The Riddle of Gender Read online

  While d’Eon was serving as minister plenipotentiary in London, his slight build and pretty features led many to believe that he was in fact a cross-dressed woman. People in England and France began placing wagers on his sex. The London Stock Exchange took bets on his gender, and the amount of money wagered on the chevalier purportedly rose to nearly two hundred thousand pounds in England alone. The fear of kidnapping began to haunt the chevalier, who suspected that those who had wagered large sums of money on the shape of his genitalia might seek to resolve the question by kidnapping and forced exposure. To avert a diplomatic crisis, King Louis XV of France sent a letter to George III of England, stating that d’Eon was a woman. Rather than calming public doubts, this letter created an even greater frenzy. Lawsuits were filed by losing bettors, doctors were called in to testify, and d’Eon was officially declared a woman by an English court. The chevalier responded to this public humiliation with dignity and defiance, writing to a friend, “I am what the hands of God have made me.”

  In exchange for d’Eon’s agreement to live quietly as a woman, the French government granted the chevalier a generous pension. Although agreeing to abandon military dress, d’Eon requested permission to continue wearing the Cross of St. Louis, which as he wrote in a letter to the king “has always been a reward for bravery on the battlefield. Many officers have become priests or politicians and have worn this distinction over their new apparel. Therefore, I do not believe that a brave woman, who was raised in men’s clothing by her family, can be denied this right after she has carried out the dangerous duties in a praiseworthy fashion.” This request was granted and Mademoiselle d’Eon spent much of the remainder of her life residing in London with a female companion. When d’Eon died in 1810, five men who had known d’Eon were asked to examine the body and record their observations in order to settle definitively the question of d’Eon’s sex. All five witnesses testified that the body was anatomically male. The deceased’s female companion of many years professed herself shocked to discover that Mademoiselle d’Eon was not the woman she had always assumed her to be.

  A generation after the Chevalier d’Eon’s death, a group of French doctors examined another puzzling corpse—that of a thirty-year-old railroad employee who had committed suicide in a squalid attic room in Paris. Abel Barbin, known for twenty-four years as Adelaide Herculine Barbin (and called Alexina), had been born with a body that appeared female. She was raised in a convent and became a teacher at an all-girl boarding school. Severe pain in her lower abdomen caused Alexina to seek medical assistance while employed at the school. The results of the doctor’s examination changed her life forever. “His hand was already slipping under my sheet and coming to a stop at the sensitive place. It pressed upon it several times, as if to find there the solution to a difficult problem. It did not leave off at that point!!! He had found the explanation that he was looking for! But it was easy to see that it exceeded all his expectations!”

  The doctor had discovered Alexina’s undescended testicles and small penis, though he did not reveal this information to either Alexina or her employer, and instead advised the headmistress of the school to terminate the young schoolmistress. Alexina sought the advice of her bishop, who sent her to a second physician, a researcher, who prepared “a voluminous report, a masterpiece in the medical style, intended to ensure before the courts a petition for rectification.” In June i860, the birth register in Barbin’s home district was amended, and the female Alexina became the male Abel—by an act of law, not surgery. Though the body remained the same, the legal person was transformed from female to male. The scandal that ensued when the newspapers and the public discovered that a man had been teaching in an all-girl boarding school condemned Abel to “abandonment, to cold isolation.” His life as a man began in pain and confusion and plummeted rapidly into despair. He attempted to make a fresh start in Paris, but, impoverished and alone in a city that granted anonymity if not happiness, Abel was unable to make the transition from convent-bred woman to working man. He committed suicide at the age of thirty, overcome by feelings of isolation and desolation, the sense that he was absolutely alone in the world.

  In his journal, Abel predicted that after his death his anomalous body would become a teaching tool and an exemplar of oddity. “When that day comes a few doctors will make a little stir around my corpse; they will shatter all the extinct mechanisms of its impulses, will draw new information from it, will analyze all the mysterious sufferings that were heaped up on a single human being.” This premonition was fulfilled as Abel’s body was autopsied and the genitals and internal organs probed, studied, and sketched for the edification of future physicians pondering the riddle of “hermaphrodites,” individuals whose bodies did not conform to traditional notions of male and female anatomy.

  Though the Chevalier d’Eon and Abel Barbin are perhaps the best-known cases of presurgical “sex changes” in Western history, physically intersexual people such as Herculine Barbin and neurologically intersexual people such as the Chevalier d’Eon have always existed. Gender variance thus appears to be a “natural” phenomenon, an example of biological diversity. Professor Milton Diamond of the University of Hawaii, who has studied the phenomenon of intersexuality for more than half a century, argues persuasively that gender variance should be considered neither an anomaly nor a pathology, but a simple variation. “Variety is Nature’s way,” he told an audience at the International Foundation for Gender Education (IFGE) in March 2003. “How many of us in this room are the same height, weight? We’re all part of a great experiment.” Unfortunately, society doesn’t view gender variance with the same benevolence that it views differences in height and (less benevolently today) weight. “Difference is a dirty word to many,” Diamond pointed out.

  As contemporary historians and writers have worked to uncover the hidden history of homosexuality, some long-dead individuals who adopted cross-gendered dress and lifestyles have been lauded as gay pioneers. The most famous such case is that of Alan Hart (nee Alberta Lucille), a Portland physician who began living as a man after a hysterectomy in 1917. The historian Jonathan Ned Katz identified Hart on the basis of a case study published by the physician who oversaw, and encouraged, Hart’s metamorphosis. Katz and the larger gay community promptly proclaimed Hart (who was married to a woman) a lesbian pioneer, and explained Hart’s decision to live as a man as an accommodation to social prejudices and coercion by a homophobic physician.

  Among gays as well as straights, the complex relationship between sexual orientation and gender identity has thus sometimes been reduced to a simple formula with four variables: male or female, gay or straight. This perspective is shared by members of the (straight) public who believe that a man who wears dresses can’t possibly be heterosexual, even if he sleeps with women only, just as some gay Americans believe that a female-bodied person who dresses like a man must be a masculine lesbian. Both gays and straights have a hard time believing that both of these individuals might in fact be heterosexual men. That idea challenges everything that we think we know about sex, gender, and sexual orientation. “Some men are born in female bodies,” said Katherine (Kit) Rachlin—a clinical psychologist who has worked with transgendered clients for more than fifteen years—at a conference I attended while beginning research on this book. Like many Americans, gay and straight, I received this statement with certain skepticism. But after having met numerous men born in female bodies and women born in male bodies, I no longer doubt that it is true.

  Sexual orientation is invisible, but gender identity is difficult to hide. It’s evident in the way we walk, the way we talk, the way we dress, the way we cut our hair. My identity as a woman is clearly visible in hundreds of small and large ways. When you pass me on the street, your brain registers my long hair, makeup, skirt, pocketbook, and painted nails, and renders the verdict “female.” Even if I cut my hair short, skipped makeup, and wore jeans and a T-shirt, you would still identify me as a woman by my physique, by my gait, and
by the way I related to you, my fellow pedestrian, as I walked by. But what if, when you passed me on the street, you felt a moment of confusion? What if you felt it necessary to turn around and stare at me as I walked away from you? What if you turned to your companion and said, “Was that a guy or a girl?” Would you be reacting to sexual orientation or gender expression?

  Many people infer the former from the latter, and believe that “masculine” women and “feminine” men are invariably gay. Feminine males and masculine females are often subject to scorn and derision, as anyone who has spent time on a playground can testify. A boy who rejects rough play and sports, who walks or talks in a way considered effeminate by his peers, is verbally and sometimes physically abused. The rules for girls are a bit looser in childhood. But by middle school, girls who are deemed inappropriately masculine by their peers are also teased and harassed. These prejudices carry through into adult life, and the all-purpose word used by many people to enforce gender conformity is “gay”—even when they are referring not to the person’s choice of partner, but to the way he or she expresses gender. It is worth noting that though an increasing number of cities and states have added “sexual orientation” to civil rights legislation, fewer have added riders protecting people whose gender expression makes them targets of discrimination or violence. This lapse is a sign of our continuing failure to understand and acknowledge the distinction between sexual orientation and gender identity, and it has major consequences.

  Julian Weiss, an attorney who has published several articles about the legal issues confronting transgendered and transsexual people, notes that “gender identity is subject to scrutiny in a way that sexual identity [orientation] is not.” The letter M or. F affixed to one’s birth certificate “publicly identifies us in every area of life, whether it be a license to drive or conduct business, proof of citizenship required to obtain employment, a benefit program such as social security, or filing of income taxes.” Biological sex (and therefore gender identity) is thus regulated by the state in a way that sexual orientation is not. Citizens of the United States and most other nations are not required to announce their sexual orientation or to affirm it in legal documents. If you are a woman who decides to begin sleeping with women, it is no one’s business but your own. But if you (a female-bodied or intersexual person assigned as female at birth) decide that you are a man and wish to live and be recognized as a man in the world, then you must petition the authorities to approve that change. In effect, you must ask the state’s permission to live as a man—and present a legitimate (medical) reason for your desire to do so.

  Law is based on custom. Deeply rooted assumptions about our bodies keep us locked into the belief that there are only two sexes—male and female—and that the sex of the body is always consistent with the sex of the brain. The equations work like this: Born with a vagina, female. Born with a penis, male. It seems incomprehensible that a child born with a penis could grow up with the certain knowledge that she is a girl, or that a child born with a vagina could be equally convinced that he is a boy. Many people are unwilling to accept that “the hands of God” or Nature could have fashioned human beings whose sense of self is at war with their flesh, or whose gender identity falls somewhere in between the poles of male and female.

  Because we live in a culture that expects science to settle questions based in the body, we look to science to tell us what it means to be male and female, how gender identity is formed, and why it is that the sex of the body sometimes seems to be at odds with the sex of the mind. But despite our sophisticated tests, science can still offer no definitive answer to this question, only tantalizing clues. When the governments of England and France attempted to solve the riddle of the Chevalier d’Eon’s sex, they called in two doctors to examine the chevalier’s body. From the evidence of their eyes (the chevalier appeared to have breasts), the doctors concluded that a woman stood before them. Only at death were the chevalier’s genitals examined, and they told a different story. Today our tools are vastly more powerful, yet they are no more accurate in predicting gender identity in certain cases than the eyeball test that established the Chevalier d’Eon’s or Herculine Barbin’s anatomical sex.

  “Ordinarily, the purpose of scientific investigation is to bring more clarity, more light into fields of obscurity. Modern researchers, however, delving into ‘the riddle of sex,’ have actually produced—so far—more obscurity, more complexity. Instead of the two conventional sexes with their anatomical differences, there may be up to ten or more separate concepts and manifestations of sex and each could be of vital importance to the individual,” the pioneering sexologist Harry Benjamin wrote in 1966. “Here are some of the kinds of sex I have in mind: chromosomal, genetic, anatomical, legal, gonadal, germinal, endocrine (hormonal), psychological and also the social sex, usually based on the sex of rearing.”

  Benjamin’s understanding of the multiplicity of factors that contribute to a person’s gender identity, and his ability to see that a lack of agreement among these components is a source of considerable anguish for some people, remains rare. Most people do not consider gender a riddle. Most do not make a distinction between anatomical sex and gender identity. Nor do they realize that it is possible for a person to have XY chromosomes yet female-body morphology and genitals as a result of androgen insensitivity syndrome (AIS), or XX chromosomes yet male-body morphology and genitals as a result of congenital adrenal hyperplasia (CAH). Those are only two of a number of genetic and endocrine conditions that can create anatomically inter-sexual people. Once these persons were called hermaphrodites, after the intersexual offspring of the gods Hermes and Aphrodite. As that myth indicates, in some cultures, intersexual and transgendered persons have been viewed with reverence and respect.

  Our own culture has not been so kind. Intersexual people have been forced to undergo physically and psychologically traumatic surgeries to “normalize” their genitalia. The medicalization of intersex conditions has caused tremendous suffering. However, it has also granted intersexual people legitimacy in the eyes of the medical profession, lawmakers, and the public. No one accuses intersexual persons of being mentally ill. Their gender variance is inscribed on their bodies, in their gonads, genitals, or chromosomes—and so seems “real” because it is a material, measurable entity. The same is not true of trans-gendered and transsexual persons, who present a baffling enigma to their families, physicians, and themselves.

  Take for example a genitally female, genetically XX girl who tells her mother at age three that she is a boy, and from her earliest childhood spurns girlish activities, clothing, and behavior. “My whole life I’m telling my mom, ‘I’m not a girl, I’m not a girl, I’m not a girl’ and thinking what the hell is going on here?” says Brad, one of the first employees of the city of San Francisco to take advantage of the new policy of insurance reimbursement for sex reassignment surgery for city employees. “When you are little, you’re kind of androgynous. Both little boys and little girls are running around, taking their shirts off, jumping in mud, throwing dirtballs. So if you are a little aggressive and gened as female, they say you’re just a tomboy. But once you get up to a certain age, like six or seven, it starts separating. And I was like, ‘You’re pushing me the wrong way. I’m supposed to be over there with the boys; why are you making me go over here with the girls?’ You look at your body and you are in the wrong body, and it’s a nightmare. You wake up in this nightmare every day and you have to deal with it. And you keep thinking, When am I gonna wake up?”

  Brad’s description of his early life was echoed by many of the trans-gendered and transsexual people I interviewed for this book, who struggled for many years to understand their suffering and confusion without being able to put a name on what they were experiencing. Gender variance is not a widely discussed subject, even in medical schools, and as a consequence many physicians, like the general public, know very little about the subject other than what they are able to glean from sensationalist media ac
counts of cross-dressing and trans-sexuality. Gender variance still seems to be considered a more suitable topic for late-night talk show jokes than for journals of public health and public policy, even though a recent needs assessment survey in Washington, D.C., estimated that the median life expectancy of a transgendered person in the nation’s capital is only thirty-seven years. Poverty, substance abuse, HIV infection, violence, and inadequate health care are the factors behind this statistic. Of the 252 transgendered people surveyed in the district, 29 percent reported no source of income, and another 31 percent reported annual incomes of under ten thousand dollars per year. Half the participants did not have health insurance and 39 percent did not have a doctor, though 52 percent had taken sex hormones at some time in their lives and 3 6 percent were taking hormones at the time of the study. A number of the respondents were working, or had worked, as commercial sex workers—a consequence of the persistent employment discrimination experienced by many transgendered people.

  Though many are far better off materially than the subjects of the Washington, D.C., study, transgendered and transsexual people of every social class and at every income level share many of the same vulnerabilities. Public prejudices make it difficult for visibly transgendered or transsexual people to gain an education, employment, housing, or health care, and acute gender dysphoria leaves people at high risk for drug abuse, depression, and suicide. “You do everything you can possibly do to check out, to get away,” says Brad, who at forty-six has been sober for sixteen years. When I asked if his drinking and drug abuse were tied to his confusion about his gender and related traumas, he replied, “Absolutely. Because I couldn’t be who I was after so many years of hiding from myself. At that point I didn’t really know who I was. It’s very much a catch-22, and you’re just like, ‘Fuck it. I’ll just take more drugs. I’ll just do more drinking. I’ll just do whatever because I can’t deal with this.’” Brad began his transition after nearly a decade of sobriety. “Without being clean and sober, I would never have gotten to this point,” he says. “I would have been dead.”