Local activists question a Cornell doctor’s surgeries
By Stephanie Black
here has been an overwhelming amount of concern among feminists and human rights activists in the United States surrounding what is known in Western cultures as “female genital mutilation.” These procedures are commonly done out of the fear of “abnormal” sexual development of a child, specifically when children are born with a larger-than-average clitoris.
Most people think of the issue in relation to Third World countries, but controversies surrounding a Cornell doctor have brought the issue to Ithaca.
The main question behind all of this is, as Anne Tamar-Mattis of Advocates for Informed Choice said, “What can we do to children’s bodies, and what can’t we do to children’s bodies?”
At Cornell University, Dr. Dix Poppas of the Weil Medical College has recently come under the scrutiny of human rights groups and feminists. As a prominent urologist and talented surgeon, Poppas performs common genital reconstruction surgeries on intersex infants and young children; but it is his unorthodox research methods after the fact that are stirring controversy. Focusing on female reconstructive surgery, Poppas follows up his surgeries annually by testing the young girls, stimulating them in their genital region with Q-tips or a “medical vibratory device” and asking them to tell him their feeling intensity on a scale of one to five.
Protected by medical institutions and professionals but called out by activists including intersex people, Poppas is one of many doctors in the nation who are conducting this type of research. The question remains, however: What is the line between treating a patient like a human being and an object of invasive research?
Abnormalities of the genital area are commonly referred to as disorders of sex development (DSD). One disease of particular concern is congenital adrenal hyperplasia (CAH), which can be fatal. Children born with CAH or other DSD can also be intersex, a term applied to a person born with sex organs that are not typical of males or females.
Female genital cutting, according to Ithaca College politics professor Peyi Soyinka-Airewele, is often accepted and even considered a social norm in other parts of the world, namely Asia and Africa. In some cultures, it is considered a part of the celebration of coming into womanhood, much like how male circumcision is common in the United States. While there are some instances where female genital cutting is detrimental and could be considered a human rights violation, most often the practice is just a normal part of life.
In Western cultures, the alteration of female genitalia holds a severe and confusing double standard: While the removal or cutting of the clitoris, as what has been deemed “female genital mutilation,” is considered to be a human rights infringement, the alteration of the genital area for cosmetic purposes is increasing with surgeries such as labioplasties and vaginal-tightening procedures. Some women are willing to do the latter but fail to take into consideration that they too, in fact, are “mutilating” their own genitals.
“What’s the difference?” Soyinka-Airewele said. “It’s the same thing.”
These kinds of issues reveal that people living in affluence in the First World have a warped sense of what is normal and what is abnormal in terms of cultural practices.
On Oct. 4, 2010, Cornell University hosted a panel discussion led by Carla Golden, professor of psychology at Ithaca College. Entitled “Differences or Disorders,” the panel sought to discuss the issues surrounding Poppas’ and his colleagues’ research, determining what is right and wrong socially.
The three other women on the panel were Janet Green of Accord Alliance, Ellen Feder of American University and Anne Tamar-Mattis, founder of Advocates for Informed Choice. Representing Weil Medical College and present to give Cornell University’s official statement on the issue was Dr. Ralph Nachman, professor of medicine and associate dean of clinical research.
The panel focused on what society perceives as normal and abnormal. They all asked the same question: “Why does it matter?”
The women of the panel spoke with great emotion about patient advocacy and the protection and support of intersex children. They had personal attachments to the problem of medical research conducted on individuals considered abnormal by doctors and society. The panelists, especially Green and Tamar-Mattis, spoke passionately about how their own lives were directly influenced by the intersex community and medical research. Green, born with CAH and a member of the intersex community, grew up being told that she was the only person in the world with her condition.
When speaking about self-esteem and how people born with physical discrepancies think of themselves, Green said, “It is important that you live your life, that you treat your body with the highest regard.”
Infants and young children, however, cannot grow up loving themselves if they are altered and operated on from birth. They have no choice, no ability to make the life-altering decision of surgery.
Even so, Nachman defended Poppas and his research for medical and other purposes, asserting that what he is doing is a standard clinical procedure.
“Clearly, the surgery he performed was a clinical activity,” Nachman said.
The issue still remains about the follow-up research activities. Tamar-Mattis, a lawyer who has an intersex partner, expressed her concern that the real problem is that the children are not being treated like human beings.
“I’ve become very worried about intersex children when they become objects of research,” Tamar-Mattis said.
While it may seem that doctors take advantage of children and their families, regional pediatricians actually refer parents to Poppas from all around the world. More often than not, parents have the best interest of their child at heart, but they are frightened about how their child will be received in society because of the physical difference. Parents agree to this surgery and research because they want their children to have happy, normal lives.
However, as Feder asked, “Why would parents consent to procedures on behalf of their children when they would refuse the procedure themselves?”
The surgery Poppas performs on infants with CAH benefits their health; however, it puts the infants who are healthy but “abnormal” at risk of psychological damage from the testing and objectification that follows.
It is not ethical to treat patients like research objects instead of human beings. The children do not determine whether they will receive surgery—their parents do. Sometimes, parents do not know what is best for their children.
Is gender identity still such a pressing problem that parents are not comfortable simply accepting their children for their differences? As Green said, “Each of us deserves to feel loved and respected for who we are.”
Stephanie Black is a freshman drama major. E-mail her at firstname.lastname@example.org.