Handbook of the Sociology of Gender by Barbara J. Risman Carissa M. Froyum & William J. Scarborough

Author:Barbara J. Risman, Carissa M. Froyum & William J. Scarborough
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

4 Disregarding Bodily Autonomy: The Individual Level of Gender Structure

The individual level of gender structure is where a person’s gender identity is internalized (Risman, 2004), which can be constraining for all of us regardless of our bodies given the power of the institutional and interactional levels of the gender structure. Yet, in the case of intersex, this constraint is uniquely complex given that doctors surgically shape an intersex person’s body to match the gender identity they choose for their patient—a process that usually happens when one is a minor child and are unable to legally refuse recommended medical interventions. This action, which is enacted at the institutional level of gender structure and enforced at the interactional level through the way in which the diagnosis is presented to parents, is a remarkable disregard for an intersex person’s bodily autonomy. By subjecting intersex people to medically unnecessary and irreversible interventions, doctors rob intersex people of the ability to form their gender identity within the body they were born with. And they do this by enforcing the individual level of gender structure that recognizes only two sexes and two genders, or in other words, masculine males and feminine females. This enforcement of the individual level of gender structure leaves many intersex people, as they discover their diagnosis and learn the truth about the surgeries they endured when they were children, feeling violated and mutilated—emotions they channel, as described in the conclusion, as they challenge the medical mutilation of intersex bodies and the perpetuation of the institutional level of gender structure (Davis, 2015a; Holmes, 2008; Karkazis, 2008; Preves, 2003).

In 2003, sociologist Sharon Preves published the very first book length academic account of the experiences of intersex people. She documented the physical and emotional struggles intersex people faced after being subjected to medically unnecessary and irreversible interventions. As Preves explains, almost all intersex people undergo surgery to “fix” their intersex body at some point in their life (see also Davis, 2015a; Holmes, 2008; Karkazis, 2008; Preves, 2003). Those who were subjected to surgery on their external genitalia were left with nerve damage and a loss of sensitivity, and for some, pain while urinating and/or genital penetration, and, among other negative consequences, leakage from the urinary tract. In many cases, intersex people are subjected to numerous surgeries in attempt to remedy the problems associated with their previous, and unnecessary, surgeries. If the initial surgery was never conducted, there would be no need for reparative interventions.

Even those without “ambiguous” external genitalia are typically still subjected to surgery in order to be squeezed into the sex binary. For example, because those with complete androgen insensitivity syndrome (CAIS) have an outward female appearance and mostly live their lives as women, doctors remove their internal and undescended testes despite the fact that the testes are the primary producers of sex hormones in the CAIS body (see, for example, Davis, 2015a; Karkazis, 2008). It’s worth noting that intersex people who undergo surgery on their external genitalia are also often subjected to having their internal anatomy surgically altered, similar to those with CAIS.

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