[Diagnosis or encounter : On the medical perception of gender, transgender and nonbinarity].

Abstract

This article reflects on the significance of medical perception in encounters with gender, trans identity and nonbinarity. Starting from the role of urology in the medical care of gender-diverse people, it shows that gender-affirming and gender-modifying treatments cannot be understood solely as somatic-medical or organ-focused interventions. They are part of complex developmental processes in which bodily well-being, gendered self-experience, social participation, sexuality, quality of life and other dimensions are closely intertwined. Gender is understood as a multidimensional self-experience that cannot be conclusively defined. Medical classifications may provide orientation, but they also carry the risk of reducing diversity to deviation or treatment need. The article juxtaposes different concepts of perception and shows that medical perception is never neutral, but is shaped by assumptions, affects, biographical experiences, cultural norms, and professional routines. This is particularly relevant in urology, where clinical practice involves intimate body regions that are highly sensitive in terms of gender and individually significant. Medical responsibility does not begin with intervention, but already in the way the patient is first encountered. In the article, the author argues for a culture of perception that pauses between first impression and clinical assessment, reflects on its interpretations and takes patients' gendered self-description seriously within a dialogical encounter.