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And, indeed, until puberty, such girls easily pass as normal pre-pubescent females.

After puberty, however, there can be a noticeable drift towards the external features of a male — such as a masculine bone structure, accelerated muscle development and a deep voice. ‘She is flat and angular and could have been designed for a medieval playing card.

Geertje Mak, Manchester University Press, Manchester, 2012, 320pp., ISBN: 978-0-7190-8690-8, £70.00 (Hbk)/£16.99 (Pbk)The steady growth of the history of sexuality as a field of academic study no doubt reflects the fact that many questions about sex, gender and the vagaries of desire remain unanswered.

Many of these questions were first articulated in the course of the nineteenth century when doctors began to turn systematic attention to the sexual body.

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I should be tempted to classify her as an American woman par excellence were it not for the suspicion that she is not a woman at all.’A well-known German graphologist, who was given a sample of her hand-writing but not her identity, concluded that the writer was ‘a woman with a strong male inclination in the sense of activity, vitality and initiative. You can see Wallis’s condition clearly next to the very rounded face of Mary.

Today, a course of oestrogen therapy can transform facial features.

It comes as no surprise, therefore, that sexually indeterminate or multivalently sexed bodies constituted a particular problem for nineteenth-century medical observers.

For they not only challenged the binary distinction between ‘male’ and ‘female’, but they also raised questions about the relationship between sex, gender and what we would now call sexuality.