Sex,gender, and intersex: anthropological,medical, and ethical critiques and proposals

ABSTRACT

The problems of intersex have received little attention from both Catholic Magisterium and theologians. Early in 2019, the Vatican Congregation for Catholic Education issued a document intended to be a pathway for a dialogue on the issue of gender in education. This essay responds to that document as a contribution to filling theological gaps in the consideration of intersex. It first explains and critiques the theological anthropology underlying the Vatican document and then analyzes and critiques Western cultural, medical approaches to intersex persons. It dialogues with the experience of intersex persons and the social sciences that document it and concludes by proposing ethical principles to guide intersex persons, their parents, and their physicians in the care and treatment of intersex.     

When There Is Not Enough to Go Around: How Black People’s Perceptions of Competition for Black Mates Affects Forced Black Identity Ascriptions of Black/White Multiracial People

Using a resource scarcity framework, the current study investigated whether Black people’s perceptions of competition for Black mates related to ascribing a Black identity onto Black/White Multiracial people. Participants took online questionnaires that assessed competition for Black mates, likelihood of forcing a Black identity onto a self-identified Black/White Multiracial person, essentialism, and contact with Multiracial people. Results indicated that increased perceptions of competition for Black mates was related to increased forced Black identity onto self-identified Black/White Multiracial people, above and beyond levels of essentialism and contact. This relationship was stronger for sexual minorities. The current research supports the proposition that scarcity of resources (i.e., mates) affects ideologies regarding Black/White Multiracial people’s identities.     

Peaceful waters: Community action in sustainable scarce resource management in a rural Zimbabwean setting

I explored community collation approaches to sustainable water management by a rural Zimbabwean community for social justice and equity with inclusivity. Informants were a convenience sample of 27 community dwellers; including villagers (n = 20), community leaders (n = 2), and policy makers (n = 5). They responded to semi-structured interviews regarding their engagement in community action for sustainable water resource management. Thematic analysis of the data yielded themes to suggest diversity in stakeholder interest, the importance of collective community participation, and attending to group cohesion processes. Regular community dwellers appeared to value local oversight and control of the water resource management; while policy makers were more invested in water resource management institution building than the mundane water resource management issues. Sustainable water resource management in rural settings is likely with identifying and bridging any gaps between local user interests and institutional policy interests.     

How Payment for Research Participation Can Be Coercive

The idea that payment for research participation can be coercive appears widespread among research ethics committee members, researchers, and regulatory bodies. Yet analysis of the concept of coercion by philosophers and bioethicists has mostly concluded that payment does not coerce, because coercion necessarily involves threats, not offers. In this article we aim to resolve this disagreement by distinguishing between two distinct but overlapping concepts of coercion. Consent-undermining coercion marks out certain actions as impermissible and certain agreements as unenforceable. By contrast, coercion as subjection indicates a way in which someone’s interests can be partially set back in virtue of being subject to another’s foreign will. While offers of payment do not normally constitute consent-undermining coercion, they do sometimes constitute coercion as subjection. We offer an analysis of coercion as subjection and propose three possible practical responses to worries about the coerciveness of payment.     

Utilizing Staff Incentives to Increase School-Wide Praise

The authors evaluated whether an incentive raffle increased teachers' use of written praise and appropriate student behavior. Participants included 93 staff members and 755 students at an elementary school in Central Illinois. School staff received didactic instruction for the importance of using praise, and praise notes were measured on a weekly basis by praise type, staff member type, and student type. Results indicated that the faculty incentive produced medium effects for praise for students, but did not impact the number of office discipline referrals. Staff members reported praise notes to be an acceptable school-wide system for managing student behavior, but had mixed feelings regarding faculty receiving incentives for writing praise notes. Implications as well as future research are discussed.     

Transgender Children and the Right to Transition: Medical Ethics When Parents Mean Well but Cause Harm

In this article, I argue that (1) transgender adolescents should have the legal right to access puberty-blocking treatment (PBT) without parental approval, and (2) the state has a role to play in publicizing information about gender dysphoria. Not only are transgender children harmed psychologically and physically via lack of access to PBT, but PBT is the established standard of care. Given that we generally think that parental authority should not go so far as to (1) severally and permanently harm a child and (2) prevent a child from access to standard physical care, then it follows that parental authority should not encompass denying gender-dysphoric children access to PBT. Moreover, transgender children without supportive parents cannot be helped without access to health care clinics and counseling to facilitate the transition. Hence there is an additional duty of the state to help facilitate sharing this information with vulnerable teens.     

Personal values and immigrant group appraisal as predictors of voluntary contact with immigrants among majority students in Israel

What predicts whether young people will establish contacts with immigrants? Students are at a pivotal point in which the campus environment can enable substantial contact with immigrants, and where world views and behavioural patterns are formed which can follow through their adult lives. Through a value‐attitude‐behavior paradigm we examine a conceptual model in which appraisal of an immigrant group as a threat and/or benefit to the host society mediates the relationship between personal values and contact. Findings among 252 students in Israel showed that (1) threat/benefit appraisal of immigrants predicted voluntary contact; (2) personal values of self‐direction and hedonism directly predicted voluntary contact; and (3) Threat/benefit appraisal mediated the relationship between self‐direction and power and contact. Results suggest that increasing awareness of benefits of immigrants can promote positive inter‐group relations.     

Can Cognitive‐Behavioral Therapy Be Optimized With Parent Psychoeducation? A Randomized Effectiveness Trial of Adolescents With Major Depression in Puerto Rico

This is a longitudinal randomized control trial on the impact of adding a parent psychoeducation intervention (TEPSI) as part of cognitive‐behavioral therapy (CBT) for adolescents with Major Depressive Disorder (MDD) in a Puerto Rican sample. We tested the efficacy of adding 8 group sessions of TEPSI to 12 sessions of individual CBT on reducing depressive symptoms, MDD diagnosis, and improving family functioning. Participants (n = 121) were randomized to individual CBT with or without TEPSI. No main group effects were found for most patient domains including depression symptoms, as well as presence of adolescent's MDD diagnosis at posttreatment. Results did show a main effect of CBT over time for depression symptoms, suicide ideation, family criticism, and the presence of MDD diagnosis decreasing from pre‐ to postintervention. A year post treatment, almost 70% of adolescents in both conditions (CBT and CBT + TEPSI) remained in remission. A main effect was obtained for treatment in the adolescent's perception of familism and family emotional involvement. The primary hypothesis that family psychoeducation would optimize CBT for depression in adolescents was not supported. Both conditions yielded similar clinical end points. The culturally adapted CBT was found effective with Latino/a adolescents showing clinically significant improvements from pretreatment to posttreatment and remained stable at a 1‐year follow‐up. Regarding family outcomes, adolescents in CBT + TEPSI remained stable from pretreatment to posttreatment on family emotional involvement, while adolescents in CBT‐alone showed an increase. The implication of these findings is discussed.     

Effects of decreasing intersession interval duration on graduated exposure treatment during simulated routine dental care

Reports suggest that individuals with developmental disabilities often engage in behavior during dental visits that precludes regular dental care. Graduated exposure therapies are an effective treatment for avoidant behavior in people with developmental delays, and some studies show that the duration of the intersession interval (ISI) can impact the effectiveness of graduated exposure treatments for typically developing individuals. The current study examined the effects of decreasing ISI on outcomes of a graduated exposure treatment during simulated routine dental care for 3 individuals diagnosed with autism. Treatment consisted of graduated exposure and extinction for disruptive behavior. Initially, sessions were conducted once per week. In subsequent conditions, treatment sessions were conducted 3‐5 times per week. A nonconcurrent multiple baseline across subjects design was used to demonstrate experimental control. Results suggest that decreasing ISI durations can produce improved treatment outcomes.     

Simple discrimination training with differential responses to establish functional and equivalence classes with preschool children

The present study assessed whether simple discrimination training with differential responses would produce functional and equivalence classes with preschool children. In Experiment 1, we exposed 10 children to simple successive discrimination training in which they had to press different buttons (selection‐based responses). Response 1 (R1) was reinforced only in the presence of A1, B1, or C1, and Response 2 (R2) was reinforced only in the presence of A2, B2, or C2. We assessed the formation of functional classes by training new selection responses in the presence of one member of each class (A1‐R3, A2‐R4) and testing to see if these responses would occur in the presence of other members. Eight children responded consistently with functional class formation. Four of these eight children also responded consistently with the formation of equivalence classes. Experiment 2 investigated whether differential motor responses (i.e., gestures) would improve equivalence class yields. Three of six children showed both functional and equivalence class formation. In general, the results indicate that the simple discrimination procedure with differential responses yielded functional and equivalence class formation.