Friday, June 7, 2013

More on the Case of the Intersex Infant in South Carolina: The Moral Principle of Doing No Harm

Toward the end of May, I wrote about a case now before the courts in South Carolina, in which parents of an adopted intersex child are suing the state of South Carolina. Mark and Pam Crawford allege that South Carolina Social Services and several doctors it employed to assign a female gender to their child did serious harm by making this decision--particularly because the child, who is now 8 years old and was an infant when the gender-assigning surgery was done, identifies as male and not female.

At The New Civil Rights Movement blog, Jean Ann Esselink provides a valuable moral analysis of this case. As she notes, a basic principle of medical intervention is to avoid doing harm whenever possible. As she also points out (echoing the Crawfords), when the state of South Carolina chose to determine this intersex baby's gender in 2006, there was no compelling medical reason at all for making this determination--which was made for an infant and without any evidence of the gender with which that infant might identify as she/he grew up.

In 2006, when the state of South Carolina took these steps, the prevailing consensus of the medical community was already that intersexed infants should be permitted to grow up, and to exhibit signs of identifying with one gender or the other, before medical intervention takes place. 

Two fundamental moral principles are at work here: do no harm, and respect the autonomy of an individual subjected to life-altering medical treatment. It might be argued, for the other side, that medical intervention in cases of intersex children spares those children psychological pain or social opprobrium. But it seems to me that this consideration weighs more lightly in the moral scales in this situation than does the injunction not to do harm. 

And it's hard not to imagine that harm has been done in a case in which an intersex baby had a female gender assigned to it, but is showing clear evidence of growing up as male-identifying. (It's also hard for me to read this story without remembering that the ardent disciple of sham gay conversation therapy, Rev. Dr. George Rekers, held the rank of Distinguished Professor of Neuropsychiatry and Behavioral Science at the University of South Carolina until certain events brought him into the international limelight in 2010.)

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