Western Management of Intersex and the Myth of Patient-Centred Care

Abstract

In response to mounting criticism, leading medical specialists in the West claim that patient-centred care delivered by a multi-disciplinary team is now the gold standard for people born with variations in sex characteristics. Psychosocial research suggests otherwise. Contemporary medical publications may aspire to patient-centred care, but the emphasis is to implement the latest biomedical research. Such an emphasis compels services to be technology bound, and the prefigured protocols acculturate bio-pathological understandings and medical courses of action. Alternative knowledge and action are obscured. One effect is that, whilst Western clinicians typically express a wish to limit normalising genital surgery on children, some procedures appear to be continuing at similar rates. Services are structured in such a way as to enable medical experts to experience their counsel as matter of fact, free of any framing effect. Responsibility for the continuation of surgery is increasingly shifted to parents. The service characteristics identified in psychosocial research contradict contemporary medical rhetoric pertaining to multi-disciplinary patient-centred care.