“Among
those advocating prenatal dexamethasone, New seems to have been particularly concerned
that CAH-affected girls may fail to grow up to be heterosexual wives and
mothers. Speaking to a group of parents of children with CAH in 2001 at a
meeting organized by the CARES Foundation, New showed a photo of a girl with
ambiguous genitalia and said:
‘The challenge here…to see what
could be done to restore this baby to normal female appearance which would be
compatible with her parents presenting her as a girl, with her eventually
becoming somebody’s wife, and having normal sexual development, and becoming a
mother. And she has all the machinery for motherhood, and therefore nothing should
stop that, if we can repair her surgically and help her psychologically to
continue to grow and develop as a girl (New 2001a)’” (Dreger et al, p. 61)
Maria
New is a well-known, well respected physician, who even the article’s authors
recognize as having done a great deal of good for the medical community at
large. Given her status as a physician she is also clearly well educated. Given
all of this, it is almost shocking to see the way in which New is so concerned
with the notion that all girls must grow up to be heterosexual wives and
mothers. It seems there can be no higher accomplishment for an individual with
XX chromosomes than to successfully utilize the machinery provided by nature to
produce more offspring. Juxtaposed with all of the modern medical technology
presented in the article it seems to be an archaic notion from another time
that has somehow persisted until now. I found New’s phrasing in her speech at
the CAH meeting to be particularly striking, especially as she is addressing
parents of children with CAH. She treats the children born with CAH as if they
are broken individuals. They must be restored, helped, and repaired so that
they can function. Such phrasing almost incites parents to take action, to
begin a dexamethasone treatment the next time they are pregnant, or to warn
their friends about the dangers of CAH. New robs the parents of the opportunity
to see their children as individuals who have developed differently from other
individuals, rather than damaged goods.
The
phrasing New uses also likely allows her in a way to dehumanize the infants she
is working with. It may be more difficult to tinker with bodies of infants who
house minds, and eventually will house dreams and hopes; but it is far easier
to tinker with a body who must be fixed in order to properly utilize its
machinery. The body becomes one that instead of housing hopes and dreams, houses eggs, fallopian tubes, and a uterus. I would also feel remiss not to mention that perhaps this child’s dreams would not include a
life path compatible with New’s ideals. Perhaps some parents also do not feel that their child would have to conform to such a path. This infant may have grown up never
wanting to be somebody’s wife or somebody’s mother. Yet their choice to lead
such a life becomes much more difficult when New and other doctors like her
make a decision to alter the anatomy or physiology of the child. This very
specific type of phrasing may also make it easier to brush off many of the
consequences that can come with the administration of dexamethasone; they
become unfortunate side effects of the work required to fix a larger problem.
Dreger, Alice, Ellen Feder, and Anne Tamar-Mattis.
"Prenatal Dexamethasone for Congenital Adrenal Hyperplasia." Journal
of Bioethical Inquiry 9.3 (2012): 277-294. Print.
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