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How Should Parents Identify the Gender of Children With Ambiguous Genitalia?
Ambiguous genitalia are a biological phenomenon when a child is born with signs of both sexes. Often in such condition, a person has genitals that are difficult to define clearly as male or female. Intersexuality is not so much a medical problem as it involves psychological complications and barriers to socialization for both the child and his or her family. When parents have children with ambiguous genitalia, they face a difficult choice and decide which sex to assign to their child. While deciding on this step, they should be fully aware of the consequences that their decision may have in the future, because after becoming a teenager, the child may feel uncomfortable in the gender role that parents defined or even get a psychological trauma after interventions to correct his or her sex.
First of all, it is necessary to understand the difficult situation in which the parents find themselves when they have a child with ambiguous genitalia. The news that a newborn has some deviations in physical development always makes parents worry and feel stressed, but in the case of this rare phenomenon, they even can experience shock and anxiety from the unknown, what they should do now. On the one hand, they strive to provide their child with the necessary support and protection. On the other hand, they find it difficult to cope with the unknown and shocking situation for them and are experiencing heightened anxiety (SANDERS, CARTER, GOODACRE & ARMSTRONG, 2009). In this case, the parents of a child with this condition should be fully informed by medical specialists about the problem, their duty to make a decision, and what consequences their choice may have. Also, they must receive the necessary psychological help so that they can accept the diagnosis of their baby and think through the best solution.
In general, the decision of the parents depends on many factors. For starters, a leading physician plays a significant role in it as he or she can persuade a couple to benefit one or another gender, and also convince them that surgical intervention is necessary at a very early age. Another factor is the understanding of the gender role of the child in society, which can also significantly affect the parents. However, as some studies show, in most cases, parents hold their personal opinions and beliefs regarding the sex of their child (Oliveira, de Paiva-e-Silva, Guerra-Junior & Maciel-Guerra, 2015). Such predisposition can be based on the previous desire of the couple to have a girl or boy, as well as the first impression after the birth of the child whether it is he or she.
In any case, parents should not take such a responsible decision on their own, although most of the responsibility and the right to vote refer to them. From the very birth of a child, a personal doctor should not only conduct a survey, keep a medical history, and monitor the health of a baby, but also work with the family and support the members in every possible way. At the same time, the doctor must carry out the necessary diagnostic procedures, such as ultrasound, a screening test for CAH, and hormonal research, to then report the results to the parents (“Ambiguous Genitalia – Children’s National Health System,” 2017). These data should notify the parents to which sex their child is predisposed more, what actions are reasonable in the current situation, and, based on this, help them make the right decision.
As with any other physical deviations from the commonly accepted norms of the human body, doctors often recommend that parents apply for surgical care for their child in order to convert the genitals into masculine or feminine. This practice is widespread and rarely questioned. However, except the rare cases when an operation is essential for the healthy functioning of vital organs, people with ambiguous genitalia do not experience significant difficulties associated with their diagnosis and can live with it comfortably. Moreover, if some intersex people successfully survive the intervention and live a full life afterward, others talk about the operation as a traumatic experience and regret it (“I Want to Be Like Nature Made Me,” 2017). That is another factor that parents should bear in mind when dealing with this problem.
In connection with what was said before, parents are even more confused. Usually, the fear that their child at a later age may face ridicule, misunderstanding, and even bullying causes them to agree to a surgical intervention when their baby is at a very young age. They hope that for their child it will be easier to transfer such an operation than in the next to be rejected by peers, to be shy of one’s body, and to suffer from uncertainty and insecurity. But the growing number of evidence that cosmetic surgery is most often improvident and unreasonable for newborns can make them think again (Beh & Diamond, 2005, p. 5-30). However, in most cases, the intervention can be carried out at a later age, which gives parents more time to think, especially when they can observe the manifestation of habits and features of the child peculiar for the male or female.
Unfortunately, even taking into account all the described factors, recommendations, and features, parents are not always able to make the right choice. It happens that at an early age, intersexual children have more pronounced signs of one sex, but at an older age, after the puberty, the signs of another gender become much more noticeable. Therefore, it is challenging for parents to make a decision that would be successful in the long term and would suit the child in the future. As some surveys show, in some cases, parents manage to guess and choose the right sex for the child, but in others, there is a high probability that the intersex people will feel uncomfortable in their own body (“A patient’s view of ambiguous genitalia,” 2002). Thus, there is no guarantee that parents can correctly determine the future life of their baby by choosing a particular gender.
Overall, the condition of ambiguous genitalia is a rare phenomenon occurred in a person since birth, which is a complicated moral choice for parents and imposes a great responsibility on them. Despite the determination of the family, there is always a chance that the decision and surgical intervention can become a traumatic experience for the intersex person and negatively affect his or her entire life. Therefore, when identifying the gender for a child, parents should take in consideration a lot of factors, such as doctors’ advice and health indicators, weigh the pros and cons, and take the time to make the best long-term decision.
A patient’s view of ambiguous genitalia. (2002). Aissg.org. Retrieved 25 December 2017, from http://www.aissg.org/articles/PISA.HTM
Ambiguous Genitalia – Children’s National Health System. (2017). Retrieved 25 December 2017, from https://childrensnational.org/choose-childrens/conditions-and-treatments/diabetes-hormonal-disorders/ambiguous-genitalia
Beh, H., & Diamond, M. (2005). David Reimer’s Legacy: Limiting parental discretion. Cardozo Journal Of Law & Gender, 12(1), 5-30.
Oliveira, M., de Paiva-e-Silva, R., Guerra-Junior, G., & Maciel-Guerra, A. (2015). Parents’ experiences of having a baby with ambiguous genitalia. Journal Of Pediatric Endocrinology And Metabolism, 28(7-8). http://dx.doi.org/10.1515/jpem-2014-0457
SANDERS, C., CARTER, B., GOODACRE, L., & ARMSTRONG, A. (2009). Parents Of Children With Ambiguous Genitalia: Stories Of Experiences Of Reconstructive Genital Surgeries And Finding Harmony. Journal Of Pediatric Urology, 5, S95. http://dx.doi.org/10.1016/j.jpurol.2009.02.170
“I Want to Be Like Nature Made Me” | Medically Unnecessary Surgeries on Intersex Children in the US. (2017). Human Rights Watch. Retrieved 25 December 2017, from https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-me/medically-unnecessary-surgeries-intersex-children-us