Intersex Management in the United States and Non-Western Cultures

In Western nations, there is growing agreement about ethical approaches to clinical intersex management. At the same time, as Western-trained physicians increasingly encounter intersex patients in other parts of the world, new ethical tensions arise. Which cultural values are fair parameters for gender-assignment decision-making, particularly in cultural milieus where there is social and economic inequality between the sexes? How can physicians uphold universal bioethical principles while remaining  culturally sensitive? Physicians have a primary commit- ment to patient beneficence and universal human rights, requiring physicians to promote concordance between the child’s assigned gender and his or her likely future gender identity. Ultimately, the potential patient distress posed by gender dysphoria fundamentally outweighs the influence of local cultural factors such as economics, gender politics, and homophobia.