“Some people are born with these kinds of problems…”, that is how the explanation started. I had the luxury of reviewing the patient’s booklet the day before, and realized that her problem was genetic. However, it is the sort of problem that doesn’t display itself until puberty. All the other girls had started to wear bras, grown mature patterns of hair, filled out their curves. But she didn’t. In the states, the parents would have brought her in at 13 or 14, realizing that something was wrong. But not here. Here, she presents in her mid-twenties with the chest of a child, no hair under her arms (or anywhere else that may signal maturity), never having seen a cyclic pattern declaring womanhood, dark eyes filled with insecurity and disgrace.
It is a rare problem, where the initial genetic material is wrong. People presenting like this can either have female or male genetic makeup, but they look, and have always thought, that they were a girl. We don’t have the tools to properly work up the genetics. Recommendations are out the window for proper care. I told her of the possibility of surgery, to reduce the risk of a rare type cancer that can sometimes come with this disorder. She didn’t want that. I counseled her on her options for making her develop breasts. Her head shook quickly, confirming her desires. She longed for woman-breasts instead of the little child chest she had worn all her life. This was the most outward, obvious sign that she was not like the other girls. She wanted some hope that she could fit in, and this was the way that had filled her dreams. She didn’t even try to hide her excitement, when she realized that the option was available. I told her that it is a process, not a quick fix. Hope of normalcy sustained the possibility, even if it were going to take a long while.
Next was the hardest part. It is a subject that none of us would want to broach. The uncomfortable nature even made me squirm. I began gently by telling her that she had great worth as a person. That God made her and thought she was valuable. But then came the sad reality. That is God’s way, but not the way of the visible world around her. Her culture gives no value to a woman who cannot bear children. Over and over I see women set aside by their husbands because they are infertile. Three husbands later, they are often still coming in looking for something that may help, some magic chance to have a baby. This girl didn’t stand a chance. I told her that because the probability for a husband was low, she should really try to stay in school and get a good education so that she could learn to support herself. She had thought of this already, and told me that she was working hard to finish her education. The cultural truths were hard and mean and ugly. She might be good enough to be used or enjoyed by a man, but she would likely never be able to depend on any commitment from one. She would never be accepted as a wife, and would certainly never be accepted by any in-laws. But in the midst of such bitter reality, the eternal truth was sweet, that she was valuable as a human being, and strongly loved by the God who made her.
Sometimes we see that life is just not kind. It is sharp and harsh. Our struggles are each different. Some can be seen from the outside, like this patients. Others lie hidden from the watchful eyes, deep in the broken parts within. But they all still bring pain. Being a Christian doesn’t make life a constant spring bouquet of fragrant pleasures. It doesn’t make every sadness better, every wrong right, at least not for now. But no matter what the road brings, or how defective we feel as we walk down it, there is a deep, abiding pleasure when we stop for a moment and remember that even in our brokenness and incompleteness, we are highly valued and deeply loved.