Kaela and Dr. Israel

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Dr. Israel is a pediatric gastroenterologist who is treating one of her best friend’s daughters, a young 14-year-old girl named Kaela. Over dinner on Friday, Mary, Kaela’s mom, was talking about how Kaela had been complaining about a stomachache that continues to get worse. Her parents have reservations about her symptoms, thinking that Kaela is faking it, because they believe that she is being bullied at school. Dr. Israel says that she is more than willing to see Kaela in her office on Monday. Kaela is usually really sweet and outgoing, but Dr. Israel notices that she is really reserved today. Dr. Israel starts the examination by asking Kaela why she is here. After listening to Kaela talk about her pain, before the examination, Kaela asks her parents to step out during the examination. Dr. Israel asks Kaela how school has been going and Kaela remains silent. Dr. Israel asks if she wants to talk about anything, saying that what she says is confidential. Kaela begins to tell Dr. Israel that she has been confused lately about her body and her attraction to other people. She has always been a tomboy, but she said that she started to notice that she likes girls more, saying that they are attractive. Dr. Israel explains to Kaela that this is common, since she is at the prime age of puberty; it is common to have a fluctuation of hormones making one have these different feelings. Kaela breaths out a sigh of relief and proceeds to thank Dr. Israel. Dr. Israel invites the parents into the room and says that she wants to run a blood and urine sample as well as an ultrasound. Everyone agrees and Kaela is asked to go downstairs to get an ultrasound. An hour later, Dr. Israel gets a phone call regarding Kaela’s findings. She is surprised to find out that Kaela is actually intersexual, the ultrasound shows that she has testes, which were inflamed and causing the pain. Dr. Israel goes down to see Kaela, to find her asleep in the waiting room. Dr. Israel calls over her parents and tell them the news. The parents nervously look at each other, and Dr. Israel asks if they already knew. The parents begin explaining to Dr. Israel that, when Kaela was born, the OB/GYN delivered the news to the parents, who had to decide if they wanted to pick a gender now or wait until the child grew up. The parents decided that, since she looked like a girl on the outside and had girl parts on the outside, then she would remain a girl. The parents beg Dr. Israel not to tell Kaela, explaining that she is in difficult place already and that telling her this news would place even more stress on her. Dr. Israel has reservations about not telling Kaela, because she knows that Kaela has been confused about her sexual identity, but she promises she will not tell. It is clear that Kaela’s parents do love her and want her to be happy, and they think that she will remain happy by not telling her. Would it be overstepping boundaries if Dr. Israel tells Kaela, a minor, about her condition against her parents’ wishes?

--Written by Elizabeth Puzniak