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Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals

机译:绘画之间的界限和至关重要不必要的干预措施在双性特征与欧洲卫生保健专业人士

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摘要

Human rights statements on intersex characteristics distinguish legitimate "medically necessary" interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist "disorder of sex development" (DSD) multidisciplinary teams located medical interventions on a continuum ranging from "medically essential" to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients "coping" abilities, and patients' own choices. Concepts of "medical necessity" were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of "medically necessary" intervention that is discursively flexible. Psychologists' long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.
机译:人权在双性语句特征区分合法的“医学上必要”从非法干预的正常化。分类似乎是部分基于解剖学知识和医疗干预措施;人权的专业语句挑战。从专家”障碍的性发展”(DSD)位于医学多学科团队在连续从干预措施“医学上重要的“不必要的两极。他们的答案来解释。描述干预阴茎、阴囊,阴蒂/唇、阴道和性腺的解剖学其本质特征是只有部分基于解剖变异和诊断。解释什么是医学上有必要,健康保健专业人员利用的理解儿童发展,父母的压力,集体反对医学化,病人“应对”能力,和病人的选择。“医疗必要性”是基于一种混合本体作为患者的双性特征物理的身体和作为现象学对象。医疗专业知识在人权问题上的挑战理由是必要的但相信一个有界的、合理的范畴”医学上必要”东拉西扯地干预灵活。双性特征的人,临床心理学家在DSD边缘化团队,可能导致一些建设有争议的干预措施作为医学上必要的。

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