Leicester, United Kingdom
The Enarees were nomadic Scythian soothsayers who lived within the areas bounded by the rivers Danube, Bug, Don, and Dnieper, and who Herodotus in the 5th century AD asserted were effeminate.1,2 Unfortunately the Scythians did not leave any written records. Hippocrates’ Airs Water and Places XX11 using the term Anarieis related not only that they dressed and acted as women, but ascribes the cause of this to horse riding.3-5 (A modern albeit matched small control study of scrotal abnormalities being associated with duration in years of horse-riding demonstrates some plausibility for this theory.5)
As recorded in Penrose, it has been suggested that “the Enarees may have been transgender women who drank mare’s urine to help them transition from male to female.”6 This theory originates from Taylor’s 1996 work, “The Prehistory of Sex.”7 He asked “Could the Enarees have made themselves look like women?” but finding no direct evidence speculates. He used unrelated quotations from Ovid Amores 1.8.5–8: “quid valeat virus amantis equae,” and Ovid Medicama Faciei Feminae 35–38: “virus amantis equae”—translated as “A poison/ liquid taken from a mare in heat.”7-10 Taylor then infers urine was used because “camel urine is the national drink of Mongolia today.”7 He further makes the conceptual leap to mare urine because at that time conjugated estrogens were industrially extracted from horse urine to produce Premarin, a medication used for “male-to-female transsexuals as part of their hormone therapy.”7,11
Why did not Taylor or anyone ask if, within this context, it was physiologically and endocrinologically possible to obtain a therapeutic effect from drinking pregnant mare’s urine? The calculation is straightforward. Pregnant mare oestrone content in urine is 100ng/ml equivalent to 0.1mcg/ml.12 It is clear that an adolescent transgender woman (a biological male) obtaining a total daily fluid requirement (2.5 litres) through drinking only pregnant mare urine would only receive a sub-therapeutic dose of oestrone (0.25mg) rather than the minimum 2.5mg required under current guidelines (which recommend oral conjugated estrogens 2.5–7.5mg/day and anti-androgen medications too).13,14 This 2.5mg figure could admittedly be a gross underestimate, being not only at the low end of the therapeutic range, it also assumes 100% absorption and 0% first passed hepatic metabolism.15 Nevertheless, to obtain a 2.5mg dose, on the above estimated concentration from pregnant mare urine would require a daily fluid volume of at least 25 litres. A 25 litre daily volume in itself would be incompatible with life. This indicates that achieving physical feminization by merely drinking mare urine is not possible.
Perhaps though Taylor would have been right after all, but only if an alternative method of extracting conjugated oestrogens by absorption would have been considered? Breene et al. in 1965 had demonstrated salt absorption in cheese, when curd is submerged in brine.16 In this alternative hypothesis curd, contained within a horsehair or cloth bag, is submerged in warm pregnant mare urine, within a buried clay pot. This is just a variation of buried clay pot irrigation which has been known for over 2100 years.17,18 Clay pots could be buried singly or as a group within a small depression. It could then be intermittently refreshed with warm urine from nearby tethered pregnant mares. One mare can daily produce between 7.6 to 11.9 litres of urine.19 The pot’s aperture could be covered with a large cloth. This, fixed in position by pegs, would absorb the urine and preferentially drain it into it by placing a small stone placed over each clay pot’s aperture, causing a further depression. The curd, having absorbed oestrogens, is then extracted and prepared as cheese for storage and later ingestion.
Is it likely that the Scythians would have used such a practice? Archaeologically this would be very challenging to definitively prove, even if it could be demonstrated within the laboratory. At the present time the theory that they physically feminized themselves by extracting oestrogen from pregnant mare urine remains unproven.
- Herodotus 4.67.2.
- Radice, B. 1972. Herodotus The Histories, trans. Penguin Books. pp. 286, 292.
- Hippocrates Airs Water and Places
- Lloyd, G.E.R. 1983. Hippocratic Writings. Penguin Books. p. 165.
- Turgut, A.T., Kosar, U., Kosar, P., Karabulut, A. 2005. Scrotal sonographic findings in equestrians. Journal of Ultrasound Medicine 24: 7: 911-7.
- Penrose, W. 2020. Gender Diversity in Classical Greek Thought. In Surtees A. and Dyer J. (Eds) Exploring Gender Diversity in the Ancient World, Edinburgh University Press, 29-42. Citing p. 40.
- Taylor, T. 1996. The Prehistory of Sex: Four Million Years of Human Sexual Culture. London. Bantam Books. pp 212-213.
- Ovid Amores8.5-8.
- Ovid Medicama Faciei Feminae 35-38.
- Virus – a poison, a liquid. In Lewis C, Short C, A Latin Dictionary, 1879. Accessed via Perseus Digital Library. http://www.perseus.tufts.edu/hopper/text?doc=virus&fromdoc=Perseus%3Atext%3A1999.04.0059. (Accessed 30th April 2023)
- Vance, D.A. 2007. Premarin: the intriguing history of a controversial drug. International Journal of Pharmacological Compounding 11:282-6.
- Rossdale Laboratories. Urine estrone sulphate levels in pregnant mares. 2023 https://www.rossdales.com/laboratories/tests-and-diseases/oestrone-sulphate-pregnancy (Accessed 30th April 2023)
- Scientific Opinion on Dietary Reference Values for water, European Food Safety Authority (EFSA), Panel on Dietetic Products, Nutrition, and Allergies (NDA). 2010. EFSA Journal 8: 1-48.
- Boston University School of Medicine. Practical Guidelines for Transgender Hormone Treatment. https://www.bumc.bu.edu/endo/clinics/transgender-medicine/guidelines/ (Accessed June 26, 2023)
- Kuhl, H. 2005. Pharmacology of estrogens and progestogens: influence of different routes of administration. Climacteric 8 (Suppl 1): 3–63.
- Breene, W.M, Olson, N.F. and Price, W.V. 1965. Salt Absorption by Cheddar Cheese Curd. Journal of Dairy Science 48:5:621-4.
- Sheng Han, S. 1974. Fan Sheng-chih Shu: An agriculturalist Book of China written by Fan Sheng-chih in the First Century BC. Science Books, Peking, 36-37. In Bainbridge, DA, 2001, Buried clay pot irrigation: a little known but very efficient traditional method of irrigation, Agricultural Water Management 48:80.
- Bainbridge, D.A. 2001. Buried clay pot irrigation: a little known but very efficient traditional method of irrigation. Agricultural Water Management 48:79-88.
- Kohn C.W, Strasser S.L. 1986. 24-hour renal clearance and excretion of endogenous substances in the mare. American Journal of Veterinary Research 47:1332-7.
DR. ANDREW N. WILLIAMS practiced as a medical doctor for many years but has returned to university to study ancient history and archaeology.