In either case, the child's relationship with parents may be damaged. This may occur at the time of the trauma if the child holds the parent responsible for failing to protect him or her from the painful experiences, or later when the child recovers or reinterprets these early experiences. Freyd (1996) suggests that some people realize the full impact of the event when they realize the betrayal, either by forming a new understanding of the event or in recovering the event of the betrayal (p. 5). The way in which events are internally evaluated and labeled may be a key component of such recovery experiences (p. 47). Joy Diane Schaffer (1995-6) suggests that parents of intersexed children should be given full informed consent, including the fact that "there is no evidence whatsoever that intersexed children benefit from genital surgery.... Parents should also be routinely informed that many intersexed adults who received childhood genital surgery consider themselves to have been harmed by the procedure, and are frequently estranged from their parents as a result" (p. 2).

Directions for Future Research

Children treated for intersex conditions within the medical establishment experience many of the same types of trauma as children who are sexually abused. A study of intersexed children's experiences of their treatment and their memory for these events is likely to more closely approximate the experience of childhood sexual abuse than studies done to date for several reasons. The medical management of intersex conditions involves direct contact with the child's genitals by a person in power over the child, and with the cooperation of his/her parents. The procedures are painful, confusing, and repeated. The family dynamics of the child's situation also parallel those in familial abuse: children are routinely silenced or misinformed about what is happening to them and parents are held responsible for the harm that is done. Finally, the outcomes of these experiences result in remarkably similar negative psychological sequelae, including depression, body image disruption, dissociative patterns, sexual dysfunction, intimacy issues, suicide attempts, and PTSD.

Research design in a study of intersexual children's experiences of medical treatment would afford distinct advantages for the memory researcher over those done to date. A fundamental criticism of past studies has been the difficulty in establishing "objective truth" regarding episodes of CAS. Because abuse is usually hidden, unless the child comes to the attention of the authorities, no documentation exists to show what events occurred. Critics of retrospective studies point out that it is therefore virtually impossible to compare the adult account with actual childhood events (the major exception to this rule being studies done by Williams, 1994a,b). In the case of intersex treatment, the researcher would have access to extensive medical documentation regarding the procedures and the child's responses while in the clinic or hospital. Intersex children could be interviewed at the time of procedures and followed longitudinally to see what happens to their memories of these events as they grow into adulthood. This would allow a more process-oriented approach to the problem of childhood memory of these traumatic experiences (How do children understand and encode trauma in the absence of external support or in the presence of misinformation? What is the effect of mood on memory processing? What is the role of parental interaction?) as well as adult recollection (How does the meaning of the trauma change over time? What is the long-term effect on the child's social and emotional development? What happens to the family dynamic when adults research their medical conditions and discover that they have been misinformed?). An observation of these children's emotional and cognitive strategies for dealing with their medical treatment may shed some light on how these processes operate for victims of child sexual abuse.

Editor's note: Tamara Alexander has been wedded in spirit to ISNA member Max Beck for almost four years. The couple make their home in Atlanta, Ga. When she is not writing papers and working on planning for a baby, Tamara is busy raising their four cats, a dog, and the consciousness of emory psychology undergraduates. Partners of intersexuals are welcome to contact her for mutual support.

© 1977 Copyright Tamara Alexander

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© 1977 Copyright Tamara Alexander

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