Review of “How the Clinic Made Gender: The Medical History of a Transformative Idea”

Abstract

Using a variety of primary sources, Sandra Eder documents the “birth” of gender through the lens of the decades-long process of physicians developing protocols for treating intersex children (formerly known as “hermaphrodites” and now increasingly understood as individuals with disorders of sexual development [DSD]). This book shows just how gender was constructed, modified, and revised as part of the work to treat intersex and later transgender individuals. Gender as a concept “underwent many transformations in the decades after it was first formulated in the [Johns] Hopkins [Hospital] clinic” (p. 186). Once cortisone was synthesized and became more widely available, concern shifted from keeping children with congenital adrenal hyperplasia (CAH) alive and thriving to determining how they could live their best lives in the context of existing cultural norms. Children born with CAH have unusual patterns of chromosomes, genitals, and physical appearance, making it a source of intersex traits. Long before the rest of the world accepted the notion of gender as a social construction, these physicians were grappling with the realization that their patients were better served by an approach that determined not their “true” sex, but the sex in which they could live their most well-adjusted life.