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Many people born with diverse sex anatomies are subjected to interventions with the aim that they can perform sex in ways that meet gendered social expectations. The offer of genital surgery takes for granted that genital intercourse is the universal sexual norm. The consolidation of heterosexual binary gendered identity assisted by ‘normal’ sexual performance usually takes primary consideration. Rarely does the current and future capacity for erotic pleasure enter into treatment planning for affected children and adults. Any pain, anxiety or absence of pleasure in the surgical patient often emerges after the event. This sexist and heterosexist fundamentalism appears to sit on a blind spot in medicine. Heterosexual genital intercourse is a valid form of intimacy and sexual expression. Its centrality is however disempowering, not just for people diagnosed with intersex/dsd conditions but for all human beings. In reserving 'sex' for genital intercourse only, it marginalises and demotes non-genital sexual experiences.

Sex research with people with a medical diagnosis relating to their sex development has been underpinned by academic interest in the gendered brain. Because research interests and questions are pre-determined, often by a cognitive science or psychiatric framework we know very little about the joy, frustration, desire, fulfilment and disappointment, in other words, the ebb and flow of sexual experiences across the lifespan, as defined and expressed by the people being researched.


PSI International is also concerned about the effects of the imposition of a health care framework upon people’s lives, including repeat clinical examinations and medical photography in childhood. The impact on adult sexual experiences should be a primary focus for future sex research in this field.

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