MALTA: Parliament considering intersex protection

The Times of Malta
February 16, 2015

Healthy hermaphrodite’ is both man and woman

Castrated at seven – but now welcoming Malta’s stance on ‘intersex’

by Claudia Calleja
When Tony Briffa was seven years old doctors in Australia made a choice that was never theirs to make – castration.

Tony was born with healthy testes, as well as a vagina, and doctors decided it made more sense for Tony to live life as a woman – called Antoinette.

But Tony – who was born intersex – never felt comfortable being a woman, or a man for that matter.
“Nature – many would say God – made me a healthy hermaphrodite... I tried my best to be a woman but I couldn’t keep up the lie forever. Something was going to give.

“At 30 I rejected what the doctors had done to me and started living life as a man. I was open about my past, about the way I was born, and what doctors had done to me. Now, at the age of 44, I am comfortable explaining I am both a man and a woman,” Tony tells Times of Malta.

It is because of this personal bitter experience that Tony, born to Maltese immigrants in Australia, is glad that the Maltese government is doing something about this through the Gender Identity Bill, currently being debated in Parliament.

The draft Bill proposes prohibiting doctors from carrying out surgery on intersex children unless it is a medical emergency.

It also allows parents to wait until an intersex child turns 14 to officially register the gender as male or female.

Tony agrees that the law should not allow doctors to change the physical sex of a child, unless it is medically essential. “Sadly, castrations and physical sex changes are exactly what happen to children all over the world – it happened to me. As a Maltese person I am very proud Malta is the first country to stand up and put a stop to it,” says Tony who was born with Partial Androgen Insensitivity Syndrome.

“I was born with the same chromosomal pattern and testes like typical boys but because my body doesn’t fully respond to testosterone I was also born with a vagina.

“Doctors decided I should be raised as a girl because my genitals appeared more female than male, but incredibly they also chose to castrate me even though there was no medical need to remove my healthy testes and they didn’t know what I would want when I was older,” Tony adds.

Tony spent many years on female hormone treatment but never identified with the imposed gender.
"Doctors decided I should be raised as a girl because my genitals appeared more female than male, but incredibly they also chose to castrate me even though there was no medical need.

“I struggled being the girl and woman doctors wanted me to be. How could I deny the real me and keep up the charade? How would I have relationships? I was lonely, confused and profoundly sad.
“Although I threw myself into my career, community work and music, my personal life suffered enormously. It affected my relationship with my parents and siblings and I avoided intimate relationships.

“I often considered ending my life,” Tony recalls.

At the age of 30 Tony renounced this imposition and lived as a man for some time. But this too felt wrong.

Tony then understood that happiness lay in being true to nature – and embracing both genders.

Armed with this new confidence Tony became the first openly intersex mayor in the Western World – serving as deputy mayor of the City of Hobsons Bay, Victoria, between 2009 and 2011, and mayor between 2011 and 2012.

Tony believes the Gender Identity Bill is important because it will stop doctors from imposing genders.

It will also ensure people could have their gender recognised without having to lie and be ashamed.
Tony has had a female and a male birth certificate and now has a blank one. Legal issues presented by Tony’s non-specific birth certificate meant marriage was not possible in Australia where the law only allows a union between a man and a woman. In September 2013, Tony married Manja Sommeling in New Zealand.

Documents, Tony believes, should not refer to a person’s gender “because it’s irrelevant”. But, if gender markers are to stay, then there should be ‘M’ or ‘F’ for those who feel male or female.

There should, however, also be additional categories such as ‘M and F’ for adult intersex people that want their sex to be recognised for what nature made them, and ‘X’ for people who feel outside of the male and female categories.

“Personally, I would not want ‘X’ on my documentation,” Tony says.

SOUTH CAROLINA: Intersex child castration case to proceed

wyff
April 10, 2014

DSS loses motion to delay case of intersex child

Child indentifies himself as a boy, despite surgery to remove genitals
GREENVILLE, S.C. —A case that accuses the Department of Social Services and medical care givers of performing unnecessary sex-assignment surgery on an intersex baby will proceed.

The decision of the 5th Judicial Circuit Court to let the case continue means the defendants will have to defend their choice to castrate the baby, who has since grown into a healthy 8-year-old who identifies himself only as a boy, named in court documents as M.C.

“The court’s decision moves M.C. a step closer to justice,” said Kristi Graunke, Southern Poverty Law Center senior supervising attorney. “This ruling holds doctors accountable when they recommend such drastic and irreversible procedures for infants but fail to ensure caregivers are fully informed about the risks and options.”

M.C. was born with an intersex condition -- a difference in reproductive or sexual anatomy that doesn’t fit the typical definition of male or female. When he was just 16 months old and in the care of the South Carolina Department of Social Services, doctors and department officials decided the child should undergo sex assignment surgery to make M.C. a girl.

“Our young client was profoundly harmed when doctors and state agents decided to remove his penis and testicles,” said Anne Tamar-Mattis, co-counsel from Advocates for Informed Choice. “We look forward to continuing the fight on M.C.’s behalf and to ensuring that no child ever has to undergo such life-altering surgeries without informed consent.”

The plaintiffs say DSS and medical staff made the decision even though there was no way of knowing at such an early age whether M.C. would grow up to be a male or female.

The lawsuit, filed by the child’s adoptive parents, claims the defendants did not even provide a hearing to determine whether the procedure was in M.C.’s best interests.

Named in the suit are the Department of Social Services, the Medical University of South Carolina, Greenville Health System and several other caregivers.

M.C. was born a premature twin at Greenville Memorial Hospital in November 2004. The biological parents would not take them home. One baby died. M.C. was abandoned in the Neonatal Intensive Care Unit.

Three months later, the Department of Social Services stepped in. Court records show the biological parents relinquished their rights.

Mark and Pam Crawford were looking to adopt a child with special needs. They would come to love M.C., but by the time they entered the picture, there was nothing they could do. The life-changing surgery was already done.

Pam Crawford said, "We looked at the situation, saw how adorable the child was, and said, 'We can do that.' It didn't really seem like such a special need to us."

Court records indicate that at birth, M.C. was identified as a male. During a reflux surgery, female organs were discovered. Doctors at the Greenville Hospital System concluded the baby was a "true hermaphrodite."

They referred the case to the Medical University of South Carolina where ultimately, sex re-assignment surgery was performed in April 2006 on the then 1-year-old.
...

"It's too late for my son, but we want to put other doctors on notice," said Mark Crawford who noted the action was "drastic and permanent."

The lawsuit says doctors, acting as agents of defendant hospitals, performed the surgery for the purpose of "assigning" the child the female gender despite their own conclusion that the toddler "was a true hermaphrodite but there was no compelling reason that she should either be made male or female."

The defendants decided to remove the child's healthy genital tissue and "radically restructure his reproductive organs in order to make his body appear to be female," the lawsuit states.

The suit filed in federal court alleges the defendants violated the child's right to privacy by deciding to go forward with the surgery. The state suit alleges medical malpractice and gross negligence.
...

Once the child was placed in state custody, the Department of Social Services was responsible for any and all medical decisions. By law, major surgery is something that should have gone all the way to the top.

Within months of M.C.'s surgery, the DSS director at the time, Kelly Aydlette, left her post. She's named in the lawsuit, along with DSS, four doctors and two hospitals.

According to court documents, the decision to turn M.C. into a girl never went before a judge.

No guardian was appointed. And it does not appear the doctors requested an ethical consultation.

Bioethicist Carmela Epright said, "I suspect strongly the reason this didn't go before a judge is because no one thought this was a hard question. They thought they had the answer."
...
.

"He wasn't sick in any way. What he was, was a problem from an adoption standpoint," Epright said.
That being said, Epright doesn't believe the Crawfords will win in court.
...

"When he started going to school, picking up friends, it was clear that he thought of himself as a boy," Pam Crawford said.
...

"It's not like he turned into a boy," she said. "He's the same exact child he's always been."

For the rest of his life, M.C. must live with a choice made for him by strangers. The only thing he got to choose was his new name.

The Crawfords hope his story will help other families understand that surgery isn't the only option.

"My greatest fear is that these things might keep happening, Crawford said, "My fear for him specifically is that he will hate his body."
...
 
Dr. William F. Schmidt, medical director of the GHS Children's Hospital, sent WYFF a statement saying, "A thorough review of the medical files will show that treatment this child received while under our care was consistent with the highest standards of medical practice and medical ethics." [Well he would say that, wouldn't he?]

Earlier story

UGANDA: Man loses penis in circumcision botch

New Vision (Uganda)
July 16, 2013

Man loses penis in medical circumcision

by Paul Kiwuuwa and Simon Masaba

At 44 years, Patrick Izimba, is a lost man after he lost his penis to a botched male medical circumcision procedure in a private clinic. Izimba is at Mulago Hospital... , where he has endured pain for the past three weeks.

Speaking with teary eyes, Izimba curses the day he read a sign post at the private clinic that offers free male medical circumcision.

“I underwent an operation at Medik Medical Centre Limited in Kawempe,” he says. “Free things are expensive they have cost me a life. I depend on pain relievers. My penis is falling off and requires me to wear a skirt.”

“Pain killers have become my daily bread because if I do not take them, I cannot sleep,” Izimba narrates. Izimba has a catheter connected to his bladder to allow urine to flow out.

He says Dr. Francis Kakooza, an employee with Medik Medical Centre, carried out the operation under the supervision of Dr. Edward Kunoya, the clinic’s director and proprietor. ...

Start of his woes
On the fateful day, Izimba met Dr. Kunonya who told him the circumcision was free, but he had to pay sh20,000 [$US 7.73] for the drugs. Izimba paid the money and was asked to bring Jik [bleach] and a polythene bag to place on the surgical table.

He recalls that before the surgery, Dr. Kakooza administered an injection which was painful. “I objected to the operation, but Kunonya shouted at me: ‘Be a man, don’t fear.’ Meanwhile, Kunonya sprayed something on my nose that threw me into sudden deep sleep,” Izimba recalls.

He woke up three hours later. “My penis was very stiff and I had lost a lot of blood. They bandaged the penis to prevent further bleeding. ...

“Kunonya transferred me to another room and I was put on a drip. I was weak. They gave me tablets to swallow. I had a sleepless night due to the pain and the penis remained stiff. The following day I reported for dressing in terrible pain, the penis skin became dry and pale,” he says.

On the third day, Izimba’s penis was still stiff; the skin had tuned so dark and began to peel off.

... Dr. Kunonya said: ... “Izimba developed a complication during the recovery period during the dressing when the skin started peeling off. ... Probably Izimba did not use the drugs as instructed. [Blame the victim.] Many patients have undergone operation in the clinic, but they heal within one week,” Kunonya said.

Expert opinion
A medical worker on routine ward duty at Mulago Hospital who preferred to speak on condition of anonymity described Izimba’s condition as “gangrene.” This means that blood supply to the penis has been cut off, evidenced by the pale skin.

“I suspect they injected certain drugs in the penile vein which blocked the supply of the blood to the penis, rendering the skin dry, causing the rotting,” the medical doctor says. He, however, says there is hope with plastic surgery to reconstruct the penis, to enable him pass urine, but not fulfill his conjugal rights. ... Izimba is married with two wives and seven children. ...

GUANGZHOU, CHINA: man loses penis after botched circumcision

Malaysia Chronicle
July 7, 2013

by

A 30-year-old man in Guangzhou has been forced to have his penis amputated after experiencing complications following what he believes to have been a botched circumcision operation and subsequent treatment. The dispute has become public after the orthopedic clinic where he was circumcised failed to reach a settlement with the man regarding compensation.?

The man, surnamed Liu, uploaded numerous pictures of his penis on Weibo, seeking help from the public.

Liu went to the Jiahan orthopedic hospital for a circumcision procedure on May 23. After the surgery, Liu experienced an edema or swelling in his penis. The doctor and his assistant told him this was a normal reaction after the surgery.

On June 6, Liu returned to the hospital for microwave radiation treatment and said the radiation light had been placed as close as 30 millimeters to his penis.

On the evening of June 7, Liu found that the tip of his penis had started turning dark, and two days later his entire penis turned black.

"I kept asking the hospital to transfer me to another hospital, but they kept turning me down at first," Liu said, adding that he had missed the optimal time for the problem to be treated.

The hospital, Liu said, not only refused to pay him the US$490,000 he requested in compensation, but also "threatened me and my wife."

Another hospital that performed the surgery to remove Liu's penis said it was not sure whether this would affect Liu's fertility.

EASTERN CAPE: 263 Circumcision injuries - "a crisis"

IOL (South Africa)
July 5, 2013

ECape circumcision situation a 'crisis'

Port Elizabeth - The influx of patients with circumcision-related injuries to Eastern Cape hospitals is a crisis, health MEC Sicelo Gqobana said on Friday.

“He described the situation as a crisis. Overall in the province there are 263 people who are being treated in hospitals for circumcision-related complications,” provincial health spokesman Sizwe Kupelo said.

The MEC visited the Mthatha General and St Barnabas hospitals on Friday to assess initiates who required immediate medical care.

He found many of the boys suffered from dehydration, gangrene, and septic wounds. Some had lost their genitals.

“He is going to make a strong recommendation (to deal with the situation) to the provincial cabinet,” Kupelo said.

“He will also consult the chair of the house of traditional leaders and the MEC for local government.”

Kupelo said the doctors and staff at the hospitals told Gqobana they had been “emotionally affected” by the extent of the injuries.

“The doctors and even the workers require counselling.”

He said the growing number of initiate patients was putting pressure on the hospitals, as the boys had to be given priority over other patients.

The health department concluded that the initiation season had been “hijacked by people motivated by greed”.

INDIA: 7-year-old castrated in botched circumcision, fighting for life

The Times of India
November 23, 2012

7-year-old loses genitals after circumcision, fighting for life

By Rajendra Sharma
ALWAR: A seven-year-old boy is battling for life after a circumcision surgery went horribly wrong at a private hospital in Alwar on Thursday. The boy's genitals had to be cut off in an attempt to save his life, said sources. An FIR has been lodged against the hospital authorities after the relatives of the boy created a ruckus.

The boy, Imran, was admitted to Sania hospital in Alwar town on November 10 for circumcision. According to sources, after the operation, some equipment was used to prevent bleeding. However, electric current accidentally passed into his private parts and the boy suffered serious injury. [In other words, they used monopole electrocautery and cooked his penis from the inside. This is malpractice.] On November 13, the boy was referred to a private hospital in Jaipur. After investigating the case, the doctors in Jaipur advised the boy's relatives to remove his genitals as it was necessary to save his life. The operation was conducted and his genitals were removed. Three days after the operation, the boy was again admitted to Sania hospital in Alwar.

The boy is now fighting for life while his relatives are protesting outside the hospital in Alwar.

Imran's grandfather Ayub Khan said: "The circumcision was carried out by Dr Tayyab Khan, a physician at Sania Hospital. He is not a surgeon. The licence of the hospital should be cancelled for carelessness."

Imran's uncle Fakruddin Khan said that the operation was to be completed in just 30 minutes but the doctors took four hours. "Two days after the circumcision, the doctors advised us to take the boy to Jaipur. When we took the boy to Jaipur, the doctors there immediately informed us that the boy's private parts were completely damaged and his genitals had to be removed. After operation, we tried to admit the boy in different hospitals but no hospital admitted him. The last option for us was Sania hospital. So we brought him here back after his genitals were removed in Jaipur."

However, denying the allegation, Dr Tayyab Khan said the circumcision was carried out by a surgeon Hariram Gupta. He said it was just an accident. [Just? Should the parents be relieved he wasn't castrated deliberately?]

Former minister Nasru Khan also reached the spot to calm down the situation but all his efforts went in vain. Nasru Khan and the protestors were involved in a heated argument at the spot. The protestors alleged that he was taking the side of the hospital.

The hospital administration assured the relatives of the boy that the hospital would bear the expenses of the boy's treatment. [His life is ruined. How will they treat that?]

KOREA: Medical benefits of castration - longer life; AAP policy expected soon

The AAP Task Force on Castration policy statement is expected soon

The Atlantic
September 25, 2012

Study: Castration Adds Years to Men's Lives

By Lindsay Abrams
PROBLEM: It's suspected that there is a biological trade-off between reproduction and longevity, the theory being that our mechanisms of repairing damaged genetic material are limited and thus relegated to the most evolutionarily advantageous repair work. Propagating our genes, it would follow, trumps living to see/attempting to control the lives of proceeding generations. The male sex hormone is implicated in this theory, and taking into account that fact that women tend to live significantly longer than men, may be responsible for limiting men's lifespan.

METHODOLOGY: Because sometimes you can't offer enough cash or college credit to put together a randomized control experiment, researchers did a (very) retrospective study of Korean eunuchs from the Chosun dynasty, which stretched from the late 14th to the early 20th century. The eunuchs, a class of nobles employed as guards at the royal palace, preserved their lineage through the adoption of castrated sons and kept detailed genealogical records, which the researchers cross-verified with other historical accounts.

RESULTS: Averaging a lifespan of 70 years, the eunuchs lived about 14 to 19 years longer than cohorts from a similar socio-economic background. The group of 81 eunuchs included three centenarians among their ranks -- making them 130 times more likely to celebrate their 100th birthday than, for example, men in the present-day U.S.

CONCLUSION: The seniority achieved by the eunuchs supports the theory that the male sex hormones decrease men's lifespan.

IMPLICATIONS: Another study that used data from a population in a mental hospital also indicates that castrated men live longer, although a third looking at castrati singers did not show an increase in lifespan along with their expanded vocal range. While these new findings may not be enough to make anyone seriously consider asking whether added years at the expense of one's genitals are worth living, they may lead to further understanding of the relationship between reproduction and aging.

The full study, "Lifespan of Korean Eunuchs" is published in the journal Current Biology.

[IntactByDefault has taken this, um, ball and run with it.]