A message to the linguistically challenged

I usually don't talk about my professional background. However, at times, when others who have degrees want to give advice, it is important that we who are intersex and/or trans, also speak with professional clarity and expect the same professional respect that non-trans/non-intersex professionals give to their peers. This is something that many of us have faced and those who are not intersex and/or trans often have no idea how they come across and they often have no idea how we often are devalued and deemed unworthy of any professional respect despite our own degrees and accomplishments. This is offensive and needs to stop.

I am a linguist with a degree in linguistics from the Université de Monptellier, France. As a linguist, I am concerned that Marshall Forstein, M.D., of Harvard Medical School pointed out in his e-mail that, contrary to claims made in petitions and frantic emails, "sexual orientation is NOT even an issue for the DSM committee to consider." What about the words "homosexuality" or "sexual orientation" does Dr. Forstein not understand? The people named to the board in question (Blanchard and Zucker) have used the word "homosexuality" repeatedly in referring to transsexuality. They are going to have input into the definitions concerning GID. Has Dr. Forstein taken the time to read what Blanchard and Zucker have written about homosexuality as part of the differential diagnosis for "GID"? If one reads their articles, it is plausible to conclude that Blanchard and Zucker would most likely try to introduce homosexuality into the DSM as part of the taxonomy for transsexuality because it is not based on GENDER at all, it is based on SEXUAL ORIENTATION.

This is what is disturbing to many people who read the rants of uninformed experts such as Dreger and it makes many of us very wary of their ability to discuss this topic with intelligence in order to make informed decisions considering the matter at hand: Zucker and Blanchard having control of the definitions of gender variance in the DSM, since they are on record as not really accepting gender as a valid construct for defining transsexuality.

Quotes from Blanchard:

"In my terminology, which follows the individual's chromosomal sex, these groups are homosexual and heterosexual transsexuals, respectively." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav

DOI 10.1007/s10508-008-9328-y)

We have the rudimentary terms used in this proposed taxonomy in the short sentence above: "chromosomal sex", "homosexual", and "heterosexual".

"There are two distinct types of cross-gender identity. The feminine gender identity that develops in homosexual males is different from the feminine gender identity that develops in heterosexual males. In other words, homosexual and heterosexual men cannot ''catch'' the same gender identity disorder in the way that homosexual and heterosexual men can both ''catch'' the identical strain of influenza virus. Each class of men is susceptible to its own type of gender identity disorder and only its own type of gender identity disorder." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)

"Homosexual and heterosexual men"? Very revealing use of the term "men" here. So there we see how Blanchard is referring to M to F transsexuals. In this case, he is referring to them as "men" and he uses the word "men" several times in that short paragraph.

If we read further in this same article, it is clear why Blanchard would refer to M to F transsexuals as "men":

"I have not seen any new research studies that present compelling evidence for a third, distinct type of male-to-female transsexualism. It is quite difficult, however, to achieve complete certainty in taxonomic work. I made this point in a lecture on the parallels between gender identity disorder (GID) and body integrity identity disorder (BIID), a condition characterized by the feeling that one's proper phenotype is that of an amputee, together with the desire for surgery to achieve this. Most, but not all, persons with BIID report some history of erotic arousal in association with thoughts of being an amputee (apotemnophilia). ." (Blanchard, Deconstructing the Feminine Essence Narrative, Archives of Sexual Behavior, Arch Sex Behav DOI 10.1007/s10508-008-9328-y)

What are the parallels between GID and BIID? As a linguist reading this rather short article, the semantic field that Blanchard has ascribed to the term GID is very problematic because he is using the term GID in a way which is inconsistent with the DSM itself.

The current edition of the Diagnostic and Statistical Manual of Mental Disorders has five criteria that must be met before a diagnosis of gender identity disorder (302.85) can be given:[2]
1. There must be evidence of a strong and persistent cross-gender identification.
2. This cross-gender identification must not merely be a desire for any perceived cultural advantages of being the other sex.
3. There must also be evidence of persistent discomfort about one's assigned sex or a sense of inappropriateness in the gender role of that sex.
4. The individual must not have a concurrent physical intersex condition (e.g., androgen insensitivity syndrome or congenital adrenal hyperplasia).
5. There must be evidence of clinically significant distress or impairment in social, occupational, or other important areas of functioning.

There is no mention of sexual orientation as a factor for diagnosing GID.
There is no mention of body image problems and desire for castration, etc. That is covered in another part of the manual: GIDNOS.
The emphasis is on IDENTIFICATION and inappropriateness of GENDER ROLE. Blanchard is not talking about GID at all as it is currently defined in the DSM. He is talking about something unrelated to this diagnosis.

He is talking about homosexuality, sexual paraphilias, body integrity issues and that is clear if one takes the time to read his work. I would not say that his findings are all wrong. I would simply point out that he is not talking about GID and that is clear from all discursive analyses I have made of his texts.

So, I would hope that professionals in the field of psychiatry would take the time to examine how Blanchard is using language, how he is using the terms which would have a great impact on future revisions of the DSM.

Now, who is the one talking about homosexuality? Blanchard himself. And he calls the people he is talking about HOMOSEXUAL MEN.

As a linguist, I am not going to take Dr. Forstein's advice because it is based on ignorance. Dr. Forstein and Dreger would be better advised to scrutinize Blanchard's use of language and terms before giving advice to those of us in the intersex/trans community about speaking about "sexual orientation" and homosexuality.

Curtis E. Hinkle
Founder, OII
http://www.intersexualite.org/

Fact Checking Alice Dreger

A fact check to the fact checker

Response to: http://alicedreger.com/informed_dissent.html
(Italics are quotes from Alice Dreger's blog)

Well, I see Alice Dreger is up to her usual: distorting the facts and creating a smokescreen so that those with power who are not being accountable for their unethical behavior appear to be justified in further victimizing marginalized communities. As usual, she is telling us what to do and being deceptive as she talks down to us – vintage Dreger – while deflecting the attention away from those who are harming people and making it look like those harmed are the real problem.

I’ve been watching the same sort of thing happen over the debate regarding Zucker and the DSM. Lots of errors about basic facts.

She should know about errors about basic facts. Her recent article in defense of J. Michael Bailey was full of errors. Click here

Some of these errors have been noted in an open letter from Marshall Forstein, M.D., of Harvard Medical School. Forstein pointed out that in his letter that, contrary to claims made in petitions and frantic emails, “sexual orientation is NOT even an issue for the DSM committee to consider.”

Once again. This appears accurate but it is not factually correct to accuse those of us who are discussing SEXUAL ORIENTATION as having our facts wrong. We are discussing sexual orientation, and she understands why because she wrote an article about this same topic herself defending J. Michael Bailey, because the people named to the DSM committee are discussing homosexuality. That is the issue and it is deceptive to put this on her blog and mischaracterize why we are discussing sexual orientation. The problem is not with the intersex or trans community. It is with Blanchard, Zucker, and Dreger. They have been writing papers and elaborating theories which conflate sexual orientation with transsexuality. So, let’s be accurate and check our facts, Alice Dreger. We are talking about this because they, the proposed members of the DSM committee write many articles about homosexuality and see it as one of only two causes of transsexuality.

And the DSM “is a guide to diagnosis and NOT to treatment.”

Once again, we know that. It is inaccurate to act as if we do not. The fact that one or two people might not know that is not necessarily the case for most of us. Why didn’t Dreger write to the people who don’t know this if she really wants to help out instead of making all of us look like uniformed troublemakers? Well, she has an agenda – to protect Zucker, Blanchard and Bailey. That’s why.

The tone of Forstein’s letter reminded me of my own tone as I lectured my well-meaning neighbors on my porch yesterday. Basically: “Geez, people! You don’t have the most basic facts right! How do you expect to gain and keep allies if you can’t get the facts straight?!”

Once again, she paints all of us with one stroke (pretending that she is addressing her neighbors but this is not written to her neighbors, is it?). This is outright propaganda. Many of us are quite informed, articulate people capable of exposing the facts. She would be well advised to get informed and stop generalizing about a whole community.

The errors Forstein chronicled are important, but arguably not as important as the erroneous claims that Zucker does “conversion therapy,” i.e., that he tries to change children’s sexual orientation from gay to straight, and that he thinks a patient turning out to be transsexual represents a “bad outcome.”

Fact check. I thought that Alice Dreger had read J. Michael Bailey’s book. In his “Queen” book, Bailey wrote:

“….Zucker believes that most boys who play with girls’ things often enough to earn a diagnosis of GID would become girls if they could. Failure to intervene increases the chances of transsexualism in adulthood, which Zucker considers a bad outcome.” (Page 31 in book)

“Zucker thinks that an important goal of treatment is to help the children accept their birth sex and to avoid becoming transsexual. His experience has convinced him that if a boy with GID becomes an adolescent with GID, the chances that he will become an adult with GID and seek a sex change are much higher. And he thinks the kind of therapy he practices helps reduce this risk” (Page 30 in book)

“…Zucker’s therapy seems kinder and more consistent, and thus more likely to be effective. Zucker believes that it is, although he is the first to ackowledge that no scientific studies currently support the effectiveness of what he does.” (Page 34 in book).

Now. One final fact check. Here is why Zucker and Blanchard are talking about homosexuality. Let’s get that fact straight. And therefore we who are opposed to their being part of the DSM committee are discussing this same topic because:

The DSM controls the definitions not the treatments

The DSM is concerned with diagnoses, not treatments per se. We know that, Alice Dreger. However, that is why people that are ideologically motivated with very little, if any, empirical data to support their theories (and Bailey himself admitted that) should not be placed in charge of the definitions or diagnoses. Here is the problem. Drucker will have input into the DIAGNOSES, not the treatments but the treatments are not the issue for Zucker and many of these people that have been influenced by him. In my opinion, they want NO TREATMENTS. I am convinced that the motivation is to tie the hands of those who would desire to provide treatments and they might be able to do that by controlling the definitions, i.e. the diagnoses. In other words, if the members of this committee, some of which I know have been influenced by the views of Zucker which are that gender identity, as opposed to gender role, is extremely malleable, even more malleable than sexual orientation, then reassignment may eventually become almost impossible, if not outright impossible in the years to come.

The theory that Blanchard et al. are expounding has two key elements which will have enormous impact on redefining transsexuality in such a way that

1) it is NOT really a GENDER identity disorder at all and

2) with ONLY TWO categories possible for all people with "gender confusion" which appears to be the word that is becoming more and more common.

Now, if GID is not about gender but SEX, and there are only two diagnoses, one of which is based on HOMOSEXUALITY, what treatments can be ethically justified by therapists if homosexuality is NOT also reintroduced as a TREATABLE disorder? If you include autogynephilia, then you have to include homosexuality because the theory that Blanchard and others are propagating posits that there must also be "trans" people motivated by homosexual orientation (and ONLY those two categories). This erases intersex and trans experience and the essential definitions that we often use to give meaning to our own sense of being – our own definitions of ourselves and if we are not allowed to define ourselves within the system to the best of our ability, then I don't see anyway to improve our well-being within that system – only further marginalization and stigma.

If Zucker is treating homosexuality in childhood and he admits that these boys grow up to be homosexuals and according to Bailey he is treating them in the hopes of preventing transsexuality, then why not treat homosexuality in adulthood to prevent transsexuality? That is why we are discussing this issue.

Professionals? It is time to act – PROFESSIONALLY

Writing to a whole community instead of addressing the people whose behavior Alice Dreger and others associated with her are denouncing is not professional. When I write about Dreger, for example, I don't generalize and characterize her behavior, writings and ideology as characteristic of the whole intersex community. Why does she include me and thousands of others who have nothing to do with the non-factual allegations she is writing about?

This is political spin. This is part of the ongoing assault against the intersex and trans communities. I and hundreds of others in the IS and Trans communities have NEVER written anything similar to this deceptive blog entry by Alice Dreger.

The documentation about Alice Dreger that I have published is based on verifiable sources, not generalizations, not innuendo, not rumors, which is more characteristic of her writings lately.

I have not claimed anything to be true about these people that I cannot back up with reliable sources. It would be advisable that she and other "experts" defending Zucker and Blanchard make the same effort when speaking about us in generalized terms. Don't include me in those generalizations without informed opinions that are reality-based, not agenda-driven spin. It is very offensive to include my work in these generalizations about the trans and intersex communities.

I would never write a blog that gave the impression that all mental health professionals were acting the same way as Zucker, Dreger and Blanchard are because I know otherwise.

What advice like this does is discredit all the well researched articles that many of us in the trans and intersex communities have written about this topic.

It is time that some of the professionals act responsibly (notably those in charge of the APA and those who are enabling Zucker and Blanchard) and inform themselves and stop giving advice until they do know the facts. It is time to demand accountability of those who provide care and who speak as ethicists about our care. The professionals in this debate have much more responsibility. Part of being a professional is that one takes the time to inform oneself of the facts. Many of us have. These factual articles are published. Read them.

Index to Intersex Pride

2006 - May 2008

Penetrating the stone wall of narcissism

A Day in Neverland: The Neverland Essence Narrative and latent homosexuality

A message of healing and hope: a holistic, person-centered approach to intersex health

The Chatty Cathy Approach to Intersex Activism

Homochromosexuality: A new psychiatric disorder

Sex versus Gender: Exposing medical violence and dishonesty

Disorders of sex development: Sexist, Classist Eugenics

Alice Dreger: The unethical ethicist?

DSD: North American Medical fascism and manufacturing consent

Elizabeth Reis defames and trivializes intersex people

Against sexists in “Blackface”

DSD - Is there really a consensus?

Disordering the lives of children

Pathological (hetero)sexism and the medicalisation of sex in children

Hermaphrodite Kisses (poem)

The fundamental error of conflating intersex with birth defects

About the violent construction of sex as a binary */**
This is a very good article I translated with the permission of the author.

Ten Misconceptions about Intersex

Why the Intergender Community is so Important to Intersexuals

Penetrating the stone wall of narcissism

Narcissistic rage within the medical and academic communities

Available on OII's webstie at: http://www.intersexualite.org/Penetrating.html

Narcissistic personality disorder is a major social problem and medical experts and others in the academic community are more prone to this severe mental illness than the population in general. [1] NPD (Narcissistic personality disorder) is defined as a pattern of grandiosity and a need for admiration or adulation which usually begins by early adulthood. Five or more of the following criteria must be met: [2]

• Feelings of grandiosity

• Obsessed with fantasies of success, power, fame and brilliance

• Firm conviction that they are unique and should associate only with those of special status

• Requires excessive admiration

• Feelings of entitlement

• Exploitative and manipulative behavior of others

• Devoid of empathy

• Envious of others

• Arrogant behavior coupled with rage when frustrated, contradicted or confronted.

"Medical narcissism is a term coined by John Banja in his book Medical Errors and Medical Narcissism. He uses the psychological concept of narcissism to explain the culture by which many medical practitioners downplay medical errors and often avoid taking personal responsibility. He claims this is part of the dehumanization of the patients from the practitioner's perspective. John Banja provided evidence that there is a higher incidence of practitioners in the medical profession with narcissistic personality disorder than the general population, and that there is a resultant general narcissistic culture in the medical profession of self-righteousness, arrogance, and denial." [3]

Medical narcissists as well as others who suffer from NPD invariably exhibit symptoms of narcissistic rage when reacting to what they perceive as the slightest injury (narcissistic injury). Narcissistic injury is any real or imagined threat to the narcissist's grandiosity and self-perception as entitled to special treatment and recognition, regardless of his actual accomplishments, if any. [4]

After years of intersex activism, some influential academics and medical researchers, Alice Dreger, Anne Lawrence and Eric Vilain et al., have all exhibited the symptoms of a violent narcissistic rage against the intersex community and have caused great damage to a vulnerable group of people who were just emerging into the collective consciousness.

Their own narcissism has been perpetuated by their own grandiosity as the gatekeepers of all sex variations with their own image as a man or woman as the standard which should be imposed on all people, especially the intersexed. Defining a person by a checklist of sex markers and arbitrarily assigning the individual as male or female without permission or any input from the child is dehumanizing and one of the most blatant forms of medical narcissism. These doctors and academics are pretending to be omniscient and in possession of some profound knowledge which is unknowable to anyone – the "true" sex of a child whose sex cannot be defined as male or female to begin with. Then, they assume that this omniscience gives them the right to surgically and/or hormonally alter the child's body long before the child has developed any awareness of their own individuality and autonomy.

The current terminology used to stigmatize and justify such medical (mal)practice, DSD or Disorders of Sex Development, originated from the narcissistic rage of the academic and medical community against the intersex community which had started to question these practices and demand accountability and respect for intersex children.

Typical of the schoolyard bully, these academics and doctors reacted with an attitude of "how dare they question our authority". The victims of their abuse, by daring to denounce it, had to be further bullied and silenced because the narcissist will not entertain the slightest criticism without flying into a rage that is totally disproportional to the points being made by the victim. The narcissist cannot admit to an error and intersex treatments are particularly prone to what would be serious medical errors if designed for treating almost any other group of people. Lack of informed consent, surgical and hormonal manipulation of an individual's body and labeling the individual as mentally ill for refusing the medical abuse which assigned the person a wrong sex: all these present serious ethical issues which the medical community should take seriously.

Instead of taking the criticisms of the intersex community seriously, their pathological narcissism has only become more impenetrable as they scramble to protect themselves against lawsuits and a loss of their self-perceived grandiosity.

The deepest wound that many intersex people live with is the lie that we are all either a male or a female. This violence against many intersexed people is so profound and brutally denied that intersex activism has almost been crushed by replacing the term “intersex” with “disorders of sex development” without any real consultation with those directly affected – intersexed people themselves.

Many of the same people are reacting the same way to the trans community. Some of them who have falsely accused some transsexuals of responding with narcissistic rage, have misinterpreted the condition, based upon narrow reading (Kohut) and thus have failed to find in themselves more severe narcissistic pathologies, including "borderline" ideology. For a more balanced approach to this, we suggest they and others read Kernberg's critiques of Kohut. Kernberg, saw a far more fragmented self, which is more descriptive of the traits exhibited by certain writers who have written recently about narcissistic rage in transsexuals than the transsexuals these writers were describing.

For such reading on the misunderstanding of narcissistic rage and its misinterpretation and displacement upon others (transsexuals), see Kernberg's criticisms of the limitations of Kohut's view of narcissism.

http://www3.interscience.wiley.com/journal/112457498/abstract?CRETRY=1&SRETRY=0

http://www.ncbi.nlm.nih.gov/pubmed/6613364?ordinalpos=46&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/pubmed/2436292?ordinalpos=27&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

For more on borderline disorders in physicians, see

http://query.nytimes.com/gst/fullpage.html?res=9E00E2DF1039F933A05755C0A967948260&sec=health&spon=&pagewanted=4

For more on how such conditions can cause a physician to sexually abuse others, see

http://www.ncbi.nlm.nih.gov/pubmed/8439943?ordinalpos=22&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

Some OII members clearly see that certain "professionals" studying transsexualism and intersex do indeed have more severe narcissistic disorders which lead to borderline personality expression. (We realize that BPD is a "controversial diagnosis". However, it certainly is no more controversial than the "diagnosis" of autogynephilia, which although not listed in the DSM, is believed by a few not-overly-suspicious OII members, to be "nominated" for its inclusion in the DSM).

ON BORDERLINE PERSONALITY DISORDER

Disturbances suffered by those with borderline personality disorder are wide-ranging. The general profile of the disorder typically includes a pervasive instability in mood, extreme "black and white" thinking, or "splitting", chaotic and unstable interpersonal relationships, self-image, identity, and behavior, as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. These disturbances have a pervasive negative impact on many or all of the psychosocial facets of life. This includes the ability to maintain relationships in work, home, and social settings.

For those persons who see in black and white and who quickly change from over-valuing and then to de-valuing those with whom they disagree, and whom they criticize even more stringently without merit, and without re-examining themselves, it is suggested that they seek modern psychoanalysis.

This is the treatment which caused analysts since Freud’s time to wonder: "can the stone wall of narcissism be penetrated?" And Spotnitz has responded with a resounding yes to that question. Although we doubt that those who pathologize transsexual and intersexed persons will be amongst Spotnitz's successes (in that their own stone wall of narcissistic defense surrounding their narcissistic rage and borderline symptoms will be penetrated), we still say to these hacademics: "Please give it the old college try".

http://www.pep-web.org/document.php?id=mpsa.021.0191a

References

[1] http://www.bullyeq.com/

[2] http://www.healthyplace.com/communities/personality_disorders/narcissism/narcissism_defined.html

[3] http://www.bullyeq.com/

[4] http://www.suite101.com/article.cfm/npd/113234

Further reading:

For a review and critique on understanding of pathological narcissism of Heinz Kohut, see the following and the writings of Otto Kernberg.

http://www.ncbi.nlm.nih.gov/pubmed/6613364?ordinalpos=44&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.psychodynamicworks.com/bookroom1/sources/99swartz.html

A Day in Neverland

The Neverland Essence Narrative and latent homosexuality

by Curtis E. Hinkle
Available on OII's website: http://www.intersexualite.org/Neverland.html

Abstract: Blanchard, Bailey and Dreger have attempted to deconstruct what they call the “feminine essence narrative”. Their articles and analysis are replete with internal contradictions and lack of empirical data. Some of the illogical fallacies included are: 1) In comparing male to female transsexuals to natal women, lesbians are not even considered as a possible control group for male to female transsexuals who are attracted to women. Instead, Blanchard suggests that homosexual transsexuals (those who are attracted to men) are the proper control group for autogynephiles. 2) Bailey pretends that he doesn’t even know what a gender identity is. However, he has a clear gender identity because he states in the very book in which he questions the validity of a gender identity that he is a heterosexual man. 3) According to Bailey, all males are gay or straight. Bisexuals are simply gay men in denial. On the other hand, he puts bisexual males who transition to female into the autogynephilic category, instead of the homosexual transsexual category. If males who say they are bisexual are really gay men, how can they fit into any other of his two transsexual categories than homosexual transsexual? 4) Women are basically bisexual according to Bailey. If so, are most natal women in denial? Wouldn’t natal women, make a perfect control group for male-to-female transsexuals as both are said to be in denial? Wouldn’t feminine lesbians, in particular, and not so-called “homosexual transsexuals”, make a perfect control group for so called autogynephilic transsexuals, since each claim NOT to be male oriented?

Recently, I read a few articles written by Blanchard, Dreger and Bailey. Everything I read was full of contradictions, illogical assumptions and binary sex categories that left me feeling I had spent a day on Neverland, the fantasy island in Peter Pan where children never grow up. The simplistic, often contradictory binary logic with overwhelming focus on male sexuality reminded me of the locker room fantasies of adolescent boys stranded on Neverland who have absolutely no idea of female sexuality whatsoever.

One of the articles I read was entitled Deconstructing the Feminine Essence Narrative by Blanchard. In this article he is writing about his proposed theory of transsexualism based on the sexual orientation of the individual and not the person's gender identity (or feminine essence narrative). First of all, I want to be clear that I am convinced that Blanchard's observations of certain behaviors in "men" seeking sex reassignment are correct and that there are those who would fall into the category he has proposed. That is not what seems so illogical and basically "Neverland" about the theory. What is conspicuous is that female sexuality is totally banned from this Neverland adventure into male-to-female transsexualism. This is very problematic because there is no possibility of deconstructing the feminine essence narrative, the alleged purpose of the essay by Blanchard, without a thorough understanding and description of female sexuality since Blanchard's theory is based on sexual orientation, not gender identity, per se.

Blanchard wrote in his article:

The notion that typical natal females are erotically aroused by—and sometimes even masturbate to—the thought or image of themselves as women might seem feasible if one considers only conventional, generic fantasies of being a beautiful, alluring woman in the act of attracting a handsome, desirable man.

This tells me more about Blanchard than the autogynephiles (who are transwomen attracted to other women) he is writing about. How could he possibly compare autogynephiles with heterosexual natal women as the control group? Why would Blanchard assume that typical natal females would necessarily be interested in attracting a handsome, desirable man? Many are interested in attracting a beautiful, desirable woman, just like the autogynephiles he is supposedly describing. Would it have to do with the constant focus on the male phallus? It certainly appears the case and is symptomatic of what I call the Neverland Essence Narrative – (phallo-centric sexual ideation generalized as a description of the only "real" sexuality that counts). Has this man never heard of femme lesbians? Wouldn't this be a more promising control group to consider? What is striking is that lesbianism is not even part of the discourse when talking about natal women, much less femme lesbians.

In the same article, Blanchard wrote:

Proponents of the feminine essence theory could argue that it is an empirical question whether heterosexual male-to-female transsexuals manifest a higher prevalence of autogynephilia than do natal females. My view, in contrast, is that the correct control group for such (necessarily survey) research is not natal females but rather homosexual male-to-female transsexuals, and that the results of such research have already shown that autogynephilia is characteristic of heterosexual transsexuals (Blanchard, 1989a).

Once again Blanchard exhibits the same logical fallacy. Instead of considering natal females as a control group, he posits that the best control group for understanding autogynephiles is made up of male to female transsexuals who are attracted to men. How odd! If the basic categories of his theory of transsexualism are defined by sexual orientation, why use a control group with an orientation towards men? Well, it seems clear. In the previous paragraph, he did not even consider the fact that there are women who have no desire for male partners. It was almost a given in his characterization of women that desiring male sex partners was the primary definition for "woman". Although he knows that lesbians exist, his text and his discourse on female sexuality (which is almost invisible) are so phallocentric that either consciously or unconsciously, there is no real representation of the wide range of diversity characteristic of female sexuality in the text even though he is supposedly talking about natal females. Very typical of the Neverland Essence Narrative. Even when talking about natal females and female sexuality, it is all based on MALE sexual orientation. It has nothing whatsoever to do with female sexuality, femininity and eroticism in femme lesbians, the female body or sensuality.

In this article, Blanchard was defending both J. Michael Bailey and Dreger who is a great fan of Bailey's. In an article by Dreger in defense of her colleague at Northwestern University, she quotes Bailey:

"gender identity… what the hell does that mean?" p 50 of his his book, The Man who would be Queen.

Who is Bailey trying to fool? I would like for Bailey to spend just one day with many of the intersexed people in the Organisation Intersex International if he really would like to meet a group of people who in fact do wonder what the hell a gender identity is because to many of us there is no defined gender identity (or feminine essence narrative or masculine essence narrative) which can be PRESCRIBED by the gatekeepers which fit with our own sense of self which can be very fluid and undefined within a binary gender identity construct. OII has many intersexed people who have an undefined gender identity and who really do question the validity of any of the "essence narratives" as valid in prescribing a gender identity for them at birth. However, when one reads Bailey's book and his articles, his question seems artificial, almost hypocritical because elsewhere in the same book, he makes it clear he identifies as a heterosexual MAN.

Quote from the "Queen" book by Bailey:

Bailey confirms this opinion when he describes his own sexual response (only) to homosexual transsexuals: "It is difficult to avoid viewing Kim from two perspectives: as a researcher but also as a single, heterosexual man" (p. 141).

Bailey knows quite well what a gender identity is and he is very explicit in informing us that he is not only a man but a heterosexual man. This is interesting because the particular woman he is sexually aroused by is described by Bailey himself as a "male". Very interesting indeed.

In another article by Bailey, who supposedly supports Blanchard's taxonomy of all male-to-female transsexuals as either homosexual transsexuals (those who are attracted to men) and autogynephilic (including those who are asexual and those who are attracted to women or who are bisexual), I was surprised that Bailey insists that bisexuality does not exist in males. How contradictory! There was an article in the New York Times which analyzed Bailey's research which allegedly proves that all males are gay or straight or lying. In other words, males who say they are bisexual are really gay men in denial.

Let's follow the logical fallacy here which is characteristic of the fundamental empirical flaw of Blanchard and Bailey's theories – anyone who does not agree with their definition of them is in denial or a liar. However, when you compare Bailey's research on bisexuality with his research on autogynephilia, it is clear who is in denial of empirical data: Blanchard and Bailey themselves.

On the one hand, their theory and taxonomy for male to female transsexualism does include bisexuality as a real orientation for m to f transsexuals. However, they both put bisexual m to f transsexuals, who transition to female, in the autogynephilic category. But wait. Bailey has concluded that bisexuality does not exist in males. They are all gay men in denial. So how can Bailey put someone who by their definition, is a gay male, in the autogynephilic category, which EXCLUDES male to female transsexuals, who are attracted exclusively to males and whom they call “homosexual transsexuals”? Wouldn't bisexual male to female transsexuals also fit their definition of gay men in denial? Wouldn't they have to be categorized according to their taxonomy instead, as “homosexual transsexuals”? The problem with this "research" is that it is not based on empirical evidence which can be falsified. It is based on Blanchard's and Bailey's own Neverland Essence Narrative projected on to all the subjects of their research. And typical of this lack of empirical methods, Bailey concluded that all females are basically bisexual – once again, female sexuality was dismissed and phallocentric arousal remains the only important criteria for categorizing all people. Neverland at its worst.

The fundamental flaw of Blanchard's, Bailey's and Dreger's attempt to deconstruct the feminine essence narrative, is their inability to see anything beyond male/female, and to conceive of a world which is not based on what makes a male's penis erect. I prefer the real world which is full of diversity where a whole spectrum of sex variations exist with some people who have no defined gender identity and for whom NO prescribed gender within the binary will ever categorize them. I prefer to conceptualize a world, where female sexuality exists, where feminine lesbians and their sensuality exist, and where the whole world does not revolve around what makes a penis erect. Neverland is especially well-suited for those who have a monochromatic vision disorder (no real rainbows on this island) with only shades of black and white where the only attraction is the ebb and flow of the inhabitants' own phallocentric erection fantasies.

In conclusion, what did I learn from this foray into Neverland? Not much really. But I did learn something about the people who pretend to be deconstructing the feminine essence narrative and questioning the very concept of gender identity as a valid construct for describing transsexuality. Bailey, Blanchard and Dreger have done absolutely nothing to deconstruct gender identity as a binary or gender identity itself. They have simply prescribed a "masculine essence narrative" on all the subjects of their discourse (male to female transsexuals) with focus on the phallus and what makes it erect in coming up with a new taxonomy for transsexualism. This is about gender policing, not science. There is nothing in the Neverland Essence Narrative that can even fathom the undefined gender identity of many intersexed people who know that NO prescribed gender (feminine or masculine) applies to them.

Now, back to reality which is a lot more interesting, complex and diverse. I will leave Neverland to those who want to perpetuate narcissistic visions of their own budding masculine essence narrative and who never developed any concept that women and intersex people really do exist. Bye-bye Neverland.

A message of healing and hope: a holistic, person-centered approach to intersex health

Curtis E. Hinkle, Founder of Organisation Intersex International

Medical treatment of intersex people has a long history of pathologizing, stigmatizing and mutilating anyone who does not have a body which is totally “female” or totally “male” according to the definitions currently in effect for those two categories. Medical approaches to intersex variations are based on a false dichotomy, the assumption that everyone “should” be either male or female even though nature has not created such a world. The treatments are based on other false assumptions:

• That heterosexual intercourse and reproduction are the most important contributions of an individual, despite the fact that intelligence, compassion and ability to care for others are equally, if not more, important for the evolution of humankind
  

• That the sex of an intersex child is a disorder itself which MUST be treated without any input from the child at all.
  

• That concealment, shame and manipulations of body parts of an intersex person will benefit the child when in fact this approach leads to trauma, a shattered sense of self and further marginalization and stigma.

The medical approach focuses on parts of a person and defines the intersex child as a disparate combination of chromosomes, genitalia, hormones, gonads and internal reproductive anatomy. This is dehumanizing. The child is not welcomed into the world as a complete, totally intact, part of the whole tapestry of nature which is constantly evolving and moving towards diversity which promotes the continued development of human potential. Welcoming diversity and respecting the wholeness of both the individual and the natural world in which we live, breathe and have our being opens human consciousness to hope, respect and finding solutions to many problems which currently face humanity, not just intersex people, but all of us.

Instead of a dehumanizing approach which focuses on body parts, we could choose to focus on the wholeness of intersex children and see this as part of their potential for development (not a disorder of sex development) and future contributions to society. This would be a radical shift from the current medicalization of sex variations but the benefits to both the intersex child and humanity itself would be enormous. This would not only promote the health of intersex children. It would promote the healing of humankind in general.

The current medical protocols based on a false dichotomy and dehumanization of intersex children are part of a wider social problem – sexism. OII has been concerned about this issue from its beginning and several years ago OII published our declaration of fundamental principles:

• Intersex is not a medical condition: intersex refers to those individuals born of “intermediate” sex between what is considered standard for male or female in our societies.
  

• Contrary to what is often asserted, the various degrees of intersex are not innately an illness or deformity. They are simply variations of the human body similar to the length of the nose, the colour of eyes, etc.
  

• We reject medical categories for the various degrees of intersex, which are in fact only different reference points on a natural continuum of anatomical and genetic variations.
  

• We stress the whole person from infancy through adulthood and choose not to focus on an individual's genitalia. We are people, not genitals. As people, we have a right to our own genitalia and our own identity without interference, forced treatment or other coercion from legal and/or medical authorities.
  

• The basic problems faced by the intersexed are socio-cultural in nature and not medical and are a result of the dogmatic fundamentalism inherent in the current binary construct of sex and gender. Some intersexed individuals are subjected to genital mutilation in childhood as a result of this totalitarian, sexist oppression. For this reason, we denounce all forms of sexism prevalent in our societies, which is principally directed against women, the intersexed, and other communities which challenge sex and gender norms.
  

• To promote visibility and the recognition of our existence as a normal and natural part of humanity will benefit not only the intersexed but all people oppressed by the sexism which prevails in our societies.
  

OII chooses to focus on healing, not managing body parts and defining children as disordered or sick when they are in fact not sick. The word “healing” is derived from the Old English word “whole”. Society can choose to welcome the wholeness of each intersex child and open up a place for them by making it possible for each one to affirm their own true sex and sense of self. This is a person-centered approach to healing and wholeness, one that would be of benefit to society as a whole.

The two central concepts of OII’s person-centered approach to healing are

• wholeness
  

• affirmation
  

We can choose to welcome children as a gift which has been entrusted to our care, as an integral part of the potential for human development as a whole, not incomplete, undeveloped beings that we control and manipulate into images and abstractions that we feel they “should” be. We can choose to accept the wholeness and oneness of life as a constantly evolving and developmental process which is to be honored and work towards harmony and mutual cooperation, not domination and manipulation. Welcoming intersex children offers hope and healing to human understanding and development towards a model based on human rights and respect for the natural world we all share as one.

The choice is ours.

The Chatty Cathy Approach to Intersex Activism

When I was a child, my sister had a doll that was rather popular for a while. It was called “Chatty Cathy.” This particular doll interested me because it could talk. However, you had to pull a string on her back to start the conversation. Pulling strings to get someone to talk who otherwise was just a dummy who really had nothing to say made a lot of sense to me. It meant that people who had almost nothing to say except a limited repertoire of stupid and often illogical ideas would speak about those ideas at the moment and in the context which was most beneficial to the person pulling the string. Their freedom of speech was not really taken from them because you could rationalize that really what you were doing was spurring debate, initiating dialog and encouraging them to express themselves.

If only the DSD activists and specialists could be more like Chatty Cathy! Well, in a sense they are. One big difference. Unethical and tyrannical methods have been used to suppress OII’s freedom of speech. Tracing it to the exact individuals involved is still a challenge. We can only trace it to the place of origin and ISP’s. It has been going on for a long time now. But the Chatty Cathy Syndrome has still been rather effective. Yes, they indeed do suffer from CCS.

Since its beginning, OII and many people with OII and its website have been systematically defamed, hacked, and blacklisted while DSD activists publish tomes and have articles published in the New York Times and other national media outlets about their freedom of speech being seriously threatened. But those of us in OII cannot even get a short letter to the editor published. So, whose freedom of speech is really in peril?

Instead of simply giving up out of frustration and giving in to their abuse of power, I felt there was one approach that should be consistently and methodically developed and used against them – “helping” them say what they really mean in front of the whole world because it was clear that what they really had to say had to be exposed so that those affected could have real discussions about their control over intersex and trans issues.

This method involved huge risks because they have the power, the degrees and academic authority. By intentionally provoking them with sarcasm, histrionic analyses and carefully chosen tropes (such as eugenics, among others), they have been making one political mistake after another and more people are starting to see what their real message is. Yes, it probably did appear (and still does appear to many people) that OII is radical, angry and irrational. That is a risk that was worth taking because the other solutions would have never been effective because it meant accepting the victimization, the suppression of our right to speak.

I started this technique many years ago in an online support group that Dreger was monitoring even though she never posted. I had noticed that once she started controlling the content on ISNA’s blog many years ago that intersex issues were slowly disappearing from the site. I wrote a post entitled, “It’s about gender, stupid”. The post was not directed to anyone in particular. It was just a general discussion about how gender, especially gender norms, often have disastrous consequences on the everyday lives of intersex people. Not long after that post, maybe a week later, this is what appeared on the home page of ISNA’s website.

“Intersex is not about gender.”

I started checking around to find out who wrote that and it appears it was Alice Dreger herself. I also found out that she was writing almost all the content on ISNA’s site for a long time. If you notice, now that she is not with ISNA, the site has published almost nothing new.

There is NOT one mention that I can find on ISNA’s website about the Christiane Völling case in Germany. That case is probably one of the most important anti-surgery cases litigated. How could ISNA not be interested in this case? With their huge medical staff, why would they not offer open and positive support? The way the case has been handled, I fear that it might not succeed in the end. But the situation could have been different had there been more open discussion about this by those who are on the medical board of ISNA. Not a word anywhere that I can find.

Instead of speaking about such an important topic, what has Alice been doing? She has been publishing one blog entry after another on her personal blog in response to OII’s criticisms. She has been writing tomes denouncing the “feminine essence narrative” and actively defending Bailey, Lawrence and Triea. These people have nothing of scientific value to defend. There simply is no science behind what they are publishing. It is political spin and gender policing.

Why the silence about Christiane Völling’s case in Germany?

Her lawsuit is an anti-surgery case that was widely publicized in Europe with articles appearing in many languages throughout the world. There was almost nothing in English except what I translated.

The reason for the silence among English-speaking experts is very simple. This is about a "feminine essence narrative." Christiane Völling was assigned MALE and her female reproductive anatomy was removed without her consent. She has proof of this and presented it in court. She won, but the surgeon is now appealing and the letters from the court still address her as "Herr Völling".

Christiane knows that she is a woman despite her assignment as male. That is the reason there is NO support from Dreger and other DSD activists of this intersex woman who has been subjected to a life of suffering.

I have so many people to thank for having helped OII, some who are not directly associated with OII but who have been open to real discussion of intersex issues. I feel very positive about the future because real science based on data from the real world, not the narcissistic rants of political correctness or bigotry (which often form marriages of convenience), will ultimately prevail.

So, if you find that some of OII’s articles are “over the top” at times, remember that we have had no other way to get our message out but by provoking the people who are suppressing our freedom of speech to show their true intentions.

Therefore, in conclusion, I would like to stress OII has been a champion of DSD activism in the sense that we have been actively involved in “Defending the Speech of Dummies”.

Homochromosexuality: A new psychiatric disorder

by Curtis E. Hinkle

13 April 2008

Available on OII's website at: http://www.intersexualite.org/Homochromosexuality.html

What is homochromosexuality? Before defining this mental illness, it would be better to look at psychiatric disorders in general, specifically psychosis, and then discuss more fully how this particular psychosis affects not only those suffering from it but society in general because this particular psychosis is presented by many influential leaders in religious, medical, feminist and other ideologically based social groups. As a result of the influence and power of those suffering from this particular psychosis, their delusional thinking has made this a more generalized psychotic delusion than other psychotic states. In other words, this particular psychiatric disorder tends to be a massive psychotic state affecting whole populations which has made study of this psychosis extremely difficult and even impossible in some areas of the world.

Psychosis is a generic psychiatric term for a mental state often described as involving a "loss of contact with reality." People suffering from it are said to be psychotic. People experiencing psychosis may report hallucinations or delusional beliefs, and may exhibit personality changes and disorganized thinking. (1)

What are the symptoms of homochromosexuality? The most salient characteristic is the rigid, irrational delusion that sex is dimorphic and that chromosomes determine the real sex of an individual. This obviously combines irreconcilable thought processes which are contradictory and causes those suffering from homochromosexuality to illogically manipulate data to fit their irrational need to refuse the fact that people are extremely diverse and that there is a spectrum of sex variations in the natural world. Despite the fact that data prove that there are not just two sexes and that the sex development process is very complex with numerous parts of the body being involved, all of which can take different pathways within the same individual, these people stubbornly cling to the idea that there is a marker somewhere for the “true” sex of an individual and that there are only two sexes. Whereas the general population often shares this delusion, it is not a psychosis in most people because they are not obsessed with the delusion to the degree that many researchers, religious leaders and certain radical feminists are, who often spend a large part of their lives in useless research and polemics to defend their delusional thinking. However, the damage of this psychosis affects the general population in very tragic and sometimes deadly ways. One of the characteristics that homochromosexuals have in common is their fetish for chromosomes as the most important marker of a person’s true sex despite all the evidence to the contrary.

Let’s consider this fetish for chromosomes which seems to be the most basic symptom of this psychiatric disorder. Essentially, fetishism is attributing some kind of inherent value or powers to an object. For example, the person who sees magical or divine significance in a material object is mistakenly ascribing inherent value to some object which does not possess that value. (2) For quite a while now it has been established as a scientific fact that a “Y” chromosome does not make one male and in fact the “Y” chromosome is not a reliable marker for determining the sex of an individual. For example, there are XY-females who have become pregnant and given birth, some more than once. (See also footnote 3) There are individuals who have no Y chromosome who have fully developed male anatomy. Despite all the facts, this fetish for chromosomes appears epidemic among certain ideologically based groups. Just recently, there was an amendment proposed in the state of California which would have defined a man as anyone having at least one Y chromosome. This was felt necessary because the proponents of this amendment were more interested in their homochromosexual idea that marriage should be only between a man and a woman and they felt they can define exactly what a man and a woman are by chromosomes – their fetish – despite the fact that we know that hormones, gonads, internal reproductive anatomy, and many regions of the brain are all involved in determining the sex of an individual. However, these little bits called chromosomes are held up as having some magically divine power to define the sex of all people despite the scientific proof to the contrary but this obsession is caused by the other comorbid symptom of this psychosis which motivates their incessant quest to find some magical fetish which would define what a man and a woman are: their irrational delusion that there are only two sexes and everyone is really a male or a female. Reality proves otherwise.

This epidemic psychosis, homochromosexuality, is ravaging whole populations and causing severe suffering because it breeds sexism and prevents individuals from developing their full human potential. It is used to keep people in their “proper” place as determined by the psychotic leaders who charismatically spread this fetishism. Women are really very different from men they claim and this little chromosome proves it. “Look at this”, they say. “It is magical. It is God’s proof that we are different.” This is psychotic. Science proves that chromosomes do not have these magical powers.

What groups of the population are most affected by homochromosexuality? One group which suffers a particularly pernicious form of this psychotic delusion is a group of researchers involved in intersex research and research on homosexuality and transsexuality. It is this group which replaced the term “intersex” with “DSD”, short for “disorders of sex development” (a diagnosis which includes a whole array of “disorders” which were previously not intersex at all) and the reason this group suffers from the most pernicious form is because they are studying the very sex variations which prove that sex is not dimorphic but they insist that it really is. Their fetishism for chromosomes is evident in their diagnostic descriptors for each DSD. Each descriptor must start with the chromosome of the individual followed by an incongruent marker which would explain why it is a “disorder” of sex development. (4) It is incredible what magical powers these people see in chromosomes despite the fact that their own research shows that chromosomes do not a man or a woman make. It makes rational discussion with such unreasonable people impossible and at this time there is no effective treatment to help these individuals.

Another group that combines mythical thinking with their fetishism for chromosomes is found among religious leaders, especially in the Catholic Church and many fundamentalist evangelical churches also. In this group, the delusion is more understandable but nonetheless just as devastating to the general population. It is understandable because they are not basing their delusional thinking on science as alleged by the DSD researchers. They are basing their delusional thinking on mythical understandings of the Bible and religious dogma which often contradict scientific data. To read the incoherent thought processes of a typical religiously-oriented homochromosexual, click here. (For more homochromosexual vignettes: Click here or here or here)

Certain radical, separatist feminists are also responsible for spreading this psychosis and one of the most well-known is Germaine Greer. She has refused to consider women with androgen insensitivity syndrome as women and refers to them as “incomplete males”. (6) They are XY she states and one cannot change one’s chromosomes. The problem with her thinking is that there are XX-men and in many cases no matter what a woman with AIS would do, they are not going to be able to be a man because their bodies will not respond to the hormone necessary to virilize their bodies. Her delusional thinking that women are some magical class of people that she can define in a manner to preserve the sacred myth that there are only two sexes and women are very different from men has led her to the altar of the same fetishistic worship – homochromosexuality.

Research is only beginning in this area. No one has been able to find a cause for homochromosexuality. However, some researchers feel that it is possibly genetic and they are working to determine the cause. Their research has an eerie resemblance to some researchers who are using intersex people to try to find the cause of homosexuality such as J Michael Bailey, Eric Vilain (7) and Sherry Berenbaum. Unfortunately these researchers have damaged their own research by proposing a method of prenatal screening for homochromosexuality if the cause is ever found to be genetic. They feel there is no other treatment that would cure this psychotic disorder and therefore feel it would be more pragmatic to eliminate this from the gene pool. They have begun to write a paper very similar to the paper that J Michael Bailey wrote. J Michael Bailey has been interested in finding the cause of homosexuality (and using intersex people to help find it) and at the same time he has written a paper in defense of prenatal screening for homosexuality (8) once the cause would be found and in defense of allowing parents to abort such fetuses. This solution is disturbing to many people and so is the research by some groups who are homochromophobes. Even though homochromosexuality is a serious illness, these people should be treated with respect and it would be more humane to look for solutions to this problem that would be less violent and also take into consideration that there may be some important reason for this genetic anomaly in the human population.

Follow-up:

More recent research on homochromosexuality proves that this psychosis has found its way into poor countries where XX fetuses are terminated, simply because it is believed they are girls, and girls are less desirable. So they say. (Also, we wonder how many XX males have been "cleansed"). Forensics is now just coming to the conclusion that homochromosexuality isn't all it is "cracked-up" (pun INTENDED) to be. Male DNA at a crime scene or female DNA at a crime scene is now coming "under investigation”.

There is a particular form of homochromosexuality which often eludes psychiatric diagnosis and as a result there is a new diagnosis for this extremely dangerous type: autohomochromophilia. Autohomochromophilia is characterized by insisting that one is not a homochromosexual but nevertheless obsessing on the idea that really the current identity politics which divide people into just two categories – those who identify as female and those who identify as male based on some physical feature – is fundamentally valid and they become enamored by viewing themselves as important and scientific as the well-established homochromosexuals who continue to spread their psychotic delusions. One classic case of autohomochromophilia is Alice Dreger who has written: "why it is silly to think of your sex as being what you think your chromosomes are." (9) However, she has spent a lot of her life defending binary homochromosexuals and preserving the male/female identity politics implicit in such homochromosexually-challenged social systems and in so doing has inflicted much damage by erasing intersex and insisting that we are all really males or females with a disorder of sex development.

Is Alice Dreger a homochromosexual in denial? A latent homochromosexual? An ego-dystonic homochromosexual? Or is she just lying which is one of the most typical symptoms of an autohomochromophile? Obviously, her faux “intersex” activism and her binary, sexist views prove the latter.

There is some research which is proving a link between homochromosexuality and folie à deux (literally, "a madness shared by two") which is a rare psychiatric syndrome in which a symptom of psychosis (particularly a paranoid or delusional belief) is transmitted from one individual to another. The same syndrome shared by more than two people may be called folie à trois, folie à quatre, folie à famille or even folie à plusieurs (madness of many). Recent psychiatric classifications refer to the syndrome as shared psychotic disorder (DSM-IV) (297.3) and induced delusional disorder (folie à deux) (F.24) in the ICD-10, although the research literature largely uses the original name.

References

(1) http://en.wikipedia.org/wiki/Psychosis

(2) http://en.wikipedia.org/wiki/Fetishism

(3) http://www.gendercare.com/library/italiano_paper3.html

See also: http://www.cmj.org/periodical/PaperList.asp?id=LW9058 and jcem.endojournals.org/cgi/content/short/jc.2007-2155v1

(4) Table 2: An example of a DSD classification

Sex chromosome DSD’s include:

(A) 45,X (Turner syndrome and variants)

(B) 47,XXY (Klinefelter syndrome and variants)

(C) 45,X/46,XY (mixed gonadal dysgenesis, ovotesticular DSD)

(D) 46,XX/46,XY (chimeric, ovotesticular DSD)

46,XY DSD’s include:

(A) Disorders of gonadal (testicular) development

1. Complete gonadal dysgenesis (Swyer syndrome)

2. Partial gonadal dysgenesis