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David Reimer

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David Reimer
Born
Bruce Peter Reimer

(1965-08-22)August 22, 1965
Winnipeg, Manitoba, Canada
DiedMay 4, 2004(2004-05-04) (aged 38)
Ottawa, Ontario, Canada
Cause of deathSuicide
Other namesBrenda Reimer, Bruce Reimer
SpouseJane Fontaine (1990–2004)
Parent(s)Janet Grace Schultz
Ronald Peter Reimer
RelativesBrian Henry Reimer (identical twin, deceased)

David Peter Reimer (August 22, 1965 – May 4, 2004) was a Canadian man born biologically male but reassigned as a girl and raised female following medical advice and intervention after his penis was accidentally destroyed during a botched circumcision in infancy.[1]

Psychologist John Money oversaw the case and reported the reassignment as successful and as evidence that gender identity is primarily learned. Academic sexologist Milton Diamond later reported that Reimer failed to identify as female since the age of 9 to 11,[2] and transitioned to living as a male at age 15. Well known in medical circles for years anonymously as the "John/Joan" case, Reimer later went public with his story to help discourage similar medical practices. He later committed suicide after suffering years of severe depression, financial instability, and a troubled marriage.[3]

History

David Reimer was born in Winnipeg, Manitoba. He was originally named Bruce, and his identical twin was named Brian. At the age of six months, after concern was raised about how both of them urinated, the boys were diagnosed with phimosis despite not being eligible for the diagnosis of phimosis. [4] [4] [5] [6][7] [8] [9] [10] [11] [12] [13] [14] [15] [12] [16] [17]: 10 [18] They were referred for circumcision at the age of seven months. On April 27, 1966, a urologist performed the operation using the unconventional method of cauterization,[17]: 11–13 [19] but the procedure did not go as doctors had planned, and Bruce's penis was burned beyond surgical repair. The doctors chose not to operate on Brian, whose phimosis soon cleared without surgical intervention.[20]

The parents, concerned about their son's prospects for future happiness and sexual function without a penis, took him to Johns Hopkins Hospital in Baltimore in early 1967 to see John Money,[17]: 49  a psychologist who was developing a reputation as a pioneer in the field of sexual development and gender identity, 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 from early childhood and that it could be changed with the appropriate behavioral interventions.[17]: 33–34  The Reimers had seen Money being interviewed in February 1967[17]: 39  on the Canadian news program This Hour Has Seven Days,[17]: 18  during which he discussed his theories about gender.[17]: 19–22 

Money and physicians working with young children born with abnormal genitalia believed that a penis could not be replaced but that a functional vagina could be constructed surgically.[citation needed]

Money claimed that Reimer would be more likely to achieve successful, functional sexual maturation as a girl than as a boy.[21][page needed][failed verification] For Money, a case where identical twin boys were involved where one could be raised as a girl provided a perfect test of his theories.[22][23]

Money and the Hopkins team persuaded the baby's parents that sex reassignment surgery would be in Reimer's best interest.[17]: 50–52  At the age of 22 months, baby Bruce underwent a bilateral orchidectomy, in which his testes were surgically removed and a rudimentary vulva was fashioned.[17]: 53–54  Bruce was reassigned to be raised as 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 a decade 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 identical twin brother, Brian, made an ideal control because the brothers shared genes, family environments, and the intrauterine environment. 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.

Reimer said that Dr. Money forced the twins to rehearse sexual acts involving "thrusting movements", with David playing the bottom role. Reimer said that, as a child, he had to get "down on all fours" with his brother, Brian Reimer, "up behind his butt" with "his crotch against" his "buttocks". Reimer said that Dr. Money forced David, in another sexual position, to have his "legs spread" with Brian on top. Reimer said that Dr. Money also forced the children to take their "clothes off" and engage in "genital inspections". On at "least one occasion", Reimer said that 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".[21][page needed]

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 follow-up 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 developed schizophrenia.[23]

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 that surgeons had placed in the abdomen. Estrogen was given during adolescence to induce breast development.

His case came to international attention in 1997 when he told his story to Milton Diamond, an academic sexologist who persuaded Reimer to allow him to report the outcome in order to dissuade physicians from treating other infants similarly.[2] Soon after, Reimer went public with his story, and John Colapinto published a widely disseminated and influential account in Rolling Stone magazine in December 1997.[24]

This was later expanded into a full-length book As Nature Made Him: The Boy Who Was Raised as a Girl,[21][page needed] in which Colapinto 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)[25] nor female hormones made him feel female. By the age of 13, Reimer was experiencing suicidal depression, and he told his parents he would take his own life if they made him see John Money again. Finally on March 14, 1980, Reimer's parents told him the truth about his gender reassignment, following advice from Reimer's endocrinologist and psychiatrist. At 14, having been informed of his past by his father, Reimer decided to assume a male gender identity, calling himself David. By 1987, Reimer had undergone treatment to reverse the reassignment, including testosterone injections, a double mastectomy, and two phalloplasty operations. On September 22, 1990, he married Jane Fontaine and became a stepfather to her three children.[citation needed]

Death

In addition to his difficult lifelong relationship with his parents, Reimer had to deal with unemployment and the death of his brother Brian from an overdose of antidepressants on July 1, 2002. On May 2, 2004, his wife Jane told him she wanted to separate. On the morning of May 4, 2004, Reimer drove to a grocery store's parking lot and took his own life by shooting himself in the head with a sawed-off shotgun.[26] He was 38 years old.[3]

Legacy

For the first thirty years after Dr. Money's initial report that the reassignment had been a success, Dr. Money's view of the malleability of gender became the dominant viewpoint among physicians and doctors, reassuring them that sexual reassignment was the correct decision in certain instances, resulting in thousands of sexual reassignments.[27]

The report and subsequent book about Reimer influenced several medical practices, reputations, and even current understanding of the biology of gender. The case accelerated the decline of sex reassignment and surgery for unambiguous XY infants with micropenis, various other rare congenital malformations, or penile loss in infancy.[27]

David Reimer has often been mentioned by Intactivists, who use him as an example of what could happen to a man if his parents decide to circumcise him at birth, and the effect it can have on him throughout his life. Only a few years after David Reimer's birth, Canada began taking a stance against infant circumcision, and it is now uncommon there.[28]

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.[29]

The case has also been treated by Judith Butler in her 2004 book Undoing Gender, which examines gender, sex, psychoanalysis, and the medical treatment of intersex people. The case of Reimer is used to re-examine Butler's theory of performativity that she originally explored in Gender Trouble.

Documentaries

The BBC science series Horizon based two episodes on his life. "The Boy Who Was Turned into a Girl" aired in 2000 and "Dr. Money and the Boy with No Penis" in 2004.[1][22][23]

  • The Chicago Hope season 6 episode "Boys Will Be Girls" (2000) was based on Reimer's life. The episode explored the theme of a child's right not to undergo sexual reassignment surgery without consent.[30]
  • The Law & Order: Special Victims Unit season 6 episode "Identity" (2005) was based on David and Brian Reimer's lives and their treatment by Money.[30]
  • The Weakerthans song "Hymn of the Medical Oddity" is about Reimer.[31]
  • The Mental episode "House of Mirrors" (2009), Dr. Jack Gallagher meets a young girl named Heather Masters with suicidal tendencies, who was born a boy.
  • The Ensemble Studio Theatre produced the play Boy (2016) inspired by Reimer's story.[32]

See also

References

  1. ^ a b "Dr. Money And The Boy With No Penis". Documentary Storm. Retrieved May 20, 2015.
  2. ^ a b Diamond, Milton; Sigmundson, HK (March 1997). "Sex reassignment at birth. Long-term review and clinical implications". Arch Pediatr Adolesc Med. 151 (3): 298–304. doi:10.1001/archpedi.1997.02170400084015. PMID 9080940. Retrieved 15 May 2013.
  3. ^ a b "David Reimer, 38, Subject of the John/Joan Case". The New York Times. May 12, 2004. Retrieved May 19, 2015.
  4. ^ a b J.E. Wright (February 1994). "Further to 'the further fate of the foreskin'". The Medical Journal of Australia. 160 (3): 134–5. PMID 8295581.
  5. ^ Sukhbir Kaur Shahid (5 March 2012). "Phimosis in Children". ISRN Urol. 2012: 707329. doi:10.5402/2012/707329. PMC 3329654. PMID 23002427.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  6. ^ "Care of the Uncircumcised Penis". Guide for parents. American Academy of Pediatrics. September 2007.
  7. ^ "Caring for an uncircumcised penis". Information for parents. Canadian Paediatric Society. July 2012.
  8. ^ Huntley JS, Bourne MC, Munro FD, Wilson-Storey D (September 2003). "Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons". J R Soc Med. 96 (9): 449–451. doi:10.1258/jrsm.96.9.449. PMC 539600. PMID 12949201.
  9. ^ Denniston; Hill (October 2010). "Gairdner was wrong". Can Fam Physician. 56 (10): 986–987. PMC 2954072. PMID 20944034. Retrieved 2014-04-05.
  10. ^ George Hill (2003). "Circumcision for phimosis and other medical indications in Western Australian boys". The Medical Journal of Australia. 178 (11): 587, author reply 589–90. PMID 12765511.
  11. ^ Thorvaldsen MA, Meyhoff H.. Patologisk eller fysiologisk fimose?. Ugeskrift for Læger. 2005;167(16):1852-62. PMID 15929334.
  12. ^ a b Rickwood AM, Walker J (1989). "Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence?". Ann R Coll Surg Engl. 71 (5): 275–7. PMC 2499015. PMID 2802472. Authors review English referral statistics and suggest phimosis is overdiagnosed, especially in boys under 5 years, because of confusion with developmentally nonretractile foreskin.
  13. ^ Spilsbury K, Semmens JB, Wisniewski ZS, Holman CD (2003). "Circumcision for phimosis and other medical indications in Western Australian boys". Med. J. Aust. 178 (4): 155–8. PMID 12580740.. Recent Australian statistics with good discussion of ascertainment problems arising from surgical statistics.
  14. ^ Van Howe RS (1998). "Cost-effective treatment of phimosis". Pediatrics. 102 (4): e43–e43. doi:10.1542/peds.102.4.e43. PMID 9755280. A review of estimated costs and complications of 3 phimosis treatments (topical steroids, praeputioplasty, and surgical circumcision). The review concludes that topical steroids should be tried first, and praeputioplasty has advantages over surgical circumcision. This article also provides a good discussion of the difficulty distinguishing pathological from physiological phimosis in young children and alleges inflation of phimosis statistics for purposes of securing insurance coverage for post-neonatal circumcision in the United States.
  15. ^ McGregor TB, Pike JG, Leonard MP (March 2007). "Pathologic and physiologic phimosis: approach to the phimotic foreskin". Can Fam Physician. 53 (3): 445–8. PMC 1949079. PMID 17872680.
  16. ^ Babu R, Harrison SK, Hutton KA (2004). "Ballooning of the foreskin and physiological phimosis: is there any objective evidence of obstructed voiding?". BJU Int. 94 (3): 384–387. doi:10.1111/j.1464-410X.2004.04935.x. PMID 15291873.
  17. ^ a b c d e f g h i Colapinto, John (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Collins. ISBN 0-06-019211-9. OCLC 42080126.
  18. ^ Woo, Elaine (May 13, 2004). "David Reimer, 38; After Botched Surgery, He Was Raised as a Girl in Gender Experiment". Los Angeles Times. Retrieved 25 June 2016.
  19. ^ "Health Check: The boy who was raised a girl". BBC News. 23 November 2010. Retrieved 19 December 2014.
  20. ^ "David Reimer: The Boy Who Lived as a Girl". CBC News. May 10, 2004. Archived from the original on August 7, 2012. Retrieved 2015-07-05. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
  21. ^ a b c Colapinto, J. (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Perennial. ISBN 0-06-092959-6. Revised in 2006
  22. ^ a b "The Boy who was Turned into a Girl". Horizon. BBC. December 7, 2000. Retrieved May 19, 2015.
  23. ^ a b c "Dr Money and the Boy with No Penis". Horizon. BBC. 2005. Retrieved 2014-09-27.
  24. ^ Colapinto, John (December 11, 1997). "The True Story of John/Joan". Rolling Stone: 54–97. Archived from the original on 2000-08-15.
  25. ^ Colapinto, 1st edition, p/ 115
  26. ^ Colapinto, J. (2004-06-03). "Gender Gap: What were the real reasons behind David Reimer's suicide?". Slate. Retrieved 2009-02-13.
  27. ^ a b "Sex unknown".(2001). Nova transcripts. Retrieved January 1, 2012, from link
  28. ^ "Canadian Paediatric Society re-affirms position against routine circumcision". CTV News. Retrieved 24 January 2016.
  29. ^ Burkeman, Oliver (2004-05-12). "Being Brenda". The Guardian. London. Retrieved 2010-05-01.
  30. ^ a b "Treatment of Circumcision on TV". The Intactivism Pages. Retrieved 2009-02-01.
  31. ^ Stewart, M.D. (October 4, 2007). "Metaphorical cats, medical oddities and men with brooms". Fast Forward Weekly.
  32. ^ "Sloan Science & Film". scienceandfilm.org. Retrieved 2016-04-22.
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