JEDDAH, 8 March 2007 — When a baby is born, the first question people ask after congratulating the parents is whether the newborn is a boy or a girl. In cases where the parents and the doctors do not know, there is a problem. This is the case with babies born with ambiguous genitalia.
“In such abnormal cases the male reproductive systems are either bigger than the female reproductive systems or smaller than the normal male systems,” said Dr. Yasser Jamal, professor of pediatric surgery at Jeddah’s King Abdul Aziz University Hospital (KAUH).
KAUH has undertaken 300 sex-correction operations in the past 25 years, operating on babies from across the Kingdom and also neighboring countries. Now, the hospital is set to establish a specialist center to deal with such cases.
The issue was the subject of discussion at the two-day Intersex Symposium that began here yesterday at the King Fahd Center for Medical Research.
Solving the problem of ambiguous genitalia begins with deciding what the baby’s chromosomes are to determine sex. If they are XX then the baby is considered to be female and if the baby has XY chromosomes, then it is considered to be a boy. There are three types of intersex babies. Either the baby has more male genitals than female genitals. In such a case, doctors fix the male side of the baby. Or the baby has more female genitals, in which case doctors would fix the female side of the baby.
The third type of intersex baby is the epicene — a baby that has one ovary and one testis. In such a situation, doctors check to see which sex the baby is closer to. If the problem is discovered when the baby has grown up, then doctors will see how the individual has been raised by his or her family. In such a case they would also take into consideration whether the individual involved is capable of marrying and getting pregnant and then accordingly decide which sex would be most appropriate.
In such cases, most parents prefer their babies become male rather than female. “Adults who grow up as females with male genitals experience less social difficulties when they go through sex-correction operations to become males since they end up having the freedom to drive, go out and do more activities than girls in our society,” said Dr. Jamal, adding that the situation is just the opposite for males who later in life become females.
Once a person’s gender is changed, his or her legal papers and identity documents are altered after a hospital report is issued saying that the individual’s sex has been changed. “I strongly do not recommend delivering babies at home. Newborn babies must be checked to treat them at an early stage if they have an intersex problem so they don’t suffer the experience of changing gender later in life. This is something which needs psychological therapy,” said Dr. Jamal.
Genetic reasons are the most common causes of intersex cases. “But certain medicines that mothers take during pregnancies also affect babies,” said Dr. Jamal.
Operations cost SR50,000 to SR100,000 — something, which hospitals perform for free as well. It takes six months to one year to diagnose a case, do the operation and complete hormonal treatment.
Dr. Jamal added that people who undergo sex change must not be ashamed of themselves because this is how Allah has created them and it is through no fault of their own. However, he pointed out, people who change their sex for no medical reason are the ones who should be ashamed.
He added that people who undergo sex correction can get married and have children unlike people who change their sex for no medical reason.
It is religiously forbidden to do surgery on normal people who want to change sex, he said, adding, “We do get some requests but I refuse doing such operations. They are fooling themselves and would be cheating their partners if they got married because they would not be able to lead a normal life afterward and their partners would be the victims.”
He then mentioned a British woman in the UK who requested a divorce after 17 years of marriage because she found out that her husband had undergone a sex change and was now female. The British courts, according to the doctor, divorced the couple and awarded custody of their daughter to the mother because the child had been conceived from an unknown sperm donor through artificial insemination. The husband apologized but the harm had already been done, said Dr. Jamal.
He added that if the courts in the UK divorced the couple by considering such a gender operation to be a form of deceit then doctors should, in the first place, not accept doing such operations.
Dr. Jamal said that the wider public is duty bound to help people who want to undergo sex changes by making them believe in themselves and develop self-confidence. As for those who have no other choice, people should help them forget their past and encourage them to move on with their new lives.
Dr. Jamal together with Dr. Muhammad Al-Bar, consultant of internal medicine at KAUH, have also published a book on the subject.
