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John Joan Case Study

a blank slate mentality had come about in psychology.

The belief that we were born blank slates, ready

to be written on by our parents, by our teachers.

And the genetics mattered for very, very, very little.

And the John/Joan case as you'll see here in a little bit, really represents I

think, the apex of thinking of us as really being born as completely malleable.

And really what the John/Joan case involves is gender behavior.

We don't ask about the health of the mother or the health of the baby.

We want to know if it's a boy or a girl.

And the reason we want probably want to know if it's a boy or a girl is because

the way we interact with other people is largely

determined by what we perceive their gender to be.

We treat boys differently from girls and we

treat them differently from virtually the moment they're born.

And that different treatment by others certainly socializes gendered behavior.

We behave differently as men and women, boys and girls in part

because of the treatment that we receive from our parents and our teachers.

In this treatment the way we treat men and women,

males and females, differently, is almost unconscious, it's almost automatic.

And it's very pervasive.

Some of you may have heard about

this, I think, really remarkable family in Toronto.

Where the

parents in the family have decided to raise their third child genderless.

Baby Storm.

But is it really the case that you could take a baby at birth and if you dressed

that baby in a dress and put that baby in a pink room, you'd end up with a girl.

Or alternatively, taking the same baby, dressing that baby in pants

and putting that baby in a blue room, you'd get a boy.

Do we really believe that that's all there is to gender behavior?

That our biology have nothing to do with it?

And that we became male and female based upon the interactions we had with others.

Not a reflection of our biology. That if we

were socialized female, we would become female.

And if we were socialized male, we would become male.

Now Money did various type of research.

He did research with transvestites. But the most convincing demonstration

of Money's gender neutrality theory, was a pair of monozygotic twins.

who were born to Rob and Janet Reimer, 1965,

in Winnipeg, Canada. Rob and Janet were working

class Canadian parents had these

monogyzotic genetically identical twins.

And, at about six or seven months, they developed a urinary infection.

>> A few weeks ago Johns Hopkins

Hospital in Baltimore announced that it was

opening a gender identity clinic especially for

people who wanted to change their sex.

Dr. John Money a psychologist.

>> Then several months later, the Reimer family saw something on television

that made them feel hopeful for the first time since the accident.

Doctor John Money, originally from New Zealand, was

a pioneer in the astonishing new field of

sex change surgery.

>> Doctor Money, it's still a pretty drastic procedure, isn't it?

>> Well it's a drastic procedure by your standards

and mine, but for the people who are living in

desperation perhaps the best way to understand it is,

that it seems no more drastic to them than circumcision.

>> We just happened to be watching TV.

>> The transsexual, certainly made an impact.

Because [INAUDIBLE] feminine seeming woman.

And I thought, here's our answer, here's our salvation, here's our hope.

[MUSIC]

>> Janet wrote to Doctor Money after the show ended.

[MUSIC]

He replied promptly. When they met, Doctor

Money suggested that the Reimer's could turn their baby son into a baby girl.

[MUSIC]

It looked as if Ron and Janet had solved the problem.

It wasn't just that Dr. Money was the answer to the Reimer's prayers.

They were the answer to his.

[BLANK_AUDIO]

On July the 3rd, 1967, when Bruce Reimer was almost two

[MUSIC]

>> He was castrated by a surgeon at John Hopkins Medical Hospital.

Without his testicles, Bruce could no longer produce male hormones.

>> It made sense at the time that he became a daughter.

[MUSIC]

Maybe it is a matter of nurture over nature, and

I thought if it was simply a matter of nurture,

I could nurture my child into being feminine.

[MUSIC]

As Doctor Money suggested, the Reimers changed Bruce's

name, to Brendan, and dressed her as a girl.

Doctor Money also gave Janet and Ron very strict instructions.

It might seem remarkable today but really people back 40,

50,60 years ago believed, that we were blank slates.

That you could produce a male or a female

just depending upon the way you raise that individual.

For John Money what was critical, was that,

and it's reflected in the video you just saw.

What was critical for him

was that the decision to raise an individual as a male or

female had to be made before that individual was two years old.

That was the first thing.

And, if you caught in the video Bruce Reimer was castrated just

prior to his second birthday which was a critical thing for many.

The second thing. Was that the socialization post

assignment, had to be unequivocal as money

told Janet and Rob Reimer. That the success of this experiment

depended critically on them, that they had to never let on to their daughter.

That she was initially born a boy.

And some people began to question whether

or not this experiment was really, truly successful.

And most significant was a psychology, psychologist

from the University of Hawaii named Milton Diamond.

Who had a hard time believing

that you could take a pair of identical twins

and make one a male and one a female.

And so he worked hard to try to actually get more details about the case.

In fact things weren't going that well for Brenda Reimer.

And ultimately, Brenda Reimer's case was

reported in a book, but originally actually

was reported in a Rolling Stone article, by this author here, John Colapinto.

That, that, who subsequently wrote a book about the case.

She didn't know the source of her unhappiness.

When she reached the age of puberty they

gave her female hormones to stimulate breast development.

And that made her very uncomfortable.

And as a result she gained a lot of weight.

You can see she's a little heavy here in the photograph.

She gained a lot of weight to try to mask the breast development.

And again Janet and Rob didn't know what

to do, with now their suicidal daughter, Brenda.

Money had told them that they could never let on

that she was born a boy, and so they feared revealing

maybe what was the source of her suicidal behavior.

But ultimately, she was so suicidal that they decided that they had to tell her.

And so at about the age of 15, they told

Brenda about the circumstances of her birth and the botched circumcision.

Her immediate reaction of course was bewilderment.

But not so much anger, as relief.

Relief that finally, there was an explanation for the way she felt.

And rather rapidly, Brenda Reimer changed back into a

boy and took the name David Reimer. And she took the name David.

Because she felt that

at this point that he felt that his life had been like David versus Goliath.

And here's a picture of him at the age of 15.

David Reimer went public with his story in order to try to help other people.

Who might be in similar circumstances, maybe not identical to

his, but similar circumstances, may be born with ambiguous genitalia.

Ultimately David married at the age of a I think

in his early 30's he married and became a father.

He couldn't biologically become a father because he

had been castrated, but he married a woman

who had children. And he became a father.

And by all accounts, was a good father.

Sadly, in 2004, at the age of 38, David Reimer committed suicide.

He never really spoke poorly or negatively of John Money.

And it's not clear what it led him to commit suicide at the age of 38.

He felt that his life was a struggle

but he felt that his struggle could help others.

It certainly an illustration of the extent to

which, the blank slate mentality did dominant within psychology.

Next time we'll talk about another case illustration.

In this case, a very important human genetic condition called phenylketonuria.

For the Canadian politician, see David J. Reimer.

David Reimer
BornBruce Peter Reimer
(1965-08-22)August 22, 1965
Winnipeg, Manitoba, Canada
DiedMay 4, 2004(2004-05-04) (aged 38)
Winnipeg, Manitoba, Canada
Cause of deathSuicide
Other namesBrenda Reimer, Bruce Reimer
Spouse(s)Jane Fontaine (1990–2004, his death)
Parent(s)Janet Grace Schultz
Ronald Peter Reimer
RelativesBrian Henry Reimer (identical twin, deceased)

David Peter Reimer (August 22, 1965 – May 4, 2004) was a Canadian man born male but reassigned as a girl and raised female following medical advice and intervention after his penis was accidentally destroyed during a botched circumcision in infancy.[1]

Psychologist John Money oversaw the case and reported the reassignment as successful and as evidence that gender identity is primarily learned. Academic sexologist Milton Diamond later reported that Reimer's realization he was not a girl crystallized between the ages of 9 and 11,[2] and he transitioned to living as a male at age 15. Well known in medical circles for years anonymously as the "John/Joan" case, Reimer later went public with his story to help discourage similar medical practices. He later committed suicide after suffering years of severe depression, financial instability, and a troubled marriage.[3]

History[edit]

David Reimer was born in Winnipeg, Manitoba. He was originally named Bruce, and his identical twin was named Brian. At the age of six months, after concern was raised about how both of them urinated, the boys were diagnosed with phimosis.[1]:10[4] They were referred for circumcision at the age of seven months. On April 27, 1966, a urologist performed the operation using the unconventional method of electrocauterization,[1]:11–13[5] but the procedure did not go as doctors had planned, and Bruce's penis was burned beyond surgical repair. The doctors chose not to operate on Brian, whose phimosis soon cleared without surgical intervention.[6]

The parents, concerned about their son's prospects for future happiness and sexual function without a penis, took him to Johns Hopkins Hospital in Baltimore in early 1967 to see John Money,[1]:49 a psychologist who was developing a reputation as a pioneer in the field of sexual development and gender identity, based on his work with intersex patients. Money was a prominent proponent of the "theory of Gender Neutrality"—that gender identity developed primarily as a result of social learning from early childhood and that it could be changed with the appropriate behavioral interventions.[1]:33–34 The Reimers had seen Money being interviewed in February 1967[1]:39 on the Canadian news program This Hour Has Seven Days,[1]:18 during which he discussed his theories about gender.[1]:19–22

Money and physicians working with young children born with intersex conditions believed that a penis could not be replaced but that a functional vagina could be constructed surgically. It was also the safest and most conventional pathway to take: Money told the parents it was what would be best for the boy.[7] Money also claimed that Reimer would be more likely to achieve successful, functional sexual maturation as a girl than as a boy.[8][page needed][not in citation given] For Money, a case where identical twin boys were involved where one could be raised as a girl provided a perfect test of his theories.[9][10]

Money and the Hopkins team persuaded the baby's parents that sex reassignment surgery would be in Reimer's best interest.[1]:50–52 At the age of 22 months, baby Bruce underwent a bilateral orchidectomy, in which his testes were surgically removed and a rudimentary vulva was fashioned.[1]:53–54 Bruce was reassigned to be raised as female and given the name Brenda. Psychological support for the reassignment and surgery was provided by John Money, who continued to see Reimer annually for about a decade for consultations and to assess the outcome. This reassignment was considered an especially valid test case of the social learning concept of gender identity for two reasons: First, Reimer's identical twin brother, Brian, made an ideal control because the brothers shared genes, family environments, and the intrauterine environment. Second, this was reputed to be the first reassignment and reconstruction performed on a male infant who had no abnormality of prenatal or early postnatal sexual differentiation.

Reimer said that Money forced the twins to rehearse sexual acts involving "thrusting movements", with David playing the bottom role. Reimer said that, as a child, he had to get "down on all fours" with his brother, Brian Reimer, "up behind his butt" with "his crotch against" his "buttocks". Reimer said that Money forced David, in another sexual position, to have his "legs spread" with Brian on top. Reimer said that Money also forced the children to take their "clothes off" and engage in "genital inspections". On at "least one occasion", Reimer said that Money took a photograph of the two children doing these activities. Money's rationale for these various treatments was his belief that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity".[8][page needed]

For several years, Money reported on Reimer'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." Notes by a former student at Money's lab state that, during the follow-up visits, which occurred only once a year, Reimer's parents routinely lied to lab staff about the success of the procedure. The twin brother, Brian, later developed schizophrenia.[10]

Reimer had experienced the visits to Baltimore as traumatic rather than therapeutic, and when Money started pressuring the family to bring him in for surgery during which a vagina would be constructed, the family discontinued the follow-up visits. From 22 months into his teenaged years, Reimer urinated through a hole that surgeons had placed in the abdomen. Estrogen was given during adolescence to induce breast development.

His case came to international attention in 1997 when he told his story to Milton Diamond, an academic sexologist who persuaded Reimer to allow him to report the outcome in order to dissuade physicians from treating other infants similarly.[2] Soon after, Reimer went public with his story, and John Colapinto published a widely disseminated and influential account in Rolling Stone magazine in December 1997.[11]

This was later expanded into a full-length book As Nature Made Him: The Boy Who Was Raised as a Girl,[8] in which Colapinto described how—contrary to Money's reports—when living as Brenda, Reimer did not identify as a girl. He was ostracized and bullied by peers (who dubbed him "cavewoman"),[5] and neither frilly dresses (which he was forced to wear during frigid Winnipeg winters),[12] nor female hormones made him feel female. By the age of 13, Reimer was experiencing suicidal depression, and he told his parents he would take his own life if they made him see John Money again. Finally, on March 14, 1980, Reimer's parents told him the truth about his gender reassignment, following advice from Reimer's endocrinologist and psychiatrist. At 14, having been informed of his past by his father, Reimer decided to assume a male gender identity, calling himself David. By 1987, Reimer had undergone treatment to reverse the reassignment, including testosterone injections, a double mastectomy, and two phalloplasty operations. On September 22, 1990, he married Jane Fontaine and adopted her three children.[citation needed]

Death[edit]

In addition to his difficult lifelong relationship with his parents, Reimer had to deal with unemployment and the death of his brother Brian from an overdose of antidepressants on July 1, 2002. On May 2, 2004, his wife Jane told him she wanted to separate. On the morning of May 4, 2004, Reimer drove to a grocery store's parking lot in his hometown of Winnipeg[4] and took his own life by shooting himself in the head with a sawed-off shotgun.[13] He was 38 years old.[3]

Legacy[edit]

For the first thirty years after Money's initial report that the reassignment had been a success, Money's view of the malleability of gender became the dominant viewpoint among physicians and doctors, reassuring them that sexual reassignment was the correct decision in certain instances, resulting in thousands of sexual reassignments.[14]

The report and subsequent book about Reimer influenced several medical practices, reputations, and even current understanding of the biology of gender. The case accelerated the decline of sex reassignment and surgery for unambiguous XY infants with micropenis, various other rare congenital malformations, or penile loss in infancy.[14]

David Reimer has often been mentioned by Intactivists, who use him as an example of what could happen to a man if his parents decide to circumcise him at birth, and the effect it can have on him throughout his life. Only a few years after David Reimer's birth, Canada began taking a stance against infant circumcision, and it is now uncommon there.[15]

Colapinto's book described unpleasant childhood therapy sessions, implying that Money had ignored or concealed the developing evidence that Reimer's reassignment to female was not going well. Money's defenders have suggested that some of the allegations about the therapy sessions may have been the result of false memory syndrome and that the family was not honest with researchers.[16]

The case has also been treated by Judith Butler in her 2004 book Undoing Gender, which examines gender, sex, psychoanalysis, and the medical treatment of intersex people. The case of Reimer is used to re-examine Butler's theory of performativity that she originally explored in Gender Trouble.

Documentaries[edit]

The BBC science series Horizon based two episodes on his life. "The Boy Who Was Turned into a Girl" aired in 2000 and "Dr. Money and the Boy with No Penis" in 2004.[17][9][10]

He was also mentioned in the 2017 documentary Gender Revolution.

In popular culture[edit]

  • The Chicago Hope season 6 episode "Boys Will Be Girls" (2000) was based on Reimer's life. The episode explored the theme of a child's right not to undergo sexual reassignment surgery without consent.[18]
  • The Law & Order: Special Victims Unitseason 6 episode "Identity" (2005) was based on David and Brian Reimer's lives and their treatment by Money.[18]
  • The Weakerthans song "Hymn of the Medical Oddity" is about Reimer.[19]
  • The Mental episode "House of Mirrors" (2009), Dr. Jack Gallagher meets a young girl named Heather Masters with suicidal tendencies, who was born a boy.
  • The Ensemble Studio Theatre produced the play Boy (2016) inspired by Reimer's story.[20]

See also[edit]

References[edit]

  1. ^ abcdefghijColapinto, John (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Collins. ISBN 0-06-019211-9. OCLC 42080126. 
  2. ^ abDiamond, Milton; Sigmundson, HK (March 1997). "Sex reassignment at birth. Long-term review and clinical implications". Arch Pediatr Adolesc Med. 151 (3): 298–304. doi:10.1001/archpedi.1997.02170400084015. PMID 9080940. Retrieved 15 May 2013. 
  3. ^ ab"David Reimer, 38, Subject of the John/Joan Case". The New York Times. May 12, 2004. Retrieved May 19, 2015. 
  4. ^ abWoo, Elaine (May 13, 2004). "David Reimer, 38; After Botched Surgery, He Was Raised as a Girl in Gender Experiment". Los Angeles Times. Retrieved 25 June 2016. 
  5. ^ ab"Health Check: The boy who was raised a girl". BBC News. 23 November 2010. Retrieved 19 December 2014. 
  6. ^"David Reimer: The Boy Who Lived as a Girl". CBC News. May 10, 2004. Archived from the original on August 7, 2012. Retrieved 2015-07-05. 
  7. ^"Health Check: The boy who was raised a girl". BBC News. 2010-11-23. Retrieved 2017-05-13. 
  8. ^ abcColapinto, J. (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Perennial. ISBN 0-06-092959-6.  Revised in 2006
  9. ^ ab"The Boy who was Turned into a Girl". Horizon. BBC. December 7, 2000. Retrieved May 19, 2015. 
  10. ^ abc"Dr Money and the Boy with No Penis". Horizon. BBC. 2005. 
  11. ^Colapinto, John (December 11, 1997). "The True Story of John/Joan". Rolling Stone: 54–97. Archived from the original on 2000-08-15. 
  12. ^Colapinto, 1st edition, p/ 115
  13. ^Colapinto, J. (2004-06-03). "Gender Gap: What were the real reasons behind David Reimer's suicide?". Slate. Retrieved 2009-02-13. 
  14. ^ ab"Sex unknown".(2001). Nova transcripts. Retrieved January 1, 2012, from link
  15. ^"Canadian Paediatric Society re-affirms position against routine circumcision". CTV News. Retrieved 24 January 2016. 
  16. ^Burkeman, Oliver (2004-05-12). "Being Brenda". The Guardian. London. Retrieved 2010-05-01. 
  17. ^O'Connell, Sanjida (writer) (November 4, 2004). "Dr. Money And The Boy With No Penis". BBC Horizon. Season 41. Episode 8. (transcript). 
  18. ^ ab"Treatment of Circumcision on TV". The Intactivism Pages. Retrieved 2009-02-01. 
  19. ^Stewart, M.D. (October 4, 2007). "Metaphorical cats, medical oddities and men with brooms". Fast Forward Weekly. Archived from the original on 2014-12-05. 
  20. ^"Sloan Science & Film". scienceandfilm.org. Retrieved 2016-04-22. 

External links[edit]