Anatomy, gonads, hormones, genes, rearing, identity and even the presumptions of others all play into a person's sex. William Reiner, who started out as a urologic surgeon, went back to school after witnessing the misery of children living with the results of sex-correction surgery. Now a child psychiatrist at Johns Hopkins University, he says the most important sex organ is the brain. All the more reason to step back from aggressive enforcement, he says. Sure, go ahead and assign sex at birth, he suggests, but in the final analysis boys will be boys, girls will be girls, and they know what they are better than any parent or doctor.
Some surgeries are medically necessary, and many seem to turn out just fine.
Cheryl Chase thinks she knows some already. She founded the network that grew into the Intersex Society of North America, a clan of 1,400 whose anatomy doesn't fit the binary ideal. Born with both ovarian and testicular tissue, Cheryl started out life as Charlie. But doctors decided later that since she was potentially fertile and had a short penis, she'd be better off as a girl. Her parents changed her name, threw away photographs and birthday cards and had her clitoris removed when she was 18 months old.