One of the most memorable and shocking stories in the history of psychology is the one known as the “John/Joan Case.” It began on August 22nd, 1965 in Winnipeg, Canada, with the birth of a set of identical twin boys, Bruce and Brian Reimer. About 7 months after their birth, the twins were taken to a local hospital for a routine procedure to correct a condition called phimosis, when the foreskin cannot retract completely from the head of the penis. The doctors used a cauterizing gun to circumcise the first child, Bruce, but due to a malfunction, ended up burning off the entire penis. (The decision was made not to perform the procedure on the second child, Brian, and the condition cleared itself within a few months.)
The doctors and the boys’ parents were horrified, and not sure how to proceed. Not long after, the Reimers saw an interview with John Money on a popular Canadian television program. Money was a psychologist and a prominent proponent of the "theory of Gender Neutrality." This theory posited that gender identity was primarily the result of social learning, and that early childhood experiences created one's sense of being male or female, also known as gender identity. Money further proposed that one’s gender could be changed with the appropriate behavioral interventions in early childhood. Money appeared on the television program with an attractive young woman who explained that she had been “born a boy,” and later had a sex-change operation to “become a girl.”
Excited by the prospect of helping their child, the Reimers soon contacted John Money and asked for his advice and guidance. Money offered to help, and soon devised a plan that he promised would create a perfectly normal life for young Bruce. What Money offered was simple: 1. castrate the child; 2. surgically fashion a vagina; 3. prescribe hormone treatments after puberty; and 4. change the child’s name, and never tell her or anyone else the truth. Follow this list perfectly, Money promised, and the child (now renamed Brenda) would grow up to be a normal, healthy, happy girl.
This project was doomed from the start. That’s because, as nearly everyone in medicine and psychology now accepts, one’s gender identity is not socially determined. Our sense of being male or female is a biological construct of the brain, as innate as hair and eye color. Bruce had been born male, and like 99% of boys, had a brain with a male gender identity. Changing his genitals, his name, his mode of dress, and the rest of his life would do nothing to alter what his genes told him he was: male
Although John Money’s published accounts (always with great secrecy, ostensibly to “protect the family’s privacy”) were glowing reports of success, the truth was something else entirely. The Reimers wrote letter after letter to Money, reporting that Brenda still acted very much like a boy, tore off her dresses, played with her brother’s toys (for which she was punished), and had no friends at school (a favorite schoolyard taunt was to call her “Sasquatch” due to her mussed hair and masculine mannerisms). Money simply instructed the Reimers to continue with his original instructions, and to be patient, while being careful to never reveal the disastrous nature of the case to the public and to his colleagues. In one report, Money bragged, "The child's behavior is so clearly that of an active little girl and so different from the boyish ways of her twin brother."
Finally, at age 14, fearing that their child was suicidal, and on the advice of her psychiatrist and endocrinologist, the Reimers opened up and told the truth. “Brenda” later stated that it was as if a light had been turned on in a dark room, and a lifetime of confusion, guilt, and shame was suddenly washed away. Now renamed David, he began trying to pick up the pieces of his shattered life, later detailed by investigative journalist John Colapinto in an award-winning book, “As Nature Made Him: The Boy Who Was Raised as a Girl.”
Although David underwent medical procedures (a double mastectomy, hormone treatments, etc.) and sought psychological treatment, and formed a loving relationship with a woman (even adopting her two children), the years of pain were too much. He suffered failed attempts to forgive his parents and John Money for what they did to him. His twin brother’s diagnosis of schizophrenia and subsequent suicide, as well as a declaration of divorce from his wife, came within a few short years of each other. In the end, David Reimer committed suicide on May 4th, 2004.
The positive epilogue is that, although David’s story is heartbreaking, his willingness to come forward and tell it publicly helped turn the tide toward understanding gender identity. For three decades before his story became public, the prevailing belief in the medical and psychiatric worlds was that gender is malleable and open to change in the first years of life. David’s story, and subsequent research, served to change this opinion to acceptance that gender is fixed, and that those who are born with a body that does not match their gender identity should be accepted as the gender they REPORT, not the one they physically present at birth.
David’s sex change operation was a failure because his gender identity was male, and no matter what John Money, his parents, or society did to him, that would never change. The same is true for the rest of us; we are who we are, and no matter what others say or do, that will never change. Here’s hoping we can carry on the legacy of David Reimer’s attempts to educate people on that important point.