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Hermaphrodites and the Medical Invention of Sex
Punctuated with remarkable case studies, this book explores extraordinary encounters between hermaphrodites--people born with "ambiguous" sexual anatomy--and the medical and scientific professionals who grappled with them. Alice Dreger focuses on events in France and Britain in the late nineteenth century, a moment of great tension for questions of sex roles. While feminists, homosexuals, and anthropological explorers openly questioned the natures and purposes of the two sexes, anatomical hermaphrodites suggested a deeper just how many human sexes are there? Ultimately hermaphrodites led doctors and scientists to another surprisingly difficult what is sex, really?
Hermaphrodites and the Medical Invention of Sex takes us inside the doctors' chambers to see how and why medical and scientific men constructed sex, gender, and sexuality as they did, and especially how the material conformation of hermaphroditic bodies--when combined with social exigencies--forced peculiar constructions. Throughout the book Dreger indicates how this history can help us to understand present-day conceptualizations of sex, gender, and sexuality. This leads to an epilogue, where the author discusses and questions the protocols employed today in the treatment of intersexuals (people born hermaphroditic). Given the history she has recounted, should these protocols be reconsidered and revised?
A meticulously researched account of a fascinating problem in the history of medicine, this book will compel the attention of historians, physicians, medical ethicists, intersexuals themselves, and anyone interested in the meanings and foundations of sexual identity.
Hermaphrodites and the Medical Invention of Sex takes us inside the doctors' chambers to see how and why medical and scientific men constructed sex, gender, and sexuality as they did, and especially how the material conformation of hermaphroditic bodies--when combined with social exigencies--forced peculiar constructions. Throughout the book Dreger indicates how this history can help us to understand present-day conceptualizations of sex, gender, and sexuality. This leads to an epilogue, where the author discusses and questions the protocols employed today in the treatment of intersexuals (people born hermaphroditic). Given the history she has recounted, should these protocols be reconsidered and revised?
A meticulously researched account of a fascinating problem in the history of medicine, this book will compel the attention of historians, physicians, medical ethicists, intersexuals themselves, and anyone interested in the meanings and foundations of sexual identity.
284 pages, Paperback
First published January 1, 1998
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Displaying 1 - 23 of 23 reviews
October 20, 2018
Lucid and enlightening. A focused history of the medical (and thus social) treatment of hermaphrodism, something that has been with mammals since the beginning, mainly restricted to Britain and France in the 19th and early 20th centuries, at a time when medicine was advancing rapidly and the definitions of everything were undergoing profound changes.
First published 1998, so twenty years old now. The earlier histories presumably hold good; the epilogue on then-contemporary procedures has now become history, though what it has morphed into for what are now called intersexed persons would require a more recent study, especially as they had then just begun make their own voices heard more and more, moving themselves from subjects to actors.
Also touches on a medical ethics quandary that appears in a lot more areas than this one, namely how shall choices be made for people who cannot choose for themselves, in this case cosmetic surgical and medical treatments of newborns and children. This wasn't an ethical issue before modern times because doctors couldn't do anything anyway. Now that choices can be made, they must be, including the choice to do nothing, so then the problem becomes the education of the choosers. (And of everyone else, for that matter.)
Recommended.
Ta, L.
February 11, 2020
The title may be off-putting for members of the queer community, but in my opinion this book is an excellent addition to the arsenal of evidence against biological essentialism in matters of sex. The author takes clear aim at a medical establishment that, as a whole, put maintaining the existing worldview at least on a level with providing care to their patients, if not ABOVE providing care, as the kind of "care" given was often inextricably tainted by that worldview (as Dreger put it, you cannot have science and medicine without scientists and doctors). The book ends with a look forward at the work the intersex community is doing to assert their bodily autonomy, which is work that we should all be supporting.
July 21, 2011
Exactly the sort of book I've been looking for. The historical approach to the subject explained a great deal about how we've come to think about "hermaphrodites." The book also points out how our notion of gender has hardly changed (it's almost become more strict) and how medicine deals with intersexed people. Dreger touches on almost everything I know of in gender theory. She addresses the history of sex from the hermaphrodite perspective, she addresses the development of sexualities, points out the dominant heterosexist culture and mentions prominent theorists who would seem to be her predecessors. While the writing is on the dry and factual side (which I don't mind at all) it was not overly academic or jargon filled.
She addresses the history of hermaphrodites while pointing out the inconsistencies on how "medical men" interpreted sex. She patiently explains that in the 1800s sex has many assumptions that we've broken down into smaller categories. Sex did not only imply a person's physical sex, but gender and sexuality. She mentions Focault and Butler, who were/are theorists in the same course of study- that is they approached systems from a historical developmental point of view. Judith Butler is currently one of the most influential authorities in queer and gender theory. Dreger manages to work in pieces and parts of theory without teaching it in an academic way.
She doesn't explain the masculine heterosexist culture indepth. I read Gender Knot by Allan Johnson, which didn't have to do with intersexed people, but with the social system and gender issues. Dreger writes about the current situation with intersexed people and doctor's authority. This was in 98, but more current books don't show a vast amount of improvement as far as the medical scene. Even though Dreger's tone is matter-of-fact, I don't think she shows any sympathy for doctors and their deeds (or sins.) Personally, I'm inclined not to sympathize with the barbaric culture that does cosmetic, often problematic and damaging surgery on infants. Fixing Sex by Karkazis is a book that focuses on intersex people and the current treatment (published in 08) of intersex "conditions." In a more forgiving way, Karkazis addresses the predicament doctors, parents and patients find themselves in.
Like I wrote before, Dreger's book was exactly what I was looking for and I thought it was very good. I would give this book 5 stars, but didn't based on the version of the book I got. I bought a digital version of the book and none of the images were in it. I didn't think it was a big deal at first, but as the book continued and Dreger talked about the images the digital version didn't have it was really annoying. It felt like I was missing a third of the content. I've not had this issue with any other digital book I've bought and sent customer service a message about this missing content. Hopefully it'll be fixed.
She addresses the history of hermaphrodites while pointing out the inconsistencies on how "medical men" interpreted sex. She patiently explains that in the 1800s sex has many assumptions that we've broken down into smaller categories. Sex did not only imply a person's physical sex, but gender and sexuality. She mentions Focault and Butler, who were/are theorists in the same course of study- that is they approached systems from a historical developmental point of view. Judith Butler is currently one of the most influential authorities in queer and gender theory. Dreger manages to work in pieces and parts of theory without teaching it in an academic way.
She doesn't explain the masculine heterosexist culture indepth. I read Gender Knot by Allan Johnson, which didn't have to do with intersexed people, but with the social system and gender issues. Dreger writes about the current situation with intersexed people and doctor's authority. This was in 98, but more current books don't show a vast amount of improvement as far as the medical scene. Even though Dreger's tone is matter-of-fact, I don't think she shows any sympathy for doctors and their deeds (or sins.) Personally, I'm inclined not to sympathize with the barbaric culture that does cosmetic, often problematic and damaging surgery on infants. Fixing Sex by Karkazis is a book that focuses on intersex people and the current treatment (published in 08) of intersex "conditions." In a more forgiving way, Karkazis addresses the predicament doctors, parents and patients find themselves in.
Like I wrote before, Dreger's book was exactly what I was looking for and I thought it was very good. I would give this book 5 stars, but didn't based on the version of the book I got. I bought a digital version of the book and none of the images were in it. I didn't think it was a big deal at first, but as the book continued and Dreger talked about the images the digital version didn't have it was really annoying. It felt like I was missing a third of the content. I've not had this issue with any other digital book I've bought and sent customer service a message about this missing content. Hopefully it'll be fixed.
January 19, 2024
The authors quotidian highlighting of how these scientists kept negotiating wether which subject was “a true male” or a “true female” that I just can’t help but reflect on the language we use today.Like how so many cis people use these paradoxical markers as combat towards LGBTQ+ folks especially gender nonconforming and trans people when there has never been an indefinite (female form)or (male form).
Even in the 19th century,pronouns are a phenomenon these medical men were debating .They didn’t know how to label someone with a body so ambiguous and contradictory as an hermaphrodite that they would often times settle with other nomenclatures including “It.”
4//5 stars
Even in the 19th century,pronouns are a phenomenon these medical men were debating .They didn’t know how to label someone with a body so ambiguous and contradictory as an hermaphrodite that they would often times settle with other nomenclatures including “It.”
4//5 stars
June 6, 2017
This is an interesting book that attempts to advise medical professionals who treat intersexed people. There are many varieties of intersexuality (a person is born with male and female characteristics). These can be mild to severe. The severe cases are very rare, but they are very difficult to treat. Dreger challenges the “modernistic” treatment protocols which called for sex assignment early in life. The theory of this protocol was that it would lead to a happier and more successful life rather than allowing the child to grow up with an ambiguous sense of sexual identity.
Dreger prefers a “postmodern” approach that considers intersexuality normal and gender identity fluid. She argues that the surgeries early in life yield questionable results and that the children still grow up with psychological problems. She thinks that no harm will come to the child if it is allowed to be intersexed and then decide later in life if they would prefer some kind of sex assignment surgery. I would need to hear more opinions about this from other doctors, but I think her views should be considered. Severe intersexuality is a difficult problem, and I doubt that there are any easy solutions.
While the question of medical treatment is the foreground of the book, there is definitely a back stream argument being made. Rare cases of intersexuality are used by feminists and homosexuals to argue that heterosexual sex is not the norm… that there is no normal when it comes to sexuality. Sex is ultimately whatever we want it to be. Does nature confirm this or deny this?
Nature is mostly modernist, not postmodernist no matter how badly we might want it to be. Nature does have its moments of gray in the dawn and dusk, but most of the time it is clearly either night or day. Nature favors the night and day of binary sexuality and heterosexuality because it is the most common form of sexuality and because it is the only way to conceive children and the best way to rear them.
Whether we should allow the pursuit of other sexualities or not, or whether we should force people to accept and celebrate other sexualities is a tremendous question today. In my community of faith, we do not accept alternate forms of sexuality because they are contrary to nature and because God has deemed them contrary to His will. But no person is forced to be a part of our community. If they disagree they are free to separate, and we will still treat them with love and respect. We will pray for them and care for them, but we cannot approve of their behavior.
In the larger society we will have to determine whether sexual behaviors contrary to nature are helpful or harmful and if they should be encouraged or discouraged. Christians have long discouraged adultery and divorce as harmful sexual behaviors, but the society has disagreed and has done little to curb them. We see the sad results in the destruction of families and poverty. I believe the same will happen with the LGBT lifestyles because they are not natural and will not prove to be helpful to society.
Notes
Ovid’s myth of Hermaphroditus is found in Book IV of Metamorphoses. The gods Hermes and Aphrodite, the embodiments of ideal manhood and womanhood, have a son named Hermaphroditus. He was a beautifully formed male. The nymph, Salmacis, saw him bathing in her fountain and wanted to be united with him. The gods, in their sense of humor, took her literally and united their bodies together being fully male and fully female.
Figure out how someone organizes the world, and you will understand how he sees the world. Page 140
Carl Linnaeus named us mammals "partly because of his fascination with women's breasts and his involvement in a debate over wet nursing; Linnaeus wanted to see women start farming out their babies too wet nurses, and this contributed to his decision to make the breast the memories the marker trait of mammals.” Page 140
In the late 19th Century scientific men chose gonodal anatomy as the marker for sex classification systems because it made it possible to uphold a stark division into male and female. Page 140 (Or because the was one of the most obvious markers of sexual identity? My note)
Postmodernism has brought with it the recognition that there can never be a single, self evident, “true” story to be told about life, disease, or condition. In the past, if a relatively disempowered person's story conflicted with the dominant story, the socially weaker individuals tail was likely to go unheard or discounted. Page 171
Intersexual's have realized that, like straight women and gay people, they need not be treated as fundamentally unacceptable or flaw– that it is not their bodies that make their lives difficult but the cultural demands forced upon their bodies. Page 173
The modern-day medical technological approach to intersexuality is extremely modernistic. Typically, after the hospital birth of an intersex baby, teams of specialists are immediately assembled. These doctors decide to which sex/death gender a given child will be assigned, and the power of modern medicine is then brought to bear to create and maintain that sex in as believable a form as possible. Page 181
That psychosocial gender identity th established in by John Money in the 1950s, holds that all children must have their gender identity fixed very early in life; that from very early in life children's anatomy must match the standard anatomy for their gender; and that boys primarily require adequate penises without a vagina, while girls primarily require a vagina with no noticeable phallus. This psychosocial theory of intersexuality presumes that these rules must be followed if intersexual children are to achieve successful adjustment appropriate to their assigned gender – that is, if they are to act like girls, boys, men, and women are supposed to… Page 182
Intersex surgeons make their decisions and incisions within a heterosexist framework. Page 184
The presumption that restitution to a male or female sex is possible and is possicle primarily via medical technology is also notably modernistic. Remarkably, the medical – technological approach rains in intersex medicine despite the fact that intersects experts ridley confess that inter-sexuality is not primarily a medical problem but instead a social problem. Page 186
Most objectionable too many feminists and where critics is the presumption inherent in these protocols that there is a right way to be a male and a right way to be a female, and that children who are born challenging these categories should be reconstructed to fit into them. Page 188
Dreger prefers a “postmodern” approach that considers intersexuality normal and gender identity fluid. She argues that the surgeries early in life yield questionable results and that the children still grow up with psychological problems. She thinks that no harm will come to the child if it is allowed to be intersexed and then decide later in life if they would prefer some kind of sex assignment surgery. I would need to hear more opinions about this from other doctors, but I think her views should be considered. Severe intersexuality is a difficult problem, and I doubt that there are any easy solutions.
While the question of medical treatment is the foreground of the book, there is definitely a back stream argument being made. Rare cases of intersexuality are used by feminists and homosexuals to argue that heterosexual sex is not the norm… that there is no normal when it comes to sexuality. Sex is ultimately whatever we want it to be. Does nature confirm this or deny this?
Nature is mostly modernist, not postmodernist no matter how badly we might want it to be. Nature does have its moments of gray in the dawn and dusk, but most of the time it is clearly either night or day. Nature favors the night and day of binary sexuality and heterosexuality because it is the most common form of sexuality and because it is the only way to conceive children and the best way to rear them.
Whether we should allow the pursuit of other sexualities or not, or whether we should force people to accept and celebrate other sexualities is a tremendous question today. In my community of faith, we do not accept alternate forms of sexuality because they are contrary to nature and because God has deemed them contrary to His will. But no person is forced to be a part of our community. If they disagree they are free to separate, and we will still treat them with love and respect. We will pray for them and care for them, but we cannot approve of their behavior.
In the larger society we will have to determine whether sexual behaviors contrary to nature are helpful or harmful and if they should be encouraged or discouraged. Christians have long discouraged adultery and divorce as harmful sexual behaviors, but the society has disagreed and has done little to curb them. We see the sad results in the destruction of families and poverty. I believe the same will happen with the LGBT lifestyles because they are not natural and will not prove to be helpful to society.
Notes
Ovid’s myth of Hermaphroditus is found in Book IV of Metamorphoses. The gods Hermes and Aphrodite, the embodiments of ideal manhood and womanhood, have a son named Hermaphroditus. He was a beautifully formed male. The nymph, Salmacis, saw him bathing in her fountain and wanted to be united with him. The gods, in their sense of humor, took her literally and united their bodies together being fully male and fully female.
Figure out how someone organizes the world, and you will understand how he sees the world. Page 140
Carl Linnaeus named us mammals "partly because of his fascination with women's breasts and his involvement in a debate over wet nursing; Linnaeus wanted to see women start farming out their babies too wet nurses, and this contributed to his decision to make the breast the memories the marker trait of mammals.” Page 140
In the late 19th Century scientific men chose gonodal anatomy as the marker for sex classification systems because it made it possible to uphold a stark division into male and female. Page 140 (Or because the was one of the most obvious markers of sexual identity? My note)
Postmodernism has brought with it the recognition that there can never be a single, self evident, “true” story to be told about life, disease, or condition. In the past, if a relatively disempowered person's story conflicted with the dominant story, the socially weaker individuals tail was likely to go unheard or discounted. Page 171
Intersexual's have realized that, like straight women and gay people, they need not be treated as fundamentally unacceptable or flaw– that it is not their bodies that make their lives difficult but the cultural demands forced upon their bodies. Page 173
The modern-day medical technological approach to intersexuality is extremely modernistic. Typically, after the hospital birth of an intersex baby, teams of specialists are immediately assembled. These doctors decide to which sex/death gender a given child will be assigned, and the power of modern medicine is then brought to bear to create and maintain that sex in as believable a form as possible. Page 181
That psychosocial gender identity th established in by John Money in the 1950s, holds that all children must have their gender identity fixed very early in life; that from very early in life children's anatomy must match the standard anatomy for their gender; and that boys primarily require adequate penises without a vagina, while girls primarily require a vagina with no noticeable phallus. This psychosocial theory of intersexuality presumes that these rules must be followed if intersexual children are to achieve successful adjustment appropriate to their assigned gender – that is, if they are to act like girls, boys, men, and women are supposed to… Page 182
Intersex surgeons make their decisions and incisions within a heterosexist framework. Page 184
The presumption that restitution to a male or female sex is possible and is possicle primarily via medical technology is also notably modernistic. Remarkably, the medical – technological approach rains in intersex medicine despite the fact that intersects experts ridley confess that inter-sexuality is not primarily a medical problem but instead a social problem. Page 186
Most objectionable too many feminists and where critics is the presumption inherent in these protocols that there is a right way to be a male and a right way to be a female, and that children who are born challenging these categories should be reconstructed to fit into them. Page 188
March 15, 2012
This book surprised and appalled me. Surprised because I didn't realize how subjective determining a person's sex is - the baby is born, the doctor takes a look, and then makes a declaration of boy or girl. Appalled because if a baby isn't easily identified as boy or girl in that look, the baby is probably in for a lifetime of surgeries and medical humiliations that are completely unnecessary health-wise but make the doctors feel better because they "fixed" a "problem".
Such a great book. I highly recommend it to everyone, but especially people who are going to have children so that they'll be better informed of the history and prepared for the doctors' b.s. pressures if they have an intersex child.
Such a great book. I highly recommend it to everyone, but especially people who are going to have children so that they'll be better informed of the history and prepared for the doctors' b.s. pressures if they have an intersex child.
June 9, 2022
Made it to p79 and saw no reason to go any further.
Really disappointed in the quality of the research. The book is poorly organized and very very very repetitive. The author takes too long to address obvious questions like what percentage of the population is considered a Hermaphrodite and then dances around the facts.
There were one or two interesting anecdotal stories but they too were underdeveloped and led to nothing substantial being learned.
I was hoping to understand more about the science and history of Hermaphrodites but learned very little and I'm not certain I can trust the source since she states herself that she has a very strong bias and agenda.
Really disappointed in the quality of the research. The book is poorly organized and very very very repetitive. The author takes too long to address obvious questions like what percentage of the population is considered a Hermaphrodite and then dances around the facts.
There were one or two interesting anecdotal stories but they too were underdeveloped and led to nothing substantial being learned.
I was hoping to understand more about the science and history of Hermaphrodites but learned very little and I'm not certain I can trust the source since she states herself that she has a very strong bias and agenda.
February 17, 2023
What is sex? Such a basic question would seem to have a straight forward answer until one considers how many people are born who aren’t clearly or completely one or the other. Dr. Dredger takes a fascinating look at how the medical profession handles such challenging cases and perhaps should be a little less anxious to do so.
April 25, 2022
I can see ways in which this book could be better, but given the way in which the topic of intersexuality or hermaphroditism has been erased from history and people’s consciousness, books like this one are extremely important.
September 8, 2018
The butler did it.
February 12, 2024
Enlightening
July 2, 2011
This book was really intriguing and did a great job both introducing and expanding on topics I'd never explored in depth. It discusses how people with ambiguous genitalia fared when encountering scientific and medical men in an age when it was believed science would eventually solve everything. As someone living with chronic illness, I can readily sympathize with the experience of intersexuals whose encounters with medicine are marked by paternalism and deceit. I found myself in particular agreeing with the author's statement toward the end of the book:
"But medicine at its best empowers rather than overpowers[...]. Medicine at it's best makes available education and choices, and values informed consent. It includes an honest assessment of risks and respect for a patient's choice."
The author makes a point of describing this attitude as postmodern, as opposed to the modern approach of 19th and early 20th century medicine described throughout the book (and often still employed today when dealing with babies born with ambiguous genitalia, an event that occurs much more frequently than most people realize). The modern approach assumed every body had a "true" sex, and the only problem was for scientific and medical men to "find" it. The postmodern approach, encouraged by intersex advocacy groups like the Intersex Society of North America, looks for a narrative that can be lived comfortably by the patient, essentially allowing "truth" to mean "that which works". In other words, meet people where they are, and don't assume anyone, no matter their scientific or medical background, is the sole arbiter of truth.
"But medicine at its best empowers rather than overpowers[...]. Medicine at it's best makes available education and choices, and values informed consent. It includes an honest assessment of risks and respect for a patient's choice."
The author makes a point of describing this attitude as postmodern, as opposed to the modern approach of 19th and early 20th century medicine described throughout the book (and often still employed today when dealing with babies born with ambiguous genitalia, an event that occurs much more frequently than most people realize). The modern approach assumed every body had a "true" sex, and the only problem was for scientific and medical men to "find" it. The postmodern approach, encouraged by intersex advocacy groups like the Intersex Society of North America, looks for a narrative that can be lived comfortably by the patient, essentially allowing "truth" to mean "that which works". In other words, meet people where they are, and don't assume anyone, no matter their scientific or medical background, is the sole arbiter of truth.
August 4, 2016
There are a lot of important issues raised in this book. It's an interesting look at how we've treated those with ambiguous genitalia over the the last few centuries. I'll be interested to see if this work and others have caused a shift in the practices done to infants. It's noteworthy that the 19th Century Intersex persons have no voice as they did not leave a record, and we only have the medical case histories. I wonder if how we treat Intersex individuals is the deepest test of our humanity? In most cases, their not sick, but society is uncomfortable with a man with a "micropenis" or a woman whose clitoris sticks beyond her labia. What we've done is unconscionable, all in the name of embarrassment. It was shocking to learn how little follow up has been done on many of these medical treatments done on infants. This book is shocking, and reminds us all that genitalia is only one signal regarding one's gender, but does not define it.
November 2, 2015
This is a really nice, succinct and quite easily written (given the abundance of medical terminology used because of the topic's interdisciplinarity) intervention in the history of medicine of the late 19th and the early 20th century. The book provides a glance on how the medicine was shaped by the society and the culture and in its turn shaped them as well. It made me realize again how little in fact have changed in medical reasoning regarding the question of people who are born with "ambiguous" genitalia and the question of what determines our sex and how many sexes should/could exist our there.
Currently reading
November 29, 2008I've been reading this for a year...it's really good, so don't let that put you off! I read the first half (or more) and have been taking a break. This book focuses on medical treatment of disorders of sex development (DSD, which is the modern medical term; hermaphroditism is the term correct to the time period covered in the book) in England, France, and Germany (I think) in the late 1700s through early 1900s. It's really a study in the culture of gender, sex, and medicine in that period...fascinating.
January 5, 2015
The epilogue was the crux of this book. It is here that Dreger delves into the moral and cultural implications of "correcting" unusual genitals. The main part of the book provides a rich historical context, but it can get dry at times. I suspect Dreger was trying to present as unbiased of a history as was reasonable possible and I certainly respect that. However, I think where Dreger shines as a writer is when she inserts herself into the text a bit and provides her own opinions and analysis. I would have liked to have seen the analysis be not quite so restricted to the epilogue.
April 27, 2012
This is a great introduction to intersex. The main problem is that it was written over a decade ago. So it must be read in a 20th century context. She does a great job summarizing over a century's worth of history.
September 4, 2015
An academic overview of the "problem" of ambiguous genitalia, intersex children and adults, and those living as one sex (and even marrying) when (medically speaking) there were internal organs of the other sex.
November 18, 2019
See highlights for sample tidbits from the book with interesting trivia, phrasing, metaphors and facts !!! Well researched and well written.
November 26, 2014
Very interesting insights into the medical side of gender.
February 16, 2009
4.5 stars, truly.
March 28, 2010
Brilliant and highly recommended!
Displaying 1 - 23 of 23 reviews