IPT Book Reviews

Title: Hermaphrodites and the Medical Invention of Sex  Positive Review
Author: Alice Domurat Dreger
Publisher: Harvard University Press, 1998

Harvard University Press
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Cambridge, MA 02138-1423
(800) 448-2242

This 268-page book begins with a description of an 1886 encounter between Sophie, a 44-year-old domestic servant who had just married her first husband but "could not accomplish the conjugal act," and a physician, Professor Michaux. Professor Michaux examined Sophie and quickly ascertained the nature of the problem — Sophie, contrary to what she had been led to believe all of her life and to what her husband believed — was really a man. She had a small penis and no vagina and her labia were really a divided scrotum. Professor Michaux tried to tell the incredulous Sophie that the problem was not her anatomy, but her understanding of her anatomy, but Sophie could not believe what she was hearing. Finally, Professor Michaux said to the stunned Sophie, "But my good woman, you are a man!" Sophie went away and did not return.

Alice Dreger explores the history of encounters between hermaphrodites — people born with ambiguous sexual anatomy — and the medical and scientific community. The body of her book, which contains 24 photographs and is illustrated with case histories, traces the history of the biomedical treatment of hermaphrodites in France and Britain in the late nineteenth and early twentieth centuries. The author describes the phenomenon of hermaphroditism and how ideas of what constitutes being a male or a female have changed over the years. She shows how doctors have been uncomfortable with hermaphrodites and have tried to find ways to ascertain a person's "true sex" and minimize the number of cases that were designated as "doubtful sex."

Along with this, the ideas about sex, gender, sexuality, and identity have been formed and changed. Over time, doctors became the accepted authorities in matters of what constitutes sexual anatomy and identity. The current medical treatment of hermaphroditism, now called intersexuality, often involves controversy among medical practitioners and between medical practitioners and the people involved.

In the epilogue, Dr. Dreger addresses three issues: (1) the present-day medical treatment for intersexuality, which calls for the creation, as soon after birth as possible, of a "believable" male or female anatomy through plastic surgery and hormonal therapy, and the silencing of any doubts which the parents might have; (2) how this treatment maintains many vestiges of nineteenth medical theory and practice; and (3) the present time in which intersexuals themselves are challenging this treatment and the rigid cultural categories behind it. The epilogue is illustrated with compelling case histories of several present-day intersexed persons and the frequently disturbing medical treatment they received as young children.

This carefully documented and well-researched book should be read by anyone who is interested in sexuality, sexual identity, intersexuality, and medical history and ethics. It is clear and well-written and should appeal to lay people as well as to professionals.

Reviewed by Hollida Wakefield, Institute for Psychological Therapies.

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