Bodies in Doubt: An American History of Intersex by Elizabeth Reis gives a history of intersex people in America until modern times, with scientific terminology and images of patients. I personally found this reading very upsetting at times, mostly in regards to the extremely unethical practices of medical professionals who have treated intersex individuals. The readings we had were chapters 4 and 5 along with the epilogue.
Chapter four, “Cutting the Gordian Knot: Gonads, Marriage, and Surgery in the 1920s and 30s” discussed the ethical and moral dilemmas doctors faced upon discovering cases of intersexuality. The fact that they started to “think they could make men and women” (82) and often justified extremely risky procedures in the name of “bodily integrity” and a constant emphasis on social acceptance. A majority of doctors in the 1920s and 1930s felt that their opinions were more important than parents’ and indeed patients’ wishes, and as a result often withheld information. Intersex people were labeled “unfortunate individuals” and “part of the dangerous classes” (89). When intersex patients professed no desire to undergo so-called corrective surgery, their physicians expressed profound disbelief – how could men live happy, successful lives without penises? How could women live without penetratable vaginas? (95) Doctors were trying to decide what “made” a man or a woman with an incomplete and biased understanding of what they were deciding. Additionally, physicians became authorities on marriage in regards to intersex people, in part because their ultimate goal was to uphold the very institution of heterosexuality, including heterosexual matrimony. Patients with no interest in marriage or heterosexual sex “raised the troubling specter of homosexuality” (105) which was just another sign of potential sexual perversion that came with being an intersex person. Finally, chapter four discussed disabled intersex people and the complete stripping away of their rights. Because doctors felt that disabled people should be taught to avoid sex altogether (what if they passed on a hereditary disease?) they struggled with deciding whether to operate on disabled intersex patients. Should they “normalize” the patients’ genitalia and provide the opportunity for sex? Or should they not intervene and run the risk of homosexual behavior?
Chapter five, “Psychology, John Money, and the Gender of Rearing in the 1940s, 50s, and 60s,” introduced John Money, arguably one of the most famous medical professionals who treated intersex people (117). His idea of the malleability of gender – that the psychological health of intersex children was entirely dependent upon how they were raised and what social norms they were exposed to – shaped popular and scientific understanding of intersex people for decades. He encouraged parents to choose a gender for their child and raise them as that gender, completely unambiguously. Surgeons and endocrinologists would then “mold” the child hormonally and physically. While these physicians’ goal was to “eliminate doubt and uncertainty” for intersex children, I often found myself wondering what would have happened if doctors had just left well enough alone. While there are intersex conditions that require medical treatment because of other symptoms and comorbidities, the nonconsensual nature of much of this treatment left me feeling sick.
The epilogue discusses the actual terminology around intersex conditions and how it has changed and continues to change over time. The author explains how “hermaphrodite” is not only archaic, but has historically been used in a derogatory fashion along with slurs and phrases like “freak of nature” (154). She discusses how the term “intersex” was actually coined in 1917 but did not gain traction until the 1990s; however, physicians rarely use it and some parents feel it refers to sexuality, which they are uncomfortable with. In the early 2000s, the phrase “disorders of sex development” was suggested as a way to provide clarity for doctors, but many intersex people felt stigmatized by the word disorder, which suggests something to be cured (156). The author, for her part, suggests “divergence of sex development,” which is fairly neutral while still being clinical enough for a doctor. While doctors are now less likely to suggest “corrective” surgery for infants, the practice still exists and has incredible risk.
I have quite a few friends who are intersex and reading this 20th-century history helped me understand a little more of their struggle. One of my friends is intersex and also identifies as transgender and xe has had a difficult time getting doctors to take xem seriously. I’ve always felt sympathetic towards xem but I feel like talking to xem more and reading these chapters helped me realize just how much xe goes through.