The David Reimer Case: A Cautionary Tale for Clinicians (cont.)
Brenda's violent opposition to Money, vaginal surgery, and visiting Johns Hopkins, came to a head on the 2 May 1978 when the Reimers returned with Brenda and Brian for
a counselling session with Money. On this occasion Brenda had to be bribed with the promise of a trip to New York in order to get her to attend the appointment.
At the interview
Brenda displayed her usual anger, anxiety and depression. However, on this occasion she started to panic when she was introduced to a transsexual woman, who told her how fantastic the surgery was and how beautifully it had all turned out for her.
Money told Brenda that she was now old enough to sign her own consent forms. Despite the fact that he said that no one should make her feel as if she was having things forced
upon her, he talked endlessly about her 'gender identity' and that she would never be a person unless she had one. The only way of achieving this, he insisted, was to have the surgery done.
It was all too much for Brenda and she bolted – with John Money and the transsexual woman in hot pursuit. Eventually the woman caught up with her in the car park and tried to calm her down. When she was eventually reunited with her
parents and brother at the hotel, Brenda declared it was Money or her life. She said that if she was ever forced to see John Money again she would commit suicide – and she meant it. They never went back.
Keith Sigmundson – the head of the Winnipeg Child Guidance Clinic – had inherited Brenda's case in 1976 and had tried to assign her to psychiatrist, Mary McKenty. At that time, however, Dr McKenty was recovering from a double
mastectomy and thinking of retirement so she turned it down. Brenda's previous relationships with other psychiatrists had been totally unsatisfactory, so when Keith Sigmundson approached Mary McKenty again in the autumn of 1978 she realised that Sigmundson
was desperate and agreed to take Brenda as a patient.
Although Brenda liked the psychiatrist's friendly and conversational style, she suspected that Dr McKenty was only being
friendly in order to persuade her to have surgery, and tried every trick in the book to test her. The kindly Dr McKenty passed all the tests that Brenda threw at her and their relationship gradually deepened into friendship.
On the 22 March 1979 John Money was due to give a speech at the Health Sciences Center in Winnipeg and invited himself to the Reimer home. Brenda started to panic. Mary McKenty and Brenda created the 'Don't
Want to See Dr Money Club' but as the time for his visit drew closer Brenda started to have terrifying dreams.
The Reimers were worried that their home was not good enough
for such a distinguished visitor but Money was avuncular and complimentary. The twins, however, hid in the basement and refused to come upstairs. Money informed the Reimers that he had missed his flight and they offered to put him up for the night –
an offer he promptly accepted.
Even though their parents eventually forced them to come up from the basement, Brian and Brenda refused to engage in polite conversation with
Money and their replies to his questions were monosyllabic. As soon as they could manage it, they escaped down to the basement again and stayed there until after Dr Money had left for the airport the next morning. It was the last time that the Reimers saw
John Money in person.
owes Professor Milton (Mickey) Diamond, Dr Keith Sigmundson, and author, John Colapinto, a debt of gratitude for their persistence in bringing the story of David Reimer to the notice of the general public.
John Colapinto's book about David Reimer, As Nature Made Him: The Boy Who Was Raised as a Girl,was an important source of information for this story. The book reached a wide range of people who otherwise would have never learned
about this case, and prompted discussion in the community regarding several fundamental ethical issues.
David Reimer could have been your child or your brother. He could
have been you. His courage in abandoning the anonymity of medical confidentiality at the request of Mickey Diamond and John Colapinto, and his patience in allowing himself to be interviewed, filmed, clucked over, and generally have his privacy invaded,
inspires admiration. Many people saw him as a hero.
What happened to Brenda/David after they lost Money? In March 1980 Dr Winter (the endocrinologist in charge of Brenda's
case) was thoroughly fed up when Brenda repeatedly refused to remove her hospital gown to allow a breast examination. After twenty minutes or so he angrily demanded to know whether she wanted to be a girl or not. Her emphatic 'NO!' bellowed at the top of her
voice finally got through to someone.
Dr Winter left the room and told Dr McKenty (who was outside in the hallway) that it was time that Brenda was told the truth. When Ron
Reimer picked Brenda up after her appointment that afternoon he bought her an ice cream and, after a faltering start, told her the whole sorry story. Although she was confused, shocked and angry, Brenda also felt an overwhelming sense of relief. Suddenly her
whole life made sense. The most important question she wanted her father to answer was, 'What was my name?'
The name of Bruce did not appeal to the young man so he chose
the name David for himself – after the biblical king who slew the giant, Goliath. It seemed fitting.
David began to have testosterone injections and underwent a phalloplasty
operation, which was less than satisfactory. A new, improved procedure was developed and he had a second phalloplasty done just before his twenty-second birthday.
been castrated by the people who had a duty of care to him and had no hope of fathering children, but he still longed for marriage and a family of his own. His brother Brian had married and was the father of two children. He was envious of his brother's happiness
but David despaired of ever finding a woman who could accept him as he was.
In 1988 Brian and his wife introduced David to an acquaintance of theirs, Jane Fontane, a blue-eyed,
strawberry blonde – and the single mother of three children. Brian's wife had told Jane about David's accident and she took it all in her stride. She and David began dating and they fell in love.
In September 1990 David and Jane were married in Winnipeg, and Bruce/Brenda Reimer became David Reimer – family man.
There are some lessons to be
learned from this case. People who seek the assistance of others need to feel confident about two things – that the person they are consulting knows what they're doing, and that they have the patient's best interests at heart.
Knowledge, skill and intellect do not provide a satisfactory standard of care if a clinician's primary interest is money, self-aggrandisement, or the satisfying of scientific curiosity without humanity. Patients
need to be assessed on a case by case basis.
Money's behaviourist theories were accepted uncritically by too many people, particularly by those dealing with intersexed children.
As Professor Diamond has said, the theory stated that biology was irrelevant and if you placed a newborn genetic male in a pink room and a genetic female in a blue room they would never find out that they were born the opposite sex if no one told them.
The implication, as far as the treatment of intersexed children was concerned, was that if a child's genitals were ambiguous you could simply assign them to whatever sex you wanted
irrespective of chromosomal sex, and they would never know the difference. And that's exactly what the medical profession did. If they felt that a child's penis was not long enough they castrated the child, told it that it was a girl, and created a vagina.
How long should an infant's penis be? How long is a piece of string?
The 'twins' case, or the 'John/Joan' case as it is also known in the medical literature, is the story
of David Reimer. The case was used to justify surgery on intersexed infants. It was based on a faulty premise and bad science. This surgery is still practiced in Australia.
On the afternoon of Tuesday, 4 May 2004 David Reimer parked his old Chevrolet next to a supermarket close
to his home in Winnipeg, Canada. Minutes later he blew his brains out with a swan-off shotgun.
His twin, Brian, then aged thirty-six, had died two years previously in mysterious
circumstances. Although the cause of death was never determined, it was generally felt to be a suicide.
David Reimer was thirty-eight years old when he died. He was a hero
to many people. John Money is eighty-two years old and remains a professor emeritus at Johns Hopkins. He declines to comment on David Reimer's treatment or the callous experiment that went so dreadfully wrong.
From Transgenders and Intersexuals: Everything You Ever Wanted to Know but Couldn't Think of the Question by Lois May.
© Lois May 2005
'There is great beauty in the subtle shades of difference and as you listen to these voices
their strength is memorable, enlightening and bound to surprise.' – Jeff McMullen, Prize-winning journalist and author of A Life of Extremes.
THIS BOOK IS AVAILABLE
If you want to buy this book but can’t find a copy in bookstores or online (not Amazon – they’re listing ridiculous prices for this book),
contact the publishers (East Street): phone Michaela Andreyev on 0400 600 840 or email her at email@example.com. East Street still has a few copies in stock.
Format: Paperback, 200 pages; Published in: Australia, 31 October 2005; Publisher: East Street Publications;
ISBN: 1921037075; EAN: 9781921037078; Age range: 15+ (younger with adult supervision)
What would you do if you asked what sex your newborn baby was and your doctor said, 'We don't know'? Approximately one person out of every hundred is born intersexed to some degree but doesn't necessarily know it. The incidence is only slightly
less than twinning, which occurs about once in every eighty births.
What would you do if your little girl constantly insisted that she was a boy? For most people, sexual
identity (their birth sex) and gender identity (the gender they feel themselves to be) coincide. For transsexuals and many intersexuals there is a conflict between their apparent biology and their innate sense of gender. Why?
Researchers are now homing in on the genetic and hormonal influences that determine our sexual development and our internal perception of gender identity. An increasing number of scientists believe that transsexuals
hold the key to solving the gender puzzle.
In this book, renowned sexologist Professor Milton Diamond explores the latest findings, transgenders and intersexuals contribute
their personal stories of courage and survival and psychologists, police and human rights activists tell of their efforts to battle prejudice and discrimination directed against this small but important group of people.
Transgenders and Intersexuals takes a courageous, rational and sympathetic look at the extraordinary and sometimes frightening world of sexual development and gender identity.
‘This book explores the issues that transgenders and intersexuals face by telling their
stories in their own words…This is the ultimate, comprehensive handbook on an issue plagued with misinformation and stigma.’ – Angela Yin, QNews.
read many books about other people but the tales in this book are harrowing to say the least, particularly for the MtF’s…All in all a good read, informative and balanced.’ – Michael Mardel, TransGender Victoria Newsletter.
‘…Well-presented, interesting and balanced account of the lives of some Australians affected/afflicted (depending on your perspective) with gender issues, and how they
have made meaning from their situations…a strong sociological case study and a reminder to us all that our inability to see shades of grey in an otherwise black and white world can lead to our own undoing, let alone that of others.’ – Jeremy
Damien Nicholas: The Bookshop Darlinghurst.