Interpreting Intersexuality Through Culture

Interpreting Intersexuality Through Culture

Science and medicine are not immune from social influence and as a result are not necessarily culturally universal In regards to sex and gender social construction plays a meaningful but often hidden role in medicine producing significant biases Hubbard 1996 For many clinicians and laypersons functioning within the traditions of biomedicine gender is understood through sexual dimorphism that only two sexes male and female possess distinct biological characteristics which form gender identity Herdt 1990 According to the pervasive Western ideology these sexes come with specific traits such as genetic markers and physical attributes and are consequently assigned behavioral gender roles The notions of distinctive gender and sex are deeply ingrained in the medical community and reinforced in everyday social interactions to the extent that the idea of ambiguity is not only foreign but distressing Perceptions of the qualities that differentiate sex influence and are influenced by the social constructs of gender through many avenues for instance science religion popular culture and so on Thus an examination of the cultural influences on sex and gender including those present in biomedicine is necessary to conceptualize real differences In exploring how village cultures in Papua New Guinea and the Dominican Republic respond to intersexuality the constructs of the dimorphic approach on the intersex individual and society can be better understood

Intersexuality when used to categorize the physiological conditions which cause gender ambiguity of various kinds may present in as many as 4 percent of live births FaustoSterling 1993 These ambiguities include inappropriate virilization and variation in the presence and construction of inner and outer genitalia varying in severity between and within the conditions that cause them Kuhnle and Krahl 2002 In a biomedical system the presence of sextyped genitalia is used as the primary means to assign sex at birth so infants with more visually apparent differences from the binary norm are recognized immediately and the assignment must wait for clinical intervention Kuhnle and Krahl 2002 Individuals whose symptoms are less visually apparent at birth for instance an enlarged clitoris mistaken for a penis atypical internal genitalia or inappropriate virilization later in life are subsequently not diagnosed at birth Recognition of an abnormal condition comes much later for these patients usually to the surprise of parents and practitioners

Its important to consider how biological reductionism as a social construct affects the understanding of sex and gender because biological sex is not always cut and dry and is not necessarily clearly allocated to male or female by the presence or lack of certain hormones or the morphology of genitalia How does a sexually dimorphic biologically reductionist approach affect the treatment of intersex individuals The reaction of the modern West has been to medicalize gender to determine those attributes that seem to most clearly define one as male or female and where nonnormative to address the ambiguity through clinical means Intersex becomes pathological requiring diagnostic parameters and medical intervention This medicalization suggests that there is a threshold for acceptable sex differentiation but that an individual ought always to fit as much as possible into one category or the other To this aim research on intersexuality has produced a range of syndromes and attempts to accurately name them a process which reinforces a medicalized view of gender and sex Conrad 2007 When faced with anomalies in the biological determinants of sex the clinicians goal is to realize an optimal gender Zucker 2002 which may or may not reflect an individuals genetics or hormones Assignment and treatment towards this optimal gender is determined using the following parameter reproductive potential good ie heteronormative sexual function minimal medical procedures an overall gendera

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