Short boys and tall girls, issues of consent
A friend pointed me at this blog post which is itself a review of another blog post about a book called Normal at any cost: Tall Girls, Short Boys, and the Attempt to Manipulate Height. However, the post I linked to goes into some other topics that are more closely related to, "Normal at any cost". Things such as Intersexed babies and fat acceptance.
Humans are a social creature, so the acceptance of our peers matters quite a lot. Standing out of the crowd is an invitation to mockery, especially among pre-ethical children, and no parent wants to put their child through that if they don't have to. If the standing out is due to something medical that can be fixed, the more well to do will fix it medically.
Some things stand out more than others. The 5th grade boy who looks like a 2nd grader, will stand out and get mocked. The 5th grade boy who uses the stall to pee every time because his ureter doesn't go all the way to the end of his penis, an intersex condition, can hide it very easily.
The protocol for handling Intersexed babies is changing these days. Not very long ago, it was standard practice to assign them to a sex by way of surgery; most intersexed babies ended up girls because a fully functional penis is something that you can't make without a good start already. These days there is a strong move afoot to wait until the child is old enough to participate in the decision making process.
Shortness has many causes. In my particular case it was because of a partially deficient pituitary gland, which meant it didn't produce enough growth hormone for me to realize my full height potential. Late onset puberty can be a cause, as the pubescent growth spurt can arrive when the skeletal growth plates are closing. Short can also be completely genetic, in that your maximum possible height may very well be 5th percentile for height. Two of these are treatable these days. Unlike intersex, treatment is best started just before and during the onset of puberty in order to maximize the growth spurt, so the decision to do something about it is made during the teens.
There is another thing that the linked blog post doesn't go into but falls into the same category. Gender dysphoria. As with intersexed babies, the standard response for handling children firmly believing they are somehow the other sex than they were born with was to try and train them into acting like their own sex. In recent years that has begun to change in some areas, where puberty is postponed through drugs so the child can get enough maturity to participate in the decision making process.
The complications of assigning babies to a sex shortly after birth has become more visible now that the internet is around for such adults to meet and talk. The young 29 year old man who experiences very painful erections because a constructed urethra that was long enough at age 9, can't stretch far enough at age 29. Baby girls who had an abnormally large clitoris pared down to more normal sizes report problems with sensation during sex as an adult. It is the adults who've lived with these complications that have helped shift the policy towards such infants.
The complications of training children who express gender dysphoric thoughts and behaviors into behaving in more orthodox ways have also come to light with the advent of the internet. The narratives of some adults seeking to transition to the other gender, usually born male, very frequently include attempts by parents to nudge them into more gender-orthodox behaviors as a small child; most of these narratives also include the phrase, "instead I just learned to hide my feelings." There have been several books on the subject that describe the clinical practices designed to correct children, with the most flagrant examples coming from the 1970's and 80's. In the wake of the removal of Homosexuality from the DSM, such clinics did a quiet business under the rubric of making sure the girly boy turned into a manly boy and thus (shh) didn't grow up to be gay.
The effects of stature is a new one on me. I hadn't heard that some girls were getting treated for becoming too tall. Any treatment for stature has to happen while the body is still growing, so it has to start young. Men who are unusually short are not taken as seriously as those who are just far enough above normal to loom over most other men. Tall women have trouble finding men to date, as the cultural assumption of the man must be taller than the woman is a fairly strong one; an inch or two taller may be OK, but half a foot is too much.
All three of these are areas where the parent is making permanent,body altering decisions on the part of their child. The motives of parents choosing to do these things to their child are all good ones. The intersexed baby will always know what they are, and as an adult will not have to deal with an unusual genital configuration scaring off partners, therefore preserving self esteem and thus ease their life. The short child will be made taller, to more efficiently move through society and thus ease their life. The gender dysphoric child will be taught how to behave, so they don't turn into transsexuals when they grow older, and have to lead that sad, sad life, and thus ease their life.
All three of these are areas where the only, or most effective, treatment is available before the child is of legal decision making age. To get the most benefit from fixing an intersexed condition, the change has to be made before the child even knows there is a difference, or keep reminding them as they grow up that 'different is OK'. To get the most benefit from height treatments, you have to administer such treatments when the child is still able to grow. To fix gender dysphoria, you either have to educate them in correct gender roles before such learning is cemented (which is generally around age 7), or start hormone treatments before the onset of puberty.
To what extent do you involve a child in a decision that will change their body for life? For height and gender issues, such decisions have to be made before the onset of puberty, which means very early teens. For children with an intersex condition, the decision can be made at any time. Are children that age even capable of fully comprehending the entire issue? Legally speaking, the parents have this right until the child turns 18.
Gender issues and intersex conditions are both things that have remediation possibilities later in life. The argument for correcting an intersex condition is largely predicated on fixing it early so the child never knew there was a problem, but urological issues can also force the need. Gender transition later in life is a documented process that involves counseling, hormone treatments to shift the body into a more correct shape, and surgery to fix the things that just hormones can't. Doing the gender transition before puberty allows the body to undergo puberty as the 'correct' gender, which allows the bones to grow in patterns correct for the new gender and results in a much more gender-orthodox body shape than an adult transition.
Overall I'm in favor of involving the child in the decision making process. As all of these issues can be addressed in the early teens, the child should already have a well formed view of the world and how they fit within it and can contribute to the discussion. In the case of the gender dysphoric child, they've already communicated their desires as that's how the condition is largely diagnosed.
Talking about these issues can help foster a sense of self autonomy that children will need as independent adults. Control of your own body is a very important sense to have. I've heard people being critical of parents who pierce their daughter's ears while they're still infants, insisting that the girl should make that decision for herself. I think such things extend to larger issues such as stature, explaining during sex, and what body they want as an adult.
Humans are a social creature, so the acceptance of our peers matters quite a lot. Standing out of the crowd is an invitation to mockery, especially among pre-ethical children, and no parent wants to put their child through that if they don't have to. If the standing out is due to something medical that can be fixed, the more well to do will fix it medically.
Some things stand out more than others. The 5th grade boy who looks like a 2nd grader, will stand out and get mocked. The 5th grade boy who uses the stall to pee every time because his ureter doesn't go all the way to the end of his penis, an intersex condition, can hide it very easily.
The protocol for handling Intersexed babies is changing these days. Not very long ago, it was standard practice to assign them to a sex by way of surgery; most intersexed babies ended up girls because a fully functional penis is something that you can't make without a good start already. These days there is a strong move afoot to wait until the child is old enough to participate in the decision making process.
Shortness has many causes. In my particular case it was because of a partially deficient pituitary gland, which meant it didn't produce enough growth hormone for me to realize my full height potential. Late onset puberty can be a cause, as the pubescent growth spurt can arrive when the skeletal growth plates are closing. Short can also be completely genetic, in that your maximum possible height may very well be 5th percentile for height. Two of these are treatable these days. Unlike intersex, treatment is best started just before and during the onset of puberty in order to maximize the growth spurt, so the decision to do something about it is made during the teens.
There is another thing that the linked blog post doesn't go into but falls into the same category. Gender dysphoria. As with intersexed babies, the standard response for handling children firmly believing they are somehow the other sex than they were born with was to try and train them into acting like their own sex. In recent years that has begun to change in some areas, where puberty is postponed through drugs so the child can get enough maturity to participate in the decision making process.
The complications of assigning babies to a sex shortly after birth has become more visible now that the internet is around for such adults to meet and talk. The young 29 year old man who experiences very painful erections because a constructed urethra that was long enough at age 9, can't stretch far enough at age 29. Baby girls who had an abnormally large clitoris pared down to more normal sizes report problems with sensation during sex as an adult. It is the adults who've lived with these complications that have helped shift the policy towards such infants.
The complications of training children who express gender dysphoric thoughts and behaviors into behaving in more orthodox ways have also come to light with the advent of the internet. The narratives of some adults seeking to transition to the other gender, usually born male, very frequently include attempts by parents to nudge them into more gender-orthodox behaviors as a small child; most of these narratives also include the phrase, "instead I just learned to hide my feelings." There have been several books on the subject that describe the clinical practices designed to correct children, with the most flagrant examples coming from the 1970's and 80's. In the wake of the removal of Homosexuality from the DSM, such clinics did a quiet business under the rubric of making sure the girly boy turned into a manly boy and thus (shh) didn't grow up to be gay.
The effects of stature is a new one on me. I hadn't heard that some girls were getting treated for becoming too tall. Any treatment for stature has to happen while the body is still growing, so it has to start young. Men who are unusually short are not taken as seriously as those who are just far enough above normal to loom over most other men. Tall women have trouble finding men to date, as the cultural assumption of the man must be taller than the woman is a fairly strong one; an inch or two taller may be OK, but half a foot is too much.
All three of these are areas where the parent is making permanent,body altering decisions on the part of their child. The motives of parents choosing to do these things to their child are all good ones. The intersexed baby will always know what they are, and as an adult will not have to deal with an unusual genital configuration scaring off partners, therefore preserving self esteem and thus ease their life. The short child will be made taller, to more efficiently move through society and thus ease their life. The gender dysphoric child will be taught how to behave, so they don't turn into transsexuals when they grow older, and have to lead that sad, sad life, and thus ease their life.
All three of these are areas where the only, or most effective, treatment is available before the child is of legal decision making age. To get the most benefit from fixing an intersexed condition, the change has to be made before the child even knows there is a difference, or keep reminding them as they grow up that 'different is OK'. To get the most benefit from height treatments, you have to administer such treatments when the child is still able to grow. To fix gender dysphoria, you either have to educate them in correct gender roles before such learning is cemented (which is generally around age 7), or start hormone treatments before the onset of puberty.
To what extent do you involve a child in a decision that will change their body for life? For height and gender issues, such decisions have to be made before the onset of puberty, which means very early teens. For children with an intersex condition, the decision can be made at any time. Are children that age even capable of fully comprehending the entire issue? Legally speaking, the parents have this right until the child turns 18.
Gender issues and intersex conditions are both things that have remediation possibilities later in life. The argument for correcting an intersex condition is largely predicated on fixing it early so the child never knew there was a problem, but urological issues can also force the need. Gender transition later in life is a documented process that involves counseling, hormone treatments to shift the body into a more correct shape, and surgery to fix the things that just hormones can't. Doing the gender transition before puberty allows the body to undergo puberty as the 'correct' gender, which allows the bones to grow in patterns correct for the new gender and results in a much more gender-orthodox body shape than an adult transition.
Overall I'm in favor of involving the child in the decision making process. As all of these issues can be addressed in the early teens, the child should already have a well formed view of the world and how they fit within it and can contribute to the discussion. In the case of the gender dysphoric child, they've already communicated their desires as that's how the condition is largely diagnosed.
Talking about these issues can help foster a sense of self autonomy that children will need as independent adults. Control of your own body is a very important sense to have. I've heard people being critical of parents who pierce their daughter's ears while they're still infants, insisting that the girl should make that decision for herself. I think such things extend to larger issues such as stature, explaining during sex, and what body they want as an adult.
posted by Corwin at 12:36 PM
0 comments
