Albucasis (d. 1031) on sex-changing surgery
On surgery and instruments, book 2, ch. 70: On the treatment of the hermaphrodite.
There are two kinds of male hermaphrodite: one had the appearence as of female pudenda with hair in the region of the perineum; the other has the same in the skin of the scrotum between the testes. Sometimes also urine is excreted through that which is in the skin of the scrotum. There is also one kind among women, in which there is, above the female pudenda, on the pubes, what resembles the male organs. These are small indeed, but protuberant, one being like the penis and the two others like testicles. This is the treatment of all three kinds, that, is, two male and one female: the superfluous growths must be cut away so that every trace is destroyed; then the ususal treatment for wounds should be applied until they are healed. As to the second kind, in man, where the opening is in the scrotum and the urine runs out of it, there is no operation for this, and no cure.
[Spink/Lewis 1973, 454-455]
Not unlike Avicenna, thus, Albucasis asserts that hermaphrodites can be ‘treated’, suggesting that the phenomena he describes are in some way pathologic. At the same time, and much more clearly so than with Avicenna, it is clear that the ‘double’ genitalia in Albucasis’ view are not really double but ‘excessive’. This is close to Aristotle, who was also very sceptical concerning ‘double-sexed’ beings (human or animals) and talked about what he regarded as apparent rather than real double sex as ‘excess’ (see here). Consequently, Albucasis states that the ‘excessive’ parts may be cut off. Note that the English (and Latin) term is a translation – we should not forget that Albucasis was thinking and writing in a different language, and could not possible have known which overtones the terms used in later translations of his works had (see Ashraf Hassan on the semantics of unṯā in Arabic – or, for the time being, the abstract to this paper). From the Western perspective, however, it may be argued that where Albucasis and related text were known, the idea of ‘treating’ those who were labelled ‘hermaphrodites’ became at least conceivable – and the report of the Colmar Annals becomes more credible to the modern historian:
A woman-turned-man. [AD] 1300. In a village near Bern, a woman lived together with her husband for ten years. As she could not be [carnally] known, the ecclesiastical court separates her from her husband. On her way to Rome, a surgeon at Bologna cut open her vulva, and a penis together with testicles appeared. Back home, he took a wife, did rural work, and had legitimate and sufficient intercourse with his wife.
[My own translation; see here for the Latin text]
It may be hard for the modern reader to imagine sex-changing surgery in medieval times; but the combination of narrative sources and learned medicine does suggest that such operations were conceivable – and were indeed performed. The Arabo-Greek traditions that informed surgical pracice are not very wel studied (hidden away by an alleged one sex-model) but certainly deserve further study if we want to understand how Western medicine established regimes to ‘treat’ double-sexed humans.
Edition and translation: Albucasis on surgery and instruments: a definite edition of the Arabic text with English translation and commentary by Martin S. Spink and Geoffrey L. Lewis, Berkeley and Los Angeles 1973.
Latin translation: Chirurgia Argelate cum Albucasi […], Venedig 1520. [https://books.google.de/books?id=AaC5pMo5fVcC]
Literature: Monica Green, Moving from Philology to Social History: The Circulation and Uses of Albucasis’s Latin Surgery in the Middle Ages, in: Between text and patient: the medical enterprise in Medieval and Early Modern Europe, hg. von Florence Eliza Glaze und Brian Nance (Micrologus’ Library 37), Florenz 2011, 331–372 [www.academia.edu].
For a pdf version, see here: https://www.academia.edu/20151957/Albucasis_d._1031_on_sex-changing_surgery.