3
RON AND JANET REIMER made their first trip to Johns Hopkins in early 1967, shortly after seeing Dr. Money on TV. The young couple—aged twenty and twenty-one respectively—were awestruck by the vast domed medical center dominating the top of a rise on Baltimore’s Monument Street. Dr. Money’s Psychohormonal Research Unit was located in the Henry Phipps Psychiatric Clinic, a gloomy Victorian building tucked away off a back courtyard. The unit’s offices, located on the fourth 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 Reimers would take place over the next eleven years) reflected the psychologist’s eccentric tastes in interior decoration. Furnished with a couch, Oriental rugs, and a profusion of potted plants, the room also featured brightly colored afghans thrown over the backs of armchairs, a collection of carved aboriginal sculptures of erect phalluses, vaginas, and breasts on a mantel, and a collection of primitive blowguns, darts, and masks hanging on the walls. The Reimers had certainly never seen anything like this before, but Dr. Money, with his smoothly confident, professional manner—not to mention the diplomas on his wall—made the Reimers feel that they were, finally, in the best possible hands. “I looked up to him like a god,” says Janet. “I accepted whatever he said.” And what Dr. Money had to say was exactly what the Reimers 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 their baby—“using nontechnical words, diagrams, and photographs of children who had been reassigned.” He explained to Ron and Janet that their baby could be given a perfectly functional vagina—“adequate for sexual intercourse and for sexual pleasure, including orgasm.” He also explained to them that although their child would not, if changed into a girl, be able to bear children, she would develop psychologically as a woman and would find her erotic attraction to men. As a married woman she would be perfectly capable of adopting children of her own.
What is not clear from Money’s written accounts of this meeting is whether Janet and Ron, whose education at the time did not go beyond ninth and seventh grades, respectively, understood that such a procedure was in fact purely experimental—that while Money and his colleagues at Johns Hopkins had performed sex reassignments on hermaphrodite children, no such infant sex change had ever been attempted on a child born, like their Bruce, with normal genitals and nervous system. Today Ron and Janet say that this was a distinction they did not fully grasp until many years later. The crucial point they gleaned from Dr. Money was his conviction that the procedure had every chance for success. “I see no reason,” Janet recalls him saying, “that it shouldn’t work.”
Money’s eagerness to begin seemed evident in his recounting of the interview almost ten years later. “If the parents stood by their decision to reassign the child as a girl,” he wrote in Sexual Signatures, “surgeons could remove the testicles and construct feminine external genitals immediately. When she was eleven or twelve years old, she could be given the female hormones.”
If Dr. Money seemed to be in a hurry, he was. He explained to Ron and Janet 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 point after which a child has locked into an identity as male or female—comes at two and a half to three years of age. Bruce was now nineteen 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.”
Ron and Janet, however, were not prepared to have Bruce immediately admitted to the hospital. They needed time to decide on something as momentous as having their child undergo a surgical sex change. They told Dr. Money that they would have to go home and think about it. Janet says that he made no secret of his impatience with the delay. Upon their return to Winnipeg, the couple received letters from him urging them to reach a final decision. “He wrote in a letter that we were ‘procrastinating,’ ” Janet recalls, “but we wanted to move slow because we had never heard of anything like this.”
Back home, Ron and Janet canvassed opinions. Their pediatrician recommended against such drastic treatment and stuck by his earlier advice that Ron and Janet wait until the child was of preschool age before beginning the long process of phalloplasty. Janet’s mother, Betty, was inclined to trust the expert from Baltimore but had no real opinion of her own. Ron decided not even to bring it up to his parents since he felt sure they would be against it.
Finally Ron and Janet realized that only they could decide the fate of their child. They alone were the ones living with the reminder, at each diaper change, of his terrible injury. Janet saw the benefits of changing their son into a daughter. “I didn’t know much back then,” she says, “and I thought women were the gentler sex. Mistakenly. I have since learned that women are the hard-core knockabout tough guys. Men are the gentler sex, by far, from my experience. But I thought, with his injury, it would be easier for Bruce to be raised as a girl—to be raised gently. He wouldn’t have to prove anything like a man had to.”
Ron, too, could see the benefits of changing Bruce’s sex. “You know how little boys are,” Ron says. “Who can pee the furthest? Whip out the wiener and whiz against the fence. Bruce wouldn’t be able to do that, and the other kids would wonder why.” And then, of course, there was the entire question of Bruce’s sex life. Ron could not even imagine the humiliations and frustrations that would entail. As a girl and woman, though, Bruce wouldn’t face all that, Ron reasoned. If what Dr. Money told them was true, she could live a normal life, she could get married, she could be happy.
Within days of their return from Baltimore, Ron and Janet stopped cutting the baby’s hair, allowing the soft, light brown locks to curl down past the ears. Janet used her sewing machine to turn his pajamas into girlish granny gowns. Their son had become, for Ron and Janet, their daughter. Dr. Money had counseled them, when deciding what to call their new daughter, to select a name beginning with the same letter as her former name and to avoid calling her after any female family members with whom her identity could become confused. Janet, following Dr. Money’s instructions, called her new baby daughter Brenda Lee.
There was, of course, still one more step to take. That summer, Ron and Janet left Brenda’s twin brother, Brian, with an aunt and uncle, then flew back to Baltimore with their daughter. Now twenty-two months old, she was still within the window that Money had established as safe for infant sex change. On Monday, 3 July 1967, Brenda underwent surgical castration in a gynecologic operating room at Johns Hopkins Hospital. The surgeon was Money’s Gender Identity Clinic cofounder, Dr. Howard Jones. Today Jones says he can recall few specifics about the case. He says that all decisions regarding reassignment of sex were the responsibility of Money and pediatric endocrinologist Dr. Robert Blizzard.
“My chief interest was the physical situation and the surgical potential,” Jones says. “Was the patient healthy and able to withstand the operation?—all that kind of stuff. The case was pretty well worked up before I ever got involved.” For Jones, the surgery on Brenda Reimer was like the routine castrations he had been performing on hermaphrodite babies over the previous twelve years—and apparently Johns Hopkins Hospital viewed the operation the same way. Officials of the hospital have declined all comment on the case, but a Johns Hopkins public relations person, JoAnne Rodgers, told me in the winter of 1998, “In all surgeries that were considered, in the sixties, to be experimental, there were protocols in place to have those approved by appropriate committees and boards.” Dr. Jones cannot recall that the hospital convened any special committee or board in the case of Bruce Reimer’s historic conversion to girlhood.
The main procedure was a bilateral orchidectomy—removal of both testicles. As Jones’s operating room notes reveal, the baby, under g
eneral anesthesia, was placed on his back on the operating table, each foot secured in a stirrup so that the groin was exposed for the doctors. Three clamps were placed on the scrotum, and two incision lines were drawn on either side of the midline. With a pair of scissors, Dr. Jones cut away the demarcated scrotal flesh in a strip 1.5 centimeters long to lay bare the testicles and seminal vesicles within. With a scalpel, Jones cut away both the right and left testicles, then used a length of catgut thread to tie off the cord and vessels that in adulthood would have carried sperm to the severed urethra.
In closing the scrotum, Dr. Jones then fashioned a rudimentary exterior vagina using the remaining scrotal skin, which he pulled up from its lower edge to meet the top edge of the incision and sewed in a manner that left the scrotum not as a single empty sack, but as two symmetrical flaps. “A rolled piece of gauze covered with telfa was then placed in the midline to effect a midline furrow leaving constructed labia majora on either side,” Jones’s operating room note concludes.
Ron and Janet 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. This was a crucial turnabout since according to Dr. Money it was a “vital consideration” that the parents of a sex-reassigned child harbor no doubts that could weaken the child’s identification as a girl and woman.
Whether Dr. Money himself was able to eradicate his own doubts about the child’s future development is debatable. In a letter he wrote on 28 August 1967, more than a month after Brenda’s sex change surgery, his tone admitted of considerable caution regarding the child’s prognosis. This was perhaps to be expected, since the letter was addressed to the Winnipeg lawyer whom Ron and Janet had hired to sue St. Boniface Hospital and the doctor who had 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.”
And indeed, by the summer of 1967, when Bruce Reimer underwent his castration, Dr. Money had special reason to be particularly reluctant to make an “absolute prediction” about the patient’s future psychosexual development. Two years earlier he had undertaken to discover if the findings of the Kansas team about the masculinizing effects on behavior of prenatal testosterone in guinea pigs could be observed in humans. Under Money’s direction, one of his graduate students, Anke Ehrhardt, had studied a group of ten girls, ranging in age from three to fourteen, who had been subjected to excesses of testosterone in the womb when their pregnant mothers had taken a synthetic steroid called progestin to prevent threatened miscarriage. Like the guinea pigs in the Kansas team’s study, nine of the ten girls had been born with masculinized genitals—an oversized clitoris and in some cases partially fused labia. As interviews with the children and their parents revealed, all nine of those girls demonstrated what Money and Ehrhardt called (in an article published six months before Bruce Reimer’s castration) “tomboyishness.” This, the authors explained, included marked preferences for “masculine-derived” clothes and “outdoor pursuits,” a “strong interest in boys’ toys” (these included guns and toy soldiers), a “high incidence of interest and participation in muscular exercise and recreation,” and a “minimal concern for feminine frills, doll play, baby care, and household chores.”
* * *
Central to Dr. Money’s program for the sex assignment 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 with baby Brenda Reimer. “He told us not to talk about it,” Ron says. “Not to tell Brenda the whole truth and that she shouldn’t know she wasn’t a girl.”
It was shortly after the Reimers’ return from Baltimore, and not long before the twins’ second birthday, when Janet first put Brenda in a dress. It was a special dress that Janet had sewn herself, using the white satin from her own wedding gown. “It was pretty and lacy,” Janet 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.”
Ron and Janet tried their best to do just that. They furnished her with dolls to play with; they tried to teach her to be neat and tidy; and they tried, whenever possible, to reinforce her identity as a girl. So when, for instance, the twins had just turned four, and Brian was watching Ron shave and asked if he could shave, too, Ron gave him an empty razor and some shaving cream to play with. When Brenda also clamored for a razor, Ron refused. “I told her girls don’t shave,” Ron says. “I told her girls don’t have to.” Janet offered to put makeup on Brenda, but Brenda didn’t want to wear makeup.
“I remember saying, ‘Oh, can I shave, too?’ ” David says of this incident, which forms his earliest childhood memory of life as Brenda. “My dad said, ‘No, no. You go with your mother.’ I started crying, ‘Why can’t I shave?’ ”
Brian says that the episode was typical of the way their parents tried to steer him and his sister Brenda into opposite sexes—and how such efforts were inevitably doomed to failure. “I recognized Brenda as my sister,” Brian says. “But she never, ever acted the part.”
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 David has been through. When David first introduced me to Brian in the summer of 1997, I instinctively assumed that the man who took my hand in a firm grip was an older brother, so different did this balding, dark-bearded, bearlike man look from his youthfully thin, smooth-faced brother. It was only when I looked a little closer at Brian’s face and recognized the startling familiarity of the eyes, nose, and distinctively shaped mouth that I realized I was meeting David’s identical twin, and that he was in fact the younger of the two (albeit by a scant twelve minutes).
As children, their physical differences were, if less pronounced, equally deceptive. Photographs of them as preschoolers show a pair of exceptionally attractive children: 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. However, by all accounts of family, teachers, guidance clinic workers, and relatives, this illusion of two children of opposite sexes disappeared the second Brenda moved, spoke, walked, or gestured.
“When I say there was nothing feminine about Brenda,” Brian laughs, “I mean there was nothing feminine. She walked like a guy. Sat with her legs apart. 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. 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. She played with my toys: Tinkertoys, dump trucks. This toy sewing machine she got just sat.” That is, David recalls, until the day when Brenda, who loved to take things apart to see how they worked, sneaked a screwdriver from her dad’s tool kit and dismantled the toy.
Enrolled in Girl Scouts, Brenda was miserable. “I remember making daisy chains and thinking, If this is the most exciting thing in Girl Scouts, forget it,” David says. “I kept thinking of the fun stuff my brother was doing in Cubs.” Given dolls at Christmas and birthdays, Brenda simply refused to play with them. “What can you do with a doll?” David says today, his voice charged with remembered frustration. “You look at it. You dress it. You undress it. Comb its hair. It’s boring! With a car, you can drive it somewhere, go places. I wanted cars.” Brenda also wanted toy guns. Once, around age eight, she went to the store to buy an umbrella. Waiting in line to pay, she saw a nearby display of toy machine guns. After a moment’s
hesitation, she put down the umbrella and bought one of the guns. At age ten, Brenda would prove to be a crack shot with the pellet rifle Ron and Janet bought for Brian—a rifle in which, ironically enough, Brian himself evinced little interest.
Brenda had always tried to co-opt Brian’s toys and clothes—a habit that would invariably initiate fights. “There were knock-down-drag-out wrestling matches all the time,” Janet says. “Brian was a weakling compared to Brenda. She was wiry. More often than not, Brenda won. Poor Brian felt so bad getting beat up by a girl.”
Ron and Janet were troubled by Brenda’s masculine behavior, but having been admonished by Dr. Money not to entertain any doubts about their daughter, they felt that to do so would only increase the problem. Instead they tried to focus on those moments when Brenda’s behavior could be construed as stereotypically feminine. “She could be sort of feminine sometimes, when she wanted to please me,” Janet says. “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 Brenda’s progress, Janet made sure to emphasize those moments so that the psychologist would know that Janet and Ron were doing everything they could to implement his plans. She also informed Money of their daughter’s masculine leanings, but the psychologist assured her that this was mere “tomboyism.” This was an explanation that Janet found comforting, and she would cling to it for many years to come. “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.”
Ron’s and Janet’s parents were struck by Brenda’s behavior. “When a girl would come to play with her,” says Ron’s mother, Helen, “she would not play like a girl, and then she would say to her mother that she wanted the girl to go home.”
As Nature Made Him Page 6