Editor's Note: The death of psychologist and sexologist John Money, on July 7, 2006, prompted us to reread this review, published in The Weekly Standard six years ago. We should note also a relevant development since the essay first appeared: Dr. Money's former patient, David Reimer, committed suicide on May 5, 2004.
As Nature Made Him
The Boy Who Was Raised as a Girl
by John Colapinto
HarperCollins, 279 pp., $ 26
Two riveting stories intertwine in John Colapinto's page-turner, As Nature Made Him: The Boy Who Was Raised as a Girl. One is a human drama, the other a cautionary tale of science gone awry. And both display, in the stark outlines of a twentieth-century morality play, the liberating power of truth and the devastation wrought by lies.
The first is the story of David Reimer -- born a healthy boy, injured at eight months in a botched circumcision, and subsequently reared as a girl -- as he struggled to retain his sanity in the midst of what he would later call his "brainwashing." When finally told the facts of his birth at the age of fourteen, he threw off the false identity thrust upon him and set about painfully to become a man.
The second story is the rise and fall of the haughty and renowned sex psychologist John Money, coiner of the term "gender identity," authority on hermaphroditism, and proponent of the view that sexual identity is principally a product of the way a child is reared. It was Money who persuaded two young Canadians, Ron and Janet Reimer, that if they implemented his program of surgery, hormone treatment, and consistent female conditioning, their injured son, Bruce, would grow up into a woman able to adopt children and normal in virtually every other respect. In his professional writings, Money presented Bruce Reimer's "sex reassignment" as an unqualified success -- a lie not fully and finally exposed until the publication of this book.
It all began when two working-class teenagers in Winnipeg, in flight from their strict Mennonite upbringings, fell in love, married, and in August 1965 became the parents of identical twin boys. After the accident in which one of the babies lost his penis, only one expert gave the despondent parents hope.
Early in 1967, Ron and Janet saw a television program featuring the charismatic Dr. Money. No wonder he impressed them. He was suave and confident and came equipped with a Harvard Ph.D., a perch at the famed Johns Hopkins Hospital in Baltimore, and grants from the National Institutes of Health. In 1967, he was the man of the hour. At his instigation, Johns Hopkins had become the first hospital in America to embrace sex-change surgery. Accounts of his pioneering work in the New York Times and leading magazines were uniformly positive. "Indeed, of all the coverage in late 1966 and early 1967," writes Colapinto, "by far the hardest-edged" was the Canadian Broadcasting Corporation program the Reimers saw, and even it left a highly favorable impression. At one point, the interviewer asked a beneficiary of Money's ministrations, the attractive Mrs. Diane (nee Richard) Baransky, "And now you feel complete as a woman?" "Oh, yes, definitely," she replied. "Yes. Completely -- body and mind." Soon Ron and Janet were on a plane to Baltimore.
The Reimers' twins were just what John Money had been longing for: a chance to prove that his theory of the primacy of rearing over biology in the formation of gender identity held not just for people born with ambiguous anatomy but also for a normal child. Money's eagerness and conviction were compelling to the Reimers, then age twenty and twenty-one and neither with more than a ninth-grade education. "I thought, with his injury, it would be easier for Bruce to be raised as a girl -- to be raised gently," Janet told Colapinto thirty years later. "He wouldn't have to prove anything, like a man had to." Ron shrank from the thought of the humiliations and frustrations in store for a male maimed in the way his son was.
So the Reimers' trips to Baltimore became annual events. There was surgery, to remove the testicles. And there were regular consultations, for the parents, for the twins together, and for "Brenda," as little Bruce became. Dr. Money impressed on the parents the necessity of never wavering in their inculcation of Brenda's femininity. In particular, the child must not be told about her birth.
But from the start, Brenda resisted feminizing. She tried to tear off her dresses and wanted to shave like Daddy and build forts and have snowball fights with her brother. Recalls her twin, Brian, "She'd get a skipping rope for a gift, and the only thing we'd use that for was to tie people up, whip people with it. She played with my toys: Tinkertoys, dump trucks. This toy sewing machine she got just sat."
Bit by bit, Colapinto evokes the nightmare that engulfed Brenda Reimer's childhood. Unable to fit in at school with either the boys or the girls, taunted by both, she fell behind socially and academically. And the annual visits to Dr. Money made things worse. Starting with her very first follow-up consultation after the castration, Brenda, then four years old, reacted with dread. Wrote Money in his notes at the time, "There was something almost maniacal about her refusals [to be tested] and the way she hit, kicked and otherwise attacked people."
Both twins were confused and repelled by Dr. Money's questioning, which, as they got older, increasingly dwelt on sex. One of Money's theories was that children need to engage in "sexual rehearsal play," mimicking copulation, as part of their normal development, and he insisted that Brenda and Brian undress and do this on their visits to him. (The twins never mentioned this to their parents; they assumed their parents knew.) Starting in 1973 when Brenda was seven, he tried to prepare her for further surgery, to excavate a vagina. She firmly refused.
Part of what makes this story so moving is the desperate vehemence with which this innately male child, though always dressed and treated as a girl from before the age of two, refused to consent to her sex reassignment. When, on what would be the Reimers' last trip to Baltimore, Dr. Money confronted the thirteen-year-old Brenda with an adult male-to-female transsexual in an effort to make the idea of surgery more appealing, Brenda bolted from the room and fled the hospital grounds. She told her mother that if she were ever forced to see Money again, she would kill herself.
Less than a year after this, Brenda, now an adolescent and increasingly alienated, started therapy with a new psychiatrist in Winnipeg, a warm and grandmotherly veteran of the profession who was able to win her patient's trust. It proved to be a turning point. Although tensions within the Reimer family were extreme, with Ron drinking and Janet battling depression, Brenda began growing psychologically stronger. Eventually, her treatment team in Winnipeg advised her parents to tell her the facts of her birth.
They did, in March 1980, and from that point on, the story becomes the inspiring one of the arduous reclamation of a life. Brenda chose a new name, David. "It reminded me of the guy with the odds stacked against him," Reimer later told Colapinto, "the guy who was facing up to a giant eight feet tall. It reminded me of courage."
Even after the embarrassing transition from Brenda to David, he suffered periods of despair, including two suicide attempts and months of voluntary isolation in a cabin in the woods. But he made a friend, in whom he managed to confide. And he had successful reconstructive surgery. One night when he was twenty-two, in his loneliness, he prayed to God for the first time in his life. His prayer, he told Colapinto, was: "You know, I've had such a terrible life. I'm not going to complain to You, because You must have some idea of why You're putting me through this. But I could be a good husband if I was given the chance: I think I could be a good father, if I was given a chance." Two months later he met Jane, a mother of three, who would become his wife.
Colapinto remarks on the almost "oracular" eloquence of David Reimer, an unassuming man who works in a slaughterhouse, likes fishing and listening to Elvis, and takes pride in the role of sole breadwinner for his family David's style is as far as possible from the cosmopolitan polish, flaunted sexual amorality, and professional hubris of his long antagonist, John Money.
A notable strength of this book is the restraint with which Colapinto presents Money's activities and their acceptance by the medical community and the mainstream press. While the reader seethes in indignation, Colapinto calmly and relentlessly piles up facts. Consider:
* At the time he had Bruce Reimer castrated, Money knew very well of evidence contradicting his theory about the primacy of learning over biology in psychosexual development. He knew this from research on hormones done at the University of Kansas -- but also from his own work. He had just co-authored, with one of his graduate students, a study of ten girls, aged three to fourteen, who had been subjected to excesses of testosterone in utero when their mothers had taken a synthetic steroid. Nine of the ten girls had been born with masculinized genitals, and all nine demonstrated "tomboyishness," marked masculine preferences in clothing, toys, and play, and a "minimal concern for feminine frills, doll play, baby care, and household chores."
* Money's own 1952 Ph.D. thesis challenged the necessity of early intervention to correct unusual genitalia. It reviewed over two hundred and fifty cases of hermaphrodites who received no surgical intervention as babies. It concluded, to its author's amazement, that the majority made an "adequate adjustment" to life, manifesting neither psychosis nor neurosis. In-depth interviews with ten of the subjects "only strengthened the investigator's impression that the condition of the genitalia plays a strikingly insignificant part in the way a person develops a stable and healthy gender identity, not to mention a secure and confident self-image."
* Money started touting the success of his work in the "twins case" when Brenda was seven. The case was the headline-grabbing centerpiece of Money's address to the annual meeting of the American Association for the Advancement of Science in 1972 and was prominent in his book published the same day, Man & Woman, Boy & Girl. He made no mention, however, of Brenda's severe academic, social, and emotional difficulties, although he himself had intervened to dissuade her school from making her repeat kindergarten, and she had later repeated first grade. Money stopped bringing up the case after 1980 and deflected inquiries about its outcome, but he continued to promote surgical sex reassignment for injured or deformed baby boys.
As depressing as Money's mendacity is the ease with which he got away with it. Money's account of the twins case could not be verified since the patient's identity remained confidential, yet the lay press lapped it up. Time magazine called the case "strong support" for the view that "conventional patterns of masculine and feminine behavior can be altered." The authors of textbooks in pediatrics, endocrinology, and the social sciences were just as gullible. The 1979 Textbook of Sexual Medicine, for example, by Robert Kolodny and sex researchers William Masters and Virginia Johnson, maintained: "The childhood development of this (genetically male) girl has been remarkably feminine and is very different from the behavior exhibited by her identical twin brother. The normality of her development can be viewed as a substantial indication of the plasticity of human gender identity and the relative importance of social learning and conditioning in this process."
Money's work lent an aura of science to the radical feminism then politically correct. And in that heyday of radical chic, his reputation was only enhanced in some quarters by his personal outlandishness. He insisted on peppering his speech with the bluntest four-letter words. He publicly advocated open marriage, recreational sex, pornography (he was an expert witness defending the 1973 film Deep Throat), and the various perversions he preferred to call "paraphilias." Even in the squarer 1980s, Money deplored the "moralistic ignorance" of those who reject pedophilia. In his collected writings Venuses Penuses (1985), he called himself a "missionary of sex."
But just as David's story culminates in his triumph over the past, so Money's wends its way to his downfall. In 1975, his protector at Johns Hopkins was replaced as chairman of the psychiatry department by Dr. Paul McHugh, a fearless scourge of corruption in modern psychiatry. Two years later, a Hopkins psychiatrist produced a longterm follow-up study of fifty adult transsexuals treated at Hopkins since 1966. It found that none of them showed measurable improvement in his life, and McHugh had the Gender Identity Clinic summarily shut down. Soon Money's course in human sexology was dropped, and when he turned sixty-five, he was expelled from the campus.
Incredibly, however, it was only in 1997 that the complete failure of David Reimer's sex change was reported in the scientific literature. This was the doing of Milton Diamond, who had been a junior member of the University of Kansas team, back in the 1950s, that had discovered the effect on adult guinea pigs' sexual behavior of exposure to hormones in utero. In the 1960s, Diamond had challenged Money's theories head on. But more than two decades passed before he was able to track down David Reimer in Winnipeg.
It was from Diamond that David learned, to his amazement, that his case was famous -- and, to his horror, that its alleged success had been cited to justify thousands of surgical sex reassignments over thirty years. This stunning information persuaded David to cooperate with Diamond and his coauthor, psychiatrist Keith Sigmundson. Their 1997 article in the Archives of Pediatrics and Adolescent Medicine recounted the child's ordeal and pleaded for an end to the practice of surgical sex reassignment of babies.
In their article, Diamond and Sigmundson continued to preserve David's privacy, calling the patient "Joan," then "John." But with As Nature Made Him, the Reimers have at last stepped from behind the veil of anonymity and fully shared their story. It is their good fortune and ours that John Colapinto could present this account. A magazine journalist, Colapinto has made the most of a wealth of medical records, including transcripts and notes from psychological sessions, as well as interviews with a wide range of participants. He never stoops to invent dialogue or otherwise presume to get inside his subject's head.
Meanwhile, John Money drips with disdain for his critics, whom he sees as "lacking in the special talent for original thinking." And why shouldn't he? His diehard supporters include the National Institutes of Health. As of the summer of 1999, Colapinto reports, the latest installment in Money's thirtyfive-year series of taxpayer-funded grants came to $ 135,956. It will be interesting to see whether the stipend survives the publication of this book.
Claudia Winkler is a managing editor at THE WEEKLY STANDARD.