The John/Joan case
“It just seems …you’re nothing if your penis is gone…They’ve got to do surgery and hormones to turn you into something.’ – David Reimer, As Nature Made Him.
In 1965 twin boys, Bruce and Brian Reimer, were born in the Canadian town of Winnipeg. In 1966, a disastrous circumcision left Bruce Reimer without a penis. Naturally his distraught parents looked for any solution that might bring hope of a normal life for their injured son.
Canadian medical specialists suggested that when Bruce was older, he could undergo phalloplasty. It was experimental surgery and far from successful in delivering a functional penis. John Money, a persuasive psychologist and sex researcher based at Johns Hopkins Hospital in Baltimore, suggested their baby could be successfully raised as a girl.
In the 1950s, Money had developed a hypothesis known as the ‘theory of gender neutrality’. He postulated that until about the age of two a child was gender neutral and could be ‘taught’ to be either a boy or girl depending on how they were socialised as a child.
The Reimer twins provided the perfect control set on which to test his theory. One twin would be raised a boy, the other a girl.
To facilitate the physical transition, Bruce was castrated and had the stump of his damaged penis removed. And so, in 1967, baby Brenda was ‘born’. The family was under strict instructions regarding Brenda’s upbringing as a girl. Under no circumstances were they to tell her the truth about her birth. When she was 12 years old Brenda would begin hormone therapy and undergo further surgery to create a proper vagina and female urinary tract.
There was a lot riding on the success of the so called John/Joan case. If it could be scientifically proven that gender was pliable then there was no justification for gender based discrimination in employment or anywhere else. Feminist scholars quoted Dr Money extensively. Thousands of infant “sex reassignments” were performed on the basis of this one case. Other baby boys, injured in identical circumstances to David Reimer, underwent forced transition on the strength of John Money’s conclusions. It became incontrovertible proof that a child’s gender identity could be changed through nurture.
But not everyone agreed with John Money’s conclusions.
In the late 1970s, Dr Milton Diamond, a prominent gender specialist, began questioning the success of this case. Diamond believed that a person’s sex is determined in the brain prior to birth and that no amount of nurturing can override hormones and genes.
John Money and Milton Diamond had locked horns many times over the years. The fact that Money refused to discuss the case and had stopped making reference to it in his more recent published texts made Diamond all the more determined to follow up on it. He placed regular advertisements in the American Psychiatric Society Journal: ‘Will whoever is treating the twins please report to Dr. Milton Diamond, University of Hawaii’.
After many years of persistent searching, Dr Diamond finally made contact with Dr Keith Sigmundson, one of the Canadian specialists who had been treating Brenda. What he learned was disturbing.
Despite everything John Money had published to the contrary, Brenda was an extremely troubled child. From the beginning she refused to conform to the acceptable standards for female behaviour. She insisted on standing to urinate and, despite having no natural testosterone, was a rough, masculine child with an ever deepening voice.
Brenda may have been forced to take female hormones but she steadfastly refused to undergo further surgery. In 1980, when she was 14, Ron and Janet Reimer realised they had to tell her the truth. Almost immediately ‘Brenda’ began living as David.
He embarked on the painful process of converting back to his biological sex. He underwent a double mastectomy to remove the breasts that had grown as a result of the oestrogen therapy; multiple genital-reconstruction operations; and regular testosterone injections to further masculinise him. The 14 year struggle of parents, psychologists, psychiatrists, surgeons and endocrinologists had failed to re-shape David Reimer’s inborn sexual identity.
Through interviews with David, his mother and wife, as well as the detailed clinical records Sigmundson had kept on the case, Milton Diamond finally had the documentary evidence to prove that the John/Joan experiment had failed.
Such was John Money’s standing in the medical community, that it took two years before a journal would agree to publish the controversial Diamond/Sigmundson paper. In March 1997 the Archives of Adolescent and Pediatric Medicine finally revealed baby Bruce’s lifelong struggle against imposed ‘girlhood’.
On a personal level, things were looking up for David. He married at age twenty-five, bought a house and adopted his new wife’s three children. He was finally the husband he had longed to be.
In December 1997, journalist John Colapinto published David Reimer’s story in Rolling Stone magazine. He was so moved by the injustices forced upon David that he sought permission from him to write a book. In 2000, Colapinto published As Nature Made Him: The boy who was raised as a girl.
The author felt it was incumbent on him to share sales revenue with the subject of his book. It was after all, David Reimer’s life he was profiting from. Sales were strong and David had no compelling financial motivation to be employed. He now had plenty of time to mull over his situation.
Sadly, David Reimer never recovered psychologically from his traumatic childhood, and in 2004, two years after the suicide of his twin brother Brian, David also took his own life.
Professor Milton Diamond said of David Reimer’s life and death:
‘I hope David Reimer’s life lives on in documenting the ill in scientific hubris and mendacity and celebrating his courage to expose the harm that was done to him in order to save others from a similar fate. The John/Joan story will be recalled by all those who think that sexual development is simply a matter of upbringing. Rearing is important but must take into account any inherent predisposition with which an individual is born.’
(E-mail correspondence, May 20, 2004)
Such was the influence of the John/Joan case that the behaviourist psychology popularised by Dr Money during the 1950s-80s still influences current thinking regarding gender and sexual behaviour. Some intersexed children are still subjected to mutilating medical procedures. Ironically, in trying to make these children look physically ‘normal’ the surgery often leaves them incapable of erotic sensation or any sexual function at all.
David Reimer was not a transsexual, but his story and the subsequent research into gender identity are important to transsexual men and women because his experiences demonstrate that gender is innate. No amount of socialisation or training can change what a person is at their core.
If Money’s theory was correct then transsexuals would not exist. Everyone would conform to the gender in which they were raised. Interestingly, John Money not only accepted the existence of transsexuals, but had already published research into the effects of hormones on foetal brains. He concluded that hormones did indeed have an effect in determining a gender identity which may be contrary to a person’s physical sex. Findings that were diametrically opposed to the theory he subsequently, disastrously tested on Bruce Reimer
Sandy (2007) The John/Joan case, Torque, Vol 7(3).