This essay explores the changing definitions and perceptions of “hermaphrodites” from the colonial period to the early twentieth century.3 Over the course of the three centuries, most medical observers would have agreed that hermaphrodites did not exist in the human species and that patients with confused or ambiguous external and internal reproductive organs were not really hermaphrodites, but cases of “mistaken sex.” Indeed, by the mid-twentieth century, “corrective” surgery for such anatomical ambiguity became routine in this country, to make infants’ genitalia look “normal” and match their supposed “true sex.” But this essay is concerned less with the medical history of surgical procedures or the professional history of doctors than with the cultural history of how American doctors and laypeople regarded bodies and identities that fell outside their conceptual boundaries of normal female and male categories. What did it mean to be male or female? Who had authority to answer that question, and what were the criteria?A question that still remains open today.
Sex is social and historical, in large part a construction whose contours and boundaries have been imposed rather than simply discovered. Consider the analogy of race. Just as we think about race in black-and-white terms in the United States, so too we think about sex in exacting binary terms. African Americans, for example, have been considered “black” on the basis of the “one-drop” rule (any known African ancestry), which sought to define and police the boundaries between blacks and whites in the interest of white racial “purity” and supremacy. Although racism and discrimination persist, the one-drop rule has disappeared in the face of more just attitudes and practices, as Americans have redefined the color line in the United States in the previous half century. Today “multiracial” is an accepted identifier employed by increasing numbers to add nuance and complexity to our formerly rigid understanding of race.I identify as female and always have. Biologically problematic, more F than M (with the medical reports to prove it), but much as I would like to be 100% F, I'm not. Biologically. That's me though. There are many IS people who do not identify with either sex (and quite a few non-IS people too). Just because I fit neatly into one binary box (psychologically anyway), I don't see why others should be compelled to when it's not appropriate for them.
Will a more complex understanding and classification of sex find similar respectability?
How distinct are the boundaries of sex? And how should those with nonconforming bodies be treated? How small must an infant’s penis be before a doctor decides the child should be surgically remade as a girl? Does an unusually large clitoris transform a girl into a boy? Is someone with a penis and a uterus male or female? What about a person with breasts and testicles? Where do we place those who have both XX and XY chromosomes in this rigid taxonomy of sex? Intersex bodies have always existed, but they have been rendered invalid and invisible historically, for the boundaries of personhood have forced them into a conventional bipolar male/female division
The insistence on a strict male/female dichotomy should not be understood as a medical conspiracy, though doctors played an enormous role in delineating the boundaries between the two sexes and bestowing on that division the imprimatur of science. Those living with ambiguous bodies generally shared the binary ideal and sought to blend in, if only because survival demanded it. Forced to choose a sex, however, they did not always adhere to the sex they chose. Nor did they always endorse or accept doctors’ suggestions for surgical correction, particularly when such surgery required an adult to change gender.ISNA disbanded shortly after this article was written. Some pediatricians continue to advocate for early intervention, due to the stigma, bullying and persecution those with visibly different bodies endure in childhood. Those who object to their arbitrarily assigned sex are labelled "mentally ill" so can safely be ignored, as well as ostracised and castigated as morally corrupt by much of organised religion.
Many children thus altered never felt at home in their assigned sex. Some never knew their medical history, as doctors advised parents and relatives to keep the matter secret. When they found out, some changed genders as adults. Others struggled to accommodate life with surgically altered sexual organs that had been severely compromised as well as with a deep sense of shame induced by enforced secrecy.
Intersex activists are currently challenging Money’s presumptions and protocols about “normalizing” procedures. As Alice Dreger, chair of the Board of Directors of the Intersex Society of North America (ISNA), put it, “Why perform irreversible surgeries that risk sensation, fertility, continence, comfort, and life without a medical reason?” ISNA’s efforts are making headway, but they are far from complete. At a recent meeting of the Section on Urology of the American Academy of Pediatrics, several leaders in the field cautioned against invasive cosmetic surgeries, while others continued to advocate early aggressive operations
Using as guides both Jewish Talmudic law and canon and civil law influenced by ancient Latin sources, early European medical manuals typically addressed the legal issues that hermaphrodites or their parents might have faced. All such precedents required that a hermaphrodite choose one sex. For example, the 1741 English treatise A Mechanical and Critical Enquiry into the Nature of Hermaphrodites, by the physician James Parsons, outlined the standard regulations. Despite his contention that human hermaphrodites did not exist, Parsons listed each possible legal question, from whether a hermaphrodite should be given a male or female name at birth to whether or not a hermaphrodite should be allowed to marry or divorce. The answers to most questions required that hermaphrodites choose one sex. Parsons stated unequivocally: “Predominancy of Sex . . . ought to be regarded; but if the Sexes seem equal, the Choice is left to the Hermaphrodite.”See what I mean when I said "Intersexed people were in many ways treated more humanely in 1750 than 1950". I meant it. It's literally true.
Unlike later medical practitioners, Parsons was willing to entrust this vital decision to laypeople
In previous posts, I've mentioned 5ARD and 17BHDD - both of which can cause an apparent "natural sex change" in some cases. Such changes do not alter gender identity, so transsexuality can either be cured, or caused, by such a change.
I've also mentioned Vitiligo, an auto-immune disease that attacks melanotic cells, leading to skin bleaching. The most famous (though not well-known) case is that of Michael Jackson.
There's still a marked resistance in the USA to the idea that such things can be. Ask nearly anyone, they'll tell you that Michael Jackson voluntarily changed his appearance, though if you ask them how skin can be bleached like that, they can't tell you. Because no such medical procedure exists.
As if individuals’ shifting back and forth between the genders at will was not bad enough, doctors reported startling cases of people suddenly, and involuntarily, changing their sex. In 1850 a Boston medical journal reported the case of a fourteen year-old who had been born female and christened Rebecca, but whose body altered into that of a boy. His father successfully petitioned the court to have the child’s name changed to William. Similarly, the Medical Examiner in 1839 reported the mysterious masculinization of an eighteen-year-old woman. At her birth, there had been some doubt as to the girl’s sex, but the “gossiping females” present at her birth decided that her organs of generation looked more female than male. Although as a child she engaged in “manly sports and the labours of the field,” she wore female attire and lived as “Elizabeth.” When she turned eighteen, however, her body changed. She was nearly six feet tall and had begun to grow a beard. Old enough to make her own decisions about sexuality, she abandoned her old name and female identity, lived as a man, and married a woman.Classical signs of 5ARD or 17BHDD, and Vitiligo respectively. These conditions are not new. They were always in the general population, and even better known in 1796 than they are today.
The unnerving possibility that individuals could suddenly change sex paralleled the early national preoccupation with race, racial categories, and the possibility of changing racial identity. In the early republic, as Americans sought to find social and political order in their unsettled national life, the potential transmutation of race raised serious questions. In 1796 Henry Moss had become a celebrity widely recognized in print as an American-born man of African descent who in middle age somehow turned white. Another man, James, from Charles County, Maryland, lived for fifteen years “a black or very dark mulatto colour,” and then white spots began to appear. Gradually increasing, the spots grew until he had become entirely white, except for a few lingering dark spots on his cheekbones. His child, the article duly noted, was born with white spots, suggesting that the offspring’s transformation might come soon.
Would "Rebecca" or "Elizabeth" be treated with such humanity today? Well, not in Ohio. Or Tennessee. Or Kansas. Or parts of Texas. As for Henry Moss - just look at the way Michael Jackson was treated as "Whacko Jacko" during his pain-wracked life (he had Lupus too, a disease often found in conjunction with Vitiligo in Black Americans).
We've come a long way in 200 years. Backwards.
And I'm doing my darndest, in this blog, with these articles, to swim against the tide of increasing bigotry and irrationality, often associated with a well-financed and highly profitable organised religion that has nothing to do with Christ's teachings, or often used as a political power source by demagogues of the far right, and by some on the left too. All too many.
I rely on exposing the facts, using references, logic, knowledge, rationality. Not telling people what to think, just laying the data before them, giving sources, and letting them make up their own minds.
In today's political climate, my approach is distinctly unfashionable, and it can get pretty lonely here at times. Meh. I volunteered. I was drafted into the whole sex-change thing, but the activism in the USA, as opposed to Australia where I live, that's just me being me. I cannot stand blatant injustice, never could, and as a child it got me into plenty of hot water. I have a choice to do this, or not to. I choose to do it, and the other things. Not because they are easy, but because they are hard. I guess you could say that I have a dream.