Search Results (14)

The persistence of a binary biomedical framework in healthcare has become increasingly inadequate to address the realities of human diversity. Recent literature highlights how this dichotomous model reinforces inequities for transgender and intersex populations, sustaining barriers to access, stigmatisation, and poorer health outcomes. In this Perspective, I critically reflect on the limitations of the binary paradigm and draw on developments in science, clinical practice, education, and policy to propose a future-oriented approach to health equity. Emerging evidence underscores the complexity of sexual development as a spectrum and the urgent need to move from pathological frameworks toward affirming care based on rights. Key advances include the adoption of affirmative care models, reforms in medical curriculum, and the rise of inclusive research methodologies that capture gender diversity beyond binaries. However, structural barriers—such as rigid clinical protocols, outdated educational content, and insufficient policy alignment—continue to hinder meaningful change. This article advocates for systemic transformation in healthcare education, practice, and research. I outline strategic priorities for the field are the implementation of gender diversity in medical training, the implementation of rights-based clinical guidelines, and the design of inclusive methodologies that remove structural discrimination. These actions are essential to build a more precise, ethical and universally inclusive health system. Ultimately, ensuring sustainable and equitable outcomes requires bridging scientific innovation with human rights principles and focussing on the lived experiences of transgender and intersex individuals. Full article

The medical treatment of people with innate Variations of Sex Characteristics (VSC) and intersex individuals remains a contested ethical field, where personal narratives have emerged as strategic and epistemological tools. This article examines how such narratives challenge entrenched medical authority, resist pathologizing models of care, and shape evolving legal and ethical frameworks. Using a reflective, interpretive approach grounded in thematic analysis of publicly available cases, we trace narrative interventions across two domains: as medical evidence in clinical contexts and as testimony in policy and legal advocacy. Examples include public protest, contested collaborations with medical professionals, and participation in legislative debates. These accounts not only document the harms of non-consensual medical interventions but also reconfigure definitions of legitimate knowledge, positioning lived experience as counter-expertise. In doing so, they disrupt traditional hierarchies of authority and contribute to the co-production of alternative visions for intersex healthcare and rights. While narrative mobilization can catalyze significant institutional change, it also entails emotional and ethical burdens for those repeatedly called upon to share their experiences. We argue that storytelling is not merely an accessory to reform but a foundational mechanism for advancing medical ethics, influencing policy, and expanding human rights protections. Full article

Gender-independent, intersex, non-binary, and transgender (GIaNT) youth have puberty health and sex education needs that are different from cisgender youth. Unfortunately, this population has historically been excluded from curricula pertaining to these issues in schools throughout the U.S. and Canada. While sex education programs are limited for all youth, and navigating puberty can range from exciting to scary for all youth, GIaNT youth are particularly vulnerable to facing negative outcomes by being omitted from such curricula. Because they are not able to access adequate information in schools and in their family/friend networks, a majority of GIaNT youth turn to the internet to seek out resources for education on puberty health and sex education. To this end, our team is in the process of creating an online educational resource (OER) that is age-appropriate and affirming for GIaNT youth to be provided with resources that are personalized to users’ unique needs. This literature review discusses content suggestions for inclusion of comprehensive puberty health and sex education that caters to GIaNT youth and their unique needs. Full article

The pursuit of sustainable protein is underway. This debate is often framed as a choice between two competing agrifood futures: the “no cow” and “clean cow” perspectives. The former comes from alternative protein advocates, while the latter aims to support practices, discourses, and livelihoods associated with regenerative ranching. The findings presented reveal greater nuance than what this simplistic dichotomy suggests. This paper utilizes data collected from fifty-eight individuals in California and Colorado (USA). Participants in the sample were identified by their attendance at various events focused on sustainability in protein production and includes a subsample of regenerative farmers who self-identified as persons of color, disabled or differently abled, and/or part of the LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual) community. The sample features a range of viewpoints associated with regenerative livestock and non-livestock protein production. The data support arguments aligned with “clean cow” framings, as determined by the anticipated scope of sustainable protein transformations. However, the paper cautions against solely relying on this frame without further interrogating its contours. It particularly notes that the values of specific “clean cow” actors and networks mirror key aspects of “no cow” perspectives. These similarities are especially evident among upstream actors like investors, corporate interests, and government sponsors. For these individuals and networks, the “no” versus “clean” distinction—despite suggesting radically different agrifood futures—overshadows underlying shared concerns that align with core elements of the status quo. A case is also made for greater reflexivity and, thus, inclusivity as we think about who is included in these debates, as the data tell us that this shapes how we frame what is at stake. Full article

Hermeneutic phenomenology’s aim is to bring forth that which needs to be thought about. It is an invitation to think. To articulate thinking, one needs to listen in the corners and the shadows of the lived experience(s) of the phenomenon being investigated. The method simultaneously holds numerous perspectives and adopts an embodied approach to embracing experiential knowledge. This paper explores the power of hermeneutical phenomenology, as a methodological approach for understanding what it means to be intersex. Intersex people have bodies that are born different to typical male-female ones. Intersex is an umbrella term that includes more than thirty ways the human body may differ according to its sex characteristics (i.e., genitalia, hormones, chromosomes, sex organs). From interviews with intersex people, we confirm that employing a hermeneutic phenomenological approach did not just answer our research questions, but also became a powerful and empowering means through which some participants were effectively able to navigate, share and ‘own’ their personal story. Indeed, the method’s person-centred and ethical underpinnings permitted some to engage in the research in ways that became empowering and transformational. Full article

The Universal Periodic Review (UPR) assesses the human rights records of all 193 UN Member States against the benchmark of the Universal Declaration of Human Rights and its core human rights treaties. To date, more than 100,000 recommendations have been provided to states under review (SUR) from peer Member States. Less than 1% address the rights of intersex persons. Western countries issue most of these cases, followed by the Latin American and Caribbean countries. African and Asian countries formulate a negligible number. This asymmetric data might mistakenly support the assumption that Western countries care more about the rights of intersex persons than non-Western countries. However, the recent groundbreaking Resolution on the Promotion and Protection of the Rights of Intersex Persons in Africa calls upon its states’ parties to stop nonconsensual genital normalisation practices on intersex persons and considers these practices as mutilation. Intersex genital mutilation (IGM) stands as a profound human rights infringement experienced by intersex individuals, who undergo medical interventions often performed on their healthy bodies. The primary objective of such interventions is to enforce conformity to prevailing medical and sociocultural norms pertaining to binary genders. I argue that Member States formulating recommendations advocating for the ban on IGM should consider contextualised factors, especially with regards to “informed consent”. This approach aims to enhance the persuasiveness of recommendations and increase the likelihood of their acceptance by SUR. Through the analysis of twenty-nine IGM-related UPR recommendations, this article addresses the effectiveness of the UPR in discussing intersex rights and the ban on IGM, with a focus on Africa. Full article

Medical professionals usually reject critiques of deferrable treatments that alter the sex characteristics of infants and children without personal informed consent on the grounds that intersex adults’ experiences reflect ‘obsolete’ practice. However, past practice is also protected from criticism by claiming ‘good intentions’, a commitment to the child’s best interest and context-dictated constraints on medical practice. I first examine foundational literature of the Optimal Gender Policy to verify the presence of statements of interests or motives, I then collect affect displays to identify motives, and I observe attitudes to clitoridectomy. Affect displays point to motives that are relevant in interpretive sociology, as they allow access to cultural or institutional dispositions when justification talk has not been provided. While a statement of interest is absent from the foundational literature, I identify the following affect displays: (1) unease and disgust; (2) attachment to heteronormativity, as well as three kinds of gratification or pleasure rewards; (3) power pleasure; (4) surgical pleasure; (5) and cosmetic pleasure. As surgical action appeases some of these affects and nourish others, previous medical professionals had interests that were their own and not centred on the children. Examination of attitudes to clitoridectomy reveals that clinicians were aware of the (phallo)clitoris’ importance to sexual pleasure but dismissed it, further invalidating claims that past practice was based on children’s best interest. Full article

People with innate variations of sex characteristics (also known as intersex traits or disorders or differences of sex development) have any of a wide range of innate physical traits that differ from medical and social norms for female and male bodies. Responses to these physical differences create experiences and risks of stigmatisation, discrimination, violence, and harmful medical practices intended to promote social and familial integration and conformity with gender stereotypes. As is evident globally, the Australian policy response to the existence and needs of people with innate variations of sex characteristics has been largely incoherent, variously framing the population as having disordered sex development in need of “fixing”, and a third sex/gender identity group in need of recognition, with only recent engagement by intersex community-controlled civil society organisations. This paper presents an overview of the context and goals of the intersex human rights movement in Australia. Australian intersex community organisations have sought to apply human rights norms and develop new infrastructure to address key health and human rights issues, and necessitating new ways of resolving policy incoherence. Together with human rights, mental health, and public health institutions, they have called for significant changes to medical models of care and reform to research and classification systems. Intersex community organising and resourcing have made a tangible difference. The Australian Capital Territory is the first jurisdiction in the country to move ahead with reforms to clinical practice, including a legislative prohibition of certain practices without personal informed consent, oversight of clinical decision-making, and investment in psychosocial support. A national community-controlled psychosocial support service has also commenced. Full article

Previous research has indicated that intersex people face specific challenges in their sexual development, including uncertainties or confusion about their gender, a negative genital self-image, and hesitance to engage in romantic and sexual relationships. However, in-depth knowledge regarding a central period in this development, adolescence, is missing. In our qualitative study, we explore which factors influence the relational and sexual development of intersex youth and what elements contribute to positive development. We interviewed eighteen intersex persons aged 18–38. We identified three main themes: (1) intersex experiences, (2) the described sexual and relational life course, and (3) factors influencing a positive development. Our findings show that intersex youth face many obstacles in their relational and sexual development, many of which are related to healthcare. However, their life stories also illuminate how healthcare professionals, as well as parents, friends, partners, teachers, and others, can make a substantial difference in intersex lives by breaking normative, binary thinking on sex and gender. Full article

Purpose: Intersex is an umbrella term used to describe the diversity or differences in the characteristics of physical sexual development. Approximately 1.7% of the population are born intersex, and 1 in every 2000 babies at birth presents genital variation. Unfortunately, there is a lack of research on the health of intersex-identifying persons in Latin America. This study aimed to document experiences of discrimination and violence among self-identifying intersex individuals in Puerto Rico and to determine if there is a significant difference in the quality of life, psychological well-being, and social well-being between intersex-identifying and endosex individuals. Methods: This was a quantitative method pilot study with a cross-sectional approach and exploratory comparative group design. An online survey was used, where a total of 12 self-identifying intersex adult participants were recruited, and 126 endosex adult participants served as a comparative group. Results: The findings show that 83% of the participants reported experiences of discrimination and different types of violence due to their intersexuality. There was a significant difference between the intersex-identifying and endosex groups in psychological well-being, including in three of its dimensions (positives relations, autonomy, and environmental mastery). However, there were no significant differences between the groups in quality of life or social well-being. Conclusion: The findings of this study provide a preliminary understanding of the health disparities of intersex-identifying individuals in Puerto Rico and suggest the need for more profound research, especially the inclusion of other Caribbean and Hispanic countries. The findings also preliminarily imply the need for local and global interventions to reduce physical and mental health disparities and to improve health, quality of life, and well-being among intersex-identifying individuals. Full article

In recent years, there has been an increasing visibility of intersex people’s issues and experiences of human rights violations amongst international human rights institutions and monitoring bodies. At the United Nations, to date, there are more than 500 treaty bodies’ concluding observations taking notice of human rights abuses against intersex persons and calling member states to fulfil their human rights obligations. This paper follows the inclusion and visibility of intersex issues in the text of the United Nations treaty bodies’ concluding observations. I looked for explicit mentions of the word “intersex” in treaty bodies’ report documents and reviewed how the concluding observations and recommendations of these bodies resonate with demands coming from intersex activist groups. I found that the main issues included in the treaty bodies’ reports concern intersex genital surgeries (IGS), autonomy claims, and demands for redress and support mechanisms, and while these issues have gained visibility, there are also a number of demands by intersex activists that remain less visible, if not invisible altogether. This paper aims at providing evidence of the increasing visibility and awareness of human rights monitoring bodies have over intersex people’s rights. Full article

The healthcare needs of lesbian, gay, bisexual, trans*, queer, and intersex (LGBTQI+) persons are often overlooked, prompting national and international calls to include diversity-related competencies into medical students’ training. However, LGBTQI+-focused healthcare education targets remain elusive, as surveys reveal considerable variability across national student populations. To generate empirical data and vocalize recommendations for medical education, we conducted the first nationwide online survey among 670 German medical students from 33 universities. Overall, most respondents reported low confidence regarding their medical training preparing them for LGBTQI+ patients, stated that LGBTQI+ themes were not covered during training, and agreed that the inclusion of such themes is urgently needed. In addition, we found gender and LGBTQI+ community member status to be key variables. Men scored lower in knowledge than women, while community members scored higher than non-community members. Similarly, community members reported higher comfort levels. Non-community men showed the highest levels of prejudice and efficacy beliefs, while at the same time had the lowest scores in contacts and the perceived importance of LGBTQI+-related teaching. Keeping subgroup differences in mind, we recommend that educational training should include LGBTQI+ healthcare aspects and address self-efficacy beliefs in future medical professionals to overcome LGBTQI+ healthcare disparities. Full article

Intersex/differences of sex development (DSD) conditions are divergences among genitalia, gonads, and chromosome patterns. These variances have been present for millennia and socially defined according to the cultural system established. The aim of this study is to describe the perspectives of adult intersex/DSD people, their relatives, and intersex/DSD expert professionals in Spain. A descriptive qualitative study design was adopted. The study was carried out in several locations in Spain. Individual in-depth interviews were conducted and addressed to 12 participants (4 intersex/DSD people, 3 relatives, and 5 professional experts). A total of 4 spheres, 10 categories, and 26 subcategories were obtained. The number of verbatims obtained in each of the spheres described were intersex/DSD as a community (n = 54), health sphere approach (n = 77), law sphere approach (n = 12), and psychosocial approach (n = 73). Regarding intersex/DSD as a community sphere, there is a clear need of promoting education on sex and body diversity. With respect to the health sphere, it is mentioned the inadequacy of services and how this has a negative impact on the health of intersex/DSD people. Regarding the law sphere, it is highlighted the need of designing legislations at a national level which protect and defend the rights of intersex/DSD people. Regarding the psychosocial sphere, these people suffer from social isolation, secrecy, shame, self-identity questioning, and mental disorders that negatively impact their quality of life. Full article

Respect for different sexual options and orientations prevents the occurrence of hate crimes against lesbian, gay, bisexual, trans and intersex (LGTBI) persons for this reason. Our aim was to review the legislation that protects the rights of LGTBI people and to quantify the victimization rates of hate crimes based on sexual identity and orientation. A retrospective observational study was conducted across all regions of Spain from 2011–2021. The laws on LGTBI rights in each region were identified. Hate crime victimization data on sexual identity and orientation were collected in annual rates per 100,000 inhabitants, annual percentage change and average change during the study period to assess the trend. The regulatory development of laws against discrimination against LGTBI individuals is heterogeneous across regions. Overall, in Spain there is an upward trend in the number of hate crime victimizations motivated by sexual identity or orientation. The effectiveness of data collection, thanks to better training and awareness of police forces regarding hate crimes and the processes of data cleansing and consolidation contributes to a greater visibility of hate crimes against LGTBI people. Full article