What if General Casimir Pulaski, revered as the “Father of the American Cavalry,” had been surgically carved into a female body at birth and made to grow up as a woman? It sounds crazy yet today, this is precisely how babies born like Pulaski are treated. This week the Smithsonian Channel’s America’s Hidden Stories episode, “The General Was Female?" reveals how years of research have determined that Pulaski was an intersex person born with XX chromosomes (typically considered female) and a variation known as Congenital Adrenal Hyperplasia (CAH). The implications are enormous.
For starters, Pulaski would not have been able to serve in the military under the current trans ban. Women were not allowed in the military then, so deeming Pulaski female due to his chromosomes, as the ban insists, would have stolen this hero of the American Revolution from us. In addition, “The General Was Female?” examines how historians credit Pulaski with saving George Washington’s life during the Battle of Brandywine, so excluding him from service would have robbed us of our very founding father as well.
In case you’re wondering why Pulaski was raised as a boy, given his female biology, it’s because having CAH often causes fetuses with XX chromosomes to masculinize in utero, sometimes to the point where they are born with genitals that look in between, or male. In the past, before chromosome tests were available, this meant that a baby with CAH who was biologically female might nevertheless be assigned male and raised as a boy if they appeared more male than female. In Pulaski's case, this worked out very well not just for him, but for the entire nation.
However, in the 1950's, the practice of subjecting intersex babies to medical procedures to make them typically male or female began; and still continues. When it comes to babies born with Pulaski’s specific type (there are many) of intersex, stakeholders commonly recommend genital surgeries and hormones to make them look female, and raising and socializing them as girls. Pulaski’s life is a powerful testament to the fact that this practice is extremely problematic.
Even though intersex people have existed since the dawn of humanity, we live in a world that is not accommodating to third sex or third gender individuals. This creates the difficult situation of having to assign a male or female sex to a baby that obviously isn’t either. Numerous parents have discussed how having to do so felt like, “a crap shoot.” So why would you make it harder to change the initial decision by adding irreversible genital surgeries to the mix?
Putting future gender identity issues aside, even in the many cases where intersex individuals have grown up content living as the sex assigned to them, countless others have stepped forward to share that the medically unnecessary surgeries they were subjected to were extremely harmful, both physically and psychologically. This is why intersex activists like myself have been advocating against this practice, and for self-determination, for over two decades, and our community’s voice has risen exponentially in recent years as more, often younger, social media savvy intersex people have joined the effort.
Some folks feel confused by the concept of intersex self-determination, but it’s actually not that complicated. As Tiger Devore, an intersex clinical psychologist, sex therapist, and movement pioneer, has been advising since the 1980’s, we recommend that parents should assign a provisional sex, with the awareness that your child may grow up to feel differently and should be supported as whatever gender they grow up to be: male, female, or non-binary (an umbrella term for anyone who feels they are both or neither a man or a woman).
Medical doctors in the field have historically devalued this approach, preferring to try to predict what gender the child will be and using medical means to create the physical sex associated with that gender. Time has proven, however, that it is impossible to predict a baby's future gender—even when they are born a typical male or female.
This past February, California Senator Scott Wiener introduced SB 201. Every intersex led organization on the planet supports the bill’s passage, which would, “absent a medical necessity, prohibit a physician and surgeon from performing any treatment or intervention on the sex characteristics of an intersex minor without the informed consent of the intersex minor.” SB 201 follows recommendations by three former surgeon generals and numerous medical associations, that medically unnecessary infant surgeries be delayed until the child is old enough to weigh in. These recommendations are based on evidence of the practice’s harms from both medical studies and countless reports by former patients.
However, medical organizations with a vested interest in the continuance of these practices, such as the California Medical Association and the Societies for Pediatric Urology, oppose SB 201, sometimes employing deceitful tactics to do so. For example, in a recent article, Dr. Lane Palmer, president of the Societies for Pediatric Urology, outlines some of the procedures that babies with CAH — which sometimes carries health risks — might need for their immediate health, and concludes SB 201, “would expressly prohibit such procedures.” The claim is unequivocally false, as the bill's text clearly states that, “The bill would authorize a physician and surgeon to perform the medical procedure without the minor’s consent if it is medically necessary and the physician and surgeon provides the written and oral disclosure to the parent or guardian and obtains their informed consent, as specified.”
It is deeply troubling that the head of a medical organization would misinform the public this way. What is even more troubling, though is the evidence that Pulaski's life sheds on what is potentially stolen from intersex individuals, as well as society, when irreversible decisions about how we can live in the world are made by others.
Hida Viloria is an intersex author and activist. Her latest book was the 2017 memoir Born Both: An Intersex Life (Hatchette Book Group).