''Fixing Sex: Intersex, Medical Authority, and Lived Experience'', a book by Stanford

anthropologist An anthropologist is a person engaged in the practice of anthropology. Anthropology is the study of aspects of humans within past and present societies. Social anthropology, cultural anthropology and philosophical anthropology study the norms and ...

and bioethicist

Katrina Karkazis Katrina Alicia Karkazis (born 1970) is an anthropologist and bioethicist. She is a professor of Sexuality, Women's and Gender Studies at Amherst College. She was previously the Carol Zicklin Endowed Chair in the Honors Academy at Brooklyn College ...

, was published in 2008. Described as "thoughtful", "meticulous", and an "authoritative treatise on intersex", the book examines the perspectives of intersex people, their families, and clinicians to offer compassionate look at the treatment of people born with atypical sex characteristics.

Synopsis

In a scholarly work, Karkazis draws heavily on interviews with intersex adults, parents, and physicians to explore how intersex is understood and treated. In part 1, she reviews the history of treatment for intersex traits, highlighting the work of John Money and the introduction of the, then new, terms "gender", "gender role" and "gender identity". She explores the events following publication of Milton Diamond's study of the David Reimer or "John/Joan" case, and the ways in which public opinion impacted on medical treatment. In part 2, Karkazis presents an analysis of current medical approaches to intersex, and the risks involved, in the wake of a 2006 "consensus statement on the management of intersex disorders". She also reviews the methods utilised to assign a sex of rearing to intersex infants, such as genitals and penis size, chromosomes, fertility, "sexing of the brain", and parental wishes; these impact upon determination whether or not to proceed with early genital surgery.Fixing Sex: Intersex, Medical Authority, and Lived Experience

Claude Migeon Claude Jean Migeon (1923 – March 4, 2018) was a French pediatric endocrinologist who spent the majority of his career at the Johns Hopkins Hospital. Early life Migeon was born in 1923 in Lievin, France, to Andre Migeon, a printer, and Pauline D ...

in '' American Journal of Human Genetics'', June 12, 2009; 84(6): 718-727. DOI: 10.1016/j.ajhg.2009.04.022. Part 3 interviews parents of children with complete androgen insensitivity syndrome and congenital adrenal hyperplasia, and adults with intersex experiences. Part 3 also looks at activism by intersex organizations.

Reception

The book has been well received by both clinicians and intersex groups. Gary Berkovitz, writing in the '' New England Journal of Medicine'' states that Karkazis's analysis is fair, compelling, and eloquent; "Current consensus guidelines recommend early separation of the vagina and urethra for female subjects with abnormalities in the formation of the sex organs... Karkazis presents a compelling argument for the deferment of subsequent surgery until the patient is able to decide."Fixing Sex: Intersex, Medical Authority, and Lived Experience
New England Journal of Medicine, April 16, 2009. DOI: 10.1056/NEJMbkrev0805101. Elizabeth Reis, reviewing the book in the '' American Journal of Bioethics'', states that the book identifies risk of incontinence, fistulas, scarring and lack of physical sensation arising from surgical intervention, and the psychological harm caused by the knowledge that "one's genitals are 'wrong,' requiring constant medical scrutiny and 'fixing'. It "masterfully examines the concerns and fears of all those with a stake in the intersex debate: physicians, parents, intersex adults, and activists. ... Karkazis’s honest, multi-pronged approach poses critical questions." Mijeon in the '' American Journal of Human Genetics'' writes that the "conclusion is quite fitting", "the history of thinking about the body ... can be highly politicized and controversial". Kenneth Copeland, former president of the Lawson Wilkins Pediatric Endocrine Society, describes the book as "Masterfully balancing all aspects of one of the most polarizing, contentious topics in medicine... the most recent authoritative treatise on intersex." Gayle Rubin describes the book as "meticulous, sensitive, and brilliantly executed".Katrina Karkazis, PhD, MPH
,

Stanford University School of Medicine Stanford University School of Medicine is the medical school of Stanford University and is located in Stanford, California. It traces its roots to the Medical Department of the University of the Pacific, founded in San Francisco in 1858. This ...

Center for Biomedical Ethics, 2013 Arlene Baratz (

Accord Alliance Accord Alliance was founded in March 2008 to support a dialogue on intersex patients and their care. They are a hosted project of the Tides Center, an organization that supports non-profit groups. Their stated mission is to promote comprehensive ...

) describes the book as "a velvet-gloved punch to the gut", "astonishing, a tale told straight from the mouths of affected adults, parents, and physicians in tender and lyrical prose." Intersex community organization Organisation Intersex International Australia regards the book as "approachable," "compelling and recommended reading".Katrina Karkazis, "Fixing Sex" (recommended reading)
Organisation Intersex International Australia, 26 January 2010 The book was referenced by ''Involuntary or coerced sterilisation of intersex people in Australia,'' a 2013 report of a committee of the Senate of Australia in 2013.Involuntary or coerced sterilisation of intersex people in Australia
Community Affairs Committee, Senate of Australia, October 2013.

Awards and recognition

The book was nominated for the

Margaret Mead Award Margaret Mead Award is an award in the field of anthropology presented (solely) by the Society for Applied Anthropology from 1979 to 1983 and jointly with the American Anthropological Association afterwards. This award was named after anthropolog ...

, 2010, and a finalist for the Lambda Literary Award, 2009.

References

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External links

Official site
Bioethics Intersex in non-fiction Medical anthropology Medical books Medical ethics Medical controversies Philosophy of sexuality Intersex and medicine Intersex rights in the United States