Sex vs gender: Doctors change their approach with intersex kids

For children born with both sex organs, gender assignment surgery is delayed until they are mature enough to identify with a gender themselves

Healthcare, Medical Generic


YOUNGSTOWN, Ohio (WKBN) – Although transgender issues have been in the news lately, another group of people who do not identify with their biological body parts are often overlooked.

The American Journal of Human Biology says about one in every 1,500 babies is born intersex, which means they have both sex organs.

From the 1960s to the 1980s, doctors acted on the idea that gender was established by a person’s genitalia and social upbringing. Pediatricians would encourage the parents of intersex babies to choose a sex to put on the birth certificate and perform “corrective” genital surgery.

Dr. Jeffrey Palmer, Director of Cosmetic Urology Institute and Director of Pediatric and Adolescent Urology Institute, questions if immediate surgeries were really necessary.

“Even though surgically we were able to develop skills in order to perform the surgery more efficiently and with better results, the issue came around that, did we actually need to operate on every single kid relatively immediately?”

Doctors now recognize that there is a difference between someone’s sex organs and their gender. They define gender identity as a combination of early prenatal brain development, chromosomes, hormones and reinforcement from social environment.

An Oklahoma University study of 94 intersex children found that more than half of them assigned a gender as babies ended up transitioning later in life. In other words, the parents chose which sex the child should be at birth but they ended up identifying more with the opposite sex later in life.

It wasn’t until the 1990s that urologists, endocrinologists and psychiatrists started working with parents differently.

“As a group, we can then meet with the parents and discuss with them the options so now there’s very few indications that we have to do surgery immediately,” Palmer said.

From 2000 to 2005, the medical outlook changed completely. Gender assignment surgery is now delayed until intersex children are mature enough to identify with a gender themselves.

“We, as counselors, need to reach out,” said April Caraway, Executive Director of the Trumbull County Mental Health and Recovery Board. “We need to help family members understand it and help the community understand it so that there’s more acceptance of something that, again, is medically an issue.”

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