Caregiver of Androgen Insensitivity Syndrome Support Group

It is a brave and honest person who can stand apart from the masses and openly challenge its most treasured beliefs. ~ Donna Evans

As humans, we understand a little about our complex bodies even with the greatest medical science. It is what it is. Then why lie? Secrecy and stigma are worse than the condition itself. Without truth and transparency, it is difficult to pass laws, provide equal rights, offer support and help for all. We need to have an environment which encourages truth, tolerance, and respect for all.  Are there only two genders or is there a third gender? Regardless of which side of the issue you are on, we can all agree that truth is always the right option and secrecy and lying have no place for a long-term solution in a civilized society. There are several issues with secrecy and lying. First it is wrong. Second it does not take into account the feelings and trauma of the person being lied to. Third it could lead to criminal acts such as if lying is a crime under oath. What are the bioethics for disclosure to spouses?

It is NOT about gender identity or it is NOT about the sexual identity, it is about the HUMAN identity which is to say the truth.

As a human being, everyone deserves a feeling of “belonging”, understanding and acceptance. Without recognition of the truth, how will an intersex person marry legally or how can an intersex couple (who are infertile) adopt a child legally or have a child through in vitro fertilization (IVF) legally?  What about the equal laws and rights of the young, male, spouse caregiver of the intersex patient? Truth above all is the right long-term solution. If allowing a “third gender” option helps foster saying the truth then maybe that is the path to take. By saying the truth, one can get rights and people are making changes in the third gender community including wanting legalizing sex reassignment surgery (SRS).

The Truth – Some Want The Third Gender and Some Don’t

Gender identity and sex identity are biological, cultural or biocultural? The western culture and laws have a narrative of binary gender – male or female. As a result, several resources and money are utilized to promote science, research, groups, communities, viewpoints only from a binary gender perspective. While for centuries, the existence of “third gender” is widely accepted in South Asian cultures like India, Pakistan, Bangladesh, Nepal and other places like Phillipines, Oman and so on. In Hindu religion, hijras are both recognized and have a special status. Culturally, people have a right to be allowed their freedom of expression as noted by Nepali LGBTI politician and activist. After all, diversity should be tolerated and celebrated. Through centuries, the “third gender” has been institutionalized and also holds a special relevance in the society. The “third gender” are enjoying more civil rights; being counted in the census, right to vote, option to display third gender on passports, and other freedoms. The “third gender” is legitimized in several places in the world. Above all, the “third gender” are free to express the truth as they see it – a fundamental right of any human being.  The western narrative of binary gender could overshadow the cultural diversities and the viewpoints of others in the world who believe in the “third gender” and respect it. With globalization occurring at a faster pace than ever before, it is important to account for everyone’s voice to be heard and be respected and not just the loudest voice in the room. It also so happens the South Asian countries happen to be some of the most populous in the world and statistically would have more “third gender” persons. Has their voice been heard or considered? Non-western cultures have accepted the truth as nature delivers for centuries instead of forcing people to use a strategy of secrecy and lying. In truth, there is respect for all human beings. Shouldn’t we be working towards an environment that fosters saying the truth?

Binary Gender Viewpoint

This is a debate which may never end. The binary gender viewpoint assumes there are only two genders in the world – male or female. Implicitly, are they denying the rights of people on how they should feel? There are several accounts of intersex people who feel neither man or woman or feel both, it just is. Why cannot intersex people feel as they do? Ironically the proponents of intersex communities fall prey to the heteronormativity norm and educate their members that they should “feel” like a woman or a man. They do not introduce the concept of the “third gender” in their education and awareness. Some members of the community just might feel more comfortable identifying themselves as the “third gender” if the option were available. And when the communities do not take up a unified approach, it is hard to change laws and instead succumb to the binary gender norm. Inadvertently, they may be even encouraging a culture of secrecy and lying which could be more devastating than the condition itself. There are instances who want a definition of gender based on biology, how will that help people who do not fall into either category? Are these viewpoints taken into account? The fundamental question is does the binary gender viewpoint encourage an environment of truth, tolerance, and respect for all?

Third Gender – Truth for Inclusivity

The best thing about recognizing the “third gender” is it gives an option for those who would like to opt for saying the truth. As a human being, they do not feel confined to a binary definition of gender. The feeling of freedom of expression is priceless in its own way for every human being. Contrary to popular belief, the binary gender approach is impeding progress in freedom of expression as noted by a famous Nepal activist and politician. Giving the ability to a person to identify themselves freely gives them the chance to say the truth. It offers them freedom from living in secrecy and lying. They can build better, meaningful relationships based on understanding and acceptance. Without recognition of the truth, how will an intersex person marry legally or how can an intersex couple (who are infertile) adopt a child legally or have a child through in vitro fertilization (IVF) legally?  It is about respecting feelings of all including the caregivers of intersex people who may have been lied to. It is important for the caregivers to be allowed to share the truth freely as they see it just like an intersex person is allowed. Or are we going to advocate infringing on caregivers’ minority rights? Are there equal laws and rights of the young, male, spouse caregiver of the intersex patient? In the end, let truth prevail. Education and awareness “inclusive” of feelings and sensitivities of all is the right solution. Imagine a medical condition like Alzheimer’s – a very traumatic condition both for the patient and the family caregiver. There is a lot of information and resources and support groups for caregivers of Alzheimer’s. The inclusive approach makes the experience so much better both for the caregivers and the patients. Isn’t truth the best way for all caregiver-patient relationships regardless of the medical condition?

“We often talk about moral values, justice and trust, but the important thing is to put them into effect in our everyday lives.” – Dalai Lama

East or West, Truth is the Best

Here is an excerpt from a recent article:

Male-to-female transgenders, also known as “hijras”, have a long history in South Asia, experts say. The Sanskrit texts of the Kama Sutra, written between 300 and 400 B.C., refers to a “third sex”. The Kama Sutra is an ancient Indian Hindu text on human sexual behavior in Sanskrit literature.

During the Mughal empire in the 16th and 17th centuries, castrated hijras – or eunuchs – were respected and considered close confidants of emperors, often being employed as royal servants and bodyguards. These jobs were so coveted that historians say some parents actually castrated their sons in order to attain favor with the Mughal kings and secure employment for their children. But despite acceptance centuries ago, hijras today live on the fringes of Indian society and face discrimination in jobs and services such as health and education.

“I think things are different today because of the kind of laws that were introduced to India when the British came. The whole concept of unnatural and natural was defined in our law,” said Indian gay rights activist Anjali Gopalan.

*************End Excerpt*************

This treatment stems from the British enacted legislation: ‘The Criminal Tribes Act 1871’ under which hijras were criminalized and persecuted. This is not about the East Vs. West. This is about the truth. Accepting the truth. Understanding the truth. Looking ahead with the truth. If we continue to sow the seeds of secrecy and lying, there maybe no fruit to enjoy.

By being truthful, the “third gender” for centuries were able to get more recognition and have a better life than today. What have they achieved  by secrecy and lying either for themselves or the ones they come in contact with?

Out With the Old…And In With The Truth

Traditionally, the medical approach has been for intersex people to have sex reassignment surgery(SRS) with or without the consent of the patient and an institutional strategy of secrecy and lying is used. Why? Today advocates of intersex people want to move from a traditional “concealment-based approach” to a “patient-centric approach”.  It is the right direction because it involves saying the truth. Have they gone far enough and “included” everyone in the “new solution”? What about including caregivers of intersex people? For example, when the surgery and treatment occurs while in a marriage and what it does to an unwitting young, spousal caregiver? Who is the advocate for the rights and what is in the best interest of the spousal caregiver of intersex people? Given that equal rights of LGBTI are still in the making, equal rights for caregiver of LGBTI are not even being discussed or on the horizon because the truth is silenced. Intersex people can identify with the issues of secrecy, lying, trauma, crisis, stigma, sensitivity, and so on. A caregiver has their own feelings as a patient caregiver of this medical condition. Worse yet if the caregiver was lied to and brought into this situation unknowingly. Having a genetic condition is no one’s control but lying about is in their control. The struggles that intersex people have gone through and are still going through are well documented and are beginning to gain some ground in altering traditional stereotypes. They will be the first ones to recognize then how much of an uphill it is for a caregiver of intersex people to be recognized. Just stick with the facts – the truth. Caregivers have all the sensitivity for intersex patients but sensitivity has to be two ways. Can we show some sensitivity to the silent, isolated, often intimidated, stigmatized, bullied, caregiver of intersex patient? A far smaller minority than the total population of intersex patients.