Article
JOHN COLLAPINTO – 11 DECEMBER 1997 – REPRINT FROM ROLLING STONE
In 1967, an anonymous baby boy was turned into a girl by doctors at Johns Hopkins Hospital. For 25 years, the case of John/Joan was called a medical triumph — proof that a child’s gender identity could be changed — and thousands of “sex reassignments” were performed based on this example. But the case was a failure, the truth never reported. Now the man who grew up as a girl tells the story of his life, and a medical controversy erupts.
In late June 1997, I arrive at an address in a working-class suburb in the North American Midwest. On the front lawn, a child’s bicycle lies on its side; an eight-year-old secondhand Toyota is parked at the curb. Inside the house, a handmade wooden cabinet in the corner of the living room holds the standard emblems of family life: wedding photos and school portraits, china figurines and souvenirs from family trips. There is a knockoff-antique coffee table, a well-worn easy chair and a sofa – which is where my host, a wiry young man dressed in a jean jacket and scuffed work boots, seats himself. He is 31 years old but could pass for a decade younger. Partly it’s the sparseness of his beard – just a few blond wisps that sprout from his jaw line; partly it’s a certain delicacy to his prominent cheekbones and tapering chin. Otherwise he looks, and sounds, exactly like what he is: a blue-collar factory worker, a man of high school education whose fondest pleasures are to do a little weekend fishing with his dad in the local river and to have a backyard barbecue with his wife and kids.Ordinarily a rough-edged and affable young man, he stops smiling when conversation turns to his childhood. Then his voice – a burred baritone – takes on a tone of aggrievement and anger, or the pleading edge of someone desperate to communicate emotions that he knows his listener can only dimly understand. How well even he understands these emotions is not clear: When describing events that occurred prior to his 15th birthday, he tends to drop the pronoun I from his speech, replacing it with the distancing you – almost as if he were speaking about someone else altogether. Which, in a sense, he is.
“It was like brainwashing,” he is saying now as he lights a cigarette. “I’d give just about anything to go to a hypnotist to black out my whole past. Because it’s torture. What they did to you in the body is sometimes not near as bad as what they did to you in the mind – with the psychological warfare in your head.”
He is referring to the extraordinary medical treatment he received after suffering the complete loss of his penis to a botched circumcision when he was 8 months old. On the advice of experts at the renowned Johns Hopkins medical center, in Baltimore, a sex-change operation was performed on him, a process that involved clinical castration and other genital surgery when he was a baby, followed by a 12-year program of social, mental and hormonal conditioning to make the transformation take hold in his psyche. The case was reported as an unqualified success, and he became one of the most famous (though unnamed) patients in the annals of modern medicine.
It’s a fame that derives not only from the fact that his medical metamorphosis was the first sex reassignment ever reported on a developmentally normal child but also from a stunning statistical long shot that lent a special significance to the case. He was born an identical twin, and his brother provided the experiment with a built-in matched control – a genetic clone who, with penis intact, was raised as a male. That the twins were reported to have grown into happy, well-adjusted children of opposite sex seemed unassailable proof of the primacy of rearing over biology in the differentiation of the sexes and was the basis for the rewriting of textbooks in a wide range of medical disciplines. Most seriously, the case set a precedent for sex reassignment as the standard treatment for thousands of newborns with similarly injured, or irregular, genitals. It also became a touchstone for the feminist movement in the 1970s, when it was cited as living proof that the gender gap is purely a result of cultural conditioning, not biology. For Dr. John Money, the medical psychologist who was the architect of the experiment, this case was to be the most publicly celebrated triumph of a 40-year career that recently earned him the accolade “one of the greatest sex researchers of the century.”
But as the mere existence of this young man in front of me would suggest, the experiment was a failure, a fact revealed in a March 1997 article in the Archives of Adolescent and Pediatric Medicine. Authors Milton Diamond, a biologist at the University of Hawaii, and Keith Sigmundson, a psychiatrist from Victoria, British Columbia, documented how the twin had struggled against his imposed girlhood from the start. The paper set off shock waves in medical circles around the world, generating furious debate about the ongoing practice of sex reassignment (a procedure more common than anyone might think). It also raised troubling questions about the way the case was reported in the first place, why it took almost 20 years for a follow-up to reveal the actual outcome and why that follow-up was conducted not by Dr. Money but by outside researchers. The answers to these questions, fascinating for what they suggest about the mysteries of sexual identity, also bring to light a 30-year rivalry between eminent sex researchers, a rivalry whose very bitterness not only dictated how this most unsettling of medical tragedies was exposed but also may, in fact, have been the impetus behind the experiment in the first place.
But what for medicine has been a highly public scandal involving some of the biggest names in the world of sex research has been for the young man sitting in front of me a purely private catastrophe. Apart from two short television appearances (his face obscured, his voice disguised), he has never spoken on the record to a journalist and has never before told his story in full. For this article, he granted more than 20 hours of candid interviews and signed confidentiality waivers giving me exclusive access to a voluminous array of legal documents, therapists’ notes, Child Guidance Clinic reports, IQ tests, medical records and psychological work-ups. He assisted me in obtaining interviews with his former therapists as well as with all of his family members, including his father, who, because of the painfulness of these events, had not spoken of them to anyone in more than 20 years.
The young man’s sole condition for talking to me was that I withhold some details of his identity. Accordingly, I will not reveal the city where he was born and raised and continues to live, and I have agreed to invent pseudonyms for his parents, whom I will call Frank and Linda Thiessen, and his sole sibling, the identical twin brother, whom I will call Kevin. The physicians in his hometown I will identify by initials. The young man himself I will call, variously, John and Joan, the pseudonyms given for him by Diamond and Sigmundson in the journal article describing the macabre double life he has been obliged to live. No other details have been changed.
“My parents feel very guilty, as if the whole thing was their fault,” John says. “But it wasn’t like that. They did what they did out of kindness, and love and desperation. When you’re desperate, you don’t necessarily do all the right things.”
The irony was that Frank and Linda Thiessen’s life together had begun with such special promise. A young couple of rural, religious backgrounds, they grew up on farms near each other and met when Linda was just 15, Frank 17. Linda, an exceptionally pretty brunette, had spent much of her teens fighting off guys who were too fresh. Frank, a tall, shy fair-haired man, was different. “I thought, ‘Well, he’s not all hands,’ “Linda recalls.” ‘I can relax with him.’ ” Three years later, at ages 18 and 20, they married and moved to a nearby city. Linda remembers Frank’s joy soon after, upon learning that he was going to be the father of twins – and his euphoria when the brothers were born, on Aug. 22, 1965. “The nurse asked him, ‘Is it boys or girls?’ ” Linda recalls. “And he said, ‘I don’t know! I just know there’s two of ’em!’ “
Shortly before the births, Frank had landed his highest-paying job ever, at a local unionized plant, and the couple now moved with their newborns into a sunny one-bedroom apartment on a quiet side street downtown. But when the twins were 7 months old, Linda noticed that their foreskins were closing, making it hard for them to urinate. Their pediatrician explained that the condition, called phimosis, was not rare and was easily remedied by circumcision. He referred them to a surgeon. The operations were scheduled for April 27, 1966, in the morning. Because Frank needed the family car to get to his job on the late shift, they brought the kids in the night before. “We weren’t worried,” Linda says. “We didn’t know we had anything to worry about.“
But early the next morning, they were jarred from sleep by a ringing phone. It was the hospital. “There’s been a slight accident,” a nurse told Linda. “The doctor needs to see you right away.”
In the children’s ward, they were met by the surgeon. Grim-faced, businesslike, he told them that John had suffered a burn to his penis. Linda remembers being shocked into numbness by the news. “I sort of froze,” she says. “I didn’t cry. It was just like I turned to stone.” Eventually she was able to gather herself enough to ask how their baby had been burned. The doctor seemed reluctant to give a full explanation – and it would, in fact, be months before the Thiessens would learn that the injury had been caused by an electro-cautery needle, a device sometimes used in circumcisions to seal blood vessels as it cuts. Through mechanical malfunction or doctor error, or both, a surge of intense heat had engulfed John’s penis. “It was blackened,” Linda says, recalling her first glimpse of his injury. “It was like a little string. And it went right up to the base, up to his body.” Over the next few days, the burnt tissue dried and broke away in pieces.
John, with a catheter where his penis used to be remained in the hospital for the next several weeks, while Frank and Linda, frantic, watched as a parade of the city’s top local specialists examined him. They gave little hope. Phallic reconstruction, a crude and makeshift expedient even today, was in its infancy in the 1960’s – a fact made plain by the plastic surgeon when he described the limitations of a phallus that would be constructed from flesh farmed from John’s thigh or abdomen: “Such a penis would not, of course, resemble a normal organ in color, texture or erectile capability,” he wrote in a report to the Thiessens’ lawyer. “It would serve as a conduit for urine, but that is all.”
Even that was optimistic, according to a urologist: “Insofar as the future outlook is concerned,” he wrote, “restoration of the penis as a functional organ is out of the question.” A psychiatrist summarized John’s emotional future this way: “He will be unable to consummate marriage or have normal heterosexual relations; he will have to recognize that he is incomplete, physically defective, and that he must live apart….”
Now desperate, Frank and Linda took baby John on a daylong train trip to the Mayo Clinic, in Rochester, Minn., where he was examined by a team of doctors who merely repeated the dire prognoses delivered by the Thiessens’ local physicians. Back home, with nowhere to turn, the couple sank into a state of mute depression. Months passed during which they could not speak of John’s injury even to each other. Then one evening in December 1966, some seven months after the accident, they saw a TV program that jolted them from their despondency.
On their small black-and-white television screen appeared a man identified as Dr. John Money. A suavely charismatic and handsome individual in his late 40s, bespectacled and with sleekly brushed-back hair, Dr. Money was speaking about the wonders of gender transformation taking place at the Johns Hopkins medical center, where he was a medical psychologist. Also on the program was a woman – one of the satisfied post-operative transsexuals who had recently been converted at Johns Hopkins.
Today, with the subject of transsexualism a staple of daytime talk shows, it’s difficult to imagine just how alien the concept seemed on that December evening in 1966. Fourteen years earlier, a spate of publicity had attended the announcement by American ex-GI George Jorgensen that he had undergone surgical transformation to become Christine. But that operation, performed in Denmark, had been roundly criticized by American doctors, who refused to perform such surgeries. The subject had faded from view – until now, when Johns Hopkins announced that it had not only performed two male-to-female sex changes (a first in America) but also established the world’s first Gender Identity Clinic, devoted solely to the practice of converting people from one sex to the other. Along with gynecologist Howard W. Jones Jr., the driving force behind Hopkins’ pioneering work in the study and treatment of transsexuals was the man on the Thiessens’ television screen: Dr. John Money.
“He was very self-confident, very confident about his opinions,” Linda recalls of her first glimpse of the man who would have such a lasting effect on the Thiessen’s lives. “He was saying that it could be that babies are born neutral and you can change their gender. Something told me that I should get in touch with this Dr. Money.”
She wrote to him soon after and described what had happened to her child. Dr. Money responded promptly, she says. In a letter, he expressed great optimism about what could be done for her baby at Johns Hopkins and urged her to bring John to Baltimore without delay. He also happened to inquire, Linda says, about the twin brother whom she had mentioned in passing. “He asked if they were identical twins,” Linda says. She informed him that they were. Dr. Money replied that he would like to run a test on the babies at Johns Hopkins, just to make sure.
After so many months of grim predictions, bleak prognoses and hopelessness, Dr. Money’s words, Linda says, felt like a balm. “Someone,” she says, “was finally listening.“
Dr. Money was, indeed, listening. But then, Linda’s cry for help was one that he might have been waiting for his entire professional life.
At the time that the Thiessen family’s plight became known to Dr. Money, he was already one of the most respected, if controversial, sex researchers in the world. Born in 1921 in New Zealand, Money had come to America at about age 26, received his Ph.D. in psychology from Harvard and then joined Johns Hopkins, where his rise as a researcher and clinician specializing in sexuality was meteoric. Within a decade of joining Hopkins, he was already widely credited as the man who had coined the term “gender identity” to describe a person’s inner sense of himself or herself as male or female, and was the world’s undisputed authority on the psychological ramifications of ambiguous genitalia. “I think he’s a thoroughly ethical and professional person,” says John Hampson, a child psychiatrist who co-authored a number of Money’s groundbreaking papers on sexual development in the mid-1950s. “He was a very conscientious scientist when it comes to collecting data and making sure of what he’s saying. I don’t know very many social scientists who could match him in that regard.” According to Hampson, Money’s ability to persuade others to adopt his point of view is one of the psychologist’s chief strengths: “He’s a terribly good speaker, very organized and very persuasive in his recital of the facts regarding a case.” Indeed, Hampson admits that Money is almost too good at the art of persuasion. “I think a lot of people were envious,” says Hampson. “He’s kind of a charismatic person, and some people dislike him. As a person, he was a little bit . . . oh . . . flamboyant; he might have been a little glib.”
Money’s often-overweening confidence actually came to him at some cost. His childhood and youth in rural New Zealand had been beset by anxieties, personal tragedies and early failure. The son of an Australian father and an English mother, he was a thin, delicate child raised in an atmosphere of strict religious observance – or what he has called “tightly sealed, evangelical religious dogma.” At age 5 he was bullied by his classmates and took shelter with a female cousin in the girls’ play shed, where no boy would be caught dead. “My fate was sealed,” he wrote in an anthology titled How I Got Into Sex. “Having not measured up as a fighter, I was set on the pathway of outwitting other kids by being an intellectual achiever. That was easier for me than for most of them.”
He was 8 years old when his father, after a long illness, died. “His death was not handled very well in our family,” Money wrote. Three days after watching his father get mysteriously carried off to the hospital, the boy was told that his father had died. His shock was compounded by the trauma of being informed by an uncle that now he would have to be the man of the household. “That’s rather heavy duty for an 8-year-old.” Money wrote. “It had a great impact on me.” Indeed. As an adult, Money would forever avoid the role of “man of the household.” After one brief marriage ended, he never remarried, and he has never had children.
Following his father’s death, Money was raised by his mother and spinster aunts. A solitary adolescent with passions for astronomy and archaeology, he also harbored ambitions to be a musician. His widowed mother could not afford piano lessons, so Money worked as a gardener on weekends to pay for music classes and used every spare moment to practice. It was an ambition doomed to disappointment, partly because Money had set the bar so high for himself: “It was difficult for me to have to admit that, irrespective of effort, I could never achieve in music the goal that I wanted to set for myself. I would not even be a good amateur.”
Upon entering Victoria University, in Wellington, Money discovered a new passion into which he would channel his thwarted creativity: the science of psychology. Like so many drawn to the study of the mind and emotions, Money initially saw the discipline as a means of solving certain gnawing questions about himself. His first serious work in psychology, the thesis for his master’s, concerned “creativity in musicians”; in it, Money writes, “I began to investigate my relative lack of success in comparison with that of other music students.”
His later decision to narrow his studies to the psychology of sex had a similarly personal basis. Having lost his religious faith in his early 20s, Money increasingly reacted against what he saw as the repressive religious strictures of his upbringing and, in particular, the anti-masturbatory, anti-sexual fervor that went with them. The academic study of sexuality, which removed even the most outlandish practices from moral considerations and placed them in the “pure” realm of scientific inquiry, was for Money an emancipation. From now on, he would be a fierce proselytizer for sexual exploration. According to journalist John Heidenry, a personal confidant of Money’s and author of the recent book What Wild Ecstacy, which traces Money’s role as a major behind-the-scenes leader of the sexual revolution of the 1960s and ’70s, the psychologist’s sexual explorations were not confined to the lab, lecture hall or library. An acknowledged but discreet bisexual, Money engaged in affairs with a number of men and women – “some briefly,” Heidenry writes, “others over a longer duration.” Indeed, by the mid-1970s, with the sexual revolution in full rampage, Money would step out publicly as a champion of open marriage, nudism and the dissemination of explicit pornography. His promotion of the culture’s sexual unbuttoning seemed boundless. “There is plenty of evidence that bisexual group sex can be as personally satisfying as a paired partnership, provided each partner is ‘tuned in’ on the same wavelength,” he wrote in his 1975 pop-psych book, Sexual Signatures. A former patient who was treated by Money in the 1970’s for a rare endocrine disorder recalls the psychologist once casually asking him if he’d ever had a “golden shower.” The patient, a sexually inexperienced youth at the time, did not know what Money was talking about. “Getting pissed on,” Money airily announced with the twinkling, slightly insinuating little smile with which he delivered such deliberately provocative comments.
According to colleagues and other former patients, such sexual frankness in conversation is a hallmark of Money’s personal style. Dr. Fred Berlin, a professor of psychiatry at the Johns Hopkins School of Medicine and a colleague who considers Money one of his most important mentors, agrees that Money is aggressively outspoken. “Because he thinks it’s important to desensitize people in discussing sexual issues, he will sometimes use four-letter words that others might find offensive,” says Berlin. “Perhaps he could be a little more willing to compromise On that. But John is an opinionated person who isn’t looking necessarily to do things differently from the way he’s concluded is best.”
But while Money’s conclusions about the best approach to sexual matters merely raised eyebrows in the mid-1970’s, they provoked outrage at the dawn of the more conservative 1980’s. Undaunted, Money continued to push on into uncharted realms. In an April 14, 1980, article in Time, Money was sharply criticized for what looked dangerously like an endorsement of incest and pedophilia. “A childhood sexual experience, such as being the partner of a relative or of an older person, need not necessarily affect the child adversely,” Money told Time. And according to a right-wing group critical of his teachings, Money reportedly told Paidika, a Dutch journal of pedophilia, “If I were to see the case of a boy aged 10 or 12 who’s intensely attracted toward a man in his 20s or 30s, if the relationship is totally mutual, and the bonding is genuinely totally mutual, then I would not call it pathological in any way.”
Money’s response to criticism has been to launch counterattacks of his own, lambasting his adoptive country for a puritanical adherence to sexual taboos. In an autobiographical essay included in his book Venuses Penuses, Money describes himself as a “missionary” of sex – and points out, with a lofty and defiant pride, “It has not been as easy for society to change as it had been for me to find my own emancipation from the 20th-century legacy of fundamentalism and Victorianism in rural New Zealand.”
Money’s experimental, taboo-breaking approach to sex was paralleled in his professional career. Eschewing the well-traveled byways of sex research, Money sought out exotic corners of the field where he could be a pioneer. He found just such a relatively undiscovered realm of human sexuality while in the first year of his Ph.D. studies in psychology at Harvard. In 1948, in a social-relations course, he learned of a 15 year-old male who was born not with a penis but with a tiny, nublike phallus resembling a clitoris and who, at puberty, developed breasts. It was Money’s first exposure to hermaphroditism – also known as intersexuality – a condition that, in its extreme or its milder forms, is estimated to occur once in every 2,000 births. Characterized by ambiguities of the external sex organs and the internal reproductive system, intersexuality is caused by any of a wide variety of genetic and hormonal irregularities, and can vary from a female born with a penis-sized clitoris and fused labia resembling a scrotum to a male born with a penis no bigger than a clitoris, undescended testes and a split scrotum indistinguishable from a vagina.
Money became fascinated with intersexuality and wrote his doctoral dissertation on the subject, which led to his invitation, in 1951, to join Johns Hopkins, where the world’s largest clinic for the study of intersexual conditions had been established. Up until then, the syndrome had been studied solely from a biological perspective. Money came at it from a psychological angle and would make a name for himself as a pioneer in examining the mental and emotional repercussions of being born as neither boy nor girl. At Hopkins, he enlisted Hampson and Hampson’s wife, Joan, to help him study some 105 intersex children and adults. Money claimed to have observed a striking fact about people who had been diagnosed with identical genital ambiguities and chromosomal makeups but who had been raised as members of the opposite sex: More than 95 percent of these intersexes fared equally well, psychologically, whether they had been raised as boys or as girls. To Money, this was proof that the primary factor that determined an intersexual child’s gender identity was not biological traits but the way that the child was raised. He concluded that these children were born psychosexually undifferentiated.
This theory was the foundation on which Money based his recommendation to pediatric surgeons and endocrinologists that they surgically and hormonally stream intersexual newborns into whichever sex the doctors wished. Such surgeries would duly range from cutting down enlarged clitorises on mildly intersexual girls to performing full sex reversals on intersexual boys born with testicles but a penis deemed too small. Money’s only provisos were that such “sex assignments” be done as early as possible – preferably within weeks of birth – and that once the sex was decided on, doctors and parents never waiver in their decision, for fear of introducing dangerous ambiguities into the child’s mind. In terms of the possible nerve destruction caused by the amputation of genital appendages, Money assured doctors that according to studies he had conducted with the Hampsons, there was no evidence of loss of sensation. “We have sought information about erotic sensation from the dozen non-juvenile . . . women we have studied,” he wrote in a 1955 paper. “None of the women . . . reported a loss of orgasm after clitoridectomy.”
Money’s protocols for the treatment of intersexual children hold to this day. Placing the greatest possible emphasis on the child’s projected “erotic functioning” as an adult and taking into account that medical science had never perfected the reconstruction of injured, or tiny, penises, Money’s recommendations meant that the vast majority of intersexual children, regardless of their chromosome status, would be turned into girls. Current guidelines dictate that to be assigned as a boy, the child must have a penis longer than 2.5 centimeters; a girl’s clitoris is surgically reduced if it exceeds 1 centimeter.
By providing a seemingly solid psychological foundation for such surgeries, Money had, in a single stroke, offered physicians a relatively simple solution to one of the most vexing and emotionally fraught conundrums in medicine: how to deal with the birth of an intersexual child. As Money’s colleague Dr. Berlin points out, “One can hardly begin to imagine what it’s like for a parent when the first question – ‘Is it a boy or a girl?’ – results in a response from the physician that they’re just not sure. John Money was one of those folks who, years ago, before this was even talked about, was out there doing his best trying to help families, trying to sort through what’s obviously a difficult circumstance.”
But Money was not interested solely in intersexes. As he has stated often in his writings, he saw intersexual syndromes, which he called “experiments of nature,” chiefly as a way to learn about the sexual development of so-called normal humans. Thus, he immediately generalized his theories about intersexes to include all children, even those born without genital irregularities. “In the light of hermaphroditic evidence ” he wrote in a 1955 paper that would become a classic in the field of sexual development, “it is no longer possible to attribute psychological maleness or femaleness to chromosomal, gonadal or hormonal origins. . . . The evidence of hermaphroditism lends support to a conception that, psychologically, sexuality is undifferentiated at birth and that it becomes differentiated as masculine or feminine in the course of the various experiences of growing up.” In simple terms, Money was advancing the view that all children form a sense of themselves as male or female according to whether they are dressed in blue or pink, given a masculine or feminine name, clothed in pants or dresses, given guns or Barbies to play with.
In a retrospective essay written in 1985 about his career as a sex researcher, Money offered crucial insight into the way he arrived at some of his more unusual theories about human sexual behavior. “I frequently find myself toying with concepts and working out potential hypotheses,” he mused. “It is like playing a game of science fiction. . . . It is as much an art as the creative process in painting, music, drama or literature.”
Money’s theory that newborns are psychosexually neutral was both unorthodox and against the current climate of science, which for decades had centered on the critical role of chromosomes and hormones in determining sexual behavior. But if his colleagues considered Money’s ideas to be science fiction, they weren’t prepared to say so publicly. His papers outlining his theory became famous in his field, helping not only to propel him to international renown as a sex researcher but also to speed his rise up the ladder at Johns Hopkins, where he ascended from assistant to associate professor of medical psychology, teaching his theory of infant sexual development to generations of medical students. By 1965, the year of John and Kevin Thiessen’s birth, Money’s reputation was virtually unassailable. He had for more than a decade been head of Hopkins’ Psychohormonal Research Unit (his clinic for treating and studying intersex kids), and he was shortly to help co-found Hopkins’ groundbreaking Gender Identity Clinic – a coup that helped earn him a reputation, says John Hampson, as “the national authority on gender disorder.”
There was, however, at least one researcher who was willing to question Money. He was a young graduate student at the University of Kansas. The son of struggling Ukrainian-Jewish immigrant parents, Milton Diamond, whom friends call Mickey, was raised in the Bronx, where he had sidestepped membership in the local street gangs for the life of a scholar. As an undergraduate majoring in biophysics at City College of New York, Diamond became fascinated by the role of hormones in the womb and their possible role in defining a person’s gender identity and sexual orientation. In his late 20s, as a grad student in endocrinology at Kansas, he conducted animal research on the subject, injecting pregnant guinea pigs and rats with different hormone cocktails to see how pre-birth events would affect later sexual behavior. The evidence in Diamond’s lab suggested a link between the hormones that bathe a developing fetus’s brain and nervous system and its later sexual functioning. It was in an effort to raise funds for his continued research that Diamond applied for a grant from the National Science Foundation Committee for Research in Problems of Sex an application that required the submission of a research paper. For his topic, Diamond decided to write a response to Money’s now-classic papers on sexual development.
Diamond’s critique appeared in The Quarterly Review of Biology in 1965. Marshaling evidence from biology, psychology, psychiatry, anthropology and endocrinology to argue that gender identity is hardwired into the brain virtually from conception, the paper was an audacious challenge to Money’s authority (especially coming from an unknown grad student at the University of Kansas). First addressing the theory about the psychosexual flexibility of intersexes, Diamond pointed out that such individuals suffer “a genetic or hormonal imbalance” in the womb. Diamond argued that even if intersexuals could be steered into one sex or the other as newborns, this was not necessarily evidence that rearing is more influential than biology. It might simply mean that the cells in their brains had undergone, in utero, an ambiguity of sexual differentiation similar to that of the cells in their genitals. In short, intersexes have an inborn, neurological capability to go both ways – a capability, Diamond hastened to point out, that genetically normal children certainly would not share.
Even a scientist less thin-skinned than John Money might have been stung by the calm, relentless logic of Diamond’s attack – which, near the end, raised the most rudimentary, Science 101 objection to the widespread acceptance of Money’s theory of psychosexual malleability in normal children. “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.”
It was a year and a half after Diamond had thrown down the gauntlet that Dr. Money received Linda Thiessen’s letter describing the terrible circumcision accident that had befallen her baby boy.
The Thiessens made their first trip to Johns Hopkins early in 1967, within weeks of first seeing Dr. Money on TV. The young couple were awestruck by the vast medical center dominating the top of a rise on Wolfe Street. Dr. Money’s Psychohormonal Research Unit was located in the Phipps Clinic, a gloomy Victorian building tucked away in a courtyard; the unit’s offices, located on an upper floor, were reached by way of a rickety turn-of-the-century elevator. Money’s own inner sanctum (where most of his meetings with the Thiessens would take place during the ensuing 12 years) was furnished with a couch, Oriental rugs and potted plants – reminding Frank more of a living room than of an office. There was also a collection of carved aboriginal sculptures of erect phalluses, vaginas and breasts that adorned a mantel. But if these artifacts were unsettling, Money himself, with his smoothly confident, professional manner – not to mention the diplomas on his wall – made the Thiessens feel that they were in the best possible hands. “I looked up to him like a god,” says Linda, who at the time was not yet out of her teens. “I accepted whatever he said.” And what Dr. Money had to say was exactly what the Thiessens ached to hear.
In his many published versions of this first interview, Money has recounted how he spelled out to the young couple the advantages of sex reassignment for baby John – “using nontechnical words, diagrams and photographs of children who had been reassigned.” What is not clear from Money’s accounts is whether Linda and Frank, whose educations at the time did not go beyond the sixth grade, understood that such a procedure was, in fact, purely experimental – that while such surgeries had been performed on intersexual children, no such sex changes had ever been attempted on a child born with normal genitals and a normal nervous system. Today, Frank and Linda say that this was a distinction they did not fully grasp until later. The crucial point that they gleaned from Dr. Money was his conviction that the procedure had every chance for success. “I see no reason,” Linda recalls him saying, “that it shouldn’t work.”
Indeed, Money’s eagerness to begin is evident in a description of the interview written almost 10 years later. In Sexual Signatures, he wrote: “If the parents stood by their decision to reassign the child as a girl, surgeons could remove the testicles and construct feminine external genitals immediately. When she was 11 or 12 years old, she could be given the female hormones.”
If Dr. Money seemed to be in a hurry, he was. He explained to Frank and Linda that they would have to make up their minds quickly. For according to one of the finer points of his theory, the “gender identity gate” – Money’s term for that moment after which a child has locked into an identity as a male or a female – comes a little after 2 years of age. John was now 17 months. “The child was still young enough so that whichever assignment was made, erotic interest would almost certainly direct itself toward the opposite sex later on,” Money wrote, “but the time for reaching a final decision was already short.”
Frank and Linda, however, needed time to decide on something as momentous as having their child undergo a surgical sex change. They went home to think about it. Linda says that Dr. Money made no secret of his impatience with the delay. “He wrote in a letter that we were ‘procrastinating,’ ” Linda recalls. “But we wanted to move slow, because we had never heard of anything like this.”
Back home, they canvassed opinions. Their pediatrician recommended against such drastic treatment, and so did their parents. But finally, Frank and Linda realized that they alone had to decide. They alone were the ones living with the reminder, at each diaper change, of John’s terrible injury. After months of indecision, they made up their minds.
That summer, five months after their first meeting with Money, they returned to Baltimore with their baby. Now 22 months old, the child was still within the window of 30 months that Money had established as safe for an infant sex change. And so, on July 3, 1967, the baby underwent surgical castration. According to the operating-room record, Dr. Howard W. Jones Jr. slit open the baby’s scrotum along the midline and removed the testes, then reclosed the scrotal tissue so that it resembled labia. The urethra was lowered to approximate the position of the female genitalia, and a cosmetic vaginal cleft was made by forming the skin around a rolled tube of gauze during the healing. It was also during this visit to Johns Hopkins, says Linda, that the promised chromosome test was conducted on the twins to determine if they were, indeed, identical. They were.
Linda and Frank say that by the time they decided to have their baby undergo clinical castration, they had eradicated any doubts they might have had about the efficacy of the treatment – a crucial turnabout, since, according to Dr. Money, it was a “vital consideration” that the parents of a sex-reassigned child harbor no second thoughts. “For any lingering doubts whatsoever in their minds,” Money wrote, “would weaken the child’s identification as a girl and woman.”
Whether Money himself was able to eradicate his own doubts about the child’s future development is debatable. In a letter he wrote a few weeks after the castration, his tone admitted of considerable caution regarding the prognosis. But then this was perhaps to be expected, since the letter was addressed to the lawyer whom Frank and Linda had hired to sue the hospital that botched the circumcision.
“The reassignment of a baby’s sex is usually undertaken only in cases of a birth defect of the genitalia,” Money wrote. “Then one usually expects that the child’s psychosexual differentiation will be congruous with the sex of rearing. In any given case, however, it is not possible to make an absolute prediction.”
Central to Money’s program for sex reassignment of hermaphrodites was his edict that the children, when very young, know nothing of their ambiguous sexual status at birth. Money put the same stricture into effect in the case of the Thiessens’ baby, whom they now called Joan. “He told us not to talk about it,” Frank says. “Not to tell Joan the whole truth and that she shouldn’t know she wasn’t a girl.”
Linda had sewn dresses and bonnets for her new daughter. It was shortly before Joan’s second birthday when Linda first put her in a dress. “It was a pretty, lacy little dress,” Linda recalls. “She was ripping at it, trying to tear it off. I remember thinking, ‘Oh, my God, she knows she’s a boy and she doesn’t want girls’ clothing. She doesn’t want to be a girl.’ But then I thought, ‘Well, maybe I can teach her to want to be a girl. Maybe I can train her so that she wants to be a girl.’ “
Linda and Frank did their best to do just that. When Joan’s brother, Kevin, at age 4, was watching Frank shave and asked to shave, too, Frank gave him an empty razor and some shaving cream to play with. But when Joan also clamored for a razor, Frank refused. “I told her that girls don’t shave,” Frank recalls. “I told her girls don’t have to.” Linda offered to put makeup on her. But Joan didn’t want to wear makeup.
“I remember saying, ‘Oh, can I shave, too?’ ” John says of this incident, which forms his earliest childhood memory. “My dad said, ‘No, no. You go with your mother.’ I started crying, ‘Why can’t I shave, too?’ ” Kevin says that the incident was typical of the way their parents tried to steer them into opposite sexes – and how such efforts were, inevitably, doomed to failure.
“I recognized Joan as my sister,” Kevin says, “but she never, ever acted the part. 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. Never used it for what it was bought for. She played with my toys: Tinkertoys, dump trucks. Toys like this sewing machine she got just sat.”
Today, with the twins having rejoined each other on the same side of the gender divide, the stark physical differences between them eerily testify to all that John has been through. At 32, Kevin is a dark-bearded, bearlike man with the thickly muscled arms and shoulders of a manual laborer. To see him standing alongside his scarecrow-thin, scantily bearded brother, you would never guess that every cell in their bodies bears identical DNA – until you compare their eyes, noses and mouths, which are indistinguishable from one twin to the other.
As children, their physical differences were, if less pronounced, equally deceptive. Photographs of them as preschoolers show a puppy-eyed little boy with a crew cut and a slim, brown-eyed girl with wavy chestnut hair framing a face of delicate prettiness. But by all accounts, this illusion of two children occupying opposite sexes disappeared the second that Joan moved, spoke, walked, gestured. “When I say there was nothing feminine about Joan,” Kevin laughs, “I mean there was nothing feminine. She walked like a guy. She talked about guy things, didn’t give a crap about cleaning house, getting married, wearing makeup…. We both wanted to play with guys, build forts and have snowball fights and play army.” Enrolled in Girl Scouts, Joan was miserable. “I remember making daisy chains and thinking, ‘If this is the most exciting thing in Girl Scouts, forget it,’ ” John says. “I kept thinking of the fun stuff my brother was doing in Cubs.”
Linda and Frank were troubled by Joan’s masculine behavior. But they had been told by Dr. Money that they must not entertain any doubts about their daughter, and they felt that to do so would only increase the problem. Instead, Frank and Linda seized on those moments when Joan’s behavior could be construed as stereotypically feminine. “And she could be sort of feminine, sometimes,” Linda says, “when she wanted to please me. She’d be less rough, keep herself clean and tidy, and help a little bit in the kitchen.”
In her letters to Dr. Money describing Joan’s progress, Linda made sure to emphasize those moments so that the psychologist would know that she and Frank were doing everything they could to implement his plans. Meanwhile, Linda comforted herself by thinking of her daughter as a tomboy. “I have seen all kinds of women in my life,” she says, “and some of them, you’d swear they were men. So I thought, ‘Well, maybe it won’t be a problem, because there are lots of women who aren’t very effeminate. Maybe it could work.’ I wanted it to work.”
Kevin didn’t question his sister’s boyish ways until they went off to school. “I was in grade one or two,” he says, “and I saw all the other girls doing their thing – combing their hair, holding their dolls. Joan was not at all like that. Not at all.” At that time, Joan had voiced the ambition to be a garbage man. “She’d say, ‘Easy job, good pay,’ ” Kevin recalls. “She was 6 or 7 years old. I thought it was kinda bizarre – my sister a garbage man?” Indeed, Kevin would finally grow so perplexed with his sister’s unconventional behavior that he went to his mother about it. “Well, that’s Joan being a tomboy,” Linda told him. “I accepted that,” Kevin says and shrugs.
That was not an explanation Joan’s schoolmates were prepared to accept. Upon entering kindergarten, she became the object of instant ridicule from classmates, both male and female. “As you’d walk by, they’d start giggling,” John remembers. “Not one, but almost the whole class. It’d be like that every day. The whole school would make fun of you about one thing or another.”
“They were cruel,” says Kevin, who witnessed his sister’s humiliation at school. “Teased every day. It wasn’t a weekly thing. Or a monthly thing. This was a daily thing. They’d call her names, ignore her, not involve her in the groups.”
“It started the first day of kindergarten,” Linda says. “Even the teacher didn’t accept her. The teachers knew there was something different.”
By then, Joan also knew that there was “something different” about her. But she didn’t know what. “You know generally what a girl is like,” John says, “and you know generally what a guy is like. And everyone is telling you that you’re a girl. But you say to yourself, ‘I don’t feel like a girl.’ You think girls are supposed to be delicate and like girl things – tea parties, things like that. But I like to do guy stuff. It doesn’t match. So you figure, ‘Well, there’s something wrong here. If I’m supposed to be like this girl over here but I’m acting like this guy, I guess I gotta be an it.’ “
Joan’s personal difficulties were obvious in her functioning in the classroom. Though tests had revealed her to be in the normal intelligence range, she seemed unable, or unwilling, to master the skills required in kindergarten. When the school threatened to hold Joan back, Linda complained to Dr. Money. He wrote a letter to the school, urging that Joan, despite her emotional difficulties, be promoted to first grade. But her problems only got worse. On Oct. 29, 1971, a few weeks after she started first grade, her behavior prompted a teacher to file a report with the district’s Child Guidance Clinic. The teacher noted that Joan “has been doing just the opposite of anything the other children do” and described the girl as “very negativistic.”
It was at a December 1972 meeting of the American Association for the Advancement of Science in Washington, D.C. that John Money unveiled, for the first time, his “twins case.” Time magazine ran a full-page story on the debut, which happened to coincide, that same week, with the release of Money’s book Man Woman, Boy Girl. Co-authored with his colleague Dr. Anke Ehrhardt, the book contained his first written account of the extraordinary twins case.
Man Woman, Boy Girl made mention of Joan’s “tomboyish traits” in passing but focused on the ways in which she conformed to the stereotypes of female behavior – examples of which were culled from Linda’s hopeful cataloging, over the years, of Joan’s fitful attempts to act more like a girl. “One thing that really amazes me is that she is so feminine,” Linda is quoted as saying. “I’ve never seen a little girl so neat and tidy as she can be when she wants to be.” No mention was made of the problems Joan had been having in school.
Indeed, the account portrayed the experiment as an unqualified success – a conclusion bolstered by what Money pointed out was an “extreme unusualness” to the case. He was referring, of course, to the existence of the identical male twin, whose interest in “cars and gas pumps and tools” was contrasted to his sister’s interest in “dolls, a doll house and a doll carriage” – a sharp division of tastes along gender lines that seemed to provide compelling evidence that boys and girls are made, not born. The significance of the case to the then-burgeoning women’s movement was obvious, since feminists had been arguing against a biological basis for sex differences for years. Indeed, Money’s own papers from the 1950’s on the total psychosexual flexibility of newborns were cited by Kate Millett in her best-selling, seminal 1970 feminist text, Sexual Politics. Money’s new twins case buttressed the feminist claim that the observable differences in the tastes, attitudes and behaviors of men and women are attributable solely to cultural expectations.
“This dramatic case,” Time duly reported in its Jan. 8, 1973, edition, “provides strong support for a major contention of women’s liberationists: that conventional patterns of masculine and feminine behavior can be altered. It also casts doubt on the theory that major sexual differences, psychological as well as anatomical, are immutably set by the genes at conception.” The New York Times Book Review hailed Man Woman Boy Girl as “the most important volume in the social sciences to appear since the Kinsey reports” and praised Money for producing “real answers to that ancient question: Is it heredity or environment?” But it was on the pediatric wards of hospitals around the world that the twins case would have its most lasting impact.
“It was the hallmark case,” says Dr. William Reiner a child psychologist at Johns Hopkins. “It was the hallmark because it was followed and written up a number of times by Money and then essentially was the source of his statements – and subsequent statements in any of the pediatric textbooks in endocrinology, urology, surgery and psychology – that you can reassign the sex of a child because it’s the social situation that is the most important.” The undisputed success of the twins case legitimized the practice of infant sex reassignment globally, says Reiner. Once confined principally to Johns Hopkins, the procedure soon spread and today is performed in virtually every major country, with the possible exception of China and India. While no annual tally of infant sex reassignments has ever been made, Reiner makes a rough, “conservative” estimate that three to five cases crop up in every major American city each year – giving the U.S. alone a total of 100 to 200 sex reassignments a year. Globally, he puts the figure at perhaps 1,000 per year. In the 25 years since Money’s twins case was first published, as many as 15,000 similar sex reassignments may have been performed.
Dr. Mel Grumbach, a pediatric endocrinologist at the University of California, San Francisco, and a world authority on the subject, confirms that the findings detailed in Money’s twins case were the decisive factor in the widespread acceptance of the practice. “”Doctors] were very influenced by the twin experience.” he says. “John Money stood up at a conference and said, ‘I’ve got these two twins, and one of them is now a girl, and the other is a boy.’ They were saying they took this normal boy and changed him over to a girl. That’s powerful. That’s really powerful. I mean, what is your response to that? This case was used to reinforce the fact that you can really do anything. You can take a normal XY male and convert it into a female in the neonatal period and it won’t make any difference.” Grumbach adds, “John Money is a major figure, and what he says gets handed down and accepted as gospel by some.”
But not all. In the seven years since he had first published his challenge to Money, Mickey Diamond, who had been hired as a biology professor at the University of Hawaii, continued his laboratory research into how the sexual nervous system is organized before birth. His studies had further convinced him that neither intersexes nor normal children are born psychosexually undifferentiated – a conviction that made him view with alarm the expanding practice of infant sex reassignment. And he was more convinced than ever that converting a non-intersexual infant from one sex to the other would be impossible. “But I didn’t have any proof at the time,” Diamond says. “I didn’t have anything except a theoretical argument to challenge the case.”
Diamond vowed to follow the case of the sex-changed twin closely – a decision, he says, that was affected by purely scientific motives. But if, by now, Diamond also felt a degree of personal involvement in his dispute with Money, that was perhaps understandable: In the chapter directly following his account of the twins case in Man Woman, Boy Girl, Money lashed out at Diamond and his colleagues, characterizing their work as “instrumental in wrecking the lives of unknown numbers of hermaphroditic youngsters.”
In 1967, at the time of John’s castration, Money stipulated that he see the child once a year for counseling. The trips, which were sometimes separated by as many as 18 months, were, as Money put it in his letter to the Thiessens’ lawyer, meant to “guard against the psychological hazards” associated with growing up as a sex-reassigned child. But according to the Thiessens and to contemporaneous clinical notes, the trips to the Psychohormonal Research Unit at Johns Hopkins only exacerbated the confusion, fear and dread that Joan was already suffering.
“You get the idea something happened to you,” John says of those mysterious annual visits to the unit, “but you don’t know what – and you don’t want to know.” Kevin, who was also required on each visit to submit to sessions with Dr. Money, found the trips equally bewildering and unsettling: “For the life of me, I couldn’t understand why, out of all the kids in my class, why am I the only one going with my [sister] to Baltimore to talk to this doctor? It made us feel like we were aliens.” The twins developed a conviction that everyone, from their parents to Dr. Money and his colleagues, was keeping something from them. “There was something not adding up,” Kevin says. “We knew that at a very early age. But we didn’t make the connection. We didn’t know.”
All they did know was that from the time they were 6 years old, Dr. Money wanted to talk to them, both singly and together, about subjects that, as Joan would later complain to an outside therapist, “I can’t even talk to my mom about.”
“Dr. Money would ask me, ‘Do you ever dream of having sex with women?’ ” Kevin recalls. “He’d say, ‘Do you ever get an erection?’ And the same with Joan. ‘Do you think about this? About that?’ “
While attempting to probe the twins’ sexual psyches, Money also tried his hand at programming Kevin’s and Joan’s respective sense of themselves as boy and girl. One of his theories of how children form their different “gender schemes” – Money’s term – was that they must understand, at an early age, the differences between male and female sex organs. Pornography, he believed, was ideal for this purpose. “Explicit sexual pictures,” he wrote in his book Sexual Signatures, “can and should be used as part of a child’s sex education”; such pictures, he said, “reinforce his or her own gender identity and gender role.”
“He would show us pictures of kids, boys and girls, with no clothes on,” Kevin says. John recalls that Dr. Money also showed them pictures of adults engaged in sexual intercourse: “He’d say to us, ‘I want to show you pictures of things that moms and dads do.’ “
During these visits, the twins discovered that Money had two sides to his personality. “One when mom and dad weren’t around,” Kevin says, “and another when they were.” When their parents were present, they say, Money was avuncular, mild-spoken. But alone with the children, he could be irritable or worse. Especially when they defied him. The children were particularly resistant to Money’s request that they remove their clothes and inspect each other’s genitals. Though they could not know this, such inspections were central to Money’s theory of how children develop a sense of themselves as boy or girl – and thus, in Money’s mind, were crucial to the successful outcome of Joan’s sex reassignment. As Money stressed in his writings of the period: “The firmest possible foundations for gender schemes are the differences between male and female genitals and reproductive behavior, a foundation our culture strives mightily to withhold from children. All young primates explore their own and each others’ genitals . . . and that includes human children everywhere…. The only thing wrong about these activities is not to enjoy them.”
But the children did not enjoy these enforced activities, which they were instructed to perform sometimes in front of Dr. Money, sometimes with as many as five or six of his colleagues in attendance. But to resist Money’s requests was to provoke his ire. “I remember getting yelled at by Money because I was defiant,” John says. “He told me to take my clothes off, and I just did not do it. I just stood there. And he screamed, ‘Now!‘ Louder than that. I thought he was going to give me a whupping. So I took my clothes off and stood there, shaking.” In a separate conversation with me, Kevin recalls that same incident. ” ‘Take your clothes off – now!‘ ” Kevin shouts.
As early as age 8, Joan began to resist going to Baltimore. Dr. Money suggested to Linda and Frank that they sweeten the pill of the annual visits by blending the trip to Hopkins with a family vacation. “Soon,” Linda says, “we were promising Disneyland and side trips to New York just to get her to go.”
It was also around Joan’s eighth birthday that Dr. Money began increasingly to focus on the issue of vaginal surgery. At the time of her castration at 22 months, Joan was left with only a cosmetic exterior vagina; the surgeon had elected to wait until Joan’s body was closer to full grown before excavating a full vaginal canal….
What were the real reasons behind David Reimer’s suicide?
JOHN COLAPINTO – 3 JUNE 2004 – SLATE
Just shy of a month ago, I got a call from David Reimer’s father telling me that David had taken his own life. I was shocked, but I cannot say I was surprised. Anyone familiar with David’s life—as a baby, after a botched circumcision, he underwent an operation to change him from boy to girl—would have understood that the real mystery was how he managed to stay alive for 38 years, given the physical and mental torments he suffered in childhood and that haunted him the rest of his life. I’d argue that a less courageous person than David would have put an end to things long ago.
After David’s suicide, press reports cited an array of reasons for his despair: bad investments, marital problems, his brother’s death two years earlier. Surprisingly little emphasis was given to the extraordinary circumstances of his upbringing. This was unfortunate because to understand David’s suicide, you first need to know his anguished history, which I chronicled in my book As Nature Made Him:The Boy Who Was Raised As a Girl.
David Reimer was one of the most famous patients in the annals of medicine. Born in 1965 in Winnipeg, he was 8 months old when a doctor used an electrocautery needle, instead of a scalpel, to excise his foreskin during a routine circumcision, burning off his entire penis as a result. David’s parents (farm kids barely out of their teens) were referred to Johns Hopkins Hospital in Baltimore, home of the world’s leading expert in gender identity, psychologist Dr. John Money, who recommended a surgical sex change, from male to female. David’s parents eventually agreed to the radical procedure, believing Dr. Money’s claims that this was their sole hope for raising a child who could have heterosexual intercourse—albeit as a sterile woman with a synthetic vagina and a body feminized with estrogen supplements.
For Dr. Money, David was the ultimate experiment to prove that nurture, not nature, determines gender identity and sexual orientation—an experiment all the more irresistible because David was an identical twin. His brother, Brian, would provide the perfect matched control, a genetic clone raised as a boy.
David’s infant “sex reassignment” was the first ever conducted on a developmentally normal child. (Money had helped to pioneer the procedure in hermaphrodites.) And according to Money’s published reports through the 1970s, the experiment was a success. The twins were happy in their assigned roles: Brian a rough and tumble boy, his sister Brenda a happy little girl. Money was featured in Time magazine and included a chapter on the twins in his famous textbook Man & Woman, Boy & Girl.
The reality was far more complicated. At age 2, Brenda angrily tore off her dresses. She refused to play with dolls and would beat up her brother and seize his toy cars and guns. In school, she was relentlessly teased for her masculine gait, tastes, and behaviors. She complained to her parents and teachers that she felt like a boy; the adults—on Dr. Money’s strict orders of secrecy—insisted that she was only going through a phase. Meanwhile, Brenda’s guilt-ridden mother attempted suicide; her father lapsed into mute alcoholism; the neglected Brian eventually descended into drug use, pretty crime, and clinical depression.
When Brenda was 14, a local psychiatrist convinced her parents that their daughter must be told the truth. David later said about the revelation: “Suddenly it all made sense why I felt the way I did. I wasn’t some sort of weirdo. I wasn’t crazy.”
David soon embarked on the painful process of converting back to his biological sex. A double mastectomy removed the breasts that had grown as a result of estrogen therapy; multiple operations, involving grafts and plastic prosthesis, created an artificial penis and testicles. Regular testosterone injections masculinized his musculature. Yet David was depressed over what he believed was the impossibility of his ever marrying. He twice attempted suicide in his early 20s.
David did eventually marry a big-hearted woman named Jane, but his dark moods persisted. He was plagued by shaming memories of the frightening annual visits to Dr. Money, who used pictures of naked adults to “reinforce” Brenda’s gender identity and who pressed her to have further surgery on her “vagina.”
When David was almost 30, he met Dr. Milton Diamond, a psychologist at the University of Hawaii and a longtime rival of Dr. Money. A biologist by training, Diamond had always been curious about the fate of the famous twin, especially after Money mysteriously stopped publishing follow-ups in the late 1970s. Through Diamond, David learned that the supposed success of his sex reassignment had been used to legitimize the widespread use of infant sex change in cases of hermaphroditism and genital injury. Outraged, David agreed to participate in a follow-up by Dr. Diamond, whose myth-shattering paper (co-authored by Dr. Keith Sigmundson) was published in Archives of Pediatrics and Adolescent Medicine in March 1997 and was featured on front pages across the globe.
I met David soon after, when he agreed to be interviewed by me for a feature story in Rolling Stone. He subsequently agreed to collaborate with me on a book about his life, As Nature Made Him, published in February 2000. In the course of our interviews, David told me that he could never forget his nightmare childhood, and he sometimes hinted that he was living on borrowed time.
Most suicides, experts say, have multiple motives, which come together in a perfect storm of misery. So it was with David. After his twin Brian died of an overdose of antidepressants in the spring of 2002, David sank into a depression. Though the two had been estranged, David had, in recent months, taken to visiting Brian’s grave, leaving flowers and, at some point prior to his own suicide, a note.
David also had marital difficulties. He was not easy to live with, given his explosive anger, his cyclical depressions, his fears of abandonment—all of which Jane weathered for almost 14 years. But with David spiraling ever deeper into sloth and despair, she told him on the weekend of May 2 that they should separate for a time. David stormed out of the house. Two days later, Jane received a call from the police, saying that they had found David but that he did not want her to know his location. Two hours after that, Jane got another call. This time the police told her that David was dead…