intersex_not_disorder1

What is in a Word?

Michelle O’Brien

Who would have thought one little word would have generated such heat amongst this supposedly small community – ‘disorder’. The response to the package ‘disorder of sex development’ has been varied – endorsement, reluctant acceptance, denial, silence, and opposition. The response to acceptance and endorsement has been character assassination, accusation, challenge. The response to opposition has been character assassination and to ignore the challenge. There has been limited discussion, mostly behind the scenes, within those in the community who take different positions; those who have been involved in promoting the new terminology have mostly acted as though those who have challenged do not exist. There has been more discussion between those who promote the terminology and those who have required it than with those who oppose it; there has been no discussion between those who require the new terminology and those who oppose it, because they do not recognise that those who oppose it exist.

Initially I was not overly concerned about the new terminology, but through discussion with people actively involved in the intersex community, I began to understand that the issue was primarily with the word ‘disorder’; a term like ‘variation’ or ‘atypical’ would not have been so problematic.

I decided to research some of the history of the terminology for intersex in the UK for myself, which was something that I could utilise myself as part of my PhD thesis. I discovered quite a lot. The first person to use the term intersex who was clearly identified as intersex and open about her intersexuality in the UK was so in 1962. The first person to object to the distinctions and terminology of hermaphrodite and male or female pseudo-hermaphrodite in the UK wrote back in the 1940’s, as a medical expert, and preferred the term intersexuality to describe the various types of intersex conditions he came across. In the 1960’s, in the UK, experts working in this area included not only transsexuality as a form of intersexuality, including it in their books on intersex disorders, one also included homosexuality and transvestism as forms of intersexuality. One of these writers continued to stand by his view that transsexuality was an intersex condition into the 1990’s.

How this changed is too detailed an analysis to put in here, and I have no desire to pre-empt some of the content of my thesis in this respect. What this set me to thinking was, how would I feel about an intersex disorder, and what exactly was the problem with intersex per se? We have been told that doctors and parents do not like it, that there are associations with homosexuality that trouble parents, that the term is too imprecise. Terms and their usage change and come into fashion and go out of fashion. For a long time ISNA tried to maintain a very narrow view of who could and couldn’t be counted as intersex; however the boundaries of intersex are not clear.

The boundaries of DSD are possible to be made clearer than intersex, because it is controlled by those who define it, not those who see themselves as included under the term intersex. Some people will be included by definition, others excluded by definition. For those who need to classify, this is a very handy device they can use to define who the people they hope to deal with are; those who they do not wish to see can be excluded and picked up by some other speciality.

I began to think about what the coverage under DSD actually had to say about the words involved in it. I began to realise that what was problematic was not the term ‘disorder’, so much as the word that was missing from it – and most specifically why that word was missing from it.

When I look at the conditions that are included under DSD, they all have one common feature. The symptoms themselves are indicators of underlying DSD, but one person with hypospadias and cryptorchidism will have a DSD, and another not. Whether they have a DSD or not depends on the underlying causes and features of that individual. So, if someone appears male, but has female chromosomes, they are included; if someone appears female, but has male chromosomes, they are included; if someone has certain ambiguities because of an unusual chromosomal arrangement outside of XX or XY, they are in; even if there are no clear signs of intersex, and unusual chromosome arrangement places people in this category; if there are signs of intersex and known genetic markers which account for this, they are in. So far so good; because before, if you asked half-a-dozen specialists from different countries, they would come up with different lists – for some Klinefelter’s would not be seen as intersex because they see a Y chromosome and a phenotype that is, on the whole, male; others would exclude CAH, because they see two X chromosomes and a phenotype that is, on the whole, female. Anything, then, that has some chromosomal or genetic-based cause for certain physical anomalies are included, and having a phenotype that is the opposite of what would normally be expected for one’s chromosomes.

When considering what is excluded from DSD, what appears to be out? OK, it is obvious that transsexuality is out – that has its own disorder diagnostic. However, some with symptoms the causes of which are not known are not included – because the definition of this type of disorder is not according to symptom but underlying condition. Thus, someone with hypospadias and/or cryptorchidism can be identified, tested, and treated for this – yet be found not to have a DSD. This will be because no cause that can be traced back to an identifiable genetic (which from here on I include chromosomal) origin. This indicates that a DSD diagnosis will not be necessary for treatment, that people will be treated in similar ways to those with DSD, but not be so categorised. It suggests that people with DSD are so categorised because they are part of a set of genetically based disorders.

So, the word that is missing from Disorder of Sex Development is ‘Genetic’; what the phrase ought to be is ‘Genetic Sex Disorder’, or GSD. I can see a couple of reasons why that might not be a terminology that would be acceptable – the first being that it is remarkably close to ‘GID’. I deliberately omitted the development (as in genetic sex development disorder), because what the criteria is based on is not the symptoms that may or may not be treated, and which may or may not be treated still, regardless of whether one is defined as having a DSD or not, but that there is an underlying cause which can be identified. It is the underlying genetics that is seen as disordered, the symptoms a manifestation of that disorder – and no doubt it will be the underlying genetics that will be the primary focus.

I guess DSD sounds better, because it appears to focus on the symptoms, helps explain things to parents, and keeps the ‘G’ word (genetics - so dreaded by the public) out of the equation as well as the ‘I’ word (intersex – so distressing to parents) and the ‘H’ word too. It appears to be all things to all men – apart from the unfortunate use of ‘disorder’. People are right, in a sense, when they say that DSD applies to their condition and does not affect them as a person or their identity. But there is a slippage between the symptomatic way of looking at intersex which is part of the way people are and this new definition which, actually, is a classification of people as being genetically diseased in some way.

How comfortable we might feel about that varies between individuals – but objection to it cannot be dismissed simply because that is what the experts want. If we went along with that line of thinking, there would never have been any progress at all where surgical interventions were concerned. Genetic research in its own right is no bad thing, nor is genetic medicine – but when a disorder is categorised in a way that the genetic aspect is not made explicitly clear as defining it, but hidden away, there is a bit of concern about why this is not clear ‘up-front’.

Or have I read this wrong somehow?

OII, DSD & ISNA

Michelle O'Brien

Within OII we have certain discussions. Seems we have two issues that keep emerging: ISNA and DSD.

ISNA

I do wish we could move on from that discussion, otherwise this group becomes based around the negative - why people don't like ISNA/Chase/Casper - which is not productive for anybody. However, I also realise that the pain needs to be talked about.

What the issue boils down to is that ISNA's position is founded on the assertion that people like Chase and others listen to intersex people in the USA, and this makes them the international authority:

Wikipedia:

"an organisation formed to represent the interest of intersexuals"

http://en.wikipedia.org/wiki/Intersex_Society_of_North_America

What I have heard people saying who come to the forum for OII, and elsewhere, (and from my own limited experience) is that the assertion that ISNA listen is not actually correct - the listening is limited to those who fit a certain criteria for being intersex that has been dictated by a few leading individuals, using medical pathologies and biases to justify herself in doing this.

Those who do not correspond with these criteria are not listened to, and some feel that they have been abused in the way they have been dealt with when approaching ISNA. From this, what could be said that ISNA has failed to listen to some people for whom the issues they seek to make representation on are relevant; that may even be many people rather than some; so they are not fully representative or inclusive of all people who are seeking to establish the truth about their circumstances and histories. Some within ISNA appear to have preferred to demonise and vilify such people and denigrate their experience, rather than listening.

I am not from the USA, so am outside the debates that go on there; however, decisions made in the USA, and representations from people in ISNA have effects here as well. Indeed, people in ISNA do cite experts and groups from the UK in their own submissions; sometimes individual members are approached by the BBC to help with their documentaries here.

My own initial communication with ISNA was one where it was made quite clear that ISNA is primarily concerned with the USA, but that they were happy to take my money. Subsequently, I received communications from them on an irregular basis, and the only time there was any form of interest in my views was when they sought to seek legitimacy for their position on DSD after they had decided to enorse the new terminology. Most other communications were about who was in charge, or asking for money.

People express that their dealings with ISNA have often bought them pain, walking away from some of thier experiences feeling abused. This is what I hear when I listen to them. The resonse about this ranges from those who belong to ISNA, but feel that their voices have not been heard, to those who have been rejected by ISNA and believe that the organisation should go because it has failed the intersex community in its broadest sense; my own view is that I have little interest in ISNA, as my engagement with them has been minimal apart from how I described, a few educational materials my college purchased for some undergraduate teaching, and some correspondence a few years back with Monica Casper. I believe that any organistation can lose its way, and when that happens it needs to be reformed, and that has to come from within. Whether this applies to ISNA or not is not an issue for me. We, as part of an international community, really need to move on from ISNA, and engage in more fruitful discussion.

DSD

This is a topic that seems quite dominant in the thinking of people on the forum at the moment, and I feel that this is a more productive focus for discussion.

I do think that DSD is best used as a description for people's pathology post-intervention, rather than pre-intervention; this would entail a focus on any disorder being the result of such intervention, not the cause of it. Disorder gives legitimacy to those who have intervened, and will do so in the future. Both Curtis and Sophie have suggested that the implications for those who find themselves in some personally conflicted situation viz-a-viz their gender expression post intervention can be considered to have other disorders that are not of the form DSD. In other words - where the DSD inducing treatment fails, rather than approaching this as evidence of the shortcomings of the disordering approach, individuals become further pathologised into other categories of disorder (such as GID or some alternative *psychosexual disorder*). This then means that "experts" can avoid difficult questions about what has gone on in the past. Those who do not correspond to the intended outcome of the disordering treatment can then be de-categorised in a way that they do not feature as evidence that the DSD approach has failed to work.

DSD is about covering-backsides, essentially, and blaming the victims when things go wrong.

OII

People in OII are not expected to tow the line on these issues, and express a range of opinions about DSD. The overwhelming response from the people I have listened to is that they haven't spent years coming to terms with being intersexed only to be told that they are disordered. People, having learned to accept themselves, want to be accepted as the people they have become through self-knowledge and self-awareness.

The best interest of future generations is of paramount importance, but people do not seem to feel that disordering will be of any benefit in that respect. It may even open up a backdoor to a system of consumer-eugenics when people are confronted with the possibility of disordered child. Whilst so much of popular interest seems focussed on children (my own experience with media enquiries is primarily about children, rather than adults), it must never be forgotten that for many, it is as adults that they have had to learn the truth of their situation. It is knowledge that has been quite hard to adapt to for some, as childhood memories have emerged cast in a new light. Intersex is not just about children, it is about adults as well.

Many in OII resist the extension of pathologising into intersex people's lives through the use of DSD, preferring that people be allowed to explore the solutions that fit them the best. The last thing most poeple I hear want is to see a rigid set of protocols for treating intersex as a disorder, of the sort dictated by the standards of care that have come with other disordered phenomena, such as GID.

OII seeks to be inclusive, not to question and challenge an individual's narrative or life-history when they pluck-up the courage to share it. OII does not seek to judge who is or is not worthy or genuine; when there has been so much denial and deceit and lack of disclosure, the establishement of one's own situation inevitably may have to fall to the individual. The role of OII is not to cast doubt on someone's authenticity or validity.

OII exists to speak for the whole person who is coming to terms with intersex, not just the medical part, the female part, the expert part, the male part, the damaged part. OII is about human beings seeking to make sense of the situation they find themselves in. I and some others see the only meaningful category as being a human being first and foremost. In that humanity, there lies love. In love, there need be no fear.

Copyright Michelle O'Brien June 2006

A Problem of Disorder

Michelle O'Brien

Recently, people were asked for feedback on a couple of pamphlets released for guidelines for care of, and advice to parents of, interrsex children. What say can I have on guidelines for dealing with children and advice for their parents?

I have no children and am not in a position to do so. Those who are who are in a position to comment about this terminology are not addressed by these pamphlets. However, in producing these pamphlets, what the authors (and the organisations that endorse them) are doing is changing the terminology used, but in a way that excludes people to whom it can be applied by extension. In other words, were this to be a pamphlet about the application of terminology to existing adults, then I would be in a position to comment; but the manner in which this change has been bought about, I am effectively disenfranchised from that discussion.

I am disenfranchised in a number of ways:

--by having the term applied to me without having been consulted.

--by being excluded from the coverage by virtue of not having an intersex condition considered acceptable to physicians and certain activists.

--by being excluded because I do not subscribe to the definition.

--by being excluded because I manifest my condition in ways deemed unnacceptable to physicians and certain activists.

This may well have a lot to do with why this has become a controversial debate. The fact that those who promote the use of this term are surprised about a reaction shows that they must be out-of-touch with many in the community they claim to represent. This is not surprising when both have for so long deemed themselves to be arbiters of who is and isn't intersex, telling others what they are, rather than listening to people.

I find that the term disorder is a problem because it is used as a way to encapsulate me - I have this disorder (DSD, GID, whatever). I think it works the other way around, the disorder emanates from me - my being, my sexual development, my gender identity, whatever, disrupts someone else’s order - dis-orders their world. That someone will try to locate this disorder in me, but actually, it is the limitations of their consciousness that means they cannot allow their world to be disrupted in this way. These disorders are social disorderings, but the approach is to locate specific solutions in the individual, rather than allowing society to become re-ordered and renewed.

If intersex is a disorder, that means that it is disorder that someone has; the problem is to do with the individual, and the way the problem has been fixed is to fix the individual (preferably before it becomes a problem for society). If it were regarded as a social issue, then it would highlight some kind of dysfunction in society; the problem would be to do with society not being able to deal with certain types of individual, and the way you would fix the problem would be to fix society.

There are medical issues around disability, but disability itself is not a disorder - although a specific disability may be called a disorder. The approach that has developed in many civilised countries (since the extremes of National Socialism illustrated the unpleasant effects of framing the problem of disability as the inferiority of individuals), has been to try and enable people who find themselves disabled. This is because the concept of disability is seen as a social problem. The problem is not that individual is different, but that society treats the person as inferior, and places obstacles to their participating fully in society - rather than removing those obstacles. This is why we have laws that enforce public buildings to ensure wheelchair access, and other means of rectifying the inequalities and discrimination against people who are regarded as having some form of disability.

The same is true for people who are gay or lesbian. Laws have been passed to remove obstacles to their full participation as productive citizens. In this country, they have rights in employment, will soon have rights in terms of the supply of goods and services, and have recently been allowed to enter into civil partnerships. This is a situation where people once considered to have a medical disorder have now been accorded full rights as citizens - theoretically.

People who are dealing with a disorder can deal with the social issues. I have Crohn's disease - when this initially flaredup I had huge discomfort; it was clearly a medical problem, and was disabling when it first appeared, and yet there were social implications as well. partially this was to do with access to public toilets. It was a nightmare going out, because I needed to be close to a toilet at all times. Any disorder may well have social implications.

When a campaign starts to become based around a disorder, then it is undergoing a fundamental paradigm-shift. A reverse example of this was when the UK Schizophrenia Fellowship became Rethink - the emphasis shifted from the problems of people encountering people with schizophrenia, to advocacy and support for people with schizophrenia; from the treatment of an illness to dealing with the illness one has, and the social issues arising from it. In the case of DSD, what seems to be happening is the opposite. What is accompanying this seems to be a lot spinning to assure people that what is going is not the reverse of what I just described, but using quite convoluted pseudo-deconstruction of certain words to assure people that by disorder people do not really mean disorder, for example, certain comments on about de-pathologising pathology.

In some ways, the word intersex has become as oppressive to some as it was once liberating - but to describe something that has become so integral to some people's own self-acceptance as disorder is immensely problematic. Whilst people may have a specific syndrome, to pull these all under the umbrella of disorder is worrying.

Organisations, like medical people, researchers and academics are free to do this re-definition, they do not answer to anyone; I hope it works out for them. But, they will lose people on the way, and have started to already, because they have chosen to reduce their sphere of coverage.

They have reduced their coverage in a number of ways:

--those alienated by having the term applied to them without consultation.

--those who do not have an intersex condition considered acceptable to physicians and certain activists.

--those who do not subscribe to the definition.

--those who manifest their intersex condition in ways deemed unnacceptable to physicians and certain activists.

But, most significantly:

those who see the consequences of treatment as having political and/or social implications are excluded by virtue of the shift towards a socio-poltically motivated medical paradigm which denies the social impact of such treatments.

There is a quite straightforward way of looking at this. Some regard DSD as potentially oppressive, and organisations using the DSD term are thereby redefining themselves as organisations which are primarily concerned with medical aspects of these conditions. According to where people stand on this matter, they become defined as being either in or out of allegiance to such organisations. DSD-subscribing organisations (and the medical practioners, researchers and academics with whom they are now integrated with) cannot enforce the use of the term on a community of which they are just a part.

This may be of benefit, in helping to liberate the term intersex by de-coupling it from medical terminology and medicalisation, to some extent. People who are primarily concerned with dealing with disorder do not have to focus on other issues - and those who are concerned with dealing with the social consequences of being intersexed can focus on that. Hopefully, somewhere in all that, the issues of unwarranted intervention in the lives of infants and children will not get lost.

It seems that this situation has these aspects -

--how to treat what is disorder.

--what is best for the human concerned (in the family and society).

--the ethical boundaries of infant, childhood and in-utero interventions.

--the social consequences of finding oneself having been treated for an intersex condition.

Medical practitioners, academics and researchers seem to have located themselves most strongly at the top of this list, with a sliding scale of priorities down to the fourth item. DSD-subscribing organisations seem to be placed most firmly in the middle two, with lesser interest in the first, and have removed themselves from an association with the fourth. This leaves the last three items the primary concern for those who do not subscribe to the term DSD.

Copyright Michelle O'Brien June 2006

Gender Identity as a Socio-Medical Construction

Michelle O'Brien

"John Money, the psychologist who worked with the Reimers from the time that David (then Bruce) terminated contact with him at age 12, used the case as proof that gender identity is socially constructed, presenting Brenda (as she had become when her parents elected the sex-reassignment surgery) as a perfectly happy, well-adjusted girl. Colapinto, on the other hand, reveals that the experiment failed dismally, as Brenda refused her girlhood from the beginning, which he considers proof that gender is biologically based and cannot be changed at the whim of others. I want to step back from this debate and question its conditions of possibility. It seems to me that Reimer's experience reveals neither that gender is natural not that it's socially constructed. Rather, it reveals the nomalizing power of gender identity itself: that particular practices that have been coded as feminine or masculine must be rooted in a preexistent identity, a sense of self that "matches" one's biology."

From: Foucault, Cultural Studies, and Governmentality

Edited by Jack Z. Bratich, Jeremy Packer and Cameron McCarthy

The way I would read this is to italicise, or place quotation marks, around the words “gender identity” in the last sentence. The author seems to display a slight confusion as to when they are discussing gender and gender identity.

“I want to step back from this debate and question its conditions of possibility”

I take them to mean, question the possibility of there being a gender identity (or gender?), regardless of whether a given gender identity (or gender? masculine/feminine) is supposed to be socially constructed or a biological essence.

“Rather, it reveals the normalizing power of gender identity itself”

Thus reads:

“it reveals the normalizing power of ‘gender identity’ itself”

As in:

it reveals the normalizing power of the notion of gender identity itself

That is, the construction of the notion of a gender identity is itself essentially normalizing - because it assumes that there is a pre-existent gender and one can have a gender identity which either conforms to this or not.

So, I take the authors to mean that gender identity is a social construct, and thus not something that exists per se, but something we have constructed. It is an extension of the concept of a gender, which is itself socially constructed - and this concept of gender is fundamentally meaningless. It is the axis upon which all specifically non-racial/religious exclusion operates. As Jeffrey Weeks ended the Sexuality after Foucault Conference (30/11/2003) by asking: what would sexuality be like in a world without gender?

Well, there would be no homosexuality or heterosexuality, because these are dependent on gender to operate, and gender is critical in order to be homophobic and heteronormative. There would be no transsexuality or transgenderism, because these rely on crossing some gender divide. There would be no intersex or intergender, because these rely on people occupying some place in which physical gender markers become in some way compromised. This is what Weeks comically posited as the “utopia” - a post-gender world. Gender is also the basis for sexism, sexual discrimination, and the domination of women by men.

It is a world that will not exist, but it is a world that some find comprehensible. It will not exist, because it is the main basis of power for white heterosexual men, who run the world for their own benefit, and who would not want to give up that power.

That is my understanding of the reading. This would be a fairly standard reading of Foucault, whose primary interest was in the mechanisms of power and control. As such, he would have seen gender as one instance of the exercise of power, and as such something socially constructed.

I felt the authors were themselves having trouble with the concept of gender identity, and not being clear which they were referring to at times, gender or gender identity. This would explain why the passage is difficult to make sense of. I regard gender identity as a socio-medical construction (like DSD), and as such it has specific meanings for medical people, meanings which have pervaded society through the media. We who have been on the receiving end of “gender identity”, particularly through encounters with the medical profession, have a different perspective; we have had to struggle with something that has been applied to us. We view gender identity from the inside. Someone who is not from a psycho-medical background, nor been on the receiving end, will never be able to fully comprehend gender identity. That is because they have an identity, and gender is usually not an issue - it is a given. For those of us for whom it has been an issue, many feel that we do not fit these medicalised notions of gender identity. For some of us, we have an identity, but a specific gender is not part of that; but, there also those who have an identity, but they feel (or some will say have been made to feel) that this identity is at odds with their gender assignment.

This accounts for the views of some intersex people - because they do occupy that place common to most people: they have an identity, and gender is not an issue. They have issues about gender, but in relation to the larger meaning of gender as talked about within feminism, not in discourse about gender identity and not in terms of issues about their gender.

I have to admit, to find the words to phrase how I understood the passage was immensely difficult - because these concepts have become so deeply embedded in our consciousness; it is hard to think around them in a way that does not rely on them being self-evident. Gender Identity is a similar construct to the unconscious. This was a creation by Freud, and has become a part of our consciousness through films and the media. It has become part of our every-day thinking: “oops, that was an unconscious slip”, for example. However, it was something he constructed, and it is perfectly possible to understand one's own consciousness without any reference to this illusory unconsciousness model. It has become so pervasive in our thinking that it is hard to think around it. I do not find that what Freud describes fits my own mind. He was using his own inner explorations, and the work with his patients, to get his information. It reflects his own mind, and the minds of many of his patients must have confirmed it.

In relation to "gender" and "gender identity", what I see in my own mind, and what I hear from quite a few people connected with OII, is that we do not think the same way as most other people. Yet, for some reason, we are supposed to. This is so fundamental to my being, and so harmless, I do not understand how this is supposed to be changed, nor why it should be. Part of the problem is that psychologists do not have a psychological model to use for people like us. They only have a male and female model, and in order to work with us, they need us to fit their model. There is nothing to be gained in their having a model that is not within their existing framework.

If you have a male model, and you have a female model, do you apply one of those models, or do you account for the possibility that there may be something different going on?. I don't know much about psychology, but I would have thought it was pretty fundamental. Now, if one applies a binary model, and then gets to deal with someone like some of us, well that would really mess things up, wouldn't it? Either we mess up the model - or the model messes up us. Experience tells me that its the latter - and the fact that we don't fit the model and the model messes us up means that we get read as being pathological, deviant, unstabe, or whatever, I would think

The author appears to me to be saying that rather than looking at a given gender identity as having constructionist or essentialist origins, they intended to take a step back and question the notion of “gender identity” altogether. This is an important distinction, and quite clever because it seems so obvious. It is a bit like the category homosexual; Foucault pointed out (in Vol. 1 of his History of Sexuality) that prior to 1869 there was no such category.

Identity-X

Michelle O'Brien

This categorisation was not always the case. Only 35 years ago, specialists were lumping together all sorts of things in this bucket - intersex would cover what we now call intersex “conditions”, it would also include transsexual, and it even included homosexuals. What tends to happen at GIC's, as far as I can make out, is that if the “patient” has some sort of intersex background, they are badgered into denying it - failing to do this presents an obstacle to treatment.

Ken Zucker presented findings in 2003/4 drawn from several decades years of research papers around the world that showed that about 7% of children with some form of early intersex assignment go on to reverse that assignment at some point after the onset of puberty. Bear in mind that this only covered those children involved in research papers, and of those who went insane or committed suicide little can be said. Then think about those who were lost to follow-up, raised in ignorance, and then decided to change as adults. In GIC's, people tend to deny their past in order to get treated. Many in the intersex community have developed an approach where IS+IGM+F = genuine intersex, IS+CGM+M (who grows up TS) = fake intersex.

There is something going on that is fundamentally transphobic - both in the medical texts and in intersex activism. 7% is a higher figure than in the wider community (way below 1%), but even were that figure only 1%, trans people with some intersex history should be accepted within both communities. Why see a glass hallf full and say it it is half empty?

If you are trans, and lay claim to some intersex history, this comes under scrutiny not only by the intersex police - but by the transsexual police also. Those who believe in the rigid-boundaries of male and female will not like it if you are not clearly one thing seeking to become clearly demarcated as another thing. Those who believe evangelically in trans as an intersex condition will take your intersex history as a suggestion that their “condition” is not really intersex as well.

In the pecking-order of stigmatisation, we all have to find our way through the polices - there are the lesbian, gay, intersex and transsexual police, often acting like Spanish inquisitors, asking deeply personal questions no other ordinary aquaintance would dream of asking. They have no right to ask people about their histories, to exclude people because they were not born female, born male, didn't have their genitals operated on as children, did have their genitals reconstructed as adults, never had anything done to their genitals at all. Yet somehow, they have invested themselves with the power to do this, and we naively accept this, and we continue to inflate their ego's and we let them get away with it.

At one time, I found it incredibly painful, but now I find I have to laugh - nobody can take away from me what I know about myself, and that is all that matters.