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Journalism of Courage
November 28: Layettes should be pink or blue? Pedhas or barfis? In cultures across the world, this is the first question asked after your little bundle of joy enters the world. For the agonised parents with an intersex infant, the situation is best described as a social emergency.
Intersex is a condition in which the infant’s genitalia cannot be classified as male or female. An All India Institute of Medical Sciences (AIMS), Delhi study has recorded 700 intersex cases in India during the past 15 years though doctors in Mumbai say that all of them may not be genuine cases.
Besides, the good news is that all of them can be corrected surgically.
"These individuals will always be infertile but they can definitely be brought up as girls or boys. Parents should understand that there is nothing to be ashamed of and take the child to a physician or pediatric surgeon immediately" says Dr Jyotsna Kirtane, Head of department of pediatric surgery, J J Hospital. Dr Kirtane was speaking at the five-day Asian Association of Pediatric surgeons’ conference organised by the BJ Wadia hospital for children, Mumbai where intersex was among the many topics on the agenda.
Explains Dr Ila Meisheri, a pediatric surgeon who runs an `Intersex clinic’ at B J Wadia Hospital, "If the child is a male pseudo hermaphrodite with 46XY Chromosomes, he looks like a female. Similarly, female pseudo hermaphrodites with 46XX Chromosomes look like males. A true hermaphrodite with mosaic chromosomal patterns like XXYY, XXY etc. could have both ovaries and testes, vagina and penis." These conditions are evident at birth and can be rectified after single or multiple surgery. Two more types of intersex conditions are usually discovered when the child attains the age of puberty. Says Dr Meisheri, "Children with the Turner syndrome (XO chromosome) grow up to be normal girls. But they have non-functional ovaries and do not develop breasts or menstruate. Giving lifelong cyclical therapy (monthly contraceptive pills) ensures breast development and induces artificial menstruation. However, these girls cannot conceive." In the Kline Felter/ super-male syndrome (XYY chromosomes), boys start growing breasts. These can be removed surgically but the boy remains impotent. Says Dr Santosh Karmarkar, associate professor of pediatric surgery at B J Wadia children’s hospital, "In most intersex cases, it is easier to change the child into a girl, but most Indian parents insist on a boy. For instance, a very wealthy family had a child like that. I clearly told them that the `boy’ would face problems in the future. The couple never returned."
The condition can also be genetic. In a certain family, there are eight such cases all brought up as girls. In these cases, the clitoris looks like the penis which can be cut off surgically. Says Dr N Danismend, a pediatric surgeon from Turkey," When cases come to us late, the child has already grown up as a girl or boy. At that stage, the adolescent and the parents refuse to `change’ the sex."
