Different Flavours

There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy –so says Shakespeare’s Hamlet. I suppose as one ages, there is a tendency to become, if not indifferent, then less surprised at the plethora of variations that exist when they are sought, less amazed at the range of combinations just waiting for discovery. Like ice cream, the world does not come in only one flavour.

But perhaps it is not just the array that so bedazzles, but that we could ever have presumed to define what is normal in anything other than in a statistical way. A Bell Curve distribution confronts us wherever we look –reality is a spectrum no less than the rainbows we all profess to admire. So, then, why is it that in some domains we are less than accepting of mixtures, less tolerant of difference? Why is there the overwhelming need to categorize things as either normal or abnormal? Natural, or unnatural? A macrocosm of only us and them?

Is it just the benefit of retrospection that allows me to notice that no one of us is the same? Or a corollary of Age that lets me thank whatever gods may be that it is like that? That not only do we differ in our tastes and thoughts, but that the discrepancies in our appearance, if nothing else, allow us to recognize each other?

At any rate, I have to say that, as a retired gynaecologist, I was pleasantly surprised to rediscover a world I thought I had left behind –intersex. It was an article in the BBC News that caught my attention: http://www.bbc.com/news/world-africa-39780214 In my day, however, we still hewed to the label ‘hermaphrodite’ if both male and female gonads were present, or even more insensitively, to something like ‘disorders of sex development’, with the medical community taking it upon itself to assign and surgically ‘correct’ the anatomical features at variance with some of the more prominent features of the melange. All this often before the person was able to decide whether or not to identify with either or both traditional sexes. I don’t for a moment believe that this was done malevolently, however, and I think we have to be careful not to apply current sensitivities to another era. Historical revisionism is always a temptation…

But the spectrum of variation is so wide in both anatomy and physiology, not to mention time of discovery, that assignation of gendered roles is fraught. For some, the worry has been that of acceptance –acceptance of any divergent anatomy, any dissonance, by society at large, but also acceptance by the individual themselves (even pronouns become problematic –assigned as they usually are by gender).

It is common nowadays (UN Office of the High Commissioner for Human Rights) to use the (hopefully) neutral term of intersex to define people who ‘are born with sex characteristics (including genitals, gonads and chromosome patterns) that do not fit typical binary notions of male or female bodies. Intersex is an umbrella term used to describe a wide range of natural bodily variations. In some cases, intersex traits are visible at birth while in others, they are not apparent until puberty. Some chromosomal intersex variations may not be physically apparent at all.’

Of course attitudes are as disparate as societies themselves. Not all have been as tolerant or accepting of difference as one might hope. The BBC article, for example, describes the attitude in some rural areas in Kenya that a baby born with ambiguous genitalia should be killed. ‘Childbirth is changing in Kenya. Increasingly, mothers are giving birth in hospitals, rather than in the village. But not so long ago the use of traditional birth attendants was the norm, and there was a tacit assumption about how to deal with intersex babies. “They used to kill them,” explains Seline Okiki, chairperson of the Ten Beloved Sisters, a group of traditional birth attendants, also from western Kenya. “If an intersex baby was born, automatically it was seen as a curse and that baby was not allowed to live. It was expected that the traditional birth attendant would kill the child and tell the mother her baby was stillborn.”’ The article goes on to say that ‘In the Luo language, there was even a euphemism for how the baby was killed. Traditional birth attendants would say that they had “broken the sweet potato”. This meant they had used a hard sweet potato to damage the baby’s delicate skull.’

‘Although there are no reliable statistics on how many Kenyans are intersex, doctors believe the rate is the same as in other countries – about 1.7% of the population.’ But the thrust of the article was really to discuss how  Zainab, a midwife in rural western Kenya defied a father’s demand that she kill his newborn baby because it was intersex. She secretly adopted the baby –and indeed, even a second one a couple of years later. ‘In Zainab’s community, and in many others in Kenya, an intersex baby is seen as a bad omen, bringing a curse upon its family and neighbours. By adopting the child, Zainab flouted traditional beliefs and risked being blamed for any misfortune.’ But she represents a slow, but nonetheless steady change in attitudes in rural Kenya.

‘These days, the Ten Beloved Sisters leave delivering babies to hospital midwives. Instead, they support expectant and new mothers and raise awareness about HIV transmission. But in more remote areas, where hospitals are hard to reach, traditional birth attendants still deliver babies the old-fashioned way and the Ten Beloved Sisters believe infanticide still happens.’ But, ‘It is hidden. Not open as it was before’.

I suppose it is progress… No, it is progress –however slow, and frustrating the pace may be, as long as there are people like Zainab there is hope. But it still leaves me shaking my head.

For some reason Robert Frost’s poem, The Road Not Taken, springs to mind, in a paraphrase of its last verse: I shall be telling this with a sigh somewhere ages and ages hence: two roads diverged in a yellow wood and she, she took the one less traveled by, and that has made all the difference


Age Prejudice

I suppose I should have seen it coming. I suppose I should have laid down firmer tracks, taken a more trodden path. I suppose I shouldn’t have been so influenced by Robert Frost’s poem, the Road Not Taken. But I was… ‘Two roads diverged in a wood, and I— I took the one less traveled by, And that has made all the difference.’ Well, at least I think I did -I didn’t mean to, or anything; it’s just something that, as I look back through the years, turned out that way.

All our paths are unique, to be sure, and it is likely the conceit of many of us to think that we, alone, have chosen singularities for ourselves –things, if not incomparable, then at least extraordinary: signatures for which only we could have been responsible.

So it is with some dismay that I came across a BBC News article describing a paper by William von Hippel, a professor of Psychology at the University of Queensland, in Australia in which he suggests that ‘although many people remain unprejudiced throughout their lives, older adults have a tendency to be more prejudiced than their younger counterparts.http://www.bbc.com/news/magazine-33523313

Older folks? Now wait a minute… As someone who did not suspect his way of life had ‘fall’n into the sere, the yellow leaf’, I feel almost blind-sided. Of course I didn’t see Harper Lee’s Go Set A Watchman coming either. I have been a life-long admirer of Atticus Finch –someone whose name I even bestowed upon a cat I once had- and Lee’s previous book To Kill A Mockingbird was always a beacon in troubled waters for me. Something that let me believe that we were more than our fists. That we could, if we chose, rise above the curses and anger that so frequently filled our streets. But even her older Atticus slipped beneath those waves it seems…

So is this how the path to maturity -the grinding road to wisdom- ends? An abnegation of all the tolerance that we have learned to espouse? An abrogation of all those principles we fought so hard to enshrine in law? A foretaste of the dark night of the soul that lurks, still hidden, behind the shadowed corners of our ever-increasing ages?

In fairness, if you read the original article in Psychological Science https://www2.psy.uq.edu.au/~uqwvonhi/S.vH.R.PS.09.pdf it attempts to frame the problem as a sort of neurologic deficit, suggesting –that age differences in implicit racial prejudice may be due to age-related deficits in inhibitory ability- perhaps absolving us elders of ultimate responsibility. As in dementia, it’s not our fault. Certainly not our wish… Some things, like grey hair or wrinkles, are merely part of the geography of age the trail runs through. But is increasing prejudice a town along the way, or a detour we didn’t have to take? A ghost town, sporting a few boarded up stores and nobody we recognize on the streets? A place we visited years ago, then left because we didn’t feel at home despite the friends we made?

The BBC report neatly summarizes von Hippel’s neurological hypothesis: The frontal lobes are the last part of the brain to develop as we progress through childhood and adolescence, and the first part of the brain to atrophy as we age. Atrophy of the frontal lobes does not diminish intelligence, but it degrades brain areas responsible for inhibiting irrelevant or inappropriate thoughts. Research suggests that this is why older adults have greater difficulty finding the word they’re looking for – and why there is a greater likelihood of them voicing ideas they would have previously suppressed.

Whoaa! I’m not sure I like that… I’ve always had irrelevant and probably inappropriate thoughts. I’ve always been a loose cannon. And now, I suppose, I should be worried that there is a threshold I might some day cross in which my age would shift me from being considered merely eccentric to a diagnosis of mild dementia –frontal lobe atrophy, no less- by default. Or maybe I should have worried about those mysterious frontal lobes all along –maybe I got a damaged pair from the outset.

Hmm, and I always figured it was the result of getting lost on that less-travelled road. It was, after all, ‘grassy and wanted wear’…