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In Which Testosterone Taints the Fountain of Youth

In A 1945 HOMAGE TO MEDICAL SCIENCE, THE FIFTY-FOUR-YEAR – OLD

bacteriologist and popular science writer Paul de Kruif published a book enti­tled The Male Hormone, in which he revealed to the world a deeply personal fact: he was taking testosterone. Beginning in his late thirties, he explained, he had become aware of his declining virility. His energy had diminished and even worse, so had his courage and self-confidence. A mere five years earlier, when his old boss had retired, the prospect of a change in his work life had filled him with terror and hysteria. ‘‘That was before testosterone. That was a nice little symptom of my own male hormone hunger, of my stage of slipping, of losing my grip.’’ But at age fifty-four, his confidence, he reported, was wax­ing strong. And he owed it all to testosterone: ‘‘I’ll be faithful and remember to take my twenty or thirty milligrams a day of testosterone. I’m not ashamed that it’s no longer made to its own degree by my own aging body. It’s chemical crutches. It’s borrowed manhood. It’s borrowed time. But just the same, it’s what makes bulls bulls.’’1

In the 1960s Dr. Robert A. Wilson claimed that estrogen could do for women what testosterone supposedly did for men. As estrogen declined dur­ing the menopause, women suffered a terrible fate. ‘‘The stigmata of Nature’s defeminization’’ included ‘‘a general stiffness of muscles, a dowager’s hump, and a vapid cow-like negative state.’’ Postmenopausal women, he wrote in the Journal of the American Geriatric Society, existed but did not live. On the streets ‘‘they pass unnoticed and, in turn, notice little.’’2 With support from Ayerst Pharmaceuticals he offered to cure the menopause—to this day, referred to as an estrogen deficiency disease—by giving women Premarin, Ayerst’s brand name for estrogen.3

Today fascination with the healing properties of estrogen and testosterone continues unabated. Estrogen and a related hormone, progesterone, have be­come the most extensively used drugs in the history of medicine.4 In the popu­lar imagination, sex and hormones are linked as they were in de Kruif’s and Wilson’s day. ‘‘Yes,’’ de Kruif wrote in 1945, ‘‘sex is chemical and the male sex chemical seemed to be the key not only to sex but to enterprise, courage and vigor.’’5 In 1996, when testosterone made it onto the cover of Newsweek, the headline read: ‘‘Attention: aging men—testosterone and other hormone treatments offer new hope for staying youthful, sexy and strong.’’6

But in the age of unisex, testosterone treatment is not just for men. Women, especially postmenopausal ones (those same cow-like creatures whose lives Dr. Wilson lamented) can also benefit from a little of the old T – molecule. One proponent of giving testosterone to older women, Dr. John Studd (really!) of the Department of Obstetrics and Gynecology at Chelsea and Westminster Hospital in London, recently said of his testosterone-treated female patients: ‘‘They may have their lives transformed. Their energy, their sexual interest, the intensity and frequency of orgasm, their wish to be touched and have sexual contact—all improve.’’7 What’s more, it turns out that men need estrogen for normal development of everything from bone growth to fertility.8

Why, then, have hormones always been strongly associated with the idea of sex, when, in fact, ‘‘sex hormones’’ apparently affect organs throughout the entire body and are not specific to either gender? The brain, lungs, bones, blood vessels, intestine, and liver (to give a partial list) all use estrogen to maintain proper growth and development.9 In broad outline, the widespread effects of estrogen and testosterone have been known for decades. One of the claims I make in this chapter and the next is that relentlessly, over this century, scientists have integrated the signs of gender—from genitalia, to the anatomy of gonads and brains, then to our very body chemistry—more thoroughly than ever into our bodies. In the case of the body’s chemistry, researchers accomplished this feat by defining as sex hormones what are, in effect, multi­site chemical growth regulators, thus rendering their far-reaching, non­sexual roles in both male and female development nearly invisible. Now that the label of sex hormone seems attached with epoxy to these steroid mole­cules, any rediscovery of their role in tissues such as bones or intestines has a strange result. By virtue of the fact that so-called sex hormones affect their physiology, these organs, so clearly not involved in reproduction, come to be seen as sex organs. Chemicals infuse the body, from head to toe, with gender meanings.

Scientists did not integrate gender into the body’s chemistry by conscious design. Indeed, they simply went about their business as talented working scientists. They investigated the hottest new research topics, found the finan­cial and material resources to support their work, established fruitful collabo­rations between investigators with different backgrounds and training, and ultimately, signed international agreements to standardize the naming and experimental evaluation of the various chemical substances they purified and examined. But in this and the following chapter, as we watch scientists engage in each of these normal activities, we will also observe how, despite a lack of overt intention, scientific work on hormone biology was deeply linked to gen­der politics. I argue that we can understand the emergence of scientific ac­counts of sex hormones only if we see the scientific and the social as part of an inextricable system of ideas and practices—simultaneously social and scientific. To illustrate, I turn to a key scientific moment in the history of hormones, one in which scientists struggled to impose gender on the internal secretions of ovaries and testes.

The discovery of ‘‘sex hormones’’ is an extraordinary episode in the his­tory of science.10 By 1940, scientists had identified, purified, and named them. As they explored hormone science (endocrinology), however, re­searchers could make hormones intelligible only in terms of the struggles around gender and race that characterized their working environments. Each choice that scientists made about how to measure and name the molecules they studied naturalized cultural ideas about gender.11 Each institution and persuasive community involved in hormone research brought to the table a social agenda about race and gender. Pharmaceutical companies, experimen­tal biologists, physicians, agricultural biologists, and sex researchers inter­sected with feminists, advocates of homosexual rights, eugenicists, birth con­trol advocates, psychologists, and charitable foundations. Each of these groups, which I will call social worlds, were linked by people, ideas, labora­tories, research materials, and funding, and much more.12 By examining how these worlds intersected, we can see the ways in which certain molecules became part of our system of gender—how gender became chemical.