Theory and Vulnerability

I teach philosophy and have researched the issue of intersex and the medical mismanagement of people born with intersex conditions. One of the struggles in examining ethical issues surrounding intersex in the context of philosophy has to do with whether I am actually attempting to help resolve ethical issues or simply using the topic of intersex to bolster my own research. Ellen K. Feder, who teaches philosophy at American University, touches on a related problem in her book Making Sense of Intersex: Changing Ethical Perspectives in Biomedicine. She writes that, although thinking about the mismanagement of intersex conditions demands theoretical thinking, she is not “working on a theoretical issue, but on the practices that [affect] people who [have] experienced violation of their bodies and senses of self.” Feder attempts to root her investigations of these ethical violations by conducting interviews with people born with intersex conditions, their family members, and physicians. She attempts to locate “the problem” of intersex not in the atypical genitalia of any person, but rather in a larger social demand for normal genital appearance. Feder attempts to shift us away from the value of autonomy in medical decisions and toward the value of vulnerability—one that focuses on interpersonal relations rather than simply the will of one person or family. While Feder might appear to dismiss certain theoretical gender approaches to problems surrounding intersex, she does lead me to reconsider how abstract theory can be made to better serve the lived conditions of people with intersex conditions. Even if I might not entirely agree with all of Feder’s approaches, she offers reflection on how it is that abstract theory can be used strategically, so that ethical philosophical theorists might reorient their discussions of intersex and other topics to help resolve social issues.

Abstract theorizing is probably not the best vehicle for immediate social change. However, many of us can agree that careful thinking about any social issue is necessary in resolving human rights issues. I have read the work of Suzanne Kessler, whom Feder cites a number of times. Feder focuses upon Kessler’s claim that we must accept “the category of gender as ‘always constructed.’” I tend to think that if such a claim became very common, people in general might relax their demands for normalization of genital appearance, since gender would be taken as something like a work of art rather than a static rule. Having invested much research in Kessler’s reasoning and arguments, I initially wanted to resist Feder’s conclusions regarding the notion of the social construction of gender. Feder goes on to state that such arguments regarding gender have not served to end the practice of medically and unnecessarily normalizing atypical genitals, but rather have only led to stronger demands for normalization. She does point out a number of times that one of the reasons parents have sought normalization of children with intersex conditions has been to “prevent” homosexuality, a reason that, for me, is ungrounded. For that reason, I do not think Feder outright rejects gender theorizing that requires us to think of gender in non-normative ways, but rather calls upon us to reevaluate our theorizing and arguments regarding the issue of intersex. She writes that the “task is not a matter of making a good argument against the standard of care (as philosophers might want), but may require instead that we consider more carefully why it is that what appear to be sound arguments against the standard of care [of people with intersex conditions] have failed.” It does seem a number of parents would be unreceptive to arguments regarding the social construction of gender. While I am unwilling to abandon those sorts of arguments, nevertheless, I should probably think about when and with whom such discussions are appropriate. If one attempts to persuade parents to delay medically unnecessary normalizing genital surgery for children with intersex conditions, one likely does not want to lead off with a highly abstract...