Intersex : Problems of theory become problems in practice

Abstract: This paper discusses the medical treatment of intersex infants: children born with ambiguous genitalia, chromosomes, or hormones. The central thesis is that unnecessary surgery, defined as surgery that is not necessary to preserve the life or physical health of the infant, is unethical when performed on infants and should be postponed until the patient is able to participate in, and contribute to, the decision. Three lines of argument are presented: One based on the lack of clinical evidence supporting unnecessary surgery; one based on how unnecessary surgery limits the child’s future choices; and one based on how problematic notions of gender have resulted in problems in practice. Together and separately, the three arguments lead to the conclusion that performing unnecessary surgery on intersex infants is unethical, and wherever possible surgery should be delayed until the patient can participate in the decision.