A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

When a child is born with ambiguousgenitalia it is declared a psychosocialemergency, and the policy first proposed byJohn Money andadapted by the American Academy of Pediatrics requires determination ofunderlying condition, selection of gender,surgical intervention, and a commitment by allparties to accept the ``real sex'' of thepatient, all no later than 18–24 months,preferably earlier. Ethicists have recentlyquestioned this protocol on several grounds:lack of medical necessity, violation ofinformed consent, uncertainty of standards ofsuccess, among others. This suggests that thefaults in the protocol can (...) be addressed andimproved. Through a rhetorical approachinformed by Perelman/Olbrechts-Tyteca, thedisciplinary pathologization and reconstructionof the body are explored as incidents ofconstraining rhetoric that enact theirpersuasion upon the body of intersexedchildren. This essay shows that thepresumptions, judgments, values, andpresuppositions brought by the physician to theidentification, diagnosis, and curativeprocedures create a network of constraints thatexclude alternative possibilities. The resultis a situation wherein parents, physicians, andintersexed patients have ``no choice'' but toaccept the medical treatment guidelines. (shrink)

Putting the ethical tools of philosophy to work, Ellen K. Feder seeks to clarify how we should understand "the problem" of intersex. Adults often report that medical interventions they underwent as children to "correct" atypical sex anatomies caused them physical and psychological harm. Proposing a philosophical framework for the treatment of children with intersex conditions—one that acknowledges the intertwined identities of parents, children, and their doctors—Feder presents a persuasive moral argument for collective responsibility to these children and their families.