is it your call, or mine??

Bimillahirrahmanirrahim..

Assalamualaikum wbt.

Following my previous post on 'ambiguus genitalia'...today, im going to 'try' (even though not very successful) to answer a question posted by sister azyan azilah:

salam kak sarah. saya selalu baca cerita akak tentang kisah belakang tabir hospital ni.

dan kita tertarik nak tanya pasal khunsa ni jugak la. kita selalu dengar pasal "transgenders" yang kata, kami lelaki tapi naluri kami perempuan. ada yang cakap,dulu diorang khunsa (ada dua kelamin) tapi mak bapak diorang yg decide untuk diorang sama ada jadikan anak mereka lelaki atau perempuan. kira macam mak abah silap percaturan la. jadi mereka seolah-olah salahkan parents diorang. jadi ada yang persoalankan, golongan ambiguus genitalia patut diberikan peluang untuk membesar sebelum ditentukan jantina mana yang diorang lebih cenderung. ini untuk elakkan kes macam ni la. macam dulu pun rasanya ada cerita zaman Rasullah s.a.w yang hamba tu wanita tapi boleh tidur dengan hamba wanita yang lain. kira bagi chance diorang besar dulu la before decide jantina.

jadi rasanya apa pendapat akak dalam kes ni? maybe soalan ni mcam nonsense dari pihak medical or professional, tapi sebagai orang yang curious dan langsung tak ada pape pengalaman dalam ilmu medical ni saya nak tahu jugak la pendapat pakar. hihi

Okay azyan..this is my answer for you:

Dear azyan,

thank u so very much for the very interesting questions...and i took sometime searching for the answer as i had to look for the right people to help me with your question..Alhamdulillah, i managed to speak to Prof Harlina Siraj today and i may have some answers for u even if it's not complete...

First of all, u have to know that the issues pertaining to ambiguus genitalia have not been studied thoroughly...we have yet to sit down with all the specialists and ulama' to understand the terms and to discuss the issues that may arise in these kinds of cases...and i am definitely not the 'pakar' in this issue :) just merely sharing with u bout what i've learned these past few years..

The reason why i mentioned that we need to clarify reg the terms with the ulama' is because, in the Al-Quran, khunsa is mentioned to have both genitalia...that was what Allah said..however, we as medical practitioners (with whatever limited experience that we have) have never seen any cases like that..so, we assume that ambiguus genitalia is one of the categories of 'khunsa' or haemophrodite...however, since we are not very sure of this..sadly to say, that i myself have never mentioned the word 'khunsa' in front of the parents and have also never discussed the repercussions involved if indeed the child is a khunsa in the islamic point of view with them...it is my weakness definitely, and may Allah be with me..insyaAllah i will do further research on this issue in the future..

from my discussion with Prof Harlina, previously when chromosomal studies were still not available, mmg byk masalah..the parents had to just simply choose one gender and bring up the child as how they perceive the gender is supposed to be...and mmg bila kanak2 ni membesar, some of them (i do not have the percentage..sorry!) will have some inclination towards the opposite gender..thus the problems such as what u mentioned arise..

however, even with the chromosomal studies that we have nowadays, it does not guarantee that the child may remain/act according to their biological gender...there have been a few cases of ambiguus genitalia of whom the chromosome was xx, however when the child reached adolescent age, her behaviour became more masculine and she decided that she wants to become a man...we cant really blame them..because even though their chromose is xx, however they may have more androgens or testosterone hormone in their body that's influencing them to behave like a male...

so, what's the point of having the chromosomal study then?well, i guess it helps the parents to clear up their mind a bit..and helps them to raise the child according to the biological gender..we can imagine how disturbed the parents may be right?so, at least with the chromosomal analysis, it helps to guide them on how to bring up the child...HOWEVER,the child and the parents MUST be on regular follow ups..and the parents MUST be counselled and forewarned that the child may behave differently when he/she reaches adolescent age...and if the child then decides to change his/her gender, it must be taken with an open mind and further discussions must be made with the drs/ulama' etc...that is why, maybe the plastic surgery for the reconstruction of the genitalia should not be done during the early years..and maybe it should be decided by the child him/herself...(obviously, this is easier said than done considering the amount of anxiety that the parents will have to bear and please dont ask me the hukum of doing the surgical reconstruction in the first place...i have not yet consulted an ustaz to answer that..huhu)

so, to answer your question...yes, it may be fair to let these children to grow up and decide their gender for themselves as to avoid any confusions/problems in future :)

im sure u still have many questions...hehe..i do too...and im sorry that my answers contain many 'maybe's...as i said, many questions are still unanswered and some other drs may have other opinions rather than the ones i stated here...

i hope to do more research on this...insyaAllah, i hope to see another professor soon..if i have anything to add..i will update u ya..?

thank u again for bringing up the issues..

if anything, can email me at sarahsofian@hotmail.com or meet me at facebook! :)

wasallam.

p/s: there's a very good article on 'gender and sexuality' by prof harlina that was published in solusi volume 25...try this link!

p/s/s: i've never heard the story reg 'khunsa' masa zaman Rasulullah SAW that sister azyan mentioned..could somebody enlighten me on this??thank you!!