Money’s prescriptions for managing intersexuality paint him, and those who agree with him, into an ideological corner. On the one hand, they believe that intersexuals inhabit bodies whose sexual development has gone awry. On the other hand, they argue that sexual development is so malleable that if one starts with a young enough child, bodies and sexual identities can be changed almost at will. But if bodily sex is so malleable, why bother maintaining the concept?117
Scientists struggling with this dilemma focus on intersexuals not only as patients in need of medical attention, but also as a kind of natural experiment. In particular, since the 1970s, intersexuals have been central to the scientific search for hormonal causes of behavioral differences between the sexes. Deliberate manipulations of hormones during development, performed with impunity on rats and monkeys, cannot be done on humans. But when nature provides us with an experiment, it seems natural enough to study her offering.
Building upon extensive animal research (see chapter 8) showing that go — nodal hormones influence behavioral development, investigators have used intersexuals to examine three widely believed in sex differences:118 differences in sexual desire,119 differences in play in children, and differences in cognition, especially spatial abilities.120 Analyzing this body of work shows how intersexuals, seen as deviations from the norm who need to be ‘‘fixed’’ in order to preserve a two-gender system, are also studied to prove how ‘‘natural’’ the system is to begin with.
Consider, for example, the attempts of modern psychologists to understand the biological origins of lesbianism by studying female intersexuality caused by hyperactive adrenal glands (CAH). CAH girls are born with masculinized genitalia because their overactive adrenal glands have, during fetal development, produced large amounts of masculinizing hormone (androgen). When discovered at birth, the overproduction of androgen is stopped by treatment with cortisone and the genitals are ‘‘feminized’’ by surgery.
Even though to date there is no direct evidence to show that, in human embryos, hormones affect brain and genital development during the same time period,121 scientists wondered if the excess prenatal androgen also affected brain development. If the fetal brain were masculinized, permanently altered by exposure to testosterone, would that ‘‘cause’’ CAH girls to have more masculine interests and sexual desires? The question itself suggests a particular theory of the lesbian as fallen woman. As the psychoanalysts Maggie Magee and Diana Miller write, ‘‘A woman who makes her emotional and intimate life with another woman is seen as having ‘fallen’ from the path of true feminine development, expressing masculine not feminine identification and desires.’’122 Applying this concept to CAH girls seemed to make sense. Their ‘‘extra’’ androgen production had caused them to fall from the path of true female development. Studying CAH girls, then, might provide support for the hypothesis that hormones, gone awry, lie at the heart ofhomosexual devel — opment.123
From 1968 to the present, approximately a dozen (the number continues to grow) studies have looked for evidence of unusual masculinity in CAH girls. Were they more aggressive and active as children? Did they prefer boys’ toys? Were they less interested in play rehearsal of mothering and, the ultimate question, did they become lesbians or harbor homosexual thoughts and de — sires?124 In the gender system that frames this research, girls who like boys’ toys, climb trees, don’t like dolls, and think about having careers are also likely to be prone to homosexuality. Sexual attraction to women is understood to be merely a male-typical form of object choice, no different in principle from liking football or erector sets. Girls with masculine interests, then, may reflect an entire suite of behaviors, of which adult homosexuality is but a postpubertal example.125
Recently Magee and Miller analyzed ten studies of CAH girls and women. Although Money and colleagues originally reported that CAH girls were more active than controls (higher energy expenditure, more aggressive, more rough-and-tumble play),126 more recent work, Miller and Magee conclude, does not bear them out.127 Furthermore, none of the studies found increased dominance assertion in CAH girls.128 A few publications report that CAH girls are less interested than control girls (often unaffected siblings) in doll play and other forms of ‘‘rehearsal’’ for motherhood. Inexplicably, however, one research group found that CAH girls spent more time playing with and caring for their pets, while other researchers found that CAH patients did not wish to have their own children and more often preferred the idea of a career to staying at home.129 All in all, the results provide little support for a role for prenatal hormones in the production of gender differences.
Magee and Miller find special fault with the ten studies of lesbianism in CAH women. These, they point out, contain no common concept of female homosexuality. Definitions range from ‘‘lesbian identity, to homosexual relationships, to homosexual experience, to same-sex fantasies’’ and dreams.130 Although several studies report increases in homosexual thoughts or fantasies, none found exclusively homosexual CAH females. One of the research groups concluded that ‘‘prenatal hormone effects do not determine the sexual orientation of an individual,’’131 others cling to the idea that ‘‘early exposure to androgens may have a masculinizing influence on sexual orientation in
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women.
Thus, a critical look at the studies ofmasculine development in CAH girls reveals a weak, problem-ridden literature. Why, then, do such studies continue to appear? I believe these highly skilled, well-trained scientists,133 return again and again to drink from the well ofintersexuality because they are so deeply immersed in their own theory of gender that other ways of collecting and interpreting data become impossible to see. They are fish who swim beautifully in their own oceans but cannot conceptualize walking on solid ground.134