Hermaphrodites and the Medical Invention of Sex. - Review - book reviews

Journal of Sex Research, Nov, 1999 by Holly Devor

Hermaphrodites and the Medical Invention of Sex. By Alice Domurat Dreger. Cambridge, MA: Harvard University Press, 1998, 266 pages. Cloth, $35.00.

In Hermaphrodites and the Medical Invention of Sex, Alice Domurat Dreger looks at the debates concerning intersexed people which circulated in the medical communities of France and Britain in the late 19th and early 20th centuries. In so doing, Dreger has also offered insight into our own fin-de-siecle quandaries about the limits of the usefulness of the concepts of sex and gender as categorizations of human beings.

Then, as now, those who would shore up the intertwined social edifices of sexism and heterosexism have need of clearly-defined dividing lines between sexes, between genders, and between sexual orientations. In this book, Dreger shows how the expertise of late 19th- and early 20th-century medical professionals was called upon to proclaim the true sex of those intersexed or hermaphroditic individuals whose bodies threatened to muddy the waters.(1) Dreger argues that gradually, over the time period under study, doubly-sexed people known as hermaphrodites were discovered to exist in numbers which caused some alarm to medical professionals. It is Dreger's thesis that this was disturbing to medical men (and Dreger takes pains to emphasize that almost without exception they were men) because it opened up the possibility of mistaken sex and, therefore, of unwitting homosexuality, neither of which were taken lightly either by medical men or by the public of the day. During this period, feminists were challenging axiomatic beliefs about proper gendered divisions in social relations, while homosexuality was in the process of becoming defined as a characterological trait rather than as a moral lapse. Against such a backdrop of social change, it was seen as extremely important that each and every individual be either male or female. If medical men allowed that there might be more than two sexes, then they might be viewed to be contributing to the collapse of the basis for gender hierarchy and to anarchy in the realm of sexuality.

Dreger chronicles how a few doctors first identified and then repaired a leak, called hermaphroditism, in the containment complex of sex/gender/sexuality. Dreger starts her exposition with a prologue, in which she introduces her readers to some of the parameters commonly used to define and determine sex categories. It is in this prologue that Dreger misses an opportunity to clear up a common bit of grammatical correctness which leads to a great deal of conceptual confusion. Throughout the book, Dreger uses sexual as an adjective where she might have used sex with greater clarity. This is especially glaring in a later chapter which she devotes to lamenting the problem of the conflation of sex with sexuality. However, in the end, this oversight does no significant damage to the overall purposes of her work.

Chapter 1 introduces the idea of the Age of Gonads, which Dreger pegs as spanning the years 1870-1915. The Age of Gonads, Dreger argues, was a response to a seeming rash of hermaphroditism which broke out at the beginning of this period of feminist and homosexual mobilization. Dreger indicates that it was more likely that the outbreak was a result of increasing numbers of people falling under medical scrutiny and an artifact of entrepreneurial publishing endeavors of medical men than of any actual increase in the number of hermaphroditic people alive at the time. In the Age of Gonads it was insisted that each and every human being must have one and only one true sex, which could be definitely determined on the basis of a careful examination of gonadal tissues. All other indicators of sex were thereby rendered moot. In chapter 2 Dreger delves into the sometimes symbiotic relationships between hermaphrodites and the doctors who studied them. Some doctors made their reputations and fortunes by becoming expert about hermaphroditic people. Some hermaphroditic people also made names and livings for themselves by becoming famous for their hermaphroditism. Dreger further points out in this chapter that the contributions of both hermaphroditic people and doctors who studied them also benefitted many other people by increasing medical and scientific knowledge about embryology, evolution, hormones, and other related areas of interest.

In chapter 3 Dreger takes her readers "In Search of the Veritable Vulva." Not surprisingly, medical men of the Age of Gonads did not always find it a simple matter to determine the exact nature of the gonads which persons contained within them. Exploratory surgery at that time was ill-advised for any number of purely practical reasons. Thus, doctors had to resort to other clues. Failing to make the kind of distinctions that many people make today between sex, gender, and sexual characteristics, medical men of the day relied upon physical appearances, gendered, and sexual behaviors to help them to determine the status of inaccessible gonads. Telling but not necessarily definitive signs of true sex included: external genitalia, menstruation or ejaculation, breast and pelvic size and shape, body hair distribution, sexual orientation, bravery or modesty; any of which might be thrown into further question by variations from stereotypical British or French race, ethnicity, age, or socially unacceptable sexual practices.