Rare condition

This case is really quite rare as it involves intersex anatomy that applies to human beings who cannot be classified as male or female because they are afflicted with Congenital Adrenal Hyperplasia (CAH) which is a condition where persons afflicted possess both male and female characteristics. Studies show that only about 1 in 10,000 to 18,000 children are born with CAH.

The person involved here is Jemma who was registered as a female in her Certificate of Live Birth. While growing up however, she developed secondary male characteristics and was diagnosed to have CAH. In her early years, she was already diagnosed to have clitoral hyperthropy, and at age 6, she underwent an ultrasound where it was discovered that she has small ovaries. When she was 13 years old her ovarian structures had minimized, she had stopped growing and she has no breast or menstrual development.

Thus she filed a Petition in the Regional Trial Court (RTC) for Correction of Entries in her birth certificate praying that her gender be changed from female to male and her first name from Jemma to Jimmy. She alleged that from all appearances and in mind and emotion, she has become a male person.

To prove her claim, Jemma reiterated her above enumerated condition. The doctor of the UP PGH Department of Psychiatry also testified and issued a medical certificate affirming that Jemma really had CAH and that genetically, she is female but because her body secretes male hormones, her female organs did not develop normally. So she has two sex organs, female and male, and her uterus is not fully developed because of lack of female hormones. She also has no monthly period anymore and her condition is permanent. Thus the doctor recommended the change of gender because Jemma has already made up her mind and has adjusted to her chosen role as male which would be more advantageous to her.

Hence the RTC granted Jemma’s petition by changing her name from Jemma to Jimmy and her gender from female to male. The RTC said that Jemma’s body produces male hormones and her actions and feelings are that of a male. The court further said that Jemma’s choice to become male and to be acknowledged and identified as male must be honored, considering that except for her intersexuality, she (he) is a normal person.

The Solicitor General (OSG) however questioned this ruling before the Supreme Court contending that Jemma’s medical condition of having Congenital Adrenal Hyperplasia does not make her a male, so the lower court erred in ordering the correction of entries in her birth certificate by changing her sex or gender from female to male, and her name from Jemma to Jimmy.

But the SC ruled that the RTC decision is correct.  It is undisputable that Jemma has CAH which causes the early or inappropriate appearance of male characteristics. A person with this condition produces too much androgen, a male hormone. A person born with CAH usually has (1) a swollen clitoris, with urethral opening at the base, an ambiguous genitalia often appearing male than female; (2) normal internal structures of the female reproductive tract such as the ovaries, uterus and fallopian tubes but as she grows older, some features start to appear male, such as deepening of the voice, growing of facial hair, and failure to menstruate at puberty.

CAH is one of the many conditions that involve intersex anatomy where an organism may have biological characteristics of both male and female sexes. During the 20th century, medicine adopted intersexuality as a term applying to human beings who cannot be classified as male or female.

In deciding this case, the court considers the compassionate call for recognition of the various degrees of intersex as variations which should not be subject to outright denial. In the absence of a law on the matter,  the court will not dictate on Jemma about so innately private matter as sexuality and lifestyle preferences, much less on whether to undergo treatment in order to become or remain as a female. Jemma is the one who has to live with his intersex anatomy. To her (him) belongs the right to the pursuit of happiness and of health. Thus to her (him) should belong the primordial choice of what action to take along the path of sexual development and maturation. In the absence of evidence that he is incompetent and that classifying her (him) as a male will harm other members of society who are equally entitled to protection under the law, the court affirms as valid and justified Jemma’s personal judgment of being male. This is just giving respect to the diversity of nature and how an individual deals with what nature has handed out. So Jemma’s congenital condition and mature decision to be a male should be respected. And considering also the consequence that Jemma’s change of name merely recognizes his preferred gender, the change of her name from Jemma to Jimmy should likewise be granted (Republic vs. Cagandahan, G.R. 166676, September 12, 2008).

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