Glass House
by Sophia Siedlberg
“You're pure estrogen, which is why you get heightened female characteristics; clear skin, great breasts. The ultimate woman is a man. Nature's cruel, huh?"
The fictional Dr House discussing a teenager with CAIS
"So my thumping you is not ladylike eh? Make your mind up, you want me to be a man don’t you? Oh sorry I hit you! And sorry to confuse you like that"
My response once to a doctor like that in real life.
House, Or "The Cure for the Common Medical Drama". A TV show that managed in 5 minutes of plot to alienate most of the intersex community and in particular women with CAIS (Complete Androgen Insensitivity Syndrome). Well I assume the joke was on women with CAIS, well no a joke would be a depiction of an opiate addicted quack that knows practically nothing of genetics, as being the heroic and brilliant "Maverick Genius".
You only have to utter the words "Fox Network" suddenly all becomes very easily explained. Of course most of the responses to House seemed to be about the incorrect talk of women with CAIS by the media, the misrepresentation and stereotyping of women with CAIS, sometimes comments about the unreliability of using XX and XY chromosome pairings as sex markers. Yes the usual, but of course most of the objections didn’t actually get anywhere with the Fox Network, hardly surprising really, considering how the Fox Network thrives on inaccuracy and misrepresentation.
But someone slipped up. I mean if a certain media empire are going to humiliate a group of people, Portraying these people as victims of child abuse and then making a joke of it is going to backfire. And then to justify the "joke" by claiming the person who was a victim of sexual abuse is the opposite sex, with daft explanations of genetics. is, well going to backfire even more. And here we go, the backfiring starts.
Lets look first at what the "Maverick Genius" (An ill informed script writer) said on the genetics, lets warm up a bit.
"His DNA says you're wrong. Frogs and snails and puppy dog tails. You've got male pseudohermaphroditism. See we all start out as girls and then we're differentiated based on our genes. The ovaries develop into testes and drop. But in about 1 in 150,000 pregnancies a fetus with an XY chromosome, a boy, develops into something else. Like you. Your testes never descended because you're immune to testosterone. You're pure estrogen, which is why you get heightened female characteristics; clear skin, great breasts. The ultimate woman is a man. Nature's cruel, huh?"
I wonder, what an XY chromosome is, I have heard this one before, It is a cracker of a joke, Some "Expert" in the UK's Guardian Newspaper in the 1990's called Dr. Emily Hanckock Said:
(Referring to the Reimer case)
"John's (David's) case suggests irrefutably that boys are created in the womb. Playing with Barbie and wearing pink dresses can never, undo the power of the XY chromosome"
Well that is a bit misleading, I suspect for a reason, This bit about an "XY chromosome" often seems to appear when trying to assert the idea of "XY = Male". It is hilarious because the use of "XY Chromosome" to assert maleness is commonplace. It is a bit of a cliché really.
OK I will be fair I am playing semantics, the two separate parts of a chromosome pairing are "Chromatids", And sometimes a chromosome is a reference to as the pairing itself. but when looking at it the way I need to (In terms of genes on the chromosomes and expression in the Mendelian sense) The notation of a singular chromosome tends not to be all that helpful. I always say "Chromosome Pairing" This is why in some documents you read of "X and Y chromosomes" (Plural). Rather than "XY Chromosome" (Singular). I stress this for a reason, because when you regard the X and the Y chromosomes as a singular you end up with less clarity about genes. OK, its like this, unlike other chromosome pairings (Where both parts consist of paired genes), the so called sex chromosomes don’t get paired genes all the time, It is why you get "X Linked" genetic conditions which can include colour blindness for example, because there is only one copy of the genes on the X chromosome when paired to a Y chromosome, Whereas a pair of X chromosomes have both sets of genes. (See how it works). It is easier to treat the X and Y chromosomes as separate entities. And while in both XX and XY pairings, it is one gene that is used from the pair, in the case of XY pairings there is no "Backup" gene just one copy on the one X chromosome.
So there is a reason why I would use X and Y chromosomes, as opposed to "XY chromosome" as you may be gathering by now. If we stick to this idea, of an X and a Y chromosome, for now, it will begin to make sense. And the "Housian" school of genetics will make even less sense.
So lets read the "Housian" explanation again.
"See we all start out as girls and then we're differentiated based on our genes."
OK on the Y chromosome there is a gene that codes for a protein that causes "proto gonads" (Which would usually develop into ovaries) to turn into testis. This is what the Housian explanation means by "differentiation". However there is a small problem with this very simplistic description. Yes SRY makes testes, but we are not talking sperm manufacturing, super testes, we are talking well, undeveloped testes really. Now lets get back to a nice little scriptwriter talking a lot of testes.
"Your testes never descended because you're immune to testosterone."
Well the "immunity" is down to the gene that makes the androgen receptor not working. Basically this is the real bloke gene not working, on the X chromosome, yes I said X chromosome. And its the only gene available remember in the XY pairing remember, you only get one copy of genes on the X chromosome in an XY pairing. you see for testes to fully develop as testes, and descend, you not only need the product of a gene on the Y chromosome, it is a gene on the X chromosome that has to work, as well, have the last word so to speak. And yes AIS is an X linked condition. Interesting really, if the "woman chromosome" says "this is not a man" after all, I wonder why the Housian explanation says otherwise, Ah well it is called going back to the idea of an "XY chrisom" which conveniently obscures the little problem with a gene on the X chromosome having the last word. the ultimate doctor is a phallocratic prick, House is cruel huh?
In the script the talking total testis continues:
"You're pure estrogen, which is why you get heightened female characteristics; clear skin, great breasts the ultimate woman is a man"
Yes, well errm lets quote bit of strange terminology from thin air. "CYP19" That was fun. It is a gene, not on the sex chromosomes but Chromosome (Pairing) 15. and it codes for an enzyme called aromatase. Now lets make this fun for Housey halfwits. remember this is chromosome 15 right, not X or Y. Nothing to do with sex in the Housian parallel universe. Aromatase converts testosterone to estrogen, you can have a woman with XX chromosomes and she would be a bit manly were it not for chromosome 15's CYP19, We are talking about steroid synthesis, Its getting a bit complex isn’t it.
Well in the case of CAIS, CYP19 working as it should is also a "problem" because a woman with CAIS would be "All Estrogen" because of her body's ability to convert Testosterone to Estrogen. but of course, we don’t mention this because the gene is not in the X or Y chromosomes. but what makes CYP19 interesting is that in the case of it working properly, it actually makes a woman with CAIS (Who is supposed to be a he according to House) even more feminine. what you don’t get to hear is that this is not to do with sex chromosomes.
Now, don’t tell anyone, I have a big secret, notice how a gene or two on other than those on the Y chromosome having the last word seems a little, well awkward. Actually there are lots of "Last word" genes, that kind of make life awkward for "Maverick Geniuses" (Like House, Mengele etc). and Scriptwriters don’t know this big secret., it is called "Polygenic expression" what it tells us is that you cannot rely on a gene on the Y chromosome to produce a male phenotype by itself. The development of sex is in truth rather complicated, it involves lots of genes, I wont list them here, it is not the point, but most conditions of sex differentiation tend to occur because of a number of genes working in a certain way.
So to simplify the Housian definition of all this down to its pure absurdity. Our fictional "Maverick Genius" seems to think with a logic that can be illustrated like this.
If you have a car with a big petrol tank it is a truck. If the petrol tank only fills to the capacity of a car's petrol tank it is still a truck, If petrol doesn’t actually burn because the spark plugs don’t work, it is a truck that can shift a huge load. And I suppose if there were lots of bits in the car not working, rather than just the spark plugs and petrol tank, it is a juggernaut. "Right yes fine, back to the class and tell me what are you taking. Ah yes the sore leg, I get it".
I bet you producers of House out there were smirking while reading this and thinking "Oh she/he whatever has veered from the sexual abuse topic" errm wrong!
I suspect that is the real but not often covered issue has been missed when people were arguing about the scientific inaccuracies of the episode of House, and that is the sight of a doctor making a joke out of a teenage girl who has suffered parental sexual abuse. I mean forgive me but.:
"Good news is, I don't think dad's going to be sleeping with him/her again. See, now it's gross".
and
“No, a joke would be me calling you a homo. See the difference? I'll schedule him for surgery.”
Is what exactly? funny? Oh so a medical diagnosis of CAIS makes the abuse different now does it? there is the backhanded comment like if she were being abused by her father and diagnosed as not having CAIS, it would be different would it, More serious, like get the cops in, but as the woman is a "male pseudohermaphrodite" It is not a problem for the police, a quick comment about the abuser being a "homo" would do. Like run that by me again? Like what sort of sicko wrote a script like that?
You see this is where we turn the heat up a bit on certain scriptwriters who think child abuse is funny. (15 is under the legal age right? Incest is illegal yes?) Oh sorry, I cant state the obvious can I, lets be fair to the House Scriptwriter, the house scriptwriter has already assumed that XY chromosomes in a woman equates with sub human. I think we have got the message from the very simplistic and absurd "scientific" explanation so cleverly delivered by a "Maverick Genius" that she somehow "deserved" to be abused because she was not some pure example of biological womanhood., but an "XY chromosome" parading as a woman. Lets do the House on House then shall we, Lets talk like a "Maverick genius" does this logic apply to all "deformity" or "imperfection" that they being abused is something that can be jokes about. What next, a kid with downs being abused and the scriptwriters joking about it via the script for Dr. House?
So what then? it is deliciously politically incorrect inst it? Like hey lets have another medical drama and call it "Mengele" where does it end, that slippery slope as the media loves to spout. funny that, how slippery slopes seem a real problem in society but in the land of twisted scriptwriting ah it is just a bit of fiction. Well how many of the 1 in 150,000 were watching this "cure for medical dramas" and feeling a bit insulted, if not threatened by it. Well they don’t matter really do they, they are there for the amusement of the audience. And then there is another sticky little question, I mean these days most parents seem to know that their child has CAIS, and does this mean that the writers of House think parents of CAIS children abuse their kids or something?
I find Dr.House as a TV show to be offensive, but deliberately so. I do not consider it "Irony" either for the simple reason that the rather insulting description of CAIS or AIS in general is a list of half truths that were designed to convince the layperson that CAIS describes a male. "Parading as a woman" .Well no, House is a misleading and false television parading as serious drama, more like
