This week Advocates for Informed Choice and the Southern Poverty Law Center, with the help of two private law firms, filed what promises to be a groundbreaking lawsuit.  According to the press releases, “M.C.,” a child adopted as a toddler in South Carolina, had been born with atypical sex anatomy and assigned female.  Now eight years old, M.C. has rejected his assignment, and identifies as a boy.  Like a similar case of sex reassignment in Colombia that led that nation’s highest court to issue of the first of what would be, over 1999-2000, a series of decisions prohibiting unnecessary normalizing surgeries and specifying the limits of parental consent to such surgeries, the case could set a new precedent regarding the performance of normalizing surgeries in the US.

Coverage of the case has promulgated a number of misunderstandings, as Alice Dreger has helpfully laid out in an essay for the Atlantic Monthly, first about the nature of intersex conditions (one article asserted that the child had been born “with both sets of genitals”), and second regarding the conflation of the birth of children with atypical sex anatomies with transgender identity.  The third misunderstanding to which Dreger points may prove a thornier problem facing the court, namely whether the physicians were justified in their actions. While I have raised questions about physicians’ complex motivations in these cases, it seems unlikely that a court would find that physicians who recommend normalizing intervention mean to harm children.  And yet, M.C. was born the same year that the US and European endocrinological societies met and settled on new standards for the care of children born with atypical sex anatomies.  While the resulting Consensus Statement published in 2006, did not prohibit normalizing surgeries entirely, it nevertheless raised significant doubts about the wisdom of surgeries of the sort to which M.C. was subjected.

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Note: The author makes financial contributions to Advocates for Informed Choice.