Gender assignment can go astray

If a 5-year-old human born with male physiology insists on long hair, prefers dolls and skirts to toy guns and trousers, is he a boy or a girl? With all our worldly knowledge, we may never know the answer.

More parents whose young children insist their gender is misidentified by their body parts are letting children decide. Seem bizarre? At first blush, yes. But perhaps it is less strange than it appears.

The trend was reported last week by The New York Times, which accompanied its article with a transfixing picture of what looked like two girls playing while running down a street. They were photographed from behind, so their most prominent features were their below-shoulder, flowing, beautiful brown hair. The caption read, "A boy, 5, left, who identifies as a girl, plays with a friend in Northern California. He began emulating girls shortly after turning 3."

That parents would let a 5-year-old boy decide he's a girl would qualify as unusual behavior to most observers. But then so is America's medical history on so-called gender assignment.

Much of human history is rife with examples of practices we would now view as entirely eccentric that were accepted as standard at one time. Take, for example, anesthetizing infants prior to surgery. Giving infants anesthesia has become standard medical procedure only within the past half-century or so. Before that, medical practitioners were not taught, indeed did not believe, that infants could experience pain. That notion strikes even the least educated among us today as ridiculous.

Perhaps we'll look back at gender assignment a half-century from now and view it as equally strange.

Gender assignment occurs when a seemingly male infant is born missing all or part of his male genitalia. Until quite recently, such children were routinely surgically sex-reassigned immediately after birth. In other words, these boys were castrated to "align them cosmetically and hormonally with a female role" in life.

Only problem is some of those "girls" grew up to be boys.

Two studies from the Johns Hopkins Children's Center released in 2000 tracked the development of 27 genetically male children with normal XY chromosomes. (Unfortunately, they also suffered from a rare disorder called cloacal exstrophy.)

"Twenty-five of the children were reassigned by physicians at birth, castrated and raised as females. (But) the majority of these children, between the ages of 5 and 16 ... subsequently "reassigned" themselves back to males. All 27 showed strong male behaviors, activities and attitudes."

So much for trusting science on gender constructs. Science still cannot explain so-called gender variance (when children born as male decide they're actually female, or vice versa) much less sexual orientation. The Times reports some researchers suspect gender is actually determined by hormone exposure in utero. Expectant mothers take note: If you are carrying a boy, you might want to think twice before ingesting soy products containing phyto-estrogens (plant estrogens) known as isoflavones. Plant estrogens have lowered testosterone levels in rats, monkeys and other animals as well as humans.

Maybe today's parent who allows a child to gender-vary really does know best. Imagine yourself in that position. Your child comes home from the hospital with male genitalia and certainly looks like a boy. But as soon as he starts to walk and talk, he insists he's a girl. He favors girls' clothing and playing with dolls. You try to change his mind. You lose. One Chicago mother of a 6-year-old boy who sees himself as a girl called the continuous battles "exhausting."

It's a tough decision. What few studies exist on gender variance suggest most boys who claim they are girls early in childhood grow up to be gay. Only about a quarter grow up to become heterosexual, again according to The New York Times. Girls with gender-variant behavior, who have been studied even less than their male counterparts, talk about wanting to have male anatomy. But research suggests most of them grow up as heterosexual women.

I don't know what I would do in that situation. Except to say, I would not stand in judgment of decisions reached by parents actually faced with such decisions.

Bonnie Erbe is a TV host and writes this column for Scripps Howard News Service. E-mail bonnieerbe@CompuServe.com.

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