Researching intersex & trans people's medical experiences
BA, DMA, MSc, HTCPD, PhD Candidate, Roehampton University, School of Business, Computing & Social Science
Up to the time of Magnus Hirschfeld (Hirschfeld, 1910/1991, Hirschfeld, 1914 /1991, Hirschfeld, 1923) the study of homosexuality, transsexuality and intersex were located together, so I set out by looking at these. I then focus on the two groups I am looking at in my research. I finish off by examining some of the work covered in my research so far.
Heterosexual binary gender system:
Notions of normality and dominance lead to discrimination and injustice
As for transsexual, but without surgery
People who identify as neither male or female (Krafft-Ebing, 1996)
Varied definitions, may be/have:
After 150 years of research, the reasons for sexual and gender diversity are not fully understood. The social and biological aspects are not clearly defined for any group. Intersex is a biological phenomena, but what is and isn't intersex is defined by people. For religious leaders, a biological cause of homosexuality and transsexuality is inconvenient undermining ideas about sin and choice. For the National Socialists biology was convenient. The views of some African leaders and Bishops about homosexuality echo those in Germany in the 1930's.
These three phenomena occur globally and throughout history, but are not always tolerated globally. To ask if homosexuality or transsexuality has some genetic or biological basis, or how it can continue to exist in evolutionary terms, is problematic: that is a political stance that assumes homosexuality is deviant, and thus needs explaining or justifying. When we discuss nature vs. nurture, we do not ask whether heterosexuality is produced this way because it is assumed to be normal.
Wherever we live or come from, problems about these issues are often problems of language: Science itself is often guided by the bias of the investigator, as are the interpretation of the findings, and implementation of policy that arises from it.
Amnesty International report (AI, 2000) highlighted that many people around the world are tortured, imprisoned and killed because of their sexuality or gender identity
Such minorities are often not tolerated in much of North and South America, the Middle East, Africa and parts of Europe. People are targeted for simply being who they are - and this is sometimes sanctioned by the state.
Figures are hard to establish, and for comparison I err on the cautious, between the most conservative and generous).
Estimates are between 3 and 10% of society I work on a figure of 5%.
Coming between the official figures, estimates from the USA on the internet and the incidence of Hijra in India, I work on a figure of 0.05%. Once the procedures in the Gender Recognition Act have been active for a few years, more detailed figures should be available for the UK.
There is a one hundred fold difference between the estimates of Sax & Fausto-Sterling (Fausto-Sterling, 2000, Sax, 2002). The latter figure is more in line with Skakkebaek's estimates of genital anomaly in the newborn in Western Europe and North America (Skakkebæk et al., 2001). I take a more cautious figure of 0.5%
Three groups of people in study:
Location of Communities & Pathologies
The following four diagrams map out four different ways of looking at three groups:
Location of information
The four locations identified by Dave King (King, 1993):
I am developing an analysis of media coverage over the past ten years. The extent of reportage on transsexuality over the past ten years has increased substantially year-on-year. Coverage of intersex is relatively recent and is a fraction of that devoted to transsexuality.
Methods - Interviews
Lesbian and Gay Archives
Frequent social isolation and bullying
Effects of medical interventions discussed
The Creation of pathologies.
It has been asked here whether the current interest in intersex issues is because some transsexed people have difficulty accepting themselves as such. Very few intersex people can be categorised as transsexed most maintain identification withthe sex of assignment and rearing. At Lübeck recently, Ken Zucker described research which showed that a very small percentage of intersex people with ambiguity assigned a sex in infancy went on to change gender role as adults. This is higher than the general population, but is still quite a low incidence. Some would question whether an intersex person can be transsexed, when there has been some question about assignment and some level of ambiguity.
One of the reasons I resist the current trend of trying to blur the lines between these phenomena is because intersex people are often accompanied by life-long medical problems. These problemshave been overlooked by assuming people are only "transsexed", and huge psychological discomfort has been caused by trying to fit people into an inappropriate pathology, just as much as an inappropriate gender-role.
I do look back to Hirschfeld, whose works are becoming increasingly available in translation after over 80 years, and read with surprising freshness. He described somatic and psychic hermaphrodites, the former being intersexed people, the latter included homosexuals and what he called transvestites (some of whom we would today see as transsexed people). This usage, it seems, would be very appropriate for a distinction and could be restricted to the two groups in question: physical and neurological intersex conditions.
Then where there is overlap, it can be accounted for, and the health needs of both communities could begin to be addressed properly.
Citation: O'Brien, M., (2004), Researching intersex & trans people's medical experiences, GENDYS 2004, The Eighth International Gender Dysphoria Conference, Manchester England.
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