Zwitter-Prozess: Ärzte unter Druck

Anne Fausto-Sterling is one of the leading theorists on science, sexuality, and gender. Trained as a molecular biologist, and a professor of Biology and Women’s Studies at Brown University, her research and writing covers a broad rage of topics: the science and politics of sex hormone research, theories of the etiology of sexual orientation, the use of animal models to “explain” human behavior, the sexual politics behind the medicalization of intersexuality (formally termed hermaphrodism). But through all of Fausto-Sterling’s writing her underlying concern is how social attitudes, biases, and prejudices—particularly about issues of sex, sexuality, and gender—inform and influence scientific research, theory, and practice: the social construction of science.

Fausto-Sterling’s first book, Myths of Gender: Biological Theories about Women and Men was published in 1986. It has since become a classic in its field. In it she looked at the commonly held assumptions of male and female difference—how much of what men and women feel, think, and do is inherently biological or innate. Are men more aggressive? Women more nurturing? Are men programmed to be more violently sexual? Do women’s hormones control their moods and actions? After examining biological, psychological, genetic, and evolutionary evidence her answer was: not much at all. But it was the theme of the book—a critique that science was, or ever could be, pure or “objective”—that caused the most critical reactions and controversy.

In her new book, Sexing the Body: Gender Politics and the Construction of Sexuality (Basic Books), Fausto-Sterling examines intersexuality, the politics of researching “gender chemistry,” and how basic brain anatomy is “gendered” by scientists and the mainstream media. What she has discovered is not only isn’t biology destiny, sometimes it isn’t even good biology.

RIOT: What started you thinking about and doing this research and writing?

ANNE FAUSTO-STERLING: What pushed me to write Myths of Gender in the first place was involvement in the feminist movement. I would be at meetings, this is in the early 1970s, where people would start having arguments about male rats being more aggressive than female rats. And they would say things like, “Well, we know that male rats....” And I thought, “Well, do we really? What do we really know about male rats. And can we apply that to human behavior.” So that was the beginning of my research and thinking. Up until then most feminist thinking about women and science was about the discrimination women faced in the field. Not many people were conceptualizing or talking about how to bring feminist ideas into the lab, or applying them to how science was done. And I realized that I was trained and had the tools to do that, to look at how preconceptions about gender affected scientific research.

You clearly take a “social constructionist” line in your work, which many other scientists don’t. Do you experience much tension or hostility from colleagues?

It really depends on the setting. Most of what I have been doing is interdisciplinary work, and women’s studies, where this is not an issue. I am also on a listserve for people interested in and committed to sexology, and here it is quite different. Many of these people are quite opposed to social constructionist ideas. They exhibit, to my mind, a quite naive, old fashioned view of science as totally and completely objective. Of course, my view is that the social is always involved in how science is done, but you can understand what the process is. Interestingly the people in the molecular biology department at Brown are rather clueless to this debate, they are just busy doing the basic ground work in experiments and research. With Sexing the Body out I am going to do a department seminar on the chapter about sex hormones—which I think is very challenging and really pushes the envelope in discussing how scientific research is profoundly affected by prevailing ideas about gender.

What is your argument?

One of the things I do in the book is address what it means to make a claim about social construction. I begin the book with several chapters discussing intersexuality—how many infants born with ambigious genitals, or a combination of external and internal genitals and reproductive organs are “fixed” by extensive surgical intervention to make them conform to traditional identities of “male” and “female” even though the reality of their bodies are far more complex. Often these surgeries cause extensive scarring and ultimately inhibit the possibility of orgasm. They don’t make these infants more “male” or “female” but are cosmetic solutions.

I begin here because this is a fairly obvious example of how our ideas about gender affect science and medical practice. But I wanted a more complicated example. I wanted to push it further and see what happened when we moved into the interior of the body—to look at something that is considered “nature’s truth” and that would be viewed by most people as untouched by social input. Hormones seemed the perfect subject to study. For one thing, we know what they are, we know the chemical formula.

So I started exploring the history of how what are usually called “sex hormones” were discovered, named, and how they work in the body. What I found was that before they were ever even identified both estrogen and testosterone were conceived of as being “female” and “male” and pertaining to, quite discretely, male or female bodies. When it turned out—through increasingly sophisticated research—that all hormones are found in both sexes scientists were quite distressed. It turned out that stallions secreted huge amounts of “female” hormones in their urine; in fact this was the best source of the hormone for further study. Scientists and researchers were so intent on patrolling the boundaries of “male” and “female” that they began by making assumptions about the studies before they did them, and then had to keep revising their ideas to “save” the early studies.

While estrogen and testosterone do have some specific reproductive functions they have many non-reproductive functions. To say they are “sex hormones” is misleading; they are hormones, present in both male and female bodies. I chose this because it is less obvious than, say, talking about how external genitals are sexed.

You argue convincingly that society, politics, and all kinds of preconceived ideas about gender and sexuality influence how scientific work is done and how conclusions are reached. What can we—as non-scientists—do to change that?

I am not sure the point is to change it. What we need to do is understand it. There is no “pure science.” Science is a particular kind of cultural activity and the nature of science is rules—providing empirical evidence, etc. The point is not to eliminate culture from science—which would be impossible—but to understand what is going on so we can make appropriate use of science in our social decisions such as how we allocate money, and on choosing research topics. An example, I think, of a socially conscious use of science and research is how to stop the AIDS virus. This would obviously be a good thing. A bad use of science and resources—and many people, including gay people, would disagree with me—is research to find a “gay gene.” This has no clear purpose, and possibly even negative effects such as a move to abort “gay fetuses,” if such a gene was identified, which I think is unlikely.

The point I think is to encourage and move with national debates and change society to be more humane. These are all ethics and value questions. Science is not a neutral place but a place where particular kinds of knowledge is produced. We all—scientists and non-scientists—have to become more comfortable about engaging in and demanding these public discussions.

In 1993 you printed an essay in The Sciences entitled “The Five Sexes: Why Male and Female Are Not Enough, this was reprinted in the New York Times a few months later as “How Many Sexes Are There?” There was a lot of outrage from both scientists and political groups—including The Catholic League for Religious and Civil Rights. Given how deeply entrenched these ideas and feelings are how is it going to be possible to make any social or political progress in changing how society views sex and gender and patterns of sexual desire?

In the article I claimed that the large number of variations of chromosome makeup, as well as internal and external genital formations found in intersexed people might lead us to reclassify, not two, but five sexes. One of my points was to get people to think outside of a simple binary sex classification system. Of course, claiming that male and female are not our only options will upset people.

I see my writing as a way to make people think about things and I think that if that can happen we will see changes. Many people feel the need to cling to simple explanations, but this doesn’t mean that change can’t, and doesn’t, happen. Look at what feminism has done in a few decades. Look at the gay movement. There are actually serious discussions and actions in legislatures about gay marriage. I think things are changing very quickly.

Some people in the gay community, and even political movement, have turned to science to make homosexuality “normal” or acceptable—particularly the use of animal models to explain, or justify human homosexual behavior. Last year, Biological Exuberance: Animal Homosexuality and Natural Diversity by Bruce Bagemihl was published in which he detailed a variety of homosexual or transgender behavior in 190 species. What do you think about using animal models of arguing for acceptance of homosexuality, bisexuality, or sexual deviation in society?

I’ve only glanced through that book and it looks fascinating. But animal models have to be used with great caution. They are usually badly done for both their application to humans and even for their application to the animals themselves. A badly done study of rat behavior tells us nothing useful about the rats, and is even more useless—if not dangerous—when applied to humans. If we are moving towards creating a more humane society, one that is caring and just, we don’t need animal models. We are on shaky ground if we base civil rights arguments for gay people on the fact that some animals have same-sex sexual encounters. I think that the questions of politics has to be fought on ethics, values and civics—not science. You can select some piece of biology and make it fit, and then someone can disagree and can argue with you—even “prove” you wrong. This is no way to work towards a better society. Biology cannot resolve social equality.

What applications do you think that your work in intersexualism have for lesbian and gay politics today? The past few years have seen a lot of fighting in the mainstream gay and lesbian politics about the role of transgendered people in the movement, with some people not seeing transgendered people or issues as relevant to a “gay and lesbian” cause. This came to a small crisis this past year when the National Gay and Lesbian task Force [NGLTF] withdrew its support from the Employment Non-Discrimination Act [ENDA] now before Congress unless transgendered people, along with lesbians, gay men, and bisexuals, were included in its language. The more conservative Human Rights Campaign [HRC] took exception to this and accused NGLTF of hurting the bill’s almost non-existent chances of passing. How do we build a movement that can deal with people’s complicated feelings about sexual orientation, gender, and sex?

I think that the movement has to be all embracing. When we use a determinist standpoint to exclude people because they don’t fit into a strict, specific category we cut ourselves off at the knees. My political interests go beyond a civil rights agenda. I am interested in broader questions of opening up gender possibilities. No matter what category we want to put be people in there is always a large variability—both cultural and biological—within those categories, why not just admit that things are more complicated.

I think, and I’m guessing, that some of the hostility to transgender people in the mainstream gay and lesbian movement is because part of being “mainstream” is convincing straight people that “we are just like everyone else.” This is harder to do if you include transgender or intersex people in that mix. In any national movement—the history of the woman’s movement shows us this—a more mainstream wing always appears and is more exclusionary, more conservative in its membership and its goals. But it does gain a certain amount of ground because of this. We always have to remember that it is the radical fringes that creates new space for the movement to grow and that also makes it possible for there to be a middle ground to begin with.


SO A PSYCHOSIS IN GERMANYS CO-NOTATIONS OF ENGLISH SOCIAL MARKS WILL BENEATH ALL PROIRITY OF BEING HERE COLORED AND STEREOTYPED INTERSEXED!

 http://www.tagesanzeiger.ch/dyn/wissen/medizin/838827.html

Intersexuelle setzt sich mit Zivilklage gegen Chirurg durch

In einem bundesweit beispiellosen Fall hat sich eine Krankenpflegerin nach jahrelangem unfreiwilligen Leben als Mann mit einer Klage gegen ihren früheren Chirurgen durchgesetzt.

Das Landgericht Köln bezeichnete einen operativen Eingriff bei der Klägerin vor mehr als 30 Jahren als rechtswidrig und gab damit der Klage der 48-Jährigen auf Schmerzensgeld grundsätzlich statt. Vor der damaligen Entfernung ihrer Eierstöcke und der Gebärmutter sei die Klägerin "nicht zutreffend aufgeklärt" worden, urteilte das Gericht. Zur Höhe des Schmerzensgeldes traf das Gericht noch keine Entscheidung. Gegen das Urteil ist Berufung beim Oberlandesgericht möglich.

Die Klägerin war durch die Operation 1977 biologisch zu einem Mann gemacht worden. Nach ihrer Geburt war sie als Junge angesehen worden, nachdem ihre äußeren Geschlechtsorgane nicht eindeutig einem Geschlecht zuzuordnen waren. Während einer Blinddarmoperation bei der damals 17-Jährigen wurde entdeckt, dass sie Eierstöcke und eine Gebärmutter hatte. Die inneren Geschlechtorgane wurden der Klägerin ein Jahr später bei der umstrittenen Operation in einer Kölner Klinik entfernt.

Der Vorsitzende Richter Dietmar Reiprich betonte bei der Urteilsverkündung, bei dem chirurgischen Eingriff seien "eindeutig nur weibliche Geschlechtsorgane" gefunden worden. Dabei habe die Klägerin vor der Operation davon ausgehen müssen, dass sie "gemischtgeschlechtlich" sei. Angesichts des gegenteiligen Befunds während der Operation habe es an der Einwilligung der Klägerin zu dem Eingriff gefehlt.
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Die Krankenpflegerin aus Düsseldorf zeigte sich "positiv überrascht" von dem Richterspruch. Sie müsse ihren Erfolg in erster Instanz nun "erst einmal geistig verarbeiten", sagte sie der Nachrichtenagentur AFP. Auch der Rechtsbeistand der 48-Jährigen begrüßte das Urteil. Das Gericht habe festgestellt, dass seiner Mandantin "schweres Unrecht" geschehen sei, betonte Anwalt Georg Groth.

Zumindest in Deutschland berücksichtigten nahezu alle Pressemeldungen, dass es sich beim vorliegenden "Zwitter-Prozess" nicht bloss um einen individuellen Einzelfall, sondern um ein grundsätzliches Verfahren handelt. Am ausgewogensten und ausführlichsten war einmal mehr die Agenturmeldung der Associated Press, nachzulesen z.B. hier:

Des Zwitters Sieg (Stern)

Seltsam nur, dass sich der letzte Satz derselben Agenturmeldung dort nicht findet, im Gegensatz z.B. zur Basler Zeitung:

Die 48-Jährige selbst hat in den nächsten Monaten noch viel vor: Seit 18 Monaten versucht sie nach eigenem Bekunden bereits ihren männlichen Vornamen auch offiziell in Christiane umzuwandeln. «Noch bin ich gegen verschlossene Türen gerannt, aber ich gebe nicht auf - jetzt erst recht nicht.»

Sehr erfeulich auch, dass das Urteil jetzt schon politische Konsequenzen zu zeigen beginnt, wie z.B. in der folgen Pressemeldung der Bundestagsfraktion Bündnis 90/Die Grünen:

Umgang mit Intersexuellen prüfen

Sehr guter Bericht auch vom WDR:

Klägerin siegt im "Zwitterprozess"-- "Das tut so gut für die Seele" (WDR-Panorama)

Im direkten Vergleich mit der ap-Meldung und zu WDR abfallend die KollegInnen von der Deutschen Depeschenagentur und vom Deutschen Depeschendienst:

Kölner "Zwitterprozess": Krankenpflegerin siegt gegen Chirurgen  (Der Westen)

Intersexuelle Frau mit Schmerzensgeldklage erfolgreich  (PR inside)

In einigen Blättern gabs übrigens schon tags zuvor eine Ankündigung:

Intersexuelle Christiane will Gerechtigkeit (Aachener Zeitung)

Auch die Agentur Agence France-Presse machte eine kurze Meldung, die jedoch der Tragweite des Urteils kaum gerecht wird:

Intersexuelle setzt sich mit Zivilklage gegen Chirurg durch

nachtrag: Offensichtlich war die afp-meldung bei google stark gekürzt! (Wie auch die ap-meldung z.B. bei Stern, siehe oben.) In "Die Welt" fand ich nun eine längere Version, da sieht's (abgesehen vom irreführenden Titel) doch schon wesentlich besser aus. Besonders gefallen hatte uns latürnich der bei afp.google weggekürzte, u.a. in der Welt aber enthaltene letzte Satz:

Am Rande des Prozesses forderte eine kleine Gruppe von Demonstranten mehr Rechte für Intersexuelle. Sie trugen T-Shirts mit der Aufschrift "Menschenrechte auch für Zwitter".

Arzt machte Frau illegal zum Mann (Die Welt)

Dieselbe ungekürzte Agenturmeldung mit adäquatem Titel:

Intersexuelle setzt sich mit Zivilklage gegen Chirurg durch (123recht.net)

Das Schlusslicht unter den Agenturmeldungen bildet klar die Schweizerische Depeschenagentur: Hier wird immer noch versucht, den Prozess als individuellen Einzelfall darzustellen, die eigentliche Tragweite wird konsequent zu leugnen versucht. Pfui, nachsitzen, setzen!

Intersexuelle klagt erfolgreich gegen Chirurg (nachrichten.ch)