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There has been increasing talk of intersex studies in the social sciences, in recent special issues devoted to the topic in Culture, Health and Sexuality, in Transgender Studies Quarterly and in Psychology of Sexualities Review, for example. Drawing on an earlier generation of scholarship and advocacy, intersex studies is engaged with an articulation of human rights and ethics. These rights are risked by ongoing routinized medical care that is described to those who experience it as patient-centred, performed by multidisciplinary teams (MDTs) and backed up by consensus statements. Sociology has had a stake in intersex studies and debates about the proper limits of medicalization since its inception in the late 1990s. While this statement could be made about any number of (de)medicalization controversies, intersex is special. Here, medical treatment has always been justified on the grounds that ‘society’ cannot tolerate intersex embodiment, often described as ‘variations in sex characteristics’ (VSC) in human rights documents, or ‘disorders’ or ‘differences of sex development’ (DSD) in medical classifications. Relatedly, intersex psychosocial subjects are often considered best off not knowing about, talking about or making social identities or movements out of their embodiment. As the form of embodiment here is about the development of sex characteristics, intersex studies also compel consideration of the relationships between bodies and society, and of those between public and private bodies. Four recent monographs on socio-legal studies, disability studies, clinical psychology and African studies show the diverse fields that intersex studies now touch. They call for sharper thinking about the forms of social construction being applied to natural variation in human sex characteristics, and the people who have them. Jointly these books illustrate how intersex is being put into dialogue with an increasing range of fields, demonstrating its wide-ranging, sociological relevance.

This article examines 1969 as an important moment in the development of British clinical and social understandings of sex and gender. Specifically, I focus on two key events: the publication of The Intersexual Disorders by Dewhurst and Gordon and the First International Symposium on Gender Identity in London. The Intersexual Disorders (1969) framed variations of sex characteristics as biological issues, but ones with necessarily negative social and psychological consequences, influenced by US clinical practices associated with John Money. The symposium was an attempt to frame gender identity as separate from biological sex, while at the same time consolidating clinical authority over issues of gender. While the book was supposed to focus on intersex and the biological, gender and trans issues haunt the content. While the symposium was supposed to focus on gender identity, there was an almost constant slippage to discussion of the biological, and of intersex variations. Both the publication and the symposium represent boundary work between concepts of sex, gender and sexuality, but also between the biological, the psychological and the social. This effected both British and international clinical and social approaches to sex, gender and sexuality, including the healthcare protocols for intersex and transgender individuals.

Aims: To ask UK women with diabetes whether they have discussed sexual health with healthcare professionals (HCPs) during diabetes care, and to explore communication barriers. Methods: An online questionnaire was developed, based on a published HCP communication survey, piloted by six women with diabetes. A total of 163 participants, recruited via social media and HCP network, completed Part 1 by selecting Likert or narrative response options, providing descriptive data. We report proportions with 95% confidence intervals (Wilson); percentages are calculated using the number responding to each item. Item-level missingness is retained as a non-analysed category, and the n is reported per question. No inferential comparisons were planned a priori. After Part 1 completion, participants could choose to finish, or to continue to Part 2 questions regarding vulval anatomy, function, and vocabulary (77 completed 2A: 80 completed 2B). Part 2 data was analysed thematically. Results: During diabetes care, a minority of participants, 44/163 (27%), said they had ever discussed sexual health, or had been advised how to access sexual health support, 28/163 (17%). If an HCP discussed sexual health, many women said they expected to feel surprised, 114/163 (70%), or pleased, 88/163 (54%). Some participants said they expected HCPs would find the topic inappropriate, 56/163 (36%), or annoying, 44/163 (27%). Some participants expressed HCP gender preference (75/163 [46%] female and 4/163 [3%] male) for such discussion. Part 2 findings revealed unmet sexual health literacy needs with potential to impact on communication with HCPs. Conclusions: Women reported infrequent communication about sexual health and diabetes during diabetes care. Findings highlight potential communication barriers for some participants including the following: unmet educational needs regarding diabetes and sexual health, lack of confidence about available support, fear of a negative HCP response, and preference for the gender of the HCP. Whereas in previous research, HCPs feared upsetting women by discussing sexual health, many participants said they expected to respond positively.

Intersex studies, although often framed as an 'emerging' field, has been rooted in activism and scholarly inquiry since at least the early 1990s. Much of this work has centred on documenting harm towards individuals with variations of sex characteristics, in what could be considered a damage-based approach. Recently, scholars and activists have begun to advocate for a shift towards intersex joy as an alternative framework. This article explores the suggested 'turn', arguing for a critical and cautious engagement with joy. While important, there is a risk that this might downplay or erase intersex accounts that complicate easy distinctions between harm and joy. We analyse historical and contemporary discourses on intersex happiness, often framed as reliant upon medical intervention. Happiness, we suggest, is always culturally and politically contingent, and is mobilised differently by parents, intersex adults, policymakers and clinicians, sometimes to justify interventions, other times to resist them. Recognising this complexity is not simply descriptive, it opens space for rethinking what counts as harm, care and flourishing, and for developing research, policies and activism attuned to both structural injustice and resistant forms of joy. We propose a flexible, desire-based approach to intersex studies that does more than document trauma or celebrate joy: it examines how both are shaped by power, how they risk being dichotomised and how scholars and stakeholders generate meaning, belonging and critique. This approach acknowledges intersex experiences as complex and contradictory, while remaining attentive to broader systems of power that structure their lives.

Aims To explore UK healthcare professionals' practice and attitudes towards asking women with diabetes about sexual health problems, including symptoms of female sexual dysfunction (FSD). Methods An online questionnaire to address the study aims was developed, piloted by ten healthcare professionals (HCPs) and completed by 111 eligible HCPs, recruited via professional networks and social media. Free text data were analysed and reported thematically. Two questions were analysed to test the hypothesis of differences between men's and women's responses. Results The majority of respondents did not ask women with diabetes about sexual problems. Multiple barriers to inquiry were reported, including inadequate training, time constraints, competing priorities, the perceived likelihood that questions will cause surprise or distress (especially for certain groups of women), the belief that sexual problems are to be expected as women age, and the belief that FSD is complex or untreatable, with unclear management pathways. Exploratory findings indicated significant differences in men and women's responses (men disagreed more strongly with prioritisation, and fewer reported routine inquiry about sexual problems in their usual practice). Conclusions HCPs reported not asking women with diabetes about sexual problems during routine care. They described multiple factors reinforcing the silence about sexual health, including inadequate education and perceived social risk for individual HCPs who deviate from the patterns of topics usually discussed in diabetes consultations.

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.