Intersexuality: An Annotated Bibliography

Last Updated 6 February 1996

Alvarado, Donna. 1994. "Intersex". San Jose Mercury News (Sunday Magazine "West"), 1.
Describes the life stories of Cheryl Chase and Morgan Holmes, based on personal interviews. Photos of Holmes. Opinions of intersex specialists Grumbach of UCSF and Gearhart of Hopkins (surgery is necessary to prevent parents from treating child as an outcast) are contrasted with personal experience of Chase and Holmes (surgery experienced as mutilation, causing sexual dysfunction). Anne Fausto-Sterling criticizes intersex specialists as unwilling to follow up patients to determine the outcome of their interventions.
Anonymous. 1994a. Be open and honest with sufferers. BMJ (British Medical Journal) 308 (16 April):1041-1042.
The author of this letter has also been subjected to secrecy surrounding her androgen insensitivity. This secrecy produced a "lifetime of unnecessary secrecy, shame, delayed action, and great damage to my personal and sexual identity and self esteem."
Anonymous. 1994b. Gender Identity in Testicular Feminization. BMJ (British Medical Journal) 308:1041.
This letter responds to "Once a dark secret" in the 19 Feb issue. The author discusses the issue of gender identity, criticizes the secrecy and the labeling of women with complete androgen insensitivity as "male" or "hermaphrodite."
Anonymous. 1994c. Once a Dark Secret. BMJ (British Medical Journal) 308 (19 February):542.
A woman with XY karyotype and "testicular feminization" (androgen insensitivity syndrome) briefly relates how damaging she has found the secrecy surrounding her condition. "Mine was a dark secret kept from all outside the medical profession (family included) but this is not an option because it both increases the feelings of freakishness and reinforces the sense of isolation. It also neglects the need for the counselling of siblings."
Berlin, Meyer, and Shlomo Josef Zevin. 1974. Encyclopedia Talmudica. Jerusalem.
The Jewish Talmud discusses hermaphrodites in many locations, and lays out regulations governing matrimony, priesthood, inheritance and other matters for intersexuals. The Talmudic sages held variously that the hermaphrodite was: of uncertain sex, but in some essential way actually either male or female; part male and part female; definitely male, but only in respect to certain laws. And, in an eerie echo of modern medical practice, one Talmudic writer even differentiates the hermaphrodite, whose sex can never be resolved, from the Tumtum, whose sex is ascertainable through surgery.
Chase, Cheryl. 1994. (Not) Another Clit Story. Libido, Winter.
This erotic short story presents the author's sexual experience after clitorectomy.
Chase, Cheryl. 1996. Affronting reason. Unpublished ms.
Since at least the 1950s, the birth of an intersexed child (one who is neither clearly male or female) has been treated as a medical problem: doctors choose a sex, use surgery and hormones to "normalize" the child's body then, almost universally, consign the entire issue to a silence enforced by shame and secrecy. I use ethnography and feminist social construction theory to understand how and why this violent struggle over sex and gender came to be waged upon my own body and psyche, and those of other intersexuals who have joined me to oppose this unique form of oppression.
Conte, Felix A., and Melvin M. Grumbach. 1989. Pathogenesis, classification, diagnosis, and treatment of anomalies of sex. In Endocrinology, edited by L. J. De Groot. Philadelphia: Saunders.
In depth presentation of etiology, diagnosis, and progress of intersex and related conditions, by two pioneers in the research. Grumbach was a student of Lawson Wilkins (considered the "father of pediatric endocrinology") at Hopkins in the 1950's. No flexibility evidenced about sex assignment, early surgery, or issues of sexual function.
Emans, S. Jean Herriot. 1990. Pediatric and Adolescent Gynecology. Boston: Little, Brown and Company.
The chapter on intersex in this medical textbook provides a guide to diagnosis and lays out the standard medical dogma. To wit, value large penises with urethral meatus at the tip, and female fertility. Assign most intersexual infants female and remove clitoral tissue, construct vagina.
Fausto-Sterling, Anne. 1985. Myths of Gender: Biological Theories about Women and Men. 2d ed. New York: BasicBooks.
Many scientists respond to the issue of sexual equality and the social and political upheaval that has accompanied it by offering us their insights, suggesting in all sincerity that, however well-intentioned, the women's liberation movement and its fellow travlers want biologically unnatural changes that would bring grief to the human race. The question of nature vs nurture - biological vs social determinism - remains a hotly debated topic. In analysing male/female differences, scientists peer through the prism of everyday culture. Their hidden agendas bear strong resemblances to broader social agendas.
Fausto-Sterling, Anne. 1993. The Five Sexes: Why Male and Female are not Enough. The Sciences, March/April, 20-25.
Fausto-Sterling questions the medical dogma that, without medical intervention, hermaphrodites are doomed to a life of misery. What would be the psychological consequences of raising children as unabashed intersexuals? Imagine a society in which sexuality is celebrated for its subtleties and not feared or ridiculed. The author's acceptance of the Victorian classification of intersexuals as male, female, and true pseudo-hermaphrodites is unfortunate, as is her naivite about the success of surgical intervention.
Groce, Nora Ellen. 1985. Everyone Here Spoke Sign Language: Hereditary Deafness on Martha's Vineyard. Cambridge: Harvard University.
Until well into the twentieth century, hereditary deafness was so common in the island community of Martha's Vineyard that nearly every family had at least one deaf member. As a result, everyone spoke sign language, and deaf community members were not considered disabled.
Hampson, J. L., and Joan G. Hampson. 1961. The Ontogenesis of Sexual Behavior in Man. In Sex and Internal Secretions, edited by W. C. Young. Baltimore: Williams and Wilkins.
In a data set of more than 250 post-adolescent hermaphrodites, "The surprise is that so many ambiguous-looking patients were able, appearance notwithstanding, to grow up and achieve a rating of psychologically healthy, or perhaps only mildly non-healthy." p1428-9.
Hendricks, Melissa. 1993. Is it a Boy or a Girl? Johns Hopkins Magazine, November, 10-16.
Surgeons at Hopkins are "artists of genital surgery", who can "carve a large phallus down into a clitoris, create a vagina using a piece of colon, mold labia out of what was a penis." They concede, however, that the surgery is performed in order to alleviate discomfort of parents and relatives, and that they cannot say whether or not their patients will be able to have orgasms. Why do they assign most infants female? "You can make a hole, but you can't build a pole," quips one surgeon.
Herdt, Gilbert, ed. 1994. Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History. New York: Zone Books.
Third Sex, Third Gender assembles recent historical and anthropological work to address the question: Is sexual dimorphism inevitable in human affairs? Byzantine eunuchs, the modern history of cultural perceptions about homosexuality, females in the Balkans who were "social males", Native American Berdache, Indian Hijra, American transgenderists all militate against an affirmative answer. Most relevant, however is Herdt's own presentation of 5-alpha reductase male pseudo-hermaphrodites among the Sambia in Papua New Guinea: they are assigned at birth to a third sex, although the Sambia worldview codes but two genders. Three cheers for his scathing deconstruction of Imperato-McGinley's analysis of 5-alpha reductase hermaphroditism in the Dominican Republic.
Holmes, Morgan. 1994. Re-Membering a Queer Body. Undercurrents, 11-13.
Ms Holmes, who was subjected during childhood to "clitoral recession" surgery which removed most of her clitoris, analyzes the cultural imperative to surgically alter intersexual children's genitals. "The medical definition of what female bodies do not have and must not have: a penis. Any body which does possess a penis must either be designated 'male' or surgically altered. ... In the minds of doctors, bodies are for procreation and heterosexual penetrative sex. ... I would have liked to have grown up in the body I was born with, to perhaps run rampant with a little physical gender terrorism instead of being restricted to this realm of paper and theory. Someone else made the decision of what and who I would always be before I even knew who and what I was."
Horowitz, Sarah. 1995. Both and Neither. SF Weekly, 1 February, 1.
For generations, doctors have been "fixing" babies born with ambiguous genitals. Now adult "intersexuals" wonder if their true identities have been surgically mutilated. The article doesn't take sides, and plays the "expert" doctors' opinions against our opinions. Needless to say, the doctors insist that no one can be allowed to remain intersexual, and we (Cheryl, Morgan, and David) assert that we are intersexual, and that we have been harmed by medicalization. Anne Fausto-Sterling takes our side, and Suzanne Kessler is "sympathetic" with ISNA's goals, but cautions that what doctors are doing is enforcing a cultural mandate, and that doctors are not likely to participate in a revolution.
Kessler, Suzanne. 1990. The Medical Construction of Gender: Case Management of Intersexual Infants. Signs: Journal of Women in Culture and Society 16 (1):3-26.
Ms Kessler interviewed six medical specialists in pediatric intersexuality to produce an account of the medical decision making process. She describes the processes by which cultural assumptions about sexuality in effect supersede objective criteria for gender assignment. Kessler concludes that the key factor in making a decision is whether or not the infant has a "viable" penis.
Kessler, Suzanne J., and Wendy McKenna. 1978. Gender: An Ethnomethodological Approach. Chicago: The University of Chicago Press.
The authors use the ethnomethodological perspective to analyze gender as a social construction. For a psychologist to ask the question, "How are girls different from boys?" overlooks the fact that in order to ask the question, she must already know what girls and boys are; she must be able to attribute gender to actual individuals. How does this process of gender attribution work? What can we learn about gender by considering the lack of cross-culturally valid criteria for distinguishing sex? The relationship between biology and gender as a social construction demonstrates that the latter provides the foundation for the former. How do children learn the rules for constructing a world of two genders?
Lane, Harlan. 1984. When the Mind Hears: A History of the Deaf. New York: Random House.
The history of deaf community, as narrated from the vantage point of Laurent Clerc, the deaf intellectual whose introduction to the US of education in Sign brought education, literacy, self-respect, and community to the deaf. Tragically, he lived to see his life's work and gift to the deaf undone, as hearing "experts" who viewed deafness as pathology succeeded in abolishing sign language from deaf education.
Lee, Ellen Hyun-Ju. 1994. Producing Sex: An Interdisciplinary Perspective on Sex Assignment Decisions for Intersexuals. Senior Thesis, Human Biology: Race and Gender, Brown University, Providence.
Ms Lee ananalyzes medical literature for clinical recommendations concerning the diagnosis and treatment of intersexed infants, while invoking deconstructive feminist theory to critique the medical "management" of ambiguous genitalia. Her interdisciplinary approach places intersexuality within a broader discourse of sex and gender, disputing the binary male/female opposition as a social construction. Especially valuable is her transcription of an interview with "Dr Y", an intersex specialist who acceded to be interviewed about gender assignment under the condition that his identity be disguised.
Lewontin, Richard, Steven Rose, and Leon Kamin. 1984. Not in our Genes. New York: Pantheon Books.
The authors, a prominent genetecist, neuroscientist, and psychologist, offer a scathing rebuttal of biological determinism and sociobiology, demolishing the claim that what an individual can do or become is fixed by their genetic makeup. The discussion of sex and biology, of intersexual karyotypes, and of Money and Erhardt's work on gender are of particular interest.
Majeski, Tom. 1994. Surgery Changes Russian Child's Sex. San Jose Mercury News, 25 July.
A Moscow family, distressed by the genital anatomy of their one year old son, brings him to US for a free sex change, clitorectomy, gonadectomy, and vaginal construction, courtesy of surgeons Reinberg (U Minn) and Gonzales (Wayne State U). Article characterizes child as having mixed gonadal dysgenesis, "both male and female chromosomes, ... genitals of both sexes".
Money, John. 1972. Man & Woman Boy & Girl: The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore: Johns Hopkins University Press.
A thorough presentation of the state of knowledge of human sexual differentiation as of 1972. Includes a number of cases, with photos, of intersex.
Money, John. 1988. Gay, Straight, and In-Between. New York: Oxford University Press.
A presentation of Money's ideas on development of sexual orientation. Includes discussion of sexual differentiation, illuminated by discussion of intersex development.
Money, John. 1991. Biographies of Gender and Hermaphroditism in Paired Comparisons. Edited by J. Money and H. Musaph, The Handbook of Sexology. New York: Elsevier.
The most extensive case histories available. Unfortunately, surgical details are sketchy, and discussion of sexual function reveals Money's devaluing of female sexuality.
Nanda, Sarena. 1994. Hijras: An Alternative Sex and Gender Role in India. In Third Sex, Third Gender: Beyond Sexual Dimorphism in Culture and History, edited by G. Herdt. New York: Zone Books.
The Hijra of India are born as men or as hermaphrodites. Most join after maturity, but when Hijra discover an intersexual infant, they claim it as their own. Indians, more than Westerners, find meaningfulness in "in-between" categories.
Roscoe, Will. 1991. The Zuni Man-Woman. Albuquerque: University of New Mexico Press.
Through a biography of We'wha, a Zuni berdache, Roscoe documents an alternative gender role, one which we would label transgendered. The berdache was an integral, high-status member of Zuni society.
Sacks, Oliver. 1989. Seeing Voices. Berkeley: University of California Press.
Especially valuable for its account of the 1988 uprising of deaf students at Gallaudet University, a defining moment in the birth of a deaf civil rights movement.
Slijper, F.M.E., S.L.S. Drop, J.C. Molenaar, and R.J. Scholtmeijer. 1994. Neonates with Abnormal Genital Development Assigned the Female Sex: Parent Counseling. Journal of Sex Education and Therapy 20 (1):9-17.
Intersex specialists are encouraged to treat sex assignment and "corrective" genital surgery as an emergency. The specialists should determine the sex assignment and prevent the parents from understanding that their child is actually intersexed. They should teach the parents to lie about their child's condition. Surgery on the infant's genitals will alleviate the parents' emotional distress. The parents should be assured that their child will be heterosexual.
Stecker, John F., Charles E. Horton, Charles J. Devine, and John B. McCraw. 1981. Hypospadias Cripples. Urologic Clinics of North America: Symposium on Hypospadias 8 (3):539-544.
Hypospadias surgery is prone to many complications, and often repeated many times. As many as 150 different surgical techniques are used. Hapless victims of repeated hypospadias surgeries are "hypospadias cripples ... trapped in a surgical maelstrom in which every operation may in fact, make matters worse."
van der Kamp, H. J., F. M. E. Slijper, H. Brandenburg, S. M. P. F. de Muinck Keizer-Schrama, S. L. S. Drop, and J. C. Molenaar. 1992. Evaluation of Young Women with Congenital Adrenal Hyperplasia: A Pilot Study. Hormone Research 37 ((suppl 3)):45-49.
This report is invaluable for its presentation of several intersexed individuals who reached adulthood without surgical "correction". The individuals, all living as men with very small penises, presented at the authors' clinic for sex therapy. They are sexually functional, and a small amount of talking therapy helped them and their partners to come to terms with their differences. The authors note without objection, though, that today infants like these patients would be assigned female and have their penises removed.
van Seters, A. P., and A. K. Slob. 1988. Mutually gratifying heterosexual relationship with micropenis of husband. Journal of Sex & Marital Therapy 14 (2 (Summer 1988)):98-107.
This report is invaluable for its presentation of several intersexed individuals who reached adulthood without surgical "correction". The individuals, all living as men with very small penises, presented at the authors' clinic for sex therapy. They are sexually functional, and a small amount of talking therapy helped them and their partners to come to terms with their differences. The authors note without objection, though, that today infants like these patients would be assigned female and have their penises removed.
Williams, Walter L. 1986. The Spirit and the Flesh: Sexual Diversity in American Indian Culture. Boston: Beacon Press.
Integrated, high status roles for transgendered people, some of whom were asserted to be intersexed, were common in American Indian culture.
Woodhouse, C. R. J. 1994. The sexual and reproductive consequences of congenital genitourinary anomalies. Journal of Urology 152 (August 1994):645-651.
A surgeon discusses prospects for adult sexual function, notes that 75% of male assignments with "ambiguous genitalia or micropenis have normal intercourse." "My own experience is that men with the smallest and most deformed penis can have a satisfying sexual relationship with their partner." It is therefore "particularly important to establish whether the alternative treatment, gender reassignment, has better results."

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