Parents sue docs for deciding gender of intersex child 10 years ago

[Nova]

...That the mom was a USAF veteran, and an MD, and a psychiatrist, and already had special needs kids, and had a law school educated stay at home husband, helped push the adoption along quickly, IMO....

If she wasn't a suitable adoptive mother, I don't know who would be!

Just because she has a bias, doesn't mean she is wrong.

As others have mentioned, it used to be "standard medical practice" to turn intersex children into girls because it was easier for surgeons. It took lawsuits to change that policy and it may be this lawsuit, whatever the final decision, will make surgeons more reluctant to make such drastic decisions for infants.

 

[SophieRose]

Quote Originally Posted by K_Z

...That the mom was a USAF veteran, and an MD, and a psychiatrist, and already had special needs kids, and had a law school educated stay at home husband, helped push the adoption along quickly, IMO....

MC was the first child of the three that the couple adopted.

 

[La Louve]

Thank you, Sophie Rose, for posting the State complaint, filed May 14, 2013.



This child's situation had become a "cause" for the mother, before she ever even heard of M.C. As I posted upthread, it is an exquisitely difficult and critical situation for everyone involved in the adoption system to make sure prospective adoptive parents with a substantial knowledge and interest in *certain* medical conditions, are not adopting kids with those conditions to further their own activism or causes. Sadly, I think this is exactly what happened here. The mother admitted a bias that was formed far before she ever met M.C., and then embraced that bias as "advocacy" in her adoption of this child, and the lawsuits. (filed with the help of the southern Poverty Law Center.)

RS&BBM

I'm having a hard time understanding how you came to that conclusion. Would you mind elaborating?

 

[La Louve]

I don't believe this child could qualify for Medicaid services, since his family is not indigent.

"Medicaid is South Carolina's aid program by which the federal and state governments share the cost of providing medical care for needy persons who have low income."
https://www.scdhhs.gov/site-page/medicaid

 

[Margo/Mom]

I don't believe this child could qualify for Medicaid services, since his family is not indigent.

"Medicaid is South Carolina's aid program by which the federal and state governments share the cost of providing medical care for needy persons who have low income."
https://www.scdhhs.gov/site-page/medicaid

Medicaid eligibility is frequently included as a part of adoption subsidy. Prior to such programs children with medical needs were frequently considered unadoptable.

 

[K_Z]

Some additional info I found on this case. Here is the original press release about the 2 lawsuits put out in 2013 by the group Advocates for Informed Choice (AIC). The press release divulges that parents Pamela and Mark Crawford are not paying for any of these lawsuits or legal fees-- the firm of Janet, Jenner, & Suggs are providing the services pro bono (free).

“My firm, Janet, Jenner & Suggs, is known for its advocacy of young children, particularly those
who suffer birth injuries,” said Ken Suggs, a partner at the law firm. “We took this case pro-bono
because we believe that it involves a significant kind of preventable injury to a young child – one
that destroys a basic human right, the right of sexual identity.

Steptoe and Johnson provided the legal services pro bono for the federal case that was dismissed earlier this year. And Steptoe is co-lead counsel for the State case.

“The commitment Steptoe is making to this case is reflective of the firm’s rich tradition of public
service,” said John Lovi, a partner at Steptoe & Johnson LLP, who is serving as co-lead counsel.
“Every year, our firm’s lawyers devote tens of thousands of hours of pro bono work on matters
ranging from death penalty cases to asylum, family law and fair housing.

Link to the current State case, filed in Richland County, SC (alleging improper informed consent and medical malpractice):

https://www.splcenter.org/sites/def...loads/case/Crawford_State_Complaint_Filed.pdf

Beginning on page 26 is the affidavits of experts Dr. Adrienne Cormack and Dr. Susan E. Stred. Dr. Cormack is a board certified urologist, who started a pediatric urology fellowship, but never completed it she did 6 months, July 07-Jan 08). Her body of published work revolves around bladder and prostate cancer-- I can find no publications from her about intersex conditions in either children or adults. She is certainly a learned physician, but I can find no compelling reason why she would have been chosen to provide an opinion on this particular case. There are certainly other professionals with more direct experience in the area of treating intersex conditions, so I'm a bit puzzled. Maybe she is a personal friend or acquaintance? Someone known to one of the law firms, or the intersex advocacy group and its leaders?

Dr. Stred is a pedes endocrinologist, and has a body of work that is more closely aligned to MC's particular issues, IMO.

Both docs mention "consensus" of the medical establishment for care of these children-- and remember, we are talking about care that occurred in 2005-6. The first official "Consensus Statement on the Care of Children with Disorders of Sex Development" was published by Lee et all in the Journal Pediatrics in August, 2006. So my point here is that at the time the infant MC was being evaluated and cared for by the SC medical center and the team of docs, there actually was not yet the current Consensus Statement. Maybe I read that wrong, but that seems to be a significant distinction. That could be quite pertinent if the case makes it to trial, related to the "gross negligence" and malpractice portion of the lawsuit.

I still don't see anything that is clearly a departure from established standards in the area of informed consent. In fact, both of the affidavits go into great detail as to the extent of the entire process of informed consent-- which clearly occurred over 16 months, not just a few days or weeks. There were clearly lots and lots of professionals communicating with, and advising the bio mom and the SC social workers (and the foster parents). I don't think the allegations about inadequate informed consent will be found in favor of the plaintiffs.

I still see this lawsuit largely as a disagreement with decisions made long before the adoptive parents were ever involved with any knowledge or, of care for the child, as opposed to any valid case of inadequate informed consent or gross negligence. That is really reaching for something that just isn't there, IMO. Disagreement on controversial and difficult decisions doesn't equal malpractice or inadequate informed consent. (Especially 10 years after the fact, when the decision making at the time clearly belonged to someone other than the plaintiffs.)

I'm interested in seeing how this case proceeds-- will try to find out more and post here.

 

[K_Z]

Just checking in on this case, to see if it did go to trial as previously planned. It is still apparently in the discovery phase, according to a motion to compel discovery filed within the last few days:

Filed in Richland County Common Pleas court, civil, case # 2013CP4002877 on 5/14/2013
Plaintiff: Pamela Crawford

Defandants: South Carolina Dept of Social Services, Greenville Hospital System, and Medical University of South Carolina

These are filings since 10-1-2015:

Crawford, Pamela Motion/Motion Filing Fee Filing 12/09/2015-10:27
Crawford, Pamela Motion/Motion Filing Fee Filing 12/07/2015-13:01
Crawford, Pamela Motion to Compel Discovery Motion 12/07/2015-12:05
Crawford, Pamela Motion/Motion Filing Fee Filing 12/03/2015-16:50
Crawford, Pamela Motion/Motion Filing Fee Filing 12/03/2015-16:50
South Carolina Dept of Social Services Motion to Amend Answer Motion 12/03/2015-16:34
South Carolina Dept of Social Services Motion For Summary Judgment Motion 12/03/2015-16:25
Crawford, Pamela Reply Memorandum Addressing Privilege Issues Implicated by D Filing 11/19/2015-14:23
Medical University Of South Carolina Memorandum in Opposition to Plaintiffs Motion to Reconsider Filing 11/02/2015-09:23
Crawford, Pamela Motion/Motion Filing Fee Filing 10/20/2015-10:41
Crawford, Pamela Consent Motion For An Extension of Time Motion 10/20/2015-08:33
Crawford, Pamela Motion/Motion Filing Fee Filing 10/16/2015-16:52
Crawford, Pamela Supplemental Memorandum of law Addressing Privilege Issues I Filing 10/16/2015-11:04
Crawford, Pamela Motion to Reconsider Instruction For Camera Review Motion 10/16/2015-11:03
Crawford, Pamela Order Granting Pro Hac Admission of Raisa L. Michalek Order 10/02/2015-08:54
Crawford, Pamela Motion for Pro Hac Admission of Raisa L. Michalek Filing 10/01/2015-14:17
Crawford, Pamela Order/Order Filing Fee Filing 10/01/2015-11:11


http://www5.rcgov.us/SCJDWEB/Public...Agency=40002&Casenum=2013CP4002877&CaseType=V

http://www5.rcgov.us/SCJDWEB/PublicIndex/PISearch.aspx

 

[PeregrineFaulkner]

First, I love your posts, Donjeta-- they always make me think critically. I don't want to give the impression I'm ranting on you-- even as I always seem to be too long winded! So here goes.

What I keep coming back to is the parents’ comments that they would be filing a lawsuit EVEN if the child had identified as female. That alone tells me that this crusade they are on has nothing at all to do with the child, and everything to do with their personal issues about gender and reproductive birth defects.

I’m very confident that this was never a case of only one “rogue doctor” making rash decisions to “lop off” tissue—this child was evaluated extensively by a whole team of professionals.

The lawsuit is about THEIR ideas about informed consent, and what THEY would have done-- 10 years after the fact. Their insistence on filing this lawsuit, AND going on the media circuit, tell me this is all about them, and not about the child at all. The child is a tool for their agenda, IMO. I think they both need extensive counseling to help them deal with all of the issues of effectively parenting this child. For the child’s sake, I hope they are getting help from mainstream, ethical providers, and not fringe activists.

I don’t agree with this lawsuit at all, and I think it’s damaging for the child, for them, for health care professionals, and for the care and acceptance of all of these kids and adults with intersex conditions.

These unfortunate kids will always have gender identity issues, because of their unique birth defects—and IMO, we are disingenuous to ever assume or think otherwise. That said, even the most strident “remove-no-tissue activists” do not advocate raising a child with an intersex condition in a neutral “third gender”. A child with both male and female genitals (inside and out), who has chromosomal mosaicism, really should be assigned a gender at birth (including doing what is needed medically and surgically). To not do so would be unethically cruel and abusive, IMO.

These kids ALSO deserve a compassionate CHANCE to assimilate, grow up, and be considered ONE gender, just like everyone else born with one gender. They shouldn't be forced to make their birth defect the centerpiece of their life-- it's not a hobby, even if their parents are activists. I think we also have to be exquisitely careful to evaluate the true motivations of adoptive parents, so that we don't place kids with activists who are "collecting" kids with certain conditions, to bolster their own crusades.

These kids should not be “forced” to be a third gender until late childhood or adulthood, or forced to share their gender situation with everyone they meet (nor should their parents divulge that private info to just anyone.) The child should not be encouraged, persuaded, or forced to consider themselves “gender queer” either, IMO-- unless they want to identify this way when they are much older. It will soon become obvious which gender the child identifies with (as in admirable kids like Jazz), and then the child can be supported in the gender they choose.

If they identify as the opposite gender later on than the one they were assigned as a result of medical diagnosis and decision making for their birth defect, then we all just deal with it as we would for any other child that is transgendered, whose genitals don't match their self concept of their gender.

(I hope I explained my thinking!)

I'm curious - what's your background on the subject of intersex children? Most human rights organizations have come out against "normalizing" surgical procedures for infants and children in recent years, and at least one country has banned them entirely. What lead you to have such a differing view?

 

[1&2&3]

At 16 months when the surgery was performed, was MC showing a preference for trucks or more feminine toys?

Boys, in particular, are very programmed into trucks, cars, building at that age. IMO. Of course, there are also boys who have no preference and will happily play with anything. Feminine little girls, in my experience, will not go towards the cars and trucks immediately. They exhibit a more mothering attitude. IMO.

 

[PeregrineFaulkner]

I was a girl who loved trucks, and who hacked the hair off all my barbies. I've never felt much desire to be a mother either, fwiw. Though I do like dresses. Gender expression doesn't always fit in tidy boxes, ime.

 

[SophieRose]

At 16 months when the surgery was performed, was MC showing a preference for trucks or more feminine toys?

Boys, in particular, are very programmed into trucks, cars, building at that age. IMO. Of course, there are also boys who have no preference and will happily play with anything. Feminine little girls, in my experience, will not go towards the cars and trucks immediately. They exhibit a more mothering attitude. IMO.

Sixteen months is very young, a child hasn't been walking very long and isn't even really talking yet.

https://www.healthychildren.org/Eng...dentity-and-Gender-Confusion-In-Children.aspx

How Does Gender Identity Develop in Children?

Around two-years-old, children become conscious of the physical differences between boys and girls. Before their third birthday, most children are easily able to label themselves as either a boy or a girl. By age four, most children have a stable sense of their gender identity. During this same time of life, children learn gender role behavior—that is, do*ing "things that boys do" or "things that girls do."

Before the age of three, children can dif*ferentiate toys typically used by boys or girls and begin to play with children of their own gender in activities identified with that gender. For example, a girl may gravitate toward dolls and playing house. By contrast, a boy may play games that are more active and enjoy toy soldiers, blocks, and toy trucks.