In her book Hermaphrodites and the Medical Invention of Sex Alice Dreger charts the ideological shifts in medical consensus over the classification of hermaphroditic bodies during the mid-19th and early 20th Centuries.  While there occurred significant changes in the favored procedures of Western medicine for the treatment of hermaphrodites during this time, Dreger’s description of the Age of Gonads shows how the medical field sometimes oscillated in its favored procedures while at a deeper level remaining in the service of a static idea.  In this case the static idea is sexual dimorphism and the procedure is the favored route for determining “true” sex.  Dreger writes, “During this period, 1870-1915, what I call the Age of Gonads, scientific and medical men, faced with and frustrated by case after case of ‘doubtful sex,’ came to an agreement that every body’s ‘true’ sex was marked by one thing and one thing only: the anatomical nature of the gonadal tissue as either ovarian or testicular,” (29).  At the beginning of said Age, gonads began their reign as the penultimate determiners of sex, and self-evidently, at the end of the Age science turned to other factors such as secondary sex characteristics for sex certainty.  This characterization presents a very clear shift from one procedure of sex determination to another, but significantly, both the adoption and the eventual abandonment of gonads as the “true” sex markers were undertaken for the motivation of upholding sexual dimorphism.  To demonstrate, when discussing why gonads were initially chosen as sex determiners, Dreger writes, “The gonadal definition of true sex seemed to preserve, in theory and practice, the strict separation between males and females,” (30).  In fact, most medical professionals, (a group which, during our era of focus, was comprised almost solely of white, heterosexual males with property or wealth) preached the gospel of sexual difference: “Many men of science, following in the footsteps of the great Charles Darwin, wrote with confidence and enthusiasm about the differences of the male and female types,” (Dreger, 26).  Worthy of mention is the fact that sexual dimorphism was generally deployed for the sake of restricting men and women to certain “natural” domains of behavior and opportunity.

When, in 1915, the Age of the Gonads as identified by Alice Dreger comes to a close, it is by the hand of a medical professional named Blair Bell: “Until 1915 when William Blair Bell did so, apparently no medical man dared to openly question the gonadal definition of true sex,” (Dreger, 158).  However, while Blair was the one to conspicuously conclude the Age of the Gonads, his reason for prescribing a change in procedure is one which strives to uphold the same ideology of sexual dimorphism which originally catalyzed the advent of the Age.  Blair’s abandonment of gonads as the true sex determiners was prompted by his experience with patients such as Dr. Russell Andrews’ patient (as referenced on Dreger’s page 161) who looked like, behaved like, and believed herself to be a woman, but in whom was discovered testicular gonadal tissue.  In such a circumstance, if the gonads were to be considered the authorities, there would be a confusing incongruity between the medically official sex and what is aesthetically observable about the person such as the appearance of secondary sex characteristics and gender presentation. This confusion is the antithesis of what is desired by a system which subscribes to sexual dimorphism: the co-mingling of “oppositional” sexual allegiances on a single body dangerously blurs the distinction between the sexes and shatters the glass wall so carefully cultivated by sexual dimorphism between the essential “natures” and capacities of men and women.  Dreger writes, “Blair Bell was, like his predecessors and successors, motivated in theory and practice by an interest in maintaining clear, medically sanctioned divisions between the two sexes… Indeed, this was largely the reason Blair Bell suggested the abandonment of the gonad-as-exclusive-marker rule.  … If men and women were to be kept distinct, Blair Bell realized, hermaphrodite-sorting would have to be accomplished in such a way as to quiet sex anomalies, not accentuate them,” (165-166).  Thus, it is significantly evident that both the rise and fall of the Age of Gonads were dictated by a curiously strong medical loyalty to sexual dimorphism; even more significantly, this persistent piece of ideology has not yet found its overdue grave, and it still continues to influence the practice of medicine and other sciences today.


By: Rosalind Rini