Intersex and Healthcare: A Narrative Review of Social Sciences Perspectives

Davide Costa

Abstract


Intersex individuals—those whose physical sex characteristics do not align with conventional male or female categories—encounter considerable challenges within healthcare systems, which often medicalize their bodies through invasive treatments aimed at “normalizing” their traits. This narrative review synthesizes key contributions from medical sociology, medical anthropology, and gender studies to examine the social processes that define, regulate, and often marginalize intersex identities in clinical contexts. Drawing on theoretical frameworks such as medicalization, biopower, stigma theory, intersectionality, and structural violence, the paper situates intersex healthcare within broader systems of normativity and control. It critiques the historical and contemporary role of healthcare institutions in reinforcing binary understandings of sex and gender, often at the cost of individual autonomy and psychosocial well-being. Comparative analyses with transgender healthcare reveal both shared and divergent mechanisms of institutional gatekeeping, underscoring the need for a justice-oriented, intersectional approach to care. This work ultimately advocates for systemic change in both healthcare delivery and policy, informed by sociological insight and intersex-led activism, emphasizing dignity, self-determination, and epistemic inclusion.

Keywords


Intersex; Sociology; Anthropology; Biopower; Intersectionality; Gender Diversity

Full Text:

PDF

References


Aboim, S. (2016). Plural Masculinities: The Remaking of the Self in Private Life. Routledge.

Ansara, Y. G. (2023). Intersex-centred sex therapy and relationship counselling: Six commonly neglected concerns of intersex adults. In Erotically Queer. Taylor & Francis.

Arboleda, J. (2022). Decolonizing intersex politics: Activism, knowledge, and the postcolonial state. Global Studies Quarterly, 2(3), ksac031.

Beauchamp, T. L. (2021). Intersex and disability: Health equity and care injustice. Disability Studies Quarterly, 41(2).

Becker, H. S. (1963). Outsiders: Studies in the Sociology of Deviance. Free Press.

Benjamin, R. (2018). Race After Technology: Abolitionist Tools for the New Jim Code. Polity.

Blackless, M., Charuvastra, A., Derryck, A., Fausto‐Sterling, A., Lauzanne, K., & Lee, E. (2000). How sexually dimorphic are we? Review and synthesis. American Journal of Human Biology: The Official Journal of the Human Biology Association, 12(2), 151-166.

Blumer, H. (1969). Symbolic Interactionism: Perspective and Method. University of California Press.

Butler, J. (2004). Undoing gender. routledge.

Carpenter, M. (2016). The human rights of intersex people: Addressing harmful practices and rhetoric of change. Reproductive Health Matters, 24(47), 74–84.

Carpenter, M. (2018). The “normalization” of intersex bodies and the “ideal” heterosexuality. Journal of Bioethical Inquiry, 15(4), 487–495.

Carpenter, M. (2018). The human rights of intersex people: Addressing harmful practices and rhetoric of change. Reproductive Health Matters, 26(52), 56–64.

Carpenter, M., & Cabral, M. (2020). Intersex human rights: Clinical and legal advocacy. Health and Human Rights Journal, 22(2), 189–200.

Chase, C. (1998). Hermaphrodites with attitude: Mapping the emergence of intersex political activism. GLQ: A Journal of Lesbian and Gay Studies, 4(2), 189–211.

Christou, A. (2025). Contested Cultural Heritage (Un) Be/Longings: Sensual, Embodied, and Gendered Stories of Trauma and Healing. Heritage (2571-9408), 8(3).

Conrad, P. (2007). The Medicalization of Society. Johns Hopkins University Press.

Costa, D. (2022). Gender Affirming Pathways in Italy between Law, Health Issues, and Social Considerations. Science and Philosophy, 10(2), 125–136.

Costa, D. (2022). The Influence of Social Capital on Health Issues among Transgender and Gender Diverse People. Science and Philosophy, 10(2), 113–124.

Costa, D. (2023). Transgender Health between Barriers: A Scoping Review and Integrated Strategies. Societies, 13(5), 125. https://doi.org/10.3390/soc13050125

Costa, D. (2024). New models on TGD Health and Barriers to health: exploring the point of view of sociology of health and illness. In TRASFORMAZIONI E INTERSEZIONI NELLA SOCIETÀ CONTEMPORANEA VOL. 2 (Vol. 2, pp. 237-260). IPS EDIZIONI.

Costa, D., & Peluso, A. (2024). How much do health professionals know about health of TGD people? An Italian cross-sectional study. AG About Gender-International Journal of Gender Studies, 13(25).

Costa, D., & Rotundo, A. (2024). The Experience of Transgender People in the Italian Healthcare Context: A Qualitative Study. AG About Gender-International Journal of Gender Studies, 13(26).

Crenshaw, K. (1991). Mapping the margins: Intersectionality, identity politics, and violence against women of color. Stanford Law Review, 43(6), 1241–1299.

Crenshaw, K. (1991). Race, gender, and sexual harassment. s. Cal. l. Rev., 65, 1467.

Darwin, H. (2017). Doing gender beyond the binary: A virtual ethnography. Symbolic Interaction, 40(3), 317-334.

Davis, G. (2015). Contesting Intersex: The Dubious Diagnosis. NYU Press.

Dreger, A. D. (1998). A history of intersexuality: From the age of gonads to the age of consent. The Journal of Clinical Ethics, 9(4), 345-355.

Driskill, Q. L. (2010). Doubleweaving two-spirit critiques: Building alliances between native and queer studies. GLQ: A Journal of Lesbian and Gay Studies, 16(1-2), 69-92.

Driskill, Q. L., Finley, C., Gilley, B. J., & Morgensen, S. L. (Eds.). (2011). Queer Indigenous Studies: Critical Interventions in Theory, Politics, and Literature. University of Arizona Press.

Erikson, K. (1991). Notes on trauma and community. American Imago, 48(4), 455-472.

Erikson, K. (1994). A New Species of Trouble: The Human Experience of Modern Disasters. Norton.

Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–325.

Farmer, P., Nizeye, B., Stulac, S., & Keshavjee, S. (2016). Structural violence and clinical medicine. Understanding and applying medical anthropology, 336-343.

Foucault, M. (1977). Discipline and Punish: The Birth of the Prison. Pantheon Books.

Foucault, M. (1978). The History of Sexuality, Volume I. Vintage Books.

Frader, J., Alderson, P., Asch, A., Aspinall, C., Davis, D., Dreger, A., ... & Parens, E. (2004). Health care professionals and intersex conditions. Archives of pediatrics & adolescent medicine, 158(5), 426-428.

Frank, A. W. (1995). The Wounded Storyteller: Body, Illness, and Ethics. University of Chicago Press.

Fricker, M. (2007). Epistemic Injustice: Power and the Ethics of Knowing. Oxford University Press.

Garland, F., & Travis, M. (2022). Intersex, law, and redress: Toward transformative justice. Feminist Legal Studies, 30(1), 77–99.

Gillam, L., Hewitt, J., & Warne, G. (2010). Ethical principles for the management of infants with disorders of sex development. Hormone Research in Paediatrics, 74(6), 412–418.

Goffman, E. (1963). Stigma: Notes on the Management of Spoiled Identity. Prentice-Hall.

Hart, B., & Shakespeare-Finch, J. (2022). Intersex lived experience: trauma and posttraumatic growth in narratives. Psychology & Sexuality, 13(4), 912-930.

Illich, I. (1976). Limits to Medicine: Medical Nemesis, the Expropriation of Health. Marion Boyars.

Johnson, P. (2019). The legal status of intersex persons in international human rights law. Human Rights Law Review, 19(4), 617–639.

Jones, T. (2016). Intersex studies: A systematic review of international health literature. SAGE Open, 6(2).

Jones, T., Hart, B., & Carpenter, M. (2016). Intersex: Stories and Statistics from Australia. Open Book Publishers.

Karkazis, K. (2008). Fixing Sex: Intersex, Medical Authority, and Lived Experience. Duke University Press.

Link, B. G., & Phelan, J. (1995). Social conditions as fundamental causes of disease. Journal of Health and Social Behavior, 35, 80–94.

Loutzenheiser, L. W. (2022). Queer Theory and Social Justice Pedagogies. Social Justice Pedagogy Across the Curriculum: The Practice of Freedom.

Makahamadze, T. (2021). Intersex bodies and African spirituality: Reclaiming ancestral identity in Zimbabwean intersex narratives. Religion and Gender, 11(2), 175–195.

Martin, E. (1996). Egg and sperm: A scientific fairy tale. Gender and Scientific Authority. Ed. Barbara Laslett. Chicago: University of Chicago P, 324-339.

Mead, M. (1928). Coming of Age in Samoa. William Morrow.

Merton, R. K. (1936). The unanticipated consequences of purposive social action. American Sociological Review, 1(6), 894–904.

Meyer, J. W. (1987). Implications of an institutional view of education for the study of educational effects. In The social organization of schools: New conceptualizations of the learning process (pp. 157-175). Boston, MA: Springer US.

Meyer, J. W., & Rowan, B. (1977). Institutionalized organizations: Formal structure as myth and ceremony. American Journal of Sociology, 83(2), 340–363.

Monro, S. (2025). Introduction to Variations of Sex Characteristics, Intersex, and DSD. In Intersex, Variations of Sex Characteristics, DSD (pp. 1-25). Routledge.

Monro, S., & Berry, A. (2024). Towards a sociology of intersex. In Research Handbook on the Sociology of Gender (pp. 76-87). Edward Elgar Publishing.

Monro, S., Crocetti, D., Yeadon-Lee, T., Garland, F., & Travis, M. (2021). Intersex living: Experiences of older intersex people in the UK. Journal of Aging Studies, 58, 100958.

Morris, R. C. (1995). All made up: Performance theory and the new anthropology of sex and gender. Annual review of anthropology, 24(1), 567-592.

Ortner, S. B. (1996). Making Gender: The Politics and Erotics of Culture. Beacon Press.

Parsons, T. (1951). The Social System. Free Press.

Plummer, K. (1990). Herbert Blumer and the life history tradition. Symbolic Interaction, 13(2), 125-144.

Puar, J. K. (2011). "I would rather be a cyborg than a goddess": Becoming-intersex in development discourse. The Transgender Studies Reader 2, 701–720.

Riessman, C. K. (2008). Narrative Methods for the Human Sciences. Sage.

Roberts, D. (1997). Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. Vintage Books.

Roen, K. (2019). Intersex or diverse sex development: Critical review of psychosocial health care research and indications for practice. The Journal of Sex Research, 56(4-5), 511-528.

Schmidt, J. (2001). Redefining fa'afafine: Western discourses and the construction of transgenderism in Samoa. Intersections: Gender, History and Culture in the Asian Context, 6.

Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal. American Psychologist, 69(6), 575–587.

Smith, C. P., & Freyd, J. J. (2014). Institutional betrayal. American Psychologist, 69(6), 575.

Spade, D. (2015). Normal Life: Administrative Violence, Critical Trans Politics, and the Limits of Law. Duke University Press.

Tamale, S. (2011). African Sexualities: A Reader. Pambazuka Press.

Tuana, N. (2009). Viscous porosity: Witnessing Katrina. In A. Alaimo & S. Hekman (Eds.), Material Feminisms (pp. 188–213). Indiana University Press.

White, J., Sepúlveda, M. J., Patterson, C. J., National Academies of Sciences, Engineering, and Medicine, & Committee on Population. (2020). Coverage, Access, and Utilization of Evidence-Based Health Care. In Understanding the Well-Being of LGBTQI+ Populations. National Academies Press (US).

Wiesemann, C., Ude-Koeller, S., Sinnecker, G. H., & Thyen, U. (2010). Ethical principles and recommendations for the medical management of intersex children. European Journal of Pediatrics, 169(6), 671–679.

Yam, S. Y. S., & Fixmer-Oraiz, N. (2023). Against gender essentialism: reproductive justice doulas and gender inclusivity in pregnancy and birth discourse. Women's studies in communication, 46(1), 1-22.

Yam, S. Y. S., & Fixmer-Oraiz, N. (2025). Doing Gender Justice: Queering Reproduction, Kin, and Care. JHU Press.

Yogyakarta Principles (2007). Principles on the application of international human rights law in relation to sexual orientation and gender identity.




DOI: http://dx.doi.org/10.23756/sp.v13i1.1683

Refbacks

  • There are currently no refbacks.


Copyright (c) 2025 Davide Costa

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Science & Philosophy - Journal of Epistemology, Science and Philosophy. ISSN 2282-7757; eISSN  2282-7765.