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I was completely deranged at the time, having just been told that my lovely little baby would have special needs — hence the deranged thought. I was so shocked by having it, and so disturbed by what I was hearing, that I sort of zoned out after that, and concentrated on trying not to throw up. But I got the basic gist: our daughter has a heart condition, which we knew about (50% chance of passing it on to her own children) and a genetic abnormality, which we’d just been told about (ditto). Pregnancy would therefore carry heavy risks.
I know why I had the thought: nobody wants to think about an innocent little infant’s future sex life: better to erase it in one fell swoop than to start wondering about Tampax and boys and the pill. As the weeks and months passed, and I stopped being mad, I’d occasionally remember my original unhinged sterilisation thought, and feel ashamed. Now, almost three years later, our original gloom-laden prognosis has not come to pass (genetic abnormalities are a lottery) and the question of what my daughter may or may not choose to do with her womb doesn’t preoccupy me overly. Besides, I have infinite faith in medicine and its advances.
The question of their daughter Ashley’s womb clearly preoccupied Mr and Mrs X, an American couple whose nine-year-old child has static encephalopathy, a severe brain impairment that means she has, and always will have, the mental age of a three-month-old baby. She can’t walk, talk, keep her head up, roll over, or sit up. She smiles and laughs, moves her arms and legs, and rarely makes eye contact.
When Ashley was six, she started showing signs of early puberty. A few months later, her parents decided to put her through radical surgery: she has had a hysterectomy, had her breast buds removed and is pumped full of oestrogen daily to ensure that her growth is forever stunted. Ashley will never be taller than she is now — 4ft 5in — or heavier than her current 75lb.
Her parents, a middle-class couple from Seattle, wrote about “the Ashley Treatment” in their blog launched on New Year’s Day. They call their daughter “the Pillow Angel”, since that is where she spends her time, and say that they will be better able to look after Ashley in her radically altered state, and that effectively being a child for ever will improve her quality of life — and, presumably, theirs. They also say that they are protecting her from a hypothetical unwanted pregnancy as a result of hypothetical child abuse. This fear of abuse is also behind the removal of her breast buds, since apparently “large breasts run in the family”.
This story makes me feel nauseous. But if there’s one thing I’ve learnt through having a child with special needs, it is not to judge other people in a similar boat. The chairman of the ethics committee at Seattle children’s hospital feels the same way (incredibly, the surgery was not sanctioned by a court, but by a hospital board). He said last week: “I totally agree with people who say ‘there’s something really bad about doing this’. But we had to get past that feeling and ask ourselves what harm was really being done to Ashley here, and there are some benefits for doing it.”
Ashley’s parents, responding to accusations that what they’d done was “grotesque”, wrote: “The oestrogen treatment is not what is grotesque here. Rather it is the prospect of having a full-grown fertile woman endowed with the mind of a baby.”
I don’t know that I’d call a disabled adult “grotesque”, especially if she were my own child; but it takes all sorts. I understand how it might arguably be called “grotesque” to deal with your adult child’s menses, or to change their nappies, but then dealing with some old people’s physical incapacities isn’t exactly a picnic either. Perhaps they should be stunted, too — perhaps we should all be, the second we show signs of serious illness, since a physically small, unwell creature is so much more appealing than an adult one, inspiring pity rather than fear, or repulsion.
I’m trying to be compassionate and not repulsed by this, but I’m finding it hard going. Take the fear of sexual abuse. Obviously, the disabled are particularly vulnerable, but surely protecting your child from abuse is a parental responsibility, not a medical one? I mean, where’s Ashley going to go — where might the abuse take place? She is house-bound, she is a “Pillow Angel”. And the thing with the breasts: what’s that about? What’s wrong with a good bra? One of the many possible manifestations of my daughter’s syndrome is that boys who have it can have an inappropriate and somewhat overwhelming interest in sex. As I say, I try not to judge, but I like to imagine that if I had a boy who suffered from that particular symptom, I wouldn’t have him castrated.
The horrible truth is that if someone wants to abuse someone else, then they will. Womb or no womb, breasts or no breasts, child or adult. The second horrible truth is that it makes us incredibly uncomfortable to view people with disabilities as sexual beings — but they are, and you can’t use brutal and invasive surgery simply because you don’t want them to be. And the third horrible truth is that looking after a sick child — even an artificially youthful child — is more emotionally bearable than looking after a sick adult. People say “aah” and feel sorry for you, instead of making excuses not to come to tea because they’re freaked out by the adult dribbling in the corner.
None of this is edifying. And I can’t offer any solutions apart from pointing out that we’d better have some new thoughts around the subject, since the galloping speed of medical advances means more and more children are being diagnosed with special needs every year.
As for Mr and Mrs X: they’re the ones looking after Ashley, and they know more than we do about her. We have to trust that they love their daughter, and are acting in her best interests. Who knows — perhaps they are. Or perhaps they’re acting in theirs, and perhaps that’s okay, too: perhaps it’s the only thing that allows them to function. None of us is in a position to judge. But that doesn’t make this story any less disturbing and sad.
India Knight was born in 1965. She lives in London with her three children, writes a weekly column for The Sunday Times, and a weblog, Isn't She Talking Yet?, on bringing up a child with special needs. She has also written two novels, My Life on a Plate and Don't You Want Me?
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From their point of view, they did the best they could for their child. I don't think anyone can or should judge whether their actions were right or wrong for their child.
But...what bothers me is that they put up this blog and came up with the term "pillow angels." That is demeaning. It makes Ashley and other people with similar disabilities seem less than human. They are not less human. They are not doll-like. Their blog has worked to turn their experience with their child into a place that encourages others to follow in their footsteps. Let each parent come to their own decision the way that Ashley's parents did, not through the encouragement of anyone else.
Becca, Columbus, OH
Since Ashley will never have the mind of an adult when she reaches adulthood, I think the parents did the right thing for their daughter. How much easier on Ashley and the parents this decision will make. Yes , I believe the parents have a right to make their life easier and in turn will make Ashleys life easier. She will be easier to hold, carry and take her places that she may never get to see. As far as her breasts go, breasts are given to a woman to nurse a child. I am sure Ashley will never need to nurse a child. The hysterectomy will prevent future pregnancies if she should have to be hospitalized where rape is fairly common. Her body will stay as her mind is and to me that is more humane. May God bless this family. You did the right thing.
Carole, Randleman, NC
Oh Honey! I am sorry about your child. I have taken care of mentally handicapped people for quite a few years now. I have to agree that this will help her parents out, but I also think that it will benefit Ashley. With programs for handicapped adults, you have to be careful. There is a lot of sexual abuse, more than some may realise. And if breast cancer runs in their family, maybe it would be best for Her breasts to be removed. It's not like She would be able to have a child or anything. So why make Her go through all the pain?
T.J. Baldwin, Connersville, Indiana
India, I think that you have totally missed the point of why this was done. It is not entirely based around avoiding sexual abuse, but this minor point has been blown out of proportion! The purpose of it is to allow her to be looked after in a nicer way without carrying equipment etc, so she can still go on trips and join in with the family more because she is more easily carried, and does have periods which could terrify her and cause her pain. Large breasts could also be painful and cumbersome for her. Another point (but not a main one so don't blow it up like the abuse thing) is that when she is taken on a trip people will reac to her better because her apparent age will more closely map her mental age, which will also cause her less upset and more dignity than being stared at. Her condition is not comparable to that of your daughter who can choose to have children at high risk, this girl does not have that option so by sterilising her no choice is taken away from her.
outraged, leeds,
How could anyone not in this position have such an opinion. I luckily have 3 healthy children but never having been in the parents position I don't know what I would do.
Maggie, Science Hill, KY
I think it is wrong for what the parents have done to Ashley but in the end it is there choice.What will happen when the parents die.Who will look after Ashley then ?
Mrs C Fishwick, bolton, united kingdom
Ashley's parents have made a tragic and selfish mistake. What they have done is horribly wrong, and no other child should have to suffer as they have made Ashley suffer.
Rita Campbell, Wasilla, AK