Biological Sex as a Political Issue: Analysis of the Health Care Protocol for Intersex Newborns in Ecuador

Abstract

This article explores how, from the consolidation of power and the exercise of domination by the State, a truth has been constructed (a relationship of power and knowledge) related to biological sex. This truth has been materialized in a situated manner within the bodies of intersex babies or those defined by medicine as "Disorders of Sexual Development" (DSD). In other words, it pertains to births that differ from the traditional categories of male and female. These bodies exhibit natural variations in biological sex, and are often referred to as "ambiguous sex (DSD)", and are usually subjected to irreversible surgical interventions aimed at "correcting" their variation to the notions of normalcy promoted by the medical-legal system, seeking to have them recognized as persons with social status and rights. The research is qualitative, based on a bibliographical review and specialized literature. Additionally, its analysis focuses on the "Protocol for the Care of People with Sexual Development Disorders," issued by the Ecuadorian Ministry of Public Health in 2017. This protocol presents various aspects, and its study adopts a situated and contextualized methodology, utilizing an intersectional approach and ethnography. The ethnographic work included collaborating with Axel, an intersex activist who participated in the development of the protocol.

Among the main findings, it is noted that, since 1950, medicine and law have articulated and consolidated the idea that certain bodies are "abnormal," which has led to medicalization and intervention in intersex babies. Another relevant finding is that the protocol is currently no longer in force, meaning that the births of intersex babies continue to be subjected to mutilating and irreversible interventions without an updated regulatory framework.