title: Negotiating intersex: A case for revising the theory of social diagnosis.
abstract: The theory of social diagnosis recognizes two principles: 1) extra-medical social structures frame diagnosis; and 2) myriad social actors, in addition to clinicians, contribute to diagnostic labels and processes. The relationship between social diagnosis and (de)medicalization remains undertheorized, however, because social diagnosis does not account for how social actors can also resist the pathologization of symptoms and conditions-sometimes at the same time as they clamor for medical recognition-thereby shaping societal definitions of disease in different, but no less important, ways. In this article, we expand the social diagnosis framework by adding a third principle, specifically that 3) social actors engage with social structures to both contribute to, and resist, the framing of a condition as pathological (i.e. medicalization and demedicalization). This revised social diagnosis framework allows for the systematic investigation of multi-directional, dynamic processes, formalizing the link between diagnosis and (de)medicalization. It also responds to long-standing calls for more contextualized research in (de)medicalization studies by offering a framework that explicitly accounts for the social contexts in which (de)medicalizing processes operate. To showcase the utility of this revised framework, we use it to guide our analyses of a highly negotiated diagnosis: intersex.
authors.affiliation: Department of Sociology, University of Chicago, 1126 East 59th Street, Chicago, IL 60637, USA. Electronic address: tmjenkins@uchicago.edu.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Jenkins
authors.affiliation: Department of Sociology, Brown University, Box 1916, Maxcy Hall, 112 George Street, Providence, RI 02912, USA. Electronic address: susan_short@brown.edu.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Short
mesh_terms: D000328:Adult; D012734:Disorders of Sex Development / Q000145:classification*; D005260:Female; D006801:Humans; D008297:Male; D062528:Medicalization; D012933:Social Identification
keywords: Demedicalization; Diagnosis; Disorders of sex development; Intersex; Medicalization; Social determinants of health