In this article, I argue that the medical conceptualization of gender identity in the United States has entered a “new regime of truth.” Drawing from a mixed-methods analysis of medical journals, I illuminate a shift in the locus of gender identity from external genitalia and pathologization of families to genes and brain structure and individualized self-conception. The sexed body itself has also undergone a transformation: Sex no longer resides solely in genitalia but has traveled to more visible parts of the body, implicating racialized aesthetic ideals in its new formulation. The re-imagining of gender identity as genetically and neurologically inscribed and the expanding locus of sex correspond to an inversion of the relationship between gender identity and the sexed body as well as shifts in medical jurisdiction. Whereas psychiatrists in the 1960s, ’70s, and ’80s understood gender as stemming from genital sex, the less popular idea that gender identity precedes the sexed body has gained traction in recent decades. If gender identity once derived from the sexed body, the sexed body must now be brought into alignment with gender identity. The increasing legitimacy of self-defined gender identity, the expanding definition of racialized sex, and the inversion of the sex–gender identity relationship elevates the role of surgeons in producing racialized and sexed bodies.

在本文中，我认为，美国对性别认同的医学概念化已进入“新的真理制度”。从医学期刊的混合方法分析得出，我阐明了性别认同的轨迹从外生殖器和家庭病理学转变为基因和脑结构以及个性化的自我概念。有性的身体本身也发生了变化：性不再仅仅存在于生殖器中，而是传播到了身体的更多可见部位，从而在其新配方中体现了种族化的审美理想。对遗传和神经学上刻写的性别认同的重新想象以及性别场所的扩大，对应于性别认同与性身体之间关系的倒置以及医疗管辖权的转移。1960年代，70年代和80年代的精神科医生认为性别是生殖器性行为产生的原因，近几十年来，关于性别认同先于性身体的较不流行的观点受到了关注。如果性别身份曾经源自性身体，则现在必须使性身体与性别身份保持一致。自我定义的性别认同的合法性不断提高，种族化性的定义不断扩大，性别与性别认同关系的倒置，提高了外科医生在生产种族化和有性别的身体中的作用。现在必须使有性的身体与性别认同保持一致。自我定义的性别认同的合法性不断提高，种族化性的定义不断扩大，性别与性别认同关系的倒置，提高了外科医生在生产种族化和有性别的身体中的作用。现在必须使有性的身体与性别认同保持一致。自我定义的性别认同的合法性不断提高，种族化性的定义不断扩大，性别与性别认同关系的倒置提高了外科医生在生产种族化和有性别的身体中的作用。