The Dear Prudence column for 4 March included the following letter from a reader:
I’m almost ready to settle down and have kids, but I have a bit of a problem. I was born with an extra toe on each foot and part of an extra finger. Surgery when I was 1 year old removed the excess appendages, however their code is still sitting inside my DNA and will probably be passed to the next generation. So when and how do I talk to my girlfriend about the fact that her future children will probably be born like I was? Should I suggest we both get genetic tests to detect potential abnormalities?
Prudence’s response was a bit of a mixed bag.
We all carry glitches in our genome, and it is up to each couple to decide how much they want to explore their genetic heritage before they potentially pass along any of these flaws. You have polydactyly, which means extra fingers or toes. (Polydactyly can also be a symptom of a number of genetic disorders, but these tend to have serious health consequences.) Polydactyly itself is a harmless birth defect, and one that is dominant, so you’re right—your children would have a good chance of inheriting it. But so what? As your own experience shows, all it took was a few snips, and you ended up with the usual five digits on your feet and hands. I know a very attractive young woman born with polydactyly (she also got a surgical fix), and she would volunteer this information in the spirit of, “Here’s an amazing fact about me.” Since this is not a big deal, you shouldn’t make it one. So next time you’re drying your feet off after a shower, or putting on your socks, you can say to your girlfriend, “I’ve never told you this, but guess what, I was born with an extra toe on each foot. Look, here are the scars.” Unless she’s a nut, she’s unlikely to run screaming from the room, and you can then explain you have a minor genetic fluke. Later, when you’re married and actually contemplating children, you can jointly discuss seeing a genetic counselor to decide how deeply into your DNA you want to delve.
I think that her letter reinforced a couple of things which I find a bit problematic; that someone with polydactyly would want a fix to end up with the “usual” arrangement of digits, for example, and that this person should frame the discussion about the issue with “but it’s ok, our child can be made normal!” It’s norming attitudes like these which probably contribute to the letter writer’s sense of shame and secrecy, so it was nice to see Prudence using “here’s an amazing fact about me” to describe polydactyly, but she ultimately fell back into patterns about norming and bodies which suggest that the only acceptable number of digits is five. That one would, of course, want to surgically alter someone who had more than five digits.
Furthermore, she noted that polydactyly itself is “harmless” but made sure to remind the letter writer that it is associated with conditions with “serious health consequences,” because obviously no one would want to have a child with one of those. Her comment about knowing a “very attractive young woman” almost seemed to come with a sense of “and it’s a good thing those extra fingers got hacked off, or her physical appeal would be in doubt!” And, of course, the throwaway comment; “unless she’s a nut,” because clearly anyone who reacts with revulsion to something like polydactyly is mentally ill. Not, say, trained to respond that way as a result of social attitudes.
And, of course, she doesn’t say “if you do have a kid with polydactyly, why not wait and see if the kid wants surgery?” No, the assumption is that a “corrective” surgery should be performed on the child as an infant, before ou has an opportunity to make the choice for ouself.
I do, however, give her credit for discussing genetic counseling in a relatively evenhanded way. She stressed that individual couples should decide whether or not they want to receive genetic testing and that it’s a choice which should be made together. I do wish that she had gone the extra mile there and said that you can receive genetic counseling and decide to have a child with someone no matter what the outcome of the counseling is. And that you can choose not to get counseling and that’s ok too.
What advice would you have given to this letter writer? Do you see other aspects of Prudie’s response which you find problematic or praiseworthy?