Intersex Rights Resolution

[ptrinkl108]

In viewing the ISNA website, I found the following resolution. It is a product of the "Society For The Study Of Social Problems". I am definitely interested in feedback.

RESOLUTION

"WHEREAS five times per day in the United States, plastic surgeons at major hospitals perform cosmetic surgery upon the genitals of infants of young children, and

WHEREAS these operations to improve genital appearance often result in severe negative effects, including the permanent loss of sexual sensation, lifelong bladder infections, and the loss of fertility, and

WHEREAS having genitalia that look atypical is not a medical emergency, so that surgery can be postponed until a child matures sufficiently to make a full informed decision whether s/he considers the risks worth the benefits,

THEREFORE BE IT RESOLVED that the Society for the Study of Social Problems urges all legislative bodies to draft legislation prohibiting genital cosmetic plastic surgery and/or accompanying hormonal treatments upon minors if it involves substantial risk to health or physical function, including future sexual function and fertility, unless the minor is sufficiently mature to give full informed consent to the procedure, and

RESOLVED that the Society for the Study of Social Problems urges
legislative bodies to define as medical malpractice cosmetic plastic surgery upon minors that involves substantial risk to health or physical function, including future sexual function and fertility, and that is performed upon a minor who does not consent or who consents and is insufficiently mature to give full informed consent."

[Kara]

I agree with the resolution.

If parents and families would focus on all of the wonderful and positive aspects of their child / loved one and take the focus off of what's "different" about them, the child would have higher self-esteem and quite possibly not spend as much time focusing on the fact that some part of them is "different".

We have drugs that can hold off puberty if the child needs more time to make an informed decision, so there's no rush to do anything as long as it's not a life threatening medical problem.

If doctors become accountable for the new set of problems they create for many of us from unnecessary surgery, maybe they would think twice about performing them. One would hope anyway.

I'm afraid that a resolution like this wouldn't pass though because of all the fear, predudice, and stigma that runs ramid throughout the medical field, not to mention the rest of our society. (Working in the medical field myself, I experience it on a daily basis.) That's why we need to get out there and educate everyone who will listen to us. MAKE THE MOST OF EVERY OPPORTUNITY !!!

That's my soapbox speech for the day.

[ptrinkl108]

Hi Kara,

Thanks for your post. I have done reseach on the "Society For The Study Of Socal Problems", and have discovered that the organization was founding in 1951, and publishes the respected sociological journal "Social Problems" through the University of California Press. Here is some of what I found:

(**** 9/26/04 UPDATE: As noted further down in this thread, the Resolution many not be the product of the Society For The Study Of Social Problem, but rather the name might have been made up by ISNA as a place holder. I have sent ISNA an email about this issue. At this point, there is no documented connection between the Society For The Study Of Social Problems and the Resolution. ****)

Peter

[Betsy]

A nice symbolic feel-good item. However, it presumes a one-size fits all approach, particularly when it comes to hormonal treatments. At what age is "mature enough"? And in the cases that Miriam has pointed out in the past, it doesn't fit at all.

And I'm not sure that using drugs to hold off puberty is any better than using drugs to ensure development. Drugs like lupron come with their own set of pitfalls as well and you could be substituting one bad choice for another.

Betsy

[Dana Gold]

Hi Peter,

Thanks for the reference to ISNA's website, which I visited and was pleasantly surprised to find a whole new format....I haven't visited their website for quite some time. In browsing more of the links offered by ISNA's home page, I came across this ( URL below) which discusses medical rhetoric inre treatment of intersex..... of particular importance/interest to me was this excerpt from the link:

A "small" penis must be constantly reaffirmed in its adequacy to fulfill masculinity. After testosterone treatments [HCG] are administered on the child, physicians look for a reaffirmation "of his allegiance to all things masculine." (Newman, Randolph and Anderson 1992, 645) Parents are reported as having "encouraged more appropriate male behavior". (Guthrie, Smith and Graham 1973, 250)


http://www.genders.org/g38/g38_hester.html


My step-father :baring_te :devil_smi did a lot more :eek: than just merely encourage me......... I wonder how many more parents (in the same situation) were that "avid" as my step-*&%$# ?

I'm thinking child (psychological, physical and perhaps sexual) abuse are major issues in the lives of many children, and feel especially so (various degrees) in intersexed children. I looked into Society for the Study of Social Problems homepage, and they didn't have all that much (maybe I just expecting more :rolleye13

Dana

[ptrinkl108]

Hi Betsy,

I would like to know more about what you are thinking. I personally think that the resolution is a step in the right direction for some of the following reasons:

1) It strengthens the concept of informed consent. I believe that parents are often influenced by a cultural bias in favor of normalizing surgery. In cases where surgery is necessary for the physical health of the child, I believe that there should be requirements that the doctors have provided parents with adequate information about the possible benefits and risks of proposed procedures. I would like there to be some written documentation that full informed consent has been provided to parents. I recommend that parents be provided references to organizations like Cares, Bodies Like Ours, and ISNA so that they can get a broader perspective. In cases, where the surgery is primarily cosmetic in nature, I believe that treatment decisions should be postponed until an age when the child can provide informed consent. What I found significant in the New York Times article was that the idea of involving the child in CAH treatment decisions at an appropriate age was seen as the best possible compromise between competing social demands.

2) I like strengthening the informed consent requirements because it avoids to obvious pitfalls. The first pitfall, as Miriam, Emi, Thea and others have pointed out, is that requirements that the definition of intersex be legislated will encounter sharp disagreements as to who is intersexed. (**Line removed at Emi's request as being inaccurate statement of what she said**) The resolution strengthens the rights of all children faced with normalizing surgeries that are basically intended to increase their acceptance by others. A second pitfall that the resolution language avoids is trying to directly ban genital surgeries and other hormonal treatments. In the past, Miriam has said that teenagers can be fully involved in making treatment decisions, and they can request genital surgeries if desired. I believe that surgeries should be available to intersex people, if we provide full informed consent for the medical procedures.

3) I like the clause of the resolution that asks that legislative bodies consider making non-consensual medical treatments a form of malpractice, in cases where the surgeries are cosmetic in nature. I would like to add that, as you have said in the past, that following the removal of the statute of limitations for priest abuse cases, that we seek to remove the statute of limitations for past intersex treatment abuses.

Peter

[ptrinkl108]

Duplicate post, sorry. -- Peter

[Sofie]

.... I came across this ( URL below) which discusses medical rhetoric inre treatment of intersex..... of particular importance/interest to me was this excerpt from the link:
.................
http://www.genders.org/g38/g38_hester.html


Dana
it's right here too as a PDF-file

http://www.bodieslikeours.org/research/psychologicalresearch.htm

[Betsy]

Point by point, or paint by numbers :teach:

As I wrote, it was the hrt issues I was responding to. Anyone can come up with a resolution (and many orgs have regarding IS treatment). No matter who does, they are symbolic in nature and mostly feel-good for the org that does it.

1) It strengthens the concept of informed consent. I believe that parents are often influenced by a cultural bias in favor of normalizing surgery. In cases, where surgery is necessary for the physical health of the child, I believe that there should be requirements that the doctors have provided adequate information about the possible benefits and risks of proposed procedures. I would like there to be some written documentation thatfull informed consent has been provided to parents, and that evidence of what information has been given be documented. I don't know much about informed consent law, but in my experience, informed consent for other medical procedures has basically been a "sign on the dotted line" affair, not much different than buying a car. I recommend that parents be provided references to organizations like Cares, Bodies Like Ours, and ISNA so that they can get a broader perspective. In cases, where the surgery is primarily cosmetic in nature, I believe that treatment decisions should be posponed until an age when the child can provide informed consent. What I found significant in the New York Times article was that the idea of involving the child in CAH treatment decisions at an appropriate age was seen as the best possible compromise between competing social demands.

I'm not sure how it would strengthen informed consent rather than merely shifting it. Not that there is anything wrong with that, and I would like to see that to occur if done properly. And yes, referral to support and advocacy orgs is vital. And yes, I agree with the premise of supplying lots of information to parents but you cannot legally force them to read it.

Not all treatment can wait until the child is old enough to participate and each condition (and even within the same diagnosis, each person is different) and has its own considerations and issues.

Even with CAH, not all surgeries are purely consmetic and often there are urinary tract issues that must be dealt with. The problem arises when docs convince parents that they can do one-stop shopping, including cosmetic clitoral surgery. Also, there are vaginal issues and that surgery must be done before puberty and while I believe it is better to wait so the child can participate to a certain extent with the process, I don't think the child is able to give informed consent at the age I would prefer to see them done (11 or 12). I don't see delaying puberty as a solution because the drugs used to do so come with serious side effects. I don't see opting out of vaginal surgery as an option because I think removal of the uterus and ovaries is a choice that only an adult should make after very careful and serious consideration.

One of the problems with the current state of affairs at least with CAH is everything is being done in infancy on the assumption the child won't remember. That in itself is a fallacy because the child will be reminded by the scars and frequent exams.

This example is just CAH, other intersex conditions have different needs and one size won't fit everyone.

Finally, while I have great respect for Cares Foundation and consider Kelly a colleague and friend, I'm not sure that someone who feels that surgery is ok if done by someone who does it frequently is a good solution. Check out their medical advisory board. To give you an idea of where she is on surgery, she feels the article in the Times was horribly biased.

2) I like strengthening the informed consent requirements because it avoids to obvious pitfalls. The first pitfall, as Miriam, Emi, Thea and others have pointed out, is that requirements that the definition of intersex be legislated will encounter sharp disagreements as to who is intersexed. When I had dinner with Emi a couple of weeks ago, she told me that strengthing informed consent requirements also would help people with cranio-facial conditions where the treatment is basically cosmetic in nature. The resolution strengthens the rights of all children faced with normalizing surgeries which are basically intended to increase their acceptence by others. A second pitfall that the resolution language avoids is trying to directly ban genital surgeries and other hormonal treatments. In the past, Miriam has said that teenagers can be fully involved in making treatment decisions, and they can request genital surgeries if desired. I believe that surgeries should be available to intersex people, if we provide full informed consent for the medical procedures.

I'm not sure trying to encompass craniofacial conditions is a wise move in our struggle to change medical protocol for intersex conditions. One major difference is that we don't wear our genitals on our face. The other being I don't see a movement by those who had cleft lip surgery in infancy speaking out against the practice.

3) I like the clause of the resolution that asks that legislative bodies consider making non-consentual medical treatments a form of malpractice, in cases where the surgeries are cosmetic in nature. I would like to add that, as you have said in the past, that following the removal of the statute of limitations for priest abuse cases, that we seek to remove the statute of limitations for past intersex treatment abuses.

It is a form of malpractice already. The current informed consent laws are not being broken. Instead, it comes down to who has the right to give consent and for what reasons? And how do we legally legislate the differences between procedures that are truly cosmetic and others that may be depending on personal definitions. Do we seek laws that treat clitoral surgery separate from hypospadius surgery? Do we seek laws that cover all consmetic surgery on children? What if you have a child with a lame leg? Laws that treat all cosmetic surgery as equal could have unintended and horrible consequences. If we seek only laws that are IS specific, you end up back at square one trying to define what exactly is an intersex condition. Not even all physicians agree on what makes up an intersex condition. I read a post from a physician on a listserv for docs just yesterday where he said CAH was not an IS condition, yet go to websites of places like Johns Hopkins and they have it defined as one.

I think kicking around legislative or legal remedies is a great exercise, but I don't see the fruition of the vast majority of them as a reality or even beneficial. Regarding informed consent, I'm pretty sure I have made myself very clear in the very recent past in regards to my support of it http://www.bodieslikeours.org/forums/showpost.php?p=5474&postcount=28. Right now, the consent that is given by parents passes legal muster. As I pointed out in the above post, legislation that requires further certain steps (even if symbolic) be taken could open that door to civil redress in the form of malpractice. legislation such as this is easily implemented, doesn't require an overhaul of current legislation because it only expands it rather than revamping it, and would not need differentiation of different situations. This is where those pesky statutes of limitations could get in the way though and seeing those laws change would be a good start.

One reality I do see is changing the protocol that doctors use when confronted with the birth of child who looks a bit different. There are many human rights violations that have gone the way of the dodo without laws but by reason, ethics, and outrage. Thankfully, that is already happening, albeit slowly.

Betsy

[Betsy]

it's right here too as a PDF-file

http://www.bodieslikeours.org/resea...calresearch.htm

J. David Hester is an interesting person and I've had some great email conversations with him. I've learned quite a bit on how to conduct productive discourse from those conversations and from his work.


Betsy

[miriam]

Dear Peter,

I fully agree with you, informed consent is the key to a better medical treatment for intersex people. But to improve the quality of informed consent we don’t need legislation. Au contraire… To have legislation you should first reach consensus with all parties involved: lawyers, medical professionals, parents of intersex people, intersex people and even with people who think that they know what is best for you but who have never seen someone with an intersex condition before.

Every person and every organization must agree to accept a decision an to take the responsibility for implementing it. Even those who don’t wholeheartedly support the decision must be willing to experiment with it for a certain period of time.

It is almost impossible to achieve that with our limited resources. (Our = we = the intersex people who have the courage and the time to do this kind of work.)

But even when we could reach the consensus and even if we could turn that consensus into legislation, you should understand that the legislation would be a kind of ‘snapshot in time’ of the state of how everybody involved thinks about the treatment of intersex people. A couple of years later some more dinosaurs will have left this world and because of our never-ending education more people will embrace our points of view. That means that a couple of years later it will be possible to reach a new consensus that will match our points of view better than the legislation does. But legislation is legislation and I’m afraid that it is easier to change the ideas of 1000 medical professionals than it is to change one official rule.

For that reason I prefer to keep lawmakers out of this.

I recommend that parents be provided references to organizations like Cares, Bodies Like Ours, and ISNA so that they can get a broader perspective.

Why not to other organizations? Many churches will say that they are qualified to help intersex people and their parents, not to mention all the organisations for transsexuals. And are we capable of helping parents? We are not trained for it and the broader perspective you mention is quite often a rather narrow perspective: our own, personal vision on our own intersex condition.

In cases, where the surgery is primarily cosmetic in nature, I believe that treatment decisions should be posponed until an age when the child can provide informed consent.

That means that YOU decide what is good for the child. But you don’t know who the child is, how she/he looks like or what the diagnosis is. That is not really better than that the parents together with a team of medical professionals decide what to do. What you’ve put here in just one line of text would take several books to describe all the rules and the exeptions tho those rules. And who are the people who will interpret the rules and the exception in those books? Medical professionals?


Groeten, Miriam

[Betsy]

I really need to clarify some stuff in my lengthy post. The whole issue of informed consent pertains to civil law---that is, a civil mechanism that enables people to sue if they feel they have been wronged. I'm pretty sure our laws (as enacted on the state level) only require that basic consent be given, but I don't believe what informed consent is to be actually defined. Most states have medical bill of rights laws that cover these basics.

The elements of what constitutes informed consent is actually addressed by medical conventions and is self-enforced by medical associations as way to keep themselves from getting sued.

For instance, The World Medical Assn has the Declaration of Helsinki covering medical research (which you could probably sue under as being subjected to medical research without your consent). In the US, what is required with informed consent is a bioethical consideration and administered by the AMA and AAp, etc. The circ folks have lots of information regarding it on their sites, particularly at CIRP for instance, http://www.cirp.org/library/ethics/AAP/

A google search of medical ethics and informed consent will give you volumes of stuff to read.

Betsy

[Betsy]

here's a pretty easy to understand article on what informed consent is:

http://www.birthsource.com/proarticlefile/proarticle121.html

And here is an article by an anti-abortion organization regarding informed consent. Note that they what they are proposing is not all that different than what I suggested in an earlier post and actually expands upon it. Miriam has a good point about the bias of support groups and the different biases that can arise which I think this model overcomes.

Anyhoo, it's at http://www.afterabortion.org/model_l.html

At the end of the day though, it's still a matter of defining what is cosmetic, what may be cosmetic, what is cosmetic now but may be medically necessary at a later date, and the biggie, just what the heck is intersex.

As much fun as the rhetoric can be, I still prefer devoting my energy to education which I agree with Miriam will bring about change a whole lot faster.

Betsy

[ptrinkl108]

Hi Betsy,

You wrote,

"At the end of the day though, it's still a matter of defining what is cosmetic, what may be cosmetic, what is cosmetic now but may be medically necessary at a later date, and the biggie, just what the heck is intersex."

I disagree with this statement. I believe that what is really important is that the rights of an intersex child be preserved as best as possible through attempting postpone normalizing surgeries until a time when the child can actively be involved in treatment decisions. I find in encouraging that the medical profession is increasingly supporting this position, in no small part because of our input. I think that it is important to investigate issues surrounding informed consent and the broader issues of just what information is being provided to intersex children about their conditions, and what treatment options are being presented to them, (including the option to not undergo normalizing surgery.) On these broader issues I believe that we are in agreement. I appreciate that you posted links to articles on informed consent. Informed consent is something that I believe is important, and should be researched further.

I generally believe that normalizing surgeries should not be done before the age of five years old. I am not an expert in child psychology, but I remember that around the age of four or five, I spent much time thinking about my identity and issues of sex and gender. Having genital scars at that age is a tremendous stigma and trauma. I got the message that not only was I different, but that somehow I did not belong on this planet.

In recent weeks, Miriam on the basis of a few informal posts on this site by a parent, suggested early surgery for CAIS. I fully support the reservations about Miriam's advice that Neko posted at the time. What if the mother goes ahead with the surgery on the basis of input from the intersex community? Does that in any way ethically justify such a course of action, if it lacks the informed consent of the child? What if studies find that most intersex people are happy with their surgical outcomes? Would that justify blanket treatment of intersex people on the basis of input from the intersex community?

The reason that I like the idea of requiring an intersex child's informed consent is that in a complex world of messy situations, the intersex person should make informed decisions about treatments. I believe that parents of intersex children are often motivated by a wide-spread cultural bias in favor of normalizing procedures for intersex children. I am trying to move away from all of the debates about what is "cosmetic" and what it is to be "intersex". An intersex person should not be required to "write a book" or get a PhD in intersex studies to answer basic questions about their bodily integrity and their future.

At the end of the day, I think that a cautious approach is best. I think that partly why Jules is happier with her situation than I am with mine, is that she was treated by concerned doctors at an age when she could appreciate their concern. I imagine that she faced many difficult and painful issues, but ultimately was able to respect her doctors because they respected her. In my case, it was more like a "hit and run" accident, where I cannot even obtain basic medical records, and I have been left with a lifetime of stigma and pain.

Peter

[Betsy]

I wrote "At the end of the day though, it's still a matter of defining what is cosmetic, what may be cosmetic, what is cosmetic now but may be medically necessary at a later date, and the biggie, just what the heck is intersex."

Peter wrote: I believe that what is really important is that the rights of an intersex child be preserved as best as possible through attempting postpone normalizing surgeries until a time when the child can actively be involved in treatment decisions.

--big snip--

I generally believe that normalizing surgeries should not be done before the age of five years old. I am not an expert in child psychology, but I remember that around the age of four or five, I spent much time thinking about my identity and issues of sex and gender. Having genital scars at that age is a tremendous stigma and trauma. I got the message that not only was I different, but that somehow I did not belong on this planet.


The reality is you are still going to have doctors dictating surgery for social reasons and calling them a medical emergency or a possible future medical emergency. It really comes down to who is defining what and the details of the definition. This is why a cut and dried solution is not viable in my opinion. Legally prohibiting a procedure because you (meaning whoever writes the legislation) doesn't like it leaves you in charge and I'm not comfortable with that no matter who is in the role of "you" It's not doable, it's not reasonable, and legally would not hold nearly as much weight as the ink the laws are printed with. Are you ready to defend yourself from someone who claims they were harmed by legislation prohibiting surgery? That could happen.

On the other hand, I don't think a five year old is anything close to capable of making a decision that will impact them for their entire life. A five year old will say whatever mommy and daddy wants at the moment. And legally, with true informed consent, the opinions of a five year old are moot. Even with the very drastic surgery I had, I didn't have a clue at age five what was going on...I was just a little girl who really liked to play with my hotwheels.

Yes, you are correct in that a cautious approach is best. There's no argument there. Reaching that point however will not be accomplished with draconian laws. It will come about by changing the way society sees someone with a queer body, by making it okay to have a queer body, and by changing the way medicine as a whole treats us.

Betsy

[miriam]

Peter, you are driving me mad...

In recent weeks, Miriam on the basis of a few informal posts on this site by a parent, suggested early surgery for CAIS. I fully support the reservations about Miriam's advice that Neko posted at the time.
Are you dyslectic or do you have a problem with your memory? I don’t know what it is but you really seem to have a problem with quoting me correct. In the thread with Butkis I gave several reasons pro and contra the removal of the gonads of her child. But I also wrote:

I’m not a medical professional, but even if I would be qualified to answer your question I really don’t know what to advise.
What is better? I don’t know.
But you wrote:

Good luck. From your description of the situation of your daughter, it seems that you are doing many things right.
May I remind you that you said this “on the basis of a few informal posts on this site by a parent”...

I meet a lot of parents and I never tell them what to do. Instead I tell them what I know about AIS and what I’ve heard from other AIS’ers. Sometimes I even tell them how I FEEL about it. And I will always tell them that I’m not a medical professional.

In another thread you also had a problem with quoting me. In that thread I asked you to show me were I wrote the words you were quoting. I’m still waiting for an answer...

Miriam

[Jules]

I think that partly why Jules is happier with her situation than I am with mine, is that she was treated by concerned doctors at an age when she could appreciate their concern. I imagine that she faced many difficult and painful issues, but ultimately was able to respect her doctors because they respected her. In my case, it was more like a "hit and run" accident, where I cannot even obtain basic medical records, and I have been left with a lifetime of stigma and pain.

Peter


Hi Peter, One of the main reasons why I'm at peace with my body is that I

know what happened to me, I had under developed genitals, and they

choose not to leave me that way. Reading my medical records have proven

to me that my issues of shame had all to do with my parents and family, and

less to do with operations or doctors vists or issues of repect. I find it very

interesting that you do not have access to your records. Most intersex

conditions are well documented by the doctors that treat such conditions.

Your records should have been hand typed during a time when many carbon

copys should have been made. Now, it is one thing to have to fight a doctor

for the records because A book was written about your condition, it is

another thing to have no basic medical records.


I can understand how much this must hurt, not knowing what happend. I

must say this, with no disrespect to the suffering that you have been

through, There are many kinds of surgery that leave all kinds of scars on

the genitals ( Like having a syst in your penis, or a hernia in the groin area) If

you don't have records you can only speculate on what happend to you as a

child.

I have always in the past injoyed your posts in the past as they have

seemed to be a voice of moderation. This post represents a doctrinaire trend.

Whats happening? Why have I seen such a change in your writing?

[ptrinkl108]

Hi Jules,

Even without medical records, I have a pretty good idea of what happened to me. My mother told me that I was born with a vaginal opening, but lacked internal female organs. My primary care physician has examined my genital scars and has confirmed massive scarring between my scrotum and anus. He reported that such scars are the result of "developmental problems". My father told me that I had also had surgery for undescended testicles. I know that my penis was always very small as a child. At puberty, I was taken to the local children's hospital for evaluation. Although my mother did not say much, she did say that the physical workup was the most important aspect of the repeated visits, not the psychological testing that was being done. Later, when I was thirteen, my mother said that she was glad that I masculinized because my parents had been extremely worried that I would not. She also said that by my masculinizing, I avoided dreaded medical treatments that she never clarified. I wish that I could get my medical records, for no other reason that in the intersex world, having one's medical records is the gold standard of one's own history. Without it, questions like the kind that you bring up seem to come up.
You would think that I would be able to get my medical records. As I was born premature, and also had a congenital hip defect, I was in the hospital for months. My parents also repeatedly told me as a child that I was treated by a national charity. But both the hospital where I was born and the national charity are not able to turn up my records. I have my Birth Certificate that confirms that I was indeed born at the hospital that I contacted about my birth records. One mystery that my mother mentioned in passings, was that I was part of a documentary film study because I was born shaped like a crescent moon from side to side. Apparently, this was because my twin, who died in childbirth, sat on me in the womb. But there are aspects of the story that I find puzzling.
It’s been a long day for me. In the space of one day, I have been implicitly accused on this forum of being possibly Dyslexic, possibly homophobic, and being a possible intersex phony. It’s really a bit much right now, and I just want to crawl under the covers and disappear.

Peter

[Emi]

I think ISNA used "Society For The Study Of Socal Problems" as a place holder for any social justice organization to insert their name--not realizing that it actually existed. Someone please tell them that it's an actual organization...

Peter wrote:
When I had dinner with Emi a couple of weeks ago, she told me that strengthening informed consent requirements would also help people with crania-facial conditions where the treatment is basically cosmetic in nature.

Peter, this is NOT what I said. NOT AT ALL. Please do not repeat this again.

I did mention craniofacial conditions in one context only, and that is when I said that we should be careful about condemning treatments that are "cosmetic in nature," because many people with craniofacial conditions who received surgery as children feel that the procedure was helpful and vastly improved their quality of life. But some insurance companies refuse to pay for these surgeries because they consider them "cosmetic in nature," and some craniofacial patient groups are lobbying for a legislation to ensure insurance coverage for them.

I told you, Peter, about the craniofacial patient groups because I fear intersex movement stepping on other groups' toes. If the San Francisco Human Rights Commission were to issue a blanket resolution against treatment that are "cosmetic in nature," for example, we would be sabotaging the struggle of craniofacial patient groups to receive insurance coverage for the surgeries they want.

Please visit the websites of craniofacial patient groups (google for "craniofacial" and you'll find them) and study what their agenda are. It's extremely important that we do not hurt other groups while we advocate for ourselves.

[ptrinkl108]

Thanks Emi for the correction. I have inserted the following in the original post: (**Line removed at Emi's request as being inaccurate statement of what she said**) I apologize for getting it wrong. Thank you for clarifying a very important issue.


Peter