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The theory of social diagnosis recognizes two principles: 1 extra-medical social structures frame diagnosis; and 2 myriad social actors, in addition to clinicians, contribute to diagnostic labels and processes. The relationship between social diagnosis and de medicalization remains undertheorized, however, because social diagnosis does not account for how social actors can also resist the pathologization of symptoms and conditions—sometimes at the same time as they clamor for medical recognition—thereby shaping societal definitions of disease in different, but no less important, ways. In this article, we expand the social diagnosis framework by adding a third principle, specifically that 3 social actors engage with social structures to both contribute to, and resist, the framing of a condition as pathological i. This revised social diagnosis framework allows for the systematic investigation of multi-directional, dynamic processes, formalizing the link between diagnosis and de medicalization. It also responds to long-standing calls for more contextualized research in de medicalization studies by offering a framework that explicitly accounts for the social contexts in which de medicalizing processes operate. To showcase the utility of this revised framework, we use it to guide our analyses of a highly negotiated diagnosis: intersex.
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Thus, there are lots of ways one can be intersex. A person with 5-alpha-reductase deficiency is born looking female but develops more along the masculine pathway at puberty. But, like I said, there are lots of other ways to be intersex. Some people with intersex look typically female on the outside but have some internal male organs, or vice versa. Not all types are noticeable at birth.
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The truth, when it finally came, was both liberating and traumatizing: Bo discovered she had been born with atypical genitalia, which surgeons had operated on to make her look—arbitrarily—more typically female, inflicting irreversible harm on her in the process, and telling her parents that they should never reveal to Bo the surgery she had undergone as an infant. But after learning the truth from her medical records, and as she traveled the country telling her story, she found this was untrue. Her California mailbox began to fill with letters from people describing similar experiences.
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Home Archive July News Graphic: Cathleen Heard Results of two studies from the Johns Hopkins Children's Center challenge accepted medical practice of "sex reassignment"--surgically converting XY males with absent or minuscule penises into anatomical females, then raising them as girls. The investigations, which are the first to go beyond individual case reports, reveal outcomes that are remarkably consistent with rare instances of infants who lost their penises in accidents and who were reassigned as females. Both clinical trials and case reports powerfully argue for nature over nurture in establishing gender identity. The studies suggest that male gender identity is directly related to normal male patterns of hormone exposure in utero," he says. The investigations began in
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