"So we must go behind even what the microscope can reveal": The Hermaphrodite's "Self" in medical discourse at the start of the twentieth century

GLQ

Volumn 11, Issue 1, 2005, Pages 65-94

  Mak, Geertje ^a  

^a NONE

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EID: 33845778564     PISSN: 10642684     EISSN: 15279375     Source Type: Journal    
DOI: 10.1215/10642684-11-1-65     Document Type: Review

References (89)

1. Throughout this article I use the terms hermaphroditism and hermaphrodite to refer, respectively, to "doubtful sex" and "someone whose sex is doubted." To stay closer to the terminology of my sources, I do not use the modern term intersex. I do not, however, adopt the terms pseudohermaphroditism or pseudohermaphrodite from the sources unless I am quoting or describing them, in order to avoid the suggestion that I could-or would want to-define a "true sex."
2. "1. würden Sie der Person Aufklärungen über ihren eigentlichen Zustand geben? 2. würden Sie ihr den Verkehr mit Männern untersagen und 3. würden Sie ihr das Heiraten absolut verbieten?" (Franz Ludwig Von Neugebauer, Hermaphroditismus beim Menschen [Leipzig: Klinkhardt, 1908], 607). My source for the material on the case of Emma R. is the supplement to Von Neugebauer's book. The translations in this article are my own.
3. "Der Arzt handle im gegebenen Falle, wo bei der betreffenden Person ausgesprochen weibliches Geschlechtsbewußtsein vorliegt, humaner, die Person nicht über die statt gehabte Erreur de sexe aufzuklären. Für den Zwitter sei sein eigenes Geschlechtsbewußtsein maßgebend und wichtiger, als der anatomischen Charakter seiner Geschlechtsdrüsen. Auch stehe nach dem alten preußischen Landrechte dem majorennen Zwitter die Wahl frei, zu welchem Geschlecht er gerechnet sein will. Gerade diese Beobachtung Königs zeigt zur Evidenz die schwache Seite der betreffenden Paragraphen im neuen deutschen bürgerlichen Gesetzbuche" (Von Neugebauer, Hermaphroditismus, 607; italics added). I have translated the German word Geschlechts-bewußtsein as sex-gender consciousness. The translation of Geschlecht is complicated. First, Geschlecht refers to one's physical sex and, in this sense, can be compared to the English word sex. As Bernice L. Hausman explains, the English word sex became restricted to physical sex only after the concept of gender (identity) had been introduced to indicate social and psychological sex
4. (Changing Sex: Transsexualism, Technology, and the Idea, of Gender [Durham: Duke University Press, 1995], 75). Second, German makes a clear distinction between Geschlecht and Sex-the latter means the sexual act-whereas the English words sex and sexual can refer to both. Therefore sexual consciousness could be confusing, for it can refer both to sexual preference and to sex-gender consciousness. So to maintain the original sense, I use the term sex-gender consciousness.
5. J. Riddle Goffe, "A Pseudohermaphrodite, in Which the Female Characteristics Predominated: Operation for Removal of the Penis and the Utilization of the Skin Covering It for the Formation of a Vaginal Canal," American Journal of Obstetrics 48 (1903): 755-63.
6. Fred J. Taussig, "Shall a Pseudo-hermaphrodite Be Allowed to Decide to Which Sex He or She Shall Belong?" American Journal of Obstetrics 49 (1904): 162-65;
7. Taussig, "Editorial Comment," Interstate Medical Journal 11 (1904): 134;
8. J. Riddle Goffe, "Hermaphroditism and the True Determination of Sex," Interstate Medical Journal 11 (1904): 314-15;
9. Fred J. Taussig, "Rejoinder to Dr. Goffe's Letter," Interstate Medical Journal 11 (1904): 316-17.
10. Franz Ludwig Von Neugebauer, "Letter to the Editor," Interstate Medical Journal 11 (1904): 317-18.
11. See Myriam Spörri, "Die Diagnose des Geschlechts: Hermaphroditismus im sexualwissenschaftlichen Diskurs zwischen 1886 und 1920" (Lizentiatsarbeit, Universität Zürich, 2000), 48-53;
12. Ulrike Klöppel, "XXOXY Ungelöst: Störungsszenarien in der Dramaturgic der zweigeschlechtlichen Ordnung," in (K)ein Geschlecht oder viele? Transgender in politischer Perspektive, ed. Jannik Franzen, Ulrike Klöppel, Bettina Schmidt, et al. (Berlin: Querverlag, 2002), 153-81;
13. and Ulrike Klöppel, "'Störfall' Hermaphroditismus und Trans-Formationen der Kategorie 'Geschlecht': Überlegungen zur Analyse der medizinischen Diskussionen über Hermaphroditismus um 1900 mit Deleuze, Guattari und Foucault," in Transformationen. Wissen-Mensch-Geschlecht. Potsdamer Studien zur Frauen- und Geschlechterforschung 6 (2002): 137-50. Klöppel's interpretation of Neugebauer's position differs from mine in that she concentrates on his theoretical position and describes his interest in psychosexual matters in relation to the gonads as a constant, although she also refers to his position in these matters as "divided" (Spagat) ('"Störfall,"' 148).
14. Von Neugebauer, Hermaphroditismus, 401.
15. Von Neugebauer, "Hermaphroditismus und Pseudohermaphroditismus, " in Handbuch der ärztlichen sachverständigen Tätigkeit, ed. Paul Dittrich, vol. 5, pt. 1, no. 3 (Vienna: Braumüller, 1916), 255-95, esp. 292-93.
16. A. Geijl, "Over operatief ingrijpen bij pseudohermaphroditismus masculinus of femininus externus," Medisch Weekblad van Noord-en Zuid-Nederland 9 (1904): 281-84, 326-30, 381-88, 397-404, 413-20, 433-35, 464-71, 494-501, 512-19, 555-58, 567-70, 586-91, 632-39. For Von Neugebauer's defense see his "Letter to the Editor," 318.
17. "De gesteldheid der geslachtsklieren heeft ter bepaling van het geslacht van den hermafrodiet en voor ons praktisch optreden tegenover den drager, minder waarde dan de toestand der copulatieorganen en den aard van het gemoeds-en zieleleven der betrokken persoon" (Geijl, "Over operatief," 590).
18. "In neuester Zeit sind über diese Frage heftige Kontroversen ausgebrochen, und ich musste mir persönlich einen sehr scharfen Angriff von Dr. Geijl in Holland gefallen lassen, der mich beschuldigte, einem Mädchen, das ich als verkannter männlichen Scheinzwitter erkannte, widerrechtlich geraten zu haben, die weibliche Metrik in eine männliche zu ändern" (Von Neugebauer, Hermaphroditismus, 62).
19. Franz Ludwig Von Neugebauer, "Mann oder Weib? Sechs eigene Beobachtungen von Scheinzwittertum und 'Erreur de Sexe,'" Zentralblatt für Gynäkologie 2 (1904): 33-51;
20. Theodor Landau, "Mann oder Weib?" Zentralblatt für Gynäkologie 7 (1904): 203-4.
21. See also Landau, "Über Hermaphroditen: Nebst einigen Bemerkungen über die Erkenntnis und die rechtliche Stellung dieser Individual," Berliner klinische Wochenschrift 15 (1903): 339-43.
22. M. R. Blondel, "Observation de pseudohermaphrodisme," Bulletins et mémoires de la Société obstétricale et gynécologique de Paris, 1899, 3-12;
23. Xavier Delore, "Des étapes de l'hermaphrodisme," L'écho médicale de Lyon 4 (1899): 193-205, 225-32;
24. see esp. 229. See also Alice Domurat Dreger, Hermaphrodites and the Medical Invention of Sex (Cambridge, MA: Harvard University Press, 1998), 125-26.
25. For the quotation see Taussig, "Shall a Pseudo-hermaphrodite?" 162.
26. Dreger, Hermaphrodites, 139-66.
27. Alice Domurat Dreger, "From the Age of Gonads to the Age of Consent," in Intersex in the Age of Ethics, ed. Alice Domurat Dreger (Hagerstown, MD: University Publishing Group, 1999), 9.
28. Dreger, Hermaphrodites, 130-31.
29. From Von Neugebauer's huge bibliography I have collected 251 cases of hermaphroditism in living adults (ages twelve and up) between 1790 and 1908. They include cases described in German, French, Dutch, and English. In approximately half of these cases I have found the original sources on which Von Neugebauer based his analyses. The database is unfinished; English cases in particular are still lacking. Other analyses of the available data and sources, on which I am preparing publications, also reveal that Dreger's "age of gonads" was far more complex than she suggests. See Geertje Mak, "Das vergeschlechtlichte Selbst als Nebenprodukt der medizinischen Geschlechter-Konstruktion: Hermaphroditen in klinischen Begegnungen im 19. Jahrhundert," Invertito 6 (2004): 95-109.
30. Hausman, Changing Sex, 78-79.
31. Robert Stoller introduced the term core gender identity about a decade later (Hausman, Changing Sex, 104).
32. Both Dreger (Hermaphrodites, 86, 92-93, 149-50) and
33. Myriam Spörri ("N.O.Body, Magnus Hirschfeld und die Diagnose des Geschlechts: Hermaphroditismus um 1900," L'homme Z.F.G. 14 [2003]: 249-50) wrongly claim that until 1910 diagnostic surgery was impossible without unsexing the hermaphrodite. Taussig ("Rejoinder," 316) refers to five diagnostic laparotomies mentioned by Von Neugebauer ("What Value Has the Knowledge of Pseudo-hermaphroditism for the Practitioner?"
34. Interstate Medical Journal 11 [1904]: 118-19).
35. For a description of two diagnostic operations see Von Neugebauer, Hermaphroditismus, 429-33.
36. My narratological approach to medical case histories and texts is mainly inspired by Mieke Bal, De theorie van vertellen en verhalen: Inleiding in de narratologie, 5th ed. (Muiderberg: Coutinho, 1990).
37. For another narratological approach to medical case histories see Julia Epstein, Altered Conditions: Disease, Medicine, and Storytelling (New York: Routledge, 1995), 23-76.
38. Goffe, "Pseudohermaphrodite," 755, 757.
39. Goffe does not literally quote the family doctor, but the shift in tenses makes it clear where the paraphrase stops.
40. The case histories of pseudohermaphrodites closely resemble those of "sexual inverts" in structure. See Geertje Mak, Mannelijke vrouwen: Over grenzen van sekse in de negentiende eeuw (Amsterdam: Boom, 1997), 174-77, 207-8.
41. Goffe, "Pseudohermaphrodite," 758-59.
42. Hausman, Changing Sex, 79.
43. Taussig, "Shall a Pseudo-hermaphrodite?" 163-64.
44. Taussig, "Editorial Comment," 134.
45. Goffe, "True Determination," 314-15.
46. Taussig, "Rejoinder," 316. Taussig is referring to Theodor Landau's article "Mann oder Weib?" The Berendes-Landau case, incidentally, involved a different person, Leopold Landau.
47. Von Neugebauer, "Letter to the Editor," 317.
48. The paragraphs concerning hermaphrodites in Das preußische Landrecht are found in section 1, part 1: §19, "Wenn Zwitter geboren werden, so bestimmen die Eltern, zu welchem Geschlecht sie erzogen werden sollen" (If children are born hermaphroditic, the parents decide which sex they shall be raised as); §20, "Jedoch steht einem solchen Menschen nach zurückgelegtem 18. Jahre die Wahl frei, zu welchem Geschlecht er sich halten will" (However, at the age of eighteen such a person is free to choose to which sex he wants to belong); §21, "Nach dieser Wahl werden seine Rechte künftig bestimmt" (This choice determines his future rights); §22, "Sind aber die Rechte eines Dritten von dem Geschlecht eines vermeintlichen Zwitters abhangig, so kann ersterer auf eine Untersuchung durch Sachverständige antragen" (However, if the rights of a third party are dependent on the sex of a putative hermaphrodite, that party may petition to have this person examined by experts); and §23, "Der Befund der Sachverständige entscheidet auch gegen die Wahl des Zwitters und seiner Eltern" (The findings of the experts supersede the choice of the hermaphrodite and his parents).
49. Dreger, Hermaphrodites, 145-50.
50. Ibid., Dreger, Hermaphrodites, 110-14.
51. Von Neugebauer, "Letter to the Editor," 318.
52. For another discussion of Geijl's attack see Von Neugebauer, Hermaphroditismus, 62.
53. Von Neugebauer, "What Value?" 120.
54. "Eine Änderung der Metrik könne nur dann stattfinden, wenn die betreffende Person selbst eine solche Änderung verlange, zwingen aber könne man sie dazu nicht" (Von Neugebauer, Hermaphroditismus, 401).
55. "Devant le chirurgien, plus encore que devant tout autre, le sujet doit demeurer libre de prendre telle détermination qu'il juge à propos et il doit demeurer certain de la discrétion" (Guermonprez, "Une erreur de sexe avec ses conséquences," Annales d'hygiène publique et de médecine légale, September-October 1892, 304).
56. The only exception was when a case was brought to court, for instance, a request for marriage nullification. When someone else's interests were involved, medical experts defined the outcome. Cf. n. 34.
57. Hausman, Changing Sex, 7.
58. Epstein, Altered Conditions, 122.
59. See N. D. Jewson, "The Disappearance of the Sick-Man from Medical Cosmology, 1770-1870," Sociology 8 (1974): 369-85; and
60. W. F. Bynum, Science and the Practice of Medicine in the Nineteenth Century (Cambridge: Cambridge University Press, 1994), 1-23.
61. G. R. Green, "Hypospadias," Quarterly Medical Journal 1 (1898): 169,
62. cited in Von Neugebauer, Hermaphroditismus, 214. The case is also mentioned by Dreger, and the "solution" seems consistent with what she describes as the English way of dealing with discrepancies between gonadal and lived sex, but she does not focus on the question of who actually arrived at this solution (Hermaphrodites, 122-23, 126). Green's case was severely criticized only thirteen years later by two French doctors
63. (Th. Tuffier and A. Lapointe, "L'hermaphrodisme: Ses variétés et ses conséquences pour la pratique médicale [d'après un cas personnel]," Revue de gynécologie et de chirurgie abdominale 17 [1911]: 209-68, esp. 266).
64. See the exchanges between Blondel and Delore and between Landau and Von Neugebauer above, as well as the one among Green, Tuffier, and Lapointe in n. 43.
65. From 1920 on, growing doubts about the possibility of reaching a medical definition of "true sex" undermined doctors' claims to authority in sex assignment matters, and consequently many patients had a say in what happened (Hausman, Changing Sex, 72-109).
66. Hausman, who claims that the concept of gender did the trick, sets out to explore "the extent to which the commonsense understanding of transsexualism as a 'disorder of gender identity' is a cover-up for the potentially more threatening idea that transsexuals are subjects who choose to engineer themselves" (ibid., 9).
67. Taussig, "Shall a Pseudo-hermaphrodite?" 162.
68. It is not always clear whether the terms used in the English sources, psycho-sexual feelings, psychic sex, and psychic sexuality, refer to sex-gender or sexual preferences or both. This confusion is another indication that those concepts were hardly distinguished at the time.
69. Goffe is wrong about this. See n. 22.
70. William Lee Howard, "Sex Perversion in America," American Journal of Dermatology and Genito-Urinary Diseases, January 1904,
71. quoted in Goffe, "True Determination," 314-15.
72. Taussig, "Rejoinder," 316, 317.
73. Mak, "Das vergeschlechtlichte Selbst."
74. "XX. Männlicher Scheinzwitter als Mädchen erzogen, erkennt spontan sein männliches Geschlecht"; "XXI. Änderung der Metrik trotz festgestellten Erreur de sexe von dem Scheinzwitter verweigert"; "LXXVII. Geschlechtsbewußtsein und Geschlechts drang; 1. Geschlechtsbewußtsein dem anatomischen Charakter der Geschlechtsdrüsen nicht entsprechend" (Von Neugebauer, Hermaphroditismus, 673-75, 698-702). Klöppel claims that Von Neugebauer was the man who opened the field of hermaphroditism to scientific research into the relation between the "psycho-sexual center" (a concept of Krafft-Ebing) and physical or gonadal sex (see '"Störfall"'; and "XXOXY Ungelöst").
75. See George Chauncey, "From Sexual Inversion to Homosexuality: Medicine and the Changing Conceptualization of Female Deviance," Salmagundi, nos. 58-59 (1982-83): 114-46;
76. Gert Hekma, "A Female Soul in a Male Body': Sexual Inversion as Gender Inversion in Nineteenth-Century Sexology," in Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History, ed. Gilbert Herdt (New York: Zone, 1994), 213-40;
77. Klaus Müller, Aber in meinem Herzen sprach eine Stimme so laut: Homosexuelle Autobiographien und medizinische Pathographien im neunzehnten Jahrhundert (Berlin: Winkel, 1991); and
78. Harry Oosterhuis, Stepchildren of Nature: Krafft-Ebing, Psychiatry, and the Making of Sexual Identity (Chicago: University of Chicago Press, 2000).
79. For a detailed analysis about the confusion of sex and sexuality in a case of sexual inversion in a woman see Mak, Mannelijke vrouwen, 225-34; and
80. Geertje Mak, "Sandor/Sarolta Vay: From Passing Woman to Sexual Invert," Journal of Women's History 16 (2004): 53-76.
81. Magnus Hirschfeld, Die Transvestiten: Eine Untersuchung über den erotischen Verkleidungstrieb, mit umfangreichen casuïstischen und historischen Material (Berlin: Medizin, 1910);
82. Havelock Ellis, Eonism and Other Supplementary Studies, vol. 7 of Studies in the Psychology of Sex (Philadelphia: Davies, 1928).
83. Oosterhuis, Stepchildren of Nature, 248. For Oosterhuis's analysis of the development of an "authentic (homo)sexual self" see 215-30.
84. Dreger, Hermaphrodites, 126-30.
85. Von Neugebauer, "What Value?" 124.
86. Magnus Hirschfeld, Geschlechtsumwandlungen: Irrtümer in der Geschlechtsbestimmung; Sechs Fälle aus dem forensischen Praxis (Berlin: Adler, 1912).
87. For an analysis see Mak, Mannelijke Vrouwen, 334-39; and
88. Magnus Hirschfeld, "Drei Fälle von irrtümlicher Geschlechtsbestimmung," Medizinische Reform: Wochenschrift für soziale Medizin 14, no. 51 (1906): 614-17.
89. Von Neugebauer, Hermaphroditismus, 607.