When it comes to biological reproduction, Buddhism faces a dilemma. The Buddha advocated celibacy as necessary for achieving enlightenment because sex is connected to attachment, which does not lead to enlightenment, at least not in early Buddhism. Nevertheless, beings need to reincarnate in order to achieve enlightenment, and monastic institutions require the laity for financial support. Elaborate theories often arise from such incongruities, as can be seen in the following foray into Buddhist medical views of conception and the formation of sexual characteristics. The medical texts reveal an early scientific discourse on gender and reproduction, one that is shown to be fraught with deep social and religious ramifications.
The connections between Buddhism and medicine go back to early, frequent epithets of Buddha as the Great Physician and of his teachings as the King of Medicine, 1 as well as to the practice of medicine in Buddhist monasteries. 2 The Buddhist Vinaya, the rules for monks and nuns, reveals a deep interest in medicine, and by the mid-third century B.C.E. medicine was part of the course of study in Buddhist monasteries, which were extending medical care to the population at large. 3 Over time, medical skill became an important part of Buddhist missionary activity in India and elsewhere. 4 Epithets connecting the Buddha with medicine and medical activities proliferated in Mahāyāna Buddhism, where healing was valorized in pivotal works such as the Lotus Sūtra, 5 through the popularity of the Medicine Buddha, and in representations of primordial buddhas as the first physicians and the first teachers of healing.