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

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6 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalArchives of Sexual Behavior
DOIs
Publication statusAccepted/In press - 21 Apr 2016

Fingerprint

Disorders of Sex Development
Interpersonal Relations
Islam
Malaysia
46,XY Gonadal Dysgenesis
Sex Reassignment Surgery
Holistic Health
Congenital Adrenal Hyperplasia
Ceremonial Behavior
Religion
Jurisprudence
Androgens
Health Services
Patient Care
Parturition
Phenotype

Keywords

  • Androgen insensitivity syndrome
  • Congenital adrenal hyperplasia
  • Disorders of sex development
  • Fatwa
  • Gender dysphoria
  • Islam

ASJC Scopus subject areas

  • Psychology(all)
  • Arts and Humanities (miscellaneous)

Cite this

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title = "The Islamic Perspectives of Gender-Related Issues in the Management of Patients With Disorders of Sex Development",
abstract = "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.",
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author = "Zainuddin, {Ani Amelia} and {Abdullah Mahdy}, Zaleha",
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