As Nature Made Him

As Money stops talking about Brenda’s case in the 1990s, Diamond starts to. In the introduction to his 1991 book, Biographies of Gender and Hermaphroditism in Paired Companions, Money fails to mention “his ultimate matched pair: the sex-changed twin and her brother” (205). He blames the absence on Diamond and the BBC crew, whose work in the early 80s, he claims, cut short follow-up with the twins.

Later that year, in a tribute volume to Money, several intellectuals attack Diamond. As a result, he “did not have the luxury of withdrawing and being silent” (207). So he seeks out Brenda, who is living as David, by finding Dr. Doreen Moggey. Moggey leads him to Dr. Sigmundson, who responds that he “was wondering how long it would take for [Diamond] to get here” (207).

When Sigmundson calls David to arrange an interview with Diamond, David has been married for less than a year. He is unaware of the academic battle over his identity. Diamond tells him, over dinner, that doctors are “doing all these surgeries [on infants] based on me” (209). He decides to help Diamond, slowly recounting the details of his childhood. In his final paper, Diamond helps secure anonymity by changing Brenda/David’s names to Joan/John, ironically the names of the Drs. Hampson, who had initially worked with Money.

In the 1994 paper, Diamond:

wrote that David’s case was evidence that gender identity and sexual orientation are largely inborn, a result of prenatal hormone exposure and other genetic influences on the brain and nervous system, which sets limits to the degree of cross-gender flexibility that any person can comfortably display (209).

In short, nature is stronger than nurture where gender and sexuality are concerned. No child, including an intersex child, would benefit from infant sex reassignment surgery. Diamond carefully avoids attacking Money specifically in the article, hoping to keep the debate theoretical.

Journals find the article controversial. After two years, it is accepted by the American Medical Association’s publication and published in March 1997. One doctor, William Reiner, agrees with Diamond deeply. Reiner runs a follow-up study on patients who have been sex reassigned. Earlier in his career, Reiner did many childhood sex-change surgeries, until he met a 14-year-old Hmong girl who threatened suicide if she did not have the surgery.

Medical tests “revealed that ‘she’ was biologically a he—a 46XY male” without differentiated genitals (212). He realized that rearing a child in a particular gender was less powerful than he had been taught. Reiner quit his surgery practice and became a child psychiatrist at Johns Hopkins. David’s case is only further evidence for the patterns he found.

Diamond’s 1997 article brings on a media frenzy. David agrees to appear on two television shows, his face obscured, and to work with a reporter from Rolling Stone, who turns out to be Colapinto himself. Colapinto’s strongest impression of David, at the first meeting, “was of David’s unequivocal masculinity” (215).

Media attention empowers others to speak, particularly intersex people who were treated under Money’s guidelines since 1955. Grassroots organization began a few years earlier with the 1993 founding of the Intersex Society of North America, but their work “changed overnight when the John/Joan case blew up” (216). In his research, Colapinto explains, he met many intersex people involved in the group: He tells their stories of assignments and therapies and the actions they take to regain their identities. The founder of the organization, Cheryl Chase, actively seeks an audience with John Money for years. She also writes to the American Academy of Pediatrics. Neither would respond.

Colapinto also describes his interviews with Paula, the other intersex child featured in Money’s stories and embroiled in his media frenzy. Paula testifies to satisfaction with her surgery and pleasure in her gender identity. She also remembers harrowing experiences in Money’s office, in which she was forced to look at pornographic images and respond to pressured questioning. She admits that the force of her mother’s attachment to Money is the main reason for her childhood appearances in the media.

Colapinto suggests the need for change in the medical field. The largest change is “the medical profession’s current view of what it means to be reared with ambiguous genitals” (232). Colapinto details a pre-1955 study of intersex children who did not undergo surgery, which he describes as “valuable” but understudied by “experts in the debate on intersex treatment” (236). The study is John Money’s PhD dissertation. 

In his second to last chapter, Colapinto turns to John Money at the time of writing. At 78, Money is still a bold and active writer in the field of sex and sexuality. Colapinto notes a subtle shift in his self-profiling in the late 80s, when he starts to describe himself “as a longtime champion of the role of biology in psychological sex differentiation” (238).

His tenure at Johns Hopkins encounters problems in the mid-70s, when Dr. Paul McHugh becomes the head of the Psychiatry Department at Johns Hopkins. McHugh scorns many practices in psychiatry, particularly sex-change surgery for adults. He sees trans identity as “one symptom in a larger complex of personality disorders” (239). Slowly, he works to end the practice at Johns Hopkins. At the same time, he pushes Money out of teaching positions and office spaces.

In the 1990s, one anonymous patient (who Colapinto refers to as Charlie Gordon) raises a complaint against Money and Hopkins. Childhood hypothyroidism leads him to Johns Hopkins, where he receive cow thyroid gland medication that causes him to develop physically and intellectually; “at age five he became a psychological research subject” and will remain so for twenty-five years (241). When he discovers his own case, with full quotations, in one of Money’s books, he files his complaint: Money never requested requisite permissions to use the extremely private material of Gordon’s life.

Gordon never receives his apology, but he does share his story with the National Bioethics Advisory Commission in 1997. Money, for his part, “remained defiant, combative, and uncowed” (243). He publicly announces and fights against his estrangement at Johns Hopkins. He also “castigated” Milton Diamond (244). Before he knows that Colapinto has spoken and worked with David Reimer, Money offers to aid him in his journalism; once he finds out, he grows “ice-cold” (246).

When Colapinto is fact-checking his Rolling Stone article, Money speaks with him on the phone. Colapinto reports that Money calls out “a conservative political bias” in the media and an antifeminist tone in coverage of David Reimer’s case (246). As for intersex people, Money claims that “you cannot be an it,” with ambiguous genitalia in childhood (248).

After the article is published, Money goes on record in a New Zealand magazine to point out the “conspiracy against him” (248). Money is still supported, as of 1999, by a National Institutes of Health grant that began in the 1950s. Several defenders of Money believe that Ron and Janet simply did not devote themselves to proper nurturing for Brenda: This is why her reassignment failed. Colapinto speaks with one of those doctors, Dr. Kenneth Zucker, about his defense of Money’s work. Slowly, Colapinto realizes that Zucker has never met the patient on whom his work is based. The information comes from several murky sources—one of whom is John Money himself.

Twenty years after Brenda’s transition to David, the Reimer family, Colapinto writes, is thriving. Ron’s business is successful. Janet’s depression receded. They find happiness in their marriage that they haven’t known since its very beginning. Still, upon reflection, both are marked by David’s life and difficulties.

Ron, particularly, struggles to see himself as a purely positive influence in David’s story. When Colapinto is visiting the Reimers, Ron coaxes him to join him and Janet in watching one of their favorite films, Crossroads. Colapinto reads the grief, guilt, and “outraged betrayal” in the film as a description of Ron’s feelings, which he has trouble voicing (256).

Brian’s teenage years are marked by violent and criminal behavior, a contrast to the “aesthetic awareness” and “sensitive side” that Colapinto notes in him as an adult (257). Brian is angry, he explains, when he learns the truth about Brenda’s identity, and it is only one of many “emotional hurdles” that marks his journey to adulthood (258). He attempts suicide before the twins’ seventeenth birthday. He starts a troubled marriage at age 19. When that falls apart, he struggles with alcoholism and depression; he cannot raise his children successfully. Now, with a new wife and the help of medication, his lot has improved.

While David used to fantasize about hurting Money if he met him, at the time of Colapinto’s writing, he has moved past blame. He marvels, though, at the idea that a penis was so crucial: “[T]hey implied that you’re nothing if your penis is gone” (262). Though David speaks candidly and often with enormous wisdom about his life story, Colapinto notes that Dr. Moggey warned him, before their interviews, that he was headed into “a dangerous psychological process” (265).

Colapinto does not find immense struggle in the interviews until he reveals to David that his introduction to his mother’s poetry publishers had been a coverup for his introduction to BBC documentary producers—this is a family secret still unshared with David. He is angry and upset to a “frighteningly intense” degree, but he calms down eventually (267).

The only psychiatrist with whom David will speak is still Dr. Mary McKenty. McKenty now struggles with Alzheimer’s, at the age of 83. She shows a clear “admiration for David” when, with Colapinto, David visits her (269).

Colapinto concludes by synthesizing that “David has shaken to its foundations the clinical practice founded on John Money’s work” and questions major Freudian understandings of childhood development (272). Manhood, though, David believes, does not rely on the presence or absence of a penis.