In the epoch of the clinic (as per Foucault, and not to challenge readers by writing about “Euro-American culture”) many human beings (we) have learned a lot about the peculiarities of sexual dimorphism (“males” without male genitalia; “females” with same; other chromosomal oddities, etc.) compounded by the mysteries concerning the origin and experiences of sexual attraction (not to mention sexual practices).  How this knowledge became facts in textbooks, the media, the law, and how it spread across miscellaneous populations, is a problem for historians.  Who knows what about all this, practically, at this particular moment in the life of a polity submitted to the regime of the clinic, is a problem for sociologists and anthropologists.  A version of the problem concerns the tracing of what is being done about it and what challenges are then faced given the possibilities that the epoch of the clinic have opened.

This brings me to the surgeons who perform “sex change” operations (search Google for “gender change” operations and find out all references are to “sex change”–another proof of Schneider’s conjecture about American kinship, 1980 [1968]).  It brings me particularly to one set of surgeons who, sometimes in the 1960s, performed the operation on “Agnes” who was made famous by Garfinkel (1967: Chapter V), and particularly on a few lines in a few notes about post-operative issues:

Immediately postoperatively, [Agnes] developed bilateral thrombophlebitis of the legs, cystitis, contracture of the urethral meatus, and despite the plastic mold which was inserted into the vagina at the time of surgery, a tendency for the vagina outlet to contract. She also required postoperatively several minor surgical procedures for modification of these complications and also to trim the former scrotal tissue to make the external labia appear more normal. Despite the plastic mold, the newly-made vagina canal had a tendency to close and heal, which required intermittent manipulations of the mold and daily dilatations. Not only were all of these conditions painful or otherwise uncomfortable but also, although minor, since they were frequent, they produced increasing worry that the surgical procedure would not end up with the desired result of a normal functioning and appearing set of female genitalia. Although these distressing conditions were carefully (and ultimately successfully) treated, at the time that she was well enough to go home these complications were still not fully resolved (Footnote 6)

 Sculpting new genitalia into a human body may be the ultimate in the (social) construction of new realities, the making of cyborgs, and the radical embodiment of a cultural arbitrary (in the service, some say, of making visible the ‘true nature’ of the subject body).  Historically, sculpting the live body (including all forms of plastic and reconstructive surgery), would not be possible in the absence of a host of well-organized people in hospitals, universities, government offices, etc.  And yet, at the moment of the surgery, the body as live object or thing (in Latour’s sense) resists.  Internal mechanisms attempt to heal what any number of cells, glands, and primitive parts of the brain, might interpret as a “wound” to be “healed” by any means necessary–if cells had access to meta-communicational discourses (remember that various parts of the body communicate with each other through many different channels).  Surgeons and nurses are well aware of this and organize themselves to resist the resistance as they use the body’s affordances “against” themselves, so to speak.

At the end, a block of marble, under Michelangelo’s hammers, yields a new David and “we” humans may say that we have won against the world and built a new reality.  But the marble, in its peculiar affordances, remains: what about the missing hormones?  The marble crumbles and museums curators fret.  Wounds heal; surgeons worry; they manipulate and dilate.

So, in effect, can “we” (those who care about such matters) tell David from the marble, Agnes from her body, the raw from the cooked?

Garfinkel, Harold 1967. Studies in ethnomethodology. Englewood Cliffs, NJ: Prentice-Hall.

Schneider, David 1980 American kinship: A cultural account.  Chicago: University of Chicago Press.  [first published in 1968]