The Epistemic Injustice Expressed in “Normalizing” Surgery on Children with Intersex Traits

Main Article Content

Renata Ziemińska


I present the notion of epistemic injustice coined by Miranda Fricker and apply it to the situation of people with intersex traits, especially intersex children who are the subjects of “normalizing” surgery. Several studies from Polish hospitals show that both early “normalizing” surgery and the decision to postpone such surgery can result in harm to an intersex child. For this reason, I claim that “normalizing” surgery is only an expression of the epistemic hermeneutical injustice existing before the surgery and that its source is the lack of an empirically adequate notion of sex characteristics. The binary notion is too simple to grasp intersex traits, and this epistemic dysfunction turns into practical harm. In contrast to Morgan Carpenter, I defend the nonbinary gender category as being important to limiting “normalizing” surgery.


Download data is not yet available.

Article Details

How to Cite
Ziemińska, Renata. 2020. “The Epistemic Injustice Expressed in ‘Normalizing’ Surgery on Children With Intersex Traits”. Diametros 17 (66):52-65.
Author Biography

Renata Ziemińska, University of Szczecin

Instytut Filozofii Uniwersytetu Szczecińskiego, profesor
Share |


Bajszczak K., Szarras-Czapnik M., Oszukowska E. et al. (2013), "Kliniczne i psychologiczne konsekwencje odroczenia gonadektomii oraz chirurgicznej korekcji obojnaczych zewnętrznych narządów płciowych do okresu dojrzałości u pacjentki z częściową niewrażliwością na androgeny,” Endokrynologia Pediatryczna/Pediatric Endocrinology 2 (43): 69–80.

Boczkowski K. (1966), “Franciszek Neugebauer (1856–1914): Pioneer in the Study of Hermaphroditism,” Polish Medical Science and History 9 (4): 155–157.

Brussels Collaboration (2019), “The Brussels Collaboration on Bodily Integrity. Medically Unnecessary Genital Cutting and the Rights of the Child: Moving Toward Consensus,” The American Journal of Bioethics 19 (10): 17–28.

Butler J. (2004), Undoing Gender, Routledge, New York and London.

Carmack A., Notini L., Earp B.D. (2016), “Should Surgery for Hypospadias be Performed Before an Age of Consent?,” Journal of Sex Research 53 (8): 1047–1058.

Carpenter M. (2018), “The ‘Normalisation’ of Intersex Bodies and ‘Othering’ of Intersex Identities,” [in:] The Legal Status of Intersex Persons, J. Scherpe, A. Dutta, T. Helms (eds.), Intersentia, Cambridge (UK): 445–514.

Chase Ch. (2002), “Affronting Reason,” [in:] GenderQueer. Voices from Beyond the Sexual Binary, J. Nestle, C. Howell, R. Wilchins (eds.), Alyson Books, Los Angeles/New York: 204–219.

Colapinto J. (2000), As Nature Made Him: The Boy Who Was Raised as a Girl, Harper Collins, New York.

Council of Europe (2017), “Document 14404. Report by Piet De Bruyn: Promoting the Human Rights of and Eliminating Discrimination Against Intersex People,” URL = [Accessed 4.11.2017].

Creighton S., Michala L., Mushtaq I. et al. (2014), “Childhood Surgery for Ambiguous Genitalia: Glimpses of Practice Changes or More of the Same?,” Psychology & Sexuality 5 (1): 34–43.

Davis G. (2015), Contesting Intersex. The Dubious Diagnosis, New York University Press, New York and London.

Diamond M., Sigmundson H.K. (1997), “Sex Reassignment at Birth: Long-Term Review and Clinical Implications,” Archives of Pediatric and Adolescent Medicine 151 (3): 298–304.

Diamond M. (2009), “Human Intersexuality: Difference or Disorder?,” Archives Sexual Behavior 38 (2): 172.

Darby R.J.L. (2013), “The Child’s Right to an Open Future: Is the Principle Applicable to Non-Therapeutic Circumcision?,” Journal of Medical Ethics 39 (7): 463–468.

Feder E. (2014), Making Sense of Intersex. Changing Ethical Perspectives in Biomedicine, Indiana University Press, Bloomington.

Earp B.D. (2019), “The Child’s Right to Bodily Integrity,” [in:] Ethics and the Contemporary World, D. Edmonds (ed.), Routledge, Abingdon and New York: 217–235.

Earp B.D., Steinfeld R. (2018), “Genital Autonomy and Sexual Well-Being,” Current Sexual Health Reports 10 (1): 7–17.

Fricker M. (2009), Epistemic Injustice. Power and the Ethics of Knowing, Oxford University Press, Oxford and New York.

Fricker M. (2017), “Evolving Concepts of Epistemic Injustice,” [in:] The Routledge Handbook of Epistemic Injustice, I.J. Kidd, J. Medina, G. Pohlhaus Jr (eds.), Routledge, New York: 53–60.

Furtado P.S., Moraes F., Lago R. et al. (2012), “Gender Dysphoria Associated with Disorders of Sex Development,” Nature Reviews Urology 9 (11): 620–627.

Gawlik A., Bielska-Brodziak A. (2016), “Dzieci bez płci. Jak polski prawodawca rozwiązuje problemy osób interseksualnych. Część pierwsza,” Prawo i Medycyna 63 (18): 5–28.

Ghattas D.Ch. (2015), “Standing up for the Human Rights of Intersex People – How Can You Help? Brussels: ILGA Europe,” URL = [Accessed 27.06.2019].

Harper C. (2007), Intersex, Berg, Oxford–New York.

Hughes I., Houk C., Ahmed S.F. et al. (2006), “Consensus Statement on Management of Intersex Disorders,” Archives of Disease in Childhood 91 (7): 554–563.

Johnson E.K., Rosoklija I., Finlayson C. et al. (2017), “Attitudes Towards “Disorders of Sex Development” Nomenclature Among Affected Individuals,” Journal of Pediatric Urology 13 (6): 608.e1–608.e8.

Karkazis K. (2008), Fixing Sex: Intersex, Medical Authority, and Lived Experience, Duke University Press, Durham.

Kolesinska Z., Ahmed S.F., Niedziela M. et al. (2014), “Changes Over Time in Sex Assignment for Disorders of Sex Development,” Pediatrics 134 (3): e710–e715.

Koertge N. (2004), “How Might We Put Gender Politics into Science?,” Philosophy of Science 71 (5): 868–879.

Kubicius K., Michałowska M. (2020), “Shaping the Body of a Child. Invasive Medical Procedures On Incompetent Patients – Some Ethical and Medical Remarks on Ashley’s Case,” Analiza i Egzystencja 49: 5–29.

Lee P.A., Nordenström A., Houk Ch.P. et al. (2016), “Global Disorders of Sex Development Update Since 2006: Perceptions, Approach and Care,” Hormone Research in Paediatrics 85: 158–180.

Mak G. (2012), Doubting Sex. Inscriptions, Bodies and Selves in Nineteenth-Century Hermaphrodite Case Histories, Manchester University Press, Manchester and New York.

Monro S., Crocetti D., Yeadon-Lee T. et al. (2017), Intersex, Variations of Sex Characteristics, and DSD: The Need for Change, Research Report, University of Huddersfield, UK, URL = [Accessed 16.11.2017].

Patino M.J.M. (2005), “Personal Account. A Women Tried and Tested,” Lancet 366: 538.

Petriczko E., Marcinkiewicz K., Słowikowska-Hilczer J. et al. (2014) „Zespół częściowej niewrażliwości na androgeny – opis przypadku,” [Partial Androgen Insensitivity Syndrome – Case Report],” Endokrynologia Pediatryczna/Pediatric Endocrinology 1 (46): 61–67.

Pisarska-Krawczyk M., Jarząbek-Bielecka G., Mizgier M. et al. (2014), „Nietypowo ukształtowane narządy płciowe lub zaburzenia rozwoju płci. Aspekty medyczne i etyczne [Ambiguous Genitalia or Disorders of Sex Development. Medical and Ethical Aspects],” Current Gynecological Oncology 12 (4): 259–270.

Reis E. (2007), “Divergence or Disorder? The Politics of Naming Intersex,” Perspectives in Biology and Medicine 50 (4): 535–543.

Reis E. (2009), Bodies in Doubt. An American History of Intersex, The Johns Hopkins University Press, Baltimore.

Schweizer K., Brunner F., Handford Ch. et al. (2014), “Gender Experience and Satisfaction With Gender Allocation in Adults with Diverse Intersex Conditions (Divergences of Sex Development, DSD),” Psychology & Sexuality 5 (1): 56–82.

Szarras-Czapnik M., Lew-Starowicz Z., Zucker K. (2007), „A Psychosexual Follow-Up Study of Patients with Mixed or Partial Gonadal Dysgenesis,” Journal of Pediatric & Adolescent Gynecology 20: 333–338.

Viloria H. (2017), Born Both. An Intersex Life, Hachette Books, New York.

Zieminska R. (2018), Niebinarne i wielowarstwowe pojęcie płci, Wydawnictwo Naukowe PWN, Warszawa.

Zillén K., Garland J., Slokenberga S. (2017), The Rights of Children in Biomedicine: Challenges Posed by Scientifi c Advances and Uncertainties, The Committee on Bioethics of the Council of Europe, URL = [Accessed 2.06.2020].