Risk and danger on the rise: Representation of intersex variations of innate sex characteristics in biomedical research

The term intersex was increasingly used in biomedicine in the later twentieth century as a label for bodies with pathologized innate sex characteristics (here ‘intersex variations’).The term met its zenith in that domain circa 2006 but had earlier been appropriated by intersex activists, who demedicalized it and claimed it as a positive embodied difference. To this day, intersex activists continue to advocate against unnecessary and harmful medicalization of their bodies. Aware that language use influences how healthcare matters are understood, we here combine two approaches (Multidimensional analysis and Corpus-Assisted Discourse Analysis) to carry out a linguistic analysis of a collection – or corpus – of research articles on intersex variations, tracing how these are represented before and after the 2006 ‘Chicago consensus’ statement, comprising recommendations and revisions of medical practices, patient care, and nomenclature. Ensuring that the corpus matches the register of academic prose, our analysis shows that the post-2006 representation of intersex variations increasingly draws on danger, risk, and anxiety. This risk-related epistemology is imbued with ideological meanings, attaching negative and possibilistic – rather than probabilistic – traits to the notion of risk, in line with the current prevalence of risk management as a risk-reducing remedy in curative medicine. This has problematic implications, in that surgery may be deemed necessary however small the possibility of adverse health consequences, and alleged evidence about risk in health contexts may be instrumentalized to silence critique questioning the need for surgery to alter innate sex characteristics. This study underscores the critical need for close scrutiny of risk discourse in biomedical research, especially in sensitive areas like intersex variations.