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Class and gender

phenoms's picture

    I'm still thinking about last class' medical/legislative activity, where, assuming a different professional role we were all supposed to give our advice about genital reassignment surgery. I was the legislator, in charge of making policy decisions regarding whether or not this surgery should be covered by healthcare. Although I am deeply uncomfortable that parents can choose this surgery for their children, it worries me more that this policy represents a limitation at the convergence of gender and class. The consequences of government policies are amplified for individuals with less money. People would still be getting gender reassignment surgery, but only people with money.  The poor are tied to their bodies in a way the wealthy are not. This is a simplified dichotomy, but a true one regardless.
    We briefly mentioned how much our discussion on genital modification reminded us of the discourse surrounding abortion (waiting periods, prescribed education,  counseling etc). The similarities extend to the legislative venue as well. When Legislators want to stop abortions, knowing full well they can't outlaw them, their solution is regulation. To make them as hard to get, for as many women. Women with means don't generally have difficulty getting around these regulations They can pay for the childcare, they can afford to travel the sometimes hundreds of miles for their procedure. The women who lack the means however, may be stuck in their pregnant bodies.
    In both cases, increased regulation and lack of coverage affect low-income people. Are these comparisons apt? Maybe I'm just frustrated with our system in which it's being a woman (or a not societally accepted man) is made much more dangerous/costly if one is not born into a middle class family. The intersection of class/ gender heavily impacts one's experiences with their own body.


AmyMay's picture

Intersex, Identity, and Medicine in a Global Context


I have to agree with leamirella and lgleysteen that we need to incorporate a broader cultural perspective into our discussions in general, and particularly in relation to gender surgeries, identity, and class.  Phenoms, your comparison of intersex surgeries to abortion procedures makes me wonder what U.S. foreign policy is regarding funding of intersex surgeries.  I wonder if U.S. foreign policy includes specifics about intersex surgeries like it did with abortion under the Bush administration's global gag rule.  (U.S. funded NGOs were prohibited from using their own funds for abortion services, lobbying for abortion rights in their respective countries, public education campaigns about abortion, and providing abortion advice/information.)  


Expanding on leamirella's point, I feel that the conversation about intersex bodies and identity linked to physical structures assumes a very individualistic concept of identity.  Such conversations about a child's future psychosocial development hinge on the idea of individual identity and individual choice.  In societies where identity is more communal, do such conversations even make sense?  How might gender development be conceived in such cultures?  I imagine that the DNA and experiences of the singular person might not come as much into play.  Perhaps the complex web of social ties that bind people to their family, government, churches, and other institution might be said to play a role in determining someone's gender.  If the self concept is conceived of in terms of social relationships, and the gender component of this identity is also more relational than biological, it seems that intersex surgeries would be at best irrelevant, and at worse mutilation.  It seems impossible to apply the discourse on intersex infants anywhere outside of our specific cultural context.


Thinking of intersex surgeries in the context of a different construction of gender and social identity more broadly, I am reminded a lot of the somewhat infamous debates within feminist circles over "female circumcision" or "female genital mutilation."  I'm not trying to get into the eurocentrism vs. sexual violence debate here, but I can see how an outsider, with a different view of what "identity"  and "gender" mean might interpret intersex surgeries as genital mutilation.  So what happens when American practice influences medical practice in other countries (which it does, since as Roughgarten emphasized, the United States dominates the world in scientific research)?  What happens when people from other cultures come to the U.S., and medical care here does not match their construction of self?  Are the opinions of these people marginalized, through language and information barriers?  I am reminded of the TV show House M.D., where the lead character frequently tricks his patients into accepting unwanted medical treatments because he knows what is best for them.  I don't think that every doctor is like House, but I definitely think that the cultural/informational/privilege/language gap that may exist between patient and doctor leaves the door open for disregard of patient wishes, however well intentioned.

someshine's picture

Refusing To Give Care

Phenoms, in thinking about the difficulties you mentioned that legislators put in place for women seeking these procedures, I’m reminded of the ways in which nurses, doctors, and other medical professionals similarly create obstacles for their patients. To think that they are able to or do completely separate their personal biases from their professional work seems foolish to me. There’s certainly a spectrum along which they actively try to prevent their patients from gaining access to and receiving proper care. Some doctors may refuse to offer care while others may harm their patients. The latter is especially applicable to the topic of gender reassignment surgery today. Southern Comfort provides a raw look at Robert Eads’ last year of life, as he dies of ovarian cancer, unable to find a doctor willing to perform surgery to save him. Having made peace with and forgiven the medical professionals that worked so hard to prevent him from getting surgery, Robert spends his last year enjoying time with the people he loves. His greatest wish is to live long enough to attend Southern Comfort, America’s “preeminent transgender gathering”, where he has long felt at home, to borrow Eli Clare’s term. I won’t spill any more details, as I think everyone reading this post should see and listen to Robert’s story. What I find so admirable is Robert’s decision to forgive the people employed to offer him care. What upsets me is the thought that there are more people in the United States who are unable to receive the care that they need because of the prejudices their doctors and nurses hold.


leamirella's picture

Just class?

I think it's really starting to get interesting now that we're not just limiting our conversations about gender reassignment surgery to just our frame of reference. During the break, I talked to lgleysteen about the exercise that we had done and we both came to the conclusion that we weren't talking enough about these issues on a more global level. We focused on legislators in American societies but we did not even think of what it would be like to be a legistator somewhere else in the world.

I do agree with your point, phenoms, but I would also like to add that rather than just thinking about class, we should also think about cultural differences as well because all of these three things tie into each other very closely. It is not just the poor who are tied to their bodies, it is also those who are part of societies that are not as focused on the individual and on the individual's choice.

This other intersection with race/cultural background is another one that heavily impacts one's relationship with their own body.