Sexing the Intersexed: an Analysis of Sociocultural Responses to Intersexuality Author(S): Sharon E

Sexing the Intersexed: An Analysis of Sociocultural Responses to Intersexuality Author(s): Sharon E. Preves Source: Signs, Vol. 27, No. 2 (Winter, 2002), pp. 523-556 Published by: The University of Chicago Press Stable URL: http://www.jstor.org/stable/3175791 Accessed: 22/01/2010 15:13 Your use of the JSTOR archive indicates your acceptance of JSTOR's Terms and Conditions of Use, available at http://www.jstor.org/page/info/about/policies/terms.jsp. JSTOR's Terms and Conditions of Use provides, in part, that unless you have obtained prior permission, you may not download an entire issue of a journal or multiple copies of articles, and you may use content in the JSTOR archive only for your personal, non-commercial use. Please contact the publisher regarding any further use of this work. Publisher contact information may be obtained at http://www.jstor.org/action/showPublisher?publisherCode=ucpress. Each copy of any part of a JSTOR transmission must contain the same copyright notice that appears on the screen or printed page of such transmission. JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact [email protected]. The University of Chicago Press is collaborating with JSTOR to digitize, preserve and extend access to Signs. http://www.jstor.org Sharon E. Preves Sexing the Intersexed: An Analysis of Sociocultural Responses to Intersexuality explore here the social construction of gender in North America through an analysis of contemporary and historical responses to infants who are born genitally ambiguous, or intersexed (hermaphroditic).' Bodies that are sexually ambiguous challenge prevailing binary understandings of sex and gender. Individuals who are intersexed have bodies that are quite literally queer or "culturallyunintelligible" (Butler 1993, 2). That is, their bodies do not conform to an overarchingand largely unexam- ined social expectation that all humans belong to one of two clearly deline- ated sex categories, female or male (Wilson 1998). While being born with ambiguous sexual organs indeed problem- atizes binary understandings of sex and gender, the majority of intersexed children do not require medical intervention for their physiological health (Diamond and Sigmundson 1997b; Dreger 1998b; Kessler 1998).2 This article contains material from my forthcoming book, to be published by Rutgers University Press in 2002. Printed with permission of the publisher. I would like to thank Jeylan Mortimer, Walter Bockting, Liz Boyle, Jacquelyn Zita, Amy Kaminsky, Doug Hart- mann, Jane McLeod, Jennifer Pierce, Carolyn Allen, Judith Howard, Alice Dreger, Clodagh Harvey, Olivia Banner, and the anonymous reviewer at Signs for their insightful suggestions for revision. I also thank Tana Adams and Leslie Zavadil for their invaluable editorial assis- tance. This article would not have been possible without the financial support of a Doctoral Dissertation Fellowship and Doctoral Dissertation Special Grant from the University of Minnesota. I view the terms intersexand hermaphroditesynonymously, despite their divergent historical context. When speaking in contemporary terms, I use the more contemporary term intersex. However, when using historical references, I use the more popular pre-twentieth- century term hermaphrodite.Interestingly, the term intersex emerged in the late nineteenth century and was used not only when referringto hermaphrodites but to homosexuals as well (Epstein 1990). For example, a woman who sexually desired other women was often labeled intersexed.Preceding the emergence of the term intersex,the label hermaphroditewas also used in relation to homosexuals in the seventeenth and eighteenth centuries (Pagliassotti 1993; Hekma 1994; Trumbach 1994). 2 While the majority of intersex conditions are found to be physiologically benign, some conditions do require surgical or hormonal intervention for reasons of physiological health. Most notably, this occurs in cases where elimination of urine and feces is rendered difficult [Signs:Journal of Women in Cultureand Society 2001, vol. 27, no. 2] ? 2001 by The Universityof Chicago.All rightsreserved. 0097-9740/2002/2702-0006$10.00 524 I Preves Nevertheless, the majority of these infants are medically assigned a defin- itive sex, undergoing surgery and hormone treatments to "correct"their variation from the anatomies expected by the designations of female and male. The impetus to control intersexual "deviance" stems from cultural tendencies toward gender binarism, homophobia, and fear of difference (Butler 1990, 1993). According to Erving Goffman (1963), the great rewardsassociated with "normalcy"will motivate individuals to attempt to pass as normal, whether they are or not. The case of intersexualityprovides a poignant example of normative expectations remaining unfulfilled. When presented with some- one or something that disrupts our basic understanding of the human body, such as intersexuality,we are presented with a case of what Goffman would label as stigma. Prevailing sex assignment theory suggests the psy- chological necessity of correcting intersexual "deviance"to preclude such stigma (Money 1968, 1991a, 1995; Money and Ehrhardt 1972). Current medical interventions on intersexed bodies rest on the funda- mental assumption that without the medical alteration of genitals to aid in unambiguous sex/gender assignment, intersexuals will live a life of alien- ation and despair. There is limited empirical evidence to demonstrate this and some recent research and activism that contradict this mode of think- ing.3 As is the case with most medical conditions, there are no manda- tory or legislative standards of care for intersex conditions, only the work of individual scholars and researchers to guide physicians on medical protocol. In some medical models, intersexuals and their bodies are treated as passive objects in need of medical action to correct "pathologies."This approach devalues intersexuals'own experiences with the very phenomenon or condition under consideration. Rather than listen to intersexuals'own critical perspectives, clinicians focus on the development of new technolo- gies and techniques for performing genital surgeries and administering ex- ogenous hormones. The medical approach is founded on the belief that intersex is pathological. Similar to the medicalization of other phenom- ena-and menopause is a good example--intersex is perceived to need treatment despite inconclusive evidence demonstrating the effectiveness of current treatment protocol. In addition to being framed as pathological, intersex is also seen as potentially disease causing, as evidenced by the due to physiological complications or, in rare cases of salt-wasting congenital adrenal hyper- plasia, where hormone therapy is required to regulate the endocrine system (Diamond and Sigmundson 1997b; Kessler 1998; Wilson and Reiner 1998). 3 Several sources reveal this recent challenge. See, e.g., Kessler 1998; Dreger 1999; and Preves 2000. S I G N S Winter 2002 I 525 emergency gonadectomies performed to prevent cancer (Kupfer, Quigley, and French 1992; Warne 1997; Grumbach and Conte 1998).4 Pejorative constructions of difference privilege normalcy in that they tend to assume that the person of difference is damaged and that the marker or observer is not. In addition, the persistent focus on the abnor- mality of intersexed bodies further privileges bodies that are not intersexed (Davis 1995). In other words, stressing intersexuals' deviance confirms a normal/abnormal opposition (Namaste 1996). As Lennard Davis says of the deaf/hearing dichotomy, "the 'problem' is not the person with disability; the problem is the way that normalcy is constructed to create the 'problem' of the disabled person" (1995, 24). Thus, when studying "deviance" one must also study "normalcy"in an effort to comprehend the very production of normalcy itself. Paying attention to an aberrationmerely serves to enforce its difference from that which is considered normal, thus perpet- uating the categories of normal and abnormal or "insider"and "outsider." While Davis is writing of disability, his idea is easily applied to other types of difference that have been stigmatized, including intersexuality. In his research on the production of deaf culture, Davis (1995) turns to Gustave Flaubert'sMadame Bovary (1887) to further illustrate his point that "normals"experience and produce disease. In Flaubert'sclassic novel, one of the characters, Hippolyte, is discriminated against because of his clubfoot. Individuals in Hippolyte's social circle persist in telling him that his foot is abnormal and in need of aesthetic repair.This social condemna- tion is contraryto his own experience of his clubfoot as the far stronger and more reliable of his two feet. Succumbing to social pressure, he undergoes "corrective"surgery, which in the end renders him disabled. He sacrificed the strength of his foot in order to make it aestheticallypleasing to others. There are direct parallels between Flaubert's Hippolyte and intersexuals who claim irreversible nerve damage to their genitals caused by "corrective" operations.5 Gender binarism and the biological construction of gender Historically in debates about the genesis of gender, biological factors have been given more weight

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