The case of an adopted intersex boy who was castrated at birth by North Carolina doctors passes another legal hurdle. The doctors now have to be accountabele for their decision to castrate the boy even though they themselves noted that it was medically unnecessary.

DSS loses motion to delay case of intersex child
Child identifies himself as a boy, despite surgery to remove genitals

GREENVILLE, S.C. —A case that accuses the Department of Social Services and medical care givers of performing unnecessary sex-assignment surgery on an intersex baby will proceed.

The decision of the 5th Judicial Circuit Court to let the case continue means the defendants will have to defend their choice to castrate the baby, who has since grown into a healthy 8-year-old who identifies himself only as a boy, named in court documents as M.C.

“The court’s decision moves M.C. a step closer to justice,” said Kristi Graunke, Southern Poverty Law Center senior supervising attorney. “This ruling holds doctors accountable when they recommend such drastic and irreversible procedures for infants but fail to ensure caregivers are fully informed about the risks and options.”

M.C. was born with an intersex condition — a difference in reproductive or sexual anatomy that doesn’t fit the typical definition of male or female. When he was just 16 months old and in the care of the South Carolina Department of Social Services, doctors and department officials decided the child should undergo sex assignment surgery to make M.C. a girl.

“Our young client was profoundly harmed when doctors and state agents decided to remove his penis and testicles,” said Anne Tamar-Mattis, co-counsel from Advocates for Informed Choice. “We look forward to continuing the fight on M.C.’s behalf and to ensuring that no child ever has to undergo such life-altering surgeries without informed consent.”

The plaintiffs say DSS and medical staff made the decision even though there was no way of knowing at such an early age whether M.C. would grow up to be a male or female.

The lawsuit, filed by the child’s adoptive parents, claims the defendants did not even provide a hearing to determine whether the procedure was in M.C.’s best interests.

Named in the suit are the Department of Social Services, the Medical University of South Carolina, Greenville Health System and several other caregivers.

M.C. was born a premature twin at Greenville Memorial Hospital in November 2004. The biological parents would not take them home. One baby died. M.C. was abandoned in the Neonatal Intensive Care Unit.

Three months later, the Department of Social Services stepped in. Court records show the biological parents relinquished their rights.

Mark and Pam Crawford were looking to adopt a child with special needs. They would come to love M.C., but by the time they entered the picture, there was nothing they could do. The life-changing surgery was already done.

Pam Crawford said, “We looked at the situation, saw how adorable the child was, and said, ‘We can do that.’ It didn’t really seem like such a special need to us.”

Court records indicate that at birth, M.C. was identified as a male. During a reflux surgery, female organs were discovered. Doctors at the Greenville Hospital System concluded the baby was a “true hermaphrodite.”

They referred the case to the Medical University of South Carolina where ultimately, sex re-assignment surgery was performed in April 2006 on the then 1-year-old.

The Crawfords adopted M.C. a few months later.

The Crawfords allege in the lawsuit that the South Carolina Department of Social Services decided to perform “dangerous and mutilating surgery” to make the child a girl.

“It’s too late for my son, but we want to put other doctors on notice,” said Mark Crawford who noted the action was “drastic and permanent.”

The lawsuit says doctors, acting as agents of defendant hospitals, performed the surgery for the purpose of “assigning” the child the female gender despite their own conclusion that the toddler “was a true hermaphrodite but there was no compelling reason that she should either be made male or female.”

The defendants decided to remove the child’s healthy genital tissue and “radically restructure his reproductive organs in order to make his body appear to be female,” the lawsuit states.

The suit filed in federal court alleges the defendants violated the child’s right to privacy by deciding to go forward with the surgery. The state suit alleges medical malpractice and gross negligence.

“We don’t think they are evil people” Mark Crawford said. “We simply think that what they did was ill-considered. It was careless.”

According to the Intersex Society of North America, the condition is seen in approximately one in every 2,000 births.

Kenneth Suggs is representing M.C. Crawford pro bono.

“This is not a decision that the government is allowed to make — to make a boy into a girl,” Suggs said.

Once the child was placed in state custody, the Department of Social Services was responsible for any and all medical decisions. By law, major surgery is something that should have gone all the way to the top.

Within months of M.C.’s surgery, the DSS director at the time, Kelly Aydlette, left her post. She’s named in the lawsuit, along with DSS, four doctors and two hospitals.

According to court documents, the decision to turn M.C. into a girl never went before a judge.

No guardian was appointed. And it does not appear the doctors requested an ethical consultation.

Bioethicist Carmela Epright said, “I suspect strongly the reason this didn’t go before a judge is because no one thought this was a hard question. They thought they had the answer.”

She is routinely asked for ethical consultations by multiple hospitals, including MUSC and GHS.

“He wasn’t sick in any way. What he was, was a problem from an adoption standpoint,” Epright said.

That being said, Epright doesn’t believe the Crawfords will win in court.

“My worry is we’re not asking questions,” she said. “We’re not having a series of meetings. We think this is good medical care, and that’s what needs to change.”

The Crawfords raised M.C. as a girl for years, but they say the signs were always there.

“When he started going to school, picking up friends, it was clear that he thought of himself as a boy,” Pam Crawford said.

By then, M.C. was old enough to tell his parents exactly what he wanted — to be referred to as a boy and to look and dress like his father.

“Once he got his hair cut, people really did mistake him as a boy and he seemed to flourish in that,” Crawford said.

They made the switch at school and at church.

“It’s not like he turned into a boy,” she said. “He’s the same exact child he’s always been.”

For the rest of his life, M.C. must live with a choice made for him by strangers. The only thing he got to choose was his new name.

The Crawfords hope his story will help other families understand that surgery isn’t the only option.

“My greatest fear is that these things might keep happening, Crawford said, “My fear for him specifically is that he will hate his body.”

The former head of DSS and the doctors named in the lawsuit declined WYFF’s requests for interviews. MUSC declined to comment on pending litigation.

Dr. William F. Schmidt, medical director of the GHS Children’s Hospital, sent WYFF a statement saying, “A thorough review of the medical files will show that treatment this child received while under our care was consistent with the highest standards of medical practice and medical ethics.”

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