David Reimer
Encyclopedia
David Reimer was a Canadian man who was born as a healthy male, but was sexually reassigned
Sex assignment
Sex assignment refers to the assigning of the biological sex at the birth of a baby. In the majority of births, a relative, midwife, or physician inspects the genitalia when the baby is delivered, sees ordinary male or female genitalia, and declares, "it's a girl" or "it's a boy" without the...

 and raised as female after his penis
Penis
The penis is a biological feature of male animals including both vertebrates and invertebrates...

 was accidentally destroyed during circumcision
Circumcision
Male circumcision is the surgical removal of some or all of the foreskin from the penis. The word "circumcision" comes from Latin and ....

. Psychologist John Money
John Money
John William Money was a psychologist, sexologist and author, specializing in research into sexual identity and biology of gender...

 oversaw the case and reported the reassignment as successful, and as evidence that gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

 is primarily learned. Academic sexologist Milton Diamond
Milton Diamond
Milton Diamond is a retired professor of anatomy and reproductive biology at the University of Hawai'i at Mānoa. He has had a very long and productive career in the study of human sexuality...

 later reported that Reimer failed to identify as female since the age of 9 to 11, and that he began living as male at age 15. Reimer later went public with his story to discourage similar medical practices. Eventually he committed suicide
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...

, due to suffering years of severe depression, financial instability and a troubled marriage.

History

David Reimer was born as a male identical twin in Winnipeg
Winnipeg
Winnipeg is the capital and largest city of Manitoba, Canada, and is the primary municipality of the Winnipeg Capital Region, with more than half of Manitoba's population. It is located near the longitudinal centre of North America, at the confluence of the Red and Assiniboine Rivers .The name...

, Manitoba
Manitoba
Manitoba is a Canadian prairie province with an area of . The province has over 110,000 lakes and has a largely continental climate because of its flat topography. Agriculture, mostly concentrated in the fertile southern and western parts of the province, is vital to the province's economy; other...

. His birth name was Bruce; his twin was named Brian. At the age of 6 months, after concern was raised about how they both urinated, the boys were diagnosed with phimosis
Phimosis
Phimosis , from the Greek phimos ), is a condition where, in men, the foreskin cannot be fully retracted over the glans penis...

. They were referred for circumcision
Circumcision
Male circumcision is the surgical removal of some or all of the foreskin from the penis. The word "circumcision" comes from Latin and ....

 at the age of 8 months. On April 27, 1966, a urologist performed the operation using the unconventional method of cauterization
Cauterization
The medical practice or technique of cauterization is the burning of part of a body to remove or close off a part of it in a process called cautery, which destroys some tissue, in an attempt to mitigate damage, remove an undesired growth, or minimize other potential medical harmful possibilities...

. The procedure did not go as doctors had planned, and Reimer's penis was burned beyond surgical repair.

The parents, concerned about their son's prospects for future happiness and sexual function without a penis, took him to Johns Hopkins Hospital
Johns Hopkins Hospital
The Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...

 in Baltimore
Baltimore
Baltimore is the largest independent city in the United States and the largest city and cultural center of the US state of Maryland. The city is located in central Maryland along the tidal portion of the Patapsco River, an arm of the Chesapeake Bay. Baltimore is sometimes referred to as Baltimore...

 to see John Money
John Money
John William Money was a psychologist, sexologist and author, specializing in research into sexual identity and biology of gender...

, a psychologist
Psychology
Psychology is the study of the mind and behavior. Its immediate goal is to understand individuals and groups by both establishing general principles and researching specific cases. For many, the ultimate goal of psychology is to benefit society...

 who was developing a reputation as a pioneer in the field of sexual development and gender identity
Gender identity
A gender identity is the way in which an individual self-identifies with a gender category, for example, as being either a man or a woman, or in some cases being neither, which can be distinct from biological sex. Basic gender identity is usually formed by age three and is extremely difficult to...

, 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
Observational learning
Observational learning is a type of learning that occurs as a function of observing, retaining and replicating novel behavior executed by others...

 from early childhood and could be changed with the appropriate behavioral interventions. The Reimers had seen Money being interviewed on the Canadian news program This Hour Has Seven Days
This Hour Has Seven Days
This Hour Has Seven Days is a controversial CBC Television newsmagazine which ran from 1964 to 1966. The show, inspired by the BBC-TV and NBC-TV satire series That Was The Week That Was, was created by Patrick Watson and Douglas Leiterman as an avenue for a more stimulating and boundary-pushing...

, where he discussed his theories about gender. He and other physicians working with young children born with abnormal genitalia believed that a penis could not be replaced but that a functional vagina
Vagina
The vagina is a fibromuscular tubular tract leading from the uterus to the exterior of the body in female placental mammals and marsupials, or to the cloaca in female birds, monotremes, and some reptiles. Female insects and other invertebrates also have a vagina, which is the terminal part of the...

 could be constructed surgically, and that he would be more likely to achieve successful, functional sexual maturation as a girl than as a boy.

They persuaded his parents that sex reassignment surgery
Sex reassignment surgery
Sex reassignment surgery is a term for the surgical procedures by which a person's physical appearance and function of their existing sexual characteristics are altered to resemble...

 would be in Reimer's best interest, and, at the age of 22 months, orchidectomy was performed to remove his testes
Testicle
The testicle is the male gonad in animals. Like the ovaries to which they are homologous, testes are components of both the reproductive system and the endocrine system...

. He was reassigned to be raised
Gender of rearing
Gender of rearing is the gender in which parents rear a child. This is the gender assigned to the child by parents and doctors , and taught to the child. Aspects of rearing include choosing a name, providing clothes, toys, education, and opportunities which are sex-congruent for their culture...

 as a 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 ten years 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 twin brother, Brian, made an ideal control
Scientific control
Scientific control allows for comparisons of concepts. It is a part of the scientific method. Scientific control is often used in discussion of natural experiments. For instance, during drug testing, scientists will try to control two groups to keep them as identical and normal as possible, then...

 since the two not only shared genes and family environments but had shared the intrauterine environment as well. 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
Sexual differentiation
Sexual differentiation is the process of development of the differences between males and females from an undifferentiated zygote...

.

Dr. Money forced the twins to rehearse sexual acts involving "thrusting movements" with David playing the bottom role. As a child, David Reimer painfully recalled having to get "down on all fours" with his brother, Brian Reimer, "up behind his butt
Doggy style
Doggy style is a group of sex positions in which the receiving partner crouches on all fours with the legs slightly apart...

" with "his crotch against" his "buttocks". In another sexual position
Sex positions
Sex positions are positions which people may adopt during or for the purpose of sexual intercourse or other sexual activities. Sexual acts are generally described by the positions the participants adopt in order to perform those acts...

, Dr. Money forced David to have his "legs spread
Missionary position
The missionary position is a "man-on-top" sex position usually described as the act in which the woman lies on her back and the partners face each other. Though often acted on and applied by heterosexual pairings, it may also be used by gay and lesbian couples.The missionary position is an example...

" with Brian on top. Dr. Money also forced the children to take their "clothes off" and engage in "genital inspections". On at "least one occasion", Dr. Money took a "photograph" of the two children doing these activities. Dr. Money's rationale for these various treatments was his belief that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity".

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 followup 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 proved to be schizophrenic
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

.

Reimer had experienced the visits to Baltimore as traumatic rather than therapeutic, and when Dr. 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 surgeons had placed in the abdomen. Estrogen
Estrogen
Estrogens , oestrogens , or œstrogens, are a group of compounds named for their importance in the estrous cycle of humans and other animals. They are the primary female sex hormones. Natural estrogens are steroid hormones, while some synthetic ones are non-steroidal...

 was given during adolescence to induce breast development. Having no contact with the family once the visits were discontinued, John Money published nothing further about the case to suggest that the reassignment had not been successful.

Reimer's account, written with John Colapinto
John Colapinto
John Colapinto is an award-winning journalist, author and novelist and is currently a staff writer at The New Yorker.Prior to working at The New Yorker, Colapinto wrote for Vanity Fair, New York magazine and The New York Times Magazine, and in 1995 he became a contributing editor at Rolling Stone,...

 two decades later, 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, and neither frilly dresses (which he was forced to wear during frigid Winnipeg winters) nor female hormones made him feel female. By the age of 13, Reimer was experiencing suicidal depression, and told his parents he would commit suicide if they made him see John Money again. In 1980, Reimer's parents told him the truth about his gender reassignment, following advice from Reimer's endocrinologist and psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

. At 14, Reimer decided to assume a male gender identity, calling himself David. By 1997, Reimer had undergone treatment to reverse the reassignment, including testosterone injections, a double mastectomy
Mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer...

, and two phalloplasty
Phalloplasty
Phalloplasty refers to the construction of a penis or, sometimes, artificial modification of the penis by surgery, often for cosmetic purposes. It is also occasionally used to refer to penis enlargement....

 operations. He also married Jane Fontaine and became a stepfather to her three children.

His case came to international attention in 1997 when he told his story to Milton Diamond
Milton Diamond
Milton Diamond is a retired professor of anatomy and reproductive biology at the University of Hawai'i at Mānoa. He has had a very long and productive career in the study of human sexuality...

, an academic sexologist
Sexology
Sexology is the scientific study of human sexuality, including human sexual interests, behavior, and function. The term does not generally refer to the non-scientific study of sex, such as political analysis or social criticism....

 who persuaded Reimer to allow him to report the outcome in order to dissuade physicians from treating other infants similarly. Soon after, Reimer went public with his story and John Colapinto published a widely disseminated and influential account in Rolling Stone
Rolling Stone
Rolling Stone is a US-based magazine devoted to music, liberal politics, and popular culture that is published every two weeks. Rolling Stone was founded in San Francisco in 1967 by Jann Wenner and music critic Ralph J...

magazine in December 1997. They went on to elaborate the story in a book, As Nature Made Him: The Boy Who Was Raised as a Girl.

Death

In addition to his lifelong difficult relationship with his parents, Reimer had to deal with unemployment and the death of his brother Brian from an overdose of antidepressant
Antidepressant
An antidepressant is a psychiatric medication used to alleviate mood disorders, such as major depression and dysthymia and anxiety disorders such as social anxiety disorder. According to Gelder, Mayou &*Geddes people with a depressive illness will experience a therapeutic effect to their mood;...

s in 2002. On May 2, 2004, his wife Jane told him she wished to temporarily separate. Reimer stormed out of the house. On May 5, Jane Reimer received a call from the police that they had located her husband but he did not want his location revealed. Two hours later they called again, informing her of his suicide. Reimer had returned home while she was out and retrieved a shotgun, sawing off its barrel before leaving. On that morning of May 5, he drove to the parking lot of a nearby grocery store, parked his car and fatally shot himself in the head.

Social effect of David Reimer's story

The report and subsequent book about Reimer influenced several medical practices and reputations, and even current understanding of the biology of gender
Biology of gender
Biology of gender can have different meanings, depending on the meaning of gender.* In medicine and biology it usually refers to the biology of sexual dimorphism, e.g...

. The case accelerated the decline of sex reassignment and surgery for unambiguous XY
XY sex-determination system
The XY sex-determination system is the sex-determination system found in humans, most other mammals, some insects and some plants . In this system, females have two of the same kind of sex chromosome , and are called the homogametic sex. Males have two distinct sex chromosomes , and are called...

 male infants with micropenis
Micropenis
Micropenis is an unusually small penis. A common criterion is a dorsal erect penile length of at least 2.5 standard deviations smaller than the mean human penis size. The condition is usually recognized shortly after birth...

, various other rare congenital malformations or penile loss in infancy.

It supported the arguments of those who feel that prenatal and early-infantile hormone
Hormone
A hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...

s have a strong influence on brain differentiation, gender identity and perhaps other sex-dimorphic
Sexual dimorphism
Sexual dimorphism is a phenotypic difference between males and females of the same species. Examples of such differences include differences in morphology, ornamentation, and behavior.-Examples:-Ornamentation / coloration:...

 behavior. The applicability of this case to appropriate sex assignment
Sex assignment
Sex assignment refers to the assigning of the biological sex at the birth of a baby. In the majority of births, a relative, midwife, or physician inspects the genitalia when the baby is delivered, sees ordinary male or female genitalia, and declares, "it's a girl" or "it's a boy" without the...

 in cases of intersex conditions involving severe deficiency of testosterone
Testosterone
Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In mammals, testosterone is primarily secreted in the testes of males and the ovaries of females, although small amounts are also secreted by the adrenal glands...

 or insensitivity
Androgen insensitivity syndrome
Androgen insensitivity syndrome is a condition that results in the partial or complete inability of the cell to respond to androgens. The unresponsiveness of the cell to the presence of androgenic hormones can impair or prevent the masculinization of male genitalia in the developing fetus, as...

 to its effects is more uncertain. For some people, the inability to predict gender identity in this case confirmed skepticism about doctors' abilities to do so in general, or about the wisdom of using genital reconstructive surgery
Genital reconstructive surgery
Genital reconstructive surgery refers to surgery performed on the genitalia of infants, children, or adults for the purpose of correcting birth defects or other anatomic abnormalities, or for the purpose of transforming normal genitalia of one sex into genitalia resembling the other...

 to commit an infant with an intersex condition or genital defect to a specific gender role
Gender role
Gender roles refer to the set of social and behavioral norms that are considered to be socially appropriate for individuals of a specific sex in the context of a specific culture, which differ widely between cultures and over time...

 before the child is old enough to claim a gender identity.

The Intersex Society of North America, which opposes involuntary sex reassignment, treats the story of David Peter Reimer as a cautionary tale about why the genitals of unconsenting minors should not be needlessly modified.

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.

In popular culture

  • The Chicago Hope
    Chicago Hope
    Chicago Hope is an American medical drama series created by David E. Kelley that ran from September 18, 1994, to May 5, 2000. It takes place in a fictional private charity hospital.-Premise:The show stars Mandy Patinkin as Dr...

    season 6 episode "Boys Will Be Girls" (2000) was based on Reimer's life and the child's right to be raised as a male.
  • The Law & Order: Special Victims Unit
    Law & Order: Special Victims Unit
    Law & Order: Special Victims Unit is an American police procedural television drama series set in New York City, where it is also primarily produced...

    season 6
    Law & Order: Special Victims Unit (season 6)
    This article contains a list of episodes for season 6 of the television series, Law & Order: Special Victims Unit.-Cast:*Christopher Meloni as Det. Elliot Stabler*Mariska Hargitay as Det. Olivia Benson*Richard Belzer as Det. John Munch...

     episode "Identity" (2005) was based on David and Brian Reimer's lives and their treatment by Money.
  • On their 2007 album Reunion Tour
    Reunion Tour
    Reunion Tour is the fourth studio album by The Weakerthans, released on September 25, 2007 in Canada and the U.S. The album was released on both compact disc and vinyl record....

    , a song by The Weakerthans
    The Weakerthans
    The Weakerthans are a four-piece Canadian indie rock band.-History:The band was formed in 1997 in Winnipeg, Manitoba by John K. Samson, after he left the punk band Propagandhi to start a publishing company. Samson joined forces with bassist John P...

     entitled "Hymn of the Medical Oddity" was inspired by the story of David Reimer.
  • The documentary BBC TV series Horizon based two episodes on his life, "The Boy who was Turned into a Girl" (2000) and "Dr. Money and the Boy with No Penis" (2004).
  • A chapter titled Doing Justice to Someone: Sex Reassignment and Allegories of Transsexuality from the 2004 book Undoing Gender
    Undoing Gender
    Undoing Gender is a book written by Judith Butler. It was published in 2004 by Routledge. Undoing Gender examines gender, sex, psychoanalysis and the medical treatment of intersex people...

    , by the feminist philosopher
    Feminist philosophy
    Feminist philosophy refers to philosophy approached from a feminist perspective. Feminist philosophy involves both attempts to use the methods of philosophy to further the cause of the feminist movements, and attempts to criticise or re-evaluate the ideas of traditional philosophy from within a...

     Judith Butler
    Judith Butler
    Judith Butler is an American post-structuralist philosopher, who has contributed to the fields of feminism, queer theory, political philosophy, and ethics. She is a professor in the Rhetoric and Comparative Literature departments at the University of California, Berkeley.Butler received her Ph.D...

    , addresses the case of David Reimer.
  • The eighth episode of Mental
    Mental (TV series)
    Mental is a television series produced by Fox's subsidiary Fox Telecolombia, which aired in the summer and fall of 2009 on FOX international channels for Latin America, Europe and Asia, starring Chris Vance and Annabella Sciorra...

    , "House of Mirrors" (2009) deals with Reimer's story.
  • A Brazilian Novel called Chocolate com pimenta had a character based on his life.

External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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