Dr David Andrew Griffiths

The medical ‘management’ of individuals with atypical sex characteristics, or intersex variations, has been under scrutiny since the beginnings of intersex activism in the 1990s. This article explores a history of intersex surgeries in Britain and the interaction with medical and popular discourses around ‘sex-change’ between 1930 and 1955. A focus on this period in Britain helps to critically elaborate on debates in intersex scholarship; provides historical context for the introduction of approaches and protocols based on John Money and colleagues’ work in the USA in the mid-century; and analyses a long history of tension and intersection between trans and intersex experiences, treatments, politics and popular representations that continue into the present.

The 2006 ‘Consensus statement on management of intersex disorders’ recommended moving to a new classification of intersex variations, framed in terms of ‘disorders of sex development’ or DSD. Part of the rationale for this change was to move away from associations with gender, and to increase clarity by grounding the classification system in genetics. While the medical community has largely accepted the move, some individuals from intersex activist communities have condemned it. In addition, people both inside and outside the medical community have disagreed about what should be covered by the classification system, in particular whether sex chromosome variations and the related diagnoses of Turner and Klinefelter’s syndromes should be included. This article explores initial descriptions of Turner and Klinefelter’s syndromes and their subsequent inclusion in intersex classifications, which were increasingly grounded in scientific understandings of sex chromosomes that emerged in the 1950s. The article questions the current drive to stabilize and ‘sort out’ intersex classifications through a grounding in genetics. Alternative social and historical definitions of intersex – such as those proposed by the intersex activists – have the potential to do more justice to the lived experience of those affected by such classifications and their consequences.

There are currently debates inside and outside intersex communities about whether to include the I in LGBTQI+. Intersex has historically been critical in arguments about the boundaries between significant ontological and epistemological categories, particularly: female and male; homosexuality and heterosexuality; and sex, gender and sexuality. There is also a long history of conflation and confusion of categories of sex, gender and sexuality. It is clear that intersex is in some way inseparable from LGBT politics. This article will present the historical case study of Georgina Somerset, a British intersex woman, focusing on 1960-1970. Somerset's story illustrates both that intersex is different and separate from issues of gender and sexuality, and that intersex is always intimately connected to LGBT issues, whether historically or in contemporary politics. I identify four contemporary tensions that can be illuminated by this history of the entanglements and tensions of LGBT and I: the difficult boundary work between intersex and trans; the association of both intersex and trans with homosexuality; the issues of distraction and instrumentalization; and the affordances and limitations of identity politics. As the "I" was there all along, the politics of recognition might help us generate different discussions of LGBTQI+ politics and responsibilities.

This article charts the historical period from the 1950s to the 1990s, focusing on the role of Psychology in the lives of LGBTIQ people in Britain. Psychology has been, and is, central to the social, legal and medical understandings of biological sex and how best to understand diversity in gender and sexuality. Likewise, gay liberation and liberationist politics also had an effect on Psychology. For the 1950s-1960s, we outline how Psychologists influenced the Law in relation to the Wolfenden Report (1957) and how expertise was centrally located within the Psy disciplines. Following this, in the 1960s-1970s, activists began to challenge this expertise and became increasingly critical of pathologisation and of ‘treatments’ for homosexuality. They did not reject Psychology wholesale, however, and some groups engaged with queer affirmative psychologists who had similar liberatory aims. Finally, for the 1980s-1998 we highlight the establishment of the Lesbian and Gay Section of the British Psychological Society which signalled institutional recognition of lesbian and gay psychologists. This is explored against a backdrop of a specific British history of HIV/AIDS and Section 28. The past fifty years have been a battleground of categories in which LGBTIQ people were conflated, compared, and confused. We demonstrate that psychologists (not all of whom adopted a pathologising perspective) alongside politicians, lawyers, doctors, journalists and activists all played a role in the boundary-making practices of this period. Across this entangled history we demonstrate varied and significant shifts in the legitimacy of professional and personal expertise. Public Significance Statement: This article presents a British history of LGBTIQ Psychology from 1954-1998. Within a complex landscape of law, social change, medicine and activism, it recognises the influence Psychology has had on the lives of LGBTIQ people and vice versa. This history is important for contemporary Psychology as LGBTIQ issues continue to be contested in Britain and further afield.

What are ‘gay genes’ and are they real? This article looks at key research into these hypothesized gay genes, made possible, in part, by the Human Genome Project. I argue that the complexity of both genetics and human sexuality demands a truly critical approach: one that takes into account feminist epistemologies of science and queer approaches to the body, while putting into conversation resources from agential realism and critical realism. This approach is able to maintain the agential complexity of genetic materiality, while also critically challenging the seemingly stable relationships between sex, gender and sexuality.

Heteronormativity structures biomedical justifications for continuing surgical interventions on infants’ genitals that are cosmetic and medically unnecessary. It would seem, then, that queer theory is uniquely suited to challenge this continuing practice. This article takes up the question of what queer theory can do for intersex, with particular focus on queer temporality. I consider the example of “hypospadias repair,” a surgical intervention justified by invoking restrictive norms of what the penis should look like and be able to do at some point in the future. In contrast, intersex activists invoke post-medical futures, structured by norms of consent and bodily integrity. While queer approaches to temporality might challenge the notion of intervening surgically on an infant for the sake of the future adult the child will become, might this queer critique also disrupt the ability of activist individuals and organizations to invoke other narratives of the future, including ones where adults have not had irreversible surgeries as infants? I will ask whether queer theories of temporality and futurity can challenge medical practices that compromise consent and bodily integrity. Can queer theory question surgery as a queer moment and help us to conceptualize all bodily differences within a more expansive frame, without reinstating heteronormative narratives of futurity?

Sex has at least two different but related meanings: a biological property that bodies can seemingly ‘have’, and a set of bodily practices that one or more people can ‘have’. In the 1950s, the endocrinologist CN Armstrong stated that biomedical evidence of sex variance and the lack of a clear legal definition of sex highlighted a problem with the criminalisation of homosexual activity. It was not until the 1970s that a clear category of legal sex was enacted in law. In this paper we consider the Wolfenden Committee (1954-57) and the legal cases of Georgina Somerset and April Ashley (1969-70). As we demonstrate, despite the complexity revealed by biomedicine, the law has not struggled to enact binary categories, due to the normative force of binary and heteronormative social understandings of sex (in all its meanings). We conclude by reflecting upon the many queer ways that people have and do sex outside of the purview of legal or medical definitions.

Hypospadias is where the urethral meatus (or “pee-hole”) is not at the tip of the penis, but somewhere on the underside. It is thought that this affects between one in 200–300 infants assigned male. Surgery to “repair” this genital variation is standard, even though hypospadias often poses no medical threat at all, and in the face of testimony from adults about the negative physical and psychological consequences of these surgeries. This chapter examines historical and contemporary reasoning by British medical professionals for cosmetic surgical interventions on boys’ penises. A recurring reason (found in historical case studies and in interviews of contemporary clinicians) is the necessity of boys peeing standing up, next to their male school friends. Situating this within intersex scholarship and activism, this chapter explores the different ideas of what a penis “means” and is considered to be for, in medical accounts of hypospadias. Specifically, three ways of conceptualising the penis are discussed: “the performative penis”, where acts such as peeing standing up inscribe the individual as male into society; “the psychological penis”, where these acts are considered important to the formation of some essential male gender identity; and the “perfect penis”, where the surgical search for perfection and the production and maintenance of penis norms are conflated in medical discourse.

Intersex has been a topic of much discussion in courses on sex and gender in the academy. Much of this discourse has centred on the nature of intersex and how far it challenges the categories of sex and gender. As Emi Koyama and Lisa Weasel pointed out in 2002, this form of academic appropriation risks diverting attention from important social justice issues towards trivial or reductive theorising about social construction. Academic enquiries into the oppression of people with intersex variations may only sometimes be helpful in bringing hegemonic forces of body normativity, prejudice and sex/gender norms into question. Some scholarship on intersex has attempted to include the experiences of intersex people to a greater extent. This research has been empirical (for instance Kessler 1998; Preves 2003; Karkazis 2008; Davis 2015; 2015a; Monro, Crocetti and Yeadon-Lee 2019; Crocetti et al. 2020), autoethnographic or informed by personal experience (Holmes 2009; Morland 2009; Davis 2015; Rubin 2017; Carpenter 2018, 2020; Malatino 2019) and archival (Griffiths 2018; Dreger 1998). Rather than focusing on what intersex people are, this growing body of work has examined the challenges that intersex people face, which include systematic oppression, discrimination and human rights violations (Ghattas 2013; FRA 2015; Carpenter 2016; Crocetti et al. 2020). The emerging field of interdisciplinary intersex studies, therefore, can be characterised by the co-constitution of knowledge with the individuals and communities it seeks to study, as intersex activists (both academics and non-academics) are important authors in the field. This special issue of Culture, Health & Sexuality brings together some of this work and introduces interdisciplinary intersex studies to a wider audience. This editorial provides an overview of intersex issues, paying homage to the activists and academics who have forged the development of this field.