HIMT 310 Healthcare Systems : Policing of Intersex Bodies

causing heightened tension within the community as many of the members of the community has embraced this new nomenclature, whereas the others found a problem with the use of 'disorder' in this particular term- DSD. Davis interviewed 36 people with intersex trait for this matter and discovered many of these opposite patterns. 24 people from this group of intersex people she interviewed have accepted the idea of intersex. These people have also accepted the general idea of gender fluidity. The rest of them accepted the use of the medical term DSD, even after knowing the term DSD has the word ‘disorder’ which is nothing but a reflection of the stigma society has about abnormality. These people strongly believe that gender is binary and most of them have supported the view of their parents and the recommendation of their respective doctor about their gender (Lee, 2011). The writer Georgiann Davis wrote about these problems faced by the community with ease, as she is an insider of this debate. She was herself an elected president of the community named Androgen Insensitivity Syndrome-DSD support group.

In the acknowledgement section of this book, Davis described her own fight she fought, when she found out that she is an intersex herself. She confessed that she was once ashamed of her own intersex status. This confession sets the tone of the book from the very beginning. This book can be described as the welcome book on the topic of different sexual identifications as she interviewed many people from the intersex community. Her own experience as an intersex, made her to relate with them, which helped her to write this well researched book.

To write this book, she interviewed total 65 people from the intersex community, medical practitioners, support groups and some non-intersex people. The age range of these people is 22 to 72. These people belonged from varied ethnicity and varied sexual identification. Most of these people from the intersex community identifies themselves as woman most of them had formal education. She had attended many of the meetings of intersex organizations to observe people. She has spent almost 300 hours just to observe the social interaction of the intersex people.

This book has six chapters. The introductory chapter is named interestingly ‘You’re in the Monkey Cage with me’. In this chapter, she described her own journey as an intersex person. The writer herself has diagnosed with CAIS (Complete Androgen Insensitivity Syndrome). From this chapter we get to know the starting of her own journey as an intersex person. The writer was diagnosed with CAIS when she was just 13. Her parents and the doctors lied to her about her condition as they removed the rudimentary testes from her body when she was just seventeen. She was told by her parents that she had underdeveloped ovaries, which were being removed as it could cause cancer. It was at 19; she had encountered with her medical records and learnt about her condition. The writer admitted that she was ashamed when she first learnt that she had XY chromosome (Male chromosome). She accepted her condition when she was almost 30 years old. This well written introductory chapter made us to be the silent witness of her journey as we read her journey through her eyes. In the reminder of the introductory chapter, she wrote her study of this community through theoretical and methodological perspective. To write the study, she interviewed the people from her community and lastly she turned the methodological lens by herself. For herself, she used the concept of ‘looking glass’ self (Cornwall, 2014). This book is based on her dissertation and examined the term intersex on institutional and individual level.

From all the chapters of this book, I found the chapter four, the most interesting. The naming of this chapter is also interesting as it called ‘The Power in a Name”. Naming seems a simple process. It is very difficult for the people from the intersex community to be labeled as a boy or girl as they struggle with their gender identity. In the recent times, the first world countries like USA and Australia, have accepted gays and lesbians and acknowledged them to be accepted in the society (Uslan, 2010). However, these people also maintain the binary gender category. Davis implemented the methodology, which was described before by the renowned bioethicist Katrina Karkazis to explain the idea of contesting intersex (Sánchez, 2010). Karkazis showed how the medical practitioners have ‘medicalized’ intersex with the ideologies of sexual orientation and gender. Davis thought, this is the precursor of ‘contesting intersex’, which is been under the radar after the formation of the term DSD.

These discussions by Davis further lead us to some questions- why intersex is a ‘dubious diagnosis’? Why intersex has been called a diagnosis at all? Davis leads us to the point that, this book is written from the perspective of a feminist. From this book, it can be understood that the prevalence of male power is the reason that the intersex are called the dubious diagnosis.  Davis sensibly describes the difference of the medically focused terminology “DSD” and its more sensible counterpart “differences of sex development”. With this book, Davis presented an emotional argument for the better care of the intersex community (Rubin, 2012). This book gives the readers an understanding of the daily struggles of the members of the intersex community with special mention about the struggle any intersex individual faces while consulting a medical professional. The Chapter 4 of this book also deals with the medical establishment. In this chapter the writer deals with many issues and refers to John Money, the doctor who has a thought that nurture would always over nature. The issue is important in this context because of the incident for which Money’s school of thought lost its credibility (Davis, 2015). Money encouraged parents of a boy to raise the boy as a girl after the mutilation of the boy because of a bad circumcision surgery. The boy committed suicide, as he could not replace his inner gender with his outer one.

As Davis herself has underwent one unwanted gender determining surgery herself, she is deeply against the idea of these surgeries which has been done until now by the doctors to determine the gender of the children to ‘fix’ them so that that they can fit at the social norms. In the third chapter of this book, Davis wrote about the medical jurisdiction the intersex bodies always goes through. She discusses how the intersex people often face many unnecessary and questionable procedures. Davis discussed the ways the people from the intersex community are subjected to these unnecessary and questionable procedures, which are not even necessary. For this, Davis herself has interviewed many medical professionals who have done these surgeries on the intersex bodies. Davis revealed that, many of these doctors felt confused over selecting the gender for these children. What they did not realized that this could affect the development of these children as it can initiate tension and stress. There were many doctors, who defended their deeds but there were many, who wanted to learn more about the effort of intersex communities to treat the patients better (Jutel, & Conrad, 2014). When she interviewed these doctors, all of them have admitted that they determine the gender of an infant by the outside appearance of the genitalia. When the intersex children shows these traits which is outside of the gender binary, they recommends immediate surgery to “correct” the “disorder”, so that the child can be raised as the previously determined gender (Bettcher, 2015). Nevertheless, there are some options for the child to undergo transition by some hormonal treatment, but the gender correction surgeries they have before, remains irreversible.

As Davis discussed about the conflict between the intersex communities over the usage of the terminology ‘DSD’, she included her own opinion in this book. She made a point that, nobody from the community is wrong about their perspective. She said that, every individual should be able to use the term freely, whatever is the best for him or her. Davis described how the different terms could affect the community (Floyd, 2011). She has advocated for the organizations who has accepted the term DSD with a change. These organizations accepts DSD as a diagnosis and replaced the term ‘disorder’ with a new and relevant term ‘differences’. However, many organizations still emphasize on the term intersex rather than accepting DSD. The last two chapters of the book (chapter 5 and 6) are dedicated to these organizations and support groups. These support groups are a great source of information for the intersex children and their families (Davis, 2015). These groups also provide a community to these children and their families. They finally find some people with the same condition, as they are which further helps them to think their condition as normal.

When Davis started her research, she was an outsider. Slowly she opened up and became a member of these groups. Davis outlined some of the support groups in this book who are dedicated for this approach to work with the young intersex children. The first section of the book is dedicated to these organizations and states the history of these organizations and their advocacy works.

As Davis interviewed 17 of the parents of intersex children, most of them believe that gender of a child is determined as a fetus and accepts the nomenclature DSD for diagnosis and the presumable treatment (Davis, 2015). The parents often hide the truth from the children and lie about the treatment (Goldie, 2014). The writer herself went to such treatment. Her parents lied to her saying that her ovaries are being removed to prevent cancer. The stigma around homosexuality and abnormality makes the parents to do so.

Davis had a deeper thought about the opinion of those parents who have intersex children. She pointed out that are many parents who like her parents, were told to keep the diagnosis of their intersex status hidden from the children. She discussed about how these children needs to know about their status of being intersex. Many parents felt that they have pressurized the surgeries on their own children. These interviews revealed one thing; rarely the doctors pass the information about the support groups (Zaccone, 2010). This leads to a huge gap between the parents of the intersex children and the doctors. Davis pointed out different to different topics over these interviews. Davis did not offer a direct solution to these problems apart from saying that the approach of the doctors should be open to know about the intersex community and the community should be more accepting of the medical practitioners (Semler, 2010). As there are a lot of mistrust between the medical practitioners and the intersex community, she could have included some more precise suggestions to bridge the gap between them.

In the last two chapters, the writer has documented “seven actions for liberation” which can be the pathway to liberation for the intersex children (Davis, & Preves, 2017). These actions are collaboration with the doctors, no unwanted and unnecessary sexual orientation surgery, peer support, empowerment of the intersex people through education, usage of feminist viewpoint on gender construction, understanding the stigma, incorporation of the children’s opinion before taking any medical decisions (Pagonis, 2017).

Davis wrote a beautiful conclusion for this book as she effortlessly assembles all the continuation of her points written previously in all the chapters about the status of the intersex condition. She discussed the effect of the nomenclature of the terms on the children or the adults of the intersex community (Roen, 2015). She concludes that regardless of the usage, the terminologies spread necessary words about the intersex community to the people.

Those common people who do not have a basic idea about the intersex community, this book can be their very first basic guide. The writer, Davis always sympathizes with the viewpoint of the people she interviewed, against her own experience as an intersex child. She also analyzed their viewpoint as both an intersex person and a scholar. This book can be said is an autoethnography. Throughout the book, Davis has acknowledged all the interactions and made an outline of the flaws of the research. As Davis included the voice of everyone associated with the upbringing of the intersex people, the book became more emotional as well as informational. Throughout the book, Davis has perceived intersex through the social viewpoint. She hopes the medical establishment also can perceive this topic in a socialist perspective. Davis has written this book beautifully and anyone can read it to expand the horizon of the knowledge at once. This book brings medical science and sociology together. This book is an important documentation for gender and medical sociologists. This book challenges the concept of conventional binary gender categories. Although, this book is based on her dissertation, it becomes personal at a time as she described her own experience about when she found out her intersex status. She also included her conversation with her own parents. This book is a must-read for a medical sociology students, medical students and teachers. This book has a potential of shaping the mind of the next generation doctors who would encounter the intersex people in future.

References:

Bettcher, T. M. (2015). Intersexuality, Transgender, and Transsexuality. The Oxford Handbook of Feminist Theory, 407.

Cornwall, S. M. (2014). Sexual Theologies for All People: Intersex and Transgender People. Oxford University Press.

Crocetti, D. (2016). Medicalizing the gendered body: Intersex/DSD and Human Rights. University of Huddersfield Repositor. Retrieved from https://eprints.hud.ac.uk/id/eprint/31794

Davis, G. (2011). “DSD is a Perfectly Fine Term”: Reasserting Medical Authority through a Shift in Intersex Terminology. In Sociology of diagnosis (pp. 155-182). Emerald Group Publishing Limited.

Davis, G. (2015). Normalizing Intersex: The Transformative Power of Stories. Narrative inquiry in bioethics, 5(2), 87-89.

Davis, G. (2015). Contesting intersex: The dubious diagnosis. NYU Press. Retrieved from https://books.google.co.in/books?hl=en&lr=&id=Mu8WCgAAQBAJ&oi=fnd&pg=PA36&dq=intersex+binary+&ots=z7dI23Aw8f&sig=b2Tl76L-7_EoQ4jfStdR6HyShII#v=onepage&q=intersex%20binary&f=false 

Davis, G., & Preves, S. (2017). Intersex and the Social Construction of Sex. Contexts, 16(1), 80-80.

Floyd, K. (2011). Masculinity inside out: The biopolitical lessons of transgender and intersex studies. In Constructions of Masculinity in British Literature from the Middle Ages to the Present (pp. 33-48). Palgrave Macmillan US.

Goldie, T. (2014). The man who invented gender: engaging the ideas of John Money. UBC Press Retrieved from https://books.google.co.in/books?hl=en&lr=&id=kbjjAwAAQBAJ&oi=fnd&pg=PP1&dq=intersex+binary+john+money&ots=hGoI1GzUMv&sig=MHEn6SEGi8g9s4JEQ85SXNVsIMY#v=onepage&q=intersex%20binary%20john%20money&f=false .

Jutel, A. G., & Conrad, P. (2014). Putting a name to it: Diagnosis in contemporary society. JHU Press. 67-78 Retrieved from https://books.google.co.in/books?hl=en&lr=&id=B6oiBQAAQBAJ&oi=fnd&pg=PP1&ots=qyGbF8lN-h&sig=0vo6LhvqoTrc2eyNkOKMhUVABTE&redir_esc=y#v=onepage&q&f=false 

Käll, L. F. (2016). Ellen Feder's Making Sense of Intersex and the Issue of Sexual Difference. Philosophy Today, 60(3), 799-807.

Kennedy, A. (2016). Fixed at Birth: Medical and Legal Erasures of Intersex Variations. UNSWLJ, 39, 813.

Lee, J. (2011). Beyond Binary Genders: Reviewing the Medical Management of Intersex Infants. International journal of the humanities, 9(12).

Pagonis, P. (2017). First Do Harm: How Intersex Kids Are Hurt by those Who Have Taken the Hippocratic Oath. Griffith Journal of Law & Human Dignity, 5(1), 40-51.

Roen, K. (2015). Intersex/DSD. In The Palgrave handbook of the psychology of sexuality and gender (pp. 183-197). Palgrave Macmillan UK.

Rubin, D. A. (2012). “An Unnamed Blank That Craved a Name”: A Genealogy of Intersex as Gender. Signs: Journal of Women in Culture and Society, 37(4), 883-908.

Sánchez, A. (2010). Intersexuality, Human Rights, and the Colombian Constitutional Court’s Notion of Gender. UCLA Center for the Study of Women.

Semler, K. O. (2010). Let the Child Decide: Surgical Intervention After Parental Consent Should No Longer Be Considered the Best Option for Children with Intersex Conditions. Seton Hall University, 4-6

Uslan, S. S. (2010). What Parents Don't Know: Informed Consent, Marriage, and Genital-Normalizing Survey on Intersex Children. Ind. LJ, 85, 301.