与欧洲卫生保健专业人员就Intersex特征划分必要和非必要干预措施的界限

IF 3.6 2区 心理学 Q1 PSYCHOLOGY, MULTIDISCIPLINARY
P. Hegarty, M. Prandelli, Tove Lundberg, L. Liao, S. Creighton, K. Roen
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引用次数: 20

摘要

关于双性人特征的人权声明将合法的“医学上必要的”干预措施与非法的正常化干预措施区分开来。具有讽刺意味的是,这种二元分类似乎部分基于解剖学和医学干预知识;人权声明所挑战的专业知识。在这里,来自专家“性发育障碍”(DSD)多学科团队的23名欧洲卫生专业人员将医疗干预定位在从“医学上必要”到非必要极点的连续范围内。他们解释了自己的答案。参与者大多描述了对阴茎/阴囊、阴蒂/阴唇、阴道和性腺解剖结构的干预,其基本特征仅部分基于解剖变异和诊断。为了解释什么是医学上必要的,医疗保健专业人员借鉴了对儿童发展、父母痛苦、集体反对医疗、患者“应对”能力和患者自己选择的外行理解。“医疗必要性”的概念建立在具有双性特征的患者作为身体和现象学主体的混合本体论基础上。基于人权的理由对医学专业知识提出挑战是有充分理由的,但前提是“医学上必要的”干预是一个有限度和有充分依据的类别,在讨论上是灵活的。心理学家长期以来对具有双性人特征的人的忽视,以及临床心理学家在DSD团队中的边缘化,可能有助于构建一些有争议的医学必要干预措施。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Drawing the Line Between Essential and Nonessential Interventions on Intersex Characteristics With European Health Care Professionals
Human rights statements on intersex characteristics distinguish legitimate “medically necessary” interventions from illegitimate normalizing ones. Ironically, this binary classification seems partially grounded in knowledge of anatomy and medical interventions; the very expertise that human rights statements challenge. Here, 23 European health professionals from specialist “disorder of sex development” (DSD) multidisciplinary teams located medical interventions on a continuum ranging from “medically essential” to nonessential poles. They explained their answers. Participants mostly described interventions on penile/scrotal, clitoral/labial, vaginal, and gonadal anatomy whose essential character was only partially grounded in anatomical variation and diagnoses. To explain what was medically necessary, health care professionals drew on lay understandings of child development, parental distress, collective opposition to medicalization, patients “coping” abilities, and patients’ own choices. Concepts of “medical necessity” were grounded in a hybrid ontology of patients with intersex traits as both physical bodies and as phenomenological subjects. Challenges to medical expertise on human rights grounds are well warranted but presume a bounded and well-grounded category of “medically necessary” intervention that is discursively flexible. Psychologists’ long-standing neglect of people with intersex characteristics, and the marginalization of clinical psychologists in DSD teams, may contribute to the construction of some controversial interventions as medically necessary.
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来源期刊
Review of General Psychology
Review of General Psychology PSYCHOLOGY, MULTIDISCIPLINARY-
CiteScore
7.60
自引率
4.80%
发文量
26
期刊介绍: Review of General Psychology seeks to publish innovative theoretical, conceptual, or methodological articles that cross-cut the traditional subdisciplines of psychology. The journal contains articles that advance theory, evaluate and integrate research literatures, provide a new historical analysis, or discuss new methodological developments in psychology as a whole. Review of General Psychology is especially interested in articles that bridge gaps between subdisciplines in psychology as well as related fields or that focus on topics that transcend traditional subdisciplinary boundaries.
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