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Intersexuality in Contemporary Culture. Michelle Morgan Lefay Holmes in the Humanities Doctoral

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Intersexuality in Contemporary Culture. Michelle Morgan Lefay Holmes in the Humanities Doctoral The Doctor Will Fix Everything: Intersexuality in Contemporary Culture. Michelle Morgan LeFay Holmes in The Humanities Doctoral Programme ., Presented in Partial Fulfilment of the Requirements for the Degree of Doctor of Philosophy at Concordia University Montréal, Quebec, Canada January 2000 O Michelle Morgan LeFay Holmes, 2000 National Library Bibliothèque nationale 1+m of Canada du Canada Acquisitions and Acquisitions et Bibliographie Services services bibliographiques 395 Wdlington Street 395, rue Welligtcul OttawaON K1A ON4 Ottawa ON K1A ON4 Canada CaMaa The author has granted a non- L'auteur a accordé une licence non exclusive licence ailowing the exclusive permettant à la National Library of Canada to Bibliothèque nationale du Canada de reproduce, loan, distribute or seli reproduire, prêter, distribuer ou copies of this thesis in microform, vendre des copies de cette thèse sous paper or electronic formats. la forme de microfiche/film, de reproduction sur papier ou sur format électronique. The author retains ownership of the L'auteur conserve la propriété du copyright in this thesis. Neither the droit d'auteur qui protège cette thèse. thesis nor substaatid extracts from it Ni la thèse ni des extraits substantiels may be printed or othenvise de celle-ci ne doivent être imprimés reproduced without the author's ou autrement reproduits sans son permission. autorisation. Abstract This dissertation, The Doctor will Fix Evevhina: Intersexualitv in Contem~oraq Cultue, authored by Michelle Morgan LeFay Holmes, is subrnitted in partid fulfillment of the doctoral degree in interdisciplinary Humanities. Using an interdisciplinary approach, this work examines the development of diagnosis and treatment of "intersexuaiity". 1 argue that interser~aiityis not a medical condition per se, and that standard treatments contravene rkethical and legal standards regarding the treatment and care of minors. 1 situate medical discourse, fiction and (auto)biography as forms of narrative within a contemporary culture, and 1 examine how each narrative form respectively creates and contests what it means to be "intersexed. Various representations of intersexuaiity interest me for their ability to shape the category. This dissertation sets out to demonstrate that the scientific narratives are no less euliural products than are fictional and personai accounts, and argues that scientific texts are merely specific forms of cultural product. Therefore, 1 do not structure scientific or medical texts as opposites of personal or fictional ones. Instead, I read each for the ways in which it st-uctures what is possible, knowable, and true about sex, gender and sexuality. This dissertation weighs the narratives of intersemals against these cultural and scientific representations to contest standard beliefs and mythological stories about hemaphroditism. The work begins with a historical perspective, moves through narrative and cultural analysis and ends with an ethical discussion of current treatment standards. A glossary follows the bibliography. Acknowledntmtnts This dissenation represents only a portion of the work that goes into a doctoral degree, and though it is authored by but one person, rnany have been involved in its production. 1 would, therefore, tike to thank my programme and my advisors, Dr. Stanley French, Dr. Veronica Hollinger and Dr. David Howes. Each of these people has facilitated the development of my thought in diverse fields which, without their help, 1 would not have been able to synthesize in this dissertation. To Dr. Hollinger 1 owe a special gratitude, for she has been with me since my undergraduate degree, providing both acadernic guidance and personal support. Some of the work presented in this dissertation has been developed out of specific conference and publication work 1 have pursued over the past five years. In 1995,I presented work on intersex bodies as queer bodies for the Queer Frontiers Graduate Student Conference held at the University of Southern California, Los Angetes. Derived fkom that paper, a version of Chapter Three will appear early in 2000 in the University of Wisconsin publication, Oueer Frontiers under the title "Queer Cut Bodies". In the spri~3of l996,I was forninate enough to begin working with clinical ethicists in both Canada and the United States. The dissertation's work on consent, the potential autonomy of minors, and truth telling in intersex management build on rny presentation at the Intersex panei of the 1996 Canadian Bioethîcs Society Meetings, held in Montréal that fall. Following from that presentation, 1 was invited to present preliminary work at the 1998 summer meetings of the McGill University Enhancement Technologies Project coordinated by Car1 Elliott and Margaret Lock. My assessment of intersex treatment protocols vis-a-vis the concept of "enhancement technologies" which appears in chapter four expands on the research was initially produced for that session. 1 am grateful for these and many other opportunities to have publicly worked through the ideas that have formed the basis of this dissertation, and I am thanl6ul for the input 1 received fiom my various audiences. My work depends in part on the cntical trailblazing theoretical, histoncal and clinical work produced over the past decade. Without the intellectual cornmitment and work produced by Alice Dregw, Anne Fausto-Sterling and Suzanne Kessler, this dissertation would not have had a starting point from which to proceed. Accomplishments are never made without the contributions of our supporters. Thanks go to my farnily for their encouragement in moments when it was most needed: June Mtzel, Ron Cowan, Eric and Bah Holmes, Maeve and Tony Holmes, and Margaret Druhan. There are some who deserve extra recognition and thanks: my mother, Trudy Cowan, who edited the penultimate draft, and my grandmother, Elsie MacBride, who boosted me over the last financiai hurdle. It is a terrible personal loss that my father passed away before the dissertation was defended; he was not always the best teacher, but he instilled in ne a fiindamental curiosity about the world around me, and for that 1 am truly gratefùl. Only a few days before defending this dissertation, 1 lost a fnend and professional colleague, Karol Steinhouse. 1 am sony that Karol did not have a chance to see the final product, for she was a great support to me. Then there are those who had to live with me throughout graduate school: 1 am especially thankfùl toTrevor, my greatest fnend and partner, who 1 aiways knew would love me, regardless of whether 1 finished the dissertation. Finally, were it not for my son, 1 would not have finished this project; Nicholas, you are my greatest inspiration. Thank you. Dedicated in memory of My grandfather, Gordon Gray MacBride, and my aunt, Margaret Marie Bracken. Table of Contents Introduction Chapter One: The Creation of Ses: Acccss to Bodily Knowledge The Medical Story Sexual Identitiy and Medicine Hi stoty Limitations of Contemporary Treatment Paradigms Creating and Contesting Stories Telling New Stories Producing New Knowledge Chapter Two: RepracnUtions and Misreprcren~tioar Fictions and Narrations Narrating Difference in Anais Erotica Tragic Births Alexina Herculine Barbin The X-Files Problems in Self-representation Chapter Three: Bodies, Knowldge, Identity Bodies of Knowledge The Consequences of Research Gaps Third Sex? Third Gender? Caveat Community Resisting Sex and Gender Chapter Four: New Methods for Managing Intencx Intersex Management: Trament or Enhancement? Surgery is not an Enhancement technoiogy A new Ethical Approach Cornmon Treatment Outcornes Chapter Five: Consent and Autoaomy What are the Limitations of Consent? Managing Parents Medical Power The Necessity of Monneci Consent Regaining Autonomy Conclusion Bibliography GIossary List of Iilustrations Morgan Holmes and son, Nicholas 99 Cheryl Chase at Mt. Sinai, New York IO1 Martha Covent~yat Mt. Sinai, New York 101 Morgan Holmes at Mt. Sinai, New York 102 Morgan Holmes, portrait by Mary Eilen iMark 1 OS Images of Cheryl Chase and Martha Coventry appear with their permission. The pomait of Morgan Holmes by Mary Ellen Mark appears by permission of the arti st. 1 Introduction This dissertation begins with the premise that there is no such thing as a natural body. This is not equivaient to saying that the body is not a biological organism. Rather, the point of refùsing to adhere to a concept of a natural body constitutes a recognition that there is always an interaction between an organism and its environment.' There is no way to apprehend the body separately from its constitutive cultural gaze. That is to say, our cultural gaze provides the terrns through which we can see or know any body or bodies as such. 1 use this prernise to examine cultural ideas about sex that Somand are informed by medical and biological discourses, and 1 work to provide a sense of how those cultural perceptions impact on the treatment of intersexuality. Chapter one maps the concerns of the dissertation, introducing the ethical and narrative questions that 1 take up in greater detail later. This dissertation accesses intersexualiîy by way of three major i~oads:cuItural theory, philosophy and ethnography; al1 of these are introduced in the first chapter where 1 begin to discuss ideological cornmitments, cultural perceptions and precepts, historical shifts in science and medicine and-themord duties of medical care providers. In chapter one, 1 map the historical commitments of medical research and consider medicine's
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