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.

Sex Is Good

But not always. And that’s kind of the point.

OK, let me back up.

Like that bad-for-you ex from whom you just can’t seem to make a clean break, the “news” story about how the feds fund questionable sex studies has come back a-knockin’ at the door. We’re supposed to be totally horrified that our tax dollars are going to fund studies that find out what turns people on and what makes people loose.

Are there some stupidly designed, rather useless studies happening in sex research? Yup. Which distinguishes sex research not at all from other academic fields. I admit, it was at a sex research conference that I conceived The Duh Award, an honor which would be given annually for the study constituting the most effort put into finding the most obvious conclusion. (The study that directly inspired The Duh Award was one showing that alcohol lowers sexual inhibitions.)

But the truth is, every field sometimes accidentally funds poorly conceived or useless research, and that isn’t reason to get rid of a field’s funding, nor to micromanage it. Why is sex research worth funding with public money?

Olympic Problems with Sex Testing

When will the International Olympic Committee learn that you can't fool with Mother Nature?

Ah, Beijing, where men are men and women are… women until proven otherwise. As reported in the New York Times, “Organizers of the Beijing Olympics have set up a sex-determination laboratory to evaluate ‘suspect’ female athletes.” According to the Times, “only athletes whose gender has been questioned will be tested in Beijing.” This approach betrays fuzzy-headed thinking of – well, of Olympic proportions. So I’m laying out here my questions to the Olympic officials involved in this business, in the hopes someone on the inside will send them along.

But first, let’s get the language straight.

The Social Construction of Sex and Me

I keep running into smart people who seem to think I believe that sex “isn’t real” because it is all “socially constructed.” Allow me to correct this erroneous social construction of me by summarizing here what I think about sex and gender. I’m tempted to say “what I know about sex and gender” because there are few things I feel as sure about as this.

Testes are real. Ovaries are equally real. They sometimes make real gametes. (I don’t mean to imply they sometimes make fantasy gametes—just that they sometimes don’t make gametes.) Chromosomes and genes are also real. As anyone who’s every forgotten to wear a pad on the right day knows, menstrual blood is real. To the delight of this straight woman, penile erections are real. So are clitoral erections. I’m equally delighted about those.

When I say these are “real,” what I mean is that these things have a material existence independent of our ability as humans to notice, study, deny, politicize, or categorize them. I can’t believe I even have to assert this claim, but some academics have gone over the deep end and disagree. (I don’t hang out with such people unless there I have some form of pain killer at the ready.)

So why would I write a book with the phrase medical invention of sex in the title?

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:

What to Wear?

Before Powerpoint became ubiquitously doable, I traveled with slides. (You remember 35 mm slides?) And I had a little ritual that centered on slides: The night before I had to leave on a speaking trip, I would drive my mate crazy by rushing all around the house demanding, “Have you seen my slides? Where are my slides?!”

Once I moved all my slides to my computer and started doing it all in Powerpoint, I couldn’t do that ritual, so I developed another to drive my mate crazy. Now the night before I leave on a speaking trip, I rush around the house pleading, “What should I wear? Help me figure out what to wear!”

It’s actually a serious problem for me, and not because I’m indecisive about clothes...although I am indecisive about clothes.

Choosing Children's Sexual Orientation

In a just-published New York Magazine piece, “The Science of Gaydar,” writer David France looks at the growing scientific evidence for innate differences between gay and straight people. France ends by gazing towards the future, and asks the question, “What if prenatal tests were able to show a predisposition to gayness?” Well, France reports, “[Northwestern University psychological professor] Michael Bailey, for one, isn’t troubled by the moral implications any more than he would oppose fetal screens for potential birth defects, though he quickly adds his personal belief that homosexuality is ‘a good’ on par with heterosexuality.”

Bailey espouses a definite Seinfeldian “not that there’s anything wrong with that” attitude toward homosexuality. In a paper he published on the subject with lawyer Aaron Greenberg in 2001, he wrote: “Because homosexuality causes no direct harm to others (other than those who take offense at it on irrational and/or inhumane grounds) and because homosexual behavior is crucial to the ability of homosexual people to enjoy their lives (as heterosexual behavior is to heterosexuals), homosexuality should not be morally condemned or proscribed.” But, Greenberg and Bailey say, it’s wrong to tell parents they can’t select for (or against) a heterosexual or homosexual predisposition in their children.