Conclusion

This book traces the constant reiteration of maleness/masculinity and femaleness/ femininity as exclusive positions in the Western heterorelational sex-gendersexuality system in cross-cultural intersexualization. On the basis and continuing attempt of the surgical and hormonal construction of two exclusive body morphologies (male and female), the gender-concept was developed. This genderconcept is based on the distinction between sex and gender and the pathologization of any possible incongruence between the two. It was not my intention to present a prescription of how to approach intersexualization, I simply attempted to show how the discursive underpinnings of intersexualization intersect with processes of racialization in neo_colonial settings. People might have different objectives they want to consider in political action aimed at the discrimination of non-normative gender identities, such as the possibility of surgery (as in the case of transsexualization) or the option to not have surgery (as in the case of intersexualized people). Intersex activists continue reclaiming their history and challenge being called a phenomenon. In this volume I intended to demonstrate that the processes of intersexualization are the phenomenon. In order to do this, I treated the ‘experts’ in intersexualization as my case studies and interrogated how these experts make their results plausible, which concepts they draw on and how they position themselves in this endeavor. I thereby focused on the development of the genderconcept in the 1950s, as well as outlining how this concept embodies the epistemology of the West since the 1950s until now. Moreover, I zoomed in on an anthropological researcher’s neo_colonialist moves to explain other cultures by superimposing this epistemology. I developed the concept of cross-cultural intersexualization in the two theoretical spaces of the Clinic and the Colony. My proposal was that in these two spaces the phantasm of intersexuality haunts the researchers who pursue the quest to find a viable distinction between men and women and the hermaphrodite/intersexualized. In line with Foucault, I argued that knowledge is not made for understanding but for cutting. I played with this figure on five levels. First of all, the knowledge that is produced in intersexualization is made for the cut in the hierarchical dichotomy between the sexes_genders. This cut works on the premise that there are men and women who behave in a certain way and inhabit certain roles in

society, which subsequently require securing to protect the status quo of the hierarchical split. The second cut that is made is in the distinction between sex and gender, which is the cut between the morphological and the social or psychological. Researchers in intersexualization, as I have demonstrated, use this cut to determine the normality of congruence between the two; women are supposed to have a specific morphology and men another. If this is not the case or if this congruence is somehow at stake then the mode of cutting enters the sphere-the separation between the normal and the abnormal. This is based on the congruence or incongruence of sex and gender. If the sex of a body cannot be identified properly or if the identity of the individual does not align to the body from which it should follow, it is determined abnormal. The fourth layer then enters the realm of intersexualization. This fourth level refers to the surgical practices in intersex management, which use the scalpel to guarantee the first level of the distinction between the sexes_genders and the second of aligning the morphology and the social or psychological. The cut in intersexualization is represented by the actual cut into the flesh of the body. Most of the time this cut features as clitorectomy, the amputation of ‘phallic flesh’ in women, which testifies to the masculinist and sexist underpinnings in intersexualization. The fifth level is represented by the fifth other that is being cut from the heterosexual, white, Euro-and US-Americancentric notion of the norm-the non-hybrid, single-sexed, and single-cultured norm. In a globalized and neo_colonial age, this other-than-the-binary-sexed-body and otherthan-the-Western-body, represented by the cross-cultural intersexualization of Caster Semenya, the Turmin-Man Sakulambei of Papua New Guinea, and the guevedoche of the Domincan Republic are cut out as presumably ambiguous and insufficiently developed in the logics of cross-cultural intersexualization that depend on the notion of development towards. However, I acknowledge that through my position as a researcher who composes a genealogical account, just as the one presented in this book, I also cut. Yet, I hope that I contribute to the growing understanding of how intersexualization works. In this volume I decided to use certain moments in the history of knowledge production to interrogate a specific body of knowledge. I made a decision between those knowledge productions which I considered as important and those which I do not see as equally influential. I also cut out the specific time frame of the period after the Second World War and the period of the late 1970s to early 1980s in which the theories of the 1950s were recycled in research on other cultures. Therefore, I also made a geographical incision, namely by focusing on researchers in the USA and their travels to Papua New Guinea and the Dominican Republic. As a researcher I have chosen particular instances in the processes of intersexualization to show how they work at exactly these points in time and space. I slice time and space and according to importance and relevance for my argument. My contribution to understanding, however, is how these cuts are made and how these lines are drawn in the first four areas in the particular historical instances I analyzed. It is important to state that I consciously chose to not explain what so-called ‘intersex conditions’ or Disorders of Sexual Development are. I deliberately

avoided repeating the cut between the normal and the abnormal. With this book I tried to avoid being complicit in the repeated articulation of diagnoses, which medicalize and pathologize bodies not in medical need of surgery. Only in a few so-called intersex conditions are surgeries medically necessary. (Some cases of CAH have severe salt loss which can be deadly.) They require treatment; however, this does neither require the diagnosis of intersexuality nor DSD, nor surgery. Most of the surgeries, which were and are still performed, serve to consolidate heterorelational sexual difference and clear-cut sexed_gender identities. The fact that surgeries are performed on some bodies to align them to sexual dimorphism only proves that the cut in sexual dimorphism is a phantasm. This fantasy, however, is constantly reaffirmed in the processes of crosscultural intersexualization. Multiple theories and references are called upon to establish the norm of the two sexes_genders as the natural expression of sexual difference. Medical and psychological experts apply a framework of the normal, which I have called the ‘operation theater’ and make it seem natural. This ‘operation theater’ is prepped with concepts such as gender role and gender identity, or by actual surgical tools such as the scalpel. I intended to show that intersexualization since the 1950s in John Money’s and Robert Stoller’s research is based on the distinction between sex and gender. In their intersexualizing research the gender-concept was invented in order to determine what is normal and what is abnormal for a body to behave and to feel. The quest for a scientifically verifiable distinction between men and women is pursued in the theories which invent categories such as gender identity and gender role; yet, this always comes down to biological determinism, even though gender as the verification tool is called upon as in the case of Caster Semenya. The decision in the social is first made on the morphological level; then, the social separation is reaffirmed on the basis of sex verification. Semenya could only continue to run in the women’s camp because her body testifies to the parameters of femaleness. Of course, at different moments during the last 50 decades Money and Stoller had developed their theories while shifting their emphasis. Intersexuality, as Morgan Holmes states, is a shifting phantasm in medical discourse which is constantly rearticulated, rephrased, and modified. However, I focused on particular moments in the history of intersexualization, which were crucial for the treatment paradigm to be established and the gender-concept to be verified by the invention of the third sex and third gender. This was later adapted by Herdt to explain the culture of the Sambia in Papua New Guinea. I focused on the research by Money and Joan and John Hampson in which they created a field of expertise that constantly feeds itself by creating the problem of intersexuality. Their sample of ‘patients’ showed no significance in regards to psychopathology; there were adult women who had ‘phallic flesh’ and showed no psychotic symptoms. However, Money and the Hampsons disregarded their results and drew the conclusion that surgical intervention on infants is necessary to secure a stable gender role. That Money et al. were able to do this reflects developments in the waxing privileges of psycho-medical experts

since the scientific revolution; their treatment recommendations are still in place. Notably, these recommendations had atrocious effects on now living adults who were diagnosed as psycho-sexual emergencies and subjected to surgical intervention as infants. Some of these adults speak out now and challenge the mutilating practices in Western hospitals. Recently, far reaching discussions also inside the medical establishment have begun and researchers review their treatment paradigms. However, the new nomenclature of Disorders of Sexual Development is emblematic for the knowledge production which is not made for an understanding of the multiplicity of bodies. Rather, it advocates the continuous cut between the normal and the abnormal. Endocrinology, genetics, and neuropsychology are only the tip of the gender iceberg, as Anne Fausto-Sterling calls it. With these conceptual tools in hand, scientific experts proceed through bodies, penetrate tissue, and colonize the psyche in order to find verifiable distinctions, in accordance with the requirement and circumstances of the sociopolitical atmospheres. In the second part of the introduction to this volume on From Myth to Medicalization I described the dawn of the heroic age of the scientist as a colonial agenda, which diagnoses and gives names, categorizes, and classifies human beings in order to assign them a place in the orders of nature. The phenomenon of intersexualization produces the notion of an ‘experiment in nature’ and then denotes it as ‘abnormal.’ Intersexualization then erases the nonnormative through surgery to reaffirm the norm. The cut is the normative cut of a heterorelational organization of the sexes_genders. Just as intersex movements gained power and challenged medical expertise, the term intersex has been replaced by the term Disorders of Sexual Development in 2005. DSD is a term which silences the fact that surgery produces embodiment. DSD veils the effects intersexualization has on the embodiment of intersexualized infants and limits the space of possibility for embodiment without surgical experience. Moreover, it reinstalls the notion of development as being a basic feature of (cross-cultural) intersexualization. To reinstall the notion of disorders in sexual development is to call upon these discourses and to pathologize that which disrupts the heterorelational organization of the sexes_genders. In the part on the Clinic, I demonstrated how John Money and Robert Stoller, in their psychological and psychoanalytical theories of gender role and gender identity, appropriated concepts such as innate bisexuality, sexual identification, and psychosexual maturity. These concepts are modified in their intersexualizing theories in relation to the postulated necessity of a development towards a heterosexual monosexuality. Intersexualization has thus a specific place in the order of theories on ‘normal gender identity development’ and ‘normal sexual differentiation’ because the category of intersexuality is the foundation for reformulations of the norms of maleness and femaleness as well as femininity and masculinity. Stoller invented the category of core gender identity to argue for an innate biological force (sex) that causes the feeling of being female or male. He later added a hermaphroditic core gender identity to these two and installed a third available position on the basis of biological determinism. For this third identity he created a category that according to him not really belongs to the

human race. He advocated surgery to normalize individuals whom he assigned this category. I identified this as the rhetorical mode of first naming the exception to the norm to then normalize it; it is the production of a hierarchy of the normal in the so-called natural development of the human towards sexual dimorphism. Yet, when intersexualization enters the space of the Colony, the notion of development produces a second rhetorical mode with regards to the Western orders of nature. In the space of the Colony the designation of hermaphroditism/ intersexuality as a ‘natural experiment’ in a more ‘natural setting’ is emblematic for this process. The Clinic of the Global North exports its modes of dissecting, displaying, diagnosing, and exhibiting to cultures of the Global South. As I have elaborated in the introduction, Caster Semenya’s presence in the media is not so different from the spectacle that Sarah Baartman was subjected to in the nineteenth century; Semenya has been othered by the representation of her body as not properly sexed and not properly gendered according to the standards of white, female, bourgeois, and civilized standards of Western femininity. Additionally, she has been othered through silencing. She has been denied a subject status from which she can claim authority over the description of her body and her identity. I argued in this book that silencing and invisibilization is a dominant feature in cross-cultural intersexualization. In the case study on clinical ethnography by Herdt and Stoller I analyzed how Sakulambei is silenced and invisibilized. Herdt’s and Stoller’s paternalistic attitude features in their behavior towards Sakulambei and in their claim to be able to extract the secret of sex of Sakulambei’s body. Here the medical Western, hegemonic gaze of the Clinic becomes a gaze which produces not just the body of the other (the intersexualized) but also produces the culture of the other, which is less sophisticated or civilized than Western culture. Subsequently, it can, therefore, host the hermaphrodite as a part of its culture. Through its being called polymorphous perverseand therefore permissive towards sexual variety-the other culture is, as whole, bound to a naïve and childlike status. By analyzing Stoller’s work in the Clinic and Herdt’s adaptation of it in the Colony, I presented the ways in which the construction of a ‘third’ in intersexualization functions and serves the purpose of consolidating a hermaphroditic gender identity on the grounds of a hermaphroditic body. This consolidates the assumption that a male body causes a male gender identity and a female body causes female identity, which is stable throughout life. In this framework, the third gender becomes the cultural yet necessary expression of a third sex. By using the concept of the polymorphous perverse to explain a postulated three-sex system in Sambian culture, this specific system is exoticized and constructed as less developed, less civilized; the two-sex one becomes newly institutionalized as hegemonic in the space of the Colony. Even though I charted the polymorphous perverse as a promising concept in Freud’s work, which could have been taken up by Money and Stoller instead of the concept of innate biology, I do see a problem in using it for the description of the organization of another culture as a whole. By championing the polymorphous perverse as a possibility

to think embodiment, desire, and subjectivity differently in the West I intended to indicate that the notion of bifurcated identification process in an oedipal setting reaffirms civilization as necessarily based on two heterorelational monosexualities. Yet, using the polymorphous perverse to describe the permissiveness to the multiplicity of embodiment of other cultures, as I demonstrated in the case in Herdt’s work, is to imply the framework of civilization. This subsequently positions the other culture as childlike and less developed in this psychoanalytical framework. I do not doubt Herdt’s intention to defy the rigid sex_gender system of the West by referring to the Sambia who are able to accommodate more than two sexes_genders. Yet, the use of this metaphor of the polymorphous perverse is not sufficiently explained; civilization as the celebration of binary sexual difference is not tackled but rather reiterated and reinstalled. Moreover, to use the sexuality of the other always implies otherness on the basis of sexuality. Normalizing processes that occur in the West are based on references to the other. The distinction between male/masculine and female/feminine as a product of these normalizing processes is in its production not just based on the referent of the ‘sex(ualized)_gendered other’ but also based on the referent of the ‘racialized/ethnicized other.’ In the part on the Colony I interrogated the underlying evolutionary discourses which ground the othering process fundamental to cross-cultural intersexualization. I hereby focused on the discourses of anthropology, psychoanalysis, and sexology as having emerged in a colonial and imperialist time which was dominated by (social) Darwinist evolutionary thinking. The orders of nature from this time are clearly present in the revived notion of the fifth other, the polymorphous perverse sexed savage in cross-cultural intersexualization. These orders are reinstalled when Herdt argues that the Sambia, who are thereby represented as immature and childlike as a culture, can accommodate a third gender that is based on a third sex. The civilized and sophisticated West produces the other and their ‘other sexuality,’ namely that of arrested development of the intersexualized body, in the arrested development of the other culture. In the Colony I intended to show that the phallocratic and ethnicized/ racialized organization of bodies along the hierarchical coordinates of ‘white’ maleness/masculinity and femaleness/femininity and their locatedness in geopolitical arrangements of bodies and identities has not ceased to be employed in the interpretation and representation of the ‘other body’ in the ‘other culture.’ Intersexuality in the other is represented as a mythical ‘phenomenon.’ The story of the other is silenced by the imposition of the story of the West and its orders of nature. However, in the excursus I very briefly looked into the reclaiming of stories by the Two-Spirit movements of Native Americans. By tracing the application of the anthropological term berdache I demonstrated that multiplicities of cultural organizations in Native American cultures were also subsumed under one umbrella term. Anthropologists then used to describe what they cannot grasp but nevertheless wanted to categorize and make intelligible in the framework of a Western bio-medical, sexological, and sometimes also psychoanalytical explanation

system of sexual dimorphism and the organization of binary genders. The TwoSpirit movements re-collect their stories and their histories and re-assemble them in a post-colonial space. These movements emphasize and combine differences in a third space in which various voices reclaim and adapt various stories. They compose a future that incorporates their histories, yet produce something new. Their assembling and reclaiming of different narratives seems to me a promising move which could also help open up the dichotomous Western sex-gendersexuality-system and make it obsolete. I want to end this book on intersexualization with a plea against epistemic and material-discursive violence i.e., the cutting scalpel and for the multiplicity of narratives, identities, and embodiments.