As Nature Made Him

In his exhaustive account entitled "As Nature Made Him," John Colapinto explores the tragic case of David Reimer, one of two twin boys who suffered a life altering accident at the young age of eight months. Following a horribly botched circumcision that resulted in the loss of his entire penis the book focuses on the parent's decision to try to give their son the most normal life that they felt they could give him. By all accounts the parents were genuinely trying to help their child who was in what seemed to be a situation with no real hope of a positive outcome. Under the supervision of a psychologist by the name of Dr. John Money, the Reimer family found themselves on a path that would be littered with challenges and pain and would leave a permanent mark on what seemed to be such a promising young family prior to the fateful accident. At the behest of Dr. Money Janet and Ron Reimer made the impossible decision to raise their male son as a female.

The Reimer's were married in 1964. Not long after they married Janet gave birth to two healthy twin boys whom they named Brian and Bruce. The couple was delighted with their new family. It would be only eight short months following the joyous arrival of the boys that the Reimer's would encounter the most difficult of circumstances that any parents could ever face. When Mrs. Reimer noticed that the boys seemed to be having difficulty urinating she became concerned. After speaking to the family doctor, Janet was urged to take the twins to the hospital to be circumcised due to a condition called phimosis, which is resolved following the removal of the foreskin. Bruce was the unfortunate twin who happened to be picked up and operated on first. There was a malfunction in of a piece of equipment that uses a needle and electricity that was not a standard piece of equipment used for this procedure, the boys penis was almost completely burned off leaving only its small withered and charred remains. Brian was never operated on and within a short period of time the condition cleared up on its own and he never suffered any further from it.

Bruce Reimer would never have a normal functioning sexual organ as the result of a procedure that was ultimately unnecessary. Devastated and guilt ridden, his parents had no idea what they should do. Plastic surgery was not nearly as advanced as it is today and although the Reimer's were told by doctors that the reconstruction of their sons penis might be possible they were careful to emphasize the fact that it would be a somewhat crude and poorly functioning replacement. Their options seemed bleak at best until one night while watching television the Reimer's saw Dr. Money for the first time. He spoke openly about gender reassignment surgery not only in adults but also in children. Encouraged by the idea that Dr. Money might provide the answer that they had been hoping for Janet wrote to Money and told him the story of their twin boys and the unfortunate accident that Bruce had suffered. His response was prompt.

Dr. Money was in many ways a pioneer in the field of gender identity studies. He was awkwardly open in speaking about sexual and gender issues and while he was a respected psychologist, he was in no small way a controversial figure with very outspoken ideas about sexual behavior and gender identity. I have to admit that in reading about Dr. Money's stances on many issues such as pedophilia, which he did not feel was a criminal act if it was consensual, I found it hard to understand how someone who shared his beliefs so openly came to be such a respected member of the psychological community. While he may have had many valid and even helpful results from some of his research, I found it difficult to look past many of his views and theories. In some aspects he may have been innovative and possibly even brilliant, but overall I found him to be sick and perverse (not to mention arrogant). Ultimately he was a man who used his academic stature to instill his somewhat distorted view of healthy sexual behavior and gender roles on others. The Reimer's were no exception.

In the case of the Reimer family, Money was presented with the most ideal opportunity for his research that he could hope for. He had theorized for years that the sex of a child is not determined by nature but by nurture. That is to say that he believed that a child was not necessarily born male or female but neutral. He theorized there was a window of time, he referred to as the gender gate, that if a child of one sex was altered to the opposite sex they could be successfully brought up as their new sex. The Reimer case was a perfect opportunity to try to prove his theory. Not only did he have a child who was a fully intact male at birth but he had a control for his experiment in the form of the twin brother who was almost biologically identical.

One of the few people to question Money was a psychologist by the name of Milton Diamond. In a critique that Diamond wrote about Dr. Money's claim of gender neutrality in newborns he raised a rather simple objection to the broad acceptance of Money's theory, "To support [such a] theory," Diamond wrote, "we have been presented with no instance of a normal individual appearing as an unequivocal male and being reared successfully as a female." (Colapinto, 48) This critique was published in the Quarterly Review of Biology one year and eight months before Money received the letter from Janet Reimer. I must have seemed like a godsend. This was his chance and he was not going to miss it.

After meeting with Dr. Money the Reimer's thought about his plan to perform surgical sex change on their son Bruce. The decision was one they were told had to be reached quickly because according to Money's theory children are locked into a gender identity between the ages of two and a half to three years of age. At the time Bruce was 19 months. Janet and Ron told Money they would need time to think it over but shortly after their return home the Reimer's stopped cutting their sons hair and Janet began to alter some of his clothing into more girlish pieces. They chose a name for their new daughter, following Money's suggestion of using the same beginning sound of the babies name, Bruce became Brenda. On Monday, July 3 1967, the change was made official when Brenda underwent sexual reassignment surgery at the age of twenty-two months, safely within the gender gate window Money had warned the parents about.

The surgery was successful. Bruce having been surgically castrated was now officially Brenda. The Reimer's were strictly advised that they must never allow even the slightest doubt of the sex of their child to slip nor could they ever tell Brenda the truth about her birth. This was absolutely vital to the success of the gender reassignment. In order for Brenda to fully except being female and experience successful development into a woman Dr. Money believed she must not know anything that may add confusion or cast any doubt on her newly assigned sex. Armed with their instructions from the doctor the Reimer family returned home hopeful.

It did not take long for the first signs of the difficulties that lie ahead to make themselves known. At a very young age Brenda showed a considerable amount of resistance to things such as wearing dresses. Even as early as kindergarten Brenda showed definite signs of not being a typical little girl. Her teachers later reflect on her demeanor and behavior by saying that there was absolutely nothing girly about her. Brenda had little success fitting in with the girls at school. At the same time she was equally unsuccessful fitting in with the boys. At a very young age she found herself in a lonely and ambiguous place, something that would not change for many miserable years.

As part of her treatment, Brenda and her brother Brian were taken by their parents for an annual visit with Dr. Money. The accounts of these visits are disturbing to say the least. Brenda, who already felt different from all of the other kids she knew, was further singled out by going on these trips that nobody else had to go on. Aside from the fact that these trips served in part to isolate and separate an already desperately lonely child, the sessions with Dr. Money grew increasingly intrusive and embarrassing for both children as they grew older. Part of Dr. Money's theory of gender identity in the case of gender reassignment cases was that there was a need for the patient to visually identify with male and female gender roles. While this may seem like somewhat logical assumption, what it ultimately boiled down to was Money showing young children graphically pornographic pictures of naked men and women and men and women engaged in sexual intercourse.

As if that was not disturbing enough, another part of Money's treatment was first introduced when the twins were six years old. Dr. Money referred to it as sexual rehearsal play or coital mimicry. During this part to their sessions the twins were told to simulate sexual intercourse with each other. Brenda would be instructed to either get on her hands and knees or lay on her back with her legs apart while her brother Brian was told to either get behind her with his groin pressed against her buttocks or to lay on top of her. "On at least one occasion, Brian says, Money took a Polaroid photograph while they were engaged in this part of therapy." (Colapinto, 87) Even if this was truly believed by Money to be a critical part of their treatment, I cannot think of a single medically or therapeutically relevant reason for these acts to be photographed. Out everything the twins suffered at the hands of doctor Money as adults they both concur that this portion of their treatment left perhaps the strongest impression on both of them.

Dr. Money was later said by the twins to have had a totally different demeanor with their parents than he did with them. He spoke and acted differently when they were around and while the boys thought they were aware of what happened in their private sessions with Money, they were not. But that is not to say that there were not signs that the parents could have possibly picked up on that may have shed some insight to his true nature. One of which was Brenda's obvious distain for the doctor. Her refusals to travel to her annual appointment with Money became more and more desperate with each passing year. Money also asked the parents to do things such as to be naked in front of the twins whenever possible and also to have sex in front of the children to reinforce their gender identity. While the parents drew the line at having sex in front of their children, it seems odd that Dr. Moneys request did not raise concerns about the man that was treating both of their children in private sessions. It is probably worth mentioning that Janet Reimer did appear naked in front of the children from time to time, an act that they found hugely awkward and embarrassing.

Despite the reality of Brenda's misery and obvious resistance to the transformation, Money published numerous accounts of the success of his "twins" case. Unbeknownst to the Reimer's, who were living in a Hell that few people could imagine, Money was receiving a great deal of recognition due to the continued successful development of the boy who was being raised as a girl. This case was making such an impact for many reasons. Many children had been sexually reassigned who were born with conditions at birth that usually involved what are called intersex conditions, which means there is some sort of defect at birth rendering the sexual organs ambiguous such as hermaphrodites. These individuals are thought by many to be more psychosexually flexible because their condition involves a genetic hormonal imbalance. In the case of Brenda Reimer there was no such hormonal imbalance so the successful results Money was reporting, though very far from the truth, completely supported nurture over nature in gender identity.

As the medical community continued to unknowingly accept the false representation of the case involving the Reimer twins, the reality was that Brenda Reimer's life grew increasingly miserable as she grew older. Her mother suffered from severe depression and her father had developed quite a problem with alcohol. Not to mention Brian, who in the midst of all of his sisters constant care and attention, was cast aside. Brian would also later say that he felt guilty when they were younger and in school because when given the choice between having friends and sticking by his socially awkward sister, he chose his friends, leaving Brenda with no one.

After years of misery, confusion and humiliation, Brenda Reimer was told the truth about her birth at the age of fourteen. Immediately after finding out the truth Brenda began the transformation back to the male she always knew she was supposed to be. She let her parents choose her new name and on July 2, 1981 David was surgically altered to finalize his transformation. He was sixteen at the time. This change, while it did help to explain many things, did not repair the damage that had been done to the family. Brian suffered from drug addiction and had many run-ins with the law. Eventually he killed himself. David met a lovely girl who was accepting of his past but he was in some ways a difficult man to be married to. Intimate relations, while made possible by phalloplasty, were sometimes interrupted by David having to retreat to the bathroom to vomit. While the phalloplasty gave David a somewhat functioning penis, the castration was irreversible and he would never be able to have children of his own because he had no testicles.

After reading this tragic story it is somewhat vindicating, if not relieving to find out that Dr. Money did eventually lose his credibility and was slowly removed from his pedestal as the leading authority on psychosexual matters. He was removed from his office at Johns Hopkins Hospital and placed in a small office off campus. He was stripped of his staff and left with only one student who was his assistant. He never did accept any responsibility for the failed Reimer case, nor did he ever admit he may have been wrong. The wheels were placed in motion for the standards of practice in cases such as the Reimer case to change. Dr. Diamond had published a paper revealing the true outcome of the famed "twins" case and David Reimer agreed to appear on television interviews in an attempt to get the truth out and hopefully spare anyone else from living a life like his. At the end of the book David seems secure in his manhood and determined to be a good husband and father to his two adopted children.

Upon further research I found that David killed himself on May 5, 2004. In an article that John Colapinto wrote about the suicide he says that right before he died Davis spoke to his wife about his sexual inadequacy and how he felt he was unable to be a true husband. On the morning of the day he killed himself, David went to the house while his wife Jane was at work and retrieved a shotgun, and sawed the barrel off of it. The final sentence of Colapinto's article reads "Then he drove to the nearby parking lot of a grocery store, parked, raised the gun, and, I hope, ended his suffering forever." (Colapinto, 2004) If anyone deserves to be released of their suffering, David Reimer certainly did. The victim of a most unfortunate accident that made a normal life impossible, David was never able to overcome the tragedy of his life. One can only hope that by making his story so publicly known, David's misfortune will in some way prevent the needless sufferings of countless others.

I have to say while I may have found parts of this book somewhat interesting, I have to say I did not enjoy reading it. I found it to be disturbing and incredibly sad. I did learn a great deal more than I would probably have ever learned about gender identity and inter-sexual individuals than I would have ever learned had I not read this book. Aside from the science I think this book has a bigger lesson. We are always learning and advancing in new ways and it is incredibly egotistical and ignorant to assume that we know unequivocally the solution to every situation. People who are in a position to influence the decisions of others and hold the power to irreversibly change their lives should not take the great responsibility lightly. Had doctor Money considered for a moment that he may be wrong in case of David Reimer he may have considered waiting to complete the irreversible castration. I think it is safe to assume that while David may have had a hard time growing up as a male without a penis, he would not have suffered nearly as much as he did being forced to live for 14 years as a female.

Works Cited

Colapinto, John. As Nature Made Him: The Boy Who Was Raised As A Girl. New York: Harper Colins, 2000.

Colapinto, John. "Gender Gap: What were the real reasons behind David Reimer's suicide." Slate 3 June 2004. 3 March 2009