Medical advances in transsexualism and the legal implications

Transsexualism is a condition wherein an individual's psychological gender is the opposite of his or her anatomic sex. The general belief now among behavioral scientists and physicians is that it is an identifiable and incapacitating disease, which can be diagnosed and successfully treated by reassignment surgery in carefully selected patients. Although many advances have been made in the reassignment surgery techniques, phalloplasty still remains a major challenge; to date, no ideal technique has been developed. The new gender created by the reassignment surgery has, in turn, led to many legal complications for postoperative transsexuals because states and the judiciary have not recognized the new gender. However, with wider acceptance of transsexuals by society, this outlook has changed for the better, with many states amending their laws in accordance with the advances in medical sciences. But in many developed and the developing countries, transsexuals are not given a legal identity, thereby adding to their agonies and miseries.     

THE TRANSSEXUAL IN SOCIETY

Because transsexuals possess bodies that their minds cannot accept, they are trapped between society's demand to conform to the anatomical self thrust on them by birth and their own desire to conform to a different interior self, Although the transsexual dresses and behaves as a member of the morphologically opposite sex, this is neither a case of transvestism nor homosexualiy. Psyahologically. the transsexual is a female within a male body, or a male within a female body. In the past these distinctions were virtually ignored by the medical world. Recently, however, attempts have been made, particularly at The Johns Hopkins Hospital, to determine precisely what constitutes transsexualism and to treat surgically those suffering from it. As important as the need to identify and heat the problem itself is the need to combat the emotionalism and prejudice surrounding the subject, which hamper serious research [Green and Money, 1969: Inside cover notes].     

法院法医鉴定制度重构——兼议法医鉴定之证据属性及审查完善

本文通过对中外法医鉴定制度的比较和分析,剖析出我国法院法医鉴定制度的现状及存在的主要问题,并对现状之成因进一步探析.全文从法医鉴定结论之证据属性及现状成因二个方面来论述我国法院去医鉴定制度必需重构的理由,并对鉴定制度中鉴定机构、鉴定人制度、鉴定结论采信方面提出了重构的模式及完善建议.     

Victorious Transsexuals in the Courtroom: A Challenge for Feminist Legal Theory

Transsexual and transgendered people, despite their exclusion from most civil rights laws, nonetheless occasionally prevail as plaintiffs in litigation. What should feminist legal theorists make of these victories? The theory one uses to win has implications for future conceptions of gender and sexuality in the law as well as for understanding contemporary conflicts and alliances among sex and gender theorists, lawyers, and activists. Conflicting theories of how to ground law's liberation claims abound, however. Evidence suggests that transsexuals secure legal victories only through a disheartening process of medicalization, normalization, and demonstration of traditional sex and gender role adherence. Recent cases, however, reveal some interesting destabilizations in law's account of the transsexual, and they provide critical legal scholars with a new perspective on rights‐claiming as a liberation strategy. Attention to the diversity of transsexual and transgendered priorities as well as to the properties of the legal process shows feminist legal theorists how to navigate the problems of identity construction and legal protection raised here sympathetically but unromantically.     

Applications of Social Network Media in Medicolegal Death Investigation

With the increased popularity of online social networking services (SNS) such as Facebook, LinkedIn, Twitter, and Google+, we propose that a wealth of new resources is available for medicolegal death investigation. Recognizing this potential, we identified cases in which social media had been useful in the past in our office and asked our investigative staff to consider using social media in current cases. These cases provided illustrative examples for this primer regarding how information from SNS was used in death investigations in our office. Information gleaned from online social media aided in establishing preliminary identification of a decedent, locating next‐of‐kin, investigating the circumstances of death as relevant to the manner of death, corroborating eyewitness accounts, and providing information relevant to time of death. Potential pitfalls were identified, such as shared accounts or online impostors. SNS proved useful to the medicolegal death investigator and medical examiner, so long as their limitations were recognized.     

Accommodating Intersexuality in European Union Anti‐Discrimination Law

This article considers the relationship between EU anti‐discrimination law and intersexuality. Recent changes in German legislation that recognise intersexuality have prompted consideration of sex and gender throughout Europe. This article considers some of the disadvantages in the way the German legislation has been adopted and attempts to remedy them through the existent Recast Directive. The article rejects the current binary approach to sex and gender and recommends a broader interpretation that understands sex as a spectrum or continuum. It concludes that anti‐discrimination law may be a more suitable realm for questions of intersex to be raised than mandatory state documentation. Anti‐discrimination law is preferable, it is submitted, because it offers individuals an opt‐in model, which does not require any medical ‘proof’. Similarly, anti‐discrimination law offers activists a fluid site of resistance that is not based on medicine or the potential fixity of the birth certificate.     

Medicolegal system in Greece. A combination of clinical and forensic pathology

At the Annual Meeting of the National Association of Medical Examiners in Chicago, Illinois, in November 1981, Dr. W. Sturner, Chief Medical Examiner of the State of Rhode Island, gave his perspectives as far as clinical forensic medicine and pathology are concerned. This topic, therefore, brought to mind the idea of writing an analysis of the medicolegal system in Greece. This article attempts to show the advantages, problems, and the perspectives of an old-style medicolegal investigation system, existing in Greece since 1910. The clinical aspects of forensic medicine and pathology is exemplified by the presentation of the preliminary results of the study of injuries in traffic accident victims, 1,600 cases examined by the author with the support of other colleagues in Athens, Greece.     

离婚案件审理中法官话语的性别偏向

运用听审记录和访谈资料进行的话语分析,向我们展示了离婚案件审理中法官话语的男性偏向,其深层次原因包括:照顾弱者政策的执行受到女性形象转变的冲击、中国日趋格式化的司法体系缺乏对性别意识和女性话语的关注,以及法官话语性别议题背后的权力配置。通过对这些因素的揭示与分析,希望促进人们对司法领域中失语群体的关注,从而有助于构建更为完善合理的司法体系。     

Medicolegal death investigator workplace safety hazards: A scoping review of the literature

In the United States, medicolegal death investigation practices and policies pertaining to sudden unexpected deaths are mandated by state government. Practices vary across states, which contributes to inconsistency in job prerequisites and training. In preparation for a study focused on occupational safety and health of medicolegal death investigators in their on-scene and follow-up activities, a scoping review was conducted to document known occupational safety risks and health-related conditions associated with death investigation. Searches used Boolean and subject heading operators both broad and narrow in scope, and search terms included scene responder, hazard, investigator, forensic pathology, injury, and safety. Twenty-five articles met inclusion criteria, which included seventeen survey-mixed method designs, two systematic reviews, five quasi-experimental designs, and one case study. Twelve articles addressed mental health and eleven focused on risks associated with infectious disease. One article addressed the risk of chemical exposure from cyanide among autopsy personnel (including forensic pathologists) and nine included a wide range of employees within the setting of medical examiner or coroner offices. One article, addressing burnout, included employees in a forensic science laboratory setting as well as medicolegal death investigators and two articles included forensic pathologists and medicolegal death investigators. Only one article addressed medicolegal death investigators specifically. Articles addressing occupational and environmental hazards of medicolegal death investigators associated with musculoskeletal, respiratory, cardiovascular, radiological, nuclear, electrical, or explosive threats were not identified. There is little published about safety risks inherent in conducting death investigations. Research is needed to adequately inform health promotion and injury prevention strategies.     

Disinterments. Their value and associated problems

This article presents our experience with several cases of disinterment, including reasons for disinterment, the methodology involved, and the value of this activity in solving medicolegal problems.     

Gender in the Context of Same‐Sex Divorce and Relationship Dissolution

This article identifies ways that judges, lawyers, researchers, and policy makers may attend to the role of gender and gender dynamics facing same‐sex couples upon divorce or other relationship dissolution. When same‐sex couples marry, the legal system and society at large may project conceptions of gender onto same‐sex couples, often in a manner that conflicts with couples' intentions and practices. Gender and gender dynamics may affect the bases for dissolution, the financial aspects of dissolution, and the determination of child custody. The article also suggests directions for future research on the impact of gender on the dissolution of same‐sex relationships.     

Sex Determination from Hand Dimensions of North and South Indians

Abstract:  When dismembered human remains are encountered, the decedent's sex may not be obvious. For these scenarios, techniques for sex determination may play a vital part of the medicolegal investigation. Five hundred hands (230 males, 270 females) from North and South Indian region were studied to investigate sexual dimorphism in hand dimensions (hand length, hand breadth, and palm length). The hand index (hand breadth/hand length × 100) and the palm index (hand breadth/palm length × 100) were derived. The hand dimensions show a higher accuracy in sex determination when compared to indices. Of all hand dimensions, hand breadth has the highest accuracy of sex determination in the study group. The sex differences were found to be statistically significant only for the hand index on the left side. The morphometric parameters of the hand show considerable sexual dimorphism in the Indian population while the hand and palm index remain poor sex indicators. The study thus has medicolegal implications when a dismembered hand is brought for examination.     

The interfaces of law and medicine.

The relationship between the legal and medical professions is improving, but many problems remain. There has been been and continues to be substantial growth in medicolegal organizations of various kinds. Better medicolegal investigative methods are being developed, and medicolegal teaching programs are on the increase. The two professions have worked together successfully on such problems as human heart transplantation and drug abuse. On the other hand, several problem areas continue to cause difficulty and friction, including medical experimentation on humans, the legal definition of death, abortion, euthanasia, and medical malpractice. The author calls on the existing medicolegal organizations to apply their expertise and influence to define and resolve these problems.     

Identification of male bloodstains by dot hybridization of human Y chromosome-specific deoxyribonucleic acid (DNA) probe

The sex determination of bloodstains was performed using a human Y chromosome-specific (DNA) fragment of 1.9-kb length as a hybridization probe. The DNA samples were taken from 1- and 4-week-old bloodstains of males and females, respectively. Strong signals with male DNA were observed by Y-probe, while faint signals with female DNA were detected. In addition, clear signals were observed in the extract samples from male bloodstains (16-week-old) on paper. Dot hybridization of the Y-probe would be widely applicable to studies on sex determination of medicolegal materials such as blood, bloodstains, teeth, and cadaverous parts.     

SILENT CHANGES: TRANSSEXUALS’ RIGHT TO MARRY IN CHINA’S MAINLAND AND HONG KONG

In comparison to the arduous process of rights advocacy in Hong Kong, transsexuals in China’s mainland achieved their right to marry via some “silent changes”: there was no legal activism from transsexual communities, no debates or hearings in the legislature, and no landmark judgments made by the judiciary. From a perspective of comparative law, this article attempts to analyze the legal changes regarding transsexuals’ right to marry in China’s mainland in light of the struggles in Hong Kong. It endeavors to discuss to what extent the seemingly “smooth” and “unintended” way of opening up marriage to transsexuals in China’s mainland could be beneficial to trans rights and equality in general.     

Determination of sex by discriminant function analysis and stature by regression analysis: a lateral cephalometric study

Determination of sex and estimation of stature from the skeleton is vital to medicolegal investigations. In the present study, an attempt is made to determine sex and estimate stature of an individual using data derived from lateral cephalogram in Central Indian population. Skull is composed of hard tissue and is the best preserved part of skeleton after death, hence, in many cases it is the only available part for forensic examination. Lateral cephalogram is ideal for the skull examination as it gives details of various anatomical points in a single radiograph, also it easily provides architectural and morphological details of skull superstructures and intra-cranial details for comparisons. A discriminant function derived from 10 cephalometric variables provided 99% reliability in sex determination. The formulae obtained from regression analysis using the maximum length of skull showed very high degree of reliability for estimation of stature in males as well as females.     

Urgent problems of forensic medical expert evaluation of disability in civil suits

The author discusses urgent medicolegal problems related to evaluation of the degree of occupational disability, necessity of additional diet for victims, which arise in connection with civil actions of persons who underwent non-occupational trauma.     

Pathological intoxication and alcohol idiosyncratic intoxication--Part I: Diagnostic and clinical aspects

The concept of pathological intoxication and its successor term, alcohol idiosyncratic reaction, has been one of ambiguity and professional disagreement. The history of such an entity reveals contradictions and varying usage--particularly in regard to the amount of alcohol required. Some feel that the current classification system is broad enough to include such reactions without the use of such terms. Laboratory and electroencephalographic findings are not diagnostic. The author suggests that if the concept is to be retained, psychiatrists utilize where possible the term "alcohol idiosyncratic reaction" in accord with Diagnostic and Statistical Manual of Mental Disorders (DSM) III guidelines, particularly in view of the medicolegal implications discussed in Part II, which follows as a separate paper.     

社会性别准入与优化法律诊所教师培训模式研究

研究认为社会性别视角是社会性别主流化在法学教育尤其是诊所教育中的重要手段与突破口.通过文献研究与实证调查,发现有关探讨未进入、未成为学术主流.研究认为立足于社会性别视角,对诊所教师培训方法、针对性及可操作模式方面有改进之必要.推进我国法律教育改革与发展,须强化培训教师社会性别意识、法律思想与思维模式,从而建立对诊所教师长期且可复制的培训模式.在充分肯定诊所教育对法学改革推动作用的同时,研究认为应以社会性别视角引导诊所教师培训模式整合.研究力求汲取国外相关成功经验,从社会性别视角入手对诊所教师培训模式作出客观评析.研究在指出我国诊所教师培训模式存在的缺失与不足时,提出将社会性别视角导入诊所教师培训模式设定与整合工程之具体设想.     

Evaluation of Purkait's triangle method for determining sexual dimorphism

The identification of sex from the skeleton is an important demographic assessment in medicolegal investigations. Rama Purkait developed a method for estimating sex using measurements from a triangle defined by three points on the proximal end of the femur using skeletal material from Bhopal, India. This method was tested with measurements on 200 Indo-European and African American adult femora from the Terry collection using discriminant function analysis to determine if Purkait's method was valuable for determining sex in Americans. A side-by-side analysis was conducted of Purkait's "triangle method" and the maximum diameter of the femoral head to determine their relative value in assessing sexual dimorphism. In the study sample a single variable from Purkait's method provided 85.5% prediction accuracy, similar to 87% for the head diameter. Combining threshold values for a single variable from Purkait's method and the femoral head diameter raised the predictability to greater than 90% for both sexes.