DOCSLIB.ORG

Born This Way: the Healthcare, Sexuality, and Social Experiences of People with Intersex Variations

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Born This Way: the Healthcare, Sexuality, and Social Experiences of People with Intersex Variations Born This Way: The Healthcare, Sexuality, and Social Experiences of People with Intersex Variations Mandy Marie Henningham BA(FA), BHealthMvt(Spt), GCert PubHlth, GCert EdStud(HigherEd), MHlthSc(Sexual Hlth) A thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy Faculty of Medicine and Health The University of Sydney 2019 Table of Contents Table of Contents ...................................................................................................................... i List of Publications ................................................................................................................. xi Authorship Attribution Statement ..................................................................................... xiii Statement of Originality ....................................................................................................... xiv Acknowledgements ................................................................................................................ xv Abstract ................................................................................................................................. xvii List of Tables ......................................................................................................................... xix List of Figures ........................................................................................................................ xxi Symbols and Abbreviations ................................................................................................ xxii Chapter One: Introduction to the Thesis .............................................................................. 1 Chapter Two: Born this way: Ethical issues in the healthcare management of infants with intersex variations and their psychosocial implications .............................................. 6 2.0 Introduction ...................................................................................................................... 6 2.1 What is Intersex? .............................................................................................................. 7 2.1.1 Prevalence ................................................................................................................. 8 2.1.2 Common intersex variations ...................................................................................... 9 2.1.3 Issues with terminology ........................................................................................... 16 2.2 Historical issues in intersex management ...................................................................... 18 2.2.1 The influential John/Joan case ................................................................................ 18 2.3 Issues in healthcare practices ......................................................................................... 20 2.3.1 Transitional care to adult healthcare services ........................................................ 20 2.3.2 Lack of base knowledge by health professionals ..................................................... 22 2.3.3 Intersex and disability ............................................................................................. 22 2.4 Ethical dilemmas in treatment ........................................................................................ 24 i 2.4.1 Functionality or ‘social emergency’?......................................................................23 2.4.2 A Western Female Genital Mutilation issue ............................................................ 27 2.4.3 Lack of informed consent ......................................................................................... 28 2.4.4 Problematic genital exams and photography .......................................................... 29 2.4.5 Ethical issues in prenatal treatments....................................................................... 30 2.5 Psychosocial implications of surgical interventions ...................................................... 32 2.5.1 Depression and trauma ........................................................................................... 32 2.5.2 Incorrect sex and gender assignments..................................................................... 32 2.5.3 Body image and interventions ................................................................................. 34 2.5.4 Secrecy ..................................................................................................................... 35 2.5.5 Counselling management ........................................................................................ 36 2.5.6 Sexual satisfaction and function .............................................................................. 38 2.5.7 Sexual desire and fantasy ........................................................................................ 40 2.6 Family relationships ....................................................................................................... 41 2.7 School experiences as an intersex student...................................................................... 42 2.8 Intersex around the world ............................................................................................... 43 2.8.1 Current issues in Australia ...................................................................................... 43 2.8.2 Current issues within the United States ................................................................... 48 2.8.3 Intersex in developing countries .............................................................................. 49 2.8.4 Cultural interpretations of intersex ......................................................................... 50 2.8.5 Rise of advocacy groups and change ...................................................................... 50 2.8.6 Recent developments................................................................................................ 51 ii 2.9 Other recommendations from existing research............................................................. 52 2.10 Conclusion .................................................................................................................... 53 2.10.1 Aims of this study ................................................................................................... 56 Chapter Three: Theorising Intersex - critical exploration of essentialist impositions of power ....................................................................................................................................... 58 3.0 Introduction ........................................................................................................................ 58 3.1 Critical and postmodern frame........................................................................................... 59 3.1.1 Aspects of critical theory ............................................................................................. 59 3.1.2 Postmodernist views on Intersex ................................................................................. 60 3.1.3 Narratives in research ................................................................................................. 60 3.2 Theory Challenging the positivist paradigm for doctors ................................................... 62 3.2.1 Problematic Positivism ............................................................................................... 62 3.2.2 Five-stage model of deviance ...................................................................................... 63 3.2.3 Concept of bodily autonomy ........................................................................................ 64 3.3 Theory Challenging the essentialist view of sex, gender and sexuality ............................ 66 3.3.1 Gender essentialism – a biological lens ...................................................................... 66 3.3.2 Citizenships ................................................................................................................. 68 Biological citizenship ....................................................................................................... 68 Social flesh citizenship...................................................................................................... 70 Intersex citizenship ........................................................................................................... 72 Intersex alignments with other citizenships in activism ................................................... 74 3.3.3 Feminist theories of sex, gender and intersexuality .................................................... 75 3.3.4 Sexuality, pleasure and fantasy ................................................................................... 78 Frameworks of sexuality ................................................................................................... 78 iii Dawn of the modern homosexual identity ........................................................................ 79 Theories of heterosexuality ............................................................................................... 82 The absence of sexuality ................................................................................................... 83 3.3.5 Queering Sex, Gender and Sexuality........................................................................... 85 The performative nature and subordination of gender
Load more

Recommended publications
  • Background Note on Human Rights Violations Against Intersex People Table of Contents 1 Introduction
    Background Note on Human Rights Violations against Intersex People Table of Contents 1 Introduction .................................................................................................................. 2 2 Understanding intersex ................................................................................................... 2 2.1 Situating the rights of intersex people......................................................................... 4 2.2 Promoting the rights of intersex people....................................................................... 7 3 Forced and coercive medical interventions......................................................................... 8 4 Violence and infanticide ............................................................................................... 20 5 Stigma and discrimination in healthcare .......................................................................... 22 6 Legal recognition, including registration at birth ............................................................... 26 7 Discrimination and stigmatization .................................................................................. 29 8 Access to justice and remedies ....................................................................................... 32 9 Addressing root causes of human rights violations ............................................................ 35 10 Conclusions and way forward..................................................................................... 37 10.1 Conclusions
    [Show full text]
  • “Hermaphrodites”? Fering from a “Gender” Issue: Most People with Intersex Condi- Tions Identify As Just a Regular Man Or a Woman
    not only are surgeries detrimental to the child’s emotional and So you wanna know about sexual functioning, but they do not even deliver what they are intended to, which is the genital that looks “normal” and enables the individual to engage in “normal” heterosexual intercourse. Contrary to the popular belief, intersex people are not suf- “Hermaphrodites”? fering from a “gender” issue: most people with intersex condi- tions identify as just a regular man or a woman. Therefore the intersex movement is not calling for the third gender category to or, an introduction to the intersex movement raise intersex children in, but to 1) raise the child either as a boy or as a girl, based on our best prediction of what the child will In biology, “hermaphrodite” means an organism that has both be most comfortable with, 2) delay all non-emergency surgeries “male” and “female” sets of reproductive organs (like snails and until the child is old enough to understand and to have a say in earthworms). In humans, there are no actual “hermaphrodites” it, and 3) be open to adjustment if and when the child decides in this sense, although doctors have called people with intersex that s/he wants to live as a gender different from his/her initial conditions as “hermaphrodites” because intersex bodies do not assignment. By postponing the surgery until the child is mature neatly comform to what doctors defi ne as the “normal” male or enough, we can preserve the widest range of possibilities for the female bodies. child to choose from, and spare the child of a childhood rife with Intersex is defi ned as the “congenital anomalies of the sexual traumas.
    [Show full text]
  • Butler-Doing-Justice.Pdf
    GLQ 7.4-05 Butler 10/16/01 5:15 PM Page 621 DOING JUSTICE TO SOMEONE Sex Reassignment and Allegories of Transsexuality Judith Butler I would like to take my point of departure from a question of power, the power of regulation, a power that determines, more or less, what we are, what we can be. I am not speaking of power only in a juridical or positive sense, but I am referring to the workings of a certain regulatory regime, one that informs the law, and one that also exceeds the law. When we ask what the conditions of intelligibility are by which the human emerges, by which the human is recognized, by which some sub- ject becomes the subject of human love, we are asking about conditions of intel- ligibility composed of norms, of practices, that have become presuppositional, without which we cannot think the human at all. So I propose to broach the rela- tionship between variable orders of intelligibility and the genesis and knowability of the human. And it is not just that there are laws that govern our intelligibility, but ways of knowing, modes of truth, that forcibly define intelligibility. This is what Foucault describes as the politics of truth, a politics that per- tains to those relations of power that circumscribe in advance what will and will not count as truth, that order the world in certain regular and regulatable ways, and that we come to accept as the given field of knowledge. We can understand the salience of this point when we begin to ask: What counts as a person? What counts as a coherent gender? What qualifies as a citizen? Whose world is legiti- mated as real? Subjectively, we ask: Who can I become in such a world where the meanings and limits of the subject are set out in advance for me? By what norms am I constrained as I begin to ask what I may become? What happens when I begin to become that for which there is no place in the given regime of truth? This is what Foucault describes as “the desubjugation of the subject in the play of .
    [Show full text]
  • The Evolution of Intersex Rights in Russia and Reframing Law and Tradition to Advance Reform
    Meyers Final Note (Do Not Delete) 5/24/2019 1:55 PM “Tragic and Glorious Pages”: The Evolution of Intersex Rights in Russia and Reframing Law and Tradition to Advance Reform MAGGIE J. MEYERS* I. INTRODUCTION “Despite all the achievements of civilization, the human being is still one of the most vulnerable creatures on earth.” - Vladimir Putin1 “You are alone, you are not normal”; that is how Aleksander Berezkin learned he was intersex.2 Born in 1984 in Novokuznetsk—a steel-producing town in southwestern Siberia, not unlike Pittsburgh in terms of climate and local economy3—Aleksander lived the life of an ordinary boy until his adolescence, when puberty failed to arrive. “When I was at school, my body looked visibly different from other teenagers,” Aleksander recalled.4 “I had no muscles . [n]o hair on the face. I was skinny and tall. With narrow shoulders and wide hips. Breast glands were enlarged. Sometimes people took me for a girl. I have been bullied and humiliated.”5 Desperate for answers and relief from the merciless taunting and social ostracism, at the age of seventeen Aleksander submitted to a genetic test that revealed the truth. While typical males have the chromosomes XY, Aleksander’s were XXY; he was diagnosed with a variation of Klinefelter syndrome, in which an extra X chromosome inhibits the body’s production of testosterone and leads to the development of stereotypically feminine traits in males.6 But Aleksander received little comfort from his intersex diagnosis, nor Copyright © 2019 by Maggie J. Meyers. * Duke University School of Law, J.D.
    [Show full text]
  • 13B. Health of Intersex People
    Affirming Care for People with Intersex Traits: Everything You Ever Wanted to Know, But Were Afraid to Ask Katharine Baratz Dalke, MD MBE She/Her/Hers Director of the Office for Culturally Responsive Health Care Education Assistant Professor of Psychiatry and Behavioral Health Penn State College of Medicine March 22, 2020 Goals By the end of this hour, you will be able to: ▪ Appreciate the diversity of intersex traits, and the conditions associated with them ▪ Describe the traditional approach to people with intersex traits and its impact on health ▪ Implement an affirming approach to physical and behavioral health care for people with intersex traits What are intersex traits? Group of congenital variations relative to endosex traits ▪ Sex chromosomes, hormones, and/or internal or external genitalia ▪ May also see variations in secondary sex traits ▪ Included among sexual and gender diverse/minority populations ▪ Present at any time across the lifespan About Language… That is complicated ▪ Hermaphroditism ▪ Intersex/uality ▪ Differences/Disorders of Sex Development ▪ Intersex (traits/conditions), DSD ▪ Endosex Why Learn About Intersex? People with intersex traits… ▪ Are common (1 in 100 - 2000) ▪ Benefit from quality medical care ▪ May receive care in SGM health settings ▪ Are rarely intentionally included in SGM health Review of Sex Development nnie Wang, NY Times Tim Bish|Unsplash Sex Chromosomes . Eggs: X, XX XO . Sperm: X, Y, O, XX, YY . Sex chromosomes initiate gonad development . Gonads produce hormones and gametes Prenatal Development
    [Show full text]
  • In Re Marriage of Simmons: a Case for Transsexual Marriage Recognition Katie D
    Loyola University Chicago Law Journal Volume 37 Article 4 Issue 3 Spring 2006 2006 In re Marriage of Simmons: A Case for Transsexual Marriage Recognition Katie D. Fletcher Loyola University Chicago, School of Law Follow this and additional works at: http://lawecommons.luc.edu/luclj Part of the Family Law Commons Recommended Citation Katie D. Fletcher, In re Marriage of Simmons: A Case for Transsexual Marriage Recognition, 37 Loy. U. Chi. L. J. 533 (2006). Available at: http://lawecommons.luc.edu/luclj/vol37/iss3/4 This Mentorship Article is brought to you for free and open access by LAW eCommons. It has been accepted for inclusion in Loyola University Chicago Law Journal by an authorized administrator of LAW eCommons. For more information, please contact [email protected]. In re Marriageof Simmons: A Case for Transsexual Marriage Recognition Katie D. Fletcher* mentored by Judge Lola Maddox** I. INTRODUCTION It's a girl! It's a boy! At birth, every individual is identified as either male or female, usually by visual examination.1 Gender and sex are typically unambiguous and most people consider them the same.2 The * J.D., Loyola University Chicago, expected January 2007. Mom and Carol, thank you for your never-ending love and support, you both inspire and spur me. This Article would not be what it is today without the invaluable assistance from the Loyola University Chicago Law Journal editorial board and members. Additionally, special thanks and gratitude to the Honorable Judge Maddox for providing insight and for encouraging and challenging me throughout the process. Finally, this Article would not have been possible without contributions in many different forms and for that I am grateful to Professor Cynthia Ho and Jody Marksamer.
    [Show full text]
  • Health and Wellbeing of People with Intersex Variations Information and Resource Paper
    Health and wellbeing of people with intersex variations Information and resource paper The Victorian Government acknowledges Victorian Aboriginal people as the First Peoples and Traditional Owners and Custodians of the land and water on which we rely. We acknowledge and respect that Aboriginal communities are steeped in traditions and customs built on a disciplined social and cultural order that has sustained 60,000 years of existence. We acknowledge the significant disruptions to social and cultural order and the ongoing hurt caused by colonisation. We acknowledge the ongoing leadership role of Aboriginal communities in addressing and preventing family violence and will continue to work in collaboration with First Peoples to eliminate family violence from all communities. Family Violence Support If you have experienced violence or sexual assault and require immediate or ongoing assistance, contact 1800 RESPECT (1800 737 732) to talk to a counsellor from the National Sexual Assault and Domestic Violence hotline. For confidential support and information, contact Safe Steps’ 24/7 family violence response line on 1800 015 188. If you are concerned for your safety or that of someone else, please contact the police in your state or territory, or call 000 for emergency assistance. To receive this publication in an accessible format, email the Diversity unit <[email protected]> Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. © State of Victoria, Department of Health and Human Services, March 2019 Victorian Department of Health and Human Services (2018) Health and wellbeing of people with intersex variations: information and resource paper. Initially prepared by T.
    [Show full text]
  • Shadow Report to the 6 National Report
    Shadow Report To the 6th National Report of the Federal Republic of Germany On the United Nations Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) Compiled by: Verein Intersexuelle Menschen e.V. / XY-Frauen Association of Intersexual People / XY-Women Lucie G.Veith Neu Wulmstorf [email protected] Sarah Luzia Hassel-Reusing Wuppertal [email protected] Claudia J. Kreuzer Trier [email protected] Editor Intersexuelle Menschen e.V. c/o A.Kumst Slebuschstieg 6 20537 Hamburg Authors Lucie G. Veith, Sarah Luzia Hassel-Reusing , Claudia J. Kreuzer English translation Maggie T. Dunham [email protected] Contact Lucie Veith Postweg 11 21629 Neu Wulmstorf [email protected] Date July 2nd 2008 2 2 Contents Foreword / Executive Summary …………………………………………………. 5 Questions to the German Government …………………………………………. 7 1. Preamble and Article 1-5 CEDAW …………………………………………… 9 1.1 Definition - What is Intersexuality? …………………………………………… 9 1.2 Denial and Ignorance of the German Government …………………………… 10 2. Article 5a 10c (Education) ……………………………………………………... 11 2.1 Prof. Dr. John Money`s Gender Theories and their Violations to Human Rights ………………………………………………………………………….. 11 3. Article 12 (Health) ……………………………………………………………… 12 3.1 Problems in Parents - Child Relations ………………………………………… 12 3.2 Medical Experiments on Human Beings ……………………………………… 13 3.3 List of Human Rights Violations as a Result of the Treatment according to the “Standards” Developed by Prof. Dr. John Money …………… 13 3.3.1 Removal of Gonads (Castration) …………………………………………. 13 3.3.2 Genital Amputation ………………………………………………………. 14 3.3.3 Effective Protection of Rights ……………………………………………. 14 3.3.4 Documentation of Treatment …………………………………………….. 15 3.3.5 Irreversible Genital Surgery of Minors and Adults ……………………… 15 3.3.6 Off–Label Use of Pharmaceuticals ……………………………………….
    [Show full text]
  • Hanging in the Balance: the Intersex Child, the Parent, and the State
    Tennessee Journal of Race, Gender, & Social Justice Volume 5 Issue 1 Article 4 2016 HANGING IN THE BALANCE: THE INTERSEX CHILD, THE PARENT, AND THE STATE Alexandra Akre Florida State University College of Law, [email protected] Follow this and additional works at: https://trace.tennessee.edu/rgsj Recommended Citation Akre, Alexandra (2016) "HANGING IN THE BALANCE: THE INTERSEX CHILD, THE PARENT, AND THE STATE," Tennessee Journal of Race, Gender, & Social Justice: Vol. 5 : Iss. 1 , Article 4. Available at: https://trace.tennessee.edu/rgsj/vol5/iss1/4 This Article is brought to you for free and open access by Volunteer, Open Access, Library Journals (VOL Journals), published in partnership with The University of Tennessee (UT) University Libraries. This article has been accepted for inclusion in Tennessee Journal of Race, Gender, & Social Justice by an authorized editor. For more information, please visit https://trace.tennessee.edu/rgsj. HANGING IN THE BALANCE: THE INTERSEX CHILD, THE PARENT, AND THE STATE Cover Page Footnote J.D. Candidate 2016, Florida State University College of Law. My thanks to Professor Courtney Cahill for her support and feedback This article is available in Tennessee Journal of Race, Gender, & Social Justice: https://trace.tennessee.edu/rgsj/vol5/ iss1/4 HANGING IN THE BALANCE: THE INTERSEX CHILD, THE PARENT, AND THE STATE Alexandra Akre* TABLE OF CONTENTS I. Introduction: The Binary & the Intersex ...................................... 37 II. Part I: Defining Intersex .............................................................. 38 III. Part II: Finding State Action in the Intersex Context ................ 42 IV. Part III: Balancing Interests ....................................................... 45 A. The Child’s Fundamental Rights ............................................ 46 i. Bodily Integrity ....................................................................
    [Show full text]
  • Pregnant People?
    COLUMBIA LAW REVIEW FORUM VOL. 119 OCTOBER 11, 2019 PAGES 173–199 PREGNANT PEOPLE? Jessica Clarke* In their article Unsexing Pregnancy, David Fontana and Naomi Schoenbaum undertake the important project of disentangling the social aspects of pregnancy from those that relate to a pregnant woman’s body. They argue that the law should stop treating the types of work either parent can do—such as purchasing a carseat, finding a pediatrician, or choosing a daycare—as exclusively the domain of the pregnant wom- an. The project’s primary aim is to undermine legal rules that assume a gendered division of labor in which men are breadwinners and women are caretakers. But Fontana and Schoenbaum argue their project will also have benefits in terms of equality for expectant LGBTQ parents. To further this project, this Response asks what unsexing pregnancy might look like for different types of pregnant people: (1) pregnant individuals who do not identify as women, (2) expectant couples in which one partner is pregnant, (3) expectant parents engaging a surrogate or pur- suing adoption, and (4) pregnant people who rely on networks of family and friends for support and caregiving. It argues that, in each of these contexts, the extension of pregnancy benefits raises a unique set of ques- tions. But across all of these contexts, it will take more than simply making existing pregnancy rules gender neutral to achieve equality. INTRODUCTION In Unsexing Pregnancy, David Fontana and Naomi Schoenbaum make a compelling case against laws premised on the assumption that the caregiving tasks associated with pregnancy should be assigned exclusively to the pregnant woman.1 They argue that pregnancy requires labor in addition to that entailed in childbirth, gestation, and related changes to the pregnant body.
    [Show full text]
  • The Sex Myth
    ‘As entertaining as it is erudite’ Catherine Hakin, Observer ieielout & ' Praise for The Sex Myth ‘She accomplishes this heroic task with humour, skill and passion in a book that is as entertaining as it is erudite’ Katherine Hakin, Observer ‘An important book . exactly the kind of level-headed analysis that could help to dispel some of the hysteria surrounding the sex industry’ Suzi Godson, The Times ‘There is a lot to admire in The Sex Myth . should be read by anyone claiming an interest in sex and, especially, sex equality’ Katie Law, Evening Standard ‘An enlightening must-read for anyone exposed to the press’ Abby O’Reilly, Independent on Sunday Dr Brooke Magnanti studied Genetic Epidemiology and gained her PhD at the Department of Forensic Pathology, University of Sheffield. Her professional interests include population-based research, stan­ dards of evidence, and human biology and anthropology. In 2009 it was revealed that she is an ex-call girl and author of the bestselling Belle de Jour series of memoirs, which were adapted into the T V series Secret Diary of a Call Girl, starring Billie Piper. Follow Brooke on Twitter @bmagnanti. By Brooke Magnanti Writing as Belle de Jour The Intimate Adventures of a London Call Girl Further Adventures of a London Call Girl Playing the Game Belle de Jour’s Guide to Men Writing as Dr Brooke Magnanti The Sex Myth The Sex Myth Why everything we’re told is wrong Dr Brooke Magnanti First published in Great Britain in 2012 by Weidenfeld & Nicolson This paperback edition published in 2013 by Phoenix, an imprint of Orion Books Ltd, Orion House, 5 Upper St Martin’s Lane London WC2H 9EA An Hachette UK company 1 3 5 7 9 10 8 6 4 2 Copyright © Bizrealm Limited 2012 Bizrealm Limited has asserted Dr Brooke Magnanti’s right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act 1988.
    [Show full text]
  • Pornography and Sex Crimes in the Czech Republic
    See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/49644341 Pornography and Sex Crimes in the Czech Republic Article in Archives of Sexual Behavior · November 2010 DOI: 10.1007/s10508-010-9696-y · Source: PubMed CITATIONS READS 49 13,163 3 authors: Milton Diamond Eva Jozifkova University of Hawaiʻi at Mānoa Jan Evangelista Purkyně University 118 PUBLICATIONS 3,359 CITATIONS 21 PUBLICATIONS 370 CITATIONS SEE PROFILE SEE PROFILE Petr Weiss Charles University in Prague 154 PUBLICATIONS 653 CITATIONS SEE PROFILE Some of the authors of this publication are also working on these related projects: Evolutionary backround of sexual practices View project The Lancet, Transgender Health Series, June 2016 View project All content following this page was uploaded by Milton Diamond on 04 June 2014. The user has requested enhancement of the downloaded file. Arch Sex Behav DOI 10.1007/s10508-010-9696-y ORIGINAL PAPER Pornography and Sex Crimes in the Czech Republic Milton Diamond • Eva Jozifkova • Petr Weiss Received: 29 July 2009 / Revised: 30 August 2010 / Accepted: 30 August 2010 Ó Springer Science+Business Media, LLC 2010 Abstract Pornography continues to be a contentious mat- Introduction ter with those on the one side arguing it detrimental to society while others argue it is pleasurable to many and a feature of One of the most contentious areas of expression and free speech free speech. The advent of the Internet with the ready avail- is that related to the presentation of sexual matters. Different ability of sexually explicit materials thereon particularly has factions in many societies object in different ways.
    [Show full text]