One, Two, or Many Sexes: Sex Differentiation in Medieval Islamicate Medical Thought

Since the 1990 publication of Thomas Laqueur’s book Making Sex, his proposed “one sex” model has served as the site of many spirited debates and discussions.¹ Joan Cadden was one of the first to criticize Laqueur’s model in her book Meanings of Sex Difference in the Middle Ages, in which she explained why her analysis differs from Laqueur’s: “Though there is much evidence in the present study that fits [Laqueur’s] ‘one-sex’ model, medieval views on the status of the uterus and the opinions of medieval physiognomers about male and female traits suggest evidence of … models not reducible to Laqueur’s.”² More recently, Katharine Park has argued that there is no evidence to support the one-sex model for medieval Europe: “Before 1500 I could find no convincing expressions of the idea of genital homology at all, even as an alternative to be discarded, except for a few brief passages in the works of several late medieval surgeons, including Guy de Chauliac, who seems to have been one of the only medieval scholars to assimilate the full text of Galen’s On the Use of Parts.”³

While Galen’s views on the similarities between male and female organs may have received little attention in medieval European medical literature, they certainly were evident in Islamicate philosopher and physician Ibn Sīnā’s (Avicenna’s) al-Qānūn fī al-ṭibb (The canon of medicine), completed in 1025. Ahmad Dallal has argued that “the ancient idea of inverse similarity between male and female sex organs” was common in Islamic medical writing of this period.⁴ Yet such overarching conclusions are undercut by a lack of sufficient analysis of either earlier Islamicate writings or the diversity in views in Islamicate medical thought and the tendency to view Islamicate understanding of sex and sex differentiation as stable and monolithic. While significant work has been done in relation to the social history of different genders in medieval and early modern Islamicate contexts,⁵ few have explored perceptions of sex differences and differentiation in Islamicate learned medical discourse.⁶ Most existing contributions have focused on the work of Ibn Sīnā, his later commentators, and other physicians with markedly Aristotelian views.⁷ Even less work has been done on ideas surrounding sexual differences and differentiation in the works of major tenth-century authors like Abū Bakr al-Rāzī (d. 925) and ‘Alī ibn ‘Abbās al-Majūsī (d. 982 or 994).⁸ A deeper investigation into the variety and historical development of these views is needed to counter tendencies to overgeneralize about this discourse, and we need recognition of the dynamic and diverse context in which Islamicate medical understandings of sex developed.⁹

This article investigates the medieval Islamicate medical discourse about the landscape of sexual difference and the attendant developments in medical traditions. The exploration of a variety of medical writings highlights the variety of divergent Islamicate views and theories about sex and fetal sexual differentiation. In what follows, I use the word “sex” to refer not to a fixed “biological” category that remains coherent throughout history but to a historically contingent category that is rooted in a specific discourse about nature, a discourse that was produced and dominated by particular groups whose claimed expertise was the human body—in the case of this article, learned physicians. This view of sex as a discourse on nature allows for consideration of parallel or competing discourses outside the Hellenistic-Islamicate context, and it gives voice to parallel or competing experts or specialists, such as atomistic philosophers and practitioners of Indian or Chinese medical traditions. Like the concept of gender, sex is historically contingent and socially conditioned; it lacks transhistorical coherence. In this article, however, I focus exclusively on sex, and I take sex to be distinct from gender. While the process of gendering occurs primarily within social and legal discourse, “sexing”—as I will call the process of medical sexual differentiation—operates within discourses on nature and the natural, and it occurs within a particular...