The Islamic Perspectives of Gender-Related Issues in the Management of Patients With Disorders of Sex Development

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• 作者：Ani Amelia Zainuddin ; Zaleha Abdullah Mahdy
• 关键词：Disorders of sex development ; Islam ; Gender dysphoria ; Fatwa ; Congenital adrenal hyperplasia ; Androgen insensitivity syndrome
• 刊名：Archives of Sexual Behavior
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：46
• 期：2
• 页码：353-360
• 全文大小：414KB
• 刊物类别：Behavioral Science
• 刊物主题：Sexual Behavior; Public Health; Social Sciences, general;
• 出版者：Springer US
• ISSN：1573-2800
• 卷排序：46

文摘

In Islam, the person with somatic sex ambiguity due to a disorder of sex development (DSD), such as 46,XX congenital adrenal hyperplasia or 46,XY androgen insensitivity, is recognized as khunsa. Two types of khunsa are distinguished: wadhih (discernible) and musykil (intractable). A recent fatwa (religious edict) in Malaysia decreed that it is permissible for male-assigned patients from these two groups to have gender reassignment surgery to female following diagnosis; however, the religious authority has yet to rule on the reassignment from female to male, if requested. The different schools of law in Islam agree on some aspects of gender-related issues like the position of khunsa in prayer congregations, but differ in their opinions on others such as property inheritance and bathing rituals. For purposes of illustration, this article includes three case reports on Muslim patients with DSD in Malaysia, focusing on issues of gender assignment: (1) a patient with 46,XX CAH, assigned as female, requesting reassignment to male; (2) a patient with 46,XX CAH, assigned female, and gender dysphoric, but undecided on the gender to be; and (3) a patient with 46,XY complete gonadal dysgenesis, raised female due to her phenotype at birth, diagnosed late, at age 18 years, and content to remain female. Gender-related issues from the perspective of Islamic jurisprudence are highlighted and discussed. To ensure holistic care, health-service providers involved in the care of Muslim patients with DSDs need to be aware of the Islamic perspectives on gender-related issues and involve expert religious authorities.