‘A Woman and Now a Man’: The legitimation of sex-assignment surgery in the United States (1849–1886)

Research output: Contribution to journalArticlepeer-review

Abstract

Throughout much of recorded history, societies that assigned rights and duties based on sex were confounded by people with unclear sex. For the sake of maintaining social and legal order in those contexts, legal systems assigned these people to what they figured was the ‘most dominant’ sex. Then, in mid-19th century United States, a new classification mechanism emerged: sex-assignment surgery, which was imagined by some surgeons to ‘fix’ one’s physical and legal sex status permanently. Other surgeons, however, fiercely opposed the new practice. This article traces the controversy around sex-assignment surgery through three high-profile cases published in US medical journals from 1849 to 1886. Its central argument is that the more general effort to transform surgery into a scientific field helped legitimate the practice of sex-assignment surgery. Although such surgery was subject to intense moral criticism because it was thought to breach the laws of men and nature, over time, these concerns were abandoned or transformed into technical or professional disagreements. In a secondary argument, which helps explain that transformation, this article shows that surgeons gradually became comfortable occupying the epistemic role of sex-classifiers and even sex-makers. That is, whereas sex classification was traditionally a legal task, the new ability to surgically construct one’s genitals engendered the notion that sex could be determined and fixed in the clinic in a legally binding manner. Accordingly, I suggest that surgery became an epistemic act of fact-making. This evolution of the consensus around sex-assignment surgery also provides an early origin story for the idea of sex as plastic and malleable by surgeons, thus offering another aspect to the history of plastic sex.

Original languageEnglish
Pages (from-to)79-105
Number of pages27
JournalSocial Studies of Science
Volume52
Issue number1
DOIs
StatePublished - Feb 2022

Bibliographical note

Funding Information:
I am grateful to Sarah S Richardson, David Jones, Sheila Jasanoff, Tal Golan, Janet E Halley, and Anna Lvovsky, for helping me develop some of the ideas in this article while writing my dissertation. I am also grateful to Suzan Bsol, Ira Rutkow, Shira Shmueli, Michelle Spektor, Kasper Schiolin, Orna Alyagon Darr, Regina Larrea Maccise, Sagit Mor, Binyamin Blum, Lihi Yona, Ido Katri, Reut Cohen, Fady Khoury, Yair Sagy, Itamar Mann and Lauren Rubenzahl. I would like to thank the STS program at Harvard and the Harvard Gender Science Lab for providing mentorship and intellectual encouragement. I am also thankful to the reviewers of Social Studies of Science for their valuable suggestions and challenges. The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Israel Science Foundation (grant No. 704/21).

Funding Information:
The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the Israel Science Foundation (grant No. 704/21).

Publisher Copyright:
© The Author(s) 2021.

Keywords

  • co-production
  • expert testimony
  • gender
  • intersex
  • law
  • medical controversy
  • sex
  • surgery

ASJC Scopus subject areas

  • History
  • Social Sciences (all)
  • History and Philosophy of Science

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