NIGERIA: "Girl" found to be intersexed at circumcision

Sun News Online
July 4, 2014

Baby born with female, male sex organs

by Gilbert Ekezie and Doris Obinna
When little Success Chisom Aniekwe was born one year ago, joy filled the hearts of his parents, Mr. & Mrs. Emmanuel Aniekwe, from Anam Community, in Anambra West Local Government Area of Anambra State. He was a chubby baby, full of life.However, the baby’s birth took a twist about eight days thereafter, when it was discovered that he had two sex organs, male and female. Ever since, pain has become a constant companion of the baby.

Now frail, with constant pain, especially when urinating, which comes through what would pass for female private part, under a little penis, the baby has been in and out of hospital, where tests and surgeries have been recommended.

Recounting her predicament, mother of the baby, Mrs. Chekwube Aniekwe, told Daily Sun that the scan she did, while pregnant, showed that the baby was a girl. She, however, stated that her confusion started when the woman, who gave the baby its first bath said the sex organ was not pronounced. The confusion increased when the mother moved to circumcise the baby, as the family wanted to circumcise its female children.

“Eight days of the baby’s birth, we went for the circumcision, when the woman noticed that my baby had both male and female organs. When the woman wanted to cut her clitoris, she said the baby was not a girl. She advised us to go back to his hospital of birth,” she stated

[So would that have been a cruel mutilation intended to destroy her sexuality forever, or a healthy medical procedure with lifelong benefits for every boy and man? Inquiring minds want to know.]

The confused mother of three explained that she went back to the hospital, where the medical director examined the baby.

She said: “When the doctor looked at the baby’s case, he quickly referred us to Lagos State University Teaching Hospital. When we got there, we were made to understand that we needed to do some tests before surgeries could be done to correct the anomaly. At the hospital, a pharmacist directed us to Isolo General Hospital. On getting to there, they said they could not handle the case.”
The parents’ quest for solution did not stop there, as they also went to the Lagos University Teaching Hospital, LUTH.

Mrs. Aniekwe said: “When we got LUTH, we were told surgeries were needed but would come only after some tests. We have not been able to do the tests because of lack of finance.”

“The last time we went to LUTH was in December 2013. At that time, one of the specialists told us that there would likely be two surgeries. We were also asked to do a hormone test to know whether the baby has womb, to know if another surgery would be added.”
...

“We made several attempts to raise money for the necessary tests but we could not and that is why we have not gone back to the hospital till now. Presently, we do not know what it would cost us to do the tests and the surgeries,” she stated.

The woman further explained her baby’s condition has caused the family a lot of pain and embarrassment. “I am being embarrassed by the problem of the baby. Everywhere, I go, people get confused, as to whether the baby is a boy or girl. Initially, I used to dress the baby like girl. I also pierced the ears and put earrings. But as time passed, the baby’s look changed to that of a boy. People tell me my baby resembles a boy. Within me, I know that there is a problem. It was when the face started changing to a boy that I started giving him a hair-cut and dressing him like a boy, even when the ears are pierced,” she stated.

Her husband, Emmanuel, described the case as a very serious challenge that has confronted the family. He, however, expressed optimism that surgeries, as doctors have recommended, would remedy the situation.

“I will be very grateful if I could be assisted financially, so that the surgeries would be done. The baby is always in pains and too tender to be undergoing such. ...

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

SOUTH CAROLINA: Surgery on intersexed child could be unconstitutional

Southern Poverty Law Center
August 23, 2013

Federal court says sex-assignment surgery on child could violate U.S. Constitution, refuses to dismiss case

by

For the first time, a federal court has concluded that a medically unnecessary sex-assignment surgery on a child with an intersex condition could be a violation of the Constitution. This marks an important step forward in seeking justice for “M.C.,” a young man who was needlessly subjected to the procedure as an infant in the care of the South Carolina Department of Social Services.

U.S. District Judge David C. Norton of the South Carolina Charleston Division denied a motion by the defendants to dismiss the case, ruling from the bench following oral arguments late yesterday.

"We applaud the court's decision and we are pleased that the court will have the opportunity to consider the deeply important constitutional issues at stake,” said Alesdair Ittelson, staff attorney for the SPLC. “By removing M.C.'s healthy body parts and trying to make him a girl absent any pressing reason, defendants violated M.C.'s constitutional rights. We look forward to the chance to make our case at trial and bring justice to M.C. and children like him."

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.

The defendants made this 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. Defendants did not even provide a hearing to determine whether the procedure was in M.C.'s best interests. M.C. has since grown into a healthy 8-year-old boy, although he will never get back the phallus and testicle that were removed.

The SPLC and co-counsel, Advocates for Informed Choice and the private firms Janet, Jenner & Suggs LLC and Steptoe & Johnson LLP, filed lawsuits in both state and federal courts in May.

Earlier story

SOUTH CAROLINA: Parents want child's sex assignment surgery case to set precedent

Post and Courier (South Carolina)
May 15, 2013

Parents sue MUSC, others for performing 'unnecessary' sex-assignment surgery on baby

by Lauren Sausser

Premature twin babies were born in Greenville on Nov. 20, 2004, each weighing less than 2 pounds.

What is intersex? Intersex, or disorders of sexual development, encompasses a variety of “conditions that lead to atypical development of physical sex characteristics,” according to the American Psychological Association. In layman's terms, many babies with intersex conditions are born with genitalia that resemble some combination of male and female reproductive organs. The American Psychological Association and the Intersex Society of North America acknowledge that it's hard to determine how many babies are born with intersex conditions, because the government does not track those statistics. “Here's what we do know: If you ask experts at medical centers how often a child is born so noticeably atypical in terms of genitalia that a specialist in sex differentiation is called in, the number comes out to about 1 in 1,500 to 1 in 2,000 births,” the society's website said.

Weeks after their birth, the twins' mother stopped visiting them in the hospital. She was nearly impossible to reach by phone, a Department of Social Services report noted. Their father wasn't around either, but the worst wasn't over yet.

One of the twins, a girl, eventually died. The second child, called M.C. in court records to protect his identity, spent 21/2 months in the Greenville Hospital System. The infant posed experts with a medical mystery. Doctors couldn't figure out if the baby was a boy or a girl.

On Tuesday, the Columbia couple who eventually adopted M.C. from state custody in 2006 filed what might be a one-of-a-kind lawsuit against the Medical University of South Carolina, DSS and the Greenville Hospital System. They say the defendants carried out an “irreversible, painful and medically unnecessary” sex-assignment operation on their son before he was old enough to choose a gender himself.

M.C. was born with a rare intersex condition called ovotesticular disorder of sexual development. It affects only one out of every 83,000 babies, the Intersex Society of North America estimates. He had parts of the male and female reproductive systems.

Court papers say physicians alternatively identified M.C. as male and female in medical records. There was no clear indication that the child was more male than female, or vice versa, at the time of the surgery in Charleston, the lawsuit alleges.

Surgeons removed evidence of M.C.'s male reproductive organs when he was 16 months old, but it is not clear why doctors ultimately decided on assigning the child as a female. Medical records included in the lawsuit show that physicians working with M.C. indicated there “was no compelling reason that she should be either male or female.”

The Crawfords initially raised M.C. as a girl, although, “It became clearer and clearer over time that he was letting us know that his gender was a boy,” Pam Crawford said in a telephone interview.

For example, he played with typical “boy toys,” wore boy clothes and always dressed up as a superhero for Halloween, his mother said.

Now, “M.C. is living as a boy with the support of his family, friends, school, religious leaders and pediatrician,” according to court records. He is in first grade. The Crawfords filed the medical malpractice lawsuit Tuesday morning in Richland County Common Pleas Court.

A separate federal lawsuit was filed in Charleston, alleging that M.C.'s constitutional “procedural due process rights to bodily integrity, privacy, procreation and liberty” were violated. The federal lawsuit names MUSC Drs. Ian Aaronson and Yaw Appiagyei-Dankah as defendants, as well as Dr. James Amrhein of Greenville Hospital System and former DSS Director Kim Aydlette.

Meredith Williams, Candi Davis, Mary Searcy, all DSS employees involved with M.C.'s case, and three other unidentified DSS employees, are also named as defendants. The lawsuits seek unspecified damages.

MUSC and the Greenville Hospital System issued statements saying that the hospitals would not comment on the pending litigation. A call to the Department of Social Services was not returned.

The lawsuit does not specify who paid for the surgery but alleges that the three doctors named as defendants “formed the treatment team that ultimately urged SCDSS officials that M.C. undergo sex assignment surgery in order to make his body appear female.” At the time of the operation, the child was in custody of the state, which authorized the recommended procedure.

The Crawfords said they hope to set a legal precedent that sex-assignment operations should not be performed until a child is old enough to make a choice.

“His choice has been taken from him. It's too late for our child. We want it to stop for other children,” Pam Crawford said.

Mark Crawford said the decision to make M.C.'s operation public wasn't easy, and the family is trying to protect their son's privacy during the court case.

“Developmentally, as appropriate, we'll try to explain these things. I think M.C. understands that his body was kind of in between male and female. ... I think he understands that's the way nature made him,” he said. “But when it comes to explaining surgery and lawsuits, that will have to wait.”

The lawsuit may be the first of its kind in the nation, according to lawyers for the Southern Poverty Law Center, a nonprofit group helping the Crawford family file the lawsuits.

Alison Piepmeier, director of Women's and Gender Studies at the College of Charleston, who is not involved in the Crawford case, said the lawsuits are evidence that gender-identity issues are being discussed more openly than ever before.

“There are a small but significant number of people born every year who are called intersex,” Piepmeier said. “What the experience that these folks show us is the categories that we assign — male and female — may be too limited.”

Earlier story

SOUTH CAROLINA: Parents sue state over intersex child's assignment surgery

WYFF News
May 14, 2013

State sued over 'hermaphrodite' toddler's sex surgery

COLUMBIA, SC (WIS) —A South Carolina couple is suing the state to challenge its decision to perform sexual-reassignment surgery on a toddler in its care who was born with both male and female internal sexual genitals.

Mark and Pam Crawford, adoptive parents of the now 8-year-old child, spoke to the media Tuesday morning about the lawsuits filed in partnership with the Southern Poverty Law Center in federal and state courts.

The Crawfords say the child was born with intersex condition, which means a person is born without sexual anatomy that fits the definition of a male or female.

The suit alleges the South Carolina Department of Social Services decided to perform "dangerous and mutilating surgery" in April, 2006 on the 16-month old to make the child a girl.

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

"Doctors decided to play God," said a SPLC representative Tuesday morning in front of the federal courthouse.

"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."

Pam Crawford said her son was operated on "simply to conform to society."

The Crawfords adopted the child, a few months after the surgery. They say he identifies himself as a boy to his pediatrician. Recently he asked for a boy's haircut and boy's clothing.

The lawsuit states 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."

At birth, the child was identified as a male because of his external genitalia, but shortly after that doctors discovered the baby had "ambiguous genitals" and both male and female internal reproductive structures, according to the lawsuit.

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 violates the child's right to privacy by deciding to go forward with the surgery. The state suit alleges medical malpractice and gross negligence.

According to the Intersex Society of North America, the condition is seen in approximately one in every 2,000 births.

The couple is suing for damages, but left the dollar amount up to the courts.

Attorneys said this may be the first lawsuit of its kind in the nation.

WISTV asked DSS for comment on the lawsuit, but they have not yet replied.

BERLIN: Intersex babies need not be assigned a sex

West-Info
February 26, 2013

A victory for intersex babies in Germany

by Mattia Rosini

There has been a small revolution for intersex babies in Germany. Born with a genetic [or other] condition that means they cannot be defined exclusively as male or female, because they have characteristics of both sexes, a new law allows their gender to remain unspecified on the birth certificate. The German government unanimously approved the amendment to the law on recording personal data at birth. Previously, the baby’s parents could choose which gender would appear on the birth certificate. However, the amendment doesn’t go far enough, according to the Ethical Council of Germany. It believes that parents of intersex children need more support and that gender reassignment surgery should be avoided.