Right to Choose: When Parents Have Child’s Body Parts Removed

 

This blog post is from Courtney Oien, Regent Family Law student:

          Ashley’s parents had a baby with a rare brain disease.  Her mental capacity remains stunted at three months old.  Ashley cannot move on her own.  Her parents are her primary caregivers, and she must rely on them to move her, clean her, and feed her.  When Ashley was about six, physicians at Seattle Children’s hospital—at the standing request of Ashley’s parents—removed Ashley’s breast buds and uterus.  They also added hormones to stunt her growth.  Far from being a quick decision, her parents had wrestled with the idea and discussed it with doctors before they decided to remove Ashley’s body parts.  Responding to criticism, her parents emphasize that keeping Ashley from growing will help ensure their ability to care for her, to lift and move her.  Ashley is as aware as an infant could be of what is going on.  This has been termed by one journalist as The Ashley Treatment.

 

          David Reimer, born in Canada during the 1960’s, was maimed by a careless circumcision, but was an otherwise healthy infant. His parents chose to remove the rest of his identifiable male body parts and replace them with surgically constructed, female genitals.  They also authorized female hormone treatments, all starting while David (called Joan) was too young to remember.  The Reimers did this at the recommendation of psychologist John Money, whom the Reimers went to for guidance over the best way to respond after their son’s parts were damaged.  Their decision was not uncommon to other parents of the time who found themselves facing the responsibility of raising a child with permanently damaged or irregular sexual organs.

          Money also recommended that David and his brother (who was also a male, but unlike David was raised as a male) keep regular sessions with him.  The psychological “treatment” that David and his brother were forced to undergo was child sexual abuse, and it ended when teenage David refused to continue sessions.  Around this time, David started dressing and acting as a boy.

          David did not find out about the botched circumcision and his actual gender until two years after he started living overtly as a boy.  This shows that David had a sense of his true gender despite growing up believing that he was the opposite sex.

          Parents’ decisions to remove their child’s body parts may be affected by case history in their jurisdiction dealing with medical emancipation, or statutes granting specific medical rights to the children.  It is important to understand these legal and medical terms.

          Medical emancipation occurs when a state grants a “mature minor” the legal rights to decide what medical treatment to receive, how often to receive it, and from which medical provider to receive treatment.  This transfer of rights from parents to child flies in the face of the traditional assumption underlying parental rights: a fit parent is presumed to be acting in the best interests of the child, and is legally protected in those decisions by fundamental constitutional rights and principles that apply to parents. 

          A 2000 article from the Guttmacher Institute shows a majority of states denied parents the right to be informed when their minor children were going to become parents themselves.  About half the states prioritized the children’s reproductive rights to contraceptive services over the parent’s right to withhold or grant permission.  Forty-four states denied parents the right to know about any psychological services that their minor children chose to obtain.  These decisions show that the state is willing to erode parental rights in the areas of the minor’s reproductive health, mental health, and emotional health.  These are narrow exceptions to the general constitutionally protected rule that parents determine the medical procedures for their children. 

          Parents today have the benefit of examples such as the two children above.  Ashley, curled on her sheep-skin rug, enjoyed a higher standard of care than David Reimer did, yet both Ashley’s parents and David’s parents were looking for the best way to take care of their child in uncharted territory.  As far as we know, Ashley is not negatively affected by her physical changes, but cognitively healthy David was hurt psychologically and physically.  When some part of the child is broken, perhaps the best guideline is to leave undamaged parts in their natural state.  Parents can preserve the decision for children to decide when they reach physically mature and legal adulthood.  Until then, a family restoration perspective would encourage the wise use of many counselors, doctors and lawyers, rather than just one doctor.