This thesis deals with some of the legal and ethical issues that arise when an individual’s genital and gonadal anatomy does not match what is perceived to be the biological (or sometimes culturally determined) norm. I focus on intersex individuals, particularly infants, who may undergo genital surgery, to ‘normalise’ genital anatomy. I compare this type of surgery to other forms of genital cutting on those too young to consent, male circumcision and female genital mutilation (FGM). I discuss how sex is complex and not yet fully understood; intersex challenges the idea that sex is a simple binary entity and the history of ‘sex testing’ in sport illustrates that there are, rarely, individuals for whom categorisation as biologically male or female is impossible. Gender is also a complex entity, but institutions such as medicine and the law still endorse a simple bipolar model of sex and gender. I argue that the assumptions on which medical practice in intersex is based are based on these simplistic gender norms. I argue that one form of intersex surgery, refashioning the clitoris, continues to be seen as a valid treatment option despite the paucity of outcome data and is not treatment for an illness but for an anatomical difference. At least some individuals who have had this procedure perceive that they have been harmed by it. Therefore I argue that the current medical and surgical approach to anatomical genital variation in intersex is ethically questionable. Furthermore it is possible to construct an argument that it is not in the best interests of the young child to undergo this procedure and that it therefore may be unlawful, even when carried out with parental consent. I also argue that, if FGM is unlawful, as it is, then other analogous procedures, such as clitoral surgery for intersex and male circumcision for non-medical reasons should similarly be unlawful. Male circumcision is held to be lawful in England at present, but the English courts have not considered genital surgery in intersex infants. If they did, then the logical conclusion ought to be to proscribe it. I argue that documents such as driving licences and passports should permit a neutral gender and that birth certification ought to permit registration without specifying sex for intersex infants. It is possible that at least some of this may come about in the future, since a recently published report from the House of Commons Women and Equalities Committee on Transgender Equality has suggested change in the current situation, one indication of the current rapid pace of change in this area of Law. I argue that education about intersex and sex and gender diversity is important for healthcare professionals and for everyone.

Studien söker svara på i vilken utsträckning andra kön än de binära omnämns i läromedel för grundskolan och huruvida materialet möjliggör könslig identitetsutveckling för ickebinära elever. Det material som studeras är läromedel för år 4-9 i ämnena biologi och samhällskunskap, utgivna mellan 2004-2016. För att räkna i vilken utsträckning omnämnanden görs av ickebinära kön, identiteter och uttryck används kvantitativ innehållsanalys. Resultatet av räkningen analyseras sedan utifrån studiens queerteoretiska och normkritiska teoretiska utgångspunkter. Studiens konklusion är att representationen av ickebinära kön är låg, framför allt gällande år 4-6 och att möjliggörandet av ickebinär identitetsutveckling således är försvårad. Detta kan innebära brister i skolornas demokrati-, likabehandlings- och antidiskrimineringsarbete. Slutsatserna kan ligga till grund för fortsatta studier i hur läromedel i framtiden skulle kunna frångå tvåkönsnormen.

Within both the scientific discourse on workforce diversity, and diversity management practice, intersexuality and transgender issues have hitherto remained marginalized topics. This chapter gives an overview of the discourses on both phenomena, and proposes starting points for more inclusive organizational diversity management initiatives. It is shown that both topics represent different aspects of the category of "gender". The common practice of conceptually lumping together intersexuality, transgenderism, and sexual orientation can be seen as one important reason that intersexuality and transgenderism are rarely considered in organizational diversity management programs in terms of concrete action. Against this background, a modified, and more integrated approach to structuring the workforce alongside the different dimensions of diversity is proposed. It is shown that the categories of "biological sex and gender", "gender identity", and "sexual orientation" cannot be regarded as being separate from each other. They represent, rather, an interrelated organizational field of action that should be considered as being one interrelated topic for organizational diversity practices. This chapter derives this claim theoretically and discusses the consequences for organizational diversity management practices. For most organizations, this would mean a fundamental rethinking of their goals, in terms of workforce diversity, and the shaping of their diversity management programs.

<p>This paper discusses the medical treatment of intersex infants: children born with ambiguous genitalia, chromosomes, or hormones. The central thesis is that unnecessary surgery, defined as surgery that is not necessary to preserve the life or physical health of the infant, is unethical when performed on infants and should be postponed until the patient is able to participate in, and contribute to, the decision. Three lines of argument are presented: One based on the lack of clinical evidence supporting unnecessary surgery; one based on how unnecessary surgery limits the child’s future choices; and one based on how problematic notions of gender have resulted in problems in practice. Together and separately, the three arguments lead to the conclusion that performing unnecessary surgery on intersex infants is unethical, and wherever possible surgery should be delayed until the patient can participate in the decision.</p>

This paper discusses the medical treatment of intersex infants: children born with ambiguous genitalia, chromosomes, or hormones. The central thesis is that unnecessary surgery, defined as surgery that is not necessary to preserve the life or physical health of the infant, is unethical when performed on infants and should be postponed until the patient is able to participate in, and contribute to, the decision. Three lines of argument are presented: One based on the lack of clinical evidence supporting unnecessary surgery; one based on how unnecessary surgery limits the child’s future choices; and one based on how problematic notions of gender have resulted in problems in practice. Together and separately, the three arguments lead to the conclusion that performing unnecessary surgery on intersex infants is unethical, and wherever possible surgery should be delayed until the patient can participate in the decision.

Chapter I The ontogeny of sex development is introduced and a definition of the intersexual state is given. A resume of intersexes recorded in South Africa is presented together with figures showing the increased demand for cytogenetic services in the country. The motivation for this study is discussed. Chapter II The biological concept of sex is outlined together with notes on the evolution of the dioecious state in animals. Thereafter a brief account of the normal and abnormal intersex states in invertebrates and vertebrates is given. Chapter III Examples of some of the abundant references to ambisexual individuals found in the classical literature, history and mythology are listed and the status of intersexes in modern society is discussed: it does not vary much from the times of ancient Greece and Rome. Chapter IV A summary of the events which led to the establishment of cytogenetics as an independent discipline is given. The discovery of nuclear sex dimorphism is noted and methods of investigation of intersexual patients are described. A detailed description is given of cytogenetic technical. "methods, ; and leads to a diagrammatic explanation of the differential diagnosis of intersexes. This is used as a basis for the classification and accordingly a simplified, unambiguous system is proposed and defended. The sources and numbers of pat~ ients recorded in this thesis are explained. Chapter V The sex chromatin is described in detail? with a description of the methods used for its demonstration and evaluation. A pilot study of normal women of the four races established that there is no inter-racial variation in chromatin frequency. Reasons are given for disregarding nuclear appendages as an accurate indication of 'sex '. Chapter VI Embryological stage s i n the development of the human urogenital tracts are recounted after considering the mechanisms of sex determination. Pathogenesis of intersexuality is considered briefly. Chapter VII Gonadal dysgenesis of the female, including Turner's syndrome and phenotypes of both male and female are presented. The classification, pathology, aetiological and cytogenetic factors are described. Illustrative case reports and extensive discussion of the syndrome are presented. Chapter VIII The Klinefelter syndrome occurs in males with supernumerary X chromosomes; a number of chromatin negative, hypogonadal conditions mimic the syndrome: they are described, with notes on the classification, pathology, aetiology and the cytogenetic features. A series of case reports demonstrate both chromatin positive and negative types. Special reference is made to the dermatoglyphic profiles which were discovered to differentiate the XY males into two groups. Chapter IX Three syndromes, the XXX, XYY and agonadism, were not encountered in this study and are consequently not discussed. Chapter X The adrenogenital syndrome has several distinctive signs which are mimicked by induced virilization; these are described and a number of case reports are presented to illustrate the syndromes. Chapter XI Male intersexes occur in several different forms: the classification of the group is explained and a distinction is made between intersexes and those with simple, or 'pseudo-intersexual', defects. The signs of the different syndromes are detailed, together with data concerning the aetiology and cytogenetics. A series of patients' case histories is used to illustrate the various syndromes. Chapter XII Idiopathic female intersexuality is defined and a short explanation of the classification is given. The signs found in this syndrome are detailed and a single case report, which is of exceptional interest because of severe masculinization and the formation of a phallic urethra, is presented. Chapter XIII Hermaphroditism is defined and the subgroups are explained. The variability of signs is discussed and details of anatomy and histology of the genital tract are given . A single hermaphrodite was encountered during the survey and the case is described. Three other patients, all infants, were suspected of being hermaphroditic but because gonadal biopsy was not undertaken they were discharged from hospital without a diagnosis having been made. Discussion of the aetiological mechanisms is presented and the need for early diagnosis and treatment is emphasized. Chapter XIV Some of the simple genital anomalies and somatic defects which resemble intersex are mentioned and are illustrated by attenuated case reports. Chapter XV The incidence of those intersexual conditions recognizable at birth by anatomical deformity is calculated from a total population of 21,000 live births recorded during the calendar year, 1969. The incidence was very low (1:7000) and does not permit analysis of inter-racial distribution. Prevalence is calculated from the number of new patients seen by the author during 1969 in Durban. Some interesting observations were made but the primary objective, to determine whether or not intersexuality is more prevalent in the Bantu than any other race, could not be answered with certainty because of the small number of patients. Hermaphroditism was shown not to be the most common type of intersex syndrome in the Bantu. Chapter XVI An outline is given of the normal dermatoglyphic features of the finger prints and palms. Some references of the patterns in Turner's and Klinefelter's syndromes are available from the literature and are compared with the profiles of patients from this series. A distinct dimorphism was found in chromatin negative hypogonadal males and was thought to distinguish between those with congenital or acquired pathology. Normal values for South Africans have not been established satisfactorily and the urgent need for this information is stressed. Chapter XVII A general discussion of the highlights of this study of the epidemiology, clinical presentation and cytogenetics of intersexuality is given and a number of conclusions are drawn . / Thesis (M.Sc.)-University of Natal, Durban, 1970.

The thesis explores the theological implications of intersex conditions (those involving the congenital development of ambiguous genitalia, a congenital disjunction of the internal and external sex anatomy, sex chromosome anomalies, or variations in gonadal development) and their medical treatment. Christian theology has valued the integrity of the body and the goodness of God reflected in creation, but has also set much store by the “complementarity” of “normal” male and female physiology (and gender as mapped onto these). It has been threatened by liminality, shifts in sexed and gendered identity, and non-marital sexual activity. However, a deconstruction or querying of male and female as essential or all-embracing human categories changes conceptions of legitimate bodiliness and of what it means for human sex to reflect God. Theologies based too unmovingly in sex or gender complementarity are dubious in light of intersex, and fail to resist imperialism, hegemony and heteronormativity. Theologies which value incarnation and bodiliness must speak with stigmatized or marginal bodies too: the Body of Christ is comprised of human members, and each member changes the Body’s definition of itself as well as being defined by it. Accepting the non-pathology of intersexed and otherwise atypical bodies necessitates a re-examination of discourses about sex, marriage, sexuality, perfection, healing and the resurrection body. Informed by existing theologies from three marginal areas (transsexualism, disability and queer theology), this beginning of a theology from intersex demonstrates the necessity of resisting erotic domination in defining bodies. Theology is always self-queering, since it contains tools for hermeneutical suspicion, for overturning religious and cultural practices which do not meet the demands of love and justice. Although intersexed people do not always align themselves with the politically queer, intersex is, unavoidably, theologically queer. The ongoing erasure of intersexed bodies and experiences demands theological responses motivated not by fear but by a desire to expand the ways in which human lives and bodies tell stories. Until theologians, medics and others accept that the male-and-female world is not the only “real” world, and that the normalizing procedures of surgery and signification which bolster it are themselves grounded in something partial and arbitrary, the silencing and devaluing of otherness in human bodies will go on. This cannot be justified.

How do members of the media represent intersex people? Do the voices of intersex activists find their way into mainstream media representations, or are they ignored? What types of discourses are produced by the presence (or lack thereof) of activist voices in news articles? The goal of this thesis is to interrogate the discourse surrounding intersex, or individuals who fall outside of the typical male/female binary for sex classification, and intersex activism in the media. The legal case M.C. vs. Aaronson, settled in 2017, was one of the first legal cases in the United States involving an intersex person. This thesis analyzes the media coverage of this case. As much of the public is still unaware of the issues facing intersex people today, media representations of intersex have the ability to make great strides in promoting awareness about the goals of intersex activism. Therefore, it is vital to investigate the way that media representations construct ideas about intersex and intersex activism. Utilizing feminist critical discourse analysis in conjunction with a “Media Guide” produced by a leading intersex organization called InterACT, I dissect seven articles written about the M.C. vs Aaronson case to study the way that their authors reproduce harmful ideas about intersex people. I focus on four specific aspects of these articles: the way they utilize photos of babies and children, the erasure of M.C.’s race, the way the articles discuss sex and gender, and who is quoted in each article. I also make the case that the InterACT “Media Guide”, while a step in the right direction, continues the perpetuation of dangerous intersex tropes.

Endocrine disrupting chemicals in wild animals, including fish, can disrupt reproduction by causing intersexuality. Organic pollutants, specifically polychlorinated biphenyls (PCBs), have been shown to be estrogenic or anti-androgenic likely contributing to intersexuality in males. Organic pollutants persist in the environment despite being restricted for use in the United States. Bluegills, Lepomis macrochirus, play a crucial role in lake food webs as forage and sport fish and may be affected by PCBs. In the current study, male bluegills collected in 2010 from selected Illinois lakes were analyzed to quantify PCB body residues and the incidence of intersexuality (n=200). Experiments were then conducted in 2011 and 2012 to assess the reproductive output of mature males with varying PCB body residues paired with mature females containing no detectable PCB body residues held in uncontaminated 0.05-hectare research ponds (Southern Illinois University Touch of Nature Pond Facility). Lake-specific male bluegill whole-body tissue PCB body residues ranged from below reporting limit to 2 mg/kg dry weight (non-lipid normalized basis) and varied significantly among lakes (F7,32= 9.59, p<0.0001). No male intersex bluegills were found. In both reproductive experiments, abundance of young declined as male PCB body residues increased (F 4,18 = 13.28; P=0.002). Adult survival was unrelated to reproductive output. Taken together, these results suggest PCBs, which are ubiquitous in aquatic and terrestrial habitats, have the ability to alter male reproductive performance, and possibly population dynamics and community structure through reduced recruitment, in the absence of overt intersexuality.

The binary conception of gender as solely male or female has had a great impact to nonbinary and intersex people in the societal and legal field. Their ability to enjoy human rights is impacted by the current normative confines of sex and gender. The aim of the following paper is to investigate how Malta and Germany have included intersex people and/or nonbinary identities in their legislation and through a socio-legal analysis examine whether their legislations achieved to provide non-discrimination policies. The paper concludes that the third legal recognition in Malta and Germany is based on different perspectives in order to include populations that do not conform to the binary dichotomy and that seek legal recognition.