Dear Imprudence: Polydactyly and the Single Person

The Dear Prudence column for 4 March included the following letter from a reader:

Dear Prudie,
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?

—Outwardly Normal

Prudence’s response was a bit of a mixed bag.

Dear Outwardly,
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.

—Prudie

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?

15 Comments

  1. All I can think reading that is … if my child had been born with extra fingers and toes my husband would think it was AWESOME, and I’d be online researching appropriate shoes for when she started walking. But, yeah, why not give the kid a choice? I’ve known some people (and one or two in my extended family) with polydactyly, but none of the extra appendages grew anywhere near in size to the other digits, so they treated them kind of like long skin tags and had them removed at various ages.

    I also am really unclear on the genetic testing thing … I always thought the point of genetic testing was to find out WHAT was swimming in your gene pool, but if you already know … why bother? I must be missing something here.

  2. This may be a small thing, but the line “when you’re married and actually contemplating children” really bugged me. She’s making the assumption that people must be married in order to be planning to have children, and that’s simply not the case. The line about her “very attractive friend” got to me too. Can people with to few fingers be attractive? What if they’re just missing a little bit from one finger? Do you have to have all your fingers, toes and limbs to be attractive? And be white and young and abled?

  3. Ugh, the nut bit…
    And sooo ironic, people who want normalcy so much they’d run away screaming are nuts?
    I would’ve probably told him about some famous polydactyls. I’d also love to give Prudence a list of famous “Nuts” (it’s gigantic). Somehow there’s this huge misconception that only normalcy leads to success, and nothing seems to remedy this better than looking at lists of famous people.
    .-= Kowalski´s last blog ..So you really think you’re smarter than Jenny McCarthy? =-.

  4. my oldest daughter has polydactyly, manifesting in large wart-like protrusions from her little finger. i’ve told her that i would not make the decision for her whether or not to remove them. i’ve also told her that i think they’re kinda cool, and make her very unique, but i would not be upset at all if she decided to have them removed. either way it was entirely her decision. she’s just about to turn 8. she gets teased some about them. i told her those kids were jerks and asked her if she’d rather them gone so she won’t be teased. she told me empahtically “no” she likes her little fingers and nobody’s cutting them off. i’m so proud of her for standing up to the jerks in her class. 🙂

  5. Politicalguineapig

    I’m kinda in the ‘give a kid a choice’ camp. Imagine how popular a boy’d be with extra fingers.
    Hsofia: It’s probably to ensure that there are no other genetic abnormalities besides the polydactyly. If the polydactyl gene is hiding a dominant or a recessive lethal gene, it’d probably be nice to know before any attempts at pregnancy.

  6. There was a girl with an extra thumb in my highschool. So apparently her parents decided to give her a choice. She got a lot of kids wanting to see. I kind of also wanted to see, but never did (didn’t ask either): so many people asked her to on a regular basis, I felt like it was probably bothersome to her.

  7. When these decisions are made by parents* when their child is an infant the parents may be responding to several kinds of bullying: There is the bullying coming from a medical establishment which considers variant bodies and minds abnormal and defective and these people are highly trained professionals with white coats and clipboards. They may have faced bullying in their own lives from peers and adults including parents regarding their variation. They will consider–and are often strongly encouraged to consider–the hypothetical bullying their child may face from peers and adults.

    It seems to me a very bad thing to respond to bullying with surgery. “These people are correct–” says the subtext here “–parts of you were so bad and other people hated them so much they had to be cut off and thrown away.” Beneath that of course lies “You are still bad. People still hate you.” When parents lie to their children who have been so altered to fit this Procrustean norm find out what’s been done to them–not just the surgery but the lying–an enormous trust has been broken (the trust may have been broken a long time ago but the discovery of it is a new wound) which may never heal.

    It would be better, I’d think, to actually be supportive of my child, to tell ou there are lots of people in the world who are afraid of anyone different. Fear makes them feel powerless (guilt does too) so they turn it to anger which makes them feel powerful, and attack anything reminding them of their fear. (And some people just like to hurt others and attack anyone who seems to be a low-risk target–anyone different usually serving this purpose well.) But no matter what they say ou is wonderful, all of ou, and I love every bit of ou. If ou is uncomfortable in ou body and wants to alter it to be more comfortable I’ll support ou: the more comfortable body is just as wonderful and I still love every bit of ou.

    Yes I’m thinking also of intersex children here and fat people and tattooed people and pierced people and everybody not cis, not het, not binary, not sexual. Variation seems wondrous to me; I know people hate and fear variation but I don’t understand it.

    * Parents here–everywhere I use the word though I don’t often draw attention to this–meaning anyone who acts as a parent. Having contributed a gamete is not required. Having contributed a gamete is not sufficient. Centering gametes not only erases other parents but encourages the person who supplied the spematozoön to believe their contribution is equivalent to the effort and risk undertaken by the person who supplied the ovum and might host the zygote through birth, giving the person whose spermatozoön carried half the zygote’s chromosomes rights amounting to partial or full ownership over the person actually doing the work and taking the risk.**

    ** Ungendering language is fun. (No, seriously.)
    .-= kaninchenzero´s last blog ..The More It Hurts the More Sense It Makes =-.

  8. I remember an incident when a young boy who had surgery to reduce the prominence of his ears died on the operating table. I was often picked on at school for the same reason at the same time that this incident happened (this must have been the early 1990s), and it never crossed my mind to have surgery just to please a bunch of kids at school. I remember feeling very upset and very angry at whoever had allowed this to happen.

  9. As someone who was born and grew up with 6 webbed toes on each foot and a couple fingers on eah hand webbed (corrected at a young age), I very much believe the parent should make the choice when the child is young. Growing up in today’s superficial society, its hard for kids to go to school with differences. I still am very embarrassed and secret about my feet. I was lucky enough to not get bugged much as a child, but that may have been due to the fact that I hid my feet as much as possible. A lot of people knew I had it because I grew up in a small town, but those who did often forgot about it because I never showed my feet. I know I shouldn’t be so secret about my feet, but I don’t want people looking at me as “different.” My family tell me I shouldn’t be so embarrassed because they are so open with it (the webbed/extra digits gene has been passed down a few generations). I have it the worst and anyone else in my family has had corrective surgery so no one barely notices their scars. I wish my parents had done corrective surgery for my feet when I was young so I could have confidence to go swimming and go bare feet. SOOOOO many times when I’ve been invited to go swimming, I make excuses why I can’t go such as “oh, I feel too fat to wear my bikini right now.” When going to beaches/lakes, I’ll wear clogs to cover my toes, but I can’t really where them in pools, so I just avoid pools usually. I now am deciding whether to do the surgery. It would be a pretty intensive procedure due to the fact that my extra toes are fully functioning and have a bone like the rest. Not only would I worry about the time it would take to recover, but now I also think about the social conflicts involved. I I have a surgery, everyone would know about my feet because I’d be wearing casts and not able to walk on them for awhile. Anywayz, I thought to give u all a different way of looking at this. I wish I was more accepting of my feet, but knowing how “different” I feel, I know there are people out there that will view me as just that if they knew.

  10. If I had been born with functional extra fingers/toes, and my parents had them removed, I’d be really disappointed, actually.

    I think there are many people who would NOT be repulsed by people with polydactyly. I’d like to believe, at least, that most people nowadays would not treat someone with a difference like having an extra finger or toe like some kind of freakshow exhibit.

  11. Ash: Although I’m not sure if it’s the choice I would make for my children, I can completely understand your perspective. Thank you for sharing your experience with us.

    As for Prudence, her advice seems to rest entirely on the fact that the condition is a) ‘harmless’ and b) easily ‘corrected’. I wonder if she’d say the same about something which was neither – albinism, for example?

  12. I’m actually a little shocked. I’ve never heard about polydactily being called a birth defect before. I had Genetics classes as part of the curriculum (in varying levels of depth) in primary school, high school and university, and polydactily was always mentioned in exercises we were supposed to do to understand the maths/probability part (and add to that Embriology, Anatomy and Physiology, human and animal, in university), and polydactily was _always_ called a phenotype, a characteristic, not a defect. It was always something like “the number of fingers is a characteristic defined by a pair of genes with a dominance relationship. 5 fingers = recessive, >5 fingers = dominant, though the dominant gene is rare in the general population”. Just like blue eyes, where I live.

  13. colorlessblue: You haven’t? It’s pretty much a bog-standard birth trope: the parents unwrap the baby to “check that he/she has ten fingers and toes”. Some people include it in the birth announcements as a proxy for announcing that they have a “perfect” baby.

    There’s even a birth announcement stationery company called “Ten Fingers And Toes”. It’s on photo frames, blog announcements, picture books, baby onesies, ‘inspirational’ quotes, and baby name websites.

  14. It sounded real familiar here too. One of the popular baby-conversation scripts runs:

    “You’re having a baby! Congratulations that’s wonderful! I thought I saw a certain glow about you. When are you due?”

    “Thank you. In about four months.”

    “Is this your first?”

    “Uh-huh.”

    “You must be so excited. I remember my first, I was so nervous I thought I was going to drop him! But don’t worry, you’ll know just what to do when you finally see him and hold him. Her? Do you know if it’s a boy or a girl?”

    “Oh! Um, actually no. We decided we didn’t want to know until it was born. We don’t care if it’s a boy or a girl really as long as it’s healthy and has all its fingers and toes.”

    As an excercise for readers with strong stomachs and/or bloody minds, see how many really appallingly normative concepts you can identify in that. You may wish to keep your favorite intoxicant close by.

  15. I was born with six fingers and six toes, one finger was missing all the bones. The extra fingers and toes were removed at an early age when the surgery was easier to perform. I still have webbed feet and always get stared at when barefoot. If you’ve ever been ‘different’ in school you know it’s not a good thing. I’m thankful my parents had the surgeries done and I will do the same for my children if they inherit this genetic problem.