As best as I can tell, this procedure was performed on girls and women who have enlarged clitorises, or clitorises that are bigger than "normal," as determined by the doctor. I am no expert on this, of course, so I don't know how one determines that, say, a 4-month-old has a too-big clitoris. Here is what Alice Dreger and Ellen K. Feder say in their article at Bioethics Forum (I recommend reading the whole thing):
... With parental consent, these girls’ clitorises have been cut down in size after the physician deemed these clitorises too big.And then there is this, from Feministing, which is so important:
For over a decade, many people (including us) have criticized this surgical practice. Critics in medicine, bioethics, and patient advocacy have questioned the surgery’s necessity, safety, and efficacy. We still know of no evidence that a large clitoris increases psychological risk (so is the surgery even necessary?), and we do know of substantial anecdotal evidence that it does not increase risk. Importantly, there also seems to be evidence that clitoroplasties performed in infancy do increase risk – of harm to physical and sexual functioning, as well as psychosocial harm.
While Dreger and Feder refer to Poppas' patients as female, I kept asking myself the question of whether he was "treating" non-intersex girls with larger clitorises, intersex children, or both? While the practice is abhorrent either way, what I ended up finding via Bird of Paradox is much worth noting: Alice Dreger has received severe criticism from the intersex community and trans community, most notably for seeking to replace the term, "intersex" with "disorders of sexual development" or DSD. (Which is obviously pathologizing and super problematic.)Yeah, I really don't know what to do with this. I mean, "first do no harm," what does that mean here? I can't imagine there is no harm. But, I figured the least I can do is pass it on and make people aware that this happened. If you can stomach more, read Dreger's follow-up article on Psychology Today, check out Dan Savage's article on The Stranger, and see a PDF of the study here. Also, Shakesville has an open discussion thread on the topic.
So did Dreger intentionally not use the term, "intersex" in her report on Poppas although many, if not all, of these children may actually be intersex? Because this surgical procedure and others like it intending to "normalize" genitals is hardly new, and has been conducted for quite some time on intersex children.
While I would believe that there may also be girls who aren't intersex being treated by Poppas for simply having a larger clitoris, we have to make sure that we include all of the children being affected here who are at risk of physical and extreme psychological harm.
**I have referred to the patients as girls and women as the study itself has, but I cannot say with any certainty that those terms are correct. If anyone has more detailed information about that, please let me know.