Transgenderism and intersexuality

Involuntary sexual reassignment of infants:
Creating transgender persons via surgery

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Background:

As noted elsewhere in this website a transgender individual is frequently defined as a person who experiences Gender Identity Disorder (a.k.a. Gender Dysphoria), Their genetic gender is different from their perceived gender. Some describe themselves as a woman trapped in a man's body, or vice versa. Others view themselves as having a male brain in a female body, or vice versa. Still others view themselves as being neither a male or female, or above gender.

In our section on intersexuality, we describe intersexual infants as being born with genitals that do not match either the classical male or female designs.

This essay describes a tragedy resulting from involuntary sexual reassignment surgery performed on an infant. It underscores the importance of waiting until a person is sufficiently mature to make an informed decision, and of carefully assessing their stability before proceeding with what is usually an irreversible surgery.

About Dr. John Money:

John William Money (1921-2006) was born and raised in an evangelical Christian home in New Zealand. At the age of eight, his father died, and he was raised by his mother and single aunts. He lost his religious faith in early adulthood. According to journalist John Colapinto:

"Money increasingly reacted against what he saw as the repressive religious strictures of his upbringing and, in particular, the anti-masturbatory, anti-sexual fervor that went with them. The academic study of sexuality, which removed even the most outlandish practices from moral considerations and placed them in the 'pure' realm of scientific inquiry, was for Money an emancipation. From now on, he would be a fierce proselytizer for sexual exploration."

He became a psychologist and sexologist at Johns Hopkins University in Baltimore, MD, heading up the Psychohormonal Research Unit there. 

According to Wikipedia, he became:

"... well-known for his research into sexual identity and biology of gender. Money identified several influential concepts and terms during his career, including gender identity, gender role, gender-identity/role, and lovemap." ₁

He was very highly regarded as a world-class expert in his field. He received many international awards. One of his early specialties was intersexuality. On the basis of this work he believed that a person's gender is not simply defined by their genitalia, but also by one's self-awareness and social assignment. According to Wikipedia:

"Money was a prominent proponent of the theory that gender identity was relatively plastic in infancy and developed primarily as a result of social learning from early childhood; some academics in the late 1960s believed that all psychological and behavioral differences between males and females were learned." ₂

This belief was particularly popular among some radical feminists at the time.

Dr. Money believed that a little after two years of age, a person's perceived gender starts to become established and later becomes essentially unchangeable. He applied this concept to one of his child patients, Bruce Thiessen (a.k.a. Brenda Thiessen, and David Reimer), with disastrous results.

About the Reimer twins:

Bruce and Brian Thiessen were born in Winnipeg, MB, Canada in 1965-AUG. They were diagnosed at the age of six months with phimosis -- a condition where the foreskin cannot be fully retracted from the head of the penis. They were circumcised at the age of eight months to relieve the condition. Brian's procedure was uneventful, but Bruce's penis was accidentally burned beyond any possibility of repair during the surgery. It later fell off in chunks. Surgical techniques that were available at the time were inadequate to the task of reconstructing a functioning penis.

His parents took him to see Dr. Money at Johns Hopkins Medical Center in Baltimore, MD. After meeting with Dr. Money and other physicians working with intersexed children, Bruce's parents accepted their recommendation that their son have his testicles and the remains of his penis removed, and that he be raised as a female. They renamed him "Brenda."

Brenda and Brian represented a great opportunity for Money's gender research because:

	They were identical twins and shared the same DNA.
	They had the same genetic gender -- male.
	They both developed as fetuses in the same womb subject to the same hormonal environment.
	They were both born with normal genitals.
	They were being raised as different genders in the same family.

They were the ideal test subjects:

	To study the plasticity of gender in early childhood, and
	To attempt to separate the influences of environment and heredity on gender identity.

The twins saw Dr. Money frequently during their childhood.

A Wikipedia essay states:

"Money often took pictures of them both in the nude, claiming it was for scientific comparison, but Reimer claimed that Money sexually abused both twins and took far too many photos for their shoots to be deemed innocent. This was a large factor contributing to his fear of Money and desire to never go back for his help. (This was said in a 20/20 [TV] interview.)"

"For several years, Money reported on Brenda's progress as the 'John/Joan case', describing apparently successful female gender development, and using this case to support the feasibility of sex reassignment and surgical reconstruction even in non-intersex cases. Money wrote: 'The child's behavior is so clearly that of an active little girl and so different from the boyish ways of her twin brother.' Estrogen was given to Brenda when she reached adolescence to induce breast development. However, Brenda had experienced the visits to Baltimore as traumatic rather than therapeutic and when Dr. Money started pressuring the family to bring 'her' in for surgery, in which a vagina would be created, the family discontinued the follow-up visits. John Money published nothing further about the case to suggest that the reassignment had not been successful." ₂

But reality in the Reimer household did not match Dr. Money's version. Brenda was "ostracized and bullied" by her peers for being a tomboy. She never felt female. At the age of 13 Brenda's parents told her the details of her surgical procedure. She immediately assumed a male gender identity and adopted the name David Reimer. By the age of 15 he was suicidally depressed and threatened to commit suicide if his parents forced him to visit Dr. Money again.

Later in life, David underwent gender reassignment surgery. He was given hormone injections, underwent a double mastectomy to have his breasts downsized, and underwent two phalloplasty operations to create a penis, imitation testicles and scrotum.

A firestorm of controversy:

In 1997, Milton Diamond, a biologist at the University of Hawaii, and Keith Sigmundson, a psychiatrist from Victoria, BC, Canada wrote an expose of the failure of Dr. Money's experiment. ₅ This blew the lid of of the John and Joan case. A firestorm of controversy erupted. A three-decade-long rivalry among world-class human sexuality researchers was exposed. Researchers and the public began to ask why it took two decades for the truth to come out.

Later in 1997, David Reimer collaborated with journalist John Colapinto who wrote an article about David's experiences in the Rolling Stone magazine. This intensified the already intense public debate about childhood gender reassignments. Colapinto wrote that the story reporting the twins:

"... to have grown into happy, well-adjusted children of opposite sex seemed unassailable proof of the primacy of rearing over biology in the differentiation of the sexes and was the basis for the rewriting of textbooks in a wide range of medical disciplines. Most seriously, the case set a precedent for sex reassignment as the standard treatment for thousands of newborns with similarly injured, or irregular, genitals. It also became a touchstone for the feminist movement in the 1970s, when it was cited as living proof that the gender gap is purely a result of cultural conditioning, not biology. For Dr John Money, the medical psychologist who was the architect of the experiment, this case was to be the most publicly celebrated triumph of a 40-year career that recently earned him the accolade ?one of the greatest sex researchers of the century.? ₃

Describing his childhood experiences, David said:

"It was like brainwashing. I'd give just about anything to go to a hypnotist to black out my whole past. Because it's torture. What they did to you in the body is sometimes not near as bad as what they did to you in the mind -- with the psychological warfare in your head. ₃

Colapinto later expanded the article into a book "As Nature Made Him: The Boy Who Was Raised as a Girl," published in 2001 and revised in 2006. ₄

The outcomes of the John/Joan case:

David married a woman and became stepfather to her three children. Financial pressures and a request by his wife for a separation led to his suicide at the age of 38.

His brother Brian had predeceased him as a result of a drug overdose.

Dr. John William Money suffered from Parkinson's and died in 2006, leaving a trail of devastation behind.

The Intersex Society of North America (ISNA) was founded in 1993 "... to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female." They made significant progress in changing attitudes concerning intersexed people, but were never able to form a cooperative relation with the medical community. They founded Accord Alliance in 2008-MAR. ISNA has since disbanded, although their website remains online "as a historical artifact." ₆

In 1995, over four decades after the first sex reassignment surgeries, Johns Hopkins medical center finally got around to performing a long-term follow up of infant patients subjected to the procedures. The study included six genetic males who, similar to Bruce/Brenda/David, were born without penises, were castrated in infancy, and raised as girls. John Colapinto reported that:

"... all six are closer to males than to females in attitudes and behavior. Two have spontaneously (without being told of their XY male chromosome status) switched back to being boys." ₃

References used:

The following information sources were used to prepare and update the above essay. The hyperlinks are not necessarily still active today.

1. "John Money," Wikipedia, 2009-JAN-07, at: http://en.wikipedia.org/
2. "David Reimer," Wikipedia, 2009-JAN-04, at: http://en.wikipedia.org/
3. John Colapinto, "The True Story of John/Joan."; Rolling Stone, 1997-DEC, Pages 54?97. See: http://infocirc.org/
4. John Colapinto, "As Nature Made Him: The Boy Who Was Raised as a Girl," Harper Perennial, (Revised 2006). Read reviews or order this book safely from Amazon.com online book store The book is very highly rated at 5 stars -- the maximum rating -- by Amazon customers.
5. Milton Diamond & Keith Sigmundson, "Sex reassignment at birth. Long-term
   review and clinical implications," Archives of Adolescent and Pediatric Medicine, 151, 1997-MAR, Pages 298-304.
6. The website of the Intersex Society of North America, now disbanded, remains online at: http://www.isna.org/

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