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Book Review: Contesting Intersex: The Dubious Diagnosis

20 Jul

book review

The question of intersex is one that challenges not only the medical community, but our entire society, encouraging us to see gender and sex (and even sexuality) as more complicated and nuanced than we might regularly imagine. The very existence of intersex bodies demands a decoupling of gender from bodies, and a dismantling of essentialist, binary views. Georgiann Davis’s new book, Contesting Intersex: The Dubious Diagnosis (2015, NYU Press), explores the role of language, medicine, and gender structures in shaping the experiences of intersex people (alternatively, people diagnosed with disorders—or differences—of sex development, DSD).

In particular, she studies the linguistic shift from ‘intersex’ (or hermaphrodite, and variations of these terms) to the new diagnosis common within medical circles, ‘DSD.’ Her key argument, amply demonstrated by interviews with members of the intersex community, doctors, activists, scholars, and parents, is that the language used to describe intersex bodies has important ramifications for the lived experiences of intersex people.

There are several important findings to support this argument. She shows historically that the medical community was primed to accept this terminological shift, at least in part to reassert their power over intersex bodies. John Money, a doctor famous for his claims that ‘nurture’ would always win over ‘nature’ in gender identity, sullied the medical community’s relationship to ‘intersex.’ Money lost credibility after encouraging parents of a male child to raise him as a girl after a botched circumcision left him mutilated. “She” eventually committed suicide, and the suicide was taken as evidence that his innate male gender could not be replaced by feminine gender socialization. This seemingly mismanaged case of sex-gender identity, along with increasing pressure on the medical community by feminist and intersex activists, meant that doctors’ authority over the diagnosis was publicly questioned. When the new diagnostic term ‘DSD’ was proposed, doctors jumped at the chance for a fresh start.

Allowing the medical community to determine the public understanding of ‘intersex’ or ‘DSD’ has important ramifications. For example, the medical community perpetuates biologized understandings of sex, gender, and the body. These understandings are used to justify medically unnecessary surgeries to “normalize” the genitalia (often at the expense of sexual sensation, and almost always at the expense of the patient’s sense of autonomy and self-determination). When coaching parents on how to raise their intersex child, doctors often encourage enforcing gendered expectations—discouraging girls from tomboy behaviors, and encouraging boys into more vigorous activities. In particularly upsetting passages, Davis exposes doctors’ sexual expectations of intersex women in particular, surgically shaping women’s bodies for penile-vaginal penetration.

Davis also documents that the language shapes intersex individuals’ experiences, beyond surgical intervention. Based on her interviews with intersex people, she finds that those who embrace the ‘DSD’ terminology have a more positive relationship with their doctors and parents—in Davis’s terms, they have better access to biological citizenship than those who use the more politicized term, ‘intersex’—but have a more troubled sense of self. She explains that this is likely due, at least in part, to the stigmatizing effect of seeing oneself as ‘disordered.’ In contrast, those who utilized ‘intersex’ had a more positive sense of self and a better relationship to their gender identity and sexuality, but often found themselves at odds with doctors. The terminology is a source of trouble within the intersex community as well, leading some activists to be at odds with one other over wording, something that concerns Davis because in-fighting may take away from more important battles.

Ultimately, this book is an important read for gender and sexuality scholars, as well as medical sociologists. Davis deftly challenges binary categories and the power of medical diagnoses. Her writing is engaging and, at times, personal—she shares her own experience as an intersex person, describing intimate conversations with her parents, problematic medical episodes, and her activist-academic desires. The book would also work well in advanced undergraduate classes or graduate seminars on gender, sexuality, and bodies, but I would highly recommend implementing it in classes aimed at non-sociology majors. For example, I’d love to see this on syllabi for medical sociology classes, which are frequented by pre-med students, who are an important but likely overlooked audience for this book. As teachers, we can also be activists, shaping the minds of our students who, in this case, will be the next generation of doctors encountering intersex bodies.

 

 

Amanda Kennedy is a contributor and founding editor of Masculinities 101.

Dilemma of a Spartan Survivor: War, Disability and Masculinity

13 Jun

As in ancient Sparta, modern American military training emphasizes physical fitness. Pictured here, two Marines wrestle to demonstrate strength (Source: Wikimedia Commons)

As in ancient Sparta, modern American military training emphasizes physical fitness. Pictured here, two Marines wrestle to demonstrate strength (Source: Wikimedia Commons)


The widespread purge of modern artistic expression that occurred upon Adolf Hitler’s rise to power in Germany in 1933 was motivated by fear. The Nazi regime was determined to use culture to control the people and they chose to promote a conservative, unadulterated classical Greek and Roman aesthetic within the Reich. Avant garde artistic movements such as impressionism, surrealism and cubism were rejected, and art inspired by these movements was deemed degenerate and was to be purged by the Reich Culture Chamber. For example, Otto Dix was labeled a degenerate artist and had his position at the Kunstakademie in Dresden terminated because of his anti-war advocacy. Perhaps his most famous painting, War Cripples, depicting German World War One veteran amputees, was displayed by the regime at the Degenerate Art Museum in Dresden and was later destroyed by the Nazis. The irony is that Dix actually volunteered for and fought for Germany in the war, and was himself almost fatally wounded in combat. Dix drew deep inspiration from war and the trauma inflicted by war on men’s bodies and minds.
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People and Periods

31 Mar

Ismael_Nery_-_Andrógino

Menstruation is one of the biggest taboos of our time. As a cis-gender woman, periods are still an awkward conversation. To even ask someone for a tampon or pad in public is more like an illegal drug deal than a basic human necessity. Everyone hides the fact that they experience this basic human function. For me, it’s something that I have to deal with once a month. But for some people it is a way of reinforcing dysphoria, and even a way of putting an individual in harms way. Women aren’t the only ones who get periods.

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Disabled Bodies

12 Feb

Two days ago I read an interesting post at Crip Confessions. The post was titled “But Won’t You be Ashamed? or Cripping Pasties”. A little background is needed. The author is going to the 2016 AVN Expo and Awards in Las Vegas. Essentially she is attending the “Oscars of Porn”.  What struck me as thought provoking was the following paragraph:

Much talk of clothes and the like have provoked side conversations coming up, including one that included the title query. I have been very open about my plan to wear pasties and frolic. I explained this to an acquaintance, and one of their first questions to me was “Won’t you be ashamed?” They were baffled I would have the audacity to wear pasties generally, and especially among porn stars – who include those with medically sculpted bodies toward social beauty, rather than away like my medically enhanced body.

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Web Series For Teens Debunks Outdated Notions Of Masculinity

11 Dec

Screen Shot 2015-12-12 at 12.03.34 a.m.

Omega Access (OA) is a Toronto based non-profit media group ‘dedicated to the idea that outstanding, real-world men can inspire a new generation to see masculinity as a spectrum and not a binary’ (O’Brien, 2015). OA are one of Movember Canada’s newest men’s health partners, who seek to engage audiences in debunking outdated notions of masculinity. They endeavor to do achieve this by celebrating men with healthy lifestyles, alternative identities and productive passions.

OA recently launched a collection of cinematic profiles on ‘alternative men’, funded by The Movember Foundation (O’Brien, 2015). These 5-minute artistic shorts tackle topics, such as, mental health, physical health, vulnerability, family, inner-strength, community, sexuality and gender roles. The aim of these short films is to ‘visually demonstrate the broad spectrum of identities men can have and inspire young men to expand their meaning of masculinity’ (O’Brien, 2015).

These short films are powerful portraits of masculinity; real life stories, beautifully illustrating the multiplicity and fluidity of masculinity. The men featured in the films provide honest accounts of their own struggle in constructing masculine identities. These struggles center around their own construct of masculinity not aligning with hegemonic notions of what it means to be a man. Hegemonic masculinity creates problematic stereotypes, expectations and notions of what it is to be a man, whilst subordinating non-hegemonic masculinities. According to the creative director of this series, Marc O’Brien, OA are “showcasing new male role models that will help break stereotypes”.

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Man Hugs – Observing a Serial Hugger!

2 Dec

My best friend in UCD is a serial-hugger. He hugs indiscriminately – men, women, children, dogs,  senior lecturers and even heads of state!  Sometimes there’s a bit of cheek kissing, other times not. With men he meets it’s usually a big strong hug; one arm over your shoulder, the other under the opposite arm pit. It’s diagonal in composition, and allows for good gripping and a deep intimate embrace. Occasionally there is a little bit of backslapping. Sometimes there are two hugs in the space of a short meeting, one as a greeting, one as a farewell. I’ve become accustomed to his embraces, which by Irish standards are pretty lengthy. Recently, I’ve been paying attention to men’s reactions when they receive one of my buddy’s hugs; and I must admit from a masculinities perspective it’s extremely interesting (and at times very amusing).

Hugging Michael D. Higgins the President of Ireland

The serial hugger in question, hugging Michael D. Higgins – President of Ireland

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Jumping for Masculinity

3 Jul

Recently my wife and I went for a stroll along a near by harbor and marina. We were enjoying each other’s company, happily taking in the fresh air, views of the yachts and fishing boats, the surrounding hills and mountains, and the deep dark sea. There was a strong breeze but the air was warm. We reached the end of the north pier and were looking down into the mouth of the harbor and over toward the south pier. There across the water on the opposite pier were three topless men. The men were jumping up and down, laughing and shouting; they were shadow boxing and shoving each other around.   My wife and I watched them for a moment, not quite sure what they were up to.

The men began jumping up onto the pier wall, looking over the pier edge to the water in the harbor below and then jumping back down off the wall. They then resumed their messing around, jumping up and down, and beating their chests like hairless apes. It was clearer now they were psyching themselves up to jump off the pier into the harbor, some thirty to forty feet below. Never wanting to miss a photo opportunity and curious of the scene that was unfolding, I turned to my wife and said – “let’s watch for a minute!”

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Debunking the Myth of Childhood Sexual Innocence

8 Jun

Hello again and welcome to the second post from ‘Porn and Hookup Culture in an Irish Primary School’. For those of you unfamiliar with the first post in the series, over the coming months I will be sharing research findings about boys’ sexualities. Last month I mentioned that adults are deeply concerned about the effects of our sexualized culture on children, often claiming that today’s children are being prematurely sexualized. That children can be sexualized before it is developmentally appropriate relies on the idea that childhood is naturally a period of sexual innocence. This month’s post therefore unpacks the very notion that children are naturally innocent.

The fear of premature sexualization is premised on several misguided assumptions. The one we will be debunking today is that children are only pre-sexual (not fully sexual) since sexuality can only ever be triggered by puberty, and children are pre-pubertal.

We see evidence for this in the culture when, for example, textbooks for courses in developmental psychology fail to include sexual development in chapters on childhood. Instead, the topic of sexuality appears only when adolescence comes into focus. Developmental psychology in turn guides everyday popular understandings of children among those involved in teaching or caring for them in Western culture. As such it is shot through with power, in this case the power to discursively normalize the absence of sexuality for children but also to pathologize its presence.

We know that sexual experience among children is commonplace. For example, in the Kinsey studies of the 1940s and 1950s parents reported seeing children aged 2-5 self-manipulating and exhibiting their genitalia, in addition to exploring other children’s. We have also known since the 1960s that it is normative for 10-13 year-olds to engage in heterosexual kissing. Childhood sexual innocence, then, is an adult fabrication more than a natural feature of childhood.

Some psychologists do argue that ‘light’ sexual activities such as those above mark normal stages along the developmental trajectory but are a far cry from the sort of sexuality that is prescribed by children’s cultural milieu. That is, the extent to which our culture is sexualized is ‘too much too soon’ for children. Recognition of children’s sexual behaviors, not to mention the power of consumer capitalism, is preferable over the downright denial of childhood sexuality.

Nevertheless, what constitutes ‘too much too soon’ is in fact contestable when compared across time and space. During the 17th century, for example, the children of the French aristocracy were not shielded from sex but rather regularly encountered references to it in songs, stories and games. Fast forward to the 20th century and the following extract, taken from fieldwork with the !Kung San of the Dobe area of Botswana, further troubles the notion of precocious sexuality:

Like her counterparts in other foraging societies, the !Kung child becomes familiar with sexuality in early life. The youngest children sleep under the same blankets with their parents and are under the blankets during their parents’ lovemaking. From the age of eight or ten, children engage in sex play, which may include intercourse (…). The !Kung have no notion of virginity. I have never been able to come up with a concept or sense of a word that would correspond to our word virgin. Given the early sex play, I will hazard a guess that there are few !Kung virgins, male or female, at puberty.

(Lee, 1985: 39)

In summary, what we deem appropriate or inappropriate for children is historically and culturally contingent with the result that we cannot take it for granted that children are prematurely sexualized by the sexualization of culture.

Another way to see how sexuality is normative for children is to step back from the view of it as an essential, biological force that gives rise to bodily activities. When we see sexuality as a set of social practices, it is easier to recognize it as integral to children’s and adults’ everyday subjectivities and identities. Allow me to explain …

Foucault argued that sexuality induces specific gender effects and we see this eloquently elaborated upon by Judith Butler (1993). Individuals are assigned one of two sexes at birth. They are then expected and encouraged to do a gender in accordance with that sex. But the way to do that gender is guided by the belief that it should be done in opposition to the other sex/gender and that it should ultimately give rise to sexual desire for that opposite sex/gender. Put simply, we are getting our gender right when we are getting heterosexuality right, and vice versa.

People tend to heterosexualize their gender in many arenas and not just when being physically sexual. The same is true for children. In past research (Renold, 2005) primary school boys could successfully heterosexualize their masculinities by being a boyfriend though they could also opt out of the boyfriend/girlfriend culture without penalty by heterosexualizing their future masculinities. This was achieved by making reference to the skills that would one day be needed when the time came to have sex with women, thus consolidating a hegemonic heterosexual masculine identity in the present.

Boys could also heterosexualize their masculinity in the present by merely playing the right sport – soccer – or by fighting with other boys, or even just engaging in fight talk. Indeed those boys failing to display similar interests were marginalized as sissies or, you guessed it, gay.

Clearly then, childhood sexuality is much more than ‘light’ practice for the future but is also experienced seriously in many painful and pleasurable ways in the present.

The sooner we allow the full range of sexuality practices come into view, the sooner we can understand children’s experiences more fully and provide appropriate support. Might the panic over the premature sexualization of childhood be interfering with this goal? This is one question we will be returning to over the course of Porn and Hookup Culture in an Irish Primary School.

Porn and Hookup Culture in an Irish Primary School

13 Apr

Welcome to the first post in a series of monthly posts on masculinities in an Irish primary school. Over the coming months I will be sharing research findings on boys’ experiences of porn and hookup culture. There has been growing concern in recent years over the ‘premature sexualization of childhood’ that is claimed to be caused by the ‘sexualization of culture’. So before actually detailing the aforementioned findings, some of the initial posts will lay out the socio-cultural context in which they were produced.

As mentioned, the research in question took place in Ireland. The data were co-produced with eleven- and twelve-year-old girls and boys during their final year of primary school. I spent the academic year of 2009/2010 hanging out with the children a couple of days a week and interviewing them in pairs and groups about my observations. Furthermore, interviewees were invited to introduce topics of their own choice for discussion.

Overall, the themes that emerged ranged from academic performance to religion, from sports, dance and athletics to friendships and family relationships. Clearly, then, the more overtly sexualized themes chosen for analysis were not necessarily central to the children’s lives. Rather I played an active role in determining what to focus on. Nevertheless, porn and hookup culture did emerge and as such warranted exploration.

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Life Cycles of Inequity: Do Black (Men’s) Lives Matter?

4 Feb

Colorlines has been running the fantastic series ‘Life Cycles of Inequity’, focusing on the life stages of Black men the US. The latest installment, produced by Kai Wright and Erin Zipper, focuses on health and mortality. First published at Colorlines.com on Jan 7 2015:

Inequity shows up in our lives in all kinds of places, but rarely can it been seen as starkly as when it presents itself in our bodies. Public health long ago established the relationship between poverty and illness. Today’s researchers are also closing in on the link between poor health and racism. The accumulated stressors of racial injustice appear to literally wear our bodies down. Perhaps no set of public health data makes this point more plainly than the statistical trends for life expectancy.

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