Making Sense of Making Sense of Intersex

Abstract

Just when you think nothing could be added to scholarship . . begins Suzanne Kessler's blurb on the back of Ellen Feder's new book, Making Sense of Intersex: Changing Ethical Perspectives in Biomedicine. This is an interesting gambit for a recommendation, implying a field chock-full of great ideas where a few might be squeezed in. Because I have been following Feder's innovative work on intersex-and many other topics-for some years, I am not primed to accept that is a subject on which nothing could be said, and just as well: this book successfully identifies a large array of issues where there is to be said and done about intersex. It also shows how this more is pressing, complex, and will involve analysis of a range of actors and institutions in relation to the child. In this way, Feder successfully avoids the trope criticized by Emi Koyama and Lisa Weasel when they argued in 2002 that in the teaching of within feminist scholarship intersex existence is understood and presented largely as a scholarly object to be studied in order to deconstruct the notion of binary sexes (and thus sexism and homophobia) rather than as a subject that has real-world implications for real (Koyama and Weasel 2002: 170). Feder has undertaken long, open-ended interviews with intersexed people and with parents and siblings of intersexed children, and with twelve pediatric specialists treating children with atypical sex anatomies, as well as undertaking the usual reviews of and philosophical literatures. Although she speaks openly about her doubts about undertaking research as a philosopher (Feder 2014: 11-12), I think that the humanity of Feder's writing, her transparency, and her commitments to complex ethical engagement not just with ideas but also with people serve this part of her project well. In fact, she has provided us with a wealth of empirical sociological knowledge about management and people that is compelling and politically motivating than much of the competing literature.The primary goals of the book, however, are not overtly ethnographic. Feder wants to show how the medical management of atypical sex is a problem of ethics (2), or, approached from another angle, to show philosophy has to offer to the task of thinking it through (6). In the course of this project, Feder reveals a number of ways that the methods and commonplaces of philosophy provide a startling and paradigm-shifting way of thinking ethically about intersex. That such ethical insights should be startling is itself interesting. One of the things the book shows very well is how thin much of the language of conventional bioethics has been in confronting the nexus of historical, affective, and political inheritances that shapes management. Clinicians still find bodies disgusting and in prima facie need of normalization; parents still find themselves profoundly uncertain how to help their children, and are still encouraged into ethically troubling medical interventions and parenting behaviours in the hope of better identifying with them. Although the work of activists and advocates has analyzed the harms of cosmetic genital surgeries conducted without informed consent, of repeated medical examinations and photography, and of secrecy and lies, these obvious wrongs-which actually can quite easily be challenged using a conventional bioethical language of beneficence, autonomy, and justice-don't seem to have had the impact on thinking and practice one might hope. In this context, I found several parts of the book much philosophically richer than existing ways of thinking, and I want to briefly describe some of those to show how the book articulates a new bioethical language that engages the habitus of contemporary biomedicine and will extend beyond the case study of intersex.The ethical analysis that centers the book aims to answer the question, what can account for the urgency 'to fix' children in ways that have been demonstrated to promote harm rather than flourishing? …