America's democratic institutions have historically been restricted - and then opened up - based on appeals to anatomy. Voting, for one, was first essentially restricted to white men. Over time, groups with other anatomies struggled their way into being seen as "created equal." Civil rights movements of all sorts - for sex equality, racial equality, dis/ability equality - have tended to be based on the idea that our common anatomy is more important than our anatomical differences. Yet even today, many legal restrictions are based on anatomical distinctions: age in voting and drinking, viability in abortion and withdrawal of life support, and sex where marriage and the draft are concerned.
As our democracy has matured, it has still retained an ancient reliance on anatomy as deeply meaningful. Yet at the same time, science has been dissolving the bright lines between anatomical categories. So what's next? What could - what will - democracy look like after anatomy?
Alice Dreger, PhD, is a professor of clinical medical humanities and bioethics in the Feinberg School of Medicine at Northwestern University in Chicago. For seven years, she served as chair of the board and director of medical education for the Intersex Society of North America (ISNA), a non-profit policy and advocacy organization for people born with atypical sex. Dreger's scholarship and patient advocacy have focused on the social and medical treatment of people born with norm-challenging body types, including intersex, conjoinment, dwarfism, and cleft lip. She has frequently collaborated with healthcare professionals on improving the care of families with children whose bodies vary from the average.
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