| Chapter 1: | Introduction |
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Prevailing rhetoric, therefore, not medical necessity, required surgical adjustment. As proof of this, John Money, the father of the medical paradigm once accepted without question for the treatment of intersexuality, wrote, along with co-author Patricia Tucker, in the book, Sexual Signatures, that “at the minimum extreme, an erect penis must be something over two and a half inches in length to penetrate far enough into a vagina for a man to begin to feel satisfied with what he can do for his partner…not being able to reciprocate in coitus can inflict terrible wounds on his ego” (56).
Despite the fact that genitals vary a great deal, the medical discourse surrounding intersexuality had in place for some time a measurement for normal based on cultural norms, and enforced by rhetoric, that rarely had anything to do with ensuring the physical well-being of the patient, aside from ego. As a result, in many cases those children otherwise healthy but perhaps with a clitoris too large or a penis too small were diagnosed as intersexual and then repaired or “normalized.” Perception, therefore, driven by discursive norms, was as much a factor as chromosomes.
One example to further illustrate this can be found in the treatment of 5-Alpha-Reductase (5-AR) Deficiency, made infamous by Jeffrey Eugenides’ 2002 novel, Middlesex. 5-AR affects only a limited population, one in which incest seems to be highly prevalent, and it has been documented as occurring quite frequently among some living in the Dominican Republic and among the Sambia people of New Guinea (Herdt 68). In this condition, children are born male, having both an XY chromosomal makeup and testicular gonad tissue. However, they lack the enzyme 5-alpha-reductase, so their bodies cannot convert testosterone into the dihydrotesterone necessary to create male genitalia. As a result, they are born with female-looking genitalia, including what appears to be “a short vagina and apparent labia and clitoris” (Dreger, Hermaphrodites 39).