Sex and Uncertainty in the Body of Christ

Intersex Conditions and Christian Theology

Susannah Cornwall

• Publisher: Routledge
• Year: 2016
• Print ISBN: 9781845536688
• eBook ISBN: 9781134940059
• Edition: 1
• Topic: Theology & Religion
• Subtopic: Religion

Mainstream Christian theology has valued the integrity of the body and the goodness of God reflected in creation. However, it has also asserted the complementarity of "normal" male and female physiology. Sex and Uncertainty in the Body of Christ offers the first systematic theology of the intersexed body.

The book analyzes the theological implications of physical intersex conditions and their medical treatment. The medical assumption of what constitutes male and female bodies is shown to raise essential questions about the meaning of incarnation and bodiliness. The book argues for a theology that speaks to stigmatized and marginal bodies, examining the impact of such a theology on sex, marriage, sexuality, perfection, healing, and the resurrected body.

Chapter 1
Introduction

I am a creature of God, and ... I'm created, and intersexed people are created, no less than anyone else, in the image and likeness of God ... This is the way that we are, and ... what we've got here is not a walking, talking pathology, but a human being (Sally Gross, speaking in van Huyssteen 2003).

Traditionally, Christian theology has valued the integrity of the body and the goodness of God reflected in creation, but has also set much store by the apparent complementarity embedded in male and female physiology. It has sometimes been threatened by liminality, shifts in sexed and gendered identity, and non-marital sexuality. Its unyielding norms of sexual morality have led to the unnecessary exclusion and alienation of individuals from the community of faith. Theology has both shaped and been shaped by a culture which has tended to shun ambiguity and liminality in favour of clearly demarcated categories of sex and gender. Humans have all but divinized male-and-female sex in asserting that it is all-encompassing - and, concomitantly, have been suspicious of 'transgressive' sexual identities. However, prompted by intersex and other marginal or contested sex-gender identities, a deconstruction or querying of male and female as essential, necessary or all-embracing human categories is possible. Human bodies and human beings are different by virtue of more than sex. In this book I show that theology should reflect an image of God and of humanity more complex and diverse than an all-encompassing male-female binary allows. Since ethics and praxis should be rooted in theology, these, too, must reflect the diverse and non-binary character of human sex.

Theologies stemming from other configurations of contested and excluded bodies help to provide models for how intersex/DSD might affect theologies in the future. Such theologies are explored throughout the book. In this introductory chapter, however, I outline the nature of intersex/DSD conditions and introduce the broad theological and ethical issues addressed in the book.¹

Introducing Intersex/DSD

Human sex is more complex than a simple male-female binary where every individual is solely and unambiguously male or female. However, the common notion of the 'hermaphrodite' as an individual with a full set of both male and female organs is also inaccurate and misleading. Estimates suggest that at least 1 in 2,500 children in Europe and North America is born with an intersex/DSD condition - roughly the same prevalence as Down's syndrome or cystic fibrosis (Preves 2003: 2-3). All human foetuses start off with genital regions which appear identical, and typically, beginning at around seven weeks' gestation, the region gradually diverges along broadly male-related or broadly female-related lines (Preves 2003: 24-26). Because the difference between typically male-related and typically female-related genitals is actually a continuum rather than a binary, some genitals appear 'ambiguous', with a glans between the typical sizes for a clitoris or penis, or a genital opening which is only partially fused, so that the child cannot be readily identified male or female at birth. Other intersex/DSD conditions only become apparent later, perhaps at puberty when a girl does not begin to menstruate as expected. Across the various conditions, the external genitalia can appear typically male, typically female, in between, or mostly absent; internal genitalia and reproductive organs can include testes, ovaries, one testis and one ovary, or an ovotestis. Chromosomes can be XX, XY, XXY, XX/XY or a range of variations.

Doctors caring for genitally-ambiguous newborns have often advised parents to sidestep questions about the baby's sex from friends and relatives until further tests and karyotyping² have been carried out and the child has beert found to be male or female, or has been designated boy or girl. It is significant that the delay in waiting to be (or to make) certain has been deemed preferable to admitting that the sex is, for a time, unknown (Kessler 1998: 22; Preves 2003: 55). Parents thus not only 'bear the burden of the secret of their child's difference', but must also '[mask] the tension produced by the necessity of concealing this difference', in order to protect the social status quo (Feder 2006: 192). The eventual gender assignment has, in many cases, been reinforced by genital surgery. Surgery on an XX child with fused labia and a large clitoris might include clitoral reduction or recession, and surgery to open the vagina. Children with XY chromosomes and testes, but very small external genitalia, may have the penis and testes removed altogether and a rudimentary vaginal opening constructed in their place. Sometimes doctors have failed to explain to parents exactly why such operations are being done (Arana et al 2005), what is involved, or the fact that the child will often need a series of further procedures and/or hormone therapy throughout its life (Feder notes that parents of intersexed children whom she approached for interview expressed surprise and even suspicion that anyone wanted to hear their side of the story - Feder 2006: 193). Although this approach might stem from good motives, it also mitigates the capacity for informed consent on behalf of the parents and their ability to communicate with the child later about the medical condition. In the recent past it was common in Britain and North America for surgeries to be performed neonatally, but pressure from intersex/DSD groups has led to an increase in delayed or non-surgical treatment. Where early genital surgeries have been carried out in the past, it has generally been advised that corrected children should never be informed about any erstwhile ambiguity of sex.

Thea Hillman notes that the nebulous 'intersex community' is not homogenous:

What many of us have in common are repeated genital displays, often from a young age. Many of us have had medical treatments done to us without our consent to make our sex anatomy conform to someone else's standards. Many of us suffer from intense shame due to treatments that sought to fix or hide our bodies. And many of us have experienced none of the above. (Hillman 2008: 149).

Although many people who received genital surgery as children have protested about their treatment (as I discuss in Chapter 2), not every individual who has had surgical intervention is unhappy with the outcome, and numerous people whose gender assignment was changed via surgery in childhood have grown up as contented and fulfilled individuals. Indeed, several support groups for people with intersex/DSD and their families have tended not to challenge established medical protocols of early surgery (Dreger and Herndon 2009: 205). The erstwhile Intersex Society of North America (ISNA) stressed in its guidance notes for parents of children with intersex/DSD conditions that not many children do change from their early gender assignment, and that children without intersex/DSD conditions might be just as likely to transition genders as they get older.³ However, it is also possible, as a group of doctors working on studying outcomes suggest, that recurrent genital surgery 'may be associated with long term dissatisfaction with sexual function and an altered perception of body image', which 'may, itself, lead to a change in gender identity from female to male or vice versa' (Ahmed, Morrison and Hughes 2004: 848).

Existing Theological Work on Intersex/DSD

Although excellent sociological studies of intersex exist (e.g. Kessler 1998; Preves 2003), and considerations of why the treatment of intersex is ethically problematic exist (e.g. Dreger 1999; Sytsma 2006a), in-depth theological explorations of the topic have seldom occurred. Where theological engagement with intersex does exist, it has very often been done as an adjunct to reflection on transsexualism or homosexuality rather than in its own right.

An early engagement with intersex from the perspective of Christianity is made by Karen Lebacqz (1997). Crucially, Lebacqz maintains that just because a phenomenon like ambiguous genitals presents in a given child, it need not be accepted as a good thing. Provocatively, she asserts,

We need not see all differences as God's mistakes, but we also need not see them all as God's will. The fact that children are born with ambiguous genitals may be incontrovertible evidence that there are not only two ways of being born, but that fact does not, alone, mean that we should allow every way of living that happens in nature (Lebacqz 1997: 224).

She asks whether, given the 'ostracism, rejection and ridicule' likely to be attached to life with unusual genitals, it is justifiable not to perform corrective surgery (Lebacqz 1997: 225). Although sympathetic to the argument that these issues are just as much social ones as ones attached to individual children, she also suspects that parents would be unwilling to allow their uncorrected intersexed children to undergo social suffering for the sake of making society more diverse and welcoming (though the testimonies of several families since 1997 show that this is not universally the case). Despite the fact that appropriate support will mitigate such suffering (Lebacqz 1997: 228-29), then, Lebacqz cannot unreservedly say that rejecting early surgery is the best path. Her essay contains helpful pointers to affinity between a politics of difference from intersex as compared to those grounded in disability and ethnicity, but I suspect it takes insufficient account of the ways in which theology itself has contributed to polarized gender norms in the West. Her suspicion that 'we cannot claim that it is necessarily God's will for people to grow up intersexed' (Lebacqz 1997: 225) is strongly belied in work by Mollenkott, Gross and others (discussed below), and means she cannot go far enough in an imaginative reconstruction of ethics grounded in sophisticated theological analysis.

Two later papers by Looy (2002) and Looy and Bouma (2005) give a useful psychological overview of the theological and ethical issues raised by intersex, including brief treatments of Bible verses such as Gen. 1. 26-31 and Mt. 19.12, but also lack close critical theological engagement. Their work, though admirably broad in scope, does not adequately question certain social assumptions about gender. For instance, they say,

A person who is intersexed, whose brain has been organized to produce predispositions and preferences that do not nicely fit either of the available gender categories, is forced to fit a Procrustean bed that is either too long or too short; neither produces a good fit, but there is no bed of the right size available (Looy and Bouma 2005: 174).

This implies that all intersexed people have predispositions and preferences which do not 'fit' gender categories, and thus feel uncomfortable. In fact, as Koyama (2006), Liao (2007) and others stress, plenty of intersexed people feel unremarkably male or female even if their genitals appear unusual. By insisting that the dichotomous gender system is 'a reasonably functional one', in which 'the vast majority of us are generally comfortable' (Looy and Bouma 2005: 174), Looy and Bouma also fail to acknowledge that stereotypes about who is or is not oppressed by arbitrary standards of conformity in gender and sex are unhelpful.

Looy and Bouma do conclude that it is hard to imagine that the diversity of genders both across various species and among humans (and the diversity of traits within genders among humans) all result from sin or a fall. It is therefore also difficult to suppose, they suggest/'that God's creational intent was monolithic females and males' (Looy and Bouma 2005: 175). Similarly, Looy suggests, 'Rather than instinctively and unreflectively labelling inter sexuality as either sinful action, or an example of a broken creation, we should at least ask whether intersexuality could be part of God's good creation' (Looy 2002:16). However, Looy and Bouma also comment,

The mere observation that a phenomenon exists in nature does not by definition mean that it is part of God's intended good creation order. It may well reflect the consequences of the fall into sin ... We believe that sin has distorted both physical experiences and cultural expressions of gender. We believe that intersexed and transgendered persons exist in, and create for all of us, a tension between healthy diversity and the distortions of sin (Looy and Bouma 2005: 175-76).

But just as the existence of pain in creation does not automatically render creation 'fallen', neither does the existence of non-binary sex and gender. Looy and Bouma's position raises further questions about where the 'line' might come between diversities which are 'healthy' and those which result from sin - and are thereby, presumably, pathological - as well as how sin might have caused (and continues to cause) distortions not factored into the original creation. Their somewhat sweeping appeals to 'science' and 'experience' are not particularly persuasive. However, their main strength is to pose questions about how Christian communities 'might ... seek to minister with persons who are intersexed and transgendered' and 'recognize that gender assignments for such persons ... are tentative and might be subject to change' (Looy and Bouma 2005: 176), even if the answers are limited to a story about one pre-pubescent transgender boy who has been welcomed into a local church boys' club.

Two 2006 essays by Hester and Jung explore some ethical implications of the treatment of intersex/DSD in theological perspective. Hester explores the notion of healing, arguing that this is more than 'healing from' something. People with intersex/DSD conditions are involved with their own healing, their own rejection of oppressive socio-cultural narratives, just as much or more than the doctors who may set out to 'cure' them through eradicating their difference (Hester 2006). Jung's piece focuses mainly on critical analysis of a natural law-type objection to intersex/DSD, arguing that 'in a polymorphic model of human sexuality intersexuality would most probably be seen as morally normative' (Jung 2006: 298). Jung notes that many behaviours often rejected by the mainstream Christian tradition (such as homosexual activity, gender-bending and intentionally child-free marriages) would not necessarily be seen as problematic if the sexually dimorphic model on which so-called gender complementarity supervenes were disturbed. I expand this argument myself in Chapter 3. Jung also briefly critiques some inadequate Christian pastoral responses to intersex/DSD (Jung 2006: 303-304), but otherwise her essay largely provides useful background to the question of sexual polymorphism in the Roman Catholic tradition rather than specifically exploring intersex/DSD itself.

Unfortunately, Quero's 2008 essay on transgender, intersex, body fascism and incarnation addresses intersex in name alone, not engaging in any detail with its specificities. Quero does not appear to have read extensively on intersex/DSD, as evidenced by his reference to 'adrenal hyplasia' (as opposed to Congenital Adrenal Hyperplasia, the condition he seems to mean) (Quero 2008: 82); and his inclusion in his title of 'transgender/intersex bodies' is bothersome. Although transgender and intersex are by no means mutually exclusive categories, neither should they be conflated; Saraswati, a woman interviewed in Mortimer's 2002 film, says, 'It's ironic that the title of this programme is Gender Trouble, because there isn't any gender trouble for me or for many of my friends who have intersex conditions. It might be trouble for other people to accept our genders or how we see ourselves, but not for us' (Saraswati, speaking in Mortimer 2002). References to 'the common experience of transgender and intersex people' (Quero 2008: 90) risk conflating the two, particularly since Quero's essay focuses almost exclusively on transgender experience rather than the specific experience of intersexed people.

Quero is right that 'there is little, if any, room for transgender and intersex people' in many Christian churches (Quero 2008: 92); however, he does not go far enough to show why or how this affects intersexed people specifically. His examples and quotations, with the exception of one footnote, exclusively draw on transgender. He insists that he is advocating for the recognition that every human life is valuable beyond the dictums of heteronormativity, but by seeming to conflate transgender and intersex experience he risks failing to recognize the particularity of human experience and identity.

One theological work to have engaged more closely with intersex is Mollenkott's Omnigender: A Trans-Religions Approach (2001 /2007).⁴ Mollenkott holds that 'the binary gender construct ignores or contradicts factual reality' (Mollenkott 2007: 2), and that Christianity has oppressed people with intersex conditions just as it has those who are transgender, homosexual and bisexual. She asserts that 'God made no mistake by creating intersexuals. Therefore, their condition represents God's perfect will for them and for our culture' (Mollenkott 2007: 7), and that a more liberating and just system than the present binary one would be a paradigm of 'omnigender': God has chosen to embody Godself in multitudinous and various human gendered particularities (Mollenkott 2007: 17-18). Sex-gender segregation across society should end: sport, prisons, schools and public toilets should all be unisex. Mollenkott, like Gross (below), draws on readings of Genesis that appeal to a primary hermaphroditism in the original human, suggesting that sex (and genital) differentiation occurs only after the asexual creature has been divided. Thus 'intersexuals are not only part of God's original plan, they are primarily so!' (Mollenkott 2007: 98) and might be 'viewed as reminders of Original Perfection' (Mollenkott 2007: 99). Mollenkott's work is one of the only theological accounts of gender which fully acknowledges the reality of intersex.

However, Omnigender still has its shortcomings. By discussing intersex as a variant of transgender alongside transsexualism, cross-dressing, homosexuality, drag and so on, the book very explicitly renders it a comparable sexuality/gender-identity issue. In fact, many people do not understand their conditions in this way, and prefer to figure their intersex/DSD state as a medical condition rather than one which inevitably affects sex-gender identity. (It is for this reason that I suggest in Chapter 5 that it is also important to consider intersex through the lens of other variant body-states such as disability.) There is much helpful discussion of how intersex may be theologically understood as similar to these other state...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• Contents
• Dedication
• Acknowledgements
• CHAPTER 1 Introduction
• CHAPTER 2 Reflecting and Reproducing: The History of Intersex
• CHAPTER 3 Relinquishing and Relating: Intersex/DSD and Marginal Bodies in the Body of Christ
• CHAPTER 4 Reassigning and Redefining: Intersex/DSD and Theologies from Transgender
• CHAPTER 5 Remembering and Re-Membering: Intersex/DSD and Theologies from Disability
• CHAPTER 6 Resisting and Reappropriating: Intersex/DSD and Queer Theologies
• CHAPTER 7 Realizing and Remaking: Conclusions
• GLOSSARY A Summary of Some Intersex/DSD Conditions and Related Terminology
• BIBLIOGRAPHY
• GENERAL INDEX
• INDEX OF SCRIPTURAL REFERENCES