Appendix G

Most adult women would not choose clitoral surgery for themselves

Dr. Suzanne Kessler, professor of psychology at the State University of New York, surveyed college women on their feelings about clitoral surgery.

The women were asked: "Suppose you had been born with a larger than normal clitoris and it would remain larger than normal as you grew to adulthood. Assuming that the physicians recommended surgically reducing your clitoris, under what circumstances would you have wanted your parents to give them permission to do it?" ... All the subjects were shown a scale with the normal ranges for clitorises and penises demonstrated in actual size, and labeled in centimeters..."

"About a fourth of the women indicated they would not have wanted a clitoral reduction under any circumstance. About half would have wanted their clitoris reduced only if the larger than normal clitoris caused health problems. Size, for them, was not a factor. The remaining fourth of the sample could imagine wanting their clitoris reduced if it were larger than normal, but only if having the surgery would not have resulted in a reduction in pleasurable sensitivity. Only one woman mentioned that other people's comments about the size of her clitoris might be a factor in her decision" (Kessler 1997, p35).

There is a wealth of literature available in which adults who were subjected to non-consensual cosmetic genital surgery as children express grief over the physical and emotional suffering caused by the surgery, and anger toward doctors who performed the surgery and parents who gave permission (Chase 1997; ISNA 1997). To date, no adult has come forth to say that she was grateful for having had this surgery performed without her consent.

Appendix H

Response to Doctors' Questions

1. Our recommendations are informed by academic research.

For example, our recommendations are in concordance with those of the following respected academic researchers:

Justine Schober M.D.
Pediatric Urologist
Hamot Medical Center

Anne Fausto-Sterling Ph.D.
Professor of Medical Science
Brown University

Milton Diamond Ph.D.
Professor of Psychology
University of Hawaii School of Medicine

Kieth Sigmundson M.D.
Department of Psychiatry
University of British Columbia

Suzanne Kessler Ph.D.
Professor of Psychology
State University of New York at Purchase

Alice Dreger Ph.D.
Adjunct Professor
Center for Ethics
Michigan State University

Howard Devore Ph.D.
Life Clinical Fellow
American Academy of Clinical Sexologists

2. ISNA performs research.

We are currently engaged, with the assistance of Aron Sousa, M.D. and Justine Schober, M.D., in a project which will use the new "Evidence Based Medicine" methodology to analyze all available published outcome data on intersex medical interventions. We are also engaged in a project, with the assistance of Justine Schober, M.D., to gauge the psychological adjustment of intersex adults, using a structured survey instrument.