07 Sullivan 087533F 29/2/08 4:13 pm Page 105
The Role of Medicine in the
(Trans)Formation of  Wrong Bodies
NIKKI SULLIVAN
The trope of the wrong body is of interest to me not least because it is at once a
universalizing concept and one which functions variously in relation to different
modes of embodiment and different surgical procedures. But the wrong body, I
want to suggest, is always something more than simply a metaphor consciously
and strategically employed by those seeking access to  corrective surgeries of one
sort or another. The wrong body is  as transsexual narratives and the narratives
of self-demand amputees make clear   materialized as somatic feeling (Prosser,
1998a: 70). Starting from Merleau-Ponty s claim that  the body can symbolize
existence because the body realizes it and is its actuality (1962: 164), this article
aims to interrogate the discursive and phenomenological effects of the trope of
the  wrong body, as they are lived by those identifying as transsexual1 and those
who refer to themselves as self-demand amputees or wannabes.2
The initial motivation for writing this article was twofold: first, my interest
was aroused by the frequency with which an analogy between transsexualism
and self-demand amputation is posited, and yet never critically interrogated, in
the medical and popular literature on self-demand amputation; and, second, I was
concerned that while the trope of the wrong body has undoubtedly played an
enormously persuasive role in the demand for, access to, and justification of sex
Body & Society 2008 SAGE Publications (Los Angeles, London, New Delhi and Singapore),
©
Vol. 14(1): 105 116
DOI: 10.1177/1357034X07087533
www.sagepublications.com
07 Sullivan 087533F 29/2/08 4:13 pm Page 106
106 % Body & Society Vol. 14 No. 1
reassignment surgeries, it has, to date, proved ineffective for those seeking the
removal of so-called healthy limbs. Consequently, this article focuses on the
tensions raised by the construction of the relation between these particular modes
of embodiment and the desired surgeries with which they are associated as at
once analogous and asymmetrical. Through my interrogation of this seemingly
paradoxical situation I have come to the conclusion that while it may be perfectly
understandable for wannabes to draw on arguments that have proved successful
in other contexts and in relation to other contested surgeries, the conception of
the relation between self-demand amputation and transsexualism as analogous is
counter-productive for the following reasons: first, it misrecognizes the wrong
body as an abstract and universalizable concept that can be applied to a range
of decontextualized object-bodies alike, and, second, in conceiving of the wrong
body as merely a thing which is separate from, and at odds with, the self, such an
analogy not only fails to account for bodily specificity, but ultimately perpetuates
the phenomenological conditions, the sense of profound alienation, that requires
wrong body narratives in the first place.3
In making this claim I am by no means proposing that wannabes simply
abandon the trope of the wrong body since, as I said earlier, the wrong body is
never simply a rhetorical device consciously and intentionally adopted for strategic
purposes. Indeed, what wannabe narratives, like transsexual narratives, make clear
is that the very fabric of these (heterogeneous) modes of being-in-the-world, is
lived as fundamentally rent, that is, as both divided and costly. This is not to imply
that transsexualism and/or self-demand amputation are innate (pre-discursive)
states of fragmented being, nor is it to suggest that they are delusional psycho-
logical states which, while experienced as  real are actually produced in/as an
aberration from a normal or natural state of wholeness. Rather, as I will demon-
strate, the lived experience of these particular modes of bodily-being is consti-
tuted by their dwelling in a world of others, a world of discourses (in large part
medical) and perceptual practices thoroughly imbricated in the material, enfleshed,
if you like.4
Common to personal accounts of both transsexualism and self-demand ampu-
tation is the image of the self trapped in a body that is alien and alienating.  I am
a woman in the shell of a man. . . . I am marked by Nature as a male, but I have
the . . . heart and soul of a woman (letter from anonymous correspondent, cited
in Cauldwell, 1949: 7) is a refrain with which we are all familiar.5 Indeed, this
split between body and self, sex and gender, has come to personify the trans-
sexual condition and to be regarded as one of the primary criteria for sex re-
assignment.6 Self-demand amputees articulate their embodied existence in similar
ways. For example, in Melody Gilbert s tellingly entitled documentary, Whole,
07 Sullivan 087533F 29/2/08 4:13 pm Page 107
The Role of Medicine in the (Trans)Formation of  Wrong Bodies % 107
one wannabe says  My legs are extraneous. They shouldn t be there . . . it doesn t
feel right that they extend beyond where I feel my body should end. . . . Legs . . .
are not something that feel a part of me , while another, an auto-amputee named
Baz, says,  I have effectively cut my leg off. And I have therefore, to your way
of thinking, mutilated myself. But to my way of thinking, what I ve done is I ve
corrected the body that is wrong. 7
In keeping with dominant ontology, then, this narrativization of wrong embodi-
ment posits a distinction between mind and body, and presupposes a self which,
while  invisible and unquantifiable, is claimed as the authentic core of be-ing
(Wilton, 2000: 241).8 Moreover, as Prosser has noted, such narratives constitute the
body as im-proper, that is, as not the property of the subject, and conceive of
surgery as the means by which to overcome somatic non-ownership, to achieve
integrity. Clearly, in a cultural context in which the body is commonly under-
stood as the property of the subject who inhabits it, somatic non-ownership is
conceived (that is, understood and experienced) as improper and thus is literally
undesirable. Hence the surgical modification of the wrong body (as a somato-
morphic legitimation strategy) could be said to function as a citational practice,
in which the subject is configured as having alienable rights in the property of
their own body, with the concomitant right to act upon that property according
to their will. However  and this is something I ll return to in due course   the
exercise of property rights is dependent . . . upon the constitution of a  rational
subject (Silverman, 1987: 162) and this at once informs medical/surgical practice
and reiterates its normalizing tenets.
This model of the self and of self-(trans)formation is, of course, founded on
the shared cultural assumption that a sense of integrity is essential to human well-
being (Anzieu, 1989: 4),9 and this is apparent in the claim, articulated by Thomas
Pruzinsky, that  the goal of . . . treatment [for transsexualism] . . . is the reduction
of discrepancies between the patient s biological sex and their subjective self-
perception (1990: 177). The question this raises, of course, is what sort of treat-
ment would most effectively reduce the non-coincidence of sex and gender, of
body and self, and thereby bring about integrity. I want to suggest  while simul-
taneously acknowledging that this is no doubt an over-simplification  that
medical discourses (in the West over the last century or so) have produced two
dominant accounts of transsexualism  biological and psychological  and that
these have led to differing models of treatment (see also Meyerowitz, 2001). Let
me begin by briefly sketching the biological model. As Prosser (1998b: 6) notes,
the conceptualization of inversion in the work of sexologists such as Karl
Ulrichs, Magnus Hirschfeld and Havelock Ellis laid the necessary ground for the
emergence of transsexual subjectivity (rather than, as has been supposed, of
07 Sullivan 087533F 29/2/08 4:13 pm Page 108
108 % Body & Society Vol. 14 No. 1
 homosexuality ). Transsexualism, Prosser writes, as a  powerful medicodiscursive
sign . . . entered the cultural lexicon first as a form of extreme [body] transvestism
(1998a: 69).10 For example, in his mid-19th-century account of  man-manly love
Ulrichs described his own identity as  anima muliebris virile corpore inclusa (a
feminine soul confined in a masculine body) (cited in Prosser, 1998b: 119), thus
configuring what Foucault later described as  a kind of interior androgyny, a
hermaphroditism of the soul (1980: 43). It is a simple fact of nature, argued
Ulrichs, that some males are born with a strong feminine element or psyche, and
vice versa. In the early 20th century both Magnus Hirschfeld and Havelock Ellis
drew on this congenital non-coincidence of body and soul/self, sex and gender
(as some might now put it), to distinguish the cross-dresser from what Hirschfeld
referred to as the  psychic transsexual , that is, the  subject [who] so identifies
himself with those . . . physical and psychic traits which recall the opposite sex
that he feels he really belongs to that sex although [he] has no delusion regarding
his anatomical confirmation (Ellis, 1928: 36).
This model was challenged by Krafft-Ebing and later by psychologists  in
particular psychoanalysts  who explained transvestism (a term they used to refer
both to cross-dressing and to what we now call transsexualism) as  a disturbance
in the psychosexual mechanism, due to influences traceable in early life (Ellis,
1928: 16). To cut a very long and complex story short, these opposed explanations
continued right through the 20th century  albeit in many and varied manifesta-
tions  and formed the foundation of two very different, but equally problematic,
responses to the question of how best to overcome the somatic non-ownership,
the lack of integrity, experienced by those whose (sexed) bodies are felt to be at
odds with their (gendered) selves.
It was Harry Benjamin who, in the 1960s, first argued in a sustained and
convincing way that while,  for a reasonably normal man or woman it is almost
inconceivable that anyone should want to change sex (1966: 3), surgery is the
only available means by which to  correct nature s anatomical  error  11 (1953:
12). Benjamin s contemporary, David O. Cauldwell, on the other hand, argued
that:  Males do not inherit genes which cause them to desire to become
females. . . . [Rather,] [p]eople who develop these patterns of behaviour (or
personality) are environmentally influenced to do so (1951: 21). The  sex trans-
mutationist , Cauldwell wrote,  is a sick person and  the destruction of any
healthy organ of the body [is] an act which either borders on criminality or is
criminal (1951: 20). In other words, Cauldwell s position was that  abnormal
minds should be treated in order to conform them with the normal body and not
vice versa (Allen, cited in King, 1996: 92).12 Despite the fact that, even now,
psychiatrists such as Paul McHugh take the Cauldwellian position, arguing that
07 Sullivan 087533F 29/2/08 4:13 pm Page 109
The Role of Medicine in the (Trans)Formation of  Wrong Bodies % 109
in  preparing [transsexuals] for surgery and for a life in the other sex . . . psychi-
atrists have collaborat[ed] with madness rather than trying to study, cure, and
ultimately prevent it (2004), sex reassignment surgery has become a common,
and largely accepted, medical practice. As Kessler and McKenna put it almost
three decades ago,  [g]enitals have turned out to be easier to change than gender
identity . . . [w]hat we have witnessed in the last 10 years is the triumph of the
surgeons over the psychotherapists in the race to restore gender to an unambigu-
ous reality (1978: 120).
In order to try to explain in a little more detail why it might be that the surgical
solution to transsexualism has taken precedence over the kinds of solutions
proposed by its opponents, I want to consider two connected factors which, I
contend, have played a central role in the development, justification and practice
of procedures associated with sex reassignment. The aim of this discussion is to
show how the discursive history of transsexualism and the modificatory practices
associated with it produce the effect of rendering them intelligible in a way that
self-demand amputation currently is not (because its discursive history is not
analogous).
As a number of transgender theorists have noted, castration and hormone
treatment were originally employed  not with a view to changing . . . sex, but in
order to treat homosexuality (King, 1996: 92). In fact it was the provisions of the
Danish Sterilization and Castration Act of 1935 which allowed castration in cases
where a person s sexuality made him likely to commit crimes (see Bullough and
Bullough, 1998: 16), that provided the necessary legal permission for Christian
Hamburger and his team to castrate Christine Jorgensen, an ex-GI whom they
originally diagnosed as homosexual.13 Even in some of the early gender identity
programmes in the USA  homosexual orientation was a requirement for SRS
[sexual reassignment surgery] (Bullough and Bullough, 1998: 21) which, it was
supposed, would make MTF (male to female) transsexuals heterosexual (see
Bentler, 1976; Freund et al., 1982).14 I am not suggesting here that this was the
only motivation for the development and practice of procedures associated with
sex reassignment. Nor do I want to overlook the fact that some medical prac-
titioners strategically used existing laws in order to attain ends other than those
envisaged by lawmakers. However, I would argue that there is little doubt that
conservative motivations/justifications such as these rendered sex reassignment
procedures palatable to the mainstream. Indeed, that the justification for sex
reassignment surgery has rested, in large part, on its demonstrated ability to
(re)produce  healthy bodies  that is, selves whose compatibility with the social
body is increased15  is frequently made clear to me by undergraduate students,
many of whom have expressed the opinion that while transsexualism is an
07 Sullivan 087533F 29/2/08 4:13 pm Page 110
110 % Body & Society Vol. 14 No. 1
unfortunate aberration and sex reassignment surgery (as a corrective procedure
that enables the transition from one sex to another) is acceptable, transgenderism
(or the modification of bodies in ways that do not render them either male or
female) is a kind of madness we cannot really afford to condone. My point, then,
is that the acceptance of sex reassignment surgeries is not necessarily founded on
some sort of commitment to difference, nor on the liberal principle that we
should, as James J. Hughes argues,  respect the transsexual subject s right to
morphological self-determination (2006: 11) since to do otherwise would be to
interfere with the his/her original autonomy.
The second (connected) factor I want to briefly mention is the emergence in
the late 1960s of a theory  which went on to gain massive currency, in particular
amongst feminists  of sex and gender as distinct. In his 1968 publication Sex and
Gender, psychoanalyst Robert Stoller put an interesting twist on the centuries-
old hierarchical distinction between mind and body, arguing that psychological
influences on gender can (and in the case of transsexuals, do) completely override
the biological fact of a person s sex (Gatens, 1996: 6). This legacy is central to the
commonly held assumption, articulated by contemporary psychologists Schaefer
and Wheeler, that  it is not genitals that make a MFTS [male to female trans-
sexual] but the feelings of wanting to be a woman . Transsexualism, they write,
 is much less an issue of sex than it is of gender (Schaefer and Wheeler, cited in
Rachlin, 1999: 3). While the sex/gender distinction, in many senses, may have
served transsexuals well, it has nevertheless done so at a cost. As the work of
writers such as Sandy Stone has made clear, such a distinction has led to the
demand for transsexuals to prove that their gender  outweighs their sex: those
seeking surgery have been required to express the  wrong body in the right way ,
that is, to articulate a  wrong body and a right mind (Jordan, 2004: 339). Further,
insofar as the sex/gender distinction constitutes the body as neutral and passive
with regard to the formation of consciousness, it reproduces a rationalist agenda
(Gatens, 1996: 7) in which the specificity of bodily being, the  identity of one s
difference (Diprose, 1994: 110) is, in effect, erased. Ultimately, then, this model
perpetuates the alienation that is so profoundly experienced by (and is constitu-
tive of) pre-transition transsexual embodiment. I will return to these concerns in
due course, but for the moment I want to consider another possible reason why
the trope of the wrong body, which has  become the crux of an authenticating
transsexual rhetoric (Prosser, 1998a: 68)  and, as such, has played an integral role
in access to, and justification of, sex reassignment procedures  has not enabled
those seeking the removal of healthy limbs to acquire access to surgery.
As I ve said, in their articulation of their subjective experience and of their
need for surgery, transsexuals (along with second-wave sexologists) have drawn
07 Sullivan 087533F 29/2/08 4:13 pm Page 111
The Role of Medicine in the (Trans)Formation of  Wrong Bodies % 111
on long-standing ideas about incongruities between female souls and male bodies
(and vice versa), between, in Stoller s scheme of things, gender and sex, as well as
on the culturally shared belief in the importance of integrity as both a necessary
characteristic of selfhood and a kind of moral soundness.16 While wannabes have
deployed a similar logic, they have had difficulty arguing  or at least persuading
others  that a full-limbed body is im-proper and that amputation will produce
the integrity they lack. And in failing to demonstrate that their bodies are
 wrong , they have also failed to convince members of the medical profession,
who have the power to decide whether surgery should be performed, that their
minds are  right .17 This dilemma, which, as John Jordan notes, stems from the
fact that such a claim  contradicts every tenet of cultural body logic (2004: 341),
can be explained by turning to a statement made by psychiatrist, Richard L.
Bruno. Bruno writes,  The notion that a wannabe is a  disabled person trapped in
a non-disabled body is difficult to justify, there being no  naturally-occurring
state of disability that would correspond to the two naturally-occurring genders
(cited in Jordan, 2004: 347). There is much that could be said about this state-
ment, but what interests me most is, first, the conflation of the removal of a limb,
or limbs, or parts thereof, with  disability , and thus with the loss of integrity.
And, second, the assumption that bodies are naturally fully abled, and that there-
fore  disability (which, unlike sex, is not naturally occurring), is inauthentic, and
thus by definition, literally undesirable. In and through this series of conflations,
then, the desire of the self-demand amputee is constituted as anathema, and his
or her difference is perceived as evidence of his/her rational and moral deficiency.
Consequently, the exercise of property rights, which, as I said earlier,  is depen-
dent . . . upon the constitution of a  rational subject (Silverman, 1987: 162), is
denied the self-demand amputee (whose body is not wrong  at least not in the
eyes of others  and whose mind, by association, cannot be right). Perhaps what
is most troubling about this is that the barring of the self-demand amputee from
the position of rational subject and thus from access to what s/he imagines as the
 surgical transition from alienation to integration or integrity (Prosser, 1998a: 80),
is justified in accordance with the same logic that, as I have shown, constitutes the
desire for and practice of sex reassignment surgeries as comprehensible, rational,
and therefore justifiable.
One possible response to the perception of self-demand amputation as onto-
logically opposed to integrity as the common good, and as therefore socially
unviable, would be to develop a critique of  disability as a visibly self-evident
 state of corporeal inferiority (Garland-Thomson, 2002: 4 5). Elsewhere, I have
argued that  disability is in fact, a  pervasive and often unarticulated epistemic
structuring device (Sullivan, 2005), an ontology which is tied inexorably to tacit
07 Sullivan 087533F 29/2/08 4:13 pm Page 112
112 % Body & Society Vol. 14 No. 1
notions of normalcy, and as such (in)forms everybody (Davis, 1995: 2). In other
words,  disability , like  normalcy , is less a visibly self-evident state than the
product of a specific form of perceptual practice. And, as Linda Martín Alcoff has
convincingly argued, despite the fact that  perception is . . . [commonly] defined
as access to truth (Merleau-Ponty, cited in Alcoff, 2001: 275),  perception repre-
sents sedimented contextual knowledges (2001: 272) or tacit body-knowledges; it
is always already imbued with historically and culturally contingent values,
idea(l)s and practices, to which the subject has tacitly consented in and through
his or her very becoming.18 The tacit body-knowledges that structure perception,
then, function, as Alcoff notes, at the level of citation, and therefore are  almost
hidden from view, and thus almost immune from critical reflection (2001: 275).
Given this, one of the aims of this article, and of my work more generally, is to
make explicit the perceptual practices involved in the construction and regulation
of (im)proper bodies, and in doing so, to strive to create and transform the lived
meanings of the materialities with which we are here concerned.
This disjunction in popular and medical responses to different modes of
 wrong embodiment , which can be explained, in part, by the association of
amputation with  disability and the concomitant assumption that  wrongness is
visibly self-evident, also makes clear the fact that the dominant notion of the
wrong body has become thoroughly imbricated in the constitution of  wrong
embodiment , rather than simply providing a description of it, and/or a strategic
tool with which to overcome it. And while it may, in some cases, produce
 positive results, it nevertheless functions to pathologize difference, reaffirm the
mind/body split, idealize integrity, universalize and decontextualize  wrongness ,
and thus ultimately fails to account for  the operations of systems and institutions
that simultaneously produce various possibilities of viable personhood and elim-
inate others (Stryker, 2006: 3). Given this, I now want to turn briefly to Merleau-
Ponty s understanding of the lived body as the fabric of the self,  the place of
one s engagement in the social and material world (Merleau-Ponty, cited in
Diprose, 1994: 104) in order to try to reconceive the (no doubt heterogeneous)
matter of  wrong embodiment .
According to Merleau-Ponty:
. . . the life of desire or perceptual life  is subtended by an  intentional arc [or corporeal
schema] which projects around about us our past, our future, our human setting, our physical,
ideological, and moral situation, or rather which results in our being situated in all these
respects. (1962: 136)
Here, the lived body is what I am, the matter or materialization of my-being-in-
the-world of others, my dwelling, rather than a biological object that is somehow
separate from the I (located in consciousness) and which the I owns and has
07 Sullivan 087533F 29/2/08 4:13 pm Page 113
The Role of Medicine in the (Trans)Formation of  Wrong Bodies % 113
property rights over. Merleau-Ponty s suggestion that in certain situations the
corporeal schema  goes limp (1962: 136), that there is a breakdown in the struc-
ture of the self such that the body becomes an object for consciousness, is useful
because it provides an alternative way to reconfigure  wrong embodiment as
situated and heterogeneous. In this state of  having rather than  being a body 
and this state is an effect of the enfleshment of the body as thought s other   one
is alienated from the world, from others and from the self. . . . [One] is alone with
the body which is a stranger (Diprose, 1994: 108). The experience of alienation,
then, is understood on this phenomenological model, not in terms of the loss of
ownership over one s body, but rather as the reduction of the lived body to a thing,
an object separate from the self (1994: 110). This being the case, both surgical and
therapeutic attempts to fix the im-proper body through the exertion of the self s
rights over it, as property, bear a cost, and that cost is, ironically, the perpetuation
of the  alienation inherent in the collapse of the lived body (1994: 110).19
Following Merleau-Ponty s claim that  the lived body is neither exclusively a
subject nor an object but both (1962: 167), I want to suggest that, rather than
being analogous (which, as I noted earlier, is how the relation between trans-
sexualism and self-demand amputation is commonly conceived in both medical
and popular accounts of the latter), what modes of pre-transition transsexual
embodiment might share with the pre-transition embodied experiences of self-
demand amputees is not the prison of an im-proper body-as-object, but the fact
that these particular modes of bodily being are currently narrativized such that
the necessarily ambiguous relation of subject and object, self and others, the lived
body as the fabric of the self, is enfleshed as rent. In an interestingly circular logic,
rent is, of course, the price one pays for inhabiting a property one does not own.
However, at the same time, enfleshment as rent, the gap not sutured  at least
never completely  by narrative, is the means by which new figures may take
shape.20 Perhaps, then, the challenge lies less in finding ways either to overcome
this contradiction or naively celebrate it, and more in developing detailed critical
ontologies of ourselves as necessarily intercorporeal beings shaped by our situ-
atedness. A critical ontology, as Foucault reminds us, is not:
. . . a doctrine, nor even . . . a permanent body of knowledge that is accumulating; it has to be
conceived as an attitude, an ethos, a philosophical life in which the critique of what we are is
at one and the same time the historical analysis of the limits that are imposed on us and an
experiment with the possibility of going beyond them. (1991: 50)
Notes
1. My use of the term transsexual in this article refers specifically to those people who desire
surgery. In employing the term in this way I do not mean to deny the existence of trans-people who
07 Sullivan 087533F 29/2/08 4:13 pm Page 114
114 % Body & Society Vol. 14 No. 1
do not desire surgery, nor do I mean to give precedence to MTFs (male to female) over FTMs (female
to male). I am aware that for many FTMs hormone therapy is preferable to SRS/GRS (sex/gender reas-
signment surgery). For further discussion of this issue see Rachlin (1999).
2. As I have argued elsewhere, any attempt to define the self-demand amputee will necessarily be
a difficult one. However, in this article I use the term to refer to those who identify themselves in this
way. For further discussion of this issue see Sullivan (2005).
3. I am grateful to A. Rez Pullen for pointing out that, despite its problematic effects, the wrong
body narrative associated with transsexualism has enabled wannabes to articulate their embodied
experiences in ways that are culturally intelligible. As a result, their experience of suffering and their
desire for surgical modification is, on one level at least, re-cognizable.
4. See Butler who writes:  every effort to refer to materiality takes place through a signifying
process which, in its phenomenality, is always already material (1993: 68).
5. This is by no means a contemporary narrative: we find in Krafft-Ebing s Psychopathia Sexualis,
for example, the case of a Hungarian doctor who allegedly reported,  I feel like a woman in a man s
form. . . . I am sure that I should not have shrunk from the castration knife, could I thus have attained
my desire (cited in Prosser, 1998b: 124).
6. Harry Benjamin s work  in particular his landmark text The Transsexual Phenomenon (1966)
which, as Sandy Stone has argued, functioned as a sort of training manual for those hoping to present
as suitable candidates for SRS  has played a significant role in this.
7. The experience of a disjunction between self and body is not, of course, unique to trans-people
and self-demand amputees (nor even necessarily common to all trans-folk and/or amputees). Rather,
while ideas about wrong bodies also abound in accounts by applicants seeking other forms of modi-
ficatory surgery  for example, the woman who argued that her emotional health was threatened by
the fact that she  look[s] like someone who is always pigging out on cake, but [she isn t] (cited in
Jordan, 2004: 340)  it could be argued that it is an experience shared by most people, to varying
degrees, and in specific circumstances. However, I would suggest that, for most people, the experience
of a split between body and self lacks the continued intensity that motivates self-demand amputees
and transsexuals to seek radical forms of surgical intervention.
8. I also think that transsexual narratives, like the narratives of self-demand amputees, could be said
to exceed this logic, but that this excess is continually denied and/or recuperated into a liberal ontology.
9. For a critique of the ideal of integrity see Perpich (2005).
10. Moreover,  the category of sexual inversion allowed the transsexual to emerge as a sex-change-
able subject (Prosser, 1998b: 118).
11. This notion of an anatomical error is reminiscent of Ellis s  Miss D (case XXXIX), who, in her
extensive narrative about the  hiatus between her  bodily structure and [her] feelings , writes:  I
regarded the conformation of my body as a mysterious accident (1998 [1915]: 91 3). Importantly, the
existence of such early narratives problematizes the conception of a one-way relation of cause and
effect between medicine and transsexualism.
12. Similarly, Merloo (1967) argued that physicians who participate in the SRS process are collab-
orating with their patient s psychosis. For a fuller account of such criticisms see Meyerowitz (2002:
84 5).
13. For a rigorous account of the Jorgensen case and the medical and popular cultural discourses
surrounding and informing it, see Meyerowitz (2002).
14. Rather than seeing this as an enlightened or altruistic move on the part of the medical
profession, it is possible to read it as a sort of eugenicist  breeding-out of  wrong bodies/sexualities.
15. This is not to suggest that SRS is simply a normalizing practice. As Susan Stryker (1994) has
made clear, the heterogeneous effects of such procedures are always in excess of their intent.
16. As Gatens notes, integrity and morality are etymologically linked (1996: 41).
17. For an interesting account of the medical profession s inability to conceive of (and thus allow
or enable) more complex forms of corporeal variance, see Spade (2006).
18. For further elaboration of this claim, see Sullivan (2005).
07 Sullivan 087533F 29/2/08 4:13 pm Page 115
The Role of Medicine in the (Trans)Formation of  Wrong Bodies % 115
19. However, I do not want to simply argue that the causal relation between consciousness and
body lauded by liberalism is a secondary, deficient mode of being-in-the world. This would, by impli-
cation, lead to a call for the restoration of a prelapsarian unitary identity, a  common good that can
only be secured at the cost of the denigration of difference.
20. I am grateful to Susan Stryker who, in her comments on an earlier version of this article, articu-
lated the notion of rent as at once a cost and an opening.
References
Alcoff, L.M. (2001)  Toward a Phenomenology of Racial Embodiment , pp. 267 83 in R. Bernasconi
(ed.) Race. Oxford: Blackwell.
Anzieu, D. (1989) The Skin Ego: A Psychoanalytic Approach to the Self. New Haven, CT: Yale
University Press.
Benjamin, H. (1953)  Transvestism and Transsexualism , International Journal of Sexology 7: 12 14.
Benjamin, H. (1966) The Transsexual Phenomenon. New York: Julian.
Bentler, P.M. (1976)  A Typology of Transsexualism: Gender Identity Theory and Data , Archives of
Sexual Behavior 5(6): 567 84.
Bullough, B. and V.L. Bullough (1998)  Transsexualism: Historical Perspectives, 1952 to Present ,
pp. 18 30 in D. Denny (ed.) Current Concepts in Transgender Identity. New York: Garland
Publishing.
Butler, J. (1993) Bodies that Matter: On the Discursive Limits of  Sex . New York: Routledge.
Cauldwell, D.O. (1949) What s Wrong With Transvestism? Girard, KS: Haldeman-Julius Publications.
Cauldwell, D.O. (1951) Sex Transmutations  Can One s Sex Be Changed? Girard, KS: Haldeman-
Julius Publications.
Davis, L.J. (1995) Enforcing Normalcy: Disability, Deafness, and the Body. London: Verso.
Diprose, R. (1994) The Bodies of Women: Ethics, Embodiment and Sexual Difference. London: Routledge.
Ellis, H. (1998/1915)  Extract from Studies in the Psychology of Sex, vol. II: Sexual Inversion , pp. 91 7
in L. Bland and L. Doan (eds) Sexology Uncensored: The Documents of Sexual Science. Cambridge:
Polity.
Ellis, H. (1928) Studies in the Psychology of Sex, vol. 7. Philadelphia, PA: F.A. Davies.
Foucault, M. (1980) The History of Sexuality, vol. 1: An Introduction, trans. R. Hurley. New York:
Vintage.
Foucault, M. (1991)  What is Enlightenment? , pp. 32 50 in P. Rabinow (ed.) The Foucault Reader.
Harmondsworth: Penguin.
Freund, K., B. Steiner and S. Chan (1982)  Two Types of Cross-gender Identity , Archives of Sexual
Behavior 11: 49 63.
Furth, G. and R. Smith (2002) Amputee Identity Disorder: Information, Questions, Answers, and
Recommendations about Self-demand Amputation. Bloomington, IN: 1st Books.
Garland-Thomson, R. (2002)  Integrating Disability, Transforming Feminist Theory , National Women s
Studies Association Journal 1(3): 1 32.
Gatens, M. (1996)  A Critique of the Sex/Gender Distinction , in Imaginary Bodies: Ethics, Power and
Corporeality. New York: Routledge.
Hirschfeld, M. (1991/1910) Transvestites: The Erotic Drive to Cross Dress, trans. M.A. Lombardi-
Nash. Buffalo, NY: Prometheus Books.
Hughes, J. (2006)  Beyond the Medical Model of Gender Dysphoria to Morphological Self-
determination , Lahey Clinic Medical Ethics 13(3): 10 11.
Jordan, J.W. (2004)  The Rhetorical Limits of the  Plastic Body  , Quarterly Journal of Speech 90(3):
327 58.
Kessler, S.J. and W. McKenna (1978) Gender: An Ethnomethodological Approach. New York: John
Wiley.
07 Sullivan 087533F 29/2/08 4:13 pm Page 116
116 % Body & Society Vol. 14 No. 1
King, D. (1996)  Gender Blending: Medical Perspectives and Technology , pp. 79 98 in R. Ekins and
D. King (eds) Blending Genders: Social Aspects of Cross-dressing and Sex-changing. London:
Routledge.
Leder, D. (1990) The Absent Body. Chicago, IL: University of Chicago Press.
McHugh, P. (2004)  Surgical Sex , First Things: Journal of Religion, Culture and Public Life 147, URL
(consulted November 2007): www.firstthings.com/article.php3?id_article=398
Merleau-Ponty, M. (1962) Phenomenology of Perception, trans. C. Smith. London: Routledge and
Kegan Paul.
Merloo, J.A.M. (1967)  Change of Sex and Collaboration with Psychosis , letter to the editor,
American Journal of Psychiatry 124(2): 263 4.
Meyerowitz, J. (2001)  Sex Research at the Borders of Gender: Transvestites, Transsexuals, and Alfred
C. Kinsey , Bulletin of the History of Medicine 75(1): 72 90.
Meyerowitz, J. (2002) How Sex Changed: A History of Transsexuality in the United States. Cambridge,
MA: Harvard University Press.
Perpich, D. (2005)  Corpus Meum: Disintegrating Bodies and the Ideal of Integrity , Hypatia 20(3):
75 91.
Prosser, J. (1998a) Second Skins: The Body Narratives of Transsexuality. New York: Columbia
University Press.
Prosser, J. (1998b)  Transsexuals and the Transsexologists: Inversion and the Emergence of Transsexual
Subjectivity , pp. 116 31 in L. Bland and L. Doan (eds) Sexology in Culture: Labelling Bodies and
Desires. Cambridge: Polity Press.
Pruzinsky, T. (1990)  Psychopathology of Body Experience: Expanded Perspectives , pp. 170 89 in
T.F. Cash and T. Pruzinsky (eds) Body Images: Development, Deviance, and Change. New York:
The Guilford Press.
Rachlin, K. (1999)  Factors which Influence Individual s Decisions when Considering Female-to-Male
Genital Reconstruction Surgery , International Journal of Transgenderism 3(3), URL (consulted
September 2005): www.symposion.com/ijt/ijt990302.htm
Silverman, D. (1987) Communication and Medical Practice: Social Relations in the Clinic. London:
Sage.
Spade, D. (2006)  Mutilating Gender , pp. 315 32 in S. Stryker and S. Whittle (eds) The Transgender
Studies Reader. New York: Routledge.
Stone, S. (1991)  The Empire Strikes Back: A Posttranssexual Manifesto , pp. 248 79 in J. Epstein and
K. Straub (eds) Body Guards: The Cultural Politics of Gender Ambiguity. New York: Routledge.
Stryker, S. (2006)  (De)Subjugated Knowledges: An Introduction to Transgender Studies , pp. 1 17 in
S. Stryker and S. Whittle (eds) The Transgender Studies Reader. New York: Routledge.
Stryker, S. (1994)  My Words to Victor Frankenstein above the Village of Chamounix , GLQ: Journal
of Gay and Lesbian Studies 1: 237 54.
Sullivan, N. (2005)  Integrity, Mayhem, and the Question of Self-demand Amputation , Continuum:
Journal of Media and Cultural Studies 19(3): 325 33.
Ulrichs, K.H. (1994) The Riddle of  Man-Manly Love, trans. M.A. Lombardi-Nash. New York:
Prometheus Books.
Wilton, T. (2000)  Out/Performing Our Selves: Sex, Gender and Cartesian Dualism , Sexualities 3(2):
237 54.
Nikki Sullivan is associate professor of critical and cultural studies at Macquarie University. She is
also the director of the newly established Somatechnics Research Centre. She is the author of A
Critical Introduction to Queer Theory (Edinburgh University Press, 2003) and Tattooed Bodies:
Subjectivity, Textuality, Ethics and Pleasure (Praeger, 2001), as well as numerous articles on body
modification and sexuality published in various international journals.