Measuring sex in homosexuals
Another way in which the hormonal tests came to be used in the clinic was in the treatment of homosexuals. In Chapter 2 we saw how clinicians expected that female sex hormones in male bodies caused disorders in masculinity. One of these “disorders” was homosexuality. The basic assumption underlying this hypothesis was that homosexual men were considered more or less “feminine,” so that a connection with female sex hormones as the agents of femininity seemed likely. An analogous concept was developed for homosexual women, although most studies were performed on men (Meyer – Bahlburg 1984:376).
In 1935 Clifford Wright, a general practitioner in Los Angeles, described this hormonal etiology of homosexuality:
All individuals are part male and part female, or bisexual, and this fact is substantiated by hormone assays in the urine. The urine of the normal man or woman shows the presence of hormones of both the male and female types…. In the normal male, the male hormone predominates; in the normal female, the female hormone predominates. This, in my opinion, is the cause of normal sex attraction. In the homosexual the dominance is reversed. In the man there is a predominance of the female element and in the homosexual woman a dominance of the male factor.
This conceptualization of homosexuality was perfectly in line with the then prevailing ideas about homosexuality. Many influential European sexologists working at the turn of the century, such as Richard von Krafft-Ebing, Havelock Ellis and Magnus Hirschfeld, asserted that homosexuality is determined by biological factors. Hirschfeld, one of the pioneers of equal rights for homosexuals, advocated the theory of intersexual stages (Zwischenstufentheorie), first introduced by a German lawyer, C. H. Uhlrichs, in the 1860s. In Hirschfeld’s opinion, homosexuality was an intersexual stage between the poles of complete maleness and femaleness. In his theory, homosexual men and women were portrayed as physically male or female, but sexually and emotionally endowed with many characteristics of the other sex. Homosexuals were thus considered as hermaphrodites or a third sex.
The experiments of one of the pioneers in sex endocrinology, the Viennese anatomist Eugen Steinach, in which he claimed to have produced hermaphroditic animals by transplanting gonads from the other sex, fitted seamlessly into this theory of intersexual stages. Steinach referred to Hirschfeld when reflecting on his animal experiments: “Homosexuality can also be ascribed to the existence of a hermaphrodite pubertal gland, just as Hirschfeld rightly postulated when he talked about the congenital disposition of the homosexual” (Steinach 1916:307). Steinach suggested that the testicles of homosexual males contained “deviated cells” which he called “F-cells” and which had a “feminizing or homosexual-making” effect (Lichtenstern 1920). Steinach’s experiments did not remain restricted to animals. In 1916, he performed the first surgical operation in which he transplanted testicular tissue from a heterosexual man into a homosexual. Medical records indicate that at least eleven homosexual men underwent the “Steinach operation” between 1916 and 1921.8 These experiments inextricably linked the discourse on homosexuality with the discourse on gender and launched the biomedical sciences’ search for biological markers of femininity and masculinity in homosexuals.9
The introduction of the hormonal theory of homosexuality, and subsequently the introduction of tests to measure sex hormones in human bodies, provided clinicians with a means to replace gonadal transplant operations with hormone treatments. The new science of sex endocrinology defined homosexuality as an endocrine imbalance. In the 1930s, the laboratory tools developed to study sex hormones were applied to measure the “male” and “female” factor in homosexuals. Physicians tested urinary extracts of homosexual patients (mostly men) in their private practice or clinic. The vaginal smear test was applied to check for the presence of the “female element.” The “male factor” was assayed with the comb test. The results of these tests were subsequently compared with the urinary hormone excretion rates of male and female sex hormones by “normal men and women” (read heterosexuals). The “normal” excretion of male sex hormones in men was set at an average of 25-45 capon units, whereas female sex hormone excretion should not exceed the norm of 12-14 mouse units (Wright 1938:450). Homosexuality thus became expressed in terms of capon and mouse units.
With the use of these hormone assays the medical profession expected to distinguish “true congenital” homosexuals from “acquired” homosexuals. This idea is in accordance with the doctrine of nineteenth-century theoreticians that there existed two types of homosexuals: a hereditary or inborn form and an acquired or learned form. This doctrine assumed implicitly that the inborn homosexual could not be changed, whereas acquired homosexuality might be reversible (Money 1980:7). Consequently, one of the two types of homosexuals could be “cured.” Following the paradigm of sex endocrinology in which sex hormones were seen as the agents of masculinity and femininity, physicians expected that sex hormones could be used as specific drugs for the treatment of homosexuality. Soon after the first sex hormones were chemically identified and synthesized, homosexuals became increasingly treated with “sex appropriate” sex hormones to change their sexual orientation (Meyer-Bahlburg 1984:376).
The homosexuality test was applied not only for medical reasons. Part of the physicians’ practice consisted of court cases. Because homosexuality was considered a criminal act, the examination of the “true nature” of people suspected of homosexuality was of major importance (Wright 1938:449). Sex endocrinologists now claimed to possess a scientific test to measure the “biological markers” of homosexuality.
The tests originally developed for laboratory research thus came to be used as diagnostic tests for medical and legal purposes, intervening into the lives of homosexual men for several decades. In the 1930s and 1940s, there were numerous treatments of male homosexuals with male sex hormones in the USA. In The Netherlands the hormonal treatment of homosexuality seems to have been practiced on a rather small scale. Publications in the Nederlands Tijdschrift voor Geneeskunde (Dutch Journal for Medicine) in the period between 1919 and 1949 do not address the hormone theory of homosexuality and describe homosexuality solely in terms of disorders in the sex glands.10 In the archives of Organon the subject of homosexuality is addressed only twice. In 1934 Laqueur requested Organon to deliverMenformon (female sex hormone) free of charge to a general practitioner in order to investigate the effects of female sex hormones in a case involving female twins, one of whom was heterosexual and the other homosexual. Beyond a brief inquiry in 1935 following the results of this experiment, stating that Organon was very interested in this newly discovered area, the issue of hormone therapy in homosexuality was addressed only once more in 1936, when Laqueur inquired about medical literature on hormones and lesbianism. In its Pocket Lexicon for Organ and Hormone Therapy Organon included homosexuality as susceptible to hormonal therapy, but suggested that “for the tune being, homosexuality can not be affected with any certainty” (Anonymous 1937).