Analysis of two Medical Documents on Hermaphroditism in the Nineteenth Century
In their medical reports, "The question of identity; the malformation of the external gential organs; hypospadias; an error about sex" and "A study of a case of incomplete hermaphroditism in a man," Dr. Chesnet and Dr. Goujon make efforts to be neutral. Their thoughts on the identity of a hermaphrodite, Herculine (Alexina) Barbin, however, reveal the underlying assumptions that shape their observations and affect their conclusions. They make assumptions about the relationships between identity and sexuality and between society and biology. The documents indicate a belief that biological sex is the same as gender, and that the two, conflated as one, determine identity as a whole. The doctors work within a framework of thought that polarizes male and female (and their associated characteristics) and leaves little room for qualities that appear to be neither, both, or somewhere in between. Both doctors also assume that reproduction is the essence, and thus determinant of sexuality. Because of this assumption, sexual characteristics that do not affect reproduction are relegated to a secondary position in determining Alexina's identity.1
The very existence of the medical reports indicates certain assumptions about the relationship between identity and sexuality. Both doctors assume that personal identity is a matter of sexthe biological arrangement of external and internal organs. The documents' function is to establish an identity for one whose sex is apparently indistinct. Dr. Chesnet's report is in fact a legal document, supporting Alexina's change of sex status. His report is subtitled "the question of identity" (124), while Tardieu's introduction to the documents is part of a text entitled "Question médico-légale de l'identité dans ses rapports avec les vices de conformation des organs sexuels [Medicolegal question of identity in relation to the defects of conformation of the sexual organs]" (122). These titles underline the struggle to determine Alexina's identity through an exploration of sex and biology, implying that a person is either a male person or a female person.
Both doctors indirectly recognize the concept (without the terminology) of "gender"a social function of sexualitybut do not distinguish this role from biological sexuality. Dr. Goujon refers to Dr. Chesnet's diagnosis of Alexina as a man as assigning her to "his true place in society" (131). He thus assumes that one belongs in either the male role or the female role in society, and the "truth" of one's placement is a product of one's biological sex. Alexina's identity is thus equated to her biological sexuality and the social sexuality that springs directly from it. It is in this framework that Dr. Chesnet acknowledges Alexina's attraction to women; it is a male behavioral characteristic resulting from male biology. Listing his reasons for judging Alexina male, Dr. Chesnet includes the fact that "her tastes, her inclinations, draw her toward women" (127).
There are two assumptions at work here: first, he assumes that it is "male" to be attracted to women, and second, he assumes that male behavior is indicative of male biology. Likewise, Dr. Goujon argues that in the absence of discriminate genital organs, the "inclinations and habits" reveal one's "true sex," allowing us to "mark out their place in society" (138-139). Dr. Goujon thus genderizes behavior absolutely and correlates this genderized behavior directly with sex. His assertion would be impossible if he acknowledged the possibility of a mixture of male and female behaviors, or the possibility that one can have a body of one sex and behavior of another sex. Therefore it is of little consequence to either doctor that Alexina has lived as a woman for twenty years. They give little mention of the emotional or mental implications of this lifestyle. Her biology constitutes her and always has. That is, though she has lived as a woman, the current arrangement of organs indicates that she would be more properly classified as a man. Thus, she is a man and has always been a man, in woman's clothing. She has a "true sex," a sex established by her biology and therefore, in the doctors' logic, the source of her identity.
To the doctors, masculine and feminine are visualized as polarities, as discrete entities. Masculine characteristics are completely distinct from feminine characteristics. If a quality appears to be indiscriminate or in between the two sexes, it must be assigned somehow to one of the two categories. This assumption affects both the conclusions of the two examinations as well as the manner in which they are carried out. Dr. Chesnet's examination of Alexina's physical appearance is shaped by his knowledge that he will have to determine a sex for her. Every characteristic is described (and perhaps thought of) in the context of its possible sexual association. For example, Dr. Chesnet describes Alexina's voice: "[It] is ordinarily that of a woman, but sometimes in conversation or when she coughs, heavy, masculine tones mingle with it" (125). He assumes first that there are "masculine tones" and feminine tones; he further assumes that one's voice can be scientifically described in terms of these sex associations. Alexina's body parts are attributed to male or female paradigms by piecemeal, even when this practice obscures reality, revealing the doctor's view that there are no sexless characteristics. In the face of apparently indiscriminate qualities, he struggles to define them in terms of sex in order to categorize them as either male or female.
When Alexina's organs appear inconclusive, it is considered a case of arrested development: the characteristic in question was intended by nature to be in one of the categories and therefore belongs to that category. Though Dr. Chesnet observes that she has "apparent labia majora" he determines that these are "in realityonly the two halves of a scrotum that remained divided" (126, emphasis added). His judgment, based on the "ovoid bodies" he can feel within these structures, is more than a decision as to which sex the organs more resemble; it is a decision about the very nature of the organ, a nature that must be either male or female. Likewise, in determining the identity of what Dr. Chesnet refers to as an "imperfect penis" (126), Dr. Goujon asserts that "this organ was a large clitoris rather than a penis" (131, emphasis added). The organ cannot be both, or in between, or a combination of the two. It is either one or the other, just as Alexina is either male or female, as it was originally intended to be, from the point of view of the doctors.
This system of polarizing the two sexes and their characteristics serves to inhibit a full understanding of the organs. Dr. Chesnet ignores or minimizes the indiscriminate qualities of Alexina's body because of his assumption that these qualities cannot exist. Though Dr. Chesnet admits that Alexina has a "predominance of masculine sexual characteristics" (128), he does not consider this a conclusion. She cannot be, for example, 'mostly male' the predominance of masculinity means that "Alexina is a man" (128). Indeed, at this point in the document, Dr. Chesnet ceases to refer to Alexina as "she" in favor of "he." Similarly, Dr. Goujon somewhat bafflingly states that Alexina's and others' cases show clearly "the fact that hermaphroditism does not exist in man and the higher animals" (139). That is, despite cases that appear to have attributes of both sexes, one always has a "true sex" and there can always be found a means to discover it (138). There simply is no neuter or combination of sexes, no hermaphroditism: there is male and there is female.
The doctors assume that reproduction can be taken as a synecdoche for sexuality, which is itself a synecdoche for identity. The sexual organs that are not directly associated with reproduction are secondary to those that are. Dr. Chesnet reduces the significance of many of Alexina's organs, many of which appear to be female, because they are non-reproductive. Referring to Alexina's discharge of seminal fluid, the ovoid bodies, and spermatic cords, he writes, "These are the real proofs of sex. We can now conclude and say: Alexina is a man" (128). The "real proof" is the capability or potential capability for reproduction. She has no apparent womb, but she is attracted to women and seems to have the male reproductive organs; therefore, she is a man. Like Dr. Chesnet, Dr. Goujon asserts that Alexina is a man because her reproductive facilities are those of a man. She ejects seminal fluid without spermatozoa, but Dr. Goujon takes great pains to assert that spermatozoa had the potential to appear. Though Alexina could "play either the masculine or feminine role in coitus, without distinction" (131), because "procreation is the natural goal of marriage", Alexina's role in marriage is that of a man. It is in this light that Dr. Goujon is able to "[confirm] the exactness of [Dr. Chesnet's] diagnosis" (131).
In this world centered on reproduction, both doctors give precedence to Alexina's post-puberty biology at the expense of the pre-puberty arrangement of organs; reproduction is only capable after puberty, so the post-puberty status is the true status. Though initially classified as a woman, according to Dr. Goujon, "physical modifications that later occurred forced him to request a rectification of his civil status, which decisively recognized his sex, which was masculine" (130). It is this latter diagnosis that constitutes Alexina's "true sex" because the latter diagnose considers reproductive capacity, the "real proof" of sex.
Three groups of assumptions, no doubt incomplete, underlie the discussion above. First, the doctors, though they recognize the social role of sexuality, do not distinguish this role from the biology of sexuality. Second, identity is based in these concepts: the doctors do not recognize sexless identity. Third, the sexes themselves are incommensurable2; for the doctors, then, it is nearly impossible to accept characteristics that are both male and female. It is this view that leads to the notion of "true sex," a notion that both doctors apply to Alexina (vii). She has a sex, either male or female; it is only a matter of discerning it from the formation of her organs. The assumptions and attitudes that the doctors held undoubtedly influenced their documents and observations of Alexina. Likewise, my own assumptions and attitudes have influenced my reading of the documents, my ability to discern the underlying assumptions, and my written analysis of the two. It is very nearly impossible to escape one's cultural influences even when attempting to analyze that very difficulty. Thus, the doctors should not necessarily be faulted for the ways in which their beliefs shaped purportedly objective documents. While it may partially obscure the scientific value of the documents, the underlying assumptions create a document of historical value, shedding light on the cultural thought structures of a period not entirely distinct from our own.
1Ideally, I would refer to Alexina with neuter pronouns but this has proved impossible. The two doctors categorized Alexina as a male, and varied between the gendered pronouns in their own documents, but I have used feminine pronouns consistently, except for in direct quotes. I find myself thinking of Alexina as a woman, if only because she lived as a woman for so many years, but except for the pronoun usagea matter of elegance and consistencyI have attempted to disengage this belief from my analysis.
2This phrase (the "incommensurability" of the sexes) I have borrowed from Thomas Lacquer's article, "Orgasm, Generation, and the Politics of Reproductive Biology." I am greatly in debt to Lacquer, for many of the ideas he highlights in his article have influenced my thinking and thus my analysis presented here.
Chestnet. "The question of identity; the malformation of the external gential organs; hypospadias; an error about sex." Being the Recently Discovered Memoirs of a Nineteenth Century French Hermaphro dite. Herculine Barbin. Trans. Richard McDougall. New York: Pantheon Books, 1980. 124-128.
Goujon, E. "A study of a case of incomplete hermaph roditism in a man." Being the Recently Discovered Memoirs of a Nineteenth Century French Hermaphro dite. Herculine Barbin. Trans. Richard McDougall. New York: Pantheon Books, 1980. 128-144.
Tardieu, Auguste. "Question médico-légale de l'identité dans ses rapports avec les vices de conformation des organes sexuels." Introduction. Chestnet. "The question of identity; the malformation of the external gential organs; hypospadias; an error about sex." Being the Recently Discovered Memoirs of a Nineteenth Century French Hermaphrodite. Herculine Barbin. Trans. Richard McDougall. New York: Pantheon Books, 1980.
Lesley Goodman is a prospective Honors English major and history minor. She enjoyed the combination of English and history in this paper, approaching the documents like literary texts, trying to decipher their language in the same way she analyzes literature, and then situating those conclusions in a historical context. "When I sit down to write a paper," she says, "I like to sketch out my argument and then outline my main points. Depending upon how much time I have, I often write out each bit of evidence that I plan to use so it's up there on the screen looking me in the face. And then I finally sit down and write the damn thing, which is kind of painful to start, but once I get going [it] is a positive experience. I tend to learn a great deal from the very act of writing a paper, both about the subject matter and about writing in general." This paper was written for Professor Pieter Judson's History 29: Sexuality and Society in Modern Europe.