Changing attitudes to sex assignment in intersex.

The existence of people who are neither ‘all male’ nor ‘all female’ has long been recognized in many societies and, with the advent of scientific medicine in European societies in the 19th century, effort has been directed at determining the ‘true sex’ of such individuals [5]. Taxonomy was a new and exciting intellectual activity, and cases of ‘doubtful sex’ were a challenge to science and medicine. According to Dreger [5], factors then accepted as indicative of true sex included appearance of the head, timbre of voice, lack of breast development, presence of penis and absence of periods . Personality traits were also considered important demarcators of sex, e.g. bravery was considered a male attribute, and modesty female . Likewise, ‘true males’ were thought to desire only ‘true females’ and vice versa. In contrast to today, the role of surgery then was to confirm a hermaphroditic diagnosis rather than to change or reinforce the ‘true sex’.