In her essay Forever Small: The Strange Case of Ashley, Eva Kittay describes a controversial medical procedure performed on a young girl known publically as Ashley, an immobile, unresponsive child with no apparent cognitive function. Ashley’s parents and doctors chose to administer growth suppressors to Ashley in order to keep her small, and thus, more manageable. Ashley also underwent several other selective surgeries, including a hysterectomy. Like many others, Kittay is critical of these procedures, known collectively as the “Ashley Treatment.”
The basis for Kittay’s criticism of the Ashley Treatment and, by extension, other selective bio-enhancements, is the concept of “body integrity.” According to Kittay, the Ashley Treatment and other enhancements treat the human body as merely an instrument, a tool for performing various tasks. However, the author claims, human beings relate to their bodies in an entirely different way. Here we face the ancient dilemma of the mind/body problem, and Kittay argues that the two cannot be separated, nor should they be. She states that the body has intrinsic value, and thus, should be treated with integrity, rather than simple utility.
This is the stance that bioconservatists take, and it has far-reaching and complex implications. Many opponents of gender reassignment surgery point to this ideal of “body integrity” to denounce the efforts of transgender people using hormonal therapy and selective surgery in an attempt to align their own personal mind/body problem. However, few bioconservatists aggressively attack cosmetic surgery, which, Kittay states, is not an infringement of body integrity. How far, then, can the concept of body integrity stretch? Where is the threshold between acceptable and unacceptable bodily transformations?
Kittay uses another example to illustrate her position on body integrity—that of young boy who desires to become a successful jockey or gymnast (careers in which small stature is advantageous), and uses growth-suppressant technology to achieve this end. Society generally frowns upon this type of procedure, and Kittay claims that it is because of humanity’s innate desire for body integrity. However, the use of growth hormone to add height is perfectly acceptable in our culture. Shouldn’t body integrity restrict the use of both procedures?
Perhaps, then, body integrity does not hold such a sway over us. Perhaps, instead, the agitation we feel when a young man chooses to restrict his growth stems from the fact that it goes against the norm. Height is almost universally well-regarded, and a desire to maintain shortness or smallness seems unnatural. Is it truly unnatural or has culture groomed us to perceive it as such? Perhaps cosmetic surgery is not so upsetting to the bioconservatists because it has now attained the status of “normal.” Can body integrity change with the times? If it can, then the concept of body integrity could one day adjust to accept the Ashley Treatment, gender reassignment surgery, and other physical enhancements.