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Appendix D
Women can be well adjusted with large clitorises
There is no evidence that these surgeries are required for healthy psychosocial development. Indeed, there are many counterexamples, of people who lived or are living happily without surgery.
Historian Alice Dreger has documented many male pseudo hermaphrodites who lived happily as women during the 19th century with atypical genitals intact (Dreger 1998 forthcoming-b).
Anne Fausto-Sterling documents 70 cases of children who grew up with ambiguous genitalia, most of whom seem to have developed ways of coping with their anatomical difference (Fausto-Sterling and Laurent 1994).
Hopkins surgeon Hugh Hampton Young documents a number of women with large clitorises who were sexually active and who rejected his offers of surgical correction (Fausto-Sterling 1993; Young 1937).
The video, Hermaphrodites Speak!, contains an interview (at 24:35 on the tape) with Hida Viloria, a young woman who discusses in a video interview how happy she is to have been able to keep her large clitoris intact (ISNA 1997).
Eli Nevada also discusses her relief at having escaped genital surgery (Nevada 1995).
"Despite a large clitoris [this patient] does not wish any [surgical] modifications to be made" (Patil and Hixson 1992).
Appendix E
Some male intersexuals raised female switch to male sex role
There is evidence that some male pseudo-hermaphrodites, even if raised female, even if subjected to genital surgery, and in spite of having an "inadequate" penis, will change sex role during adolescence or early adulthood, living as men rather than as women.
Money found that three (10%) of 23 patients who were male pseudo- hermaphrodites raised female switched to living as men as adults (Money, Devore, and Norman 1986). Dr. Howard Devore, a co-author of this study, is a clinical psychotherapist with extensive experience in assisting intersexual patients and parents of intersexual children. Dr. Devore is an outspoken opponent of early genital surgery and a member of ISNA's advisory board.
"In fact, present data is increasing that despite great care in rearing these [male pseudo hermaphrodites] as females, some, or perhaps many of them, have strong male tendencies or may even change their assigned sex when they reach 12 to 14 years of age" (Reiner 1997a, p224). Dr. Reiner is engaged in a prospective investigation of fifteen male pseudo hermaphrodites assigned and raised female, with early genital surgery. To date, two out of the seven who have reached adolescence have declared themselves male. The other eight are too young yet for any assessment (1997b). Reiner reports a similar case, without prospective investigation, in (Reiner 1996).
Even female pseudo-hermaphrodites assigned and reared female, with early genital surgery, are considerably likely to switch to living as men as adults (Meyer-Bahlburg et al. 1996).
The video tape "I Am What I Feel To Be" (Fama Film A.G. 1997) presents interviews in Spanish with a number of people who were born as male pseudo hermaphrodites, raised female, and later switched to live as men (Fama Film A.G. 1997).
Appendix F
Men can be well adjusted with small penises
Surgeons Justine Schober M.D. (neé Reilly) and C R J Woodhouse M.D. interviewed 20 patients who were diagnosed in infancy with micropenis. Twelve of these patients were adults (17 years of age or older) at the time of the interview. All had stretched penis length smaller than the 10th percentile one was only 4 cm (erect penis length cannot exceed stretched flaccid penis length). "The group appears to form close and long-lasting relationships. They often attribute partner sexual satisfaction and the stability of their relationships to their need to make extra effort including nonpenetrating techniques. . . . The small penis has not deferred them from a male sexual role. [Nine of twelve of the adult patients] are already sexually active. . . . Vaginal penetration usually is possible but adjustment of position or technique may be necessary. . . . Two main conclusions may be drawn from our series: a small penis does not preclude normal male role and a micropenis or microphallus alone should not dictate a female gender assignment in infancy" (Reilly and Woodhouse 1989).
"My own experience is that men with the smallest and most deformed penis can have a satisfying relationship with their partner" (Woodhouse 1994).
The video tape "I Am What I Feel To Be" (Fama Film A.G. 1997) presents interviews in Spanish with a number of people who were born as male pseudo hermaphrodites, raised female, and later changed to live as men. Both they and their partners describe their lives as sexually fulfilling, in spite of penises so small that until puberty they were considered to be girls (Fama Film A.G. 1997).
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