The Weird Business of Sex Reassignment


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At a meeting of endocrinologists in Boston in May, studies were reported, by Hopkins psychiatrist William Reiner, of more than two dozen children who had been the subject of sex reassignment when they were too young to provide informed consent, and who are now understandably angry and thwarted people. The mistakes made were huge, awful and grisly in the context of self-confident assertions by people like John Money who were caught up in the giddy days of sexual optionality in the 60s. Alice Dreger of Michigan State University, who studies the intersex community, has compared the whole ghastly episode to the Tuskegee experiment, in which hundreds of men were not given medication to cure their venereal disease because researchers wanted to document the course of the deadly illness.


Dreger is certainly correct. We can extend the point to a wider array of violations of the temple of the body. One of the strangest acts of perverse political libertinism in the Giuliani administration was the legalization of tattoo parlors as legitimate public services. I don't know about you, but tattoos give me the willies. So do the various piercings of body parts. Temporary whims of fashion and self-promotion become permanent features of a person's life?like the drunken sailor who has I love Suzie tattooed on his biceps only to wake up a week later next to Clarissa, who fails to share his enthusiasm for her new friend's history.


What people do with their own bodies is obviously their own business. If the body is a temple, they can worship it how they wish. But it doesn't mean that the spectacle they may create is necessarily agreeable to others. And what should be the moral, to say nothing of legal, limits of tolerance of self-chosen bodily enhancement? If I am hiring a public relations officer for my smooth legal firm, am I engaging in illegal discrimination if I pass on a potential representative of my business whose tattoos make him look like some Oriental sofa, while the various knickknacks stuck in parts of his face raise the question, does he rattle when he brushes his teeth?


It's easy to accept that there should be no discrimination against people for characteristics they haven't chosen, such as how they look or what group they're from. But what about people who confect themselves into something that may be stylish in their neighborhood bar or dance club but irritating and even repulsive to other people, who respect the body as a real and decent natural form? Does the immigration service have to grant asylum to someone who chooses to be a transvestite and then claims his fellow countrymen discriminate against him so severely that he is in mortal danger? A recent case suggests that the answer, according to at least one hearing officer, is "yes," and that elective sexuality may become a new category of victimhood on the basis of which particular legal rights may be claimed.


One clear-cut case in which public policy is slowly turning to the idea that nature is natural is in sports, where of course the impact of drugs on performance has been loud and resonant. Despite all the Foucaultian sociological posturing about the social causation of sexuality, there has long been a lively industry of using male-like hormones to improve performance of both men and women. The female athletes who sued or threatened to sue their East German coaches for giving them "vitamins" are receiving at least some moral comfort, even if they can't have their femininity and fertility back. Now the International Olympic Committee has agreed to carry out on-the-spot tests at the Sydney Olympics for the synthetic hormone EPO, or erythropoietin. Enthusiasts of sports pharmacology will recall that luxuriously ample supplies of the substance were liberated from an official Tour de France car being driven by a Belgian employee of one of the competing cycling teams. I once rented a house to Dr. Wade Exum, who has been recently involved in medical supervision of the Olympic movement, and who has suggested that there has been inappropriate use of drugs by Olympic athletes, to say nothing of inadequate testing and lots of looks the other way. He claims he was discriminated against because of his black skin, but it is far more likely that he was sent off because he was right about the grubby poisoned underside of a huge business.


Once at a party I met a man who was going to assume the chairmanship of a major department at the Johns Hopkins medical school. He asked me what I thought about the "sex reassignment clinic," which was at that time world-class and thriving in its miserable field, and the subject of much propaganda about the glad anything-goes of human sexuality. I told him what I thought?which in fact I had been earlier asked to do by a university committee beginning to question the enterprise. The chairman-to-be was straightforward and said with perplexed anger, "They're cutting guys' cocks off down there." The clinic was soon sharply curtailed, but not soon enough.


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