Fixing sex. Intersex, medical authority, and lived experience. Katrina Karkazis. New York: Duke University Press, 2008 (xiii + 364 pp). ISBN 978 0 8223 4318 9.

Currently, there is an intense ethical debate about genital surgery for infants born with ambiguous genitalia. The controversy rose to a new level of intensity in Australia in 2008 with the involvement of the Australian Human Rights Commission and the Victorian Government Department of Justice. Doctors in Europe and North America are facing the same dilemmas.

This new book, possibly the best contribution to the debate yet published, is very welcome, not only because it is timely but because it is deeply thoughtful, thoroughly researched and very respectful of all points of view. The author, Katrina Karkazis, PhD, MPH, is a Senior Research Scholar with the Center for Biomedical Ethics at Stanford University in the United States.

In addressing the historical basis for current understanding of sex and gender, Karkazis discusses the contribution to the understanding of sex development made by John Money (a psychologist at Johns Hopkins University) in depth, in a way that is refreshingly generous. She traces the development of what became the traditional treatment model, the scepticism that emerged, and the origins of Internet-based patient advocacy groups in the mid 1990s. Her exploration of what is posted on discussion boards is balanced by her careful study of what scientific long-term outcome studies have, and have not, delivered. She has also conducted hundreds of interviews with doctors, parents and adult patients.

Her book concludes with the following: