Revisiting the Claims of Past Medical Innocence and Good Intentions

Medical professionals usually reject critiques of deferrable treatments that alter the sex characteristics of infants and children without personal informed consent on the grounds that intersex adults’ experiences reflect ‘obsolete’ practice. However, past practice is also protected from criticism by claiming ‘good intentions’, a commitment to the child’s best interest and context-dictated constraints on medical practice. I first examine foundational literature of the Optimal Gender Policy to verify the presence of statements of interests or motives, I then collect affect displays to identify motives, and I observe attitudes to clitoridectomy. Affect displays point to motives that are relevant in interpretive sociology, as they allow access to cultural or institutional dispositions when justification talk has not been provided. While a statement of interest is absent from the foundational literature, I identify the following affect displays: (1) unease and disgust; (2) attachment to heteronormativity, as well as three kinds of gratification or pleasure rewards; (3) power pleasure; (4) surgical pleasure; (5) and cosmetic pleasure. As surgical action appeases some of these affects and nourish others, previous medical professionals had interests that were their own and not centred on the children. Examination of attitudes to clitoridectomy reveals that clinicians were aware of the (phallo)clitoris’ importance to sexual pleasure but dismissed it, further invalidating claims that past practice was based on children’s best interest.