Katrina Karkazis, Ph.D., MPH
Book
Fixing Sex: Intersex, Medical Authority, and Lived Experience, Durham, NC: Duke University Press (November 2008).
What happens when a baby is born with “ambiguous” genitalia or a combination of “male” and “female” body parts? Clinicians and parents in these situations are confronted with complicated questions such as whether a girl can have XY chromosomes, or whether some penises are “too small” for a male sex assignment. Since the 1950s, standard treatment has involved determining a sex for these infants and performing surgery to normalize the infant’s genitalia. Over the past decade intersex advocates have mounted unprecedented challenges to treatment, offering alternative perspectives about the meaning and appropriate medical response to intersexuality and driving the field of those who treat intersex conditions into a deep crisis. Katrina Karkazis offers a nuanced, compassionate picture of these charged issues in Fixing Sex, the first book to examine contemporary controversies over the medical management of intersexuality in the United States from the multiple perspectives of those most intimately involved.
Drawing extensively on interviews with adults with intersex conditions, parents, and physicians, Karkazis moves beyond the heated rhetoric to reveal the complex reality of how intersexuality is understood, treated, and experienced today. As she unravels the historical, technological, social, and political forces that have culminated in debates surrounding intersexuality, Karkazis exposes the contentious disagreements among theorists, physicians, intersex adults, activists, and parents—and all that those debates imply about gender and the changing landscape of intersex management. She argues that by viewing intersexuality exclusively through a narrow medical lens we avoid much more difficult questions. Do gender atypical bodies require treatment? Should physicians intervene to control the “sex” of the body? As this illuminating book reveals, debates over treatment for intersexuality force reassessment of the seemingly natural connections between gender, biology, and the body.
“The cultural rules of gender are complex, and they are never more tested than in the case of intersex. Fixing Sex is a huge addition to the field, encompassing as it does the views of clinicians, patients, parents, and others. The topic is intrinsically interesting, but Katrina Karkazis’s wonderful writing makes this a compelling story and a great read.”
—Abraham Verghese, M.D., author of The Tennis Partner and Senior Associate Chair for the Theory and Practice of Medicine, Stanford University
“With her fascinating field data, Katrina Karkazis exposes the contentious disagreements among theoreticians, physicians, intersex adults, and parents—and all that those debates imply about the changing landscape of gender and intersex management.”
—Suzanne J. Kessler, author of Lessons from the Intersexed
“I couldn’t put Fixing Sex down once I started it! Masterfully balancing all aspects of one of the most polarizing, contentious topics in medicine, this thoughtful book is destined to become the most recent authoritative treatise on intersex. Non-medical persons will find it easily digestible, yet it is a ‘must-read’ for every pediatrician and pediatric subspecialist caring for children with disorders of sex development.”
—Kenneth C. Copeland, M.D., Jonas Professor of Pediatrics, University of Oklahoma College of Medicine, and former President of the Lawson Wilkins Pediatric Endocrine Society
“This meticulous, sensitive, and brilliantly executed book will transform our knowledge of intersexuality, gender, and the ethnographic study of medical practice.”
—Gayle Rubin, Assistant Professor of Anthropology and Women’s Studies, University of Michigan
“This book is a velvet-gloved punch to the gut. Fixing Sex is astonishing, a tale told straight from the mouths of affected adults, parents, and physicians in tender and lyrical prose. It resonated deeply with my memories of motherhood in the disorders of sex development community. But the chapters devoted to clinicians made me weep. A physician myself, I remember my disbelief as the worlds of intersex and medicine collided in my own family. An extraordinary book for a wide audience, it is a huge step toward reconciliation and spiritual healing for its protagonists.”
—Arlene B. Baratz, M.D., family and medical consultant, Androgen Insensitivity Syndrome Support Group and Accord Alliance
Selected Publications
| 2010 | Karkazis, K., Tamar-Mattis, A., and A. Kon. “Surgery for Disorders of Sex Development: Implementing A Model for Shared Decision-Making,” Journal of Pediatric Endocrinology & Metabolism 23(8): 789-806. pdf |
| 2010 | Karkazis, K. and W. Rossi. “Children with Disorders of Sex Development: An Updated Approach to Optimize Care,” forthcoming Pediatrics in Review. |
| 2008 | Karkazis, K. and E. Feder. “Naming the Problem: Disorders and their Meanings,” The Lancet 372(9655): 2016-17. |
| 2008 | Grunwell, J., Illes, J., and K. Karkazis. “Advancing Neuroregenerative Medicine: A Call for Expanded Collaboration between Scientists and Ethicists,” Neuroethics. |
| 2008 | “What’s in a Name?: The Controversy over Disorders of Sex Development,” Hastings Center Report, 38(5): 33-36. |
| 2008 | Chalfin, M., Murphy, E., and K. Karkazis. “Women’s Neuroethics? Why Sex Matters for Neuroethics,” American Journal of Bioethics 8(1):1-2. |
| 2008 | Karkazis, K. “Disorders of Sex Development: Improving Care for Affected Persons and their Families,” American Journal of Psychiatry 165(2): 265-266. |
| 2006 | Karkazis, K. “Early Genital Surgery to Remain Controversial,” Pediatrics 118(2): 814-5. pdf |
| 2005 | Caron, L., Karkazis, K., Raffin, T., Swan, G., and B. Koenig. “Nicotine Addiction Through a Neurogenomic Prism: Ethics, Public Health, and Smoking,” Nicotine and Tobacco Research 7(2): 181-197. pdf |
| 1994 | Maine, D., Karkazis, K., and N. Bolan. “The Bad Old Days Are Still Here: Abortion Mortality in Developing Countries,” Journal of the American Medical Women's Association, 49(5): 137-142. pdf |
Popular Press and Media Interviews
Weil, Elizabeth. “What if It’s (Sort of) a Boy and (Sort of) a Girl?,” New York Times Magazine, September 24, 2006: 48-53. link
Karkazis, K. “Abstinence-Only Sex Education is Ethically Indefensible,” Open Forum, San Francisco Chronicle, January 12, 2006: Section B, p. 9. link
Karkazis, K. “A Thorny Issue.” Letter to the editor, New York Times, September 26, 2004, national edition: Section 9, p. 15. link
Navarro, Mireya. “When Gender Isn’t a Given,” New York Times, September 19, 2004, national edition: Section 9, p. 1+. link
Selected Talks
| 2010 | Care for Persons with Disorders of Sex Development: Ongoing Challenges,” Canadian Pediatric Endocrine Group Annual Meeting, Calgary, Canada, March 5, 2010. |
| 2010 | “Care for Persons with Disorders of Sex Development: Ongoing Challenges,” University of Texas, Southerwestern, February 10, 2010. |
| 2009 | “Ethics in the Hospital,” New Nursing Graduates, Stanford Hospitals and Clinics, December 8, 2009. |
| 2009 | “Rethinking Care for Persons with Disorders of Sex Development,” University of Pennsylvania, November 19, 2009. |
| 2009 | "Implementing a Shared Decision-Making Model for Decisions about Genital Surgery,” Third World Congress on Hypospadias and Disorders of Sex Development, Toronto, Canada, November 12-15, 2009. |
| 2009 | “Rethinking Care for Persons with Disorders of Sex Development,” UC San Francisco, October 8, 2009. |
| 2009 | Pediatric Grand Rounds, Hershey Medical Center, Pennsylvania State University, September 29, 2009. |
| 2009 | Pediatric Grand Rounds, UC Davis, September 18, 2009. |
| 2009 | Advanced Legal and Ethical Issues in Pediatrics, UC Davis, May 14, 2009. |
| 2009 | Women’s Herstory Month, Stanford University, April 30, 2009. |
| 2009 | UC San Francisco, March 10, 2009. |
| 2009 | Health Professions Speaker Series, San Francisco State University, March 4, 2009. |
| 2009 | Intersex, LGBT Forum, UC San Francisco, February 28, 2009. |
| 2009 | Writer’s Forum, Stanford University, February 19, 2009. |
| 2008 | “Disorders of Sex Development: A Comprehensive Approach” at American Society for Reproductive Medicine, San Francisco, November 8-9 2008. |
| 2008 | “Women's Neuroethics: Why Gender Matters for Neuroethics,” American Society for Bioethics and Humanities, Cleveland, October 23-26, 2008. |
| 2008 | “The Future of Food: Toward a Bioethics of Food,” American Society for Bioethics and Humanities, Cleveland, October 23-26, 2008. |
| 2008 | “Toward a New Standard of Care for Disorders of Sex Development,” National Conference in Child Health Psychology, Miami, Florida, April 10-12, 2008. |
| 2008 | “Nicotine Addiction: A ‘Disease of the Brain’?” (with Molly Dingel and Barbara Koenig), Midwest Sociological Society Annual Meeting, St. Louis, Missouri, March 27-30 2008. |
| 2007 | “Toward a New Standard of Care for Disorders of Sex Development,” C.S. Mott Children’s Hospital, University of Michigan, November 9, 2007. |
| 2007 | “Toward a New Standard of Care for Disorders of Sex Development,” Children’s Hospital of Orange County, October 17, 2007. |
| 2007 | “New Standard of Care for the Management of Disorders of Sex Development,” annual meeting of the Pediatric Endocrinology Nursing Society, Portland Oregon, April 20, 2007. |
| 2006 | Grand Rounds, Department of Genetic Counselors, Lucille Packard Children’s Hospital, December 1, 2006. |
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