I remember an older patient I had been working with for a couple of years telling me a story about his childhood, when his mother was always upset with how wet the bathroom floor was after he stood to pee. She felt he just didn’t know what he was doing, and she charged his father with teaching the boy how to get it in the bowl. The father saw that he made a lot of spray and just told him to do the best he could or sit down. They never took him to a doctor or thought that what he had needed to be fixed.
I asked him if he had ever been told a name for the genital difference he was talking about or wanted to know what that was called. His answer was clear and simple: “No and no.”
There are times when naming something gives that thing a life and meaning that it would never have had without that naming. Sometimes that is good, but sometimes it isn’t.
Hypospadias, epispadias: medical-sounding diagnostic names.
Hermaphroditism, intersex, disorders of sexual development (DSDs): descriptive names, but each with a history and set of implications that can be really stigmatizing to the person who is so categorized.
Medical diagnoses typically imply a need for treatment. Descriptive names imply a category, a type, even an identity.
Like the patient I described above, most people, I think, just want to go about the business of their lives as a person without having to live under the weight of being “a hermaphrodite with hypospadias” or any combination of the above names. So despite all the current discussion about which of these names and categories are the most currently “correct,” let me offer up a simple guide to this nomenclature minefield.
Your medical history is your most private information. Your diagnosis is probably important to the doctor who cares for you, but that probably is about as far as that goes. You are not your diagnosis. How your diagnosis affects how you think about yourself, and how you talk about yourself and your history to your closest intimates, is much more important than getting that diagnostic title correct. There is a lot to say about this, but not in this short article.
Are you a hermaphrodite? Are you an intersex person? Sure, if that fits for you. The diagnosis gives credence to that idea, but if that isn’t how you know yourself, then it doesn’t fit, no matter what any expert or medical records may say. (There’s more here, too, for another time.)
Do you have a disorder of sexual development? If you believe that nature makes males and females, penises and vaginas, that either are perfectly formed or otherwise are “disordered,” then yes, you have a DSD. Science, with its wish for neat categories and deterministic reduction, likes “this or that and nothing in between” kinds of naming. Society and culture like this kind of binary definition so that we can function as a group with cooperative rules about who does what; men do certain things, and
women do other things. If those categories blur, it’s a lot of trouble for a lot of people.
Nature doesn’t care about science or culture or society or even religion. Nature came before, and will exist long past, all of those constructs that we have made up.
So, how do you want to name yourself? For me, I am Tiger.