Thursday, July 1, 2010

Brave New World: Curing Lesbianism- Treat Your Fetus and Have a Girly Girl

What is wrong with this woman?


Johanna Sigurdardottir is the Prime Minister of Iceland, a lesbian, married to a same-sex partner and any way you look at it, a success story. Unless, perhaps, you're a pediatric endocrinologist at Mount Sinai in New York and Associate Dean of Clinical Research of the School of Medicine at Florida International University.

A reader, who asked not to be named, sent me this little jewel of a column by Dan Savage (the well-known sex columnist) this afternoon. I have to admit, when I read the headline, I thought it was a joke. Like I thought when I clicked on the link I'd end up at The Onion or on some supreme Stephen Colbert or Jon Stewart link. But I was wrong. About more than one thing actually.

Warning: If you are offended by proper names for female genitalia, go back. Look at a palate cleanser. Stay away.  Sissy.

The Dan Savage headline blazoned: 

I have to confess my utter ignorance. I really, actually (and  I know it's naïve) didn't think that lesbianism was something that we needed to prevent. Cancer, I could see. Malaria, HIV, Diabetes (especially Type 1), Multiple Sclerosis, a slew of autoimmune diseases (including my two, please), mental retardation, congenital liver disease and short gut syndrome, scoliosis, kyphosis, osteoporosis, heartbreak, rape, genocide, war, discrimination, injustice and world hunger.... yeah. I want them all to go away. But lesbianism?

When I think of things to prevent, I think of things really awful, morbid, painful, depressing, unfair. Call me crazy, but I don't think of sexual orientation different from my own as any of those things. When I think of gay men and women, I think of my friends. I think, perhaps stereotypically, of powerful women and creative men. I think of the world being richer for its diversity. And I think of that diversity as being Darwinian and that maybe in an overcrowded world, humans that are less likely to reproduce with their chosen partner are doing us, and the planet a favor. And if you read the post below, they might even help take care of some of the children who really need taking care of, to boot.

Yeah, I know I'm crazy.

But, to the point... Dr. Maria New, studies Congenital Adrenal Hyperplasia. She has this cool foundation, The Maria New Children's Hormone Foundation. Dr. New wants to make your daughter not just straight, but to make her clitoris downright average, to make her like babies and want to make some of her own, to be married to a boy and to be... just a "normal" girl.

The good news is that just like me, Dr. New believes that homosexuality (in women at least) is biological and not psychological or philosophical or spiritual. That is probably the very last point on which I feel any sense of kindred spirit with Dr. New. Dr. New has reported hormonal norms and demonstrated the genetic basis for the principal form of Congenital Adrenal Hyperplasia (CAH or 21-hydroxylase deficiency) which she believes, if you read her literature on her website and various publications, leads to lesbianism.

From Dr. New's Foundation website:

"Prenatal treatment of affected females avoids development of ambiguous genitalia, a hallmark of the disorder. Prenatal diagnosis of affected children of both sexes enables families at risk to ensure optimal care of classically affected newborns.

Dr. New’s team is currently developing gene therapy for CAH. Gene therapy offers the possibility of moving beyond palliative treatment to cure of the disorder."

Disorder? Families at risk? Wowza. Sounds serious. What's Dr. New talking about?

Well, you can see a hint here: “Sexual Orientation in Women with Classical or Non-Classical Congenital Adrenal Hyperplasia as a Function of Degree of Prenatal Androgen Excess” published in 2008 in Archives of Sexual Behavior.  An article which correlates excessive androgen exposure in utero to CAH and, [deep breath] lesbianism. Because females exposed to too much androgen in utero are prone to some very, very bad things. They are, according to Alice Dreger, Ellen Feder and Anne Tamar-Mattis, at the highly regarded Hastings Center on Bioethics

"(CAH women) as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role. As children, they show an unusually low interest in engaging in maternal play with baby dolls, and their interest in caring for infants, the frequency of daydreams or fantasies of pregnancy and motherhood, or the expressed wish of experiencing pregnancy and having children of their own appear to be relatively low in all age groups.”

And further (from the same source):

“Dr. New and her colleague, pediatric endocrinologist Dr. Saroj Nimkarn of Weill Cornell Medical College, go further, constructing low interest in babies and men – and even interest in what they consider to be men’s occupations and games – as ‘abnormal.’”

Part of the purported concern is that some of these female infants have what are termed ambiguous genitals. Which means their clitoris is larger than usual. But they are genetically XX (female) and indeed have female genitalia like ovaries and uteri. But a nice pair of panties will cover that evidence. I don't mean to minimize it, but really, in a younger child genitals are not commonly on display as they would be in a locker room for an adolescent. And as any parent of a very young child can tell you, things.... change, shrink, grow, shift, as your child matures. There's been a lot of press lately on Cornell allowing Dr. Dix Poppas to carve up baby girls whose clitoris just doesn't look aesthetically pleasing (too large) without taking into consideration what it may do to damage the children in the long term sexually and even hygenically. Risks of nerve damage, incontinence, loss of sensation and other issues are not mentioned in Dr. Poppas' literature. He just wants baby girls to have better looking clitorises and vaginas. (Don't even go there....)  Dreger, a professor at Northwestern University and Feder, a professor in philosophy and religion at American University take Dr. Poppas to task in a Hastings Center paper as well. My much beloved Cynical Nymph blogged on the horrors of Dr. Poppas's work and questioned Cornell just last week, as did Feministing.

But "fixing" tomboyish and ambiguously endowed women isn't just a matter of cutting off pieces of their clitoris. It's much deeper than that. It deals with what hormones did (or didn't) do to their brain in utero. And that's where Dr. New comes in. 

She wants to fix your daughter before she's even born. 

Dr. New wants to use Dexamethasone, off-label, during a pregnancy, on a female fetus, to make the chances of her being girly, in spite of genes that might make her tomboyish or androgenized, or uppity. Dreger and Feder note that, 

"The use of prenatal dexamethasone treatments for CAH represents, to our knowledge, the first systematic medical effort attached to a 'paradigm' of attempting in utero to reduce rates of homosexuality, bisexuality, and 'low maternal interest.'"  

Dexamethasone is not without risks and Dr. New is recommending a treatment that is not only off-label but which has seen no clinical trials for CAH, no Internal Review Board at the institutions at which she works, and most controversially is used as soon as a woman knows she's pregnant, before she even knows if the fetus is male or female, just because there is a suspicion that the fetus will have CAH. Time magazine has just published a brief article about the controversy, noting that some women have had daughters that not only still have CAH, but who also have, following dexamethasone treatment throughout their pregnancy, mysterious health issues. Some of these parents claim they were not informed of risks and that they further mistakenly thought that Dr. New's "dex" cure, in one case prescribed by another doctor, was a studied and proven treatment.  Dexamethasone is an extremely potent steroid and Dr. New is using this drug, off-label, throughout pregnancy in her patients and there is scant peer-reviewed evidence that the treatment works well nor is there evidence that it is needed? And this is medicine? I may not think the fetus is sacred but I sure don't advocate treating she/he like a petri dish experiment, either.

Most disturbingly, the bioethicists at Hastings Center further, and rather ominously, note:

"...We think Nimkarn and New’s “paradigm for prenatal diagnosis and treatment” suggests a reason why activists for gay and lesbian rights should be wary of believing that claims for the innateness of homosexuality will lead to liberation. Evidence that homosexual orientation is inborn could, instead, very well lead to new means of pathologization and prevention, as it seems to be in the case we’ve been tracking."  (Alice Dreger and Ellen K. Feder for the Hastings Center)

So here's what I was naïve about. I was thinking that if you could say that homosexuality was genetic that it would be better, not worse. Plus, I guess I was really naïve thinking that my parents were just fine with me being a tomboy. And my being interested in math and science and history. And for thinking Barbie was stupid, even back in the 1960's. For thinking it was okay to know how to use all the tools in my grandfather's shop (he worked for NASA and IBM building all kinds of electronic stuff), that climbing trees and rocks and sides of mountains was awesome and that it was better to know how to rewire a light switch or to know how to check the oil in my car than it was to be sure my fingernail polish didn't clash with my toenail polish. And in spite of the fact that I LOVE high heels and earrings and purses in unusual colors and silly PJs, that it was probably way more important to know how to handle a stick shift, check my circuit breaker box or know how to use a Makita drill.

And I look around at all the uppity women I know. Some straight, married, with kids, some straight, married and wouldn't want a baby in their arms if it was that or the coal mines. Some lesbian, with kids, some lesbian without. Some I'll never know from one year to the next who they'll bring to a party. But I have to say that I think they're a pretty magnificent bunch of humans and many have done great, great things. I wouldn't trade them for all the world. Frankly, when I look at the uppity women that make waves in the world, a few judges I know, some MDs or DVMs or attorneys or Hillary Clinton or Julia Gillard or Johanna Sigurdardottir, I really just don't think the world is better off without them. Or without its  Madame Curies and Lise Meitners and Rosalind Franklins... or even women who have gotten to be the head of Pediatrics at Cornell and Chief of Pediatric Endocrinology for 38 years and members of the National Academy of Sciences? 

Dr. New has had an extraordinary career if you look at her bio at the NIH. Born in 1928, she reports that her greatest career obstacle was being a woman.

How ironic is that?

Sadly, I'm kind of wishing that, if the capstone of her career is trying to eliminate lesbianism, it was little Maria who had stayed at home, enjoyed making babies and had followed the nice "traditional child-care/housewife role".

And I'm really hoping that someone informs the pediatricians doing all this horrible stuff, and the hospitals letting them get away with it, that a person's value to society is NOT defined by the appearance of their genitals and the gender of their sex partners. And that feeding a fetus hormones to make their minds more "gender normal" is just plain wrong.

In honor of the uppity women I know and the many that I don't know but admire or have admired from history, I'm going to be offering up palate cleansers of UPPITY WOMEN throughout the month of July. If y'all want to suggest any, post a comment or email me:


  1. There is so much headdesk here that I get a headdesk concussion and pursuant nausea.

    Or it might just be nausea over the idea of exposing a fetus to unknown risks just so she'll eventually want to play with pink frilly dresses a bit more.

  2. Sure she isn't a descendant of Josef Mengele?

  3. I reeeeally don't understand this. I don't understand a mother-to-be taking this risk just so she can MAYBE have a girly daughter (basically).

    And as you know, I REALLY don't understand the obsession with making female genitalia look just a certain way.

  4. The whole thing made me so mad I had trouble sleeping. Take some hormones and make your daughter a future Stepford wife.

    It's definitely the Nouvelle Eugenics. Jen. But whatever we call it, it's still wrong.