Nature versus nurture was always too simple a formulation. Now, we ask: Is it chance, choice, family, culture, hormones or genes that determine who we are and whom we love? Or some combination of these factors? Or, more intriguingly, a combination that differs for different people?
For all the sophistication of our twenty-first-century science, we still haven't much more than a clue. There's a dizzying litany of potential explanations for sexual behavior, inclinations, identity. And sometimes it seems as though competing disciplines are tugging us in opposite directions.
Our recent historians of sexuality, following Michel Foucault, have tended to favor social-constructionist approaches that suggest the mutability of sexual behavior. Writers such as George Chauncey (Gay New York) and Jonathan Ned Katz (The Invention of Heterosexuality) have explored how cultural categories shape both behavior and identity. During more liberal eras, as social repression eases, a wider variety of sexual expressions and labels becomes possible. Today, we have not simply gay, lesbian, bisexual and transgendered people, but also a panorama of subcategories–like bisexual gay men and male-to-female transsexuals.
But even as shifting sexual paradigms are tracked (or defined) by historians and social theorists, scientists remain wedded to what postmodernists dismiss as "essentialism." In thrall to what Dean Hamer called "the science of desire," they search for the "gay gene," differences in brain size, the hormonal elixirs that propel gender change–all the mysteries of sex that may lie embedded in biology.
Even within movements for sexual liberation, there is considerable debate about the nature of sexuality and gender. The gay rights movement has fought against the notion that gay men or lesbians somehow opt for a "lifestyle" of same-sex love. Gayness is supposed to be a state analogous, say, to blackness, a condition one is born with that provokes discrimination and deserves legal protection. Even the expression "sexual preference," which is descriptively accurate, has acquired a pejorative cast because it seems to leave open the possibility of choice. "Sexual orientation," considered fixed and unchanging, though paradoxically often revealed only over time and through experience, has become the politically correct term.
But the essentialist notion of sexuality advanced by the gay rights movement has come under attack by bisexual activists, many of whom perceive sexuality and sexual identity as more fluid, more susceptible to choice. "Are there people that are born bisexual and can't help it? No, I don't really believe that," Elias Farajaje-Jones, a Washington-based bisexual activist, once told me. Of course, just because many bisexuals experience their own sexuality as fluid doesn't mean that other people–gay, lesbian, straight or even bisexual–don't feel straitjacketed by an innate sexual nature they are powerless to alter.
Similar questions arise about gender. Second- and third-wave feminists have been fretting since the 1960s about the competing pulls of biology and culture in determining gender differences. As women have assumed aggressive leadership positions in the corporate world and (a few) men have begun to stay home and nurture their progeny, we've been able to conceive of gender-based roles, if not gender itself, as an outworn social construct–a mask that one can, with proper support or an act of will, simply shuck off. Never mind all those women now being drawn ineluctably back into the home, trading corporate perks for childcare. Perhaps their support system, or their own energy, simply gave out.
And then come the transsexuals, to confuse us all over again. While the feminists were busy arguing over gender roles, transsexuals were…well, what were they doing? Asserting that gender identity is fixed, immutable and overwhelming–even if it doesn't necessarily accord with biological sex? Or contesting whether gender, bifurcated rigidly into male and female, is a valid category at all?
Two excellent new books take us deeper into the debate, even if in the end they can't quite resolve it. In Normal: Transsexual CEOs, Crossdressing Cops, and Hermaphrodites With Attitude, novelist and psychotherapist Amy Bloom has given us a slim volume composed of three journalistic pieces that offer both insight and entertainment. By contrast, Joanne Meyerowitz's How Sex Changed: A History of Transsexuality in the United States is a sober, comprehensive cultural history that draws on previously unavailable archival sources. It is likely to become a standard reference in the field.
How Sex Changed follows the growing self-identification and assertiveness of transsexuals in American society. One of its great strengths is its examination of the intersection and interaction of science and culture, a type of inquiry that should serve as a model for future work on gender issues. Meyerowitz, professor of history at Indiana University and editor of The Journal of American History, shows how medical advances helped define transsexuals, and how they in turn pushed the boundaries of medicine.
The linchpin of her book is the story of Christine Jorgensen, whose sex-change operations in Copenhagen became an international sensation in 1952. "Her story opened debate on the visibility and mutability of sex," Meyerowitz writes. "It raised questions that resonated with force in the 1950s and engage us still today. How do we determine who is male and who is female, and why do we care? Can humans actually change sex?"
How Sex Changed starts out with a discussion of late-nineteenth- and early- twentieth-century research that laid the groundwork for the notion that sex can change. The theory of universal bisexuality, a term that commingled sex, sexuality and gender, "made sex change seem possible," Meyerowitz argues. The idea was that the sexes were not polar opposites but rather overlapping–a position later adopted by none other than Jorgensen herself.
Early sex-change operations were done in Europe in the 1920s and '30s, and they were featured in often-lurid press accounts. These accounts helped still-inchoate transsexuals "reconfigure their own identities," Meyerowitz writes. And they fueled demand for the operations–demand that was nearly always met by rejection unless prospective patients could prove that they had sexually ambiguous genitalia.
World War II marked a sea change, thanks in part to growing respect for science and the breakdown of traditional gender roles. By 1950, Meyerowitz reports, a few American doctors had quietly begun performing sex-change operations on patients who were not intersexed. And then came Jorgensen–who turned out to be anything but quiet.
Born in New York to Danish-American parents as George William Jorgensen Jr., she later described an unhappy, even despairing childhood, filled with longings for girlish things. George served in the Army as a clerk, moved to Hollywood, studied photography–and started reading about sex-change research. He began taking female hormones, first on his own and then under medical supervision. In Denmark, in September 1951, he had his testicles removed. More hormone treatments followed; then removal of the penis. By this time, after a period of gender ambiguity, Jorgensen had begun living as a woman. The New York Daily News broke the story–quite likely, Meyerowitz reveals, on the basis of a leak by Jorgensen herself.
Meyerowitz's chapter on Jorgensen is marvelously detailed and draws on previously sealed archival records from the Christine Jorgensen Collection of the Royal Danish Library and a thorough reading of popular accounts. Jorgensen didn't just provoke questioning about gender boundaries and sexuality (she always preferred men, while disdaining homosexuality). To Meyerowitz, she was also an exemplum of "the individual spirit that refused to succumb to the strictures of an increasingly homogenized society" and of science's "twin potential for progress and disaster." Jorgensen overcame a press backlash to become a successful entertainer and author, and her feminine self-presentation attracted far more fans than detractors. Early on, she won an award from the Scandinavian Societies of Greater New York as "Woman of the Year." Writes a frankly admiring Meyerowitz: "Jorgensen weathered it all with dignity and grace" and "refused to present herself as a dirty joke." But now the press spotlight was illuminated, and the surgical floodgates slowly opened. Charlotte McLeod, "Bunny" Breckinridge, Tamara Rees and others started to walk through. A few female-to-male cases also achieved notoriety. And sex change made its way into B-movies and cheap paperback novels.
Meanwhile, even as the concept of transsexuality gained currency, causes and cures remained controversial. In the United States, psychotherapy long remained the treatment of choice for what was viewed as a pathological condition. Gradually, surgical intervention became more available, with Johns Hopkins Hospital in Baltimore leading the way in the mid-1960s. Still, neither psychoanalysis nor biology offered any convincing etiology for the mismatch between gender identity and biological sex.
In successive chapters, writing in a relatively clear, restrained academic style, Meyerowitz describes the quest for surgery; the relationships between transsexuals and other sexual minorities and subcultures ("identities were neither entirely fixed nor entirely fluid"); and the organizational and legal history of the transgender movement. Occasionally the text becomes dense with acronyms, and the level of detail numbing. But these are minor flaws in an otherwise intelligent, even indispensable, account.
Bloom, unlike Meyerowitz, plays with irony. Her subject in Normal is what most of us don't consider normal when it comes to the expression of gender. Her first piece, "The Body Lies: Female-to-Male Transsexuals," focuses on a group of transsexuals who've received relatively less attention than their male-to-female (MTF) counterparts. Bloom's sympathetic, almost therapeutic tone is signaled by an extended opening metaphor that borrows from Franz Kafka's Metamorphosis:
What would you go through not to have to live the life of Kafka's Gregor Samsa? Not to realize, early in childhood, that other people perceive a slight, unmistakable bugginess about you, which you find horrifying but they claim to find unremarkable? That glimpses of yourself in the mirror are upsetting and puzzling and to be avoided, since they show a self that is not you?… Would you hesitate to pay thirty thousand dollars and experience some sharp but passing physical misery in order to be returned to your own dear, soft, skin-covered self?
Bloom tells us that FTMs, once virtually invisible compared with such transsexual superstars as Jorgensen and Renée Richards, are now believed to be just as common as MTFs. Her goal is to help us understand their desire to pursue sex-change operations, from mastectomies and hysterectomies to metoidioplasties and phalloplasties. This is no easy feat, considering that the latter two surgeries don't sound much better than anesthetized genital mutilation.
Bloom weaves back and forth between the doctors and their patients, describing both these excruciating medical interventions and the lives they've successfully transformed. (One quibble: She warns that she has used some pseudonyms and changed some identifying details, unsurprising given the subject matter and the stigma still attached to it. But she doesn't always make clear which names have been changed. This matters, because it would tell us how "out" particular subjects are, or how comfortable they are with their life histories.)
In meeting these postoperative transsexuals, Bloom keeps gauging her own reactions, just as the reader might: Do they look male? Act male? Is the chemistry she feels the same as she'd feel with other men? What do their parents and their romantic partners say about them?
While gender identity issues have often dominated the lives of these transsexuals, one post-op FTM, whom Bloom calls Luis, has a provocative dissenting view. "Gender is slippery," he declares. "Male, female–I don't even understand that anymore…. Gender is an illusion." That's a conclusion that undercuts the typical salvation narrative of transsexual discomfort, self-realization and corrective surgery, and Bloom's own narrative as well. If gender is an illusion, then why bother with painful, expensive physical alteration? And yet that remains the treatment of choice for what are labeled, with a troubling circularity, "high intensity" transsexuals.
Prompted by Luis, Bloom admits that gender eludes definition. "We know that neither the object of desire nor the drinking of beer nor the clenching of fists makes maleness," she writes. "We don't know what does, and neither do the transsexual men, and neither do the people who treat them, psychologically and surgically." One might easily stop there, awed by the unknowable. But Bloom can't resist ending her piece, many pages later, on an upbeat note, with the story of the pseudonymous Michael, who tells her: "We, people who have been through this transition–we are among the few people in the world who have overcome obstacles and fulfilled their lifelong dreams."
In contrast to transsexuals, who long for surgical transformation, the new activists of the intersexed argue against surgery–at least when it is nonconsensual and medically unnecessary. So we learn in "Hermaphrodites With Attitude: The Intersexed," in which Bloom offers another challenge to a polarized model of biological sex and gender.
Bloom tells us that some 2,000 intersexed babies, whose genitals and therefore biological sex are confusing, are born each year. Thanks in part to the influence of Johns Hopkins University sexologist John Money, surgery has frequently been done to "correct" the anatomy of these babies. Any boy possessing, for example, "a small and inadequate penis" would very likely have that penis removed. His parents would then be told to raise him as a girl, with frilly dresses and plenty of dolls. Sex reassignment was supposed to work, since gender (as many feminists also argued) was supposed to be learned. But, as John Colapinto eloquently demonstrated in As Nature Made Him: The Boy Who Was Raised as a Girl, sometimes the practical results of Money's theories were disastrous.
The case Colapinto detailed, which involved a botched circumcision rather than hermaphroditism per se, represents one extreme. But Bloom suggests that, like gender, biological sex may well exist on a continuum. At least in some instances, she writes, the search for a child's "true" sex may be analogous to the search for a mythic "true" love–"composed of equal parts convention, social mandate, human need, and commitment to a dream."
The heroine of "Hermaphrodites With Attitude" is Cheryl Chase, founder of the Intersex Society of North America (ISNA), which aims to stop what it considers barbarous, unnecessary surgeries on intersexed babies. Bloom backs her, and adds, with postmodernist panache, that the intersexed have much to teach us: "about the odd significance we give to gender, about the elusive nature of truth, about the understandable, sometimes dangerous human yearning for simplicity."
Only in the middle piece of Normal, "Conservative Men in Conservative Dresses: Heterosexual Crossdressers," does Bloom's generosity of spirit fail her. "Heterosexual crossdressers bother almost everyone," she begins, and it turns out she herself is not immune from annoyance. She has two main complaints about these men: They (dishonestly, she thinks) downplay the erotic and fetishistic aspects of crossdressing. And they ask for too much tolerance from their beleaguered, sad but generally sympathetic wives, whom Bloom compares to golf widows or wives in Al-Anon. Many of these women make do, she asserts, with "not much sex and a certain amount of constant pain."
As for the crossdressers themselves, Bloom accepts that they are neither gay drag queens nor transsexual wannabes. But there's not much she finds appealing about what she calls "a world of traditional men, traditional marriages, and truths turned inside out." To turn truths inside out, though, may be one role that all of Bloom's subjects usefully play.
In their different ways, both Meyerowitz and Bloom show us just how shaky our certainties about sexuality and gender really are. As a society, we have made what looks like progress: We can now distinguish among biological sex, gender and sexuality–concepts that were hopelessly confused a century ago. But, Meyerowitz reminds us, we are still busily contesting "the meanings of biological sex, the sources of gender, and the categories of sexuality"–issues that neither today's history nor today's science is ready to settle.