The Tale of Tea with Jim the Third

It was one of those messages I get occasionally, this time from a man who had suddenly realized we were just a few blocks away from each other. The writer's father was at a nearby Northwestern hospital, suffering from a terminal cancer.

"While trying to pass some time I went to ISNA's Web site only to discover that it was no more. [The Intersex Society of North America] basically saved my life. Wonderful people such as yourself, Cheryl Chase, Anne Fausto-Sterling, etc., have no idea how much of a difference [you made] and how many lives you have deeply affected. THANK YOU! It would be an honor meet you and shake your hand."

I offered to meet the next morning at the local tea place. And then I started wondering, as I often do with these out-of-the-blue communiqués, if this message was a fake. Was I being set up?

Pink Boys with Puppy Dog Tails

What to do with a "pink boy"?

In my e-mail in-box a few weeks ago, I received a polite message from a woman named Sarah Hoffman who was writing to ask why I was being such a gender conservative. Sarah didn't quite put it that way, but that was the gist of her message, and given that I'm usually accused of being a gender radical, I sat up and listened. And as I read the whole of Sarah's message, I realized she was absolutely right.

Sarah identifies herself as a mother of a "pink boy" - a boy whose manner of play and dress has often tended toward what's common in girls. Sarah was writing to me specifically in response to a piece I'd written for the Hastings Center Report called "Gender Identity Disorder in Childhood: Inconclusive Advice to Parents." There I had outlined the two basic clinical approaches taken to children labeled as having "gender identity disorder," and had mentioned my sympathies for and reservations about each.

Hot Cosmo Piece Screws Nasty Men!

Why do some women pay to let scummy men get into their pants?

I've been bemoaning the death of the free press a lot lately. With Internet competition, newspapers just don't have the resources to support good investigative journalism much anymore. So imagine my surprise when, on the check-out line of my grocery store yesterday, I discovered that the free press is alive and well in the form of . . . Cosmo?

"VAGINAS UNDER ATTACK," screams the cover of the July issue: "Don't Let Greedy Gyno Talk You Into This Horrible Mistake." So I'm going to forgive Cosmo the mistake of capitalizing a preposition in a title. Because Molly Triffin's on-the-ground reporting for Cosmo has the potential to save scores of young women from unnecessary pain, scarring, and loss of sexual function.

Inside the magazine, Triffin's story gets the title "WARNING: These Doctors May Be Dangerous to Your Vagina." Again, I'm going to forgive Cosmo, this time for using the word "vagina" to talk mostly about vulvas. Why? Because Triffin kicks ass. She bothered to go for herself to the International Society of Cosmetogynecology's Global Symposium on Cosmetic Vaginal Surgery.

And what did she see there?

To Have Is to Hold

What's wrong with trying to engineer your child's sexual orientation?

Or more specifically, what's wrong with taking a steroid, while you're pregnant, to try to increase the odds that your female fetus will someday grow up to be a straight woman who gives you grandchildren, and not a lesbian daughter more interested in puppies?

I have a funny feeling I'm about to get hit by various versions of that question, since Ellen Feder of American University, Anne Tamar-Mattis of Advocates for Informed Choice, and I just submitted a new post to Bioethics Forum revealing what we think is the first organized medical "paradigm" for attempting to prevent homosexuality in the womb.

Let me give five answers to that question. Maybe six.

Sugar, Boys, and Sugar Boys

Ok, here goes: I'm going to see how many people I can offend by suggesting that maybe many little gay boys, like many little girls, are made up of sugar and spice and everything nice.

In North America, I suffer from a terrible disease. When the disease flares up, I am virtually incapacitated by the symptoms. But if I go to many other parts of the world-for example, most of Asia, I am miraculously cured. There's something in the North American environment that makes me sick, and that thing is largely absent in Asia. What is it?

Milk. It took me a long time to figure out that my body can't tolerate lactose, the sugar in milk, long enough that I also managed to develop an allergy to the milk protein casein. If I lived in a part of the world where milk was not part of the adult diet, I'd be fine. In fact, that's most of the world; scientists estimate that eighty percent of the world's adult human population is lactose intolerant. Thus, most of the world's cuisines skip milk. Frankly, from an evolutionary perspective, it's rather freaky to keep eating milk past the age of weaning. Y'all are freaks. I'm normal.

Except in North America, that is, where I live in constant fear of accidentally ingesting milk. I've learned the hard way that Americans sometimes hide milk in margarine, Cool Whip, baba ganoush, "vegan" muffins, Tums (Tums!), French fries, and, increasingly--tragically--beer.

Now, as my good friend Paul Vasey, the super sharp Canadian sex researcher, packs to head off for his annual research trip to Samoa, I have been thinking about how my milk problem is analogous to what Paul has been tracing in his work with regard to male androphilia. "Androphilia" refers to being sexually attracted to males. Paul uses the term "male androphilia" where other researchers talk about "male homosexuality" because Paul studies a special population of people in Samoa, the fa'afafine.

How and Why to Take "Gender Identity Disorder" Out of the DSM

As a wizened gender rights advocate, I know better than to assume the activists making the most noise are actually representative of “the community” they insist they represent. So, while American transgender activists have lately been fairly unified and very vocal about the need to remove “Gender Identity Disorder” (GID) from the Diagnostic and Statistical Manual of Mental Disorders (DSM), I know that not all trans people agree.

Footnote to a Footnote: On Roving Medicine

Why language and little groups of radicals matter.

“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” This insight from Margaret Mead functioned as the guiding inspiration for those of us who worked for years as the Intersex Society of North America. A footnote to a recent Hastings Center Report article made clear Mead was right. And, because Mead was right, the history of social change (including in medicine) is actually significantly more interesting than it at first appears.

Is a Small Penis in the Hand Worth Three in the Bush?

OK, that title may be too cheeky. But it got your attention. Here’s what I’m thinking about….

The internationally-syndicated sex-advice columnist Dan Savage recently asked me to help out with a reader who thought he had a small penis and was considering “enhancement” surgery or pills. As a consequence, I’ve gotten a bunch of mail from guys with penis size questions or comments. A man I’ll call Bob wrote to say this:

“I am one of the people with extreme small [penis] size but am proof it doesn’t cause problems if you learn to work with it. I have 3 grown children now and am happily married. We are all given many differences in life and how we deal with them is what makes the difference. Keep sending the messages…your work is important.”

When I wrote Bob to thank him for his mail and to ask him if I could quote him, he followed-up:

Really Changing Sex

What would it take to get the government to worry less about our genders?

On Tuesday, the New York Times reported that New York City “is moving forward with a plan to let people alter the sex on their birth certificates even if they have not had sex-change surgery.” Under the new plan “being considered by the city’s Board of Health… people born in the city would be able to change the documented sex on their birth certificates by providing affidavits from a doctor and a mental health professional laying out why their patients should be considered members of the opposite sex, and asserting that their proposed change would be permanent.” No more need to get surgery or even hormone treatments to get the legal gender you feel is right for you.

Quite a progressive move, this. And nicely in keeping with the long history of liberal democracy, wherein social and political identities have been increasingly decoupled from anatomy. Think about it: your social identity and legal rights depend a lot less on your body type now than they did fifty years ago, and much less than they did a hundred or five hundred years ago. Most of the major civil rights movements have been about just this: arguing against body-based discrimination, whether it be race-based, sex-based, or ability-based.

Why should a person have to go through expensive and dangerous transsexual surgeries – many of which she might not want or be able to afford – to get people to recognize her as the gender she says she is?

But even for a gender progressive, the New York city approach raises a host of questions.

Proof that I Like Penises

Why circumcize perfectly healthy penises?


So, a new randomized control trial comes out showing that circumcision in adult males can dramatically reduce HIV infection rates, and all my friends who opted for circumcising their baby boys are holding up the dozens of national news accounts of this saying to me, "See?! See?!" Like I just condemned my son to die of AIDS because I let him keep his foreskin.

Meanwhile, the subset of those friends who are Jewish keep hinting I might be anti-Semitic for suggesting that the Jewish ritual of neonatal male circumcision probably ought to end. Oy!

First things first: