Medicine: Abnormalities

The offspring of the Greek gods Hermes and Aphrodite was bi-sexual Hermaphrodites. The Egyptian moon deity, too, was hermaphroditic, and one Biblical commentator declares: “When the Holy One . . . created the first man, he created him a hermaphrodite.” In spite of the antiquity of man’s interest in the subject, until last week there was still a place for an exhaustive clinical study of hermaphroditism and what to do about it surgically, which has now been filled by Dr. Hugh Hampton Young’s Genital Abnormalities, Hermaphroditism and Related Adrenal Diseases (Williams & Wilkins; $10).

Causes. Dr. Young, a professor at Johns Hopkins, who is the dean of American urologists, knows of only 20 indisputable cases of true hermaphroditism, patients who had within themselves both ovaries and testes—sole and essential criteria of femininity or masculinity. All others whom he has seen in his 40 years as urological surgeon, or has read about, have been pseudo-hermaphrodites. These exhibit a most amazing variety of genital abnormalities. But on the testimony of their sex glands, no matter how rudimentary those glands might be. Dr. Young classifies them as male or female. Statistics, he notes, “indicate that pseudohermaphroditism occurs once in 1,000 persons.”

How these usually unhappy creatures happen to develop is beyond biology’s present knowledge. Dr. Young guesses: “Fundamentally these disturbances of development must rest on the original chromosome formula” in the fertilized ovum which turns into a hermaphroditic baby. The embryo through the sixth to seventh week shows no differentiation into male or female. Thereafter, in the normal course of gestation, the primitive gonad becomes male or female, and the rest of the genital apparatus follows suit. But, in an astonishingly frequent number of gestations, something occurs to interfere with the development of the accessory male or female apparatus. The only thing a doctor can do about the matter is—in embarrassing cases—to operate. Dr. Young, who has tried, finds hormone treatment of little avail at present for true or pseudo-hermaphrodites.

Cases. In his treatise on genital abnormalities Dr. Young gives the medical histories of 55 cases, and the plastic surgical operations which he performed on as many of them as he could to make them at least look like normal men or women. One hermaphrodite, who passed as a Negress, told him: “I have derived great pleasure from, many sexual affairs with women, and never with my two husbands.” Dr. Young assured her-him that it would be easy to make her into a man, but only at the cost of her female configuration. The hermaphrodite: “If you did that, I would have to quit my husband and go to work. So I think I’ll stay as I am.”

Dr. Young, with the aid of his brother-in-law, Dr. John Archibald Campbell Colston, transformed one pseudohermaphrodite by grafting a pair of testicles taken from a healthy 18-year-old Maryland convict a few minutes after he was hanged. The cure lasted for three years, when the patient lost his self-confidence, regained his effeminate obesity, disappeared.

Another hermaphrodite refused decisive plastic surgery because he made a living by self-exhibition in a circus.