Ashley

The parents of a severely disabled girl are having her sex organs removed and giving her hormonal treatments to stunt her growth. Understandably, there has been outrage, but I don't think what they're doing is bad.

Some, if not most, of you will disagree with me - and that's fine, I can totally see the other side too - but I think the parents did the right thing here in removing her sex organs, and I don't think stunting her growth is actively wrong. I'm thinking my way through this by putting myself in the little girl's shoes, and the more I think about it, the more I think the parents were not wrong.

How would I feel if my sex organs were removed? Well, in early adolescence, I wouldn't miss them and might even be glad that I didn't have them. (IRL, I felt the trappings of fertility were a burden for several years, and thereafter felt they were a tolerable nuisance.) In later adolescence, I would either have come to terms with the absence of sex organs, or I would resent their absence because it prevents me from having a sex life. But that's the benefit I get from sex organs - they make me more physically attractive, thus increasing my likelihood of finding someone to have sex with me, or they make sex physically possible. Other people also enjoy sex organs because they enable them to reproduce. But none of these apply to this little girl. She will never be able to consent to sex or even comprehend sex, and of course she will never be able to reproduce, so her sex organs are simply a burden for her. I think they did her a favour by removing them, and if I were in her position I would want them removed.

The other issue is that the parents made this decision unilaterally. How would I feel if my parents unilaterally made a decision to have my sex organs removed? I would feel that they are exceeding their authority - I would feel that they should have consulted me, or, if I was rather young, my parents and medical team should have educated me objectively to the point where I could have made an informed decision myself. However, this little girl will never be able to make an informed decision herself. She probably doesn't even grasp the concept of an informed decision. I don't even know whether or not she understands that she's an autonomous being. There is simply no possibility whatsoever of consulting her, at all, ever, so it was not inappropriate for the parents to make the decision unilaterally.

Now for the size thing. How would I feel if I underwent medical treatment to stop me from growing? I would feel cheated. I've long aspired to be a grownup, and part of that is being grownup size. I like being grownup size. I like that I can reach things, I like being treated with grownup respect, I like it when I can come across as authoritative, I like being able to look over the cubicle walls and see where everyone is. Being tall is fun. However, this little girl will never be able to stand up, so she will never be able to actually be tall. She could be long, but being long is an inconvenience (have you ever tried to sleep on a too-short bed?). Because she has the physical and mental abilities of a three-month-old, she will never look grownup or come across as authoritative anyway. None of the reasons why I enjoy being tall will ever apply to her. In fact, given her severe disabilities, I think being small would be the least of her problems.

How would I feel if my parents unilaterally decided to stop me from growing? I would think that's sick and twisted, that they cannot let go and accept the fact that I'm growing up, and that if they wanted something little and cute, they really should have gotten a chihuahua instead. But none of these statements apply to this little girl. She will always be physically and mentally three months old. She will never be an adult, she will never be independent, her parents cannot let go because she will always need care. With the mind of a three month old, I'm not sure if she even comprehends the concept of independence, never mind that she will never have it. Maybe she wants to be held all the time, maybe she has no need for privacy, maybe she doesn't want to be apart from her parents (I'm not a child development expert, but that sounds about right for a three-month-old to me.) Again, this little girl will never be in a position to make that decision for herself, and will never be able to comprehend what might have been. Even if she does perceive herself as different from everyone else, it will be because she is so severely disabled, not because she is small.

The most frequent argument I hear against these measures is that the parents did it for their own convenience, not for the child's convenience. This is a very good point - parents should make their kid's medical decisions based on what's best for the child, not what's easiest for the parents. But we have to ask, are these measures any inconvenience to the little girl? I don't think they are. I think by removing her sex organs they're doing her a favour (although she will never realize it), and making her small is no inconvenience to her whatsoever. While, as a general rule, I don't think parental convenience should be a factor in decision-making, I don't think there's anything wrong with making it more convenient for the parents if doing so is not inconvenient or unpleasant for the child.

I've also seen a few red-herring-type arguments in this debate, so I'd like to briefly address them here. The first is drawing a parallel between removal of her sex organs and female circumsion. I don't think this is an apt comparison, because breasts and uterus will be a burden to her, while the clitoris is no problem whatsoever. If she has or ever develops sufficient motor control (I have no idea whether or not this is possible for someone with the motor skills of a three-month-old), she may even figure out how to use her clitoris to give herself pleasure, which would be a safe and appropriate way for her to enjoy her own sexuality despite the fact that she will never be able to properly consent to sex. Her breasts and uterus can give her no such pleasure. Therefore, removing the sex organs removes a burden that gives her no pleasure, while removing the clitoris would be removing something that's gives her pleasure without any inconvenience.

The other red herring I've seen is that keeping her small is just as bad, ethically, as would be removing her arms and legs to make her lighter. This is not an apt comparison either, because her limbs are some benefit to her. The general consensus among the first page of Google results is that a three-month-old can move their arms and legs and hold things in their hands, and that doing so amuses them. They would also keep her balanced while lying down, and allow her to roll over if that's within her abilities. So removing her limbs would make her smaller and lighter, but at the expense of what little mobility and ability to interact with her environment she does have. However, hormonally stunting her growth makes her smaller and lighter at a negligible cost.

I certainly don't think this situation is black and white. If her parents weren't taking these measures, it would never occur to me that they should be taken. It might occur to me to recommend tubal ligation, but that's about it. I also think we need to carefully keep an eye on the slippery slope thing - this one case shouldn't be a wide-open door to allowing parents to alter their disabled children willy-nilly. However, the more I think about it, the more I feel that the parents in this particular case are not doing anything wrong, and may even be doing what's best for their child.