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

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

and

bioethicist Bioethics is both a field of study and professional practice, interested in ethics, ethical issues related to health (primarily focused on the human, but also increasingly includes animal ethics), including those emerging from advances in biolo ...

Katrina Karkazis, was published in 2008. Described as "thoughtful", "meticulous", and an "authoritative treatise on intersex", the book examines the perspectives of

intersex Intersex people are those born with any of several sex characteristics, including chromosome patterns, gonads, or genitals that, according to the Office of the United Nations High Commissioner for Human Rights, "do not fit typical binar ...

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 David Reimer (born Bruce Peter Reimer; 22 August 1965 – 4 May 2004) was a Canadian man raised as a girl following medical advice and intervention after his penis was severely injured during a botched circumcision in infancy. The psychologis ...

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 in ''

American Journal of Human Genetics The ''American Journal of Human Genetics'' is a monthly peer-reviewed scientific journal in the field of human genetics. It was established in 1948 by the American Society of Human Genetics and covers all aspects of heredity in humans, including ...

'', 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 Congenital adrenal hyperplasia (CAH) is a group of Genetic disorder#Autosomal recessive, autosomal recessive disorders characterized by impaired cortisol synthesis. It results from the deficiency of one of the five enzymes required for the Biosy ...

, and adults with intersex experiences. Part 3 also looks at activism by intersex

organizations An organization or organisation ( Commonwealth English; see spelling differences) is an entity—such as a company, or corporation or an institution (formal organization), or an association—comprising one or more people and having a par ...

Reception

The book has been well received by both clinicians and intersex groups. Gary Berkovitz, writing in the ''

New England Journal of Medicine ''The New England Journal of Medicine'' (''NEJM'') is a weekly medical journal published by the Massachusetts Medical Society. Founded in 1812, the journal is among the most prestigious peer-reviewed medical journals. Its 2023 impact factor was ...

'' 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 ''

'' 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 The Stanford University School of Medicine is the medical school of Stanford University and is located in Stanford, California, United States. It traces its roots to the Medical Department of the University of the Pacific, founded in San Fra ...

Center for Biomedical Ethics, 2013 Arlene Baratz ( Accord Alliance) 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 Intersex Human Rights Australia (IHRA) is a voluntary organisation for intersex people that promotes the human rights and bodily autonomy of intersex people in Australia, and provides education and information services. Established in 2009 and i ...

regards the book as "approachable," "compelling and recommended reading".Katrina Karkazis, "Fixing Sex" (recommended reading)

, 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, 2010, and a finalist for the

Lambda Literary Award Lambda Literary Awards, also known as the "Lammys", are awarded yearly by Lambda Literary Foundation, Lambda Literary to recognize the crucial role LGBTQ+ writers play in shaping the world. The Lammys celebrate the very best in LGBTQ+ literatur ...

, 2009.

References

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External links

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