Imperatives of Normality: From “Intersex” to “Disorders of Sex Development”

In May 2006 the U.S. and European endocrinological societies published a consensus statement announcing a significant change in nomenclature. No longer would nineteenth-century variations on the term hermaphrodite, or the more newly introduced term intersex, be used in a medical context to describe “congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical”; instead the preferred term henceforth would be disorders of sex development (DSDs). The announcement met with significant controversy, which I here examine in terms of the historical convergence of the treatment of homosexuality and intersex. The contemporary association of homosexuality with intersex risks obscuring genuine medical concerns unique to the treatment of intersex conditions and the consequences for affected individuals. At the same time, we must reckon with the ways that the complex and persistent identification of homosexuality with intersex has shaped the motivations both for the prevailing standard of care that has been so harmful and for the organized resistance to these practices in the intersex movement. Michel Foucault’s understanding of the power of “normalization” can help us make sense of the history of medicalization and its pernicious effects, but in addition can allow those with intersex conditions and their allies to understand the positive possibilities that the change from intersex to DSDs can bring.