Mark and Pam Crawford adopted their son, M.C., not long after doctors at the Medical University of South Carolina performed a sex reassignment surgery on the 16-month-old. Though initially raised as a girl, it wasn’t long before M.C. started presenting as a boy. Now the couple has filed lawsuits at both the state and federal levels against MUSC, the S.C. Department of Social Services, and the Greenville Hospital System (where M.C. spent two months after he was abandoned by his mother). The couple will be represented by Advocates for Informed Choice and the Southern Poverty Law Center, the prominent civil rights firm based in Montgomery, Ala.

The City Paper recently spoke with Alesdair H. Ittelson, the SPLC staff attorney who is handling the Crawfords’ case.

City Paper: What are the basics of this case?

Alesdair H. Ittelson: M.C. was an infant under the care of the S.C. Department of Social Services, and he was born with something called a difference in sex development, which is also referred to as an intersex condition. When he was born, he was immediately identified as male, but a little bit later on it was found out by his medical team that he actually had ambiguous genitalia. It’s medically recognized now that in the case of those born with intersex conditions or differences of sex development, the best cause of action is to not perform surgery until the individual is able to identify who they are. But unfortunately, the S.C. Department of Social Services and the doctors who were tasked with M.C.’s care determined that they should surgically assign him to be a woman. [Editor’s note: MUSC, S.C. DSS, and the Greenville Hospital System will not comment on pending litigation.] They performed an incredibly invasive surgery in which they removed all of his male reproductive and sexual tissue and refashioned genitals for him that fit their stereotype of what a girl should look like. They did this when he was about 16 months old and obviously couldn’t consent to such a procedure. He is now eight and clearly is a boy and identifies as a boy. He came out to his pediatrician and his parents and his school and his religious community, but nothing will ever give him back what was taken by those doctors. The Southern Poverty Law Center has worked for a long time on behalf of those who aren’t given a voice, and we think that M.C. is very worthy of our support, and the Crawfords in general. We want to work with them to make sure that this never happens to another child ever again.

CP: How will the federal and state lawsuits be handled?

AI: We have two different lawsuits. One is a federal complaint and that is a civil rights claim under the 14th Amendment to the U.S. Constitution. Those claims are procedural and substantive due process. Those go through the federal courts. Our state complaint involves the medical malpractice claim, and those will proceed on their own timeline and against the various defendants that are named in those specific complaints.

I think the main takeaway is what happened to M.C. is not only a violation of the Constitution, but it’s also medical malpractice, and those two things are in two separate lawsuits.

CP: Is this new ground for SPLC? How did you come in, and why is this important for your overall message?

AI: One of our founders, [Joseph J. Levin Jr.], represented a number of young African-American women in your very state, in South Carolina, when they were sterilized against their consent because of the color of their skin and their economic status. This was in the ’70s. When I brought this case to Joe, he said, ‘I can’t believe this is still happening in South Carolina.’ Like I said before, the Southern Poverty Law Center works to give a voice for those who are most vulnerable. This has never been done before. This is a first-of-its-kind case, but we see this as a continuation of a long line of work and so we’re happy to be working on it.

CP: What are the deeper issues in this case? What’s the bigger picture?

AI: What M.C. went through, and what he’s going to have to go through, I wouldn’t wish that on any person. It’s going to be very difficult, and it already has been very difficult for him. I’m an attorney and my job is to advocate on behalf of my client, but I hope this sends the message to people who think that they can trample on those who don’t have a voice. This is a practice that should never be done. Especially in the case of M.C., there was no medical necessity. This wasn’t something that had to be done. There was no negative outcome as a result of waiting until he was old enough to identify who he was. I never want to see this happen to another kid.

CP: How have the Crawfords and the SPLC reacted to the national attention?

AI: The Crawfords are an incredibly brave and courageous family. They thought long and hard about whether or not it was right for their family to go down this road, but they knew that they were lucky and that they had a very supportive community and they were a strong enough family and community to go forward with this potential litigation. The response from their community for them has really been extremely positive. A lot of M.C.’s schoolmates have been very supportive, friends of Pam and Mark have been very supportive, and it’s really all about how to get the best outcome for M.C. That’s been really great, and we’ve already had a lot of interest in terms of people reaching out and trying to find out if there’s anything they can do for M.C. from across the nation, which has been really, really beautiful.

The Southern Povery Law Center has a history of doing this kind of work and getting positive outcomes for those we represent, so we’re a little bit more used to the national attention, but nothing we do is for the attention. It’s because we want to change the lives of people who are underserved, and so we’re happy for the attention and we hope that it changes people’s perspectives and opens their eyes to what’s going on here. Our goal is to raise awareness and put an end to a practice.


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