Posted by nastypup at pcp04985504pcs.benslm01.pa.comcast.net on January 24, 2004 at 00:10:52:
females! This is worse than a horror flick! Can you imagine being born a male and some doctor deciding you'd be better off as a female because your dick is too small? So you get "assigned" as a female and they castrate you, create what looks like female genitalia and give you female hormones for the rest of your life. This isn't some backward country -- it's right here in the good old USA! I wonder how many years this idiotic practice existed before the doctors concluded that it didn't work? Read this article from the New England Journal of Medicine.
"Genetic Males Often Self-Identify as Male Despite Female Assignment"
By Karla Gale
NEW YORK (Reuters Health) Jan 21 - Males born with severe phallic inadequacy are often assigned at birth to the female sex. Over time, many of these individuals assume a male identity, despite hormonal treatments and rearing practices, investigators report in The New England Journal of Medicine for January 22nd.
"The idea that you can raise a child from birth as a particular sex and the child will become that sex is an extraordinarily new idea," co-author Dr. William G. Reiner told Reuters Health. "For genetic males exposed to normal amounts of male hormones in utero, it looks like a substantial number of them are going to recognize that they are male, no matter what you do."
Dr. Reiner and Dr. John P. Gearhart, both at Johns Hopkins Medical Institutions in Baltimore, assessed 16 genetic males treated at their cloacal-exstrophy clinic. This condition is caused by a developmental defect in pelvic embryogenesis, they explain, with normal prenatal androgen levels and normal testes. The recent emphasis on postnatal, nonhormonal influences has led physicians to assign genetic males to the female sex.
Fourteen in their cohort had undergone orchiectomy and construction of vulvae soon after birth. Two subjects were reared as males because of parent preference. When the children were between 5 and 16 years old, the authors questioned parents and subjects themselves regarding their psychosexual development and sexual identity. Annual interviews were conducted during follow-up of 34 to 98 months.
Eight subjects declared "unwavering male identity," four after being told about their birth status and four spontaneously between ages 7 and 12. One refused to discuss sexual identity after being told about the birth condition.
Those wishing to live as males used male restrooms when they were away from their families and school, and all eight expressed a desire for surgical penis construction. Moreover, parents found that children seemed to be happier since undergoing transition to the male sex.
Five subjects, none of whom were told of their birth status, maintained a female identity throughout follow-up. They kept their female names and always used female bathrooms.
However, all 16 subjects displayed "moderate-to-marked male-typical behaviors," the investigators write. For example, they were more aggressive, they did not play with dolls and they had difficulty fitting in with girls, but not with boys. The children did not want to dress in girl's clothes after about age 4.
Dr. Reiner, currently at the University of Oklahoma in Oklahoma City, recommends that genital reconstruction surgery be delayed in these infants. "You're making enormous assumptions in a newborn that you can't substantiate," he said. "The only way to substantiate anything in a newborn is to wait until they're older." He believes that all of these genetic males will eventually want surgery to construct a penis.
Waiting also means that more of these patients will have their natural testes, he added, thus avoiding the need for lifelong hormone replacement therapy.
In an editorial, Dr. Daniel D. Federman notes that these findings point "strongly to a hormonal role in the sexualization of the brain."
Because medicine recognizes gender differences in the epidemiology, clinical manifestations, and treatment of disease, he believes health professionals "should be interested in the effects of sex differences in the earliest stages of development and in the entire course of patients' lives."
Dr. Federman is based at Harvard Medical School in Boston.
N Engl J Med 2004;350:323-324,333-341.