“But the resistance!” Moggey says. Sullen, angry, unresponsive, Brenda often simply refused to speak, scowling and directing her gaze to the floor. Mere mention of the word penis or vagina would induce in the child an explosive panic. Brenda remained immovable on the subject of vaginal surgery or returning to the Psychohormonal Research Unit. “Won’t look at pictures of female bodies with Dr. Money,” Moggey noted on 20 January. “Won’t accept going to see Dr. Money.”
Struck by the obvious depth of the child’s aversion and concerned that Money had not yet grasped the severity of the problems that Brenda and her family had been laboring under, Moggey wrote to him again on 2 February. This time she wrote at greater length and was explicit about Brenda’s problems: she explained that the child was two years behind her peers academically and had not progressed well in school “from day one”; that Brian was “embarrassed” by Brenda’s “tomboy like behavior”; that Brenda was having trouble making friends and talked openly about being different from other girls; that she was “not interested in developing female shape,” felt anything to do with her body was “dirty,” was still refusing surgery, and had expressed embarrassment about her trips to Baltimore where “a man [was] showing her pictures of nude bodies”; and that furthermore “she is saying no to returning to see you and threatens to run away if this is necessary.” Moggey ended the letter by saying that despite Brenda’s resistance, she was continuing to work toward making the girl return to Baltimore, “as I do feel Brenda needs to start her hormone therapy and start developing female characteristics.”
Money’s reply, dated 9 February, was brief. Failing to allude even glancingly to the many issues raised by Moggey, he simply reiterated his great pleasure that the psychiatrist had become involved, his happiness in working “in closest collaboration” with her, and his “great relief” that Moggey was helping to prepare Brenda for her return to Johns Hopkins.
Money’s relief was to be short-lived. After two more months of trying—in vain—to convince Brenda to return to Johns Hopkins, Moggey decided that no amount of therapy could remove the girl’s fierce resistance. That spring Moggey spoke to Ron and Janet about the alternative of Brenda’s undergoing the vaginal surgery not in Baltimore, but in Winnipeg—a plan that would not only save considerable time, energy, and money for the Reimers, but also remove for Brenda the deep anxiety associated with her visits to Johns Hopkins.
Still Ron and Janet expressed trepidation about deviating in any way from Money’s program. They would agree to it only if Dr. Money himself approved the plan. On 18 April, Moggey wrote to him again and apprised him of the proposal to have Brenda’s surgery performed in Winnipeg—“unless,” she added, “there is some particular reason for returning to Johns Hopkins.”
As it happened, Money considered there to be many reasons for the child to return to Johns Hopkins. He outlined these reasons in a two-page, single-spaced letter that seemed to carry, under its surface smoothness, a strong undertone of desperation at the prospect of losing control of, and contact with, his most famous research subject.
“It goes without saying the Reimers have freedom of choice with respect to location of professional services,” Money began. “I shall go along with their decision, whatever it is. Nonetheless, I believe their wisest decision will be not to lose their Johns Hopkins contact, but to work out a joint program of cooperation between us and Brenda’s local specialists.” Citing the “unique” benefits of the “close collaboration between medical psychology, endocrinology and surgery” at Johns Hopkins, which, Money claimed, “eliminates the possibility of conflicting opinions among experts not accustomed to working together,” he also extolled the vagina-building skills of Howard Jones, the surgeon who had castrated Brenda a decade earlier and who was scheduled to construct her artificial genitals. Yet apparently aware that even his own formidable powers of persuasion were not quite up to the task of explaining why it was more practicable for the child to travel two thousand miles for a complicated operation requiring lengthy follow-up care (rather than have the surgery in a hospital just minutes from home), Money concluded his letter with a plea that regardless of where the surgery was done, he not lose contact with Brenda. “I would like to continue seeing her,” he wrote, “on approximately an annual basis in the future as in the past.”
Only when the Reimers saw that Dr. Money would not stand in the way of Brenda’s having the surgery in Winnipeg did they agree to the change in plan. But on the issue of Brenda’s returning to Baltimore for her annual follow-ups, Ron and Janet found themselves once again persuaded by Money’s eloquence. They decided that if Brenda’s fears could be overcome by the local psychiatrists, they would continue to bring her to the Psychohormonal Research Unit for her yearly counseling sessions with Dr. Money. “We felt like we had nowhere else to turn,” says Janet. “No one knew us, or Brenda, as well as Dr. Money did.”
8
In the spring of Brenda’s sixth-grade year at Agassiz Drive, her case was transferred to a new psychiatrist when Dr. Moggey, for family reasons, had to leave Winnipeg and go to live in Brandon, a small town some fifty miles north of the city. Moggey referred Brenda to Dr. Janice Ingimundson, a thirty-two-year-old alumna of the University of Manitoba Medical School. Ingimundson was a coolly rational Freudian whose considerable wit and warmth were carefully concealed under a scrupulously correct analytic detachment. Not a member of the city’s Child Guidance Clinic, Ingimundson had her own private practice, which she operated out of an office in downtown Winnipeg. Her first session with Brenda was on 6 May 1977. She recalls being taken aback at her first glimpse of the patient.
“All the documentation claimed that this child had accepted her gender identity as a female,” Ingimundson says. “Yet my one visual memory of this youngster is of kind of a”—she curls her hands into fists and bends her elbows in a boxer’s pose—“tough girl. A rather boyish-looking girl. Rugged.”
Little that Brenda said in her sessions contradicted Ingimundson’s first impression. Though at times Brenda said what she thought the psychiatrist wanted to hear (“I want to be pretty; I’m a girl, not a boy”), in the same breath she would inevitably reveal contradictory feelings about herself. She defended her preference for boy’s clothing, telling Ingimundson, “I like dressing like this. It doesn’t feel right to be in a dress, like I shouldn’t be in one.” Asked about her feelings for boys, Brenda said she “wants to beat up on [them]” and then added a comment that offered almost an embarrassment of riches for a devotee of Freudian symbolism. If a boy “laid a finger on her,” Brenda told the psychiatrist, “she would take her father’s ax and cut it off.” When Ingimundson tried to touch on the topic of vaginal surgery, Brenda grew especially truculent. “I have decided not to have that,” she informed the psychiatrist, “and I don’t want to talk about it.”
Troubled by such statements, Ingimundson nevertheless took Dr. Money’s word that Brenda had formed a female gender identity. The psychiatrist felt she had little choice. “I thought, The decision has been made,” Ingimundson says. “If you open up this can of worms now and say, ‘Maybe this was the wrong decision’—well, who is going to do that?” Accordingly, Ingimundson (like Moggey before her) resolved to work hard to assure Brenda that she was a girl and urge her to submit as soon as possible to the vaginal surgery. Yet from their first session on, Ingimundson was uncomfortable with every aspect of the case—and in particular her sense that on some subconscious level the child knew that she was a boy, yet knew she must not speak of it.
“You’d talk to her,” Ingimundson explains, “and conventionally masculine interests would come forward. Which is not surprising; you see that in girls. But her embarrassment—not embarrassment, but her difficulty—in talking about those kinds of interests was acute. She didn’t want to expose them. She used to say she had a ‘secret.’ She talked about wanting to be a ‘detective.’ She wanted to solve the mystery. That’s the therapeutic puzzle: she wants to know, but she doesn’t want to
know. People in therapy want to know, but they don’t want to know. They want to know only if it’s good news.”
And according to Ingimundson, it was clear that Brenda had come to believe that the truth was anything but good news. Ingimundson continues: “Brenda was basically saying, ‘There’s nothing wrong with me, why do these people want to cut into me?’ And in retrospect, she was right. ‘I’m a boy, I’m a male, so in that sense, there’s nothing wrong with me; but anatomically, if I’m a girl, then there is something wrong with me.’ So this is the bind that she’s in. ‘If I admit that I’m a boy, then I have to admit that there’s something wrong with me anatomically. And if I admit that there’s something wrong with me anatomically, what happened?’ ”
Thus convinced that Brenda’s resistance stemmed from her inkling that she was not being told the whole truth about herself, Ingimundson, after their second session, talked to Brenda’s parents. She urged Ron and Janet to begin preparing Brenda against the day when she would be informed about the circumstances of her birth, the accident she had suffered, and her subsequent sex change. “She has to be told,” Ingimundson said, “and she has to be helped in accepting it.” Only then, the psychiatrist believed, would Brenda recognize that there was no choice but to go forward with the vaginal surgery. In her notes, Ingimundson registered Ron’s and Janet’s terror at the prospect of telling Brenda the truth.
“I kind of wish that you could tell her,” Janet said. But Ingimundson assured her that it was more appropriate for Brenda to hear the truth from her parents. They should go slowly at first, laying the groundwork. Meanwhile Ingimundson would prepare Brenda emotionally for the final revelation.
A few days later, Ron had a private talk with Brenda. Sitting on the edge of her bed, he managed to choke out the statement that when Brenda was a baby, a doctor had “made a mistake down there” and that the surgery she was going to have was so that “other doctors” could fix up the “first doctor’s mistake.” Ron found it impossible to make any mention of Brenda’s true birth status, her sex change, or in any way to explain what this “mistake” had been. Nor did Brenda evince any interest in these matters; in fact, her reaction seemed to suggest that she wanted to hear nothing more about them. As Ron later reported to Ingimundson, Brenda’s sole response to his mysterious utterances about the “doctor who made a mistake” was to ask, “Did you beat him up?”
Today David explains that Ron’s halting talk of an “accident” did nothing to tip Brenda off to the fact that she was a male who had been surgically changed into a girl. “You’re not going to think of that in a million years,” David says. “So I didn’t know what he was talking about—and I didn’t want to know.”
* * *
Meanwhile Brenda was having her usual difficulties at school. “She has only been in the school for 4 days, and principal related peer problems,” scribbled the school’s social worker in Brenda’s file. “Teasing—‘looks like a boy, etc.’ ”
As the school year progressed, however, Brenda was gradually accepted into a small clique of misfit tomboys led by a girl named Heather Legarry, a short-haired brunet with an open smile. “I had been the subject of shunning several times throughout those early school years,” says Heather today. “I knew what it was like, and I never would do that to another person—ever.” Brenda, she says, seemed a natural candidate for inclusion in the group of tomboys who played soccer and dodge ball, climbed the jungle gym, and rode bikes. Though distrustful, at first, of Heather’s overtures, Brenda finally dropped her guard and began to hang around with Heather and her friends. “Heather was the first friend I ever had,” David says. “I didn’t know what a friend was.”
Heather, for her part, valued Brenda as a girl devoid of the duplicity and backstabbing that had poisoned so many of her relations with girls in the past and that even threatened the harmony of her current clique of tomboys. “Brenda didn’t speak much,” Heather says, “but when she did she was never vindictive or false. She was very honest. If she told me something was black or white, it was.”
At the same time, Heather was not blind to what she calls Brenda’s “oddity.” Partly this was a feature of what Heather describes as Brenda’s acute anxiety. “Brenda was always nervous about doing things that were the least bit unusual—like cutting through the university grounds on our bikes, which I did all the time. She was very nervous, very unsure of herself.” Heather says that this nervousness even affected Brenda’s speech. “Just making a sentence sometimes seemed hard for her.”
And there was something still more odd about Brenda. “As far as I knew, Brenda was a girl—physically,” Heather explains. “But from everything that she did and said, she indicated that she didn’t want to be a girl. The other girls in our group were competitive against the boys; we wanted to prove we could do whatever they could do. We wanted to show them. We might get in arguments with the guys, but we wouldn’t have gone as far as to fight with them physically. I wouldn’t want a bruise on my face, for example. But Brenda fought with the boys. Brenda would take the bruises.” Heather pauses and thinks about this for a moment. “I myself was a tomboy,” she resumes, “but I never wanted to be a boy. Brenda did.”
Heather’s impression was only strengthened when, one day on the school playground, she noticed a small bald patch near the crown of Brenda’s head. The hairless area was the result of an accident when Brenda was a baby—she’d pulled the cord of the electric frying pan while her father was cooking and been hit by hot grease. But that’s not the story Brenda told to Heather. “She said she had deliberately taken a hot frying pan to her head to burn off the hair,” Heather recalls, “because she ‘wanted to be bald like a man.’ ”
* * *
It was through her friendship with Heather that Brenda became increasingly aware of a new and perilous undercurrent in the life of the classroom. She first noticed it when overhearing bits of conversation among the other girls—talk of “crushes” and “going steady” and “kissing.” Then she saw boys and girls passing notes when the teacher’s back was turned. Once she saw one. It was a love note, and it was signed “xoxoxox.”
Brenda recognized in these developments a fertile field for fresh embarrassments and humiliations. She had resolved to give wide berth to the burgeoning dating scene—a resolution that she did not think would be difficult to keep, since none of the boys showed any romantic interest in her. Still, it soon became clear to her that she could not avoid the awakening sexuality of her peers entirely. That fall Heather took Brenda along to a birthday party for one of their classmates. The party began innocuously enough. With their host’s parents acting as chaperones, the children dutifully played games of pin the tail on the donkey and Twister while a children’s album played on the stereo. But when the parents left the room and went downstairs, everything changed.
“One of the kids took the record off—zzzzt!—and put on a makeout tune,” David recalls. “Another guy put the lights out. Suddenly everyone’s slow dancing and making out. I’m looking at Heather, and Heather was looking at me. We were the only two left over.” The pair beat a quick retreat downstairs. “But you could hear through the vents,” David says. “I could sense what was going on.”
I asked David how he had felt as Brenda, watching his classmates pair off romantically. He thought for a moment. “I guess envious,” he said finally. “These people looked like they knew where they belonged. There was no place for me to feel comfortable with anybody or anything.”
Brenda’s escalating alienation was clear in her sessions with Dr. Ingimundson, who continued doggedly to try to get Brenda to open up and discuss her genitals and to agree, finally, to surgery. But Brenda could not be budged.
“Not responsive to my efforts to engage,” the psychiatrist wrote, when she and Brenda were three months into their sessions. “Silent . . . staring off into space—head turned away. . . . Telling me she feels trapped in office—wants to get out—or feels trapped inside self.”
9
IN THE SUMMER OF 1977, Brenda suddenly had to fend off an attack on a new front. On her last several trips to Baltimore, Dr. Money had spoken to her about the medication she would soon need in order to become a “normal girl.” He was talking about estrogens, the female hormones that would simulate the effects of female puberty on Brenda’s broad-shouldered, narrow-hipped boy’s physique. Like the vaginal surgery, the prospect of growing breasts struck Brenda as a nightmare. So she was suspicious when one day soon after the end of her sixth-grade year at Agassiz Drive, her father produced a package of pills and told her to start taking them.
“What’s this medicine for?” she asked.
Ron, struggling for the best way to put it, finally came up with, “It’s to make you wear a bra.”
“I said, ‘I don’t wanna wear a bra!’ ” David recalls. “I threw a fit.”
The depths of Brenda’s resistance to the hormones was clear in her dealings with the doctor whose specific job it was to prescribe and regulate her estrogen therapy—a pediatric endocrinologist named Jeremy Winter. A thirty-four-year-old professor at the Children’s Hospital of Winnipeg, Winter had trained in Philadelphia under the respected endocrinologist Alfred Bongiovanni, who himself had trained at Johns Hopkins under Lawson Wilkins.
Given this academic pedigree, it was perhaps not surprising that Winter was the Winnipeg doctor least inclined to question the methods or conclusions of Money’s twins case. Before meeting Brenda, he anticipated no problems with the treatment.
As Nature Made Him Page 12