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How the Clinic Made Gender

The Medical History of a Transformative Idea

An eye-opening exploration of the medical origins of gender in modern US history. 

Today, a world without “gender” is hard to imagine. Gender is at the center of contentious political and social debates, shapes policy decisions, and informs our everyday lives. Its formulation, however, is lesser known: Gender was first used in clinical practice. This book tells the story of the invention of gender in American medicine, detailing how it was shaped by mid-twentieth-century American notions of culture, personality, and social engineering. 

Sandra Eder shows how the concept of gender transformed from a pragmatic tool in the sex assignment of children with intersex traits in the 1950s to an essential category in clinics for transgender individuals in the 1960s. Following gender outside the clinic, she reconstructs the variable ways feminists integrated gender into their theories and practices in the 1970s. The process by which ideas about gender became medicalized, enforced, and popularized was messy, and the route by which gender came to be understood and applied through the treatment of patients with intersex traits was fraught and contested. In historicizing the emergence of the sex/gender binary, Eder reveals the role of medical practice in developing a transformative idea and the interdependence between practice and wider social norms that inform the attitudes of physicians and researchers. She shows that ideas like gender can take on a life of their own and may be used to question the normative perceptions they were based on. Illuminating and deeply researched, the book closes a notable gap in the history of gender and will inspire current debates on the relationship between social norms and medical practice. 


“Eder’s remarkable medical history of gender in the clinic is a timely, sensitive account of how physicians, patients, psychologists, therapists, feminists, and trans activists created a world in which medical alterations of sex could become routine and standards of care were defined and contested. Eder moves skillfully between the medical, scientific, and social sides of this story, deftly showing how sexual stereotypes were perpetuated by the very practitioners that argued gender was something learned, not dictated by biology. Those familiar with either the biomedical background or with the importance of gender to feminist interpretations will find this book illuminating. For those not familiar, or for those wishing to teach this subject, Eder’s book is an outstanding guide to an important history.”

Angela N. H. Creager, Princeton University | FASEB Journal

“A welcome and powerful contribution to histories of gender. Eder, a historian at the University of California, Berkeley, joins other scholars, particularly Joanne Meyerowitz, in telling her ‘uneasy origin story’ of how the ideas of gender and ‘gender role’ emerged and were put into medical practice in the mid-20th century. . . . Eder shines in her methodological deployment of patient case records from the Pediatric Endocrinology Clinic to reconstruct life stories. . . . These stories of patients’ resistance are a pivotal contribution to Eder’s important and sweeping, decades-long account of gender’s medical and political invention and reinvention.”

Social History of Medicine

“Using an impressive array of patient records, interviews, and primary and secondary sources, Eder presents a complex and finely nuanced account of changing sociomedical understandings of the most humane methods of dealing with congenital adrenal hyperplasia and similar conditions. . . . Highly recommended.” 


"The most comprehensive account of the emergence of the concept of 'gender' as well as the most comprehensive treatment I have seen of the various ways in which intersex patients were diagnosed and treated in the twentieth century. I can imagine How the Clinic Made Gender becoming a field-defining book in that it successfully and convincingly charts the clinical emergence of the concept of gender. This is a signature contribution and will be an eye-opening read even for specialists."

Kimberly A. Hamlin, author of Free Thinker

"A stunningly original book. Eder shows that the concept of gender was originally mobilized not in the feminist debates of the 1970s and ’80s but decades earlier by social scientists and clinicians in their engagement with intersex children at the Johns Hopkins Hospital. For the first time, we hear the stories of the children and their parents through Eder's extensive quotations from personal medical records."

Thomas W. Laqueur, author of Making Sex

"This is an important book that richly historicizes the emergence of the construct of ‘gender’ from practices of intersex case management in the mid-twentieth century."

Sarah S. Richardson, author of Sex Itself

Table of Contents

Chapter 1: Sex before Gender: From Determining True Sex to Finding the Better Sex
Robert: Hope
Chapter 2: Happy and Well Adjusted: The Psychologization of Sex in the 1930s and 1940s
Karen: Coming of Age
Chapter 3: Culture, Gender, and Personality
Chapter 4: Making Boys and Girls: Gender at Johns Hopkins
Chapter 5: Gender in the Clinic: The Process of Normalization
Chapter 6: The Circulations of Gender, Cortisone, and Intersex Case Management
Janet: Despair
Chapter 7: The Life of Gender: Reformulations and Adaptations


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