Sex change surgery performed on 16-month-old South Carolina child without consent

 photo MCBIKE_zps88641981.jpgM. C. Crawford is 8 years old.  He was Identified as a male at birth until doctors determined that he had ambiguous genitalia, with parts of both female and male reproductive structures.  When a court terminated the parental rights of his mother and he was abandoned by his father, he was placed in state custody.  At 16 months old doctors removed his penis and one testicle, leaving enough to form a clitoris and labia.  A bit after that the child was adopted in South Carolina by Pam and Mark Crawford.

The first thought that I had was, let’s make sure they don’t do the surgery.

Pam Crawford

Unfortunately the Crawfords were too late.  They raised M. C. as a girl until about a year ago, when he told his parents he wanted to be raised as a boy.

On Tuesday lawyers for the Crawford family said they were filing suit against the Department of Social Services.

Interspersed throughout will be comments from medical ethicist Alice Dreger, published in The Atlantic:  When to Do Surgery on a Child with ‘Both’ Genitalia.

Doctors have believed for many years, based on little to no evidence (even faked evidence:  {cf. the David Reimer case}), that children require male-typical or female-typical genitals in order to grow up psychologically healthy.


The doctors knew that sex assignment surgeries on infants … poses a significant risk of imposing a gender that is ultimately rejected by the patient.

–the lawsuit

The suit claims that the optional surgery should have been delayed until the child was old enough to self-identify his gender.

That was a permanent, irreversible decision that was not theirs to make.

–Ken Suggs, attorney for the Crawfords

The lawsuit describes how the defendants violated M.C.’s substantive and procedural due process rights, outlined in the 14th Amendment, by subjecting M.C. to the unnecessary surgery “without notice or a hearing to determine whether the procedure was in M.C.’s best interest.”


There is local television coverage here.

When M. C. was adopted, the Crawfords knew that he was born with ambiguous genitalia, but did not know that doctors had operated on him.  When they found that out, they raised their child as a girl until he told them how he felt.  Since then they have supported his decision, cut his hair short and allowed him to dress as a boy.  They say that he is happy and has the support of his community and his school.

They are suing so that future families don’t have to go through this.

We feel very strongly that these decisions to permanently alter somebody’s genitalia and their reproductive ability for no medical reason whatsoever is an abhorrent practice and can’t be continued.

It is too late for our son.  The damage has been done to him.

Pam Crawford

Because M.C. has rejected the gender assignment given to him, this case is also causing some people to confuse intersex (sex anatomy that is read as being not typical to males or females) with transgender (rejection of the gender assignment given to a person at birth).  M.C. is a relatively rare case in involving both intersex and transgender.  Far more often, the concerns of intersex and transgender people represent opposite sides of the same coin: intersex people get surgeries they don’t want, and transgender people can’t get the surgeries they do want.  M.C. should certainly be supported in his self-identification as a boy, but one would hope that the courts might understand his rights to have been violated even if he had grown to be a girl.


The lawsuit accuses the Medical University of South Carolina, where the operation was performed and Greenville hospital, where he was born, of medical malpractice for operating without informed consent and failure to inform the patient of potential problems associated with the surgery.  Also named in the suit are the South Carolina Department of Social Services and individual employees who performed the irreversible surgery.  The suit was filed in both state and federal court.

M. C. is currently healthy, but is still faces possible sterilization and loss of sexual function as he matures.  The medically unnecessary surgery is often performed on intersex children because adults are uncomfortable about having a child which cannot be easily identified as a boy or a girl.

These doctors wanted to play God.

–Alesdair Ittelson, Southern Poverty Law Center

About one in 2000 children is born intersex according to Advocates for Informed Choice.

Typically, children with these conditions develop as a boy or girl as they grow.  Despite not knowing whether M.C. would grow up to be a man or woman, or whether he would elect to have any surgery at all, the defendants performed sex-assignment surgery on a 16-month-old child, removing his healthy phallus in an attempt to make M.C. a girl.  M.C. has shown signs of developing a male gender and now, at age 8, has clearly identified himself as a boy.


What people mean when they say a person “was born with both sets of genitals” is that a child may be born with a phallus that looks a lot like a penis plus a vagina (the tubular organ that goes from the outside of the body towards the uterus, if there is a uterus).  This can happen because of hormones, in conditions like congenital adrenal hyperplasia and partial androgen insensitivity syndrome.  But to say that gives you “both sets of genitals” is to pretend that somehow all that matters to males is their penises and all that matters to females in their vaginas.  In fact, many of us women also care about our clitorises.  (For that matter, many men care about their scrotums.)


Since the 1950s doctors have performed this kind of surgery on infants with intersex conditions, often failing to provide full information about risks to the child’s parents or guardians.  The lawsuit, the first of its kind in the US, seeks to end this inhumane practice.

By performing this needless surgery, the state and the doctors told M.C. that he was not acceptable or loveable the way he was born.  They disfigured him because they could not accept him for who he was – not because he needed any surgery.  M.C. is a charming, enchanting and resilient kid.  We will not stop until we get justice for our son.

–Pam Crawford

You can offer your support for M. C. here.


    • Robyn on May 18, 2013 at 00:03

    …International Day Against Homophobia and Transphobia, commonly called IDAHO…with, I guess, the assumption that the T is silent.  Note also that the I (for intersex) is invisible.

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