Articulating Intersex: A Crisis at the Intersection of Scientific Facts and Social Ideals

198 Pages·2019·2.142 MB·English

by  Natalie Delimata

Philosophy and Medicine P&M131
Natalie Delimata
Articulating
Intersex: A Crisis
at the Intersection
of Scientifi c Facts
and Social Ideals
Philosophy and Medicine
Volume 131
Series Editors
Søren Holm, The University of Manchester, UK
Lisa Rasmussen, UNC Charlotte, USA
Founding Editors
H. Tristram Engelhardt, Rice University, Houston, TX, USA†
Stuart F. Spicker†
Editorial Board
George Agich, National University of Singapore
Bob Baker, Union College, USA
Jeffrey Bishop, Saint Louis University, USA
Ana Borovecki, University of Zagreb, Croatia
Ruiping Fan, City University of Hong Kong
Volnei Garrafa, International Center for Bioethics and Humanities-University
of Brasília/Brazil
D. Micah Hester, University of Arkansas for Medical Sciences, 
Little Rock, AR, USA
Bjørn Hoffman, Norwegian University of Science and Technology, Norway
Ana lltis, Wake Forest University, Winston-Salem, NC, USA
John Lantos, Childrens’ Mercy, Kansas City, MI, USA
Chris Tollefsen, University of South Carolina, USA
Dr Teck Chuan Voo, Centre for Biomedical Ethics, Yong Loo Lin School
of Medicine, National University of Singapore
More information about this series at http://www.springer.com/series/6414
Natalie Delimata
Articulating Intersex:
A Crisis at the Intersection
of Scientific Facts and Social
Ideals
Natalie Delimata
Department of Social Science
Institute of Technology, Sligo
Sligo, Ireland
ISSN 0376-7418 ISSN 2215-0080 (electronic)
Philosophy and Medicine
ISBN 978-3-030-21897-3 ISBN 978-3-030-21898-0 (eBook)
https://doi.org/10.1007/978-3-030-21898-0
© Springer Nature Switzerland AG 2019
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For my family, in all their wonderful
complexity
Acknowledgements
I would like to gratefully acknowledge the clinicians who engaged with this work.
Without their contributions and willingness to admit me to their world, I would not
have gained the insights and experiences that form the foundation of this work.
I was supported in writing this book through a grant from CRiSP (Centre for
Research in the Social Professions) and would like to acknowledge the director of
CRiSP, Catherine McGuinn, Institute of Technology, Sligo, for facilitating my
application.
During the decade it took to write this book, I have been fortunate to work with
many wise, knowledgeable and above all generous people who have inspired,
advised and encouraged me along the way. For this, I would very much like to thank
Richard Auchus, Hera Cook, Tamsin Cavaliero, Georgiann Davis, Marion Dowd,
Martha Doyle, Fiona Fox, Peter Hegarty, Kieran Keohane, Peter Lee, Karen Lin-Su,
Mary McLoughlin, Breda McTaggart, Michelle O’Brien, Jacqueline O’Toole,
Gwen Scarbrough, Margaret Simmonds, Perry Share and most of all Chris Sparks.
I would like to extend a very special thank you to my family and friends,
especially my mum, dad, sister and brother and my kids, Finn, Kai and Axel, for
their patience and ongoing encouragement. I reserve the greatest thanks for my
partner, Jonathan May, whose support not only made this book possible but whose
willingness to endlessly discuss the difficulties and discoveries made it a pleasure.
vii
Contents
1 Introduction ............................................................................................. 1
References ................................................................................................. 4
2 Historical Overview ................................................................................ 7
2.1 Introduction ...................................................................................... 7
2.2 John Money: Shifting from Biological to Psychological Sex .......... 8
2.2.1 Introduction .......................................................................... 8
2.2.2 Money’s Theory of Psychosexual Development .................. 9
2.2.3 Money’s Theory and Intersex Treatment Protocol ............... 10
2.3 Milton Diamond’s Criticism of Money’s Theory ............................ 11
2.3.1 Organisational/Activational Theory of Sex Development ... 11
2.3.2 Money’s Twin Case .............................................................. 11
2.3.3 The Collapse of Money’s Twin Case ................................... 12
2.4 The Intersex Patient Advocacy Movement ...................................... 12
2.4.1 Introduction .......................................................................... 12
2.4.2 Shame, Secrecy and Surgery ................................................ 13
2.4.3 The Emergence of Intersex Advocacy ................................. 14
2.4.4 Initial Responses to the Intersex Advocacy Movement ....... 14
2.5 The ‘Consensus’ Statement .............................................................. 15
2.6 Conclusion ....................................................................................... 16
References ................................................................................................. 16
3 Normative Interventions and Inclusive Practices ................................ 19
3.1 Introduction ...................................................................................... 19
3.2 Normative Interventions ................................................................... 21
3.2.1 Normative Nomenclature ..................................................... 21
3.2.2 Surgical ‘Correction’............................................................ 22
3.2.3 Preimplantation Genetic Diagnosis (PGD)
and Termination ................................................................... 23
3.3 Inclusive Practices ............................................................................ 25
3.3.1 Introduction .......................................................................... 25
3.3.2 International Intersex Fora ................................................... 25
ix
x Contents
3.3.3 Intersex Activism: Submissions and Effects ........................ 26
3.3.4 UN General Assembly on Torture and Intersex ................... 26
3.3.5 Council of Europe Commissioner for Human Rights
on Intersex ............................................................................ 27
3.3.6 World Health Organisation (WHO) on Intersex .................. 27
3.3.7 Malta: Intersex Legislation and the GIGESC Act 2014 ....... 28
3.3.8 Atypical Sex and Religious Inclusion .................................. 28
3.3.9 Atypical Sex, Visibility and Inclusion ................................. 29
3.4 Conclusion ....................................................................................... 29
References ................................................................................................. 30
4 Contested Realities .................................................................................. 35
4.1 Introduction ...................................................................................... 35
4.2 Articulating Intersex: Competing Realities ..................................... 36
4.2.1 Incompatible Realities Intersect ........................................... 36
4.2.2 Goffman, Authenticity and Reality ...................................... 39
4.2.3 Althusser and Interpellation ................................................. 40
4.3 Collaborating Across Incompatible Realities ................................... 41
4.3.1 Mistranslated Communication ............................................. 41
4.3.2 Same Sign, Different Meaning............................................. 42
4.4 The Limits of Principlism ................................................................ 44
4.4.1 Introduction .......................................................................... 44
4.4.2 Ethical Lies .......................................................................... 45
4.4.3 Common Morality ................................................................ 48
4.4.4 Critique of Common Morality ............................................. 49
4.5 Conclusion ....................................................................................... 50
References ................................................................................................. 52
5 Dynamic Coherentism ............................................................................ 55
5.1 Introduction ...................................................................................... 55
5.2 David Hume ..................................................................................... 56
5.2.1 Relations of Ideas/Matters of Fact ....................................... 56
5.2.2 Knowledge Requires Meaning A Priori............................... 57
5.2.3 The Is/Ought Distinction ...................................................... 57
5.3 Logical Positivism............................................................................ 59
5.3.1 The Vienna Circle ................................................................ 59
5.3.2 The Linguistic Turn .............................................................. 60
5.3.3 The Problems of Underdetermination
and Incommensurability ....................................................... 61
5.4 The Growing Problem of Induction ................................................. 61
5.4.1 Introduction .......................................................................... 61
5.4.2 Hempel’s Ravens .................................................................. 61
5.4.3 Goodman’s Grue .................................................................. 62
5.5 Quine’s Two Dogmas ....................................................................... 63
5.5.1 Introduction .......................................................................... 63
Contents xi
5.5.2 One Object – Many Meanings ............................................. 63
5.5.3 Collapse of the Analytic/Synthetic Dichotomy .................... 63
5.6 Realism and Naturalism ................................................................... 65
5.6.1 Scientific Realism ................................................................ 65
5.6.2 Medical Realism .................................................................. 66
5.6.3 Naturalism ............................................................................ 67
5.7 Poststructuralism .............................................................................. 68
5.7.1 Introduction .......................................................................... 68
5.7.2 Kuhn’s Paradigmatic Science ............................................... 69
5.7.3 Foucault, Power and Discourse ............................................ 70
5.7.4 Butler, Sex and Gender Performance ................................... 72
5.8 Biomedical and Social Science Perspective on Sex ......................... 73
5.9 Putnam’s Collapsing of the Fact/Value Dichotomy ......................... 74
5.9.1 Black with Fact, White with Convention
and Red with Value .............................................................. 74
5.9.2 Thick and Thin Ethics .......................................................... 75
5.10 Discussion and Synthesis ................................................................. 76
5.10.1 Introduction .......................................................................... 76
5.10.2 Two Forces ........................................................................... 77
5.10.3 Dynamic Coherentism ......................................................... 78
5.10.4 Reinvigorating Hume’s Negation Test ................................. 78
5.10.5 Disinterpellation – A Tear in the Fabric of Knowledge ....... 79
5.11 Conclusion ....................................................................................... 81
References ................................................................................................. 82
6 Disinterpellation and Essential Kinds ................................................... 85
6.1 Introduction ...................................................................................... 85
6.2 Aristotle on Essential Kinds ............................................................. 87
6.3 Hume on Kinds ................................................................................ 88
6.3.1 Impressions and Ideas .......................................................... 88
6.3.2 Abstract Ideas ....................................................................... 89
6.3.3 Critique of Hume’s Concept of Generals ............................. 90
6.4 Quine on Kinds ................................................................................ 91
6.4.1 Kinds and Induction ............................................................. 91
6.4.2 Kind Recognition and Natural Selection ............................. 92
6.4.3 The Science of Kinds ........................................................... 92
6.4.4 Critique of Quinean Kinds ................................................... 93
6.5 Kripke and Putnam on Essential Kinds ........................................... 94
6.5.1 Introduction .......................................................................... 94
6.5.2 John Locke: Real and Nominal Essences ............................ 94
6.5.3 Kripke’s Essentialism ........................................................... 95
6.5.4 Limits of Kripke’s Essentialism ........................................... 98
6.5.5 Putnam’s Essentialism ......................................................... 100
6.5.6 Critique of Putnam’s Essentialism ....................................... 103