Center: 
Amsterdam
Discipline(s): 
Sociology
Gender Studies
Course code: 
SO/GS 340
Terms offered: 
Summer
Credits: 
3
Language of instruction: 
English
Instructor: 
Margriet van Heesch
Description: 

Western gender-critical thinkers such as queer-theorists, philosophers, sociologists and anthropologists studied the ways in which gender ideologies influence the male/female, nature-culture, and mind-body dichotomies in scientific and medical knowledge. Their critique was directed at the unaccounted use of the heterosexual matrix as a natural fact, overlooking and marginalizing those who cannot meet the male/female dichotomy, such as people that were born with both male and female sex characteristics. In medical publications these conditions are known as “disorders of sex development,” “hermaphroditism,” or “intersexuality.”

In this course we will close-read the Dutch medical case studies of “patients” with atypical sex anatomies. Subsequently, with the help of international academic critics, we will conduct a discourse analysis of sex and gender ideologies that have informed the medical protocol from 1940 up until now. We will zoom in on how intersexuality became a medical problem, that was supposed to be cured with cosmetic surgery, hormone replacement therapy and the withholding of medical information.

Looking closely at both the original Dutch medical texts and the international scholarly endeavors that deconstructed medical knowledge as contingent and situated, this course provides students with a tool kit to develop their own ways of challenging gender dichotomies in science and medicine. Dutch medical, biological and neurological case studies on intersexuality will be studied as well as Dutch and international scholarly endeavors that deconstruct sexist assumptions.

To reach an understanding of how the scientific discourses on sex and gender restrict or facilitate lived experiences of people with intersex conditions, we will look at the structuring ideologies along or against the lines of the heterosexual matrix. The scientific production of two opposite genders, male and female, will be studied at the cross section of other identity categories such a sex, sexuality, ethnicity, race, religion, age, class, health and citizenship.

Prerequisites: 

Because this is an interdisciplinary course, students of all backgrounds are welcome. Some knowledge or interest in gender studies, discourse analysis and narrative analysis is recommended.

Additional student cost: 

No additional costs; all readings will be available on Moodle.

Learning outcomes: 

The aim of the course is to provide students with the following insights and skills:

  • Describe the history of intersexuality in The Netherlands and in an international context.
  • Analyze and deconstruct how power-knowledge-pleasure-regimes (Foucault) inform the lived experiences of people with atypical sex anatomies and the heterosexual matrix in the Netherlands and internationally.
  • Critically analyze how scientific knowledge both affirms and resists dominant discourses on how we should embody our male or female gender.
  • Describe how different scientific and scholarly disciplines produce different knowledge on gender in the Netherlands.
Method of presentation: 

Lectures, student presentations, viewings of documentaries and class discussions on the readings.

Required work and form of assessment: 
  • Midterm #1 (20%): Write a 3-page discourse analysis of one of the medical or scientific class readings that deconstructs the “facts” of gender binary and/or heterosexual matrix.
  • Midterm #2 (15%): Write a 3-page review of one of the viewed documentaries. In this review, you should elaborate on your doubts and fascinations.
  • Presentation and participation (30%): In class we will imitate an academic conference setting in which students will take on the roles of chair, speaker and discussant. Students will give presentations of exactly 10 minutes in which they will place the class readings in the context of the heterosexual matrix and gender ideologies. The chairperson will be in charge of time and lead the exchange of inspired thoughts and positive feedback, brought on by the designated discussants.
  • Final paper (35%): 7-8 page research paper or essay that employs knowledge learned in the course on “intersexuality”. A research paper differs from an essay and is an academic endeavor. You will start with an observation, something that fascinates or troubles you and that makes you wonder. This wonderment is the basis for a research question. You will then justify how you are going to look for answers followed by an analysis that will result in possible answers and conclusions. During the last session, all papers will be shared in class, following the same academic conference setting.
content: 

Week 1: Knowing Sex and Science in The Netherlands

Session 1: Introduction: Sex and Science: What is intersexuality?

In the first meeting we will get to know each other. The instructor will explain the practical and academic details of the course; she will give tips on how to read medical texts and how to decipher “medicalese”, and of course on how to present in class and have a positive experience at the same time.

Session 2: How Do We Gain Insight Into Scientific Epistemologies?

The learning goal of this session is twofold. First we will brush up our discourse analysis skills with the insightful examples that the British sociologist Rosalind Gill gives us. Then we will remind ourselves where this discussion on discourse originated in the first place. We do this by reading a segment from French philosopher Michel Foucault’s classic: ‘The Will to Knowledge’.

Power-knowledge-pleasure regimes are most of all dynamic. Power never comes from one side and wherever there is power exercised there is resistance.

  • Gill, Rosalind. “Discourse Analysis.” In Qualitative Researching with Text, Image and Sound: A Practical Handbook, edited by Martin W. Bauer and George Gaskell, 172-90. London: Sage, 2000.
  • Foucault, Michel. “The Deployment of Sexuality: Method.” In History of Sexuality Volume I: The Will to Knowledge, 92-102. London: Penguin Books, 1976.
  • Hekma, Gert. “How Libertine Is the Netherlands? Exploring Contemporary Dutch Sexual Cultures.” In Regulating Sex: The Politics of Intimacy and Identity, edited by Elizabeth Bernstein and Laurie Schaffner. New York: Routledge, 2005.

Week 2: How Did Intersexuality Become a Legal Problem?

Session 3: What does the law have to do with it?

Napoleon Bonaparte introduced the Civil Code in France in 1804, which was later also implemented in the occupied European countries such as The Netherlands. This Civil Code included an article that was especially created for those persons who were mistakenly assigned the ’wrong’ sex. According to this Civil Code, a person whose parents or midwife apparently could not figure out whether it was a girl or a boy was allowed to adjust his/her birth certificate once in his/her life. This change had to take place before marriage. According to Foucault, this ‘misjudgment article’ stemmed from older church law and this is the first account of the existence of variations in sex development in the Western world. We will read a Dutch Sociology study of law and ‘interseksuals’ and ‘transseksuals’ in The Netherlands. We will also read the memoirs of French schoolteacher Herculine Barbin. He/she was raised a girl and used the misjudgment article to continue living in her “rightful” sex as a man. After her/his suicide in 1868 doctors not only scrutinized her/his body but also her/his memoirs. Foucault had the memoirs and the medical reports reprinted in 1978 and he also wrote a short discourse analysis about this particular case.

  • Orobio de Castro, Ines. Made to Order, Sex/Gender in a Transsexual Perspective. Amsterdam: Het Spinhuis, 1993. (pp 1-50.)
  • Foucault, Michel. Herculine Barbin, Being the Recently Discovered Memoirs of a Nineteenth-Century Hermaphrodite. Translated by Richard McDougall. New York: Colophon, 1980.

Session 4: Trying To Rewrite the law: Dutch Transgender Politics

To continue to understand the juridical enforcement of the heterosexual matrix we will read a historical overview and beautiful deconstruction of ideologies of American gender critic Julia Epstein. To complement this, we will study the outcomes of the Human Rights Watch Report of Kathinka Ridderbos. This study focused on a Dutch law that violated human rights. This law forced individuals to be sterilized before they could legally change their sex.

  • Epstein, Julia. “Either/or—Neither/Both: Sexual Ambiguity and the Ideology of Gender.” Genders 7 (1990): 99-142.
  • Ridderbos, Kathinka Human Rights Watch Report Transgender Law in The Netherlands (2012)

Week 3: How Did Intersexuality Become a Medical Problem?

Session 5: Doctor Knows Best: Withholding of Truth

As Iara Lessa stated in 2006: “Discourses are systems of thoughts composed of idea’s attitudes, courses of action, beliefs and practices that systematically construct the subjects and the worlds of which they speak.” We therefore will look closely at Dutch examples of how medicalisation of people with varieties in sex development is ‘accounted for’ by medical experts. How do they justify irreversible surgical proceedings, and hormone therapy in children without their consent or in adults without full information? The medical case studies at hand concern Dutch women born with XY chromosomes due to a rare gene variation that could be traced back to the Dutch Mennonites.

  • Heremans, G.F., A.J. Moolenaar, and H.H. van Gelderen. “Female Phenotype in a Male Child Due to 17-Alpha-Hydroxylase Deficiency.” Archives of Disease in Childhood 51, no. 9 (1976): 721-23.
  • Imai, Tsuneo, Toshihiko Yanase, Michael R. Waterman, Evan R. Simpson, and John J. Pratt. “Canadian Mennonites and Individuals Residing in the Friesland Region of the Netherlands Share Same Molecular Basis of 17alpha-Hydroxylase Deficiency.” Human Genetics 89 (1992): 95-96.
  • Spronk, P.E., F. Bergkamp, and R.W. Ten Kate. “17alpha-Hydroxylase Deficiency; a Rare Cause of Chronic Hypertension.” The Netherlands Journal of Medicine 49, no. 5 (1996): 205-08.

Session 6: Patients Know Better: Finding Out the Truth

All good medicine includes long-term research to study the outcomes of medical interference. But how does one do this if the female “patients” in question were not supposed to know anything about the details of their condition, such as having XY chromosomes? We will discuss the outcomes of surgical interventions and withholding information for women with XY chromosomes in The Netherlands. Whilst they were not supposed to, all these women found out about their situation by chance. How did these women manage this “unknowing” (Segdwick) with regards to their lives, careers and relationships?

Who knows best, doctor or patient? How does the knowledge of a doctor, who ‘knows’, differ form a patient, who ‘feels’? American philosopher of science Joan Fujimora shows us that exact science does not provide the ‘truths’ it aims to provide.

  • Fujimura, Joan. “Authorizing Knowledge in Science and Anthropology.” American Anthropologist 100, no. 2 (1998): 347-60.
  • Heesch, Margriet van. “Do I Have XY Chromosomes?” In Critical Intersex, edited by Morgan Holmes, 123-47. Farnham: Ashgate, 2009.

Week 4: How Did Doctors Try to Cure Intersexuality?

Session 7: Psychologists: It is better not to talk about it.

Western medical protocol describes how medical experts such as endocrinologists, geneticists, surgeons and gynecologists should team up to tackle the complexity of an infant born with a sex variation. In the protocol it is stressed that a psychologist should also be consulted to council the distressed parents. How do Dutch psychologists perceive their role in erasing the atypical sex anatomy of the newborn?

  • Slijper, F. M. E. , and S. L. S. Drop, et al. “Neonates with Abnormal Genital Development Assigned the Female Sex: Parent Counseling.” Journal of Sex Education and Therapy 20, no. 1 (1994): 9-17.
  • Dessens, Arianne B., Froukje M.E. Slijper, and Stenvert L.S. Drop. “Gender Dysphoria and Gender Change in Chromosomal Females with Congenital Adrenal Hyperplasia.” Archives of Sexual Behavior 34, no. 4 (2005): 389-97.
  • Slijper, Froukje M. E., Stenvert L. S. Drop, Jan C. Molenaar, and Sabine M. P. F. de Muinck Keizer-Schramer. “Long-Term Psychological Evaluation of Intersex Children.” Archives of Sexual Behaviour 27, no. 2 (1998): 125-44.
  • Slijper, Froukje M. E., P.G. Frets, A.L.M. Boehmer, S.L.S. Drop, and M.F. Niermijer. “Androgen Insensitivity Syndrome (AIS): Emotional Reactions of Parents and Adult Patients to the Clinical Diagnosis of Ais and Its Confirmation by Androgen Receptor Gene Mutation Analysis.” Hormone Research, no. 53 (2000): 9-15.
  • van der Kamp, H. J., Froukje M. E. Slijper, H. Brandenburg, S. M. P. F. de Muinck Keizer-Schrama, S. L. S. Drop, and J. C. Molenaar. “Evaluation of Young Women with Congenital Adrenal Hyperplasia: A Pilot Study.” Hormone Research 37, no. (suppl 3) (1992): 45-49.

Session 8: Surgeons: It is easier to cut a hole than to build a pole

When a penis is considered too small or a clitoris deemed too large, compared to the norm, a surgeon can solve the problem. Or not? Can surgery make genitals look ‘normal’? Can we argue that choices made for sex variant children may have been too much influenced by experimental surgical techniques that changed along the advancement of the technology of the Operating Room and personal interpretations of penile and clitoral size?

  • De Jong, Tom P. V. M., and Thomas M. L. Boemers. “Neonatal Management of Female Intersex by Clitorovaginoplasty.” The Journal of Urology 154, no. 2 (Part 2) (1995): 830-32.
  • Slijper, Froukje M. E. “Clitoral Surgery and Sexual Outcome in Intersex Conditions.” In The Lancet, 1236, 2003.
  • Esme, Danielle L., Werner H. Beekman, J. Joris Hage, and Martine D.  Nipshagen. “Combined Use of Ultrasonic-Assisted Liposuction and Semicircular Periareolar Incision for the Treatment of Gynecomastia.” Annals of Plastic Surgery 59, no. 6 (2007): 629-34.
  • Hage, J. Joris, Refaat B. Karim, Joannes J. A. M. Bloem, Harold M. Suliman, and Marcel van Alphen. “Sculpturing the Neoclitoris in Vaginoplasty for Male-to-Female Transsexuals.” Plastic and Reconstructive Surgery 93, no. 2 (1994): 358-64.
  • Mureau, Marc, Froukje Slijper, and et al. “Psychosocial Functioning of Children, Adolescents, and Adults Following Hypospadias Surgery: A Comparative Study.” Journal of Pediatric Psychology 22 (1997): 371-87.

Week 5: How Do People with Intersex Conditions Experience the Cure?

Session 9: Emergence of Intersex Society of North America

How did people with varieties in sex development experience the medical interventions and evaluate their medical care?  How were they able to find a voice after being silenced and how did they try to change the Western medical protocol? These voices were to be heard from 1993 with the founding of the Intersex Society and the emergence of the Internet.

  • Chase, Cheryl. “Affronting Reason.” In Looking Queer: Image and Identity in Lesbian, Bisexual, Gay and Transgendered Communities, edited by Dawn Atkins, 209-35. New York: Harrington Park Press, 1998.
  • “Intersex Society of North America: Intersexuals Advocate for Change.” American Medical Student Association Task Force Quarterly, Fall 1995, 30-31.
  • “Spare the Knife, Study the Child (Letter).” Ob.Gyn.News, 1 October 1997, 14-15.
  • “Stop Medically Unnecessary Surgery (Letter).” San Francisco Bay Times, 28 Nov 1996, 17.
  • “Surgical Progress Not the Answer to Intersexuality.” Journal of Clinical Ethics 9, no. 4 (1998): 385-92.

Session 10: Contemporary Debates on Intersexuality

The last word will be given to Canadian experience expert and anthropologist Morgan Holmes who provides the most insightful analysis of the contemporary debate/

  • Holmes, Morgan. Intersex, a Perilous Difference. Selinsgrove: Susquehanna University Press, 2008.

Week 6: Toolkit for studying sex and science

Session 11: How can we learn from Sex and Science, The Dutch Case?

  • Holmes, Morgan. Critical Intersex. Farnham: Ashgate, 2009.

Session 12: Final Paper Presentations

Required readings: 
  • Chase, Cheryl. “Affronting Reason.” In Looking Queer: Image and Identity in Lesbian, Bisexual, Gay and Transgendered Communities, edited by Dawn Atkins, 209-35. New York: Harrington Park Press, 1998.
  • De Jong, Tom P. V. M., and Thomas M. L. Boemers. “Neonatal Management of Female Intersex by Clitorovaginoplasty.” The Journal of Urology 154, no. 2 (Part 2) (1995): 830-32.
  • Dessens, Arianne B., Froukje M.E. Slijper, and Stenvert L.S. Drop. “Gender Dysphoria and Gender Change in Chromosomal Females with Congenital Adrenal Hyperplasia.” Archives of Sexual Behavior 34, no. 4 (2005): 389-97.
  • Epstein, Julia. “Either/or—Neither/Both: Sexual Ambiguity and the Ideology of Gender.” Genders 7 (1990): 99-142.
  • Esme, Danielle L., Werner H. Beekman, J. Joris Hage, and Martine D.  Nipshagen. “Combined Use of Ultrasonic-Assisted Liposuction and Semicircular Periareolar Incision for the Treatment of Gynecomastia.” Annals of Plastic Surgery 59, no. 6 (2007): 629-34.
  • Foucault, Michel. “The Deployment of Sexuality: Method.” In History of Sexuality Volume I: The Will to Knowledge, 92-102. London: Penguin Books, 1976.
  • Foucault, Michel. Herculine Barbin, Being the Recently Discovered Memoirs of a Nineteenth-Century Hermaphrodite. Translated by Richard McDougall. New York: Colophon, 1980.
  • Fujimura, Joan. “Authorizing Knowledge in Science and Anthropology.” American Anthropologist 100, no. 2 (1998): 347-60.
  • Gill, Rosalind. “Discourse Analysis.” In Qualitative Researching with Text, Image and Sound: A Practical Handbook, edited by Martin W. Bauer and George Gaskell, 172-90. London: Sage, 2000.
  • Hage, J. Joris, Refaat B. Karim, Joannes J. A. M. Bloem, Harold M. Suliman, and Marcel van Alphen. “Sculpturing the Neoclitoris in Vaginoplasty for Male-to-Female Transsexuals.” Plastic and Reconstructive Surgery 93, no. 2 (1994): 358-64.
  • Heesch, Margriet van. “Do I Have XY Chromosomes?” In Critical Intersex, edited by Morgan Holmes, 123-47. Farnham: Ashgate, 2009.
  • Hekma, Gert. “How Libertine Is the Netherlands? Exploring Contemporary Dutch Sexual Cultures.” In Regulating Sex: The Politics of Intimacy and Identity, edited by Elizabeth Bernstein and Laurie Schaffner. New York: Routledge, 2005.
  • Heremans, G.F., A.J. Moolenaar, and H.H. van Gelderen. “Female Phenotype in a Male Child Due to 17-Alpha-Hydroxylase Deficiency.” Archives of Disease in Childhood 51, no. 9 (1976): 721-23.
  • Holmes, Morgan. Critical Intersex. Farnham: Ashgate, 2009.
  • Holmes, Morgan. Intersex, a Perilous Difference. Selinsgrove: Susquehanna University Press, 2008.
  • Imai, Tsuneo, Toshihiko Yanase, Michael R. Waterman, Evan R. Simpson, and John J. Pratt. “Canadian Mennonites and Individuals Residing in the Friesland Region of the Netherlands Share Same Molecular Basis of 17alpha-Hydroxylase Deficiency.” Human Genetics 89 (1992): 95-96.
  • Mureau, Marc, Froukje Slijper, and et al. “Psychosocial Functioning of Children, Adolescents, and Adults Following Hypospadias Surgery: A Comparative Study.” Journal of Pediatric Psychology 22 (1997): 371-87.
  • Orobio de Castro, Ines. Made to Order, Sex/Gender in a Transsexual Perspective. Amsterdam: Het Spinhuis, 1993. (pp 1-50.)
  • Ridderbos, Kathinka Human Rights Watch Report Transgender Law in The Netherlands (2012)
  • Slijper, Froukje M. E. “Clitoral Surgery and Sexual Outcome in Intersex Conditions.” In The Lancet, 1236, 2003.
  • Slijper, F. M. E. , and S. L. S. Drop, et al. “Neonates with Abnormal Genital Development Assigned the Female Sex: Parent Counseling.” Journal of Sex Education and Therapy 20, no. 1 (1994): 9-17.
  • Slijper, Froukje M. E., P.G. Frets, A.L.M. Boehmer, S.L.S. Drop, and M.F. Niermijer. “Androgen Insensitivity Syndrome (AIS): Emotional Reactions of Parents and Adult Patients to the Clinical Diagnosis of Ais and Its Confirmation by Androgen Receptor Gene Mutation Analysis.” Hormone Research, no. 53 (2000): 9-15.
  • Slijper, Froukje M. E., Stenvert L. S. Drop, Jan C. Molenaar, and Sabine M. P. F. de Muinck Keizer-Schramer. “Long-Term Psychological Evaluation of Intersex Children.” Archives of Sexual Behaviour 27, no. 2 (1998): 125-44.
  • Spronk, P.E., F. Bergkamp, and R.W. Ten Kate. “17alpha-Hydroxylase Deficiency; a Rare Cause of Chronic Hypertension.” The Netherlands Journal of Medicine 49, no. 5 (1996): 205-08.
  • Van der Kamp, H. J., Froukje M. E. Slijper, H. Brandenburg, S. M. P. F. de Muinck Keizer-Schrama, S. L. S. Drop, and J. C. Molenaar. “Evaluation of Young Women with Congenital Adrenal Hyperplasia: A Pilot Study.” Hormone Research 37, no. (suppl 3) (1992): 45-49.
  • “Intersex Society of North America: Intersexuals Advocate for Change.” American Medical Student Association Task Force Quarterly, Fall 1995, 30-31.
  • “Spare the Knife, Study the Child (Letter).” Ob.Gyn.News, 1 October 1997, 14-15.
  • “Stop Medically Unnecessary Surgery (Letter).” San Francisco Bay Times, 28 Nov 1996, 17.
  • “Surgical Progress Not the Answer to Intersexuality.” Journal of Clinical Ethics 9, no. 4 (1998): 385-92.
Brief Biography of Instructor: 

Margriet van Heesch (MA Comparative Literature) is about to earn her Ph.D. from the University of Amsterdam on life stories of Dutch men and women born with intersex conditions (DSD) and growing up with medical interventions. She is currently a lecturer employed by the Faculties of Behavioral Sciences and Humanities at the same University, where since 2006 she has taught MA and BA seminars and lectures on anthropology, sex, gender and sexuality, queer studies, and since 2008 also romantic love. Among her more recent publications is a chapter on the lived experiences of women born with male genetic makeup: Heesch, Margriet van. “Do I Have XY Chromosomes?” In Critical Intersex, edited by Morgan Holmes, 123-47. Farnham: Ashgate, 2009.