By Sean Saifa Wall, Board Co-President, Advocates for Informed Choice and Joe Jackson, Research Assistant at the Urban Strategies Council
In South Carolina, Pam and Mark Crawford set a precedent in the movement for intersex rights in the United States. In conjunction with several law firms, Steptoe and Johnson LLC in New York, the Southern Poverty Law Center in Alabama, and Janet Jenner and Suggs in South Carolina, the Crawfords are bringing a lawsuit against the South Carolina State Department of Social Services, as well the Medical University of South Carolina for causing harm to their adopted child, MC. Although MC was born with healthy male and female genital tissue, doctors made the decision to castrate his healthy phallus, remove one of his gonads with testicular tissue and create what is viewed as typical female anatomy. In addition to this violation, this case is also complicated by the fact that MC is a child of color and was in foster care at the time. Even when biological parents are present, children who are born intersex are usually subject to invasive and unwanted genital surgeries. In a social context, MC’s case stands at the junction of how medical providers mishandle children born intersex and the pervasive mistreatment of children, especially those of color, in the foster care system.
The case in South Carolina has revealed a system of state care that is fundamentally broken and in need of serious repair. To better understand the significance of MC’s experience as a foster child, let us first understand the child welfare system. Children of color, particularly black and Native American children, are overrepresented in foster care. For example, although black children comprise only 14% of the U.S. population, 28% of children in foster care are African American. Likewise, Native American children make up only .9% of the population but represented 1.9% in the foster care system as of 2010. For whites and Latinos, on the other hand, the rates are proportionate to their populations. In South Carolina specifically, African Americans comprise 30% of the general population, yet are 40% of the children in foster care. Another vulnerable and underreported population in this system is children with disabilities. Children with disabilities are at “greater risk for negative experiences that include neglect, physical and emotional abuse and are more likely to have poor life outcomes.”
A recent New York Times article reveals that the South Carolina foster care system is now under careful scrutiny because of the abuses suffered by young people in its care. For example, a lawsuit has again been brought against the Department of Social Services in South Carolina after a 12-year old boy was raped by an older boy in a state group home. This and many other abuses has led to an internal audit that found, “that children in state care had been starved to death, were not getting proper medical care or, in at least one case, were placed back into a home where the child suffered more sexual abuse.” As noted in the article, this system is suffering from “ too few foster homes, overloaded social workers and inattentive leadership.” All of these findings substantiate MC’s systemic vulnerability and the structural barriers that impact children in the foster care system.
MC’s case also reflects our collective lack of care for young black and brown boys in addition to our social anxiety around assigning a gender to an intersex child. According to his medical records, MC could have been raised as either a boy or a girl. However, when MC was only 16 months old, he was subjected to a highly invasive sex reassignment surgery to “correct” his body. Like most children born intersex, MC’s genitals at birth were clearly non-threatening to him and given the time that elapsed between his birth and surgery, there could have been more thought and deliberation given to his particular case. Instead, MC ended up with case workers and physicians who believed that his unique body structures were pathological and needed correction.
Instead of taking an alarmist perspective, MC could have been assigned female without genital surgery and given the choice to decide his own gender and genital configuration when he became of age. The bottom line is simple: MC was not given the opportunity to live in this world with the body that he was born with. Instead doctors who prized this “rare genetic find,” did not even consider him as a self-determined human being. Therein lies the problem: doctors can explore and experiment, but do not respect the integrity or self-determination of patients.
MC’s case exists within a larger system that is continuing to not only fail intersex children, but is also failing to protect children who are racially and economically marginalized. Although MC has been let down by social workers who were his state-appointed guardians, he has been fortunate to be adopted by caring, thoughtful parents who want to seek justice for him and other children born intersex. In seeking justice for MC, let us also continue to advocate for those children who still languish in the foster care system as well as those of us in our community impacted by multiple forms of oppression.
 Summers Alicia, Wood Steve, and Russell Jesse. Disproportionality rates for Children of Color in Foster Care. University of Nevada, Reno, Nevada.: National Council of Family and Juvenile Court Judges; 2012 87p.
 See Footnote 1
 “Forgotten Children, A Case for Action for Children and Youth with Disabilities in Foster Care.” United Cerebral Palsy and Children’s Rights Project, 2006.
 Severson, Kim. “South Carolina Soul Searching on Welfare of Children.” New York Times 13 June 2013.