Doubting Sex: Inscriptions, Bodies, and Selves in Nineteenth-Century Hermaphrodite Case Histories by Geertje Mak (review)

Geertje Mak’s study of hermaphroditism in nineteenth-century Europe illuminates the social and institutional mechanisms through which sex was made routine and self-evident by examining cases in which it was neither—cases, that is, of “doubtful sex.” Mak identifies three overlapping yet distinct “rationales” of sex through which these cases were negotiated: sex as an inscription in the community; sex as a representation of the body; and sex as a representation of the self. For Mak, however, body and self, the long-time bailiwicks of sex and gender scholars, are really twin scions of a single transformation in sexual discourse. Historically, she suggests, the necessary and perhaps sufficient condition for conceiving a sexed self, an object standing in contradistinction to the sexed body, was the abstracting of the body from the person it instantiated. In this way, it became possible to think of bodily sex as an expression of psychic sex, but also as potentially in conflict with it.

Sex as inscription is a far less familiar way of thinking about sexual difference, Mak suggests. While elucidating this rationale on its own historical terms, she also deploys it as a kind of foil for the logic of sex as body and/ versus self. Under the framework of sex as inscription, Mak argues that male and female are best understood as locations within the social matrix of a particular time and place, enacted through characteristic clothing, employments, institutions, physical places, and interpersonal relationships. During the first half of the nineteenth century, so long as these elements of a person’s social identity remained self-consistent, there was neither cause nor means to look “past” them to a “real” sex; male or female simply was as male or female did. Dissonance created by conflicting gender inscriptions presented a threat to social order, which generally was defused through concealment and containment rather than through exposure and formal arbitration.

The cases Mak is able to investigate, of course, are precisely those in which the ordinary policy of concealment broke down. Almost always, these cases involved others whose own places in the social matrix were at stake, often because of marriage or prospective marriage. A close and informed reading of her source materials enables Mak to infer the rule from these exceptional cases. The use of statements by medical practitioners to draw conclusions about a rationale of sex characterized precisely by its not coming under the purview of medical expertise poses a more serious challenge to her argument. She navigates this challenge through what she calls a “praxeographic” approach to the history of medicine, relying on exhaustive research into the French and German medical literature. Mak’s analysis is replete with documentation from physicians’ reports, legal correspondence, and an incisive rereading of Herculine Barbin’s memoirs, which she triangulates to show how cases of doubtful sex were managed in practice. Ultimately, she presents a cogent argument that collapsing physicians’ attentions to the physical aspects of sexuality into a modern body/self-dialectic misconstrues the historical significance of early-nineteenth-century statements by medical practitioners, thereby impoverishing our understanding of the universe of potential meanings in which maleness and femaleness were embedded.

Mak’s narrative turns on the emergence of new medical and medicolegal protocols that allowed unprecedentedly intrusive internal examinations, surgeries, and tissue analysis. The possibility of applying techniques of dissection to a living body gained traction through and helped to fortify an objectified view of the body, creating a conceptual void into which the psychic “self” would emerge. These changes in medical practice, of course, depended on a host of other changes in the social conventions circumscribing the relationship between medical experts and their patients—particularly their presumed-female patients—all of which is well-trod ground for medical historians. On one level, certainly, Doubting Sex is a medicalization story—a story of how physicians became...