What is a woman? ‘Common sense’ in history

Writing in Premier Christianity recently, after the recent Supreme Court ruling, Lois McLatchie-Miller blithely claimed that ‘What is a woman?’ was ‘A matter that was never in doubt throughout human history’. My position on that, as a historian? Not so (I even published both an academic book and a trade book on precisely this topic). 

Not for the first time, I am amazed at how people who don’t know much history assume that our questions today are new ones. They aren’t. And it isn’t just me saying this. Today, my attention was drawn to two petitions, ‘Not In Our Name: Feminist Academics and Educators Speak Out Against Transphobia’ and ‘Historians for trans rights’. The first of these already has over 2000 signatures. As a medical historian reacting not only to the Supreme Court ruling, but also to the increased intolerance towards people who don’t fit binaries, one of the many things which strikes me is how those refusing to accept trans people’s identities are reluctant to bring intersex people into their reasoning. I think that’s because the existence of intersex people already challenges a simple ‘common sense’ male/female binary around the body as being the thing that tells us who we are, ‘really’.

Ah, ‘common sense’. ‘Common sense wins the day’, a recent headline in the Daily Telegraph announced. But ‘common sense’ is, as the anthropologist Clifford Geertz noted in a 1979 article I read back when I was a student, ‘a cultural system’. Common sense is invoked to avoid discussion, to quash disagreement, by insisting that this is obvious, something everyone knows, a ‘simple fact’ (are there any such?) rather than being a reflection upon experience. It ‘pretends to reach past illusion to truth, to, as we say, things as they are’. Geertz’s point is, however, that the content of common sense ‘varies … radically from one place and time to the next’.

This means that common sense is a historical category. So here’s some more history.

How can we know if someone is intersex? For some people today, a medical problem will lead to tests that reveal this, but most of us don’t have our chromosomes tested, or our bodies scanned to see if there are unexpected organs in there; a womb in someone living as a man, testicular tissue in someone living as a woman. In the past, it was very unlikely that anyone would have known that there was such a mixture. Not only were visible body parts understood very differently, but chromosomes, hormones or gametes were entirely unknown. Going by visible body parts alone, there is a very long history of a mixture of fascination with intersex bodies alongside attempts to classify those bodies as ‘really’ male or female.

Before looking at this in more detail, let’s backtrack to ancient Greek medicine, the so-called ‘Hippocratic texts’ dating mostly to the fourth century BC. These demonstrate conflicting, coexisting ways of thinking about sex and gender. On Generation/Nature of the Child offers a spectrum model, going from manly men to girly women, with everything in between – including the hermaphrodite, whose body is both male and female. The sex and gender identity of the child may depend on whether the ‘seed’ of the mother or of the father is dominant at conception, or on the location within the womb in which the mingled seed eventually settles down. Diseases of Women, however, works with a binary view of the sexes. Here, while there is plenty of focus on the womb, the true source of sexual difference resides not in having or missing any particular body part, but in the texture of the all the flesh: women’s is ‘spongier’ than men’s and therefore takes up more fluid from their diet, meaning that blood has to be expelled (as menses) so that it does not overwhelm the body. In one of the case histories given in another treatise, Epidemics, a woman called Phaethousa, who had previously given birth (clear evidence of a womb), stops menstruating and develops a beard, a scenario which is interpreted as the result of her husband’s absence: having a man somehow anchors a woman in her femininity. In the original version of this story, these physical changes are not seen as evidence that she is becoming a man: she remains a woman, although her body can’t sustain the changes and she dies.

Yes, this is another world, but one which went on being influential for western medicine up to the nineteenth century. It interests me that, when Phaethousa’s story was retold in the sixteenth century, her death was left out by medical and other writers who worked with another form of ‘common sense’ which held that spontaneous sex change was entirely possible, but only in one direction: towards the male. As Amatus Lusitanus wrote in 1552, Nature ‘always adds, and never takes away; she always drives out, and never sends back; she is always moved towards the more worthy form, never the unworthy’. This picked up stories told by writers from the Roman Empire, such as Pliny the Elder, about women who became men, about male sexual organs which spontaneously emerged from within the body. This could be considered the ‘true sex’ finally becoming clear. So, sixteenth-century ‘common sense’ would say that men can’t become women; bodies just don’t work like that. Such a view may come to the same conclusion as a modern trans-denier, but originates in an entirely different world view. Women becoming men, though; for a sixteenth-century writer, that’s the way the world works, as Nature only moves towards perfection.

Hermaphrodites, those whose bodies had both male and female characteristics visible, were often troubling to medical writers – and, I’d assume, to those who came to them seeking advice. Were they perfect, originating in the ideal balance of male and female ‘seed’? In the second half of the sixteenth century, Ambroise Paré included them in his treatise on monsters; ‘monster’ is, for us, a highly loaded term, but in the past it could be applied to any phenomena that are not natural, sometimes taken as evidence of God’s power to do amazing things. Paré subdivided them into four categories in a way that prefigures current attempts to allocate as many intersex people as possible to one sex or the other. The categories were based on the visible organs associated with reproduction as there was no knowledge of chromosomes, hormones, or gametes. There was the ‘male hermaphrodite’, who could impregnate a woman, and the ‘female hermaphrodite’ who produced ‘female seed’ and also menses. Because at this time most people believed that men and women both produced seed, with that of a woman being thinner and weaker, there was still a hint of a spectrum, of relative rather than absolute difference, in this model. Someone could be defined as a ‘female hermaphrodite’ even if they had a penis, but only if this penis proved incapable of an erection: only men had erections, although of course now we recognise the clitoris as an erectile part. Then there were hermaphrodites who were neither one sex nor the other, as they had no functioning sexual organs. Finally, the ‘male and female hermaphrodite’, with both sets of sexual parts ‘complete and perfect’. 

Physicians could guide the ‘male and female hermaphrodite’ towards one sex or the other by assessing body hair or facial features. But there was still public fascination with those who did not fit the binaries and, by the seventeenth century, hermaphrodites were on display as curiosities. In June 1740 an Angolan hermaphrodite was displayed in London; reacting to this person, James Parsons argued that all so-called hermaphrodites were female, but with very long clitorises. Thirty years later, Thomas Young argued the reverse: they were all male and the enlarged clitoris was a penis. Chillingly, while trying to define the intersex out of existence, he also described the creation of a ‘hermaphrodite’ through surgery on a boy, modifying his body to make him appear to have labia and a vagina.

There was one other way of allocating people to one sex or the other: character. Perhaps the most interesting of the many medical men who wrote about hermaphrodites is Sir James Young Simpson, who would become better known for his enthusiasm for pain relief, including in childbirth. Like others, he tried to reduce the number of ‘true’ hermaphrodites, including suggesting that a prolapsed womb could be mistaken for a penis. He also considered body hair, breast development and menstruation. In his treatise on ‘Hermaphroditism’, published in the late 1830s, he mentioned the case of Maria Arsano of Naples, who after her death at the age of 80 was found to be male internally; at the time, her body was being prepared as a teaching aid. While she was alive, this had not been suspected; although she had never menstruated, she appeared to be a woman. She had, however, married and ‘from being constantly employed in domestic occupation, the mental character was feminine’. In the early twentieth century, a time when some gynaecologists focused on gonadal tissue rather than external appearance or behaviour, others thought that any surgical changes to the body should be ‘in accordance with the social happiness of the person concerned’ and that meant favouring the person’s self-identification. 

That Premier Christianity article was headlined ‘Men cannot become women’. Historically, however, the ‘common sense’ of the past was that women could become men. Historical ‘common sense’ has also supported the idea that ‘social happiness’ was more important than exterior or interior body parts.