Update 3/8/14: Advocates for Informed Choice just posted an annotated video of the segment, and it is fantastic.

A recent Nightlight segment featured a promising story of the treatment of individuals born with atypical sex anatomies. It included the story of M.C., whose parents’ legal cases against the attending physicians and the state of South Carolina may be found here.

The most dramatic moment of the segment was the encounter between intersex activist Sean Saifa Wall and Terry Hensle, the Columbia University urologist who performed feminizing surgery when Wall was 13. (The reporter misleadingly recounts that this surgery “turned [Wall] biologically into a girl,” as if the removal of testes defined femaleness.) Wall, who had not felt like a girl as a child, transitioned in his mid-twenties.

When viewers are introduced to Hensle, he explains in response to the reporter’s question that parents are grateful for his work, and grants that as much as he might have enjoyed “playing God,” as the reporter suggested, “it was not,” he says, “the right thing to do.” He enthusiastically affirmed the value of hearing from former patients who had undergone normalizing interventions in the past, and readily agrees to a meeting with Wall, his former patient.

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Hensle wants Wall to understand that the decisions that were made on his behalf were not made “out of malice.” Perhaps for this reason, in response to the reporter’s question concerning whether Hensle experiences any remorse for the harm he has caused Wall and patients like him, Hensle immediately responds that he has “no regrets;” and yet, Hensle claims with a particular vehemence that he “absolutely” would do things differently now. How can it be that Hensle could have no remorse, but would not repeat the actions that he now understands to have caused harm?

That these two claims are not contradictory for Hensle may indicate that he is focused solely on the question of his own culpability rather than the (surely regrettable) harm his actions have caused to Wall and to so many other patients. But in refusing to recognize his responsibility to repair the harm he has caused, Hensle commits another harm. As Margaret Walker has argued in her book, Moral Repair, to turn away from the task of repair, “is not only not to do something, it is to do wrong once again”:

Failures to repair wrongs are additional wrongs that create additional obligations to repair the failures. Where wrongs persist unrepaired repeatedly, in an extended series of refusals or failures to repair, the lack of reparative effort on the part of those responsible for repair accrues layers of disregard, indifference, disrespect, contempt, belittlement, or intended careless humiliation.

It may be that physicians refuse this responsibility for fear of legal claims of liability, either to themselves or for the institutions with which they are affiliated. Or perhaps it is, simply, a failure of moral courage. In either case, we all must take responsibility for the recognition both of past harms, and of ongoing harms that, we see, come in many forms.