In a medical review article published in 1886, doctors dispute the genitalia of a patient, based purely on whether she is capable of having penetrative vaginal sex with her husband.

Case studies of ambiguous genitalia proliferate widely in medical literature and journals beginning in the late 1800s. Elizabeth Reis (2021) writes that: “Ever since the early 19th century, when doctors began to professionalize and publish their cases in medical journals, we can trace not only their cruelly judgmental descriptors of these conditions and people, but the damaging therapeutic treatment they have dispensed as well.”

One physician in this era hypothesizes that if given a choice, intersex people would choose to live as men to have more power and avoid childbirth, implying that intersex gender roles are fluid and dependent on social factors, as well as the desire for pleasure.