Discussion Thread: Dexamethasone and "Fixing" Broken Girls

Recently Alice Dreger and Ellen K. Feder called our attention to a terrible medical malfeasance regarding FGC at Cornell University. They are now, with their colleague Anne Tamar-Mattis, sending up flares about the use of dexamethasone, "a risky Class C steroid," which is apparently being offered (I use the word advisedly) to pregnant women whose female fetuses are suspected of having a form of congenital adrenal hyperplasia, which can result in "ambiguous" or "masculinized" genitalia.

And that's not all:

One group of researchers, however, seems to be suggesting that prenatal dex also might prevent affected girls from turning out to be homosexual or bisexual.

...They specifically point to reasons to believe that it is prenatal androgens that have an impact on the development of sexual orientation. The authors write, "Most women were heterosexual, but the rates of bisexual and homosexual orientation were increased above controls ... and correlated with the degree of prenatal androgenization."

...And it isn't just that many women with CAH have a lower interest, compared to other women, in having sex with men. In another paper entitled "What Causes Low Rates of Child-Bearing in Congenital Adrenal Hyperplasia?" Meyer-Bahlburg writes that "CAH women as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role. As children, they show an unusually low interest in engaging in maternal play with baby dolls, and their interest in caring for infants, the frequency of daydreams or fantasies of pregnancy and motherhood, or the expressed wish of experiencing pregnancy and having children of their own appear to be relatively low in all age groups."

In the same article, Meyer-Bahlburg suggests that treatments with prenatal dexamethasone might cause these girls' behavior to be closer to the expectation of heterosexual norms: "Long term follow-up studies of the behavioral outcome will show whether dexamethasone treatment also prevents the effects of prenatal androgens on brain and behavior."

Further, these women might have a disproportionate and "abnormal" interest in "men's occupations and games." The authors of this piece note the irony of "one of the first women pediatric endocrinologists and a member of the National Academy of Sciences constructing women who go into 'men's' fields as 'abnormal'," and conclude the article thus:

Needless to say, we do not think it reasonable or just to use medicine to try to prevent homosexual and bisexual orientations. Nor do we think it reasonable to use medicine to prevent uppity women, like the sort who might raise just these kinds of alarms. Consider that our declaration of our conflict of interest.

Suffice it to say, for my part, I share their contempt.

A couple of brief notes:

1. I feel obliged to point out that there's no objective reason to solve the "problem(s)" of atypical genitals, bi- or homosexuality, women who are single and/or childless by choice, or in some other way deviate from the kyriarchal narratives of what "normal womanhood" should look like. It is because of our rigid heteronormative gender binary, and the prejudices that arise therefrom, that these things are "problems," but the privileges we confer are arbitrary, based on collective inventions, and they can be changed. It is enormously frustrating when scientists treat natural variation as a problem to be solved, and necessarily deny humans' capacity for ideological adaptation in order to sustain that pretense.

2. Similarly frustrating is the discordance in which Alice Dreger could be so right on calling out this shit, and yet so wrong in defending J. Michael Bailey's transsexual dichotomy theories as merely saying "unpopular things." (Autumn's got more in her archives.) That's not really here nor there in terms of the particular piece being discussed, but it's certainly a failure that needs to be acknowledged in this space.

[H/T to Shaker Tia.]