Hermaphrodites and the Medical Invention of Sex, and: Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the-Century Brooklyn (review)

Hermaphrodites and the Medical Invention of Sex by Alice Domurant Dreger. Cambridge, MA: Harvard University Press, 1998, 268 pp., $35.00 hardcover, $16.95 paper.

Conduct Unbecoming a Woman: Medicine on Trial in Turn-of-the-Century Brooklyn by Regina Morantz-Sanchez. New York: Oxford University Press, 1999, 292 pp., $30.00 hardcover.

What is a woman? What is a man? Over the past three decades, women's studies scholars have explored these questions and in the process challenged traditional notions of gender, sex, and sexuality. The general consensus among women's studies scholars today is that both femininity and masculinity are socially constructed. Nevertheless, the notion that there is only one "normal" way to be a woman or a man persists in both Western medicine and society. As the noted feminist scholar Anne Fausto-Sterling observes in a recent article, within the medical community in particular, the wish "that there be only two sexes, that heterosexuality alone is normal, that there is one true model of psychological health--have gone virtually unexamined." Fausto-Sterling even suggests that the notion that there are only two sexes is outdated, and that society and medicine should recognize that "there are many gradations running from female to male" (1993, 20, 22).

These two fascinating books explore the roots of Western medicine's preoccupation with enforcing "normative" notions of masculinity and femininity. In Hermaphrodites and the Medical Invention of Sex, Alice Domurant Dreger examines the medical treatment of persons with ambiguous genitalia in late-nineteenth- and early-twentieth-century France and Great Britain. According to Dreger, the "discovery" of significant numbers of hermaphrodites during this period was a product of both medical developments and broader social anxieties. The rise of gynecology as a medical specialty combined with greater access to medical care meant that larger numbers of people in France and Britain received medical examinations, including scrutiny of their genitalia. At the same time, says Dreger, the proliferation of feminists, homosexuals, and other individuals who challenged sexual boundaries "resulted in a concomitant reaction on the part of many medical and scientific men to insist on tighter definitions of acceptable forms of malehood and femalehood" (26). The need to firm up the boundary between male and female led doctors to deny the existence of "true" hermaphrodites. Instead, medical professionals argued that each body had a "true" sex that could be determined through extensive medical examination and which could be secured through surgery and other medical treatments.

Dreger shows how the method of determining the "true" sex of a particular body changed over time: during the late-nineteenth century, doctors used the anatomical nature of a person's gonads, i.e. ovaries and testicles, to determine "true" sex. If an individual had ovaries, she was a woman. If an individual had testicles, he was a man. By the 1910s, says Dreger, this "Age of Gonads" had started to decline. Here Dreger focuses on the work of the Liverpool physician Blair Bell, who argued that sex assignment should be made according to the predominance of secondary sexual characteristics, not the gonads alone. Nevertheless, Bell continued to support the idea that every ambiguous body had a single true sex that could be reinforced through medical intervention.

Dreger concludes the book with an Epilogue that describes how this preoccupation with determining "true" sex continues to affect the treatment of intersexuals in present-day United States. This is the only section of the book in which Dreger was able to present the voices of intersexuals themselves, since the medical records she examined for her historical study did not record the opinions of hermaphrodites. Intersexuals and others interested in promoting the rights of the transgendered will find this section of the book to be both fascinating and uplifting. My only complaint is that there is a...