Turkiye Klinikleri Journal of Medical Ethics-Law and History

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Kız mı Oğlan mı? Tıbbi, Etik ve Hukuki Yönleri ile Cinsiyet Gelişim Bozukluğu: Geleneksel Derleme
Girl or Boy? The Medical, Ethical and Legal Aspects of Disorders of Sex Development: Traditional Review
Sevtap METİNa, Adem AZb,c, Hakan ERTİNb
aİstanbul Üniversitesi Hukuk Fakültesi, Kamu Hukuku Bölümü, Hukuk Felsefesi ve Sosyolojisi ABD, İstanbul, TÜRKİYE
bİstanbul Üniversitesi İstanbul Tıp Fakültesi, Deontoloji ve Tıp Tarihi ABD, İstanbul, TÜRKİYE
cSağlık Bilimleri Üniversitesi Haseki Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, İstanbul, TÜRKİYE
Turkiye Klinikleri J Med Ethics. 2021;29(3):435-42
doi: 10.5336/mdethic.2021-83425
Article Language: TR
Full Text
ÖZET
 Her yenidoğana, geleneksel olarak fiziksel görünümü üzerinden kadın ya da erkek olarak bir cinsiyet atfedilmektedir. Fenotipi tipik bir kadın ya da erkeğe benzemeyen veya genotipi ile farklılık gösteren bebekler ise bu ikili cinsiyet sınıflandırmasının dışında kalmaktadır. Bu durum, güncel literatürde cinsiyet gelişim bozukluğu [disorders of sex development (DSD)] olarak tanımlanmaktadır. DSD olgularında en önemli etik sorun, DSD'li bireylerin cinsiyet atama kararıdır. Burada küçüğün tüm hayatını etkileyecek önemli ve geri döndürülemez bir cerrahi müdahale söz konusudur. Bu kararın ameliyatı gerçekleştirecek tek bir hekim ya da ebeveyn tarafından verilmesi, biyoetiğin temel prensiplerinden özerklik hakkının hekime ya da aileye devredilmesi anlamına gelecektir. Ayrıca yapılacak bu cerrahi işlem biyoetiğin yararlı olma, zarar vermeme ve adalet ilkeleri açısından da tartışmalıdır. Bunun yanı sıra en öncelikli hukuki sorun, rıza dışı uygulanan tıbbi müdahalelerdir. DSD'li bireyler ile ilgili hukuk sistemimizde açık bir hukuki düzenleme bulunmadığından, DSD'ler söz konusu olduğunda genital düzeltme ameliyatlarının da sonucu olarak biyolojik cinsiyet ve nüfus kayıtlarında bir değişikliğe yol açmasıyla Türk Medeni Kanunu madde 40 kapsamında ele alınması gerektiği öne sürülmektedir. DSD olguları, biyolojik özellikleri ile birlikte düşünüldüğünde Türk Medeni Kanunu'nun madde 40 kapsamına sokulması yerine haricen ele alınarak ayrı bir düzenlemeye tabi tutulması gerekmektedir. Bu çalışmada, DSD olguları tıp, etik ve hukuk perspektifinden ele alınacaktır.

Anahtar Kelimeler: Cinsiyet gelişim bozukluğu; interseks; etik; hukuk
ABSTRACT
 A gender is attributed to each newborn, either male or female, based on their physical appearance. Babies whose phenotype doesn't fit typical male or female, or whose genotype differs, are excluded from this binary gender classification. This condition is defined as 'disorders of sex development (DSD)' in the current literature. The most important ethical problem in DSD cases is gender assignment. Because irreversible surgical interventions that will affect the whole life of the child are performed for gender assignment. If the family or the physician, who will perform the operation, makes this decision; it means the transfer of the autonomy right to the physician or the family, one of the basic bioethical principles. In addition, this surgical operation is controversial in terms of the beneficial, doing no harm, and justice principles of bioethics. Besides, the most important legal problem is medical interventions without consent. There is no clear legal regulation in Turkey regarding DSD but in DSD, due to changes in gender, it is claimed that genital correction surgeries should be handled according to article 40 of the Turkish Civil Code. When we consider DSD cases together with their biological features, it is necessary to interpret DSD with a different regulation from article 40 of the Turkish Civil Code. In this study, DSD cases will be discussed from the perspective of medicine, ethics, and legal.

Keywords: Disorders of sex development; intersex; ethics; legal
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