Sexing the Body

Preface

Sexing the Body was first published in 2000. In my previous book, Myths of Gender: Biological Theories About Women and Men (1985), I had exhorted scholars to examine the personal and political components of their scholarly viewpoints. Individual scientists are inclined to believe one or another claim about biology based in part on scientific evidence and in part on whether the claim confirms some aspect of life that seems personally familiar. As someone who has lived part of her life as an unabashed heterosexual, part as an unabashed lesbian, and part in transition, I was certainly open to theories of sexuality that allow for flexibility and the development of new behavior patterns, even in adulthood. I did not find it surprising, however, that someone who always felt either heterosexual or homosexual might be more open to theories that posit a biologically determined sexuality that unfolds as one grows into adulthood.

In 1985, however, I had little understanding of how cultural points of view insinuated themselves into the production of scientific knowledge and I felt a need to explore this question in greater detail. The result was a ten-year foray into the field of science and technology studies (STS), an area of inquiry that explores how science itself works—how it produces reliable knowledge even if that knowledge contains cultural biases. As I explored STS ideas, the concepts that led to Sexing the Body took shape in my head. What could it mean to think that biology itself might be socially constructed (as the argument would have been phrased during the 1990s)? How would someone steeped in the concepts developed by STS researchers conceptualize sex, gender, hormones, and genitalia? In 2000 I put forward my thoughts on such topics in Sexing the Body. My goal was to to convince readers of the need for theories that allow for a good deal of human variation and that integrate the analytical powers of the biological and the social into the systematic analysis of human development. Now, twenty years later, I’m delighted to have the opportunity to update the book and especially to further develop my thoughts on how humans acquire different identities and ways of being in the world.

Much has changed in the past two decades, from the rapid spread of same-sex marriage to the proliferation of new gender identities and labels. Nevertheless, for this new edition of Sexing the Body, I have chosen not to alter the book’s original nine chapters. These, I think, still form a coherent argument. Furthermore, they were written at a particular moment in my own intellectual development and focused around the hotly debated arguments in which the field of sex/sexuality and gender studies engaged during the 1990s. It would confuse me and the reader to try to integrate how I think about these same issues in 2020 into text written over twenty years ago. Instead, I have added a new chapter 10, “A Sea of Gender,” which offers a contemporary, 2020 roadmap for understanding how gender/sex develops in individuals, and how big-picture patterns of difference and sameness emerge. Then, in a new afterword, I follow into the present some of the topics examined at length in the original chapters. I describe, for example, recent attempts to (again) limit competitive athletics to only certain kinds of women—looking especially at the International Olympic Committee’s ban on long-distance women runners who have naturally high testosterone levels. I update the reader on the intersex rights movement and changes in clinical treatment of infants born with mixed genitalia, and I review a rapidly growing literature on gender/sex differences and similarities in the brain.

For a book written for a general audience, this volume has an unusually large notes and bibliography section. That is because, in essence, I have written two books in one: a narrative accessible to a general audience, and a scholarly work intended to advance discussion and arguments within academic circles. At times the scholarly discussion can become arcane or devolve into side issues that deflect attention from the main narrative. Furthermore, academics often demand detailed evidence in the form of quotes from original sources or detailed accounts of a particular experiment. One of the ways I have used the notes is to carry on the scholarly discussions without distracting the general reader. Although one need not do so to follow my general argument, I nevertheless urge everyone to read the notes, as they add both depth and diversity to the text.

Furthermore, Sexing the Body is a highly synthetic work, and thus most readers, be they academicians or members of a general audience, will be unfamiliar with—and quite possibly skeptical of—at least some of the areas on which I touch. For this reason, as well, I chose to footnote heavily, indicating that claims I make even in passing have substantial backing in the academic literature. Then, too, readers intrigued with particular topics can use the notes and bibliography as a resource for further reading of their own. This, I fear, is the teacher in me. My biggest desire in writing this book is to stimulate discussion and reading on the part of my readers, so the rich and up-to-date bibliography draws on significant literatures in fields ranging from science studies to feminism to sexuality studies to human development to systems theory and biology.

I have also included a fair amount of artwork, and again this is unusual for a book of this type. Some of the illustrations consist of cartoons or humorous drawings describing events discussed in the text. I was inspired to take this route by others who have conveyed scientific ideas using cartoons. Many people think of science as a humorless profession, and feminists are always accused of lacking a sense of humor. But this feminist scientist finds humor everywhere. I hope that some of the illustrations encourage readers suspicious of the cultures of science and of feminism to see that it is possible to be deeply serious about one’s profession while maintaining a sense of humor.

Biology itself is a very visual field, as a glance at current biology textbooks reveals. Some of my illustrations, then, are intended to convey information visually, rather than verbally. In this, I am merely being true to my own academic tradition. At any rate, I encourage the reader to laugh if so moved, to study diagrams if he or she wishes, or to skip over the illustrations and focus on the text if that is the reader’s preferred mode.

1

DUELING DUALISMS

MALE OR FEMALE?

In the rush and excitement of leaving for the 1988 Olympics, Maria Patiño, Spain’s top woman hurdler, forgot the requisite doctor’s certificate stating, for the benefit of Olympic officials, what seemed patently obvious to anyone who looked at her: she was female. But the International Olympic Committee (IOC) had anticipated the possibility that some competitors would forget their certificates of femininity. Patiño had only to report to the “femininity control head office,”1 scrape some cells off the side of her cheek, and all would be in order—or so she thought.

A few hours after the cheek scraping she got a call. Something was wrong. She went for a second examination, but the doctors were mum. Then, as she rode to the Olympic stadium to start her first race, track officials broke the news: she had failed the sex test. She may have looked like a woman, had a woman’s strength, and never had reason to suspect that she wasn’t a woman, but the examinations revealed that Patiño’s cells sported a Y chromosome, and that her labia hid testes within. Furthermore, she had neither ovaries nor a uterus.2 According to the IOC’s definition, Patiño was not a woman. She was barred from competing on Spain’s Olympic team.

Spanish athletic officials told Patiño to fake an injury and withdraw without publicizing the embarrassing facts. When she refused, the European press heard about it and the secret was out. Within months after returning to Spain, Patiño’s life fell apart. Spanish officials stripped her of past titles and barred her from further competition. Her boyfriend deserted her. She was evicted from the national athletic residence, her scholarship was revoked, and suddenly she had to struggle to make a living. The national press had a field day at her expense. As she later said, “I was erased from the map, as if I had never existed. I gave twelve years to sports.”3

Down but not out, Patiño spent thousands of dollars consulting doctors about her situation. They explained that she had been born with a condition called androgen insensitivity. This meant that, although she had a Y chromosome and her testes made plenty of testosterone, her cells couldn’t detect this masculinizing hormone. As a result, her body had never developed male characteristics. But at puberty her testes produced estrogen (as do the testes of all men), which, because of her body’s inability to respond to its testosterone, caused her breasts to grow, her waist to narrow, and her hips to widen. Despite a Y chromosome and testes, she had grown up as a female and developed a female form.

Patiño resolved to fight the IOC ruling. “I knew I was a woman,” she insisted to one reporter, “in the eyes of medicine, God and most of all, in my own eyes.”4 She enlisted the help of Alison Carlson, a former Stanford University tennis player and biologist opposed to sex testing, and together they began to build a case. Patiño underwent examinations in which doctors “checked out her pelvic structures and shoulders to decide if she was feminine enough to compete.”5 After two and a half years the International Amateur Athletic Federation (IAAF) reinstated her, and by 1992 Patiño had rejoined the Spanish Olympic squad, going down in history as the first woman ever to challenge sex testing for female athletes. Despite the IAAF’s flexibility, however, the IOC has remained adamant: even if looking for a Y chromosome wasn’t the most scientific approach to sex testing, testing must be done.

The members of the International Olympic Committee remain convinced that a more scientifically advanced method of testing will be able to reveal the true sex of each athlete. But why is the IOC so worried about sex testing? In part, IOC rules reflect cold war political anxieties: during the 1968 Olympics, for instance, the IOC instituted “scientific” sex testing in response to rumors that some Eastern European competitors were trying to win glory for the Communist cause by cheating—having men masquerade as women to gain unfair advantage. The only known case of a man infiltrating women’s competition occurred back in 1936 when Hermann Ratjen, a member of the Nazi Youth, entered the women’s high-jump competition as “Dora.” His maleness didn’t translate into much of an advantage: he made it to the finals, but came in fourth, behind three women.

Although the IOC didn’t require modern chromosome screening in the interest of international politics until 1968, it had long policed the sex of Olympic competitors in an effort to mollify those who feared that women’s participation in sports threatened to turn them into manly creatures. In 1912, Pierre de Coubertin, founder of the modern Olympics (from which women were originally banned), argued that “women’s sports are all against the law of nature.”6 If women were by nature not athletic competitors, then what was one to make of the sportswomen who pushed their way onto the Olympic scene? Olympic officials rushed to certify the femininity of the women they let through the door, because the very act of competing seemed to imply that they could not be true women.7 In the context of gender politics, employing sex police made a great deal of sense.8

SEX OR GENDER?

Until 1968 female Olympic competitors were often asked to parade naked in front of a board of examiners. Breasts and a vagina were all one needed to certify one’s femininity. But many women complained that this procedure was degrading. Partly because such complaints mounted, the IOC decided to make use of the modern “scientific” chromosome test. The problem, though, is that this test, and the more sophisticated polymerase chain reaction to detect small regions of DNA associated with testes development that the IOC uses today, cannot do the work the IOC wants it to do. A body’s sex is simply too complex. There is no either/or. Rather, there are shades of difference. In chapters 2–4 I’ll address how scientists, medical professionals, and the wider public have made sense of (or ought to make sense of) bodies that present themselves as neither entirely male nor entirely female. One of the major claims I make in this book is that labeling someone a man or a woman is a social decision. We may use scientific knowledge to help us make the decision, but only our beliefs about gender—not science—can define our sex. Furthermore, our beliefs about gender affect what kinds of knowledge scientists produce about sex in the first place.

Over the last few decades, the relation between social expression of masculinity and femininity and their physical underpinnings has been hotly debated in scientific and social arenas. In 1972 the sexologists John Money and Anke Ehrhardt popularized the idea that sex and gender are separate categories. Sex, they argued, refers to physical attributes and is anatomically and physiologically determined. Gender they saw as a psychological transformation of the self—the internal conviction that one is either male or female (gender identity) and the behavioral expressions of that conviction.9

Meanwhile, the second-wave feminists of the 1970s also argued that sex is distinct from gender—that social institutions, themselves designed to perpetuate gender inequality, produce most of the differences between men and women.10 Feminists argued that although men’s and women’s bodies serve different reproductive functions, few other sex differences come with the territory, unchangeable by life’s vicissitudes. If girls couldn’t learn math as easily as boys, the problem wasn’t built into their brains. The difficulty resulted from gender norms—different expectations and opportunities for boys and girls. Having a penis rather than a vagina is a sex difference. Boys performing better than girls on math exams is a gender difference. Presumably, the latter could be changed even if the former could not.

Money, Ehrhardt, and feminists set the terms so that sex represented the body’s anatomy and physiological workings and gender represented social forces that molded behavior.11 Feminists did not question the realm of physical sex; it was the psychological and cultural meanings of these differences—gender—that was at issue. But feminist definitions of sex and gender left open the possibility that male/female differences in cognitive function and behavior12 could result from sex differences, and thus, in some circles, the matter of sex versus gender became a debate about how “hardwired” intelligence and a variety of behaviors are in the brain,13 while in others there seemed no choice but to ignore many of the findings of contemporary neurobiology.

In ceding the territory of physical sex, feminists left themselves open to renewed attack on the grounds of biological difference.14 Indeed, feminism has encountered massive resistance from the domains of biology, medicine, and significant components of social science. Despite many positive social changes, the 1970s optimism that women would achieve full economic and social equality once gender inequity was addressed in the social sphere has faded in the face of a seemingly recalcitrant inequality.15 All of which has prompted feminist scholars, on the one hand, to question the notion of sex itself,16 while on the other to deepen their inquiry into what we might mean by words such as gender, culture, and experience. The anthropologist Henrietta L. Moore, for example, argues against reducing accounts of gender, culture, and experience to their “linguistic and cognitive elements.” In this book (especially in chapter 9) I argue, as does Moore, that “what is at issue is the embodied nature of identities and experience. Experience… is not individual and fixed, but irredeemably social and processual.”17

Our bodies are too complex to provide clear-cut answers about sexual difference. The more we look for a simple physical basis for “sex,” the more it becomes clear that “sex” is not a pure physical category. What bodily signals and functions we define as male or female come already entangled in our ideas about gender. Consider the problem facing the International Olympic Committee. Committee members want to decide definitively who is male and who is female. But how? If Pierre de Coubertin were still around, the answer would be simple: anybody who desired to compete could not, by definition, be a female. But those days are past. Could the IOC use muscle strength as some measure of sex? In some cases. But the strengths of men and women, especially highly trained athletes, overlap. (Remember that three women beat Hermann Ratjen’s high jump.) And although Maria Patiño fit a commonsense definition of femininity in terms of looks and strength, she also had testes and a Y chromosome. But why should these be the deciding factors?

The IOC may use chromosome or DNA tests or inspection of the breasts and genitals to ascertain the sex of a competitor, but doctors faced with uncertainty about a child’s sex use different criteria. They focus primarily on reproductive abilities (in the case of a potential girl) or penis size (in the case of a prospective boy). If a child is born with two X chromosomes, oviducts, ovaries, and a uterus on the inside, but a penis and scrotum on the outside, for instance, is the child a boy or a girl? Most doctors declare the child a girl, despite the penis, because of her potential to give birth, and intervene using surgery and hormones to carry out the decision. Choosing which criteria to use in determining sex, and choosing to make the determination at all, are social decisions for which scientists can offer no absolute guidelines.

REAL OR CONSTRUCTED?

I enter the debates about sex and gender as a biologist and a social activist.18 Daily, my life weaves in and out of a web of conflict over the politics of sexuality and the making and using of knowledge about the biology of human behavior. The central tenet of this book is that truths about human sexuality created by scholars in general and by biologists in particular are one component of political, social, and moral struggles about our cultures and economies.19 At the same time, components of our political, social, and moral struggles become, quite literally, embodied, incorporated into our very physiological being. My intent is to show how these mutually dependent claims work, in part by addressing such issues as how—through their daily lives, experiments, and medical practices—scientists create truths about sexuality; how our bodies incorporate and confirm these truths; and how these truths, sculpted by the social milieu in which biologists practice their trade, in turn refashion our cultural environment.

My take on the problem is idiosyncratic, and for good reason. Intellectually, I inhabit three seemingly incompatible worlds. In my home department I interact with molecular biologists, scientists who examine living beings from the perspective of the molecules from which they are built. They describe a microscopic world in which cause and effect remain mostly inside a single cell. Molecular biologists rarely think about interacting organs within an individual body, and even less often about how a body bounded by skin interacts with the world on the other side of the skin. Their vision of what makes an organism tick is decidedly bottom up, small to large, inside to outside.

I also interact with a virtual community—a group of scholars drawn together by a common interest in sexuality—and connected by something called a listserve. On a listserve, one can pose questions, think out loud, comment on relevant news items, argue about theories of human sexuality, and report the latest research findings. The comments are read by a group of people hooked together via electronic mail. My listserve (which I call “Loveweb”) consists of a diverse group of scholars—psychologists, animal behaviorists, hormone biologists, sociologists, anthropologists, and philosophers. Although many points of view coexist in this group, the vocal majority favor body-based, biological explanations of human sexual behavior. Loveweb members have technical names for preferences they believe to be immutable. In addition to homosexual, heterosexual, and bisexual, for example, they speak of hebephilia (attracted primarily to pubescent girls), ephebephilia (aroused by young males in their late teens or early twenties), pedophilia (aroused by children), gynephilia (aroused by adult women), and androphilia (attracted to adult men). Many Loveweb members believe that we acquire our sexual essence before birth and that it unfolds as we grow and develop.20

Unlike molecular biologists and Loveweb members, feminist theorists view the body not as essence, but as a bare scaffolding on which discourse and performance build a completely acculturated being. Feminist theorists write persuasively and often imaginatively about the processes by which culture molds and effectively creates the body. Furthermore, they have an eye on politics (writ large), which neither molecular biologists nor Loveweb participants have. Most feminist scholars concern themselves with real-world power relationships. They have often come to their theoretical work because they want to understand (and change) social, political, and economic inequality. Unlike the inhabitants of my other two worlds, feminist theorists reject what Donna Haraway, a leading feminist theoretician, calls “the God-trick”—producing knowledge from above, from a place that denies the individual scholar’s location in a real and troubled world. Instead, they understand that all scholarship adds threads to a web that positions racialized bodies, sexes, genders, and preferences in relationship to one another. New or differently spun threads change our relationships, change how we are in the world.21

Traveling among these varied intellectual worlds produces more than a little discomfort. When I lurk on Loveweb, I put up with gratuitous feminist-bashing aimed at some mythic feminist who derides biology and seems to have a patently stupid view of how the world works. When I attend feminist conferences, people howl in disbelief at the ideas debated on Loveweb. And the molecular biologists don’t think much of either of the other worlds. The questions asked by feminists and Loveweb participants seem too complicated; studying sex in bacteria or yeast is the only way to go.

To my molecular biology, Loveweb, and feminist colleagues, then, I say the following: as a biologist, I believe in the material world. As a scientist, I believe in building specific knowledge by conducting experiments. But as a feminist Witness (in the Quaker sense of the word) and in recent years as a historian, I also believe that what we call “facts” about the living world are not universal truths. Rather, as Haraway writes, they “are rooted in specific histories, practices, languages and peoples.”22 Ever since the field of biology emerged in the United States and Europe at the start of the nineteenth century, it has been bound up in debates over sexual, racial, and national politics.23 And as our social viewpoints have shifted, so has the science of the body.24

Many historians mark the seventeenth and eighteenth centuries as periods of great change in our concepts of sex and sexuality.25 During this period a notion of legal equality replaced the feudal exercise of arbitrary and violent power given by divine right. As the historian Michel Foucault saw it, society still required some form of discipline. A growing capitalism needed new methods to control the “insertion of bodies into the machinery of production and the adjustment of the phenomena of population to economic processes.”26 Foucault divided this power over living bodies (bio-power) into two forms. The first centered on the individual body. The role of many science professionals (including the so-called human sciences—psychology, sociology, and economics) became to optimize and standardize the body’s function.27 In Europe and North America, Foucault’s standardized body has, traditionally, been male and Caucasian. And although this book focuses on gender, I regularly discuss the ways in which the ideas of both race and gender emerge from underlying assumptions about the body’s physical nature.28 Understanding how race and gender work—together and independently—helps us learn more about how the social becomes embodied.

Foucault’s second form of bio-power—“a biopolitics of the population”29—emerged during the early nineteenth century as pioneer social scientists began to develop the survey and statistical methods needed to supervise and manage “births and mortality, the level of health, life expectancy and longevity.”30 For Foucault, “discipline” had a double meaning. On the one hand, it implied a form of control or punishment; on the other, it referred to an academic body of knowledge—the discipline of history or biology. The disciplinary knowledge developed in the fields of embryology, endocrinology, surgery, psychology, and biochemistry have encouraged physicians to attempt to control the very gender of the body—including “its capacities, gestures, movements, location and behaviors.”31

By helping the normal take precedence over the natural, physicians have also contributed to populational biopolitics. We have become, Foucault writes, “a society of normalization.”32 One important mid-twentieth-century sexologist went so far as to name the male and female models in his anatomy text Norma and Normman (sic).33 Today we see the notion of pathology applied in many settings—from the sick, diseased, or different body,34 to the single-parent family in the urban ghetto.35 But imposing a gender norm is socially, not scientifically, driven. The lack of research into the normal distributions of genital anatomy, as well as many surgeons’ lack of interest in using such data when they do exist (discussed in chapters 3 and 4), clearly illustrate this claim. From the viewpoint of medical practitioners, progress in the handling of intersexuality involves maintaining the normal. Accordingly, there ought to be only two boxes: male and female. The knowledge developed by the medical disciplines empowers doctors to maintain a mythology of the normal by changing the intersexual body to fit, as nearly as possible, into one or the other cubbyhole.