Source of book: I own this
It is hard to believe it has been a decade since I wrote my series on the Bathroom Wars™, aka the demonization of transgender people, which has become the favorite hobby horse of the hate-obsessed right wing in the Trump era.
In that series, I talked about the issues facing intersex people, and the perceived necessity of right wingers to deny that they exist - and to force them into a rigid gender binary. Later, I talked about how denialism about queer people is fundamentally driven by misogyny and the need to preserve a hierarchy of power that justifies male violence against women.
I link both of these for different reasons. The first in part is because I talk about an intersex client I had over a quarter century ago. Representing that client opened my eyes to a lot of things, including the legally sanctioned genital mutilation that continues to be done to intersex people. The second is because it really ties in with some of the things that Hermaphrodites and the Medical Invention of Sex points out.
One thing I will note is that, not only have I learned a lot more since I wrote the first post, there has been a definite shift in my understanding of white evangelicals in the intervening time.
I used to think that they could respond to an appeal to some combination of facts, empathy, and human decency. I no longer believe that. Most white evangelicals are driven by terror of and vicious hatred for people different from them - and while that includes people with different beliefs, skin colors, and national origins, what they hate the most are people who are outside of their rigid gender and sexuality binary. Can some change their mind? Yes. But most of those who can already have, now that Trump has revealed the evil that lies at the core of white evangelicalism.
Okay, so, that out of the way, I want to talk about what this book is and isn’t.
This is not a book about intersex variations. You are not going to learn about the various causes of intersex traits, their challenges, fertility options, or other scientific specifics.
Rather, this is a book about the modern history of how medicine has responded to the existence of intersex people.
The author is a historian, as she makes clear with a fun Star Trek reference:
I often wanted to retreat to a paraphrase of Star Trek’s Dr. McCoy - “Damn it, I’m a historian, not a doctor or an ethicist or a sociologist!”
Intersex people are nothing new. They have always existed. St. Augustine talks about them. They are a part of many ancient mythologies. We have evidence of their existence dating back to the dawn of human writing about humans. They are a natural and normal part of nature.
This has, historically, been recognized - it really is a modern affectation to believe in only two sexes, and a rigid binary.
The Hippocratic paradigm assumed that sex existed along a sort of continuum from the extreme male to the extreme female and that the hermaphrodite therefor was s/he who lay in the middle.
This is because of how organisms develop. Rather than create two completely different templates for male and female, we have a lot of overlap in the DNA assembly instructions. It’s as if a motorcycle and a helicopter were made using mostly the same parts, and the parts that differed were variations on the same parts.
This is literally the case for male and female. It is why male mammals have nipples. It is why the same structures in early development can become either male or female genitalia and gonads.
Because of this development process, wherein genitals and brains develop on different schedules and in different environments, not only can genitals and gonads not fit the pattern of “male” or “female” development, brains too can develop in a way that they do not match genitals. (This is very likely why transgender people exist - they are intersex at a level that we do not currently have the technology to understand.)
Again, most of this isn’t addressed in the book, other than to give enough background to understand a bit of the why. The book focuses on how doctors (nearly all of them white and male) dealt with the obvious existence of people who didn’t fit classifications.
I will get into more detail later in the post, but I will give the big spoiler: because of societal pressure for there to be a gender binary, doctors spent their time and efforts not in bettering the lives of intersex people, but in “determining” what the “true” sex of their patients were, then forcing them into living as that supposed “true” sex.
That this led - and continues to lead - to much suffering and even suicide should surprise nobody.
The Procrustian approach has never served humans well.
While there has been some progress around the world in the treatment of intersex people, the religious right here in the United States continues to deny that they exist, instead insisting that everyone is either male or female and can be mutilated to better “match” that assigned sex.
And that really is what this is about: giving doctors and governments the right to “determine” what sex a person is, and mutilate their bodies without consent in order to preserve the myth of a rigid sexual binary.
Before I get into the book itself, I want to note that “hermaphrodite” is now considered an outdated and inaccurate term - it has been used as a slur at times, and few intersex individuals have both male and female traits. The more usual is a set of traits that have elements of male and female.
Instead, I will use “intersex” as the more medically accurate and preferred term when using my own words, and “hermaphrodite” only when quoting the author or especially the 19th Century doctors who are quoted extensively in the book. The book was published in 1998, and a lot has changed since then in terms of terminology, so understand that Dreger will seem a bit dated at times.
The book opens with the story of Sophie, a Belgian woman whose case came to the attention of a doctor named Dandois when she consulted him regarding a difficulty her husband had in penetrating her vagina.
Further examination revealed that Sophie’s genitals were a bit unusual. She had an incomplete opening, and a phallus-like organ that was too big to be a typical clitoris, and too small to be a typical penis. The urethra did not go through it. Her labia had at least one testicle in them - at least as far as the doctor could tell through feel.
In what is a theme of the book, the doctor decided that Sophie wasn’t a woman at all, despite being raised as one, identifying as one, and being otherwise happily married to a man.
Sophie was furious to find out that the doctor considered her a man and wanted her to change her name and mode of living to reflect that.
Far better would have been for the doctor to have understood how intersex traits work, and educated Sophie (and her husband) about the nature of her body.
The author explains how sex (and not just gender) is complicated.
The sexual development of any individual is a complicated and amazing event, involving the working of chromosomes, the action of self-produced and/or ingested hormones, the effects of environmental agents like toxins and nutritional substances, social norms like those that dictate circumcision or clitoridectomy or certain levels of physical prowess, family dynamics, individual sexual encounters, accidents, and so on. What it means to be a male, a female, or a hermaphrodite - or what it means to become a male, a female, or a hermaphrodite - goes far beyond the “sex chromosomes.”
Dreger continues:
Indeed, when we focus on hermaphrodites, as this book does, we sometimes forget how much variation in sexual anatomy there is among undoubted males and females. Clitorises and penises, for instance, come in a wide range of shapes and sizes even in people labeled “normal” in terms of their sex.
The same is true for secondary sexual characteristics, as the author points out.
Also important to the discussion is that our society is structured around a sex binary, which includes everything from pronouns to bathrooms to clothing. And our understanding of what makes one “male” or “female” is so culturally conditioned that any supposed “test” for sex will be inadequate at best.
Although it seems not so difficult to recognize that some bodies look fairly unusual in terms of the genitalia, it is difficult to answer the question of what exactly a hermaphrodite is, because to do so one must first decide what trait or traits are so important to femalehood and manhood that the possession of a combination of those traits by any single body would necessarily designate that single body hermaphroditic.
The author talks about the history of “sex testing” for athletes, which itself led to great difficulties in defining what made one male or female.
In contrast to the increasing difficulty of drawing a rigid line as we have learned more about human sexual development, the trend noted in the book regarding how male, female, and intersex were defined has been to exclude more and more people from being “true hermaphrodites” and instead assign them to “male” or “female,” consequences be damned.
Hermaphrodites get reduced in number (by being sorted and surgically made into “boy/man” or “girl/woman” types) chiefly because we have many social distinctions that depend on their being (only) two sexes.
And this is also about compulsory heterosexuality.
Even a cursory study of the phenomenon of sex-sorting, one soon discovers that a significant motivation for the biomedical treatment of hermaphrodites is the desire to keep people straight. That phrase - keep people straight - should be taken figuratively, but literally as well: medical doctors, scientists, hermaphrodites’ parents, and other lay people have historically been interested in sorting people according to their sexes to avoid or prevent what might be considered homosexuality.
The author, in her class on this topic, finds that students will ask her in exasperation what the real key is to male, female, and other.
But, as I tell them, and as we shall see, the answer necessarily changes with time, with place, with technology, and with the many serious implications - theoretical and practical, scientific and political - of any given answer. The answer is, in a critical sense, historical - specific to time and place…What it means to be a male, a female, or a hermaphrodite - and how you know you are a male, a female, or hermaphrodite, and what will happen to you if you are identified as a male, a female, or a hermaphrodite - is specific to time and place.
Throughout the book, the author uses “medical men” and similar gendered terms, and notes that the reason for this is that they were all men. This is problematic in many ways, and not just in the sense of obvious sexism. Without the perspectives of women and intersex people, the decisions made tended to reflect the need to maintain patriarchal norms, not do what is best for individual humans.
Indeed this classification system developed in direct response to the exigencies of hermaphroditism and especially in response to the pervasive interest among medical and scientific men in keeping social sex borders clear, distinct, and “naturally” justified.
There is in fact one woman in this book, Clemence Royer, and it is interesting that she very often had a different perspective on matters than the men she worked with.
Just one example of a questionable path history took as a result was that of looking at sex as being determined by one single trait, that of gonads. This is expanded on in a later chapter. This had the effect, particularly in the United States, of shifting power away from intersex people, their families, and their partners, to doctors now tasked with the mandate of “assigning” the sex of newborns to one pole of the binary.
Many authorities existed in the lives of hermaphrodites in the late nineteenth century, from midwives to grandmothers, to surgeons and physicians, to lovers and friends, to the hermaphrodite him/herself. Today, by contrast, especially in the United States, physicians possess the vast share of the say in what a person’s sex is and/or will be.
As the author gets into the meat of the history, she notes that the medical and scientific establishment - once exclusively male - has all too often tried to justify current social conditions as being “natural” and those advocating for social change as “unnatural.”
[M]any medical and scientific men in France and Britain vigorously tried to argue and to evidence that the existing social sex boundaries in their cultures reflected and were therefore necessitated by “natural” sex boundaries - that (most) women did what (most) women did because they were female, that (most) men were manly because of their manhood, that to do otherwise would not only be unusual, and perhaps immoral, but also unnatural. Never could the two sexes meet in ideas, talents, or roles, for they had parted so long in the past.
As part of the discussion of one of the more common intersex variations, Androgen Insensitivity Syndrome, there is a really interesting point that the author makes that I hadn’t thought of, but now seems obvious.
Generally AIS individuals do not develop very much noticeable body hair, and they grow tall with long arms and legs. Indeed, with these features - tall, smooth-skinned bodies with rounded hips and breasts and long limbs - they seem to fit the dominant feminine idea in the United States today better than most medically “true” females.
The author notes the rumor (not conclusively evidenced but plausible) that many fashion models may in fact be intersex.
One of the scientists quoted a lot (for good and bad) is Pozzi, who contributed a great deal to the understanding of embryonic development. One particular good line is this one:
“Up to a certain age the foetus has potentially the organs of both sexes, and it is only by the ascendant development of the one set that the other is suppressed. Nor is the suppressal [sic] in either sex ever absolute, for every male has mammary glands and every female has a clitoris, organs which definitely belong to the other sex, and which persist only because the suppressal has been incomplete.”
Later in this chapter, the author again comments on the various case studies these scientists wrote.
Often these texts contained background information on the types or likely origin of hermaphroditeism (and as already noted, a few amusing anecdotes). The implied “morals” of these narratives usually included some or all of the following: that the anatomy is the locus of truth; that the doubtful patient really had a single true male or female sex; that men and women were fundamentally different and that they should (and would) be true to their sexed natures; that if they were not, bad things would happen; that the medical man must do what he could, with theory and practice, to solve hermaphroditism.
The next chapter gets into the shift toward looking at genitals as determinative - and assigning sex based on fairly arbitrary measurements. Which again disregards the actual needs and experiences of intersex people.
Socially and psychologically the resolution of these cases of “mistaken sex” could be rather sticky, but medically it seemed a cinch.
This chapter also has an interesting discussion of the intersection of sex, gender, and sexuality. We now think in terms of this “tripartite division,” but not that long ago, they were lumped together a lot more. So everything from who a person was sexually attracted to, to their aptitude for culturally gendered activities could be considered evidence of being a “hermaphrodite.” By this measure, my wife could be considered more male than I am, even though she is a cis female.
But of course, the pressure on physicians was to fit everyone into a binary, and to conclusively and confidently state that they knew what sex any individual “really” was.
[I]n any single instance of doubtful sex, medical practitioners searched the person in question for every possible sign of sex, within and without the doubtful body, in its anatomy, physiology, demeanor, tastes, and talents. The idea here was that the “true sex” of every body would ultimately be found and settled.
…
This again reinforced the hopeful belief that there really could be no true hermaphroditism in humans, no truly profound mixing of the male or female - since all anomalous signs were only “apparent” or “false.”
This is the lie that the religious right clings to in their desperate need to keep male and female completely separate - and women subordinated to men.
Oh yeah, and I should also mention yet another false belief of the religious right (and anti-trans people in particular) that still poisons our politics.
On both sides of the Channel, male sexuality was thought naturally, frightfully insidious, and the possibility (and occasional incidence) of masked males placed among unsuspecting females caused medical men terrific anxiety. Indeed, the pernicious character of male sexuality constituted a major reason for raising doubtful children as males: if a masked male were raised among females, the logic went, his sexuality was bound to erupt, forcing him to behave “like a wolf in a sheepfold.”
And, of course, the related fear that a “feminine” man might lure men into homosexuality.
Obviously a general fear underlay all these anxious pronouncements, namely a fear of all sexual encounters that did not conform to particular kinds of socially sanctioned heterosexual relations.
Part of my deconstruction from fundamentalism was driven by my realization that so much of the doctrine wasn’t grounded in anything positive, but a fear - a terror - of human sexuality. My discovery that intersex people existed pretty much ended any delusion that there was anything “natural” about a particular form of heterosexuality, and I realized that any ethical discussion of sexuality really needed to be based on universal ethical precepts such as consent and responsibility for consequences.
There is also a great discussion of the intersection of culture, sexuality, and sexed traits. One of the best bits comes from Karl Ulrichs, who considered himself (in the 19th century!) to be non-binary, a third sex, with both masculine and feminine traits, despite not being intersex. It was this kind of thought that led to a push to liberalize laws related to sexuality and gender. As I tend to think these days, I believe that being LGBTQ is essentially on the intersex continuum - you can read my thoughts about that here. This was already being discussed 150 years ago.
A quote by Xavier Mayne is also forward-looking:
“By what right have we gone on insisting that each specimen of sex in humanity must conform absolutely to [one of] two theories [the “normal” male or “normal” female], must follow out [one of] two programmes only, or else be thought amiss, imperfect, and degenerate[?] Why have we set up masculinity and femininity as processes that have not perfectly logical and respectable inter-steps?”
Indeed. Even if those intersteps are as cultural as my wife being a natural leader and me playing violin and loving cats.
But all of this is primarily cultural, not biological. They are the product not of observation of how nature exists, but of human organization. The author has a great line about this.
What I soon realized about these taxonomies was that they were incredibly interesting. They were, in an important sense, where half the action played. Figure out how someone organizes his world, and you will understand how he sees the world. You will also see how the organization system likely arranges the world in such a way as to reinforce that system maker’s idea of the world - how what seems important gains in importance, how what seems unimportant fades from view.
This took on great importance once those doing the organization settled on gonads as the determining factor for “male” and “female.”
Now a practitioner could also, as we have seen, by a single criterion decide who was “truly” a man and who a woman. This very strict conceptual order was imposed on any being who seemed otherwise likely to threaten the borders between males and females.
And as far as that goes, why choose gonads over other markers? Most of us will never see most other people’s genitals, let alone examine their gonad tissue under a microscope.
I think it more likely that the choice of gonads as markers of true sex derived from the late nineteenth-century idea that the fundamental difference between men and women lay in their reproductive capabilities.
Or, more crassly, the belief that female humans exist primarily to make babies and serve men.
I therefore suspect that the widespread adoption of the gonadal definition of sex was driven not by a strictly “scientific” rationale but instead for the most part by pragmatism: it accomplished the desired preservation of clear distinctions between males and females in theory and practice in the face of creeping sexual doubt. The practical result of the adoption of the gonadal definition was that most bodies, no matter how ambiguous looking or acting, were entitled only to a single sex, and “true” living hermaphrodites were - by definition - impossible.
You can see this belief still acting as the governing basis for the religious right’s insistence that there are only two sexes, and everyone can be forced into one category or other. In other words, intersex people don’t really exist, despite all evidence that they do. And we all know why this is so important to them.
In trying to understand the revision of true hermaphroditism as a concept, it certainly would be a mistake to neglect the inevitable importance of the concurrent rise of social challenges to sex borders.
As women and LGBTQ people demanded more social, economic, and political equality, the white males who gatekept medicine insisted on increasingly rigid categories - and tied gender essentialist beliefs to those categories.
For a medical man to admit a living, doubtful subject to true hermaphroditism would have been potentially to add to the threat of social sex confusion fomented by people like feminists and homosexuals.
Even as medical practice moved away from a purely gonadal view of sex later in the 20th Century, the idea that humans needed to be forced into the sexual binary, with nonconsensual surgery if deemed necessary, endured.
So true sex would, perhaps, no longer be dictated exclusively by the anatomical nature of the gonads. But only two true sexes would still exist, with a limit of one to each body, and the medical man would still be the interpreter - and now, when necessary and possible, the amplifier - of true sex.
This - the assignment to and the surgical construction of a single, believable sex for each ambiguous body - was the way of the future.
This idea is crucial to understanding the terms used regarding both intersex and transgender individuals: “assigned male at birth” and “assigned female at birth.” Because what has happened is not that a person is male or female, but that they were assigned the designation of male or female when they were born, by a medical professional, and were then expected to conform to that assignment, regardless of whether it fit them or not.
Notice that once again, the person who actually exists is treated as irrelevant. They are not asked what they think would be best for them. Instead, it is society’s need to classify humans within a caste system that wins.
The epilogue is truly fascinating, and I took a lot of notes. The author makes the argument that the missing ingredient in the history are the voices of intersex people themselves. Instead, cisgender doctors and often parents have forced infants into nonconsensual genital mutilation that often results in functional problems later. She addresses three issues, which she lists as follows:
The present-day medical treatment protocols for intersexuality, which call for the creation, as soon after birth as possible, of a “believeable” masculine or feminine anatomy via plastic surgery and hormonal therapy, and a silencing of any doubt parents or others might have.
How these protocols, however well intentioned, maintain many vestiges of nineteenth-century medical theory and practice.
The present moment in which intersexuals are finally themselves challenging medical treatment protocols and the rigid cultural categories that impel those protocols.
Two quotes open the epilogue, and they are both worth reading.
“One of our most difficult duties as human beings is to listen to the voices of those who suffer…These voices bespeak conditions of embodiment that most of us would rather forget our vulnerability to. Listening is hard, but it is also a fundamental moral act; to realize the best potential in postmodern times requires an ethics of listening.” (Arthur Frank)
This cuts to the heart of the issue, and also to why I believe the religious right is evil. Fundamentally, if we are to show basic human decency to our fellow humans, we must listen to those who suffer. And that is the one thing the religious right utterly refuses to do.
It is why they lecture the poor, dismiss racism as a myth, insist on the subordination of women, and deny that LGBTQ people actually exist.
True morality requires listening, not lecturing. And “listening with” as the author puts it.
The second quote is all about this specific issue.
“Genital ambiguity is “corrected” not because it is threatening to the infant’s life but because it is threatening to the infant’s culture.” (Suzanne Kessler)
Intersex people and how we have treated them are evidence that what we have is a cultural problem. Our refusal to accept that not everyone fits the binary is rooted in misogyny, the belief in the inferiority of women and the necessity of their mistreatment. It is this that fuels the anti-transgender panic and hate. And why the religious right insists on silencing the voices of the hurting. As hemophiliac Donald Bateman noted:
“[T]he social history of medicine is usually recorded by its practitioners, by social workers, or researchers. Not much of it is chronicled by its victims or the recipients of treatment. The sick, like the poor, leave very few archives behind them.”
One of the benefits of the 21st Century and indeed the internet, for all its faults, is that the voices of the sick, the poor, and intersex people are finally being heard. (There are several intersex vlogers on YouTube that I have followed over the years as part of my ongoing work to stay current on LGBTQIA issues for both personal and professional reasons.) This in turn is, of course, leading to further cultural panic and pearl clutching by the religious right, as they see their false narrative crumbling, and young people, particularly women, fleeing their churches.
Rather than address their own appalling lack of empathy and ethical behavior, right wing bigots choose to cast empathy itself as a “sin,” and maintenance of social hierarchies as the sole measure of morality. Is it any wonder so many of us left?
Ethical behavior means recognizing and respecting the imperatives embedded in stories of suffering.
I grew up being warned of the dangers of Postmodernism, mostly by people who had no idea what the hell they were talking about. As an adult, I have come to realize that Postmodernism, while as incomplete as any other lens through which to view the world, has one brilliant insight.
[P]ostmodernism has brought with it the recognition that there never can be a single, self-evident, “true” story to be told about a life, disease, or condition. In the past, if a relatively disempowered person’s story conflicted with the dominant story, the socially weaker individual’s tale was likely to go unheard or discounted. Postmodernists like Frank recognize, however, that the decision to call one story “true” or primary is a complicated one involving many value choices. With this recognition, intersexuals and others are now able to tell and “hear” stories about intersexual life that challenge or conflict with the classic modernist medical story about relatively simple, containable, attacking invader “diseases” and heroic, purgative “cures.” Postmodernist intersexuals refuse to take their doctors’ stories about them, their “problems,” and their treatments as primary; instead they reject, change, or incorporate medical narratives into their own narratives and make their own stories primary - at least in their own lives.
And more:
Finally, postmodernism, in its appreciation of the social construction of concepts like sexual identity and normality, has given intersexuals the opportunity to see their plight as contingent to social times and places - to see their experiences as culturally, historically specific and therefore not inherent in or necessary to their bodies. Cultural histories such as the one presented in this book have demonstrated the cultural dependency of the categorization and treatments of males, females, and hermaphrodites. Awareness of the “social construction” of these categories has enabled intersexuals to object to their treatment as “freaks” or “problems” to be corrected and disappeared. Intersexuals have also looked beyond the history of hermaphrodites to the history of the medical treatment of homosexuality and have noted that, until very recently, gay and lesbian people were also widely regarded as troubling and troubled “freaks” to be “fixed.” The history of the biomedical construction of womanhood reads similarly. Intersexuals have realized that, like straight women and gay people, they need not be treated as fundamentally unacceptable or flawed - that it is not their bodies that make their lives difficult, but the cultural demands forced upon their bodies.
This is ultimately why the right wing HATES Postmodernism so much. Instead of white conservative males getting to cram their preferred narrative down everyone else’s throat, all of a sudden the perspectives of women, racial minorities, sexual and gender minorities, the poor, and more are given a more equal weight, and the gatekeepers of white male wealth privilege are losing their shit, and take their terror out on those they see as the easiest targets. (Currently immigrants and transgender people are bearing the brunt of this.)
But despite all of this, marginalized voices insist on being heard, and the right wing’s scream of rage at cultural change, while dangerous when combined with political power, will ultimately be self-destructive. Because no ideology can give the middle finger to reality forever.
Part of telling that story - indeed of telling any story from a marginalized point of view - is to correctly call out the abuse that those with power wish to inflict. As intersexual advocate Cheryl Chase said:
“The time has come for intersexuals to denounce our treatment as abuse, to embrace and openly assert our identities as intersexuals, to intentionally affront that sort of reason which requires that we be mutilated and silenced.”
Sven Nicholson is also quoted, talking about the mutilation of his genitals that left him damaged in his ability to urinate.
“In retrospect, I wish that the operations had never happened, that I had simply been allowed to live out my life with the plumbing system originally given to me by my creator.”
Although progress has been made in some areas, the perceived need to find a “true” sex of a child continues to lead to poor care. Following the gonadal theory, there was a shift for a while to the idea that a child’s gender identity was socially formed, and that one could raise a child as either sex and they would be fine conforming to that sex. (Spoiler: it doesn’t work.)
That psychosocial gender-identity theory, established 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 boy’s primarily require “adequate” penises with no vagina, while girls primarily require a vagina with no noticeable phallus.
So, surgical intervention became standard, regardless of the need. And, in practice, this usually meant assigning intersex infants to “girl” as happened to my client.
The logic behind the tendency to assign the female gender in cases of intersexuality rests not only on the belief that boys need “adequate” penises, but also on the opinion among surgeons that “a functional vagina can be constructed in virtually everyone [while] a functional penis is a much more difficult goal.”
More colloquially, “it’s easier to poke a hole than build a pole.”
Horrifyingly, this determination is done by measuring the phallus. “Too small,” and it gets cut off. “Big enough” and you are a man. A few millimeters difference…
But also, the sexism - phallocentrism - is evident here as well. A “functional” vagina need only be a hole big enough to be penetrated by a typical penis. It does not need to lubricate, feel pleasure, or give any benefit to the person who has it. It is merely a “penis house” as the gross patriarchy bros put it.
This surgical approach to a non-problem continues to be used, even though the justification for it has proven again and again to be false.
Remarkably, the medical-technological approach reigns in intersex medicine despite the fact that intersex experts readily confess that intersexuality is not primarily a medical problem but is instead a social problem.
Exactly. We should not be trying to “fit” humans to perceived social standards. We should change society to accommodate the reality of intersex humans.
Intersexual, feminist, and “queer theory” critics of today’s dominant treatment protocols point out a number of problems with the modernist medical approach to intersexuality. Most objectionable to many feminist and queer critics is the presumption inherent in these protocols is 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 (and thereby reify) them.
This is a problem that goes far beyond intersexuals but affects any person who fails to conform to the rigid demands of culture. In our own political moment, this is at the core of our problem: the right wing demands that there is in fact only one “right” way to be male or be female, and that one right way demands female subservience, male dominance, and the erasure - and perhaps extermination of LGBTQ and intersex people.
And not only that - many of us who think of ourselves as cishet men are also outside of this “right” way to be. A German study found that a mere 55% of males had what they considered “normal” genitals. All except for one of the men studied had fathered children. (And the one who didn’t was gay.) But, not “normal” enough apparently.
Intersexual activists also question whether anyone should have her ability to enjoy sex or physical health risked without her personal consent just because she has a clitoris (or a penis) which statistically falls outside the standard deviation.
Just saying.
At the end, Dreger circles back to the history - and the cultural expectations that led us where we are.
The roots of the one-body-one-sex rule and medical doctors’ role in it were laid down in the late nineteenth century. In spite of all the cultural changes that have occurred, we still have the one-body-one-sex rule, and that rule continues to be driven largely by the same engines that drive it in the nineteenth century: an interest in keeping clear male/female gender distinctions, and a concomitant interest in retaining a clear division between heterosexuality and homosexuality and in supporting what is seen as heterosexuality…The way intersexuals are treated today has much of the same effect intended by the conceptual and practical treatment of the last century: to keep two clear sexes and to retain the notion that heterosexuality is normal and that homosexuality is not.
And finally:
The hermaphrodite was and continues to be a person whose body gets caught up in cultural “border wars” - wars over the borders separating males and females, men and women, boys and girls, borders separating the acceptable heterosexual and the disfavored homosexual, borders separating those with authority from those without.
The book closes with a call for a better approach to human variety. We need not police the boundaries of sex and gender, mutilate bodies to make them “normal,” or marginalize people who don’t fit easy categories.
Nature is diverse. Nature is queer. Get over it. And start treating people with love and empathy, even if their bodies or experiences make you uncomfortable.
This book is an excellent look at history, and provides inspiration to do better in the future.
