インターセクシュアリティの医療倫理問題 : セックスとジェンダーの迷路2

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  • Ethical Issues on Intersexuality
  • インターセクシュアリティ ノ イリョウ リンリ モンダイ : セックス ト ジェンダー ノ メイロ(2)

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How should we treat intersexual individuals? It has been standard pediatric practice to recommend surgery for infants with ambiguous genitalia or loss of panis. In females, any large clitoris is to be reduced or removed. In males with less than an adequate penis, the preferred surgical approach is sex reassignment. This management philosophy is based on 2 beliefs: (1) individuals are psychosexually neutral at birth and (2) healthy psychosexual development is dependent on the appearence of the genitals. This philosophy was strongly supported by the classical and well-known "John/Joan" case. But reports of the success of John/Joan were premature and wrong. Diamond and Sigmundson recently reported that John failed to identify as a female, and she had in fact chosen to resume life as John. They conclude that the evidence seems overwhelming that humans are not psychosexually neutral. If they are correct, we need a new philosophy for dealing with intersexual individuals. I propose that we have to realise that there are several limitations in our capacity to clinically manage intersexuality. At first.it appears impossible to draw any distinct, line between males and females. And we are unable to predict with confidence the gender that an intersexed newborn will settle into during adulthood. And finally, it is unlikely that surgical reassignment will ever truly "normalize" an individual. In accordance with these limitations, we have to be more careful when undergoing gender reassignment for infants with traumatized genitalia.

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