Intersexuality, Cultural Influences, and Cultural Relativism

Abstract

In the following, a difficult case involving intersex is examined. Although intersexuality is somewhat rare, leading pediatric urologists and endocrinologists involved in the treatment of intersexuality report all having dealt with similar cases.1 Since the case involves a conflict of cultural values, physicians have tended to resolve the issue by an appeal to the duty to respect the values of other cultures.2 Published commentaries on the case have also framed the issue in terms of cultural relativism.3 The aim of this paper is to show that the justification for the resolution of the case need not, and should not involve either subscribing or succumbing to cultural relativism.4 The argument clarifies the role of cultural considerations in ethical decision-making. I argue that understanding the appropriate role of cultural values in ethical decision-making is vital to the integrity of the medical profession. The paper begins with a description of the case, followed by an account of how it would have been addressed according to previous practices for dealing with intersexuality. Then a description of our revised practices and the factors that led to them will be provided, along with an application of those practices to the case. In the second section, evidence of cultural disparities in the medical treatment of intersexuality will be canvassed. The third section addresses the question of what is entailed by the duty to respect the values of other cultures, stressing that respecting the values of other cultures does not require condoning, accepting, or acceding to those values. In the fourth section, I provide a resolution of the case based on empirical studies on the intersexual condition involved and a realistic confrontation with all morally relevant circumstances of the case.