PhD in Sociology
Thesis defendef on 29 september 2019: The Obvious Sex. The Medical Management of and Knowledge about Intersex in France: the case of Congenital Adrenal Hyperplasia (1950-2018)
Under the supervision of Ilana Löwy
This dissertation traces the transformations of biomedical knowledge and practice on intersex in France. It studies the 20th century emergence and development of a new apparatus consisting in early medicalization of children with atypical sex. It specifically examines the example of the management the intersex variation Congenital Adrenal Hyperplasia (CAH). This normalizing apparatus was based on a paradigm shift instituted by a new protocol developed at the Johns Hopkins Hospital in the 1950s. This research analyzes the way this protocol was received and implemented in France. Examining the systematic medical management of “CAH girls” from this historical point of view reveals a process of medical knowledge production that creates several ideas that come to be self-evident: their unequivocal female sex and the presumed necessity of early medical interventions. These “obvious” ideas are supported by new biomedical techniques as well as by psychological theories on gender and sexuality. Drawing on archives of scientific publications and interviews with key actors in this medical process, this dissertation shows that the multiplication of knowledge and medical intervention technologies paradoxically produces forms of ignorance and resistance within the current French medical field to abandon this paradigm that has now long been criticized. By studying two areas of medical action and knowledge production (prenatal diagnosis and long term follow-up studies), this dissertation focuses on the way these obvious ideas about sex persist despite the uncertain and complex nature of this knowledge that intersexuality destabilizes. This phenomenon can be understood in light of the contemporary context where medicine enjoys social legitimacy and exclusive control over the subject and deploys a variety of mechanisms to reject alternative forms of expertise.