Monday, September 14, 2009

What Make a "Birth Defect" a Defect?

Of the thousands of articles written on Caster Semenya, this one by Seth Borenstein takes a much more sensible approach - talk to medical experts who specialize in intersex conditions and former athletes who have been through the gender-testing circus. So far so good. But the title of the article: "The birth defect people don’t talk about" sort of brings me up short. In his defense, Borenstein uses the words of the experts he quotes when calling intersexuality a birth defect. And in their defense, the medical experts he consulted come from a discipline in which functionality is the measure of health and well-being. So in some regards it makes sense to refer to being intersexed as a defective condition. But I have a different sort of problem with this characterization.

It seems to me that intersexuality is a "defect" primarily because of our culture. If we weren't so insistent on forcing people to fit into one of two boxes, and if we didn't assume that childlessness is always a tragedy of epic proportions, then being born intersexed wouldn't be a defect. It seems like we could imagine a culture in which being intersexed was just another way of being - neither better nor worse. But using the phrase "birth defect" seems to reinforce the normativity that saturates our culture regarding gender. And this seems like something the medical experts in this field should be avoiding, given the fact that apparently they want to distance themselves from the historic secrecy and enforced surgical procedures and bullying of parents of intersexed children. This kind of treatment was based on the same normative framework that casts intersex conditions as birth defects. And moving away from that framework would benefit all of us, whether we realize it or not.


  1. Agreed. I think for Caster Semenya (and for others, I imagine) being intersex is going to bring up more than a lot of problems. But anything that isn't strictly medical is caused more by the reaction of society than anything else.

    Incidentally I find it odd that the news (here at least) is pointing out that it's something she is born with and not her fault. Which is true. But it begs the question 'as opposed to what'.

  2. I would be inclined to categorize a condition that causes infertility a "birth defect." And I don't know if/how the various intersex conditions affect sexual functioning. But I totally agree that not fitting neatly into the M or F box is a problem our culture has - not the individuals.

  3. Serendipity9/15/2009


    “It is no measure of health to be well adjusted to a profoundly sick society.”
    -Jiddu Krishnamurti

  4. I'm curious to know how intersexed people themselves view this classification of intersex as a birth defect? Has anyone read anything on this or heard anyone's position? And does anyone know if all conditions that lead to infertility are classified as birth defects?

  5. Cass,

    I haven't, which is why I stated this in a sort of tentative way. The resources I use in the classes I teach don't mention this categorization of intersex as a birth defect, and they're fairly recent. There might be something on the Intersex Society's website. I do know that the way the medical experts talked about intersex in this article (in terms of holding off on surgeries and treatments until the individual is old enough to have a voice, etc) reflected the position that the Intersex Society has been fighting for for years, and that's encouraging.

  6. From what I've heard, Semenya is "on suicide watch" now. So sad. :-(