The Value of Thinking Intersex Otherwise

Across Intersex Matters David A. Rubin calls on a wide range of parties—including medical practitioners and feminist scholars, as well as human rights activists and everyday people—to upend their habitual modes of perception and “think intersex otherwise” to enact a range of valuable ethical and political goals. Acknowledging the term is contested, Rubin defines intersex in their introduction as “people born with anatomies that defy received understandings of the nature of sexual difference” (1). Thus, in contrast to the common medical tendency to view intersex as a biological abnormality fixable via surgical normalization, and departing from a widespread scholarly view of intersex as a peripheral issue only of concern to a small group of minorities, Rubin gives sustained attention to the ways “intersex lives, bodies, narratives, theories, and activisms materialize and become meaningful” (4). This alternative approach enables Rubin to productively revise a host of key concepts, including embodiment, racialized gender, sexuality, health, normality, and human rights. Rubin not only illustrates the central role played by the medicalization of intersex in the formation of the sex/gender distinction but also shows how thinking differently (i.e., genealogically, inter-sectionally, trans-nationally) about intersex can yield a valuable reworking of many of the core terms within Women, Gender, and Sexuality Studies (WGSS).In their first chapter, “‘An Unnamed Blank That Craved a Name’: A Genealogy of Intersex as Gender,” Rubin establishes the book's genealogical and theoretical framework by excavating an account of intersexuality's underappreciated role in the production of gender as a concept in Western biomedicine and feminism (16). Following Foucault, Rubin clarifies that genealogy opposes itself to history as a search for origins and instead focuses on “conditions of emergence and force relations that shape diverse and discontinuous embodied histories” (21). As an analysis of the will-to-knowledge, Rubin astutely notes that the method of genealogy is particularly valuable to oppositional fields such as WGSS as it makes intelligible the buried exclusions by which dominant historical formations constitute themselves.In this first chapter Rubin specifically traces how the psycho-endocrinologist John Money, via his biomedical research at Harvard in the 1950s, created the notion of “gender role” (masculine and feminine gender as distinct from sex and as something capable of being socially constructed) to deal with the unruly material heterogeneity of intersex bodies. Lingering over a paragraph from Money's “Lexical History and Constructionist Ideology of Gender,” Rubin keenly observes that, “The ‘unnamed blank that craved a name’ to which Money refers in this passage can be read as a displacement of the biological instability exposed by intersexuality. . . . Money used gender role to name and thereby semantically fill (or cover over) the void left by sex's lack of conceptual and referential unity” (33). Rubin shows, then, that decades prior to Judith Butler's radical reversal of the sex/gender distinction in Gender Trouble (1990), Money presumed (albeit for normalizing purposes) that socially constructed gender could organize sex. Thus, rather than continue to see intersex as overdetermined by the sex/gender differentiation, Rubin provocatively argues that we should reverse this view given that, historically speaking, intersexuality actually “preceded and inaugurated what we would today call the sex/gender distinction” (22).In a fascinating twist, Rubin subsequently points out that second-wave feminists such as British sociologist Ann Oakley drew directly on Money's sex/gender distinction and his idea of gender as a social construct in the 1970s to counter the patriarchal notion “anatomy is destiny.” In doing so, however, these early feminists failed to acknowledge the foundational exclusions of Money's notion of gender and often inadvertently reified the conservative idea that binary sex forms a preexisting, biological foundation for cultural expressions of gender. It is precisely this assumption that later feminists, such as Kessler, Fausto-Sterling, and Butler, will upend by demonstrating, in various ways, how the cultural view of sexual dimorphism as a natural ideal distorts our reading of the actual biological diversity of sex while simultaneously masking this move. Extending this insight, Rubin makes the powerful claim that it is therefore important to view gender as “a historically and geopolitically situated technology of subjectification and subjection whose intelligibility as a binary system is contingent not only on the erasure of the racializations of sexual dimorphism in Western science and culture but also on yet another erasure: of the medicalization of intersex, trans, and gender non-confirming subjects” (22).In their second chapter, “Intersex Trouble in Feminist Studies,” Rubin focuses directly on the past two decades of feminist and queer scholarship on intersex. Here Rubin argues that queer feminist methods of deconstruction, exemplified by Kessler, Fausto-Sterling, and Butler, should be valued for their ability to apprehend the uncertainties intersex bodies provoke, productively rethink sex/gender and nature/culture distinctions, and interrupt heteronormativity's equation of genitalia with sex and gender (16). However, in addition to praising these authors, Rubin shows how their scholarship can fetishize intersex alterity and entrench intersex exceptionalism in ways that mirror similar problems in some contemporary scholarship. As a result, Rubin encourages a more nuanced approach to Kessler, Fausto-Sterling, and Butler's work that can appreciate its poststructuralist tools while taking care to avoid replicating the all-too-common tendency toward intersex essentialism and fetishization.In chapter three, “‘Stigma and Trauma, Not Gender’: A Genealogy of US Intersex Activism,” Rubin traces a genealogy of the intersex movement in the United States and rethinks intersex critiques of WGSS, queer theory, and feminist scholarship. In particular, Rubin revisits the bold decision of US-based intersex scholars and activists such as Chase, Dreger, Herndon, Koyama, Rosario, and Karkazis to argue, contra queer feminist scholars and in line with the Intersex Society of North America (ISNA), that intersex is a matter of “stigma and trauma, not gender.” Analyzing this move, Rubin contends that in making this claim, intersex activists and scholars problematically erase the genealogical links to the medicalization of intersex and also figure the materiality of intersex experience as somehow divorced from gender regulation and other manifestations of biopower (17). Departing from these scholars, Rubin contends that, rather than dismiss feminist and queer theoretical tools, such work should be valued for its capacious interpretive resources, which enable us to situate the medicalization of intersex and activist responses in relation to biopolitics and geopolitics as well as recognize the limitations of neoliberal models of subjectivity and political reform for reimagining intersex.Rubin's fourth chapter, “Provincializing Intersex: Transnational Intersex Activism, Human Rights, and Body Politics,” extends and deepens the genealogy of intersex activism initiated in chapter three. In this section Rubin now explores how debates about intersex are “shaped, challenged, and interrupted by geopolitical power relationships, global activism, and transnational feminism” (17). To do so, Rubin examines two key events in the history of intersex activism: (1) ISNA's failed attempt to lobby for the inclusion of unnecessary intersex surgeries in the US Congress's 1997 federal ban on female genital mutilation (FGM) and (2) ISNA's influence on two 1999 decisions by the Constitutional Court of Colombia to revise the definition of informed consent and limit doctors' ability to perform normalizing surgeries (17). In their analyses of these events, Rubin pays special attention to how human-rights discourse, US imperialism, biopolitics, and neoliberalism shape the locational politics of intersex activist projects situated in specific national contexts. Importantly and provocatively, Rubin contends that the transnational regulation of sexed bodies occurs not only through the globalization of Western biomedical models of sex/gender normativity but also through the circulation of human-rights discourse and imposition of US neoliberal democratic frames of subjectivity. Here Rubin calls on human rights activists to revise their sense of intersex by reflecting on how a juridical frame, while often touted as inherently liberating, can, in fact, produce regulatory effects that enhance other repressive geopolitical and biopolitical measures. Rubin concludes this chapter by highlighting the admirable work of intersex activists and scholars in Colombia and other nations who have successfully contested “the US-centrism, unmarked whiteness, and imperialism of western/global northern intersex human rights campaigns” (18).The final chapter of Intersex Matters, “Intersectionality and Intersex in Transnational Times,” explores the historically nonexistent relationship between the feminist paradigm of intersectionality and the field of intersex studies. Here Rubin notes two unfortunate trends: intersectional scholarship often fails to address how intersex might reconfigure the grounding presuppositions of intersectionality as a theoretical framework, while intersex studies rarely account for the role of racialized gender, nation, and sexuality in the medical and social management of intersex in specific geopolitical locations (18). To address both gaps, Rubin considers how intersectional perspectives can help “expand, complexify, and refine” our sense of intersex while, at the same time, intersex might spark a “rethinking of the premises of intersectionality” (18). Working toward these two goals, Rubin conducts a discursive analysis of media representations and scholarly and activist accounts of South African professional runner Caster Semenya. Here Rubin shows the contestations over Semenya's story were as much about “racialized gender and sexuality, imperial history, and national context” as they were about intersex and the politics of sex and gender (18). For this reason, Rubin argues that Semenya's story was never entirely her own but rather became a vehicle for the appropriative agendas of Western and non-Western elites, which were both complicit in the silencing of subaltern speech.Rubin concludes their book with an important reflection appropriately titled “Thinking Intersex Otherwise: Disorders of Sex Development, Social Justice, and the Ethics of Uncertainty.” In this last section Rubin ruminates on the 2005 proposal by a coalition of Western-trained medical experts and activists to rename intersex conditions with the acronym DSD, for “disorders of sexual development.” While the medical community has largely embraced DSD terminology, some activists and scholars have raised concerns over its political and ethical implications. Rubin helpfully situates this debate within the context of (1) contemporary reterritorializations of empire, (2) processes of neoliberal restructuring, and (3) the retooling of biopolitical technologies of corporeal regulation (18). This enables Rubin to demonstrate how DSD nomenclature reinforces a “medico-scientific attempt to pin meanings and bodies down and to control and obscure the uncertainties about embodiment that intersex bodies expose” (18). To counter this process Rubin proposes an “ethics of uncertainty” as a vital tool for challenging the medicalization of people of atypical sex and for thinking intersex otherwise. Thus, even in this final chapter, we find Rubin not only identifying problematic pathways but also offering constructive resources for forging alternative, more ethical, routes. Importantly, following Derrida, ethics is linked here to making the world more hospitable for “people whose anatomies call intersexist, heteronormative, masculinist, transphobic, white supremacist, and ableist technologies of gender regulation into question” (151). Rubin emphasizes that enacting such ethics will require ongoing critical reevaluation of the politics of embodiment on both local and global levels as well as learning “to be open to the boundless, the incalculable, and the uncertain” (152). While some might dismiss such a proposal as merely an abstract, theoretical ideal, Rubin's impressive exemplification of such an ethics across the pages of their book proves otherwise and renders this text worthy of widespread engagement by scholars in trans*, intersex, women's, gender, and sexuality studies, and beyond

Epistemology · Human sexuality · Medicalization · Narrative · Normality · Political science · Politics · Sociology · Value (mathematics · Gender Studies · Law · Psychology · Race, Genetics, and Society · Reproductive Health and Technologies · Sexual Differentiation and Disorders · Social Psychology