Introduction

While the past three chapters have explored the multifaceted framings of intersex within law and policy, this chapter returns to the realms of healthcare and unpicks the ways in which intersex has been embedded within psychology. We do so to consider the extent to which psychosocial frameworks could disrupt medical embodiment. The institutional location of psychology makes it well placed to instigate an internal rupturing of medical embodiment from within the discipline of healthcare itself and thus may offers greater opportunity for change in comparison to the legal frameworks addressed in Chapter 5. Moreover, psychosocial frameworks focus on both the psychological and social needs of individuals. Consequently, this framework has significant potential to shape individuals’ relationships and dynamic encounters with institutions beyond healthcare, grounded in practices of self-acceptance and destigmatization. While we acknowledge that psychology has a problematic history and raises the possibility of harm, this chapter argues that, if done correctly, this institutional framework has the potential at present to facilitate the reconceptualization of intersex embodiment away from the disorder narrative towards a thicker concept of intersex medical and legal embodiment. The Maltese response had hoped that law, specifically the GIGESC Act, would bring about this reconceptualization of intersex and made space for such psychosocial frameworks. However, as Chapter 5 demonstrated, this internal shift in healthcare provision must happen in tandem to legislative responses or else an implementation gap will follow. We consider what is demanded of healthcare provision (chiefly psychosocial care) to improve the medical and legal embodiment of intersex people and how far this has been achieved in practice.

This chapter begins by exploring the long-standing role psychology has played in terms of how intersex is understood and how this has been challenged in recent years. As discussed in Chapter 2, John Money was central in cementing the importance of psychology to intersex management in the 1950s. Accordingly, early psychological constructions of intersex continued the medical legacies set out in Chapter 2 that framed intersex embodiment in terms of a physiological ‘disorder’ in need of ‘fixing’. Money’s psychological practices were rooted in determining ‘true sex’ and its concomitant reliance on heterosexuality as an indicator of ‘success’. This influential conceptualization of intersex has dominated psychological approaches towards intersex.