Advertisement

Health Care Analysis

, Volume 17, Issue 2, pp 134–143 | Cite as

Normalizing Medicine: Between “Intersexuals” and Individuals with “Disorders of Sex Development”

  • Ellen K. Feder
Original Article

Abstract

In this paper, I apply Michel Foucault’s analysis of normalization to the 2006 announcement by the US and European Endocrinological Societies that variations on the term “hermaphrodite” and “intersex” would be replaced by the term, “Disorders of Sex Development” or DSD. I argue that the change should be understood as normalizing in a positive sense; rather than fighting for the demedicalization of conditions that have significant consequences for individuals’ health, this change can promote the transformation of the conceptualization of intersex conditions from “disorders like no other” to “disorders like many others.” Understood in these terms, I conclude, medical attention to those with atypical anatomies should be recast from a preoccupation with “normal appearance” to the concern with human flourishing that is the proper object of medical attention.

Keywords

Disorders of Sex Development Foucault Identity Intersex Normalization 

Notes

Acknowledgments

The invitation to the symposium, “Self, Identities, and Bioethics” sponsored by the Division of Health and Society of Linköping University, prompted the argument that appears here, and I am grateful to the participants of the symposium for their challenging questions and generous support. Special thanks are owed Erik Malmqvist for his detailed remarks, as are readings of Eileen Findlay, Shelley Harshe, Katrina Karkazis, Andrea Tschemplik, and an anonymous reviewer.

References

  1. 1.
    Baecheler, M.-N. (2006) Children are not disorders. http://adc.bmj.com/cgi/eletters/91/7/554.
  2. 2.
    Baratz, A. B. (2006). DSD support from a physician and mother. http://adc.bmj.com/cgi/eletters/91/7/554.
  3. 3.
    Barnes, D. (1995). The making of a social disease: Tuberculosis in nineteenth-century France. Berkeley: University of California Press.Google Scholar
  4. 4.
    Chase, C. (1993). Letters from readers. The Sciences, 33, 3.Google Scholar
  5. 5.
    Chase, C. (2006). Disorders of sex development similar to more familiar disorders. http://adc.bmj.com/cgi/eletters/91/7/554.
  6. 6.
    Colapinto, J. (1997). The true story of John/Joan. Rolling Stone (San Francisco, Calif.), 11, 65–66.Google Scholar
  7. 7.
    Diamond, M., & Beh, H. G. (2006). Variations of sex development instead of disorders of sex development. http://adc.bmj.com/cgi/eletters/91/7/554.
  8. 8.
    Diamond, M., & Sigmundson, H. K. (1997). Sex reassignment at birth: A long term review and clinical implications. Archives of Pediatrics & Adolescent Medicine, 150, 298–304.Google Scholar
  9. 9.
    Dreger, A. D. (1998). Hermaphrodites and the medical invention of sex. Cambridge: Harvard University Press.Google Scholar
  10. 10.
    Dreger, A. D., et al. (2005). Changing the nomenclature/taxonomy for intersex: A scientific and clinical rationale. Journal of Pediatric Endocrinology & Metabolism, 18, 729–733.Google Scholar
  11. 11.
    Feder, E. K. (2009). Imperatives of normality: From ‘Intersex’ to ‘Disorders of Sex Development’. GLQ, “Intersex and After”, 15, 2.Google Scholar
  12. 12.
    Feder, E. K., & Karkazis, K. (2008). What’s in a name?: The controversy over ‘Disorders of Sex Development’. The Hastings Center Report, 38(5), 33–36. doi: 10.1353/hcr.0.0062.PubMedCrossRefGoogle Scholar
  13. 13.
    Foucault, M. ([1976] 1990). The history of sexuality, vol. 1: An Introduction (R. Hurley, Trans.). New York: Vintage.Google Scholar
  14. 14.
    Foucault, M. ([1963] 1994). The birth of the clinic: An archaeology of medical perception (A. M. S. Smith, Trans.). New York: Vintage.Google Scholar
  15. 15.
    Foucault, M. (1996). The social extension of the norm, interview by T. Warner, In Silvère Lotringer (Ed.), Foucault Live: Collected Interviews, 1961–1984, 2nd ed., Trans. Lysa Hochroth and John Johnston, New York: Semiotext(e).Google Scholar
  16. 16.
    Hacking, I. (1986). Making up people. In T. C. Heller, et al. (Eds.), Reconstructing individualism: Autonomy, individuality and the self in western thought (pp. 222–236). Stanford, CA: Stanford University Press.Google Scholar
  17. 17.
    Hampson, J. G., Money, J., & Hampson, J. L. (1955). Hermaphrodism: Recommendations concerning case management. The Journal of Clinical Endocrinology and Metabolism, 4, 547–556.Google Scholar
  18. 18.
    Heyes, C. J. (2007). Self-transformations: Foucault, ethics, and normalized bodies. New York: Oxford University Press.Google Scholar
  19. 19.
    Hughes, I. A., et al. (2006). Consensus statement on management of intersex disorders. Archives of Disease in Childhood, 91, 554–563. doi: 10.1136/adc.2006.098319.PubMedCrossRefGoogle Scholar
  20. 20.
    Jouanna, J. (1998). Hippocrates (M. B. DeBevoise, Trans.). Baltimore: The Johns Hopkins University Press.Google Scholar
  21. 21.
    Karkazis, K. (2008). Fixing sex: Intersex, medical authority, and lived experience. Durham, NC: Duke University Press.Google Scholar
  22. 22.
    Katz, J. N. (1995). The invention of heterosexuality. New York: Dutton.Google Scholar
  23. 23.
    Kraut, A. (1994). Silent travelers: Germs, genes, and the immigrant menace. Baltimore: Johns Hopkins University Press.Google Scholar
  24. 24.
    Lloyd, G. E. R. (Ed.). (1983). Hippocratic Writings, trans. J. Chadwick. New York: Penguin.Google Scholar
  25. 25.
    Money, J., & Ehrhardt, A. (1982). Man and woman, boy and girl: The differentiation and dimorphism of gender identity from conception to maturity. Baltimore: Johns Hopkins University Press.Google Scholar
  26. 26.
    Plato (1989). Symposium (A. Nehamas & P. Woodruff, Trans.). Indianapolis: Hackett Publishing.Google Scholar
  27. 27.
    Reiner, W. (2005). Gender identity and sex-of-rearing in children with disorders of sexual differentiation. Journal of Pediatric Endocrinology & Metabolism, 18, 549–553.Google Scholar
  28. 28.
    Reiner, W. G., & Gearhart, J. P. (2004). Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth. The New England Journal of Medicine, 350, 333–341. doi: 10.1056/NEJMoa022236.PubMedCrossRefGoogle Scholar
  29. 29.
    Reis, E. (2007). Divergence of disorder: The politics of naming interex. Perspectives in Biology and Medicine, 50(4), 535–543. doi: 10.1353/pbm.2007.0054.PubMedCrossRefGoogle Scholar
  30. 30.
    Stampp, K. M. (1956). The peculiar institution: Slavery in the ante-bellum south. New York: Alfred A. Knopf.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Philosophy and ReligionAmerican UniversityWashingtonUSA

Personalised recommendations