December 30, 2013
Jim Ambrose was born in 1976, with, he wrote last year, “genitals that frightened my parents and caregivers.” He had one X and one Y chromosome, but his sex organs were ambiguous, resembling a large clitoris or a small penis. Doctors have an easier time eliminating tissue than adding it, and so they decided to surgically remove the organ and the nearby testes. The baby was raised as a girl, named Kristi Bruce.
When Ambrose was twelve years old, he began to take female hormones. At eighteen, he prepared to undergo a vaginoplasty, the surgical reconstruction of the vagina. Suffering from depression, Ambrose contemplated suicide. “I knew that I wasn’t a girl,” he later told a reporter. The following year, Ambrose obtained his medical records, and discovered what had happened to him as an infant: “I was sterilized at birth—and no one ever told me.” Ambrose was born with a condition that inhibited testosterone production; after adolescence, he began to take testosterone shots, and had surgery to remove his breasts.
Approximately one in every fifteen hundred to two thousand children born each year is diagnosed with a disorder or difference of sexual development. (Accurate figures are difficult to obtain, because it is difficult to measure degrees of physical and hormonal difference, and because many, like Ambrose, may not know they were diagnosed as such.) Some advocates believe the numbers are even higher: by the broadest measurement, one out of every hundred children has some subtle form of “sex anatomy variation.” Parents whose newborn babies have indeterminate genitalia typically follow what has long been the standard medical advice, to have doctors perform surgery to help the child conform to one or the other fixed gender category. Traditionally, the choice has been which gender to assign to the baby, not whether to put a baby through invasive surgery at all.