Does Transnational Intersex Activism Trickle Down into the Clinic? Assessing the Presence and Use of Human Rights Discourse and Framing in DSD healthcare in the Netherlands

The medical management of people with differences/disorders of sex development (DSDs) has come under increased international scrutiny over the past two decades. Intersex activists, NGOs, and international human rights bodies have criticized states for continuing to allow non-consensual unnecessary medical interventions such as normalizing genital surgeries performed on babies. Still, most states medicalize intersex and deflect responsibility for human rights issues associated with non-consensual interventions. Responsibility for what is framed as a medical matter is placed in the hands of clinicians, who claim that their practices have changed and are still changing - even though evidence for this supposed shift is lacking. Focusing on a DSD-clinic in the Netherlands, this paper asks to what extent and in what ways healthcare practitioners respond to human rights discourse and incorporate human rights discussions into their work. Based on observational data from clinical multidisciplinary meetings and interviews with involved healthcare staff, I conclude that human rights framing is present in clinical practice. However, it is used in an unstructured and irregular fashion. Moreover, frames are used performatively to mask the lack of actual change. This article illuminates the limited extent to which intersex activism achieves its aim of transforming DSD healthcare practice. Keywords: DSD, intersex activism, healthcare practice, human rights