Sexing the Body

Sexing the Body: Gender Politics and the Construction of Sexuality is a 2000 book by Brown University Professor of Biology and Gender Studies Anne Fausto-Sterling, in which she explores the social construction of gender, and the social and medical treatment of intersex people. She stated that in it she sets out to "convince readers of the need for theories that allow for a good deal of human variation and that integrate the analytical powers of the biological and the social into the systematic analysis of human development."

Synopsis
Fausto-Sterling mentions the most common types of intersex, congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome (AIS), gonadal dysgenesis, hypospadias, and unusual chromosome compositions such as XXY (Klinefelter Syndrome) or X0 (Turner Syndrome).

She gives John Money's view of intersexuality by stating,: “Intersexuality, in Money's view, resulted from fundamentally ab-normal processes. Their patients required medical treatment because they ought to have become either a male or a female. The goal of treatment was to assure proper psychosexual development by assigning the young mixed-sex child to the proper gender…” Money declared, "From the sum total of hermaphroditic evidence, the conclusion that emerges is that sexual behavior and orientation as male or female does not have an innate, instinctive basis.” Money is disproved in chapter 3 of Sexing the Body when it is stated that congenital adrenal hyperplasia (CAH) girls tend to manufacture larger amounts of masculine hormones until birth and the production of these male hormones raises the question among scientist of whether or not the excess male hormones that a CAH girl produces has an effect on her brain development.

Fausto-Sterling argues surgery on intersex babies should wait until the child can make an informed decision, and label surgery without consent as genital mutilation. In "Sexing the Body", Sterling describes the grueling process of transforming an intersex person into the desired sex, and the appearance of a "densely scarred and immobile penis" or “extensive suturing [or] skin transplants in such a way that it seems difficult for anyone to endure. Although the decision should be made strictly by the parents without any coercion or influence presented by the doctor, it is ultimately the “physicians who decide how to manage intersexuality”. No matter how impartial they attempt to be, physicians simply “act out of, and perpetuate, deeply held beliefs about male and female sexuality, gender roles, and the (im)proper place of homosexuality in normal development” when performing the necessary surgery for the chosen gender.

Fausto-Sterling’s article titled “Of Gender and Genitals: The Use and Abuse of the Modern Intersexual” criticizes the standard model of sex and gender by using the case of intersex individuals by explaining how those individuals are neither male nor female so they do not fit in the sex binary. It is suggested that “bodies… only live within the productive constrains of certain highly regulatory schemas.” People must be “culturally intelligible as males or females”. While the standard model says that sex is biologically determined, Fausto-Sterling challenges this by stating “From the sum total of hermaphroditic evidence, the conclusion that emerges is that sexual behavior and orientation as male or female does not have an innate, instinctive basis."

Oftentimes, doctors decide the sex of an intersex infant immediately after birth. Doctors choose the sex based on what they believe a male or a female should look like. In essence, society decides what is male or female. Fausto-Sterling portrays how our society puts a great deal of trust in doctors because they are seen as the experts and those who decide what nature tells us. Doctors for decades past have felt the need to immediately “correct” intersex children after birth. Fausto-Sterling states, “The attending physician, realizing that the newborn's genitalia are either/or, neither/both, consults a pediatric endocrinologist (children's hormone specialist) and a surgeon. They declare a state of medical emergency. According to current treatment standards, there is no time to waste in quiet reflection or open-ended consultations with the parents”. Doctors felt that this was a medical emergency because intersex children were seen as abnormal, and because we live in a society based on heternormativity, physicians were pressured to make anything abnormal, normal. Fausto-Sterling mentions that “no masculine women or effeminate men need apply.” These individuals are considered to be “unthinkable, abject, unlivable.” As this belief is deeply rooted in people’s mind, it is essential and imperative for “surgeons, psychologists, and endocrinologists, through their surgical skills, [to] try to make good facsimiles of culturally intelligible bodies.” Contrary to the belief that physicians thought it was vital to immediately decide a sex for an intersex child, evidence shows that just because science chooses a sex for a child that does not guarantee that the child will grow up to “fit” that gender role. For example, the article states, “These individuals seemed to be listening to some inner voice that said that everyone in authority surrounding h/her was wrong. Doctors and parents might have insisted that they were female, removed their testes, injected them with estrogen, and surgically provided them with a vagina, but still, they knew they were really males”. These individuals are the exception to the standard model and a prime example of why the standard model is not relevant. These types of people do not properly fit the sexual dimorphism so a more acceptable categorization would be the alternative model. The alternative model a spectrum with completely male on one side and completely female on the other, leaving room for sexually ambiguous humans to be categorized somewhere in between.

In "Of Gender and Genitals", Anne Fausto-Sterling illustrates how the standard model of the difference between sex and gender can be at times damaging and how it necessitates that doctors’ uphold to certain protocol in order to maintain it. She informs the reader that the extensive surgeries intersex children undergo soon after birth are both “unnecessary and sexually damaging”. Infants, if born intersex, are subjected to a number of considerable surgeries as soon as they are born merely to uphold to society’s standard model. If society’s view changed to that of a gender-sex spectrum, these babies would be given the freedom to choose their own gender when they become of age. Unfortunately that was not the case in the past. Instead, for example, intersex babies, who were chosen to function as a male, experienced multiple surgeries “on their penises during the first couple of years of their lives”. When dealing with the parents of intersex children, doctors must follow certain guidelines so as not to dishearten the parents’ of their children’s normality. Fausto-Sterling specifically references some doctors’ endeavor towards “discouraging any feeling of sexual ambiguity” for their children.

Anne Fausto-Sterling says, "[o]ur conceptions of the nature of gender difference shape, even as they reflect, the ways we structure our social system and polity; they also shape and reflect our understanding of our physical bodies."