David Reimer

For the Canadian politician, see [[:David J. Reimer]]. For the American diplomat, see [[:David Dale Reimer]].

David Reimer
Born	Bruce Peter Reimer (1965-08-22)22 August 1965 Winnipeg, Manitoba, Canada
Died	4 May 2004(2004-05-04) (aged 38) Winnipeg, Manitoba, Canada
Cause of death	Suicide
Other names	Brenda Reimer Bruce Reimer
Spouse	Jane Fontaine ​ (m. 1990)​
Parents	Janet Reimer Ron Reimer
Relatives	Brian Henry Reimer (identical twin)

David Peter Reimer (1965–2004) was a Canadian man born 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.

The psychologist John Money oversaw the case and reported the reassignment as successful and as evidence that gender identity is primarily learned. The academic sexologist Milton Diamond later reported that Reimer's realization he was not a girl crystallized between the ages of 9 and 11 years and he 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.

Infancy

David Reimer was born in Winnipeg, Manitoba, on 22 August 1965. 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. They were referred for circumcision at the age of seven months. On 27 April 1966 a urologist performed the operation using the unconventional method of electrocauterization, 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.

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, 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 behavioural interventions. The Reimers had seen Money being interviewed in February 1967 on the Canadian news program This Hour Has Seven Days, during which he discussed his theories about gender.

Money and physicians working with young children born with intersex conditions believed that a penis could not be replaced but that a functional vagina could be constructed surgically. It was also the safest and most conventional pathway to take: Money told the parents it was what would be best for the boy. Money also claimed that Reimer would be more likely to achieve successful, functional sexual maturation as a girl than as a boy. 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.

Money and the Hopkins team persuaded the baby's parents that sex reassignment surgery would be in Reimer's best interest. 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. 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.

Later childhood and adolescence

Reimer said that 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 Money forced David, in another sexual position, to have his "legs spread" with Brian on top. Reimer said that Money also forced the children to take their "clothes off" and engage in "genital inspections". On at "least one occasion", Reimer said that Money took a photograph of the two children doing these activities. Money's rationale for these various treatments was his belief that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity".

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.

Reimer had experienced the visits to Baltimore as traumatic rather than therapeutic, and when 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, inducing breast development.

Adulthood

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. 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. The article won the National Magazine Award for Reporting.

This was later expanded into a full-length book As Nature Made Him: The Boy Who Was Raised as a Girl, 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 (who dubbed him "cavewoman"), and neither frilly dresses (which he was forced to wear during frigid Winnipeg winters), nor female hormones made him feel female. By the age of 13 years, Reimer was experiencing suicidal depression and he told his parents he would take his own life if they made him see Money again. Finally, on 14 March 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 22 September 1990 he married Jane Fontaine and adopted her three children.

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 1 July 2002. On 2 May 2004 his wife Jane told him she wanted to separate. On the morning of 4 May 2004, Reimer drove to a grocery store's parking lot in his hometown of Winnipeg and took his own life by shooting himself in the head with a sawed-off shotgun. He was 38 years old. He was buried in St. Vital Cemetery in Winnipeg.

Legacy

For the first thirty years after Money's initial report that the reassignment had been a success, 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.

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.

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 Reimer's birth, Canada began taking a stance against infant circumcision and it is now uncommon in the country.

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.

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.

He was also mentioned in the 2017 documentary Gender Revolution: A Journey with Katie Couric.

In popular culture

• The Chicago Hope 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.
• The Law & Order: Special Victims Unit episode "Identity" (2005) was based on David and Brian Reimer's lives and their treatment by Money.
• "Hymn of the Medical Oddity", a song by the Winnipeg-based indie rock band The Weakerthans, is about Reimer.
• The Mental episode "House of Mirrors" (2009), the show's protagonist, the psychiatrist 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.

See also

• Herculine Barbin
• Genital modification and mutilation
• History of intersex surgery
• Nature versus nurture
• Penectomy

References

Bibliography

Balthazart, Jacques (2012). The Biology of Homosexuality. New York: Oxford University Press. doi:10.1093/acprof:oso/9780199838820.001.0001. ISBN 978-0-19-983882-0. {{cite book}}: Invalid |ref=harv (help)

Bockting, Walter O. (2010). "Nurturing Nature and the Nature of Science: Toward Transcendence". The Journal of Sex Research. 37 (4): 378–379. doi:10.1080/00224490009552061. ISSN 1559-8519. {{cite journal}}: Invalid |ref=harv (help)

Butler, Judith (2004). Undoing Gender. New York: Routledge (published 2015). ISBN 978-0-203-49962-7. {{cite book}}: Invalid |ref=harv (help)

Colapinto, John (2001a). As Nature Made Him: The Boy Who Was Raised as a Girl. New York: HarperCollins. ISBN 978-0-06-019211-2. {{cite book}}: Invalid |ref=harv (help)

 ———  (2001b). As Nature Made Him: The Boy Who Was Raised as a Girl. New York: Harper Perennial (published 2006). ISBN 978-0-06-092959-6. {{cite book}}: Invalid |ref=harv (help)

Diamond, Milton; Sigmundson, H. Keith (1997). "Sex Reassignment at Birth: Long-Term Review and Clinical Implications". Archives of Pediatrics and Adolescent Medicine. 151 (3): 298–304. doi:10.1001/archpedi.1997.02170400084015. PMID 9080940. Retrieved 15 May 2013 – via University of Hawaii. {{cite journal}}: Invalid |ref=harv (help)

Gaetano, Phil (2017). "David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case". Embryo Project Encyclopedia. Tempe, Arizona: Arizona State University. hdl:10776/13009. ISSN 1940-5030. Retrieved 7 May 2018. {{cite encyclopedia}}: Invalid |ref=harv (help)

Karkazis, Katrina (2008). Fixing Sex: Intersex, Medical Authority, and Lived Experience. Durham, North Carolina: Duke University Press. ISBN 978-0-8223-8921-7. {{cite book}}: Invalid |ref=harv (help)

Marinucci, Mimi (2010). Feminism is Queer: The Intimate Connection between Queer and Feminist Theory. London: Zed Books. ISBN 978-1-84813-475-1. {{cite book}}: Invalid |ref=harv (help)

McQuail, Josephine A., ed. (2018). Janet Frame in Focus: Women Analyze the Works of the New Zealand Writer. Jefferson, North Carolina: McFarland & Company. ISBN 978-1-4766-2854-7. {{cite book}}: Invalid |ref=harv (help)

Rolls, Geoff (2015). Classic Case Studies in Psychology (3rd ed.). London: Routledge. ISBN 978-1-84872-270-5. {{cite book}}: Invalid |ref=harv (help)

Walker, Jesse (2010). "The Death of David Reimer: A Tale of Sex, Science, and Abuse". In Plante, Rebecca F.; Maurer, Lis M. (eds.). Doing Gender Diversity: Readings in Theory and Real-World Experience. New York: Routledge (published 2018). pp. 33ff. ISBN 978-0-429-98056-5. {{cite book}}: Invalid |ref=harv (help)

Warnke, Georgia (2008). After Identity: Rethinking Race, Sex, and Gender. Cambridge, England: Cambridge University Press. ISBN 978-0-511-39180-4. {{cite book}}: Invalid |ref=harv (help)

Further reading

Colapinto, John (2004). "Gender Gap: What Were the Real Reasons behind David Reimer's Suicide?". Slate. Retrieved 13 February 2009.

Money, John; Ehrhardt, Anke A. (1972). Man & Woman, Boy & Girl: The Differentiation and Dimorphism of Gender Identity from Conception to Maturity. Baltimore, Maryland: Johns Hopkins University Press.

Money, John; Tucker, Patricia (1975). Sexual Signatures: On Being a Man or a Woman. Boston: Little, Brown and Company.

Preves, Sharon E. (2002). "Sexing the Intersexed: An Analysis of Sociocultural Responses to Intersexuality". Signs. 27 (2): 523–556. doi:10.1086/495696. ISSN 1545-6943. JSTOR 3175791.