[10] Due to the presence of intersex traits, Ardhanarishvara is associated with the hijra,[11][page needed] a third sex category that has been accepted in South Asia for centuries.
Since he gives this instruction specifically to "all you men and women," his hijra followers, being neither, remain on the banks of the river for fourteen years until Rama returns from exile.
[11][page needed] According to Leah DeVun, a "traditional Hippocratic/Galenic model of sexual difference – popularized by the late antique physician Galen and the ascendant theory for much of the Middle Ages – viewed sex as a spectrum that encompassed masculine men, feminine women, and many shades in between, including hermaphrodites, a perfect balance of male and female".
[16] DeVun contrasts this with an Aristotelian view of intersex, which argued that "hermaphrodites were not an intermediate sex but a case of doubled or superfluous genitals", and this later influenced Aquinas.
[17] Ovid wrote the most influential narrative[18] of how Hermaphroditus became androgynous, emphasizing that, although the handsome youth was on the cusp of sexual adulthood, he rejected love as Narcissus had, at the site of a reflective pool.
[20] The myth of Hylas, the young companion of Hercules who was abducted by water nymphs, shares with Hermaphroditus and Narcissus the theme of the dangers that face the beautiful adolescent male as he transitions to adult masculinity, with varying outcomes for each.
[25] Isidore of Seville (c. 560–636) described a hermaphrodite fancifully as those who "have the right breast of a man and the left of a woman, and after coitus in turn can both sire and bear children.
"[28] In traditional Roman religion, a hermaphroditic birth was a kind of prodigium, an occurrence that signalled a disturbance of the pax deorum, Rome's treaty with the gods.
[31]In c.400, Augustine wrote in The Literal Meaning of Genesis that humans were created in two sexes, despite "as happens in some births, in the case of what we call androgynes".
[3][33][34] A broad sense of the term "eunuch" is reflected in the compendium of ancient Roman laws collected by Justinian I in the 6th century known as the Digest or Pandects.
Eunuchs (spadones) sold in the slave markets were deemed by the jurist Ulpian to be "not defective or diseased, but healthy", because they were anatomically able to procreate just like monorchids (D 21.1.6.2).
[36][37] Both Hanafi and Hanbali lawmakers also recognized that puberty could clarify a new dominant sex in intersex individuals who were labeled khuntha, male, or female in childhood.
This understanding of the effect of puberty on intersex conditions appears in Islamic law as early as the eleventh century CE, notably by Ibn Qudama.
[36] In Abnormal (Les anormaux), Michel Foucault suggested it is likely that, "from the Middle Ages to the sixteenth century ... hermaphrodites were considered to be monsters and were executed, burnt at the stake and their ashes thrown to the winds.
[39] Canon Law sources provide evidence of alternative perspectives, based upon prevailing visual indications and the performance of gendered roles.
[40] The 12th-century Decretum Gratiani states that "Whether an hermaphrodite may witness a testament, depends on which sex prevails" ("Hermafroditus an ad testamentum adhiberi possit, qualitas sexus incalescentis ostendit.").
"[46] The thirteenth-century canon lawyer Henry of Segusio argued that a "perfect hermaphrodite" where no sex prevailed should choose their legal gender under oath.
[47][39] A 2021 study in the European Journal of Archaeology concluded that a grave from 1050 to 1300 in Hattula, Finland, containing a body buried in feminine clothing with brooches, furs and a hiltless sword, which earlier researchers speculated to be two bodies (a male and female) or a powerful woman, was one person with Klinefelter syndrome and that "the overall context of the grave indicates that it was a respected person".
[52] In a court case, heard at the Castellania in 1774 during the Order of St. John in Malta, 17-year-old Rosa Mifsud from Luqa, later described in the British Medical Journal as a pseudo-hermaphrodite, petitioned for a change in sex classification from female.
Traveling intersex persons, like Derrier and Katharina/Karl Hohmann, who allowed themselves to be examined by physicians were instrumental in the development of codified standards for sexing.
[55][56] During the Victorian era, medical authors attempted to ascertain whether or not humans could be hermaphrodites, adopting a precise biological definition to the term.
Historical accounts including those of Vietnamese general Lê Văn Duyệt (18th/19th-century) who helped to unify Vietnam; Gottlieb Göttlich, a 19th-century German travelling medical case; and Levi Suydam, an intersex person in 19th-century USA whose capacity to vote in male-only elections was questioned.
[63][64] Historical accounts from the early twentieth century include that of Australian Florrie Cox, whose marriage was annulled due to "malformation frigidity".
[69] Dialog between what were once antagonistic groups of activists and clinicians has led to only slight changes in medical policies and how intersex patients and their families are treated in some locations.