Full citation:Linton, Anne E. 2022. Unmaking Sex: The Gender Outlaws of Nineteenth-Century France. Cambridge University Press, Cambridge. ISBN 978-1-316-51182-4
The introduction opens, as is often the case, with a case history illustrating the main theme of the book. A patient was referred to a doctor for “suffering in the genital parts” and on examination the doctor could make no solid conclusion about what sex the person was. Not only did the person have ambiguous genitals, but they performed socially alternately as a woman (at home) and a man (outside the home).
Several factors brought intersexuality into focus in 19th century France—a focus that manifested both in literature and medical records. France seems to have been a particular flashpoint for this topic and the present book explores why that was the case, as well as making connections between the literary and medical traditions. In contradiction to some theorist’s positions that the idea of everyone having a “true sex” was solidly established by the 19th century, this study finds that both literature and medicine served to undermine this position, concluding that sex could, in many cases, be unknowable.
The topic of 19th century interest does not correspond exactly to the modern category of intersexuality, not only because many conditions classified that way today were not identifiable by 19th century medicine, but also because the historic category of “hermaphrodite” encompass social and behavioral elements as well as physiology. The 19th century position (inherited from earlier eras) was that sex, gender, and sexuality were expected to align, therefore any contradiction or ambiguity within those categories could result in a diagnosis of hermaphrodism.
There is a survey of 19th century French literature that features either characters described as hermaphrodites, or whose indeterminant gender is a key plot point. The exploration of indeterminant gender in fiction was echoed by the language in medical case studies that debated (with no consensus) how to properly assign sex in ambiguous cases.
Fiction was not the only venue for spreading popular awareness of intersexuality. Divorce cases in which it featured were publicized in the papers, intersex people were exhibited in medical schools and “freak shows.” New medical specialties competed for authority over the phenomenon. Although traces of the mythological bi-functional hermaphrodite remained in literature, often as a romanticized and idealized figure, increasingly the depictions were realistic, appearing in decadent literature—though combinations of the two motifs also occurred.
The book begins by examining the historic reasons behind the explosion of interest in 19th century France. This includes medical discussions around sex categorization and the consequences of indeterminacy, especially as they played out in the court. Literary narratives intersect with science in how these cases are argued, which leads to the book’s study of the motif in literature.
Another aspect of this specific moment in intersex history was the spread of accessible literature on the topic that intersex people could use to interrogate their own lives and bodies. In the case of Marie B., who raised questions about herself in the context of a marriage proposal, her own studies of literature on hermaphroditism led her to a contradictory opinion from the doctors—they concluded she was a man, whereas she had confirmed to her own satisfaction that she was a woman.
The introduction goes on to discuss the data and methodology.
Why were hermaphrodites so prevalent in 19th century French fiction and medicine? The rise of large public hospitals serving the poor, an interest in treating venereal diseases (involving examination of the genitals), and expansion of medical publications—all increased visibility. French law (as a legacy of the Napoleonic code) required doctors to record the sex of each birth within three days, with no allowance for ambiguity. Urbanization, shifting family dynamics, and a decreased birth rate raised interest and anxiety around reproductive topics. There was a conflict between sociopolitical efforts to “naturalize” gender difference, while at the same time doctors were identifying cases that undermined the concept.
[Note: The author assumes a detailed knowledge of the central topic of the chapter, Herculine Barbin. To contextualize the material, here is some background, based largely on Wikipedia. Barbin was classified as female at birth and was educated at a convent school. There she fell in love with a fellow female student, then later with a fellow female teacher. Severe abdominal pain led her to a series of medical examinations, which identified anomalies in her anatomy.]
The literary style of the memoirs of Herculine Barbin is compared to fictional representations of hermaphrodites. Barbin offers what may be the only firsthand account from a 19th century intersex person. Indeed their memoirs were sometimes treated as fictional, plagiarized for other authors fictions, and appropriated for inclusion in medical reports.
This chapter looks at the purposes and conclusions of medical investigations of intersex people, and how those conclusions relate to the idea that all people have a “true sex.” Doctors came down on both sides of the question, as well as disagreeing about methods of sex determination.
Barbin was born in 1838 and recorded (as required by law) as female. In Barbin’s own writings both female and male gendered forms are used, predominantly female before the medical examinations that resulted in a change of legal sex, and mixed male and female afterward. This distinction is largely erased in English translations, and even the original French must be treated with caution as it survives only in excerpted form, as the original manuscript was lost.
Barbin’s legal sex change was done in 1860 (so when they were about 22). But having been required to change legal sex and start a new life, Barbin struggled to rebuild their life, fell into poverty, and committed suicide in 1868. All of which was recorded in their memoirs.
Barbin predicted that their death would renew medical interest in their case. The excerpted version of their memoirs was published in 1872 by Ambroise Tardieu as part of a study of sexual variation. A century later, Foucault would claim to “rediscover” the memoirs, and assert that they had not previously received much interest. (Not true.) Discussions of Barbin’s life generally pointed to their suicide as a consequence of their erroneous sex assignment at birth (rather than a consequence of the disruption of their life by the imposed sex reassignment in adulthood which Barbin alludes to).
Central to Barbin’s life was the importance of story to understanding and shaping identity. Barbin was well read, and one can’t find various literary influences in the memoirs.
The excerpts in Tardieu’s edition were edited and appropriated for an erotic novel L’hermaphrodite au couvent in 1905 written under a transparent pseudonym by a man who also wrote a medical study of hermaphrodism. The novel also draws on the tradition of convent-set erotica, offering sexual encounters that appear nowhere in the memoirs. Appended to the novel were various case studies, with the purpose of validating the believability of the events in the story. Both the novel and Tardieu’s commentary on the memoirs justify Barbin’s (or the fictional character’s) erotic desire for women as being due to an essential male nature.
Barbin had sought medical treatment due to abdominal pain, thought to be menstrual cramps, but the initial doctor, having observed Barbin’s ambiguous anatomy, made no direct diagnosis, only vague cautions about socializing with young girls. It was Tardieu who diagnosed the pain as due to “strangulation of the seminal gland” internally. Much of the anxiety expressed around “incorrect” sex assignment involved the possibility of a covertly male person having access to young women, with the assumed result of sexual activity.
Medical reports investigating cases of “doubtful sex” were often written in dramatic style: opening with a mystery, maintaining suspense, dropping hints, then finally offering a conclusion. The initial “mystery” could include failure to conform to gender stereotypes, as well as more concrete medical issues. The failure to perform perfect femininity was considered a symptom of inner maleness, and vice versa (although the former seems more common). The belief in this underlying “true sex,” combined with heteronormativity shaped pre-formed conclusions about the proper fate of intersex patients. It’s worth noting that Barbin’s memoirs came to no such conclusion about the underlying cause of their attraction to women.
One school of medical thought held that “true sex” depended entirely on the nature of the gonads present. Superficial anatomy, secondary sex characteristics, socialization, and self identity were irrelevant. In Foucault’s study of the subject he claims that, before this “true sex” approach in the 19th century, intersex people were free to choose their gender category—a claim that’s easily contradicted. Further, even once gonadal “true sex” became the dominant approach, doctors disagreed over individual cases, sometimes modifying their conclusions to achieve the happiest situation for the patient. An example is given of two different scholarly analysis of the same historic case. One held that the diagnosis supported a “gonad-based true sex” approach, while the other showed that the tests used by the doctors produced variable conclusions as to what that “true sex” was.
When standard approaches produced contradictions (or pointed to the necessity of recognizing same-sex desire) then literary techniques might be brought to bear to achieve the desired harmonious result. The desire for identifying a “true sex” and it’s intersection with sexuality contributed to the medicalization of sexuality in the 19th century. It was one more factor that must be brought into alignment to support a complete separation of sex categories.
Louise-Julie-Anna—a patient with conflicting attributes—was told that “her very existence was criminal.” This was based in part on a diagnosis of masculinity due to her failure to perform acceptable femaleness, despite having been categorized as female and living as a woman. Whereupon she sought a second opinion. The first doctor had diagnosed her as a deceptive man. The second doctor, noting both male and female anatomy, while concluding she was a man, noted the evidence for her female self-identification and used feminine language for her. He noted that she had had sexual relations with men (and only men) and exhibited feminine “modesty.” Thus both doctors brought heteronormative gender stereotypes to bear on the question, with opposing conclusions, despite agreeing on the question of gonadal sex.
The original trigger for her examination was a combination of excess facial hair, an organ intermediate in size between a clitoris and penis, and a hernia resulting in a strangulated organ, identified by the original two doctors as an undescended testicle. The pain from this condition had not been addressed by the initial examinations, but she convinced a third doctor to surgically remove the organ, at which point it was declared to be an ovary, not a testicle, though the surgeon later walked this back. In the meantime, the patient reframed her story to seek support for removing the corresponding organ. This evidently raised some concerns as castration was illegal (presumably removing the strangulated organ was a special case), whereas presumably removing an ovary raised no similar concerns. (It isn’t clear from the text what the eventual outcome was.)
Medical debates over “true sex” also addressed the question of whether a “true hermaphrodite”—that is, a person with both functional ovaries and functional testes—was possible. The debate was largely conducted on the basis of theory and of supporting the integrity of previous diagnoses. (There’s an extensive discussion of the details of this debate.) The debate also challenged the French legal requirement for sex categorization within three days of birth, noting that diagnostic features such as menstruation and secondary sex characteristics might not be apparent until puberty.
(There is an extensive discussion of the timeline for theories about “true sex” versus “two hermaphroditism.” The two approaches are found to coexist throughout most of the 19th century.)
The chapter opens with an 1881 French annulment petition involving a wealthy 22 year-old woman and a younger non-wealthy aristocrat. The case—which involved “doubtful sex” was covered in detail in the French press and even made it to the New York Times under the headline “Queer French Lawsuit.” [See side-note below.] (Note that both parties were Spanish, though the court case was in France.) The arrangement was planned as a double wedding, Mercedes de Campo to the young (less than 18-year-old) Count San Antonio, and San Antonio’s sister to Mercedes’ brother. Mercedes was reluctant, but was pressured into it by the families. Mercedes’ marriage was not a success and her husband eventually admitted that it would never be consummated. After initial attempts to keep things quiet, Mercedes sued for annulment on the basis that her husband was not a man—that his gender could not be determined. The case never came to court as the French court determined it had no jurisdiction over Spanish citizens, leaving the question of San Antonio’s sex undetermined. Despite this, the theoretical questions behind the case were argued in detail in the media and medical journals.
[Side-note: This headline illustrates some of the problems with determining when the word “queer” first became associated with variant sexuality or gender. Since such variation was invariably considered “curious and strange”—one of the pre-existing senses of “queer”—the word might be used without intending any special sub-sense. I wouldn’t want to suggest that the use of “queer” here was meant as a sort of dog-whistle, but neither would I rule out the possibility that it was in the process of acquiring that function at this date. I once ran across a mid-19th century description of sculptor Harriet Hosmer that described her as “queer” in the specific context of her gender transgression, but alas I’ve lost track of the quote and haven’t been able to track it down again.]
As noted previously, the visibility of intersex people was increasing due to the rise of public hospitals and new medical specialties, as well as the legal requirements for registering the sex of infants. French law had no place for anyone not clearly categorized as male or female. Marriage was predicated on the presumption of reproduction. And various sociopolitical forces increased anxiety about a falling birth rate.
Various persons proposed addressing the problem of “doubtful sex” by changing the laws, but this was not necessarily out of sympathy for the uncategorized people. Reasons might include “to safeguard marriage” or to avoid the chaos of legal changes of sex category in adulthood. Non-binary people threatened the legal structure of French society, and changes were demanded to mitigate the situation, even if it required the creation of a third legal sex category. One advocate cited the “horror” of being required to change legal sex later in life, complete with the resulting consequences for gender performance, social life, and economic options.
[Note: Of course, the option of not tying gender performance and legal rights to opportunities to one’s sex category wasn’t considered—and is still debated today.]
Medical manuals provided detailed guidance for determining a newborn’s sex, but these were being demonstrated to be inadequate in a minority of cases. Further, in some cases “erroneous” categorization was not identified until puberty or when discovered due to an unrelated medical procedure. Some were not identified until after death and only by the chance of there being an autopsy.
The professional concerns were not a matter of abstract correctness of category. One author wrote luridly of the fear of “deformed, incomplete men…hidden, disguised under women’s clothing…taking advantage of their sterility in order to surrender themselves to libertinage, to prostitution, and to the most audacious depravation.” [Note: Sound familiar? Depraved men disguised as women?]
And, of course, the increase of interest into cases of doubtful sex was self perpetuating as doctors rushed to publish case studies.
As early as the late 1890s, doctors had begun to advocate for a legal third category of “doubtful sex”—if only to make their job of sex categorization easier. What this would mean for a child’s upbringing wasn’t always addressed, but the proposals included re-examination at puberty or before marriage. Another proposal was to simply erase non-binary people from the legal landscape, removing the privileges and rights associated with either male or female, forbidding marriage and inheritance. [Note: The wording suggests that this was aimed primarily at removing any rights association with male status.]
One author of the time noted that Germany and Austria allowed for a classification of “doubtful sex” which could be revisited later. The debate continued into the early 20th century, when some pointed out the negative implications for non-binary people of creating an official category. It could single them out for mockery without creating a social context for their lives. The consequences of this concern included a policy of doubling down on the need for strict binary assignment and, if considered necessary, infant surgery to align the child’s body with the assigned sex. Other others argued that, by not assigning people to a “third sex” they were free to pursue sex reassignment or not, as they chose. There was quite a mixture of prioritizing civil concerns versus patient concerns on both sides of the third category debate.
The book returns to the context for France being a flashpoint for intersex concerns. Other countries often had legal contexts for addressing intersex persons, but the Napoleonic code (implemented 1804) not only declined to recognize non-binary sex as existing, but removed impotence and genital variation as legal grounds for divorce. This had consequences for couples when intersexuality was not identified as an issue until after marriage. Previously, when impotence was grounds for annulment, many of the physical consequences of intersexuality would allow for a separation (if desired and raised by the couple). Similarly, apparently female physiology that didn’t allow for penetration could also be grounds. This was the situation that still held in Germany and England, for example. But under the new laws in France, the only way to dissolve a marriage in the case of an intersex partner was to claim that their sex had been incorrectly assigned previously.
When questions of doubtful sex came into the courtroom we can see the types of concerns and evidence brought to bear. (The book cites the case of Anne Grandjean, although the question of intersexuality in that case isn’t at all obvious. See my discussion of the relevant documents: https://alpennia.com/lhmp/publication/6335) despite 19th century French law being silent on the topic of non-binary status, some argued that it could be used as grounds for divorce under other clauses in the law.
A detailed court history is given of a couple where, after two years of marriage, the husband petitioned for annulment on the grounds that his wife lacked the necessary female organs to be considered a woman. The wife resisted this framing and refused the court mandated midwife’s examination. She brought her own physician’s testimony that she had “some” female organs, although her vagina was imperforate. A number of other doctors provided “expert” testimony, despite having never examined the defendant. There is an extensive presentation of their arguments, based entirely on their various personal pet theories, and contradictory both in terms of what was prioritized as evidence and their eventual conclusions. In some cases, it’s clear that the witnesses had already decided that the marriage should be annulled and constructed their arguments toward this end. In the end, the court ruled against the defendant based on this highly convoluted reasoning, compounded by her continuing refusal to submit to a medical examination. Across the course of the testimony, she had been declared to be a malformed woman, a malformed man, and a person with no sex at all.
The key arguments were presented by Dr. Tardieu (discussed earlier), but by the end of his life his theories were being dismantled in several areas, partly on the basis of being contradicted by the observable data. (There is a brief discussion of how these legal issues continued to play out across the 20th century.)
One aspect of the legal situation was a rising concern over the possibility of unidentified “same-sex” marriages. If all people had a “true sex” but that sex could not necessarily be determined based on apparent anatomy, then there might be all manner of marriages that actually involved people of the same sex, where the matter had not been brought to light. While some viewed this as an existential crisis, especially in the context of falling birth rates, others felt there was no need to prevent non-binary people from marrying or to annul such marriages, if the couple didn’t desire it. Some doctors recorded conclusions regarding “true sex”—and even operations to address anomalies—related to patients they had concluded were in “same-sex” marriages without feeling any obligation to inform the authorities or act further on the matter. (Or even, in some cases, to inform the patient of their conclusions.) In such cases, their records might mention the happiness of the marriage as a significant factor.
The opinions and attitudes of physicians had an enormous power over the outcome of such consultations. Rarely we see a record of a patient rejecting the result and going for a second opinion. In cases where an original sex category became obviously in error later, the support of a doctor’s testimony was essential if the person wanted an official reclassification. While in other cases, a doctor’s testimony could override the patient’s desires and completely overturn their life, as in the case of Barbin.
The second half of this book looks at the use of hermaphroditism (in its various interpretations) in 19th century French fiction, and how that interacted with real-life dynamics. The subjects of those novels were not necessarily depicted as intersex, but might challenge the integrated sex/gender/sexuality binary in other ways. Given the treatment of grammatical gender in French and the lack of any obvious way to express non-binary identity, the problems represented by a gender-transgressive character are always foregrounded. Similar linguistic issues arose in medical reports of ambiguous patients, with doctors alternating gendered language, or resorting to references like “the patient” (which would have grammatical gender unrelated to the referent).
Novelists sometimes tackled the challenge in innovative ways, using circumlocutions and epicene names to keep character gender mysterious, as in Cuisin’s Clémentine (1820).
This was one of a multitude of 19th century French novels—many now obscure—that took androgyny as a theme. Better known works include Balzac’s La fille aux yeux d’or, Gauthier’s Mademoiselle de Maupin, Rashilde’s Monsieur Venus, and others.
Linton’s study argues against the traditional literary distinction between the “romantic androgyne” and the “decadent hermaphrodite” themes, as well as arguing that literary androgyny was closely connected to interest in intersexuality.
In one group of novels, the sex category of the protagonist is obscured until the conclusion and is the main driver of the plot, challenging the reader’s understanding of sexual difference. The consequences of the final reveal are often dodged by removing the protagonist from the story’s context by various means, without undermining the tension that pervaded the story.
The chapter focuses on a detailed dissection of several texts, which goes well beyond what is of interest to the Project, so I will only hit some highlights.
In Clémentine the eponymous protagonist has been imprinted prenatally with mixed sex characteristics by their mother’s obsessions. Although this manifests partially as mixed gender behavior, there is a dawning realization that their body is anomalous as well. The novel takes a hostile attitude toward medical curiosity and the treatment of intersex people as “curiosities” for study and display (while depicting Clémentine’s humiliating experiences in some detail). Clémentine variously attracts the romantic attention of both men and women but only returns that of the men.
Like the protagonists of Fragoletta and Mademoiselle de Maupin, an inherent part of Clémentine’s masculinity is a swashbuckling virtuosity with the sword, as well as an irresistible attractiveness to both sexes. The stories are variable in the extent to which they embrace or only tease a pansexual dynamic that inherently encompasses some form of homosexuality.
At this point I’m going to give up on the detailed summary, sorry.
One quoted passage from a translation of Madamoiselle de Maupin is worth giving in full as it demonstrates the types of characteristics that were believed to reflect biological sex. “Neither one nor the other of these sexes is my own; I have neither the foolish submissiveness, nor the timidity, nor the pettiness of women. I do not have the vices of men either, their disgusting, vile nature and their brutal tendencies; – I am of a third sex altogether that does not yet have a name; higher or lower than them, inferior or superior. I have the body and the soul of a woman, the mind and the strength of a man, and I have too much or not enough of one or the other to be able to pair up with either.”
As usual, the chapter opens with an illustrative example: a real-life case that reflects the literary themes to be discussed. An aristocratic family line pins their hopes on a child who is first classified as female, then reclassified at adolescence when masculine characteristics emerge (both anatomical and behavioral). But the heir had undescended testicles and was understood to be incapable of reproduction. A marriage was arranged, a false pregnancy was created, and a baby was obtained to continue at the family line. The deception ended unhappily. The wife died “of a broken heart,” the child was later repudiated, and the intersex person at the center of the schemes dies of venereal disease—labeled “depraved and degenerate” by the doctor reporting the case.
Toward the end of the 19th century, the motif of intersexuality as a result of hereditary “degeneracy” enters both the medical and literary discourse around intersexuality. “Doubtful sex” became associated in the imagination with mental illness, intellectual disability, and an attraction to debauchery.
The chapter examines these connections in the context of Zola’s novel La curée. Doctors were no longer focused on determining “true sex” but on diagnosing the consequences for society of the presence of such persons. The image of hereditary degeneracy covered a wide variety of contexts, including sexuality, criminality, and poverty. These theories held that “degeneracy” was caused by a combination of heredity and societal factors. (This is a pre-Darwinian time when genetics was not well understood.) In Zola’s novel, the environmental factors included participation in homosexual relationships in school (by characters of both sexes).
Zola (in a different novel) describes a “hermaphroditism” that encompasses anatomy, sexuality, and behavior. A similar view is found in medical writing, where things such as hysteria and “sexual inversion” or traced to hereditary defects in the patient’s family.
The societal interest in intersexuality shifted from viewing it as an individual curiosity to one of a whole range of symptoms of the decline of civilization, alarming in particular in how it affected the birthrate. (France’s birthrate declined consistently between 1825 and 1939. While other European countries saw similar declines in the 19th century, they were recovering by the turn of the century.)
Zola was not alone in considering that single sex boarding schools were a major cause of homosexual tendencies, which then would lead to other forms of degeneracy. Medical writers also identified “innate” sexual inversion, in addition to this situational cause. [Note: We are in the middle of the development of sexology at this time, though the author doesn’t really touch on that larger picture—possibly because France wasn’t at the center of the sexology movement.]
One aspect of “degeneracy” theory was that undesired behaviors—however acquired—could imprint themselves on the person’s genetics and be passed to future generations. Thus the treatment of such persons, some suggested, should not focus on “curing” them and returning them to ordinary society. While many early German sexologists focused on destigmatizing variant sexuality, suggesting the creation of a “third sex” category, French authors took a more negative view. [Note: All of this was focused primarily on people assigned male.] French theory associated inversion with effeminacy, impotance, and intersexuality. This tendency contributed to sidelining French thought from the mainstream of sexology.
Within this milieu, Geoffrey Saint-Hilaire stood out as contrary, arguing for the analogy of male and female anatomy (a “one-sex” view) and for the impossibility of determining a “true sex” in some doubtful cases. He also rejected “degeneracy theory” and saw no connection between intersexuality and mental illness or homosexuality. Although Saint-Hilaire demonstrates the variety of French thought, he was also very much in the minority.
In viewing homosexuality as involving mixed gender characteristics (e.g., “a woman in a man’s body”) the fields of intersexuality and sexual preference were intertwined within the larger concept of hermaphroditism.
As noted previously, the conflation of anatomy and behavior under “degeneracy theory” was reflected in an increasing interest by doctors in the psychology and family history of their patients, not simply their physical anatomy. Several case studies are presented that show how degeneracy theory distorted the analysis of intersex cases. Whereas previously the goal had been to establish a “true sex” and reassign the person to that category, now any anatomical ambiguity was treated as a symptom of a general mental and moral flaw, and diagnosis could mean exclusion from society entirely. The patient’s preferences and goals, rather than being taken into account, were treated as evidence of duplicity.
Beliefs that maternal experiences could be “imprinted” on a developing fetus meant that mothers could be blamed for any abnormalities in a child, including intersexuality—a motif that occurs in both medical writings and literature. [Note: this idea had a very long history, but was brought to the fore by a focus on family histories of intersex people.]
The rest of the chapter is deep literary criticism of Zola’s novel.
Epilogue: The Nineteenth-Century Roots of Contemporary Resistance to “True Sex”
This section discusses the history of medical interventions to “correct” intersex bodies and how 19th century attitudes and practices continued into the 20th century, including the increasing preference by doctors to withhold information from patients and their families. The chapter also covers how minority medical resistance to “true sex” ideas served to inform shifting attitudes within the 20th century.