Many of us have come to realize that gender exists on a broad continuum that runs from capital "M" Masculine to capital "F" Feminine. What most of us don't realize, however, is that sex itself - the biology of how our bodies are sexed - is also fluid. In reality, sex is far more complex than the chromosomes XX - for female and XY - for male. Sex is not binary: a penis and testes for boy and a clitoris, vagina and ovaries for girl. In Kelli's case, doctors labeled her as a "true hermaphrodite," a rather silly label that doesn't actually refer to persons who have two sets of genitals but rather to persons who have both testicular and ovarian tissue in their gonads. Labels aside, she is a wonderful, living testament to how there are different dimensions of how our bodies are sexed. Nature presents us with complexity and diversity.

The cause of intersexuality can be chromosomal or hormonal. Kelli has a chromosomal "mosaic," a pattern called XY, XX, XO. Because so few people are tested, geneticists suspect mosaic chromosomes may be far more common than we know. According to Cheryl Chase, Founder of the Intersex Society of North America (www.isna.org), when the International Olympic Committee began to implement genetic sex testing only for women, they ended up kicking out 1 out of 400 women contestants - some of whom had no idea there was anything unusual about them. Women with androgen insensitivity syndrome, for example, have XY cells but cannot process testosterone, and they look like females. Why then would Olympic officials kick them out of the Olympics?

In 1988, Spain's top woman hurdler - Maria Patino - was barred from competing on Spain's Olympic team because she had failed the "sex test." She may have looked like a woman, had a woman's strength, and never had reason to suspect that she wasn't a woman, but examinations revealed that Patino's cells sported a Y chromosome and that her labia hid testes within. She also had neither ovaries nor a uterus - so, in short, Olympic officials did not consider her to be a "real" woman. Patino resolved to fight the IOC ruling. "I knew I was a woman," she insisted to one reporter, "in the eyes of medicine, God and most of all, in my own eyes."

But modern medicine regards most intersex children - especially those with ambiguous genitals - as a "psychosocial emergency." American medical protocols were established in the 1950's: assign a sex (usually female), operate, and shield the family from the notion that their baby's gender is in question. Although doctors are moving towards a more humanistic and "counseling-centered" approach to dealing with these kids, surgeons typically perform plastic surgery early to protect the child - and the parents from any sense of ambiguity. And while surgeons ultimately think they are using the tools of modern medicine to help these children fit into a harsh, unforgiving world that views these kids as "freaks," they have over-looked the fact that we are creators of the world we live in. And medicine is intimately involved in the construction of sexuality.

But why is modern medicine so intolerant of sex difference in the body? Is social change not possible? Using the surgery-centered argument, should we be making all kids white because we live in a racist society? Should homosexuality be considered an aberration become we live in a homophobic world? And should doctors and parents really be making irreversible changes on an intersex child's body because the child isn't old enough to "know what's best?" Are we so sure that we "know what's best for the child?"

Doctors are society's authority figures in this area and their reaction to children who are born intersexed has a profound impact on how parents - and society at large - view these children. "The doctors view it as an abnormality," says Kelli's mother, Debbie Hartman (elefun@interactive.net), "you can pretty much make people think what you want them to think by the way you word things." It is because of the way doctors "worded things," that made Debbie consent to several invasive genital surgeries on her child.

"The reason the parents are so disturbed," says Chase, "is that doctors have created a situation in which the parents are hyper-anxious about what their child's gender is. Doctors think the surgery will eliminate the parent's anxiety but in fact it leaves the parents with this ticking time bomb in their chest." An intersex child should be raised with a regular gender identity - without altering their genitals. With therapy and a supportive family, an intersexual could make his or her own decision about whether to choose plastic genital surgery - or not.

"We have to be able to be flexible," says intersex activist Dr. Bruce Wilson, "and accept that our first guess may not be right. I've taken that approach with families and they're open to it - they love their child and they can accept the fact that we're saying this child who we think is going to be a little girl may at 13 or 14 say I'm not a girl, I'm a boy." And what if this child's genitals have been surgically "feminized" as an infant?

And given that there is evidence that "cosmetically-altered genitals" have damaged sexual function, is it worth sacrificing sexual pleasure merely because we want these kids fitting into the locker room? There is, after all, no medical need to do the surgery. It's our anxieties about sex and sexuality and the fear that these children might grow up to be "homosexuals" that are driving the surgery to "normalize" intersex genitals. But according to Wilson, "no genital repair gives you completely normal looking genitals - so then we're really talking a matter of degree when doctors make their locker-room argument." And to the child, he adds, I don't think a degree is significant.

And so, ultimately, these are the kinds of issues that I want people to be aware of when they watch this piece. "I have so much emotion about what happened," says Debbie Hartman. "The only thing I can say is I'm glad I have my child, I love her undyingly. I eat, breathe and sleep her. Whether they made her cosmetically correct in their eyes as a female - what's the difference to me? If her genitals were left alone, I wouldn't have raised her any different. After the surgeries, my child wasn't the same anymore and I knew that was my decision. Lacking any information, I made the decision to take something away that my child was born with. And that's why I put my hand right there - on those bandages - and I cried for the longest time." Parental love is definitely not dependent on plastic surgery.

Michelle Melles
Segment Producer, SEXTV