Non-invasive prenatal testing: a revolutionary journey in prenatal testing

Four Women Composer-Pianists To Perform In Program At Drexel University's Mandell Theater

Four diverse and fiercely talented women composer-pianists will perform a new work that features four grand pianos surrounded by an on-stage audience on April 3, 4, and 5 at Drexel University's Mandell Theater.

Eight Eight Time, is another ambitious work presented by Journey Arts and supported by The Pew Center for Arts & Heritage. Four pianos, eight hands, original poetry, and film will converge to explore the milestones that shape women's lives.

Eight Eight Time features original compositions by acclaimed jazz pianists Kendrah Butler-Waters, Terry Klinefelter, Suzzette Ortiz, and Sumi Tonooka, interwoven with poetry by Yolanda Wisher and evocative visuals by Lunise Cerin. The all-women ensemble brings together a diverse range of voices and perspectives, reflecting the rich tapestry of the community.

The production, held during Jazz Appreciation Month, draws inspiration from intimate story circles and community workshops, where participants shared their personal experiences with the artists—from childbirth and caregiving to their reflections on the passing of loved ones and generational legacies. 

These stories are woven into the suite's spoken cadences and emotional tones, creating a rich, harmonic framework. The 12-movement suite includes solo and four-piano works composed by each artist, each with room for improvisation, reflecting the collaborative spirit of its creation.

The audience will be seated on risers surrounding the four grand pianos on stage, lending an intimate feeling to the event.

Kendrah Butler-Waters: Pianist and composer whose work has been featured on NPR, WRTI, PBS, and WHYY. Recipient of the prestigious Kimmel Center Jazz Residency award.

Terry Klinefelter: Former Principal Keyboard with the Harrisburg Symphony Orchestra and acclaimed recording artist.

Suzzette Ortiz: Puerto Rican composer and arranger with a wide range of published choral works.

Sumi Tonooka: Celebrated Black-Japanese composer and pianist known for her jazz performances, film scores, and symphonic works.

Yolanda Wisher: Former Poet Laureate of Montgomery County and Philadelphia, recognized for her commitment to social change through art.

Lunise Cerin: Award-winning filmmaker from Port-au-Prince, Haiti, and Philadelphia.

"In a conversation between four grand pianos, with visuals by filmmaker Lunise Cerin and poetry by the inimitable Yolanda Wisher, Eight Eight Time literally invents a new storytelling language, inviting all of us to sit up, lean in, and be blown away by this love letter to life's most exquisite and mundane moments," says Artistic Director Marla Burkholder."

Last fall, Journey Arts announced its new name and new branding. Now in its 22nd season, the intentionally nomadic performing arts presenter is committed to showcasing more ambitious and complex productions, expanding funding opportunities, and increasing support for artistic development. 

Photo credit: Tshay Williams

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The Intersex Spectrum

  The Intersex Spectrumby Carl Gold

Physical gender is not always just a matter of XX or XY, girl or boy. In approximately one out of every 100 births, seemingly tiny errors occur during the various stages of fetal sex differentiation, causing a baby's body to develop abnormally. Problems in the formation of chromosomes, gonads, or external genitals can lead to a range of intersex conditions. The most common and well-researched of these conditions are explained below. For information on intersex conditions not mentioned here, see http://www.Hopkinsmedicine.Org/pediatricendocrinology/.

Congenital Adrenal Hyperplasia (CAH)—One in 13,000 birthsTwo hormones are critical in normal sex differentiation. The testes of normal 46,XY males secrete both Müllerian Inhibiting Substance (also known as MIS or antimüllerian hormone) and masculinizing androgenic hormones, while the ovaries of a normal 46,XX female secrete neither. In CAH, the absence of a critical enzyme allows a 46,XX fetus to produce androgens, resulting in ambiguous external genitals. A CAH individual may have an oversized clitoris and fused labia.

Testosterone Biosynthetic Defects—One in 13,000 birthsIn a condition related to CAH, some 46,XY individuals do not have the properly functioning enzymes needed to convert cholesterol to testosterone. When such enzymes prove completely incapable of creating testosterone, the genitals appear female; when the enzymes function at a low level, ambiguous genitals form.

Androgen Insensitivity Syndrome (AIS)—One in 13,000 birthsAIS affects the section of the 46,XY population that is physically unable to react to androgens. In Complete AIS (CAIS), testes exist in the abdomen while the external genitals are female. The Wolffian, or male, duct structures do not form because of the lack of response to androgens. The Müllerian, or female, duct structures do not evolve because the testes still release MIS. At puberty, CAIS individuals grow breasts but do not menstruate. The testes are sometimes removed from the abdomen because they may develop cancer.

Partial AIS (PAIS) is marked by a limited response to androgens. The external genitals are ambiguous and duct development is incomplete. Depending on the selection of hormone treatment, PAIS individuals may exhibit partial male or partial female development at puberty.

Gonadal Dysgenesis—One in 150,000 birthsIn gonadal dysgenesis, the androgen receptors are intact while the androgen-secreting testes are not. Complete Gonadal Dysgenesis, in which neither androgens nor MIS are produced, yields female genitals and Müllerian duct formation, despite a genetic profile suggesting maleness. With estrogen treatment, female puberty can be achieved. Partial Gonadal Dysgenesis results in ambiguous genitals and duct development, as some androgens and MIS are produced. Like PAIS, the choice of hormone treatments determines the physical gender of the adult with Partial Gonadal Dysgenesis.

5-Alpha Reductase Deficiency—No estimate available5-Alpha Reductase is the enzyme that facilitates the conversion of testosterone to another hormone, dihydrotestosterone (DHT). When a genetic male is deficient in 5-Alpha Reductase, the powerful DHT hormone is not produced. While testes and Wolffian ducts do exist, the male external genitals are similar in size to those of a normal female. If left intact, an adult 5-Alpha Reductase Deficiency individual will appear generally male but with small genitals and no facial hair.

Micropenis—No estimate availableIn order to create a proper penis in a 46,XY individual, androgens must be secreted twice during fetal life. First, the androgens help to shape the basic structures into a penis and scrotum; later, the androgens enlarge the penis. A micropenis is the result of normal androgen secretion in the first stage and little or no androgen secretion in the second. The penis is normal in shape and function, but extremely small in size. While earlier surgeons often converted micropenises to female genitals, today micropenises are often left intact. Individuals with intact micropenises are often given testosterone to stimulate masculinizing puberty.

Klinefelter Syndrome—One in 1,000 birthsSometimes chromosomes join but do not form standard 46,XX or 46,XY combinations. Individuals with Klinefelter Syndrome are genetically 47,XXY and live as men. Small penis and testes, low androgen secretion, and possible female breast development are characteristics of this syndrome.

Turner Syndrome—No estimate availableLike Klinefelter Syndrome, Turner Syndrome is marked by an abnormal karyotype, 45,XO. While Turner women have female external genitals, the individuals lack properly formed ovaries. Without estrogen treatment, no breast growth occurs. Other possible features of Turner Syndrome include short stature, webbing of the neck, and misshapen internal organs.

Timing Defect—No estimate availableIf all of the proper stages of normal male sex differentiation occur, but the timing is incorrect by just days, errors may arise. The occasional outcome in a 46,XY individual with this timing defect is ambiguous external genitals.

Note: The information above was adapted from "Syndromes of Abnormal Sex Differentiation," written by physicians at The Johns Hopkins Children's Center in Baltimore, Maryland. The statistics on frequency were obtained from the Intersex Society of North America (www.Isna.Org).

Carl Gold is a former intern at NOVA Online.

Photos: WGBH/NOVA

My Life as an IntersexualShare Your StoryTwo Sexes Are Not EnoughThe Intersex SpectrumHow Is Sex Determined?ResourcesTranscriptSite MapSex: Unknown HomeSearchSite MapPreviously FeaturedScheduleFeedbackTeachersShopJoin Us/E-MailAbout NOVAEditor's PicksWatch NOVAs onlineTo printPBS OnlineNOVA OnlineWGBH

©Updated November 2001

 

Huge Prejudice Exists Within The LGBTQ+ Community Says Genderquake Housemate

Originally named Bradley, Brooke Moore was assigned the male gender at birth and went to an all-boys school. But at the age of 13, Brooke – who now lives as a woman – began to develop breasts, and she never grew an Adam's apple or facial hair. Eventually, she was diagnosed with Klinefelter syndrome, meaning she was born with an extra X chromosome.

Klinefelter's is relatively common, affecting around 1 in every 660 males. "But it's so rare to have it at the level I do," explains Brooke, "where it physically will start turning a man into a woman."

Brooke is one of eleven housemates in the new Channel 4 documentary Genderquake, which brings together people from across the gender spectrum to live together under one roof and explore their differing views on gender fluidity.

Brooke – who is a beauty blogger identifying as a heterosexual trans female – says she wanted to take part in Genderquake to show that there are other kinds of transitioning journeys that don't necessarily involve surgery and pills.

"I've always posted YouTube videos and things, and one of the biggest comments that I get is that [my subscribers have] never seen someone like me. This is even from other trans girls, saying: 'I've never met anyone who's not had to do hormones, or a boob job, or stuff like that.'

"So I thought it was good to show that there are more trans people out there, there's not just one definitive type."

In the virtual world, Brooke has experienced huge prejudice from within the LGBTQ+ community. Before entering the Genderquake house, she had never met another trans person face to face, only having spoken to people on the internet. "I've tried to break into the trans community online through YouTube, but I was pushed out of it by other trans people because I didn't meet their norms," she says.

"I always felt excluded from the excluded kids, I was beyond marginalised, I was out the door, down the road."

This problem of prejudice within the LGBTQ+ community was also recently exemplified in an episode of First Dates, where two gay men were criticised by some viewers for pursuing "straight-acting" partners, presenting themselves as typically masculine and liking football and beer.

But back in the Genderquake house, Brooke says her experience felt refreshingly inclusive. "I fully expected to go into this house and meet trans people for the first time and for them to absolutely hate me… but it didn't happen, we were all really good friends," she says.

"A lot of trans women don't like other trans women who are happy to keep everything, and to be proud to keep everything, so that sort of put me on the outskirts." Brooke has decided to keep her male genitalia, and her friends joke that she's "a woman with a little bit extra".

Brooke says that Genderquake was a "liberating" social experiment for her. "I've never let down my walls like that before, I've always kept myself in a very tight-knit little bubble of friends and family. I've never opened up to strangers before because I always thought I'd be shot down, so it was really liberating by the end."

Genderquake also widened Brooke's views on sexuality, in that she started to become attracted to a lesbian housemate, Howie. "I was like, 'What the hell is this?!' And I do not like women, period, like in that way."

As the first episode shows, Howie turns a lot of heads in the house – it doesn't seem to matter what sexuality people are, somehow they still fancy Howie. "When you spend that much time with people and you're in a confined little space," says Brooke, "you start to see more than just the outer packaging. Because if I saw Howie on a night out, I'd be like no, she's beautiful but she's a woman.

"But then after spending a solid week with her, her energy is so masculine but in a really beautiful way... It wasn't just me, there were quite a few of us like, 'What the hell is she doing? She's turning us all'."

These feelings of belonging and of altered perception that Brooke had when she left the Genderquake house are evidence once again that social experiments like this can be really effective. It was a success when Anne Robinson welcomed people to her country home to talk about abortion last year, Heineken's famous ad used the same concept in its Open Your World campaign, and Channel 4 are doing it again with Genderquake. This focus-group format could be a real driving force for change – here's to more of the same.

Genderquake begins on Monday 7th May at 9pm on Channel 4

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