Legal Issues About Sexual Differentiation Disease

Abstract

Sexual differentiation disease is the abnormal condition in development situation of sexual differentiation which is the basis of gender determination. This thesis reviewed for the person born with this disease to enable normal growth without emotional disorders and inferiority complex under the system of male or female choice. The points are summarized as follows. First, it is about the malpractice of medical operation for gender confirmation. Malpractice cannot be admitted because the medical operation for gender confirmation of the son was suitable medical level at that time. Second, it is about the relation with the guarantee of gender determination of the son. About this, all unnecessary surgical operations should be postponed until the time when the son becomes mature and decides for himself. In addition, the doctor has the obligation to provide all information to the person with parental rights when the doctor is going to perform the gender confirmation operation on the patient with sexual differentiation disease. Especially, if the gender confirmation operation is not an emergency, the doctor should explain to the person with parental rights, thus the person with parental rights should not be misunderstood as emergency situation and not to perform early gender confirmation operation. Furthermore, the doctor should explain the side effect that the newborn baby can lose fertility through the gender confirmation operation. That is an important matter about basic human right to body, so if these information were not provided, it is against informed consent. Even in case the patient with sexual differentiation disease can live as male or female either, the son should be able to decide his gender as best interest not facing identity problem when he grow up. Third, it is about the birth registration of the person with sexual differentiation disease. About this, like family registration practice in Japan, birth registration should be reported in an undetermined state for happiness of the son, and the irreversible treatment like genital organ removal should be prohibited until the son can decide for himself. In addition, it is appropriate for the son to decide his gender and complete family relation register subsequently after adolescence appearing second sexual characteristics through sexual differentiation of brain. Fourth, it is about the decision criteria of gender correction to sexual differentiation disease. Recently, as the decision criteria, not only sex chromosome as the sole absolute criteria but also cause of abnormality, condition of internal and external genital organs, composition of sex chromosome, surgical operation possibility of external genital organs and prediction of future sexual function should be considered, and simultaneously, it also should be considered which gender would secure for his happy life, and then the doctor shall select the gender to perform operational treatment.