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No shame if your genitals look different

Saturday November 30 2019

INTERSEX

She did not know how to handle these social pressures in addition to her worries about the biology of her genitals. PHOTO | FILE | NATION MEDIA GROUP 

JOACHIM OSUR
By JOACHIM OSUR
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A number of people come to the Sexology Clinic for an examination of their genitals.

Most of these people are usually worried that their genitals are abnormal. Some think that their penises are small, others bigger than normal.

Some ladies also hate the look of their private parts and want it fashioned so as to look beautiful.

I was therefore not surprised when Laura, a 27-year-old journalist, walked into the consultation room and declared that she was abnormal "down there".

She had never had a boyfriend and was worried that if she attempted to get one she would be abandoned as soon as the man discovered the abnormality.

"I was in a boarding school for my secondary education, and for those four years I woke up at 3am to shower," she said, teary-eyed. "I avoided situations where my peers would look at my genitals."

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SOCIAL PRESSURE

Laura could not even amass the courage to discuss her situation with her mum. Unfortunately, she was the only girl in the family.

"You are the first person I have opened up to," she explains. "I have thought of committing suicide because this is a difficult situation to be in."

What stressed Laura most is that all her peers had boyfriends. Some of her age-mates were already married. Her relatives were already pilling pressure on her to get married.

She did not know how to handle these social pressures in addition to her worries about the biology of her genitals.

I examined Laura and true to her word, her genitals did not conform to the binary classification of male and female.

Although she had a vagina and also got her monthly periods like any other woman, what could have been her clitoris was anatomically a grown man's penis.

"I am always dressed in tight underpants and jeans since I get erections and the bulge can be embarrassing," Laura explained.

INTERSEX

I diagnosed Laura to be intersex. Intersex is a state where one's genitals, reproductive organs, hormone systems or genetic make-up do not conform to what we generally classify as male or female.

Many times the external genitals are what make people realise that they are different. Medical tests should, however, be done to determine if there are any other differences in an affected person.

Therefore, I ordered a plethora of tests on Laura. But results showed that other than her external genitals, everything else conformed to the female sexual formation.

Laura had also been socialised as a girl and in addition, developed physical features of a woman at puberty.

In the management of intersex, it is important not to confuse one's sex formation with their gender of choice. Laura had always taken herself to be a woman and I respected that.

"I am attracted sexually to men and I would like to marry and have children. I want the penis-like clitoris cut off so that I can feel comfortable with my body as a woman," she explained.

SURGERY

Historically, doctors and parents have colluded to assign sex to newborn intersex babies then followed up to do surgeries to make the genitals look like those of a male or female.

Many of the children then grow into adulthood without being told that such surgeries were ever done.

Occasionally, children who were thought to be male would grow female sexual characteristics such as breasts and those who were thought to be female would grow beards.

Their gender of choice and sexual orientation may also be very different from what they were assigned at birth.

Doctors are sometimes forced to put such children on hormones and force their bodies to grow into what they naturally were not.

The psychological trauma of knowing that your body was altered at birth can be traumatising.

COUNSELLING

Most affected children slide into depression and other psychiatric problems.

It has now been agreed in the medical circles that intersex surgeries in infancy and trying to hide one's identity from them is unethical.

It is encouraged that intersex people are allowed to grow as they are into adulthood without interference unless the differences they have in their genitalia or reproductive systems pose a medical danger.

"I am happy that I recognise who I am," Laura said. "Please chop off the penis, I do not need it."

Laura went through a series of counselling sessions. In the end, she still opted for the surgery. She visited the clinic last week, two years after our first meeting. She was carrying a baby.

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