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askygoneonfireEllen K. Feder, 'Imperatives of Normality: From "Intersex" to "Disorders of Sex Development"' in GLQ: A Journal of Lesbian and Gay Studies 15 (2009) 225-247
Summary:
This article examines the reasons behind the conflation of intersex identity with homosexual identity and the inherent inaccuracies of the same. It considers the possibilities allowed for by the endocrinological societies decision to abandon the use of the term hermaphrodite and intersex in favour of 'disorders of sexual development' or DSDs.
Feder argues that whilst both intersex and homosexual identities were 'an invention' of the medical establishment; essentially sharing an origin, their current position has been mistakenly conflated. Their difference is, to Feder, clear: intersex has an underlying medical condition which can and does require medical intervention in order for the individual to flourish whilst homosexuality as an identity is an entirely cultural construction.
Intersex has, of recent years, become something of a cause célèbre of the Queer liberation movement. The acts of medical normalisation practiced on intersex bodies epitomises the psychological and social normalisation of queer persons.
However, the nuance which Feder expounds her theory upon is that intersex should not be considered an identity. Rather it is a word which signifies a range of physical, hormonal abnormalities which frequently require medical intervention. The change of terminology to reclassify intersex bodies as having a disorder rather than inserting the individual into an identity based on physical markers is, Feder argues, an important step forward; by disentangling genital presentation from identity it is hoped that doctors will increasingly view the individual only in terms of conditions which need medical intervention in order for the patient to live a long and healthy life. Doctors will no longer see a person who is intrinsically part of a group who need to be normalised in order to be reinserted to society
Feder identifies an essential anachronism of the current treatment of intersex/DSDs: "originally surgical correction of genitals to conform to sex assignment was thought to be essential to the development of a healthy gender identity", while this rationale was challenged and discarded, there has been no change in treatment. Doctors continue to 'correct' genital 'ambiguity' which can be understood as an act of 'punishing' abnormality as expounded by Foucault; conformity to social norms is so well imprinted in the brains of citizens that the only acceptable action to take in the face of difference is to enforce conformity; to exercise the same methods of normalisation on another as have been exercised on you.
By redefining intersex as a disorder the terminology no longer encourages the medical profession to view the indivdual as a non-conformist whose actions and body needs to be normalised - a patient suffering a condition like no other which justifies procedures and treatments which would be considered beyond the ethical scope of a doctor's position for any other condition - but a person whose genitalia and hormonal balance is incidental unless it is causing physical discomfort or threat to their wellbeing. In short, encouraging them only to treat those aspects of physical health which are disordered, rather than any and every aspect of the body/identity which needs normalising,
Response:
The co-opting of intersex by queer activism as being the utopian body of a queer, gender delimited future is an interesting one, and the argument that Feder makes against this ellision of aims is certainly compelling but the arguments made through the example of the medical treatment of intersex persons are important ones. The medical treatment of the intersex person is the physical expression of the exercise of normalising power of heteronormativity over sexuality, gender and the acts one chooses to engage in with one's own body. Queer activism gains a nice, neat, clear demonstration of its arguments against the power structures of society although it certainly appears that in so doing they are erasing the individual experience of what it is to be the person subjected to necessary and unnecessary medical procedures in the name of 'curing intersexuality'. The places where this merging of experience is accurate is how it reveals the way in which power works and can alter an individual's interaction with the world so completely:
In many ways the effect of these changes to terminology on the individual, social (not medical, I fully agree with the positive potential of the change there) level is likely to be slow to take effect, medical conditions associated with DSDs will affect gender presentation of affected individuals and whilst gender and sexuality are policed by the structures of normalising power of society variations in any individual will always be subject to negative attentions which can hinder the development of an integrated and confident identity so it seems the intersex/DSD fight is far from won although certainly the shift in the arrogant assurance of doctors forcing cosmetic surgeries on DSD cases is a great leap forward.
Summary:
This article examines the reasons behind the conflation of intersex identity with homosexual identity and the inherent inaccuracies of the same. It considers the possibilities allowed for by the endocrinological societies decision to abandon the use of the term hermaphrodite and intersex in favour of 'disorders of sexual development' or DSDs.
Feder argues that whilst both intersex and homosexual identities were 'an invention' of the medical establishment; essentially sharing an origin, their current position has been mistakenly conflated. Their difference is, to Feder, clear: intersex has an underlying medical condition which can and does require medical intervention in order for the individual to flourish whilst homosexuality as an identity is an entirely cultural construction.
Intersex has, of recent years, become something of a cause célèbre of the Queer liberation movement. The acts of medical normalisation practiced on intersex bodies epitomises the psychological and social normalisation of queer persons.
However, the nuance which Feder expounds her theory upon is that intersex should not be considered an identity. Rather it is a word which signifies a range of physical, hormonal abnormalities which frequently require medical intervention. The change of terminology to reclassify intersex bodies as having a disorder rather than inserting the individual into an identity based on physical markers is, Feder argues, an important step forward; by disentangling genital presentation from identity it is hoped that doctors will increasingly view the individual only in terms of conditions which need medical intervention in order for the patient to live a long and healthy life. Doctors will no longer see a person who is intrinsically part of a group who need to be normalised in order to be reinserted to society
Feder identifies an essential anachronism of the current treatment of intersex/DSDs: "originally surgical correction of genitals to conform to sex assignment was thought to be essential to the development of a healthy gender identity", while this rationale was challenged and discarded, there has been no change in treatment. Doctors continue to 'correct' genital 'ambiguity' which can be understood as an act of 'punishing' abnormality as expounded by Foucault; conformity to social norms is so well imprinted in the brains of citizens that the only acceptable action to take in the face of difference is to enforce conformity; to exercise the same methods of normalisation on another as have been exercised on you.
By redefining intersex as a disorder the terminology no longer encourages the medical profession to view the indivdual as a non-conformist whose actions and body needs to be normalised - a patient suffering a condition like no other which justifies procedures and treatments which would be considered beyond the ethical scope of a doctor's position for any other condition - but a person whose genitalia and hormonal balance is incidental unless it is causing physical discomfort or threat to their wellbeing. In short, encouraging them only to treat those aspects of physical health which are disordered, rather than any and every aspect of the body/identity which needs normalising,
Response:
The co-opting of intersex by queer activism as being the utopian body of a queer, gender delimited future is an interesting one, and the argument that Feder makes against this ellision of aims is certainly compelling but the arguments made through the example of the medical treatment of intersex persons are important ones. The medical treatment of the intersex person is the physical expression of the exercise of normalising power of heteronormativity over sexuality, gender and the acts one chooses to engage in with one's own body. Queer activism gains a nice, neat, clear demonstration of its arguments against the power structures of society although it certainly appears that in so doing they are erasing the individual experience of what it is to be the person subjected to necessary and unnecessary medical procedures in the name of 'curing intersexuality'. The places where this merging of experience is accurate is how it reveals the way in which power works and can alter an individual's interaction with the world so completely:
"We must cease once and for all todescribe the effects of power in negative terms; it 'excludes', it 'represses', it 'censors', it abstracts', it 'masks', it 'conceals'. In fact, power produces; it produces reality; it produces domains of objects and rituals of truth." (Foucault from Discipline and Punish)
Looked at in these terms, working via the powerful institution that is the medical profession intersex activists are producing intersex anew as neither identity nor pathology, but a collection of physical quirks and anomalies, some of which require targeted, impartial medical intervention. Contrastingly, the homosexual activism has nto sought to change the essential production of homosexual as an 'other' but removed the association with it as a pathology in favour of making it an idenity. Homosexual remains caught in the dichotomous relationship of gay/straight, outside/inside, other/normal. One wonders how the world would look now if the core principle driving the liberation campaign of queer persons was to discard the notion of 'different' sexualities rather than request acceptance of the difference.
Feder seems to conclude that the notion of intersex as an identtiy should and will evaporate with the change of terminology in the medical establishment but then goes on to describe how the invented identity of 'homosexual' (a term, if you don't know, that came into usage 11 years before 'heterosexual' and was created exclusively to pathologise a sexual practice) has become a positive rallying point which has created powerful organisations which have a positive influence on the lives of those who fall under the umbrella identity 'queer'. I wonder, and have no answers at all to the question, whether there is anything lost by those who have conditions associated with intersexuality by not having a shared identity anymore. The Intersex Society of North America has shut its doors and reopened a few houses down as the Accord Alliance, maintaining the notion of a shared experience through 'Alliance' but abandoning a convenient umbrella term which people can gather beneath. Queer groups provide shelter and support from the prejudices invitied to queer folks by that 'invented identity', Persons with DSDs will doubtless suffer similar prejudice at their non-conforming bodily sex appearance and in some cases the disparity between gender identity and gender presentation.In many ways the effect of these changes to terminology on the individual, social (not medical, I fully agree with the positive potential of the change there) level is likely to be slow to take effect, medical conditions associated with DSDs will affect gender presentation of affected individuals and whilst gender and sexuality are policed by the structures of normalising power of society variations in any individual will always be subject to negative attentions which can hinder the development of an integrated and confident identity so it seems the intersex/DSD fight is far from won although certainly the shift in the arrogant assurance of doctors forcing cosmetic surgeries on DSD cases is a great leap forward.
