Written by The Statesman Journal Newpaper July 11,2002

Man learns he was born a girl









As a child, Gerald Donais unknowingly underwent surgeries for his 'intersex' condition.

By Susan Tom

Statesman Journal
July 11, 2002

When Geraldine Anette Donais came into the world in 1959, she had the normal number of fingers and toes, and the usual cute scowl. She also had an ovotestis, the first sign that fate had other plans for the baby.

Three months before she turned 4, Geraldine got a new gender and name.

The legal change was recorded in 1963, but the physical transformation took three surgeries and wasn’t completed until Gerald Alan Donais was about 9.

Donais, of Falls City, will be among a group of adults on the Montel Williams show Friday morning talking about what it’s like to grow up “intersex.”

True hermaphrodites, individuals who have male and female sex organs, are rare.

But children who are born with ambiguous genitalia are more common than people realize.

That was the case with Donais, who was born with a vagina, uterus, one normal ovary and the telltale ovotestis. Ovotestis is a single reproductive organ that has ovary and testicle components.

The odds of being born intersex, with key masculine and feminine anatomical features, can vary from 1 in 500 to 1 in 10,000 or more, depending on how “key” is defined, said Dr. Dan Marks, a pediatric endocrinologist at OHSU in Portland. He gets called to consult on at least one intersex case a month.

“It’s really a continuum,” Marks said. “We all start out as female. The default pathway is to develop as a female fetus and only when it is acted on by male hormones does the child go through the process of changing into a male.”

For every female structure, there’s a corresponding structure in the male, he said. Intersex individuals are the result of the fetus not getting enough male hormones or the female getting too much, Marks said.

Donais’ parents never suspected their baby girl was different until a cyst was removed at 8 months. That was when the biological parents, now estranged from Donais, learned that one of the two ovaries was an ovotestis.

They never told him.

Donais didn’t find out he was born Geraldine until last September.

Life was going well for him and Cheryl, his wife of two decades, until seven years ago, when he had a mental breakdown.

Confused, frustrated and angry, the 42-year-old looked to his past for answers. In piecing together his childhood of abuse, he tracked down what was left of his medical records and came across the word “vaginal.”

Donais found more snippets from the University of Oregon Medical School, now OHSU, that indicated he completed a “genital correction” from female to male in 1968.

After the initial shock, the revelation helped explain his attraction to both sexes during his teens and possibly the origins of some of his health problems.

“I always knew something was wrong,” Donais said. “I never felt right.”

But he desperately wanted to be normal. Cheryl made it easy; she was kind hearted and loving.

Through it all, their 20-year marriage remained solid.

Cheryl admitted she was initially dumbfounded.

“I looked at him differently,” she said. “I was scared. What’s it going to be like now? Are we going to have the same relationship?”

Historically, treatment often included hormonal medication and surgical intervention as soon as possible to avoid the social and emotional stigmas attached to sexual deviation.

That treatment approach has come under fire in recent years.

The Intersex Society of North America, a nonprofit organization devoted to ending the shame, secrecy and unwanted genital surgeries, said it should be up to the individual to determine gender.

Emi Koyama of Portland, program assistant for the society, said doctors and parents have viewed the condition as a horrible shame that needed to be corrected. Rarely were children informed about what was being done to their bodies.

“The issue is not whether the child will be happy,” Koyama said. “Doctors say the child will be miserable if they don’t do the surgery, that they will be teased in school. But who hasn’t been teased in school?”

The American Academy of Pediatrics issued a policy statement in 2000 that called for doctors and parents to refrain from immediately assigning a gender to newborns with genital abnormalities until the child’s condition can be thoroughly reviewed and carefully considered.

Some intersex disorders are not as apparent and may not be diagnosed until childhood or adolescence, the academy said.

Dr. Marks of OHSU said while intersex babies can pose a psychological emergency for families, doctors rarely operate until the baby is at least a year old.

A physical exam, ultrasound, blood, chromosome tests and other lab work are done immediately to diagnose the problem to determine a treatment plan. Sexual function, fertility and other issues are taken into account. But there are some potentially life-threatening conditions which require an immediate response.

The biggest challenge for doctors is to be unbiased in the options they present parents.

“Physicians are beginning to consider their options more carefully,” Marks said. “It used to be a knee-jerk reaction. We’re beginning to learn that some of our past assumptions are wrong.”

Still, gender assignment is a loaded issue.

Most cases are treated in the first several years because parents want to protect their children.

But adults who had surgery to correct intersex conditions early in life say sexual identity is not only cosmetic.

Donais said he would have remained female had he had a choice.

But when he and Cheryl realized that, Geraldine or Gerald, Donais was still the same person, acceptance came quickly.

People may be pressured to conform to fit what’s acceptable or normal, but they can’t change who they are, Donais said.

“There is no boundary, but society sets a boundary,” he said.