Working towards epistemic justice in intersex-related clinical and research practices

Abstract

Abstract Background Miranda Fricker introduced the concept epistemic injustice in 2007 to refer to situations in which a person is misrecognised in their capacity as a knower, differentiating between testimonial and hermeneutical injustice, and proposing ideas on epistemic justice. In intersex studies and activism, reflections on epistemic injustice and strategies for working towards epistemic justice are becoming increasingly relevant within broader analyses of institutional harm. This presentation aims to explore reflections on experiences of epistemic injustice in intersex-related clinical and research practices, as well as recommendations for working towards epistemic justice contributed by intersex studies and activism. Methods The analysis is based on a narrative review of intersex studies and activist discourses conducted over the last fifteen years, and a scoping review on intersex studies published in 2024. It is also informed by discussions shared in the INIA: Intersex – New Interdisciplinary Approaches project (European Commission, MSC-ITN 859869). Results Reviewed authors from the field of intersex studies and activism contribute critical reflections on human rights violations and forms of epistemic injustice intersex people face in the clinical and research context. They also developed recommendations for working towards epistemic justice in clinical and research practices, based on epistemic justice theories, human rights frameworks, depathologisation perspectives, and reflexivity approaches. These contributions can be related to other critical knowledge fields, such as LGBTI, trans, crip, deaf, and mad studies, as well as broader analyses of institutional harm. Conclusions The knowledge of critical analyses and recommendations contributed by intersex studies and activism can support the implementation of respectful clinical and research practices based on epistemic justice, human rights, depathologisation, and reflexivity.