HSTS and medicine in history

Today, HSTS has become a subject for medical intervention on two levels: hormonal (endocrine) and surgical. But for thousands of years, HSTS lived without the benefits of modern medicine and science. So how did they manage?

Ancient Sumer: a tradition that persisted.

The earliest references that we have to HSTS come from Sumer, a region of Eastern Mesopotamia, now Iraq. This was made up of independent city-states, some of which, including the most prominent, Uruk, were Goddess cities. Although we can’t be sure of the political make-up of these societies, there is considerable evidence that there was at least a power-balance between men and women in them, even if this did not extend to full female authority. (There has never been, as far as we know, a culture that was genuinely ‘ruled’ by women.)

However, these societies do appear to have been matrifocal with women, and motherhood, at their centre. This replicates circumstances found in other, more modern cultures in which motherhood is venerated.

One intervention that was common in these ancient societies, amongst HSTS, was castration. Typically a young boy would enter the temple in service of the Goddess. In Sumer this was Inanna, who had a sister, Ereshkigal. These were actually two aspects of the same goddess. Inanna was the light or daytime aspect; she represented birth and life, love, physicality and the pleasures and pains of the flesh. Ereshkigal was the dark aspect; she represented death but also regeneration, reflection and mysticism. Inanna walked the Earth while Ereshkigal was the Queen of Darkness and her abode was the Underworld.

This binary pair was the model for many, across the region and down the centuries, notably Aset (later Isis) and Nephthys, who played exactly the same roles in Egyptian culture. Aset was married to the god of life and light, Osiris, while Nephthys was the consort of Seti (Set), who is the model for the Biblical Satan. Aset was the mother of the saviour god Horus, who was the model, or own of them, for the Christian Jesus.

In mythology, deities that are equivalent to others, in different cultures, are called ‘cogantes’. One cognate of Ereshkigal was the Phrygian goddess Cybele and we know a lot about her and her devotees, because her cult was imported to Rome.

In the cult of Cybele, young males known as ‘galli’ by the Romans (this was pejorative) would work themselves into a trance using music, dance and narcotics, and then, after tying a blessed cord around their penis and scrotum, would, with one upward cut, remove all at once. If they survived, they would be ‘reborn’ as women. They would then enter the service of the goddess as priestesses.

This practice, in every detail, is carried on even today amongst the hijra of India.

We know from accounts of its effects on castrati, the Italian opera singers whose voices were once so prized, that castration prior to puberty tends to have different effects to when it is carried out after. In the former case, one side-effect can be excessive tallness. This was clearly not an issue for the opera-house managers; in an era when most Italian males were around 5’8″, castrati might reach 6’6″. When carried out after puberty, however, this effect does not occur. In both cases, castration produces an immediate cessation of masculinisation.

This was the effect that the galli, the hijra and others sought. Unfortunately, it does carry a risk of osteoporosis, since the body requires normal levels of sex hormones to prevent this.

What about less drastic methods? Well, there are tantalising accounts, from the Roman author Herotodus and others, of Scythian transwomen using the distilled urine of pregnant mares. We presume the function of the distillation was to drive off excess water and to concentrate the solution. It must have tasted disgusting. Nevertheless, the story is plausible, since pregnant mare urine is used even today as a source of oestrogen, notably in the preparation PreMarIn. Pharmaceutical companies, producing this and similar products today, keep herds of horses simply for the production of urine.

Today, thankfully, more palatable methods of feminisation are available and these have crossed the sex barrier and can be used to treat FtM transitioners too. But in essence they are not so very different from the ancient methods.

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