Presentation on theme: "INTERSEX: a view from both sides of the fence"— Presentation transcript:
1INTERSEX: a view from both sides of the fence mani mitchellcounsellorchange agentintersexualp.t.s.d.queerkiwi
2INTERSEX: a view from both sides of the fence In memoryKeith TaylorSydney (Gosford) Psychotherapist
3INTERSEX: a view from both sides of the fence Clarification:In this presentation I am using the term intersex as a reclaimed word.I am also using DSD not because I like it or agree with it – it is sadly the ‘new’ medical termI acknowledge that many intersex people do not see themselves as queer or queer (glbt*i) identified, I am in this presentation talking only about people who do.I am NOT seeing intersex as a reality, something that is in itself pathologyIn this presentation I am taking about intersex identified people who are experiencing and or seeking help with mental health issues.
4INTERSEX: a view from both sides of the fence One side: Educator - disaster/mental health professionalOther: Intersex/DSD I live with the long term consequences of childhood trauma - sexual abuse (PTSD)
5INTERSEX: a view from both sides of the fence Intersex: a medical umbrella term used since the 1950”sDefinitionA body that someone has decided is not standard male or female.Incidence: Visible during a persons childhood live births.Actual*, as high as live births. (invisible – not diagnosed)* Work of Professor Milton Diamond Hawaii
6INTERSEX: a view from both sides of the fence The ‘modern’ (1950’s) treatment paradigm. Still very much anchored in the thinking of sexologist Dr John Money.Focus psycho/social (emergency) – need for clear agreed gender (Gender seen as a binary)Congruent bodyChild rearingSecrecyHetro-normative – binary (male, female) eurocentric – trans/homophobic response to difference
7INTERSEX: a view from both sides of the fence Very few intersex conditions that are truly life threatening and needing surgery or treatment.Salt wasting CAHUrinary tract issues.“the existence of intersexed bodies threatens to disrupt the Western notion that there are only two sexes that are quite distinct from one another, scientists and medical practitioners have used their cultural authority to affirm sexual boundaries and to secure their own place as the legitimate arbiters of sex and gender.”
8INTERSEX: a view from both sides of the fence TreatmentTypicallyAggressive: gendering the child– following it up with‘normalising’surgeryand or hormones
9INTERSEX: a view from both sides of the fence Surgerynot alwaysconfinedto genitals
11INTERSEX: a view from both sides of the fence The trans/homophobic ‘shadow’…Every intersex (DSD) persons story/journey will be different.My contention: you can not do this work with clients if you have not done your own – AND that your comfortable being outside your comfort zone and working with an reality (story) that may well be poorly (sometimes impossibly) languaged.
12INTERSEX: a view from both sides of the fence Intersex DSD knowledge/informationIts your responsibility to learn, its not your clients job to teach youUnless you are considering paying them to do so!Warning: Doing work in this area has the potential to challenge and change much of what you know, have assumed and think about the human world.
13INTERSEX: a view from both sides of the fence The mythical‘hermaphrodite’
14INTERSEX: a view from both sides of the fence Impact: (potential) as a clinician be aware the client may know their story or they may know very little!Your client might be comfortable talking – unable to – or not consider any of the following relevantHave you and your client agreed what it is you want to do in counselling?When was the intersex reality identified (birth/later)Was the difference significant or notWhat was the difference (there are over 30 diagnosable intersex conditions)Was there an issue around gender?Did the assignment change?
15INTERSEX: a view from both sides of the fence Was your client abused by family as a result of their being different – physical – emotional – handed over for adoption – family break up –Was your client abused: bullying /teasing/violence/sexual abuse (home – school – community)or an ‘abuser’ during their childhood (acting out)During the clients teen years what went on – how was it going through puberty -
16INTERSEX: a view from both sides of the fence Was being a teenager a positive experienceWere there issues with relationships – family – school – peers – intimate.AlcoholDrugsViolenceDepression – anxiety – self harm – suicidal – (attempts) hospitalizationInterpersonal skills – okay - problematic
17INTERSEX: a view from both sides of the fence How does your client feel about their intersex/DSD status/identity now – is it a problem?Does your client have a stable gender identity that they are comfortable with itDoes your client have a stable sexual orientation – how has sexual experiences been for them, are there intimacy difficultiesIs there a fertility issue and is it a strength/a problem or neither for your clientIs there anything they want to change
18INTERSEX: a view from both sides of the fence Image shownwith awarenessto the ownerof this bodyI show it with respectonly soyou may understanda little more..
19INTERSEX: a view from both sides of the fence Other things to consider:Impacts ofShame - fear - secrecy - lies - silence -Rejection - discrimination - trust violation - isolationA missing/lost personal narrativeBeing born differentthe hospital ‘freak’ - teaching opportunityTraumaTo be queer is to be the person that was supposed to ‘die’
20INTERSEX: a view from both sides of the fence Other things to consider:Revenge (desire)AngerTrust - repair issues (physical and or psychological)DissociationAbsence of self carePoor sense of selfGrief/lossCulture (does your client come from a culture where intersex is treated differently)
21INTERSEX: a view from both sides of the fence Moving forward:Educate yourself….Work with respectAssume nothingWork alongside your clientListen (exquisitely)Expect to be ‘checked out’. (many times)If you get it wrong - apologiseBe alert to transference - counter transference !Typically this is not fast work!
22INTERSEX: a view from both sides of the fence Moving forward:Gender identity issues(if your client does not identify or is exploring issues related to their assigned birth gender)Then you both have some potentially complicated work ahead.Your role may well be critical helping your client move forward - points to consideryour client may or may not identify in the binaryif your client sees themselves outside the binary can you support them?If the person had genital surgery as a child this process will not be straightforward.
23INTERSEX: a view from both sides of the fence Moving forward:RememberYour client is the expert - not you.Beyond Blue p3“60% of intersex people reported having experienced depression, and over 70% had seen a counsellor or a psychiatrist during the previous five years.”
28INTERSEX: a view from both sides of the fence thankyou
29INTERSEX: a view from both sides of the fence References:Kennedy, K. Psychological Distress in people with intersex conditions. Leeds, 2006.Mental health promotion and prevention services to gay, lesbian, bisexual, transgender and intersex Populations in New Zealand. Te Po ISBNDepression and anxiety in gay, lesbian, bisexual, trans and intersex populations. Beyond BlueBerkley Journal of Law and Justice.Exceptions to the rule: 2006 Volume 21.Davies, D. (2000) Therapeutic perspectives on working with lesbian, gay and bisexual clients. Open University Press.Dreger, A. (1999) Intersex in the age of Ethics. University Publishing Group.
30INTERSEX: a view from both sides of the fence References:Preves, S.E. (2003) Intersex and Identify. London. Rutgers University Press.Reis, E. (2009) Bodies in Doubt an American History of Intersex. Baltimore. Johns Hopkins University Press.Karkazis, K (2008) Fixing Sex Intersex, Medical Authority and Lived Experience. London, Duke UniversityMay, L (2005) transgenders and intersexuals . East street publications.