The role of psychologists in multi-disciplinary teams for intersex/diverse sex development: interviews with British and Swedish clinical specialists

This is an interview study with 32 British and Swedish health professionals who worked in multidisciplinary teams (MDTs) that delivered care for children and adults with intersex variations, otherwise referenced in biomedicine as disorders of sex development (DSD). The present qualitative analysis focuses, first, on the health professionals' talk about their team and, second, on their talk about contributions of the psychologist in the team. Although all of the interviewees referred to their team as a MDT, their talk reflected an overwhelmingly unidisciplinary, medicalised knowing and talking of intersex variations. This understanding prefigures service priorities and dictates clinical processes. Psychologists were said to be important, but their contributions were typically considered more relevant after medical interventions and, however valuable, were understood as optional. Above all, psychological contributions were conceptualised in such a way as to preclude strategic applications of psychological theories and research to re-think variations of physical sex development and the care process. The present analysis suggests a need to substantially re-work relationships between team members and reflect on the overall care ethos in order to engage patients and families psychologically. Until then, DSD specialists may be more accurately described as working in a multi-professional service than providing integrated MDT care.