The Volatility of Sex: Intersexuality,Gender and Clinical Practice in the 1950s

The term ‘gender role’ was coined at Johns Hopkins's paediatric endocrinology clinic in the 1950s, where Dr Lawson Wilkins and psychologist John Money diagnosed, treated and evaluated intersexual children, most of them suffering from a condition called congenital adrenal hyperplasia (CAH). Going beyond existing discourses on the medicalisation of intersexuality, I reframe the emergence of gender as an element in the development of a specific medical treatment for an endocrinological condition and excavate the complex and contingent historical factors that led to the formulation of gender role in the Hopkins context. Using previously unavailable patient records from the clinic, this article follows the patients through their medical encounters and describes the process of normalisation around the diagnosis, treatment and management of CAH. By paying specific attention to the practices at the clinic, I show that diagnosing a child's sex often depended on the physicians’ skill, experience and techniques. Correct gender role was folded into the management of CAH as one aspect of successful treatment. Normalisation was a process, in which treating somatic effects and assuring psychological healthiness were deeply enmeshed in the conviction that a normal life would only be possible as a clearly gendered and sexed person.