafe, ineffective, and deeply harmful. Parents can learn to raise these children as boys and girls without cosmetic genital surgeries; we knew of some who had. Intersex children can be told the truth about their bodily differences, and they can grow up to decide for themselves what they want to do with their own bodies in terms of optional medical care.
And to all this the doctors would say, “Oh, gosh, yes, we’ve been meaning to fix this. Thanks!” And it would all change.
Aron kept shaking his head at me. “Medicine is not like that,” he’d say. “Medicine is often not rational and not evidence-based.” But he’d say it not so often nor so firmly as to discourage me. Aron has a theory that, for the sake of progressive change, people should sometimes be left in a state of productive naïveté, and that was his prescription for me in this case. So I plunged ahead, thinking reform of the system would take about six months, maybe twelve at the outside.
Bo must have figured out early that she needed to keep me motivated, so she did something really smart. She brought me around to meet as many intersex people as she could and made me listen to their stories. I started listening with a tape recorder and often found myself losing it, breaking down crying. In the medical literature, all of these people were “lost to follow-up.” They had dropped out of treatment and were invisible to medical surveillance, so what few outcomes studies there were (and there were almost none into adulthood) did not count them. No one really understood what these people had been through. I mean, a few people had heard these individuals’ stories one-on-one, but no one except maybe Bo and a couple of other intersex people had heard how this population had suffered collectively.
There was Martha Coventry, who had had most of her “enlarged clitoris” cut off when she was six, because her parents were worried about gender confusion. There was David Cameron Strachan, who as an adult had been diagnosed with Klinefelter’s syndrome (XXY chromosomes) and had been shot full of testosterone by a doctor who maybe had thought that upping his sex drive would turn David from gay to straight. (Instead, it had made David uncomfortably hairy and horny, and he’d headed right to the San Francisco Castro District, just as HIV was arriving there, too.) There was a woman whom I’ll call Beth Lawrence, who had learned that she’d been born with testes when she had opened a sealed envelope that a doctor had told her not to open but to give straight to her next doctor. Beth had opened it in the parking lot outside her doctor’s office and found a medical journal article about her, her sisters, and her cousins, none of whom had been told they had testes. The article featured a large photograph of Beth as a teenager, standing naked in a medical setting, with her head cropped off—I suppose to keep her from being recognizable as Beth Lawrence.
Of course, the pose and the crop also kept her from being recognizable as fully human. Beth still had that journal article, which she kept in the original envelope. Sitting in her backyard with her and Bo and looking at the article, I realized something bizarre: When we’d first met, I had insanely expected that Bo would walk up to me naked in black and white with her eyes blacked out. That’s how the medical journals had led me to think of contemporary intersex people. Even though I had been conversing with Bo by e-mail, I had subconsciously expected her to show up naked with a helpful grid behind her, her arms and legs splayed so as to show off her proportions to the medical student gazing upon her in the book.
The fact that intersex adults actually meet you in full color, with their clothes on, with families and lives and mortgage debt and a lot of pain and trails of therapists who didn’t even believe their unbelievable histories—this all just made me more and more upset. Pediatric endocrinologists and pediatric urologists came to my invited academic lectures and told me they felt sure their patients were all doing fine. That just made me disoriented. Where are these happy patients? I asked. They told me they could not say. Privacy prevented it, they said. Ask your happy patients if they will talk to me confidentially, I said. Oh no, they said. We wouldn’t want you upsetting them. “But,” one assured me, “I know my patients are doing great because I get invited to their weddings.”
“That’s sweet,” I answered, trying to hide my sarcasm. “How many have you been invited to?”
“Um . . .” He hesitated. “One, I guess.”
Bo also introduced me to a few people she’d found who had grown up with ambiguous genitalia, having gone “uncorrected” for various reasons. There was one woman whose sexually sensible mother had decided there just wasn’t any good reason to follow the doctor’s advice to shorten her young daughter’s noticeably long clitoris. There was another who had been too sickly as a child to be sent into elective surgery and so had escaped, growing up unharmed and ultimately pursuing a career in medicine. A third I met because she came to hear a talk I was giving in her town. This woman came up to me after my lecture to say she thought she might be intersex, because her clitoris was bigger than most. “How big?” I asked. She showed me her little finger and said she used her clit to penetrate her partner’s vagina, quietly adding that they both enjoyed it.
Whenever I felt my energy starting to flag, the universe seemed to send me something to renew my sense of urgency. One day Aron found himself having to calm down a young woman who had just been told by one of Aron’s internal medicine residents that she was really a male pseudohermaphrodite—that she was really a man—because he had figured out that she had testes inside. Aron called to get from me the name and number of a representative of the Androgen Insensitivity Syndrome Support Group. Another day, I got a call from a nineteen-year-old man who had just found out he had ovaries and a uterus inside of him. One of his doctors was suggesting he get a “sex change” so that he could be a woman and have a baby. I knew just how badly that doc wanted that publication.
“Do you want to be a woman? Do you think of yourself as a woman?” I asked the young man.
“No,” he said, “but the doctor says because I have ovaries . . .”
“Look,” I told him, “I don’t let my ovaries tell me what to do. I don’t think you should let your ovaries tell you what to do.”
I especially remember sitting at work in my Michigan State University assistant professor office one day and out of the blue getting a call from a weeping pediatric nurse I had never met. She calmed down just enough to explain to me that they had a baby in their pediatric ICU who had been sent into surgery to make her genitals look more normal. The baby had gone into surgery healthy. The anesthesia had gone wrong, as it sometimes does in babies, and now she was going to die. This little girl was going to die just because her clitoris had been “too big.” And now her parents would have to live with that twisted memory of guilt, shame, and grief. I knew that story would never enter the medical literature. Surgeons rarely report when it all goes wrong. They have their own guilt, shame, and grief, typically left as unprocessed as the parents’.
• • •
DAY BY DAY, the Intersex Society became increasingly intertwined with my existence. When Bo decided to legally incorporate, she asked me and Aron if she could use our home address, because we had a stable residence and were actively involved. Upon incorporation, I became the first chair of the board of directors, and if I remember correctly, Aron became vice president. We didn’t expect him to actually do anything; we just needed a certain number of signatures, and we thought that having MDs on the board would help persuade the IRS to give us nonprofit status. Bo’s partner, Robin, took some other executive title. I started joking that our first task should be to work on the board member–to–bed ratio. The final addition to the board was another Michigan State medical faculty member, Bruce Wilson, one of the first pediatric endocrinologists to say we were right.
We worked with a small army of other intersex activists who were also out there pushing for change. Many of them, like Max Beck, Mani Mitchell, Emi Koyama, Hida Viloria, and Tiger Devore, told their own stories on television and in documentaries and spoke to any group that invited them. Early on, Bo gave me a handful of “phall-o-meters” to start handing out, a little tool developed by the intersex activist Kiira Triea. The phall-o-meter showed graphically how doctors decided whose phallus would be cut and to what length to make them fit social norms. It was a to-scale measuring stick that went from “just a girl” (for a small clit) to “fix it quick” (in between) to “phew, just squeaks by” (a barely acceptable penis) to “OK” to “Texan” to “Wow, surgeon!” (for the big ’uns). I handed these out on all sides and left them behind everywhere, between the pages of in-flight magazines, in the stalls of women’s bathrooms on campuses I was visiting, and in the hands of all the surgeons I ran into. The male surgeons just loved them.
Bo had taught me this blitzkrieg method. We simply took every opportunity that came along and sought out any others we thought might work. She encouraged me to keep working the academic angle, and I did, doing scholarship in support of the movement. The last chapter of the book based on my dissertation provided an extensive ethical critique of the modern-day management of intersex. That it had Harvard University Press’s name attached definitely helped. I spun off that last chapter as an article for the Hastings Center Report, the journal of the leading independent medical ethics institute. The next book I published was an edited anthology called Intersex in the Age of Ethics.
For that collection, Bo and I wanted a front cover that showed the contrast between the monstrous medical image of intersex and the real lives of intersex people—to make the point that you never know who around you is intersex and the point that the medical approach is what makes someone a monster. We had realized how powerful images were in getting people to change their thinking. So we took photos that all the contributors—intersex and non-intersex—gave us of themselves, and put those, all mixed up, on the front cover. A few were bare-chested men; most were fully clothed. You couldn’t tell who was intersex and who wasn’t. For the center of the montage, we wanted a classic medical image—naked, eyes blacked out, against the grid—but I didn’t dare use a real image and reexploit someone. I can’t remember if Bo or the publisher suggested it, but one of them said to me, “Why don’t we do a picture of you, Alice?”
So I paid a university photographer whom I’d come to know fifty bucks to meet me at his apartment and photograph me naked standing in the “medical pose” with a band of paper meant to look like a hospital ID bracelet taped around my right wrist. He then used Photoshop to put a grid behind me and a black band over my eyes. He also blurred out my naughty bits. (I didn’t have tenure.) When my friends and students saw the book, they immediately recognized me. So much for the idea that the black band makes any difference! I just told them I do nudity only if the plot requires it.
The plot required so much. Time, money, and lots of personal effort to keep the activists from infighting due to jealousy, philosophical differences, and pent-up fury. And so much effort to keep Bo from falling into another black abyss of posttraumatic depression. Because I could write and speak well, I did one television show after another, quickly learning what to wear (no white and no small prints; lots of powder and bright lipstick; a serious look with a kind smile) and how to wrap a clear message around a killer story. I wrote newsletter material, teaching materials, and fund-raising appeals. I learned how to ask people, point-blank, for money to support us. Money was always short; Aron and I regularly dumped in infusions of cash, trying to keep enough in the till to keep Bo from having to do other work, so she could stay focused on ISNA. A sizable percentage of the donor list was made up of our personal friends and family members. Bo spent down her life’s savings as we pressed on.
Now and again, we caught a break. Someone would invite us to speak at a place where there was a doc with enough doubts that she or he would then sign on to help us. Someone with power would have an adult child who was gay or lesbian, enabling that powerful person to appreciate at the gut level the way that discrimination against sexual minorities manifests in every bit of life.
A big break came in 2000 when John Colapinto published the “John/Joan” story in his blockbuster book As Nature Made Him: The Boy Who Was Raised as a Girl. Colapinto’s work brought to national attention the story of one male child whom John Money had recommended sex-changing after the baby’s penis had been accidentally burned off during a medical circumcision at eight months of age. The patient, now known as David Reimer, had not been born intersex, as most of Money’s patients had been; David Reimer had been born a typical male, with an identical twin brother. But after his circumcision accident, the family was referred to Johns Hopkins and, on Money’s recommendation, the baby had been surgically and socially turned into a girl named Brenda. After all, a boy without a penis (or with a very small one) couldn’t grow up to be a real man! At least that’s what Money et al. had been saying for years. Money must have been thrilled when he encountered the Reimers: Here, in a set of identical non-intersex twin baby boys, was the perfect case to prove his theory that gender identity development depended primarily on genital appearance and upbringing. If one of the Reimers’ twin boys could be turned into a girl, this would be the Hope Diamond in Money’s crown.
Thanks to Money’s desire to use David Reimer to prove that gender is mostly a product of genital appearance and nurture, not inborn nature, Reimer had gotten caught in the Johns Hopkins intersex vortex and had had the same history of shame, secrecy, loss of function, trauma, and anger as many intersex adults. Importantly, Reimer also failed to prove Money’s theory. As little Brenda, he kept acting boyish, and upon being told the truth of his medical history as a teenager, he immediately declared himself a boy and socially became a boy again. Nevertheless, Money simply lied about the outcome, leading everyone to continue believing his experiment with “Brenda” had worked.
Although As Nature Made Him entailed great coverage of our work at ISNA, Colapinto’s account moved people for a reason we had come to resent: The public was ever so upset that a “real” little boy had been turned into a girl. They were upset about the sex-change of a non-intersex child and about having been led to believe that gender is a product of nurture, not nature. To us, the primary issue in these cases wasn’t the nature of gender. Yes, the reason all these kids—Reimer and his born-intersex cohort—had been traumatized was because of a wrong theory of gender that said that we can make you into a boy or a girl if we just make your body look convincing in infancy. But the trauma for most of these folks didn’t come from getting the wrong gender label as a baby.
Bo and I knew what the clinicians knew—that most intersex people kept the gender assignments they were given, whether surgeons made their genitals look typical for their gender or not. And we knew that people who changed their gender labels as teenagers and adults did not find misidentified gender to be the core of their suffering. The problem in intersex care wasn’t a problem of gender identity per se. The problem was that, in the service of strict gender norms, people were being cut up, lied to, and made to feel profoundly ashamed of themselves. Bo said it as plainly as she could: Intersex is not primarily about gender identity; it is about shame, secrecy, and trauma. Doctors were so obsessed with “getting the gender right” that they didn’t see that they were causing so much harm. If they could have obsessed less about gender identity outcomes in these cases and focused on actual physical and psychological health, they might have done a lot less damage. They needed to stop treating these cases as gender identity experiments and start treating them as patients.
But most people didn’t want to hear about shame, secrecy, and trauma when we talked about intersex. They wanted to hear about the nature-nurture debate. Just like John Money, they wanted to use intersex people in the service of their theory building about gender identity. All that happened when people started to take the nature of gender identity seriously was that docs stopped turning boys with micropenis into girls and started pumping them full of risky drugs to try to get their penises to grow bigger. The clitoral surgeries—those kept up.
It would be easy to fall into the belief that these were all evil doctors. Truth is, they were basically good people. They had been told in their medical training the same story the surgeon told me early in my work: If you don’t do this, these kids will kill themselves at puberty. Based on this mythology, they believed they had to do early genital surgeries. Bill Reiner, a urologist who had trained at Money’s gender clinic and who later turned against Money’s approach, told me that he’d once tried to find evidence that kids had killed themselves as a result of being left “uncorrected.” Like me, Bill couldn’t find it.
The myth of teen intersex suicide was part of what my friend Howard Brody, a physician-ethicist, took to calling the maximin strategy in medicine. When a doc “maximins,” she maximizes the number of interventions in the hope of minimizing the odds of the worst possible thing happening to that patient. You operate out of fear of the worst-case scenario. Howard had traced this in obstetrics, and had shown how obstetricians were actively harming mothers and babies during normal births in an effort to keep them from dying. They were throwing every possible intervention at them, because then, if the mother or baby died during a birth, at least the doctor had tried everything. It was just a natural coping strategy in a stressful situation. But when you looked at the aggregate evidence, the interventions meant to prevent the worst harm actually resulted in more net harm.
That’s what was going on with these intersex specialists. They were afraid to “do nothing,” as they put it. We said, “Don’t do nothing; call in mental health professionals to help with shame, fear, and grief.” But the doctors said they didn’t know whom to call. And it was true; Money, a psychologist, had popularized this whole system of care in his writings, but it had really been founded and disseminated throughout the medical world by Lawson Wilkins, the founder of pediatric endocrinology. Instead of teams of psychologists to help intersex people and their parents, there were only pediatric endocrinologists, who knew little of psychology except what they had been told: Gender is all about genital appearance; call the surgeon.
When I would ask treating physicians, “What is the goal of pediatric intersex treatment?” I was amazed at how often they could not articulate an answer. It was clear that they were operating from a combination of institutional inertia and an impulsive (beneficent) need to quiet down parents they thought might get upset. It would have been much easier if all these doctors had been evil. Instead, they were good—human, scared. They tried hard to write us off as evil, but when they met us, they realized that we were also good—and human and scared.
OK, so I’m not so sure John Money was good. He had used and abused so many of my intersex friends who’d had the misfortune as children to end up in his Johns Hopkins clinic that we called the place the Death Star. Money had known that David Reimer’s life had not turned out well, that he had never been a straightforward girl, and that as a teen he had reverted to being a boy. He had lied about and to Reimer and hurt many other people in the process. It was tempting to try to take Money down, to go after him personally.
But Bo was smart again. Even though the one time she’d met Money in person at some cocktail party, he’d started screaming at her at the top of his lungs, she decided that we would not engage in ad hominem attacks, not even against Money (except in private, over a lot of alcohol). She said if we take down an individual, the system has not changed. That person becomes a scapegoat, and nothing really changes. And she was right. Reporters would come to me and say, “Well, Dr. So-and-So says that he now knows John Money was wrong about gender, so now he agrees with you, and there are no more ethical issues.” Meanwhile, Dr. So-and-So would be routinely performing surgery on baby girls with big clitorises and telling adolescent girls with testes that they had “twisted ovaries” that needed to come out, with no evidence for the supposed medical necessity or benefit of these approaches, especially when compared to the risk of harm.
But we were seeing signs that we were making progress. By the early 2000s, journalists started finding it impossible to locate a doctor who would say, on camera or in print, that we were wrong about anything. And they found more and more who were willing to say we were right. Articles and op-eds started appearing in medical journals calling for outcomes research to determine what had really happened. Medical students were rising up against being taught the old model; we heard of them handing their professors our literature and demanding that they be taught by someone whose ethics were in keeping with what they were being taught in their ethics classes. Our activist allies were being increasingly invited not just to local churches and synagogues to speak of their lives, but to medical centers, too. Little by little, Bo and I were being invited to give not just talks at medical events, but to deliver grand-rounds presentations at children’s hospitals and keynotes at medical conferences.
• • •
IN MY OWN SCHOLARSHIP, I branched out from intersex in response to a question from Bo: How much of the reaction to babies born (as she was) with ambiguous genitalia is about fear of sex, and how much is about fear of abnormality? I decided to look at conjoined twins, thinking that by studying them I could control historically for sexual attitudes. Silly me! I soon found that conjoined twin babies, like intersex babies, had gotten tangled up in adult sexual phobias. As I researched the history, it became clear that conjoined twin separations, rather than being based on evidence of what would leave the twins best off, had often been based on an adult sexual fear: If you left conjoined twins to grow up conjoined, they might never have sex! Or they might even have sex! I remember bells going off when I ran across one news report of conjoined infant sisters from Guatemala; a UCLA surgeon told a reporter that when he made the final cut that separated them, he announced to his team in the OR, “We now have two weddings to go to.” Hello. Happy weddings as a measure of whether the medical intervention was justified? That sounded very familiar.
Once I assembled the data about the history of medical responses to conjoined twinning, I was shocked to realize not only that sex phobias were sometimes driving separations, but also that in many cases separation likely left twins worse off, with more impairment and shorter life spans. Were they better off psychologically? Who could tell?—because, as with intersex, though surgery was often done for putative psychosocial reasons, no one was really looking at long-term psychosocial outcomes of those left alone or of those “fixed.” Yet if we looked across a broad span of history at what was known about people left conjoined, it turned out that being conjoined was often probably better than being left with massive surgical damage (or, um, left dead). Conjoined twins old enough to give their own views said was that they were OK with their condition; they understood that it wasn’t normal for other people, but it was normal for them. Only one set of conjoined twins in history, Ladan and Laleh Bijani, has ever elected separation for themselves, and even in that case, there is reason to believe the twenty-nine-year-old sisters may not have had an accurate understanding of the level of risk associated with separation of head-joined twins like them. Just after the sisters’ deaths from surgery, the lead surgeon involved told reporters, “At least we helped them achieve their dream of separation.”
About halfway through my study of the surgical treatment of conjoined twinning, I realized that, if I let the evidence lead me where it seemed to go, I was going to have to start arguing against some conjoined twin separations—not all, but ones that looked as though they weren’t in the patients’ best interest as far as the evidence went.
That’s when I realized I’d better grow my hair out.
By then it had become clear that some of the resistance among the doctors we were arguing with over intersex was their perception that Bo and I were really just champions of the “gay agenda.” We were really just there to recruit their infant patients, for the toasters I hear you get when you convert a certain number of people to being gay. We were read as queer. Hell, Bo was queer, and clear about it. (I was often presumed to be her romantic partner.) So our intersex “agenda” was being read by many doctors as really being about lesbian, gay, bisexual, and transgender (LGBT) rights. To be fair, their reading was not without cause. Intersex had quickly gotten wrapped up in the LGBT rainbow. Many early intersex activists identified as gay or lesbian—or simply queer—and their political consciousness about LGBT rights had caused them to be politically astute about intersex, too. Non-intersex LGBT activists had also helped the intersex-rights movement from the start, because they immediately understood this to be an issue of discrimination against a sexual minority. And homophobia was very clearly motivating a lot of the old clinical regime. How else could you explain outcomes studies that measured not whether women could have orgasms after clitorectomy, but whether these women were getting penetrated by men?
Still, it was highly unlikely that we could undo homophobia in a short time, so how were we going to get around the clinicians’ resistance? It became clear that it might help if we tried as hard as we could to take the perceived gay agenda off the table. That meant I had to stop being read and easily written off as a lesbian feminist. If I was going to argue for something as radical as letting girls keep their big clits and sometimes letting conjoined babies live until they died naturally, I was going to have to look less socially radical and try to act less aggressive—less “manly.” So I grew out my hair and invested in some pretty dresses and even pantyhose and pumps. I started categorizing surgeons into two classes: those powerful enough to be worth shaving my legs for and those not. I started carrying around an index-card reminder to myself: “Talk slower. Don’t shriek.” To my mother’s delight, I even started wearing lipstick off camera. When one of my old friends discovered me in this drag, I confessed that, yes, I had, in fact, become a whore for social justice.
And it helped. It also helped that I started cracking a joke at the start of every medical talk: “I’m not a doctor, but I sleep with one.” It helped that we started talking with doctors about the very real stress they were feeling. It helped that we started praising them effusively for every baby step forward. It helped that we introduced one reformer to another, so that they had some peer support in their little revolution. It helped that we made them feel special, invaluable, and liked. We started paying attention to relationships, having meals with the people we were trying to change, or at least coffee. It helped that we started treating them as humans.
And it really helped that—unlike most of our putative academic political allies, who wanted to just spew cute slogans and academic postmodernist horseshit—Bo and I mastered all the scientific and medical evidence and language we could. We learned enough biochemistry and anatomy to keep up with every question or argument thrown at us. We asked clinical researchers for data in advance of their publications so as to sound one step ahead of the curve. When doctors plagiarized from my or Bo’s work, rather than fighting for our citation, we shut up and smiled and let them believe they had come to it on their own. We pushed as many people as we could into the limelight and stayed back more and more, to make our ranks look as big as possible. With Bo’s expertise in computers, my writing skills, and our joint ally building, we looked very big.
At some point, Bo and I had the discussion about whether, if the evidence showed people were better off with cosmetic genital surgeries done in infancy, we would accept it. We came to the same conclusion: If most of the women who’d had clitoroplasties as babies (and who truly knew what had happened to them) said they were satisfied that that had been the right choice, and if most of those who’d been left with large clits regretted their parents’ choice to forego infant cosmetic clitoral reduction surgeries, we would accept that infant cosmetic clitoral reductions worked to improve quality of life. In other words, we were clear that we were in this for people’s well-being, not for some particular identity outcome.
This put us at odds with a lot of people in the movement. Many had come to see intersex as a core type of human identity, something that could only be solidified by surgery but never taken away. Bo had actively supported that identity formation; she had needed people to feel it to motivate them to fight. We didn’t know of any successful rights movement that wasn’t based on an essentialized shared identity (even if just constructed in politically expedient ways). Nevertheless, Bo and I decided we’d be perfectly happy if sex anomalies became so accepted that there simply was no intersex identity. We would be perfectly satisfied when the data showed that—with or without surgery—affected adults felt they had been treated justly. Our issue was not that funny-looking genitals held some special magical life-giving power that was being tragically taken away by surgeons. Our issue was not that hermaphroditic identity was being disappeared. Our issue was that women with big clits left intact seemed quite a bit better off than those who had been operated on. On the rare occasion when we met a woman with a big clit who had opted for surgery as an adult, she never regretted her parents’ choice to leave it alone, and she always regretted her choice to have it shortened. We took that as further evidence that the problem was not identity as male, female, or intersex. It was the fact that the medical interventions didn’t work: They didn’t leave people better off.
Bo and I agreed that, if we put ourselves out of business—if, because of our work pushing for an evidence-based approach to intersex care, everyone born with a sex anomaly ended up feeling really great, so there was no need for an intersex sociopolitical identity, an intersex rights movement, or an ISNA—that would be just fine with us. We weren’t in this for lifelong identities as intersex activists, as leaders of the “intersex community.” The goal really was our goal. This again distinguished us, in ways I only later understood, from many activists, who bank on always being able to keep fighting over an identity issue. We wanted to retire. Our aim was to plant enough seeds of change in the medical system that change would continue without us.
Year by year, we saw more and more evidence of that possibility. In 2002, Jeffrey Eugenides’ novel Middlesex came out. At first, it wasn’t clear it was going to have much impact, but I knew when I looked at his book that I needed to pay attention to it. He credited my historical work in his acknowledgments, and his protagonist was a member of ISNA, the organization still legally registered to my home address. Very early in his book-tour cycle, I went over to one of Eugenides’ readings at an Ann Arbor bookstore. I stayed after the public reading to talk to the author one-on-one. He worried aloud that no one wanted to buy this book—no one wanted to hear about intersex. I told him I thought that pretty clearly wasn’t true, and that it would probably be OK. He alluded to the attributed shame he was getting for working on a book about this, and I sympathized, saying I was writing about conjoined twins and feeling like a freak. Look, I said to him, if we’re feeling this much shame just by writing about this stuff, imagine what the people really living with it are experiencing.
The next time I ran into Eugenides was five years later, in 2007, at the Oprah studio, when Oprah featured Middlesex on her book club. By then, the book had been awarded a Pulitzer. (I was brought on to the show as the “medical expert” because they couldn’t find any doctor who could explain intersex and sex development clearly to Oprah and her audience.) Not long after the 2002 Ann Arbor bookstore meeting, I could tell that Eugenides’ novel was going to take off, because it seemed that on every flight I took, I was seated next to a person reading Middlesex. And it wasn’t just young, gender-comfy people reading this book. It was old ladies and businessmen. (Hermaphrodites, I thought, are a very marketable skill.) And most important, doctors were reading this book, the doctors we were trying to change. I even heard from some who told me they were moved by this book in a way they had never been moved before—that they suddenly understood intersex to be one survivable part of a whole life. Here we had been feeding them real stories, but it was this novel that convinced them they needed to change their practices!
• • •
DURING THE BIG BLOOM in popularity of Eugenides’ book, in 2004, Bo and I sneaked in together to the intersex session of the American Academy of Pediatrics Section on Urology, in San Francisco. We got a friendly doc to register us as “family” so that we could have name badges and slip in through security without being noticed on the regular registered participant list. We sat together and quietly listened to what the big guys were saying. They were tangled up in doubt. Progress!
Tina Schober—a surgeon out of western Pennsylvania who’d become a pariah for associating with us—had actually been invited to speak. The UCSF surgeon Larry Baskin was admitting that they weren’t really sure about where they should be cutting the clitoris, because the nerves were turning out to be located where they hadn’t been expected to be, so that the outcomes were unclear, unpredictable. Indianapolis surgeon Richard Rink, who had always advocated “total urogenital mobilization”—ripping out everything that didn’t seem right to the doctor and rebuilding a girl’s genitals from scratch using Frankenstein stitches—was now expressing doubt about what the whole process was really based on. Of course, he then proceeded to say that, as a consequence, he was now just advocating “partial urogenital mobilization.” But we were thrilled to hear Rink say that the most important consideration was “how to preserve function.” He even told his colleagues, “I think there is a very important question: no one has proved it is a problem to have a large glans or a large clitoris, [so] should we really do anything about this?”
Afterward, we went up to say hello to the various panelists, and a few seemed shocked when they realized we had been there listening. I heard one person ask about what security thought they were doing at the door, but most of them were now cordial, though uncomfortable. Bo and I were not, after all, with the extremists on the picket line outside, anticircumcisionists who were covered in mock blood, calling doctors butchers. We were being taken very seriously.
However, because we were being taken seriously, we were taking crap from certain intersex activist quarters. I was an especially easy target of the identity-card-carrying activists. I was not intersex, I was not queer, I was not a clinician, so what was I doing there? In the story of the intersex rights movement, I was just plain funny looking. Some accused me of being a kind of mole—of “being in bed with the doctors.” When people put this charge to my face, I asked whether they realized that being in bed with the doctors provided a lot more opportunities to tickle their nuts, so to speak, than simply yelling at them from outside the window. In fact, I admitted, I found the window-yellers useful, precisely because they made us look sane and reasonable. (I even donated cash to their groups to keep them yelling.)
And we were sane and reasonable.
But by then, totally exhausted. Eight years into our collaboration, Bo and I were both well on our way to being out of steam. When you think you’re Good fighting Evil, you can continue fighting well past the point that would otherwise count as spent. But Bo and I had come to realize we were not Good fighting Evil. We were dealing with well-intentioned but myopic people who weren’t seeing what we couldn’t help but see when we took the long view in weighing the evidence.
Fully understanding how tired Bo was of it all, in 2004 I found myself having to push her to attend a hearing of the San Francisco Human Rights Commission that had been organized by David Strachan and Thea Hillman. The commission was investigating whether the treatment of intersex children constituted a human rights abuse. I thought this could be pretty scrumptious—I was fantasizing about writing our press release with the headline “Human Rights Abuses at U.S. Children’s Hospitals.” I talked Bo into going, and we went with Robin, Bo’s wife. (Although at that time they could not be married legally because they were both identified by the state as women, Bo and Robin had decided a couple of years earlier to have a private wedding. They asked Aron and me to officiate.)
When it came time for public testimony at the Human Rights Commission, I got up and said a bunch of things, and so did other people, and everyone kept wondering, when would Bo get up and say something? When would the most prominent member of the movement speak? She finally realized she had to—there was no way out of what she saw as a waste of time. She’d told me the docs would never listen to the San Francisco Human Rights Commission, no matter what they said, so she had not prepared anything to say. By then I had developed the habit of leaving index cards in my bag so that I could quickly write down what I thought we should say. I grabbed some cards, started scribbling, and wrote something like this:
What the Human Rights Commission has done here today is to recognize me as a human being. You’ve stated that just because I was born looking in a way that bothered other people doesn’t mean that I should have been excluded from human rights protections that have been afforded other people. . . .
Bo got up and went to the microphone in the front of the little hearing room. Glancing down at the index card, she started to speak. And then she suddenly stopped speaking. I turned to Robin and, groaning, whispered, “Oh no, she can’t read my handwriting.”
Robin answered, taking my hand, “No, Alice, no. She’s crying. She can read what you wrote, and she’s crying.”
Robin and I had never seen Bo cry in public before. I wasn’t even sure I had seen her cry ever.
I realized at that moment that, after almost a decade together, we had finally gotten to the core of the matter. What I had learned from her was what I had written down on that card: that all she had ever wanted was simply to be treated as human. All of these people were simply asking to be given basic rights that were automatically accorded to all other humans: the right not to have your sex changed without your consent, the right to be told the truth about your medical history, and the right to be treated as an equal member of the human family without having to first pass through an operating theater.
We weren’t asking for a new, third gender category for our society, nor for a belief in innate gender identity, nor anything else so culturally radical. We were just asking for children and adults who had been born with sex anomalies to be recognized as fully human, deserving of decent medical science, and deserving of basic human justice.
The good news was that a lot of people, including the doctors, were truly starting to get it.