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Temporal sociomedical approaches to intersex* bodies

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A Correction to this article was published on 22 July 2022

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Abstract

The history of the field of intersex bodies/bodies with variations of sex development (VSD) reflects the ongoing tension between sociomedical attempts to control uncertainty and reduce the duration of corporeal uncertainty by means of early diagnosis and treatment, and the embodied subjects who resist or challenge these attempts, which ultimately increase uncertainty. Based on various qualitative studies in the field of intersex, this article describes three temporal sociomedical approaches that have evolved over the last decade and aims to address the uncertainty surrounding intersex/VSD bodies. These approaches are (1) the corrective-concealing approach, which includes early surgeries and hormone therapies intended to “correct” intersex conditions and the deliberate concealment of the ambiguity and uncertainty associated with intersex conditions; (2) the preventive approach, which involves early genetic diagnostic methods aimed at regulating or preventing the recurrence of hereditary conditions under the umbrella of VSD; and (3) the wait-and-see approach, which perceives intersex bodies as natural variations and encourages parents to take time, wait, and give their children the right to bodily autonomy. A comparison of these approaches from biopolitical, phenomenological, and pragmatic perspectives reveals that time is an essential social agent in addressing and controlling uncertainty, a gatekeeper of social norms and social and physical orders, and, on the other hand, a sociopolitical agent that enables creative social change.

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Notes

  1. Intersex is also known as “disorder of sex development” (DSD), “difference of sex development” (DSD), and “hermaphroditism.” The multiplicity of these terms reflects the ongoing struggle to classify these bodies. I use the terms ‘intersex’ and ‘variations of sex development’ (VSD) to highlight how these bodies challenge the established gender binary. There has been much misunderstanding and debate over terminology. Intersex as a biological term was coined in 1917 by renowned biologist Richard Goldschmidt. In the 1990s, intersex became a physical-political category, an umbrella term for many conditions that challenge the binary, heteronormative concept of sex and gender.

  2. Ambiguous genitalia is a medical umbrella term for external genitalia that appear different from typical female/male genitalia.

  3. All the participants names are pseudo-names.

  4. There are many physical characteristics under the umbrella of VSD and the medical intervention to which I refer to relates to conditions in which the external genitalia are different from “normative” genitals, such as a large clitoris, a small penis, a closed vagina, the absence of testes, and so on, as well as to conditions in which the internal sex organs are partially developed or do not develop at all. In these cases, the medical intervention includes the removal of the gonads and other internal organs that did not develop normally, as well as the administration of hormone replacement therapy in adolescence.

  5. Some conditions on the intersex spectrum are characterized by atypical genitalia. These include CCAH, hypospadias, partial androgen insensitivity, 5-alpha reductase deficiency, 17 beta-hydroxysteroid dehydrogenase, cryptorchidism, and others.

  6. For example, in Germany, intersex activism led to the passing of unique and historical laws, including the gender identity law, which enables people with intersex/VSD bodies to define their gender identities (Gesetzzur Änderung der in das Geburtenregistereinzutragenden Angaben, 2018) and a new law (passed in March 2021) that regulates and prevents medical intervention to normalize intersex babies’ bodies according to the gender binary. In Malta and Portugal, there are already laws that protect intersex children’s bodily autonomy. An example of a succesful lawsuit in this realm is that of the Crawfords against the Medical University of South Carolina for performing genital surgery that was detrimental to their child’s physical and emotional well-being.

  7. There are different forms of CAH. The severe form is the classical or salt wasting form, which includes atypical genitalia (the internal sex organs are typically female), increased growth, and early sexual development, but the most important issue is the health risk posed by this condition. The salt wasting, if not treated, causes dizziness, dehydration, and loss of consciousness, and may even result in death. The simple and non-classical forms pose fewer health risks, but are also characterized by accelerated growth and sexual development.

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  1. Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel

    Limor Meoded Danon

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  1. Limor Meoded Danon
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Correspondence to Limor Meoded Danon.

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Meoded Danon, L. Temporal sociomedical approaches to intersex* bodies. HPLS 44, 28 (2022). https://doi.org/10.1007/s40656-022-00511-0

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