Abstract

After 20 years of debate on intersex care, there has been a slight movement away from the paradigm of ‘optimal gender’ including early genital modification to conform to predicted gender identity towards a paradigm of ‘full consent’ including the provision of full information about the risks, benefits and alternatives to interventions and the postponement of irreversible interventions on minors too young to give informed consent. However, controversy continues. Against this background, the aim of this study was to analyse core aspects of current debates in intersex care. Focus was placed on controversies about surgery on external genitalia; gonadectomies; the expressed wishes of patients under the age of consent; and how to deal with intersex within the family. Eight guideline-based interviews were conducted with two people with intersex/diverse sex development conditions who had been subjected to surgery, two parents of children with an intersex/dsd condition, two medical doctors, and two psychologists. Data were analysed thematically. Findings indicate that while ‘full consent’ influenced actions and debate, the persons involved held differing opinions about how this policy can or should be achieved. In addition, the data illustrated how concepts such as normalcy, identity and sexuality are relevant when dealing with intersex issues.

摘要

在对双性人关怀进行了 20 年的辩论之后，从“最佳性别”范式（包括早期生殖器改造以符合预测的性别认同）转向“完全同意”范式，包括提供有关干预措施的风险、益处和替代方案，以及推迟对年龄太小而无法给予知情同意的未成年人进行不可逆转的干预措施。然而，争议仍在继续。在此背景下，本研究的目的是分析当前双性人护理辩论的核心方面。焦点是关于外生殖器手术的争议；性腺切除术；未满同意年龄的患者表达的意愿；以及如何处理家庭中的双性人。对两个接受过手术的双性人/多元性发育疾病患者、两名双性人/dsd 疾病儿童的父母、两名医生和两名心理学家进行了八次基于指南的访谈。数据进行了专题分析。调查结果表明，虽然“完全同意”会影响行动和辩论，但有关人员对如何或应该如何实现该政策持有不同意见。此外，数据还说明了在处理双性人问题时，常态、身份和性等概念是如何相关的。有关人士对如何或应该如何实现这一政策持有不同意见。此外，数据还说明了在处理双性人问题时，常态、身份和性等概念是如何相关的。有关人士对如何或应该如何实现这一政策持有不同意见。此外，数据还说明了在处理双性人问题时，常态、身份和性等概念是如何相关的。