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→Intersex surgeries: wikify Reimer
Genital corrective surgeries in infancy were justified by (1) the belief that genital surgery is less emotionally traumatic if performed before the age of long-term memory, (2) the assumption that a firm gender identity would be best supported by genitalia that "looked the part," (3) the preference of parents for an "early fix," and (4) the observation of many surgeons that connective tissue, skin, and organs of infants heal faster, with less scarring than those of adolescents and adults. However, one of the drawbacks of surgery in infancy was that it would be decades before outcomes in terms of adult sexual function and gender identity could be assessed.
Intactivism and intersex activism intersected in 1965, when baby [[David Reimer|Bruce Reimer ]] had his penis burned during a circumcision. Johns Hopkins psychologist John Money recommended sexually reassigning the baby as a female (conveniently this would serve as an experiment for John Money's theories, as Bruce's twin brother had not been operated). Bruce was renamed Brenda, castrated, subjected to hormone treatment, and raised as a girl. During adolescence, the parents had to tell her the truth, and Brenda resumed a male identity, now taking the name David. David underwent double mastectomy and two phalloplasties, and replaced hormonal treatment with testosterone. After learning that John Money continued presenting his case as a success, and that intersex children were routinely subjected to sexual reassignment, David went public with his story in 1997. David committed suicide in 2004.
The 1970s and 1980s were perhaps the decades when surgery and surgery-supported sex reassignment were most uncritically accepted in academic opinion, in most children's hospitals, and by society at large. In this context, enhancing the ability of people born with abnormalities of the genitalia to engage in "normal" heterosexual intercourse as adults assumed increasing importance as a goal of medical management. Many felt that a child could not become a happy adult if his penis was too small to insert in a vagina, or if her vagina was too small to receive a penis.
During the 1980s some of these surgeries were discouraged. However, feminizing reconstructive surgery continued to be recommended and performed throughout the 1990s on most virilized infant girls with CAH, as well as infants with ambiguity due to androgen insensitivity syndrome, gonadal dysgenesis, and some XY infants with cloacal exstrophy.
A more abrupt and sweeping re-evaluation of reconstructive genital surgery began about 1997, triggered by a combination of factors. One of the major factors was the rise of patient advocacy groups that expressed dissatisfaction with several aspects of their own past treatments. The Intersex Society of North America was the most influential and persistent, and has advocated postponing genital surgery until a child is old enough to display a clear gender identity and consent to the surgery. [[David Reimer]]'s case became public, destroying the very foundation used to justify early intersex surgeries.
Numerous organizations have been created to increase public awareness of intersex conditions and advocate for the rights of intersex children to self-determination and genital integrity.