Back To the Main SiteBeyond Boxes Series: Medical Professionals and Making Men
Peter Hyndal presented at a Men’s Health Conference in Newcastle, last week. A “National Health Gathering” presented by the Australasian Men’s Health Forum. For the conference he wrote a paper named Beyond boxes: Sex and gender diversity and health service provision
We’ll be posting the contents of his presentation over the next few weeks, in tasty bite sized morsels, and the full presentation (with all its references intact) will be available to download at the end of the series.
First post: Introduction and Terms
Second Post: What does sex and gender diversity have to do with Men’s Health?
Todays post, is beyond the jump:
The involvement of the medical profession in “creating men”
The starting premise in talking about mens health is that men “pre-exist” their interaction with health services. But I really want to challenge this position – because in my view, the medical profession plays an active and critical role in “making men” and in maintaining the illusion of binary sexes.
In the first few minutes of each of our lives, a doctor physically examined our genitals and ticked a box on a form – decalring to the world that we were either male or female. Why? Who was the patient? The mother? The newly born child? And what health need was being met by performing the examination? The answer is that there was no medical purpose at all – the only purpose was a legal one. And the examination itself was not performed on behalf of the patient, but on behalf of the state.
Many intersex infants with visibly atypical genitals have been subjected to surgery to more clearly ‘align’ them to a male or female physicality. Often this has occurred soon after birth – without the individuals express consent – and where there is no health related reason to perform the surgery1. Here the medical profession actively perpetuates the myth that all people are unquestionably either male or female, in this case, by surgically removing those body parts that prove that there is variation in human biology.
Some, but by no means all trans people have medical interventions to align their physicality with their gender identity . This may include hormones, and/or surgery such as mastectomy or genital reconstruction. Health services are necessarily involved in these interventions where they occur, and again, the role of those health care providers is fraught. Medical professionals here play the role of ‘gatekeeper’ – determining who can have surgery, under what conditions, what kind of surgery, and when access to that surgery will be permitted.
Many people in Australia are unable to change their legal sex from that assigned at birth. But for those who are able to apply for such a change (whether on the grounds of an intersex condition, or on the grounds of transsexuality), the new legal sex will only be recognised upon producing ‘medical proof’. Here the medical profession plays the role of ‘gatekeeper’ not just to the medical services provided to sex and gender diverse individuals, but also as to what legal rights their patients will have recognised by the state.
With the medical profession concurrently filling so many conflicting roles, they simply are not currently in a position that allows good health care provision to sex and gender diverse individuals.
We need to move from a medicalisation of identity, and acknowledge people as who they are without requiring state sanctioned medical intervention to ‘normalise’ their bodies.
We also need to adopt nationally consistent Standards of Care based on an informed consent model to assist health services to provide appropriate levels of care to sex and gender diverse communities.
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The A Gender Agenda Blog » Beyond Boxes: Primary Health Care posted on October 15, 2009:
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