‘Chinese… what is the best word?’: Language, culture and the pathologization of innate sex characteristics in plurilingual Hong Kong

Abstract

<p>The human body displays an array of innate sex characteristics, ranging from expected, normalized variations (i.e., endosex) to minority ones that do not meet medical and/or social norms of binary male and female (i.e. intersex). Naming and classification systems have material consequences for general access to health care but also mental well-being. This study uses metapragmatic discourse analysis (i.e., analysis of talk about language) to mitigate cultural appropriation and commodification, treating interviewees as collaborators who analyse language in a process of joint discovery with the researcher. The data for analysis have been selected from research interviews with doctors in Hong Kong who work closely with intersex children and their parents. Discourse analysis of the audio-recorded interviews, following the principles of interactional sociolinguistics, serves to reveal affordances and constraints of the globally circulating yet locally interpreted terminology that is available in English, Cantonese, and Mandarin. The doctors’ accounts relate interactional difficulty with crossing the boundary between medical English (in which they were trained) and Cantonese when speaking to parents about their child’s non-normative innate sex characteristics. When attempting to translate technical English terms into Cantonese, doctors find their vocabulary knowledge lacking and problematic, with parents likely to become upset or withdrawn due to anxiety and embarrassment. In response, the doctors claim to simply keep the terms in English or avoid them altogether, falling back instead on descriptions of the child’s body using everyday Cantonese vocabulary. Adding to the pathologization already underway via the framing created by the hospital space, both strategies potentially exacerbate the lived intensity of the parents’ experience. The talk finishes with discussion of potential clashes of interactional norms with the context of [parent]patient-centred medicine, and how this relates to lived experience of people whose innate sex characteristics get pathologized (and their families).<br></p>