Variations in Sex Development: Medicine, Culture and Psychological Practice PDF
Preview Variations in Sex Development: Medicine, Culture and Psychological Practice
VARIATIONS IN SEX DEVELOPMENT - is a licensed psychologist, independent scholar and trainer/supervisor forhealth professionals in theUK. Published online by Cambridge University Press Acompassionate,insightful,andnecessarybookfromaforemostpsychologiston intersex. A long-time advocate for improving care, Dr. Liao expertly guides readers through one of the most contested areas of medicine. With lucidity, urgency, and a unique blend of science and storytelling, Variations in Sex Development nimbly navigates complex debates that deepen our appreciation of what constitutes good care. – Katrina Karkazis, Professorof Sexuality, Women’s, and Gender Studies, and author, Fixing Sex: Intersex, MedicalAuthority and Lived Experience. Thisbookwillrevolutionisepsychologicalpracticeinthefield.Nootherpsychol- ogist in the history of Intersex/differences in sex development (DSD) has forged and maintained such fruitful working relationships across the terrain of interna- tionalprofessional and peerexperts.EVERYpsychologistinthisfieldofpractice shouldownthisbookanduseitasaprimer,guideandbackbonefortheirclinical practice and professional development. –Julie Alderson, Consultant Clinical Psychologist,and Chair, Paediatric Psychology Network DSD Special Interest Group,UK. “Dr. Liao’s extensive experience in working with, alongside, and on behalf of peoplewithvariationsinsexdevelopmentmakesherespeciallyequippedtowrite thistext.Theinclusion ofpracticevignetteswillenhancereaders’skillsintaking anintersectional,anti-oppressiveapproachtotherapeuticwork.Thisbookprom- ises to be the first to explain to mental health providers how to compassionately and ethically work with intersex people and their loved ones.” –LourdesDoloresFollins,psychotherapist,author,andco-editor,BlackLGBT HealthinTheUnitedStates:TheIntersectionofRace,Gender,andSexual Orientation. Thissubjectmatterofthisbookshouldalwaysmakeusthinkwithanopenmind. I thoroughly enjoyed reading this wonderful and thought-provoking book. You mayagreeordisagreewiththeauthorattimes,butyouwillbenefitfromengaging with thechallenges that the bookposes. – Dan Wood, Professorof Urology, and senioreditor, Journal ofPediatric Urology. DrLiaohasdistilleddecadesofknowledgeandexperienceinaMUSTREADfor every care provider in differences in sex development (DSD). Away from dog- maticinterpretations,thebookportraitstheevolutionofDSDmanagementand spellsoutwhatopen-mindedandholisticcaremayactuallylooklike,sothatitcan be acompass forthe future. – Lina Michala,Assistant Professorin Paediatric and Adolescent Gynaecology, University of Athens. An insightful, compassionate and nuanced analysis of care needs, controversies and advocacy, with a long awaited focus on psychosocial concerns of individuals and families. A distillation of decades of expertise, this book is indispensable reading forpeerworkers and health, social care and education professionals. –MorganCarpenter, Executive Director of Intersex Human Rights Australia. Published online by Cambridge University Press VARIATIONS IN SEX DEVELOPMENT Medicine, Culture and Psychological Practice LIH-MEI LIAO Published online by Cambridge University Press ShaftesburyRoad,Cambridge,UnitedKingdom OneLibertyPlaza,thFloor,NewYork,,USA WilliamstownRoad,PortMelbourne,,Australia –,rdFloor,Plot,SplendorForum,JasolaDistrictCentre,NewDelhi–,India PenangRoad,#–/,VisioncrestCommercial,Singapore CambridgeUniversityPressispartofCambridgeUniversityPress&Assessment, adepartmentoftheUniversityofCambridge. WesharetheUniversity’smissiontocontributetosocietythroughthepursuitof education,learningandresearchatthehighestinternationallevelsofexcellence. www.cambridge.org Informationonthistitle:www.cambridge.org/ :./ ©CambridgeUniversityPress&Assessment Thispublicationisincopyright.Subjecttostatutoryexceptionandtotheprovisions ofrelevantcollectivelicensingagreements,noreproductionofanypartmaytake placewithoutthewrittenpermissionofCambridgeUniversityPress&Assessment. Firstpublished PrintedintheUnitedKingdombyTJBooksLimited,PadstowCornwall AcataloguerecordforthispublicationisavailablefromtheBritishLibrary. LibraryofCongressCataloging-in-PublicationData :Liao,Lih-Mei,author. :Variationsinsexdevelopment:medicine,cultureand psychologicalpractice/Lih-MeiLiao. :Cambridge,UnitedKingdom;NewYork,NY: CambridgeUniversityPress,.|Includesbibliographicalreferencesandindex. :(print)|(ebook)| (hardback)|(epub) ::Intersexuality.|Intersexpeople–Medicalcare.| Intersexpeople–Mentalhealthservices.|Intersexpeople–Identity. :. (print)| (ebook)| ./–dc/eng/ LCrecordavailableathttps://lccn.loc.gov/ LCebookrecordavailableathttps://lccn.loc.gov/ ----Hardback CambridgeUniversityPress&Assessmenthasnoresponsibilityforthepersistence oraccuracyofURLsforexternalorthird-partyinternetwebsitesreferredtointhis publicationanddoesnotguaranteethatanycontentonsuchwebsitesis,orwill remain,accurateorappropriate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateandup-to-dateinformation thatisinaccordwithacceptedstandardsandpracticeatthetimeofpublication.Althoughcasehistories aredrawnfromactualcases,everyefforthasbeenmadetodisguisetheidentitiesofthe individualsinvolved.Nevertheless,theauthors,editors,andpublisherscanmakenowarrantiesthatthe informationcontainedhereinistotallyfreefromerror,notleastbecauseclinicalstandardsare constantlychangingthroughresearchandregulation.Theauthors,editors,andpublisherstherefore disclaimallliabilityfordirectorconsequentialdamagesresultingfromtheuseofmaterialcontainedin thisbook.Readersarestronglyadvisedtopaycarefulattentiontoinformationprovidedbythe manufacturerofanydrugsorequipmentthattheyplantouse. Published online by Cambridge University Press For SheHan, memories of SangMin, Antonia, Jordana Published online by Cambridge University Press Published online by Cambridge University Press Contents Preface page ix List of Abbreviations xv Circles and Squares Introductory Notes Evolving Terms and Definitions Medical and Psychological Controversies Adult Outcome of Childhood Genital Surgery Advocacy, Public Engagement and Healthcare Reform The New Care Standard Introductory Notes Psychological Practice: Epistemic Considerations Psychological Practice: Process Considerations vii Published online by Cambridge University Press viii Contents Introductory Notes Choosing “Normalizing” Genital Surgery Caretakers’ Grief and Growth Assigning Legal Gender Disclosure Sexual Intimacy Childfreedom References Index Colour Plates section to be found between pp. and Published online by Cambridge University Press Preface Thisbookisaboutpsychologicalpracticeforpeopleandfamiliesimpacted by a wide range of developmental presentations whereby the sex chromo- somes, reproductive anatomy and urogenital characteristics – in combina- tion–donotmapclearlyontothesocialcategoriesoffemaleormale.The bookgoessomewaytoexplainwhythisisacontestedhealthcarefieldand to visualize ethical psychological practices. ff Irreconcilable Di erences in Language Inthepast,medicaldoctorsandscientistsreferredtoatypicalbiologicalsex asintersex.Today,thepresentationsaregroupedunderthecollectiveterm differencesinsexdevelopment(DSD).Meanwhile,thetermvariationsinsex characteristics (VSC) has been introduced as a less stigmatizing term than intersex and DSD. The irreconcilable debate on terminology is under- standable. It is a contest about who gets to name whom. Therefore, it is unlikely that any one term will receive broad acceptance by those whom it describes. Under thecollective term(s) are highly variable bodilypresentations. In medicine,diagnosticworkupistriggeredeitherbyvisiblegenitalvariations in an infant or by atypical or absent pubertal development in an adolescent. People who are born with the said physical variations are as different from one another as people without variations in terms of identity,sexualityandallhumanattributes.Whilemanypeoplewithlived experience have reclaimed intersex as a personal/political identity, many moreconsiderthemselvesasgender-normativewithabodilyvariationthat does not define them. The evolving terms and changing criteria make it important to empha- size that this book is about psychological practice in the field of intersex/ DSD/VSC, by which I mean nonsexually dimorphic combinations of genetic, reproductive and urogenital characteristics, as described in Chapter . As this is a healthcare book, it has to be in dialogue with the clinical literature. This means engaging with medical terminology when referencing medical publications. For example, I refer to intersex medicine when discussing past medical practices and to DSD services when discuss- ing current medical practices. Otherwise, I use vocabularies such as ix https://doi.org/10.1017/9781009000345.001 Published online by Cambridge University Press
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