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summary This article complicates the history of the standardization of intersex case management developed at the Johns Hopkins Hospital in the 1950s by focusing on clinical practices and logics and the transatlantic circulation of knowledge. Using patient records and published studies, I follow the exchanges between pediatric endocrinologists Lawson Wilkins (Pediatric Endocrinology Clinic, Baltimore) and Andrea Prader (University Children's Hospital, Zürich) on cortisone treatment for children with congenital adrenal hyperplasia (CAH), on psychosexuality and gender role, on choosing and changing the sex of intersex children, and on genital surgery. I argue that a focus on the transatlantic exchanges between these two clinics illuminates a more complex genealogy of modern intersex case management. It also provides insight into how physicians understood their clinical practice and sheds light on the messiness and pragmatic contingencies of what only in retrospect appears to have been a consistent treatment regime. [ABSTRACT FROM AUTHOR]

The term 'gender role' was coined at Johns Hopkins's paediatric endocrinology clinic in the 1950s, where Dr Lawson Wilkins and psychologist John Money diagnosed, treated and evaluated intersexual children, most of them suffering from a condition called congenital adrenal hyperplasia (CAH). Going beyond existing discourses on the medicalisation of intersexuality, I reframe the emergence of gender as an element in the development of a specific medical treatment for an endocrinological condition and excavate the complex and contingent historical factors that led to the formulation of gender role in the Hopkins context. Using previously unavailable patient records from the clinic, this article follows the patients through their medical encounters and describes the process of normalisation around the diagnosis, treatment and management of CAH. By paying specific attention to the practices at the clinic, I show that diagnosing a child's sex often depended on the physicians' skill, experience and techniques. Correct gender role was folded into the management of CAH as one aspect of successful treatment. Normalisation was a process, in which treating somatic effects and assuring psychological healthiness were deeply enmeshed in the conviction that a normal life would only be possible as a clearly gendered and sexed person. [ABSTRACT FROM AUTHOR]