Med: Human Development & Gender Identity

March 29, 2008

When I first decided to write this blog, it was because of a funny quote that I read from one of our lecture transcriptions: “One of the twins lost his penis at 8 months due to a fairly traumatic circumcision accident.” I wanted to write a comedic piece regarding malpractice and doctors’ opinions, using the word “fairly” as a starting point–it seemed odd to use the phrase fairly traumatic to characterize an event as significant as castration.

But as I began typing, I came to the realization that a serious exploration of the topic from which the above quote was derived could be warranted; after all, the many medical topics that we discuss everyday–even if we make light of them in class–have profound implications for the people experiencing them. And this was quite true about the case I’m going to discuss.

In 1975, a pair of monozygotic (identical) twin boys were born to the Reimer family. Around the age of 8 months they were taken into the hospital for circumcision; however, a “fairly” traumatic accident left one of the boys without a penis. Not knowing how to proceed, the mother read about Dr. John Money–a pioneer at the time in gender identity–and his work in identifying children as “blank slates” in regards to gender–that is, their gender is socially constructed AFTER the birth of the child and could therefore be changed. The mother soon wrote to Dr. Money, and it was ultimately decided that a full castration and creation of a blind-pouch vagina, in conjunction with hormone treatments and psychotherapy, would allow the boy (David) to actually be raised as a girl (Brenda). Dr. Money worked closely with them and used this case as proof of his theories, and he became famous by touting the “plasticity of gender.” Unfortunately, he could not have been more wrong.

The family did their best to raise Brenda as a girl: her hair was grown out, she was given girl toys, and she was dressed in girl clothing. But this never really worked out. Brenda never wanted to wear dresses, and had the aggressive demeanor of a young boy. In an article from Rolling Stone in 1997 from her identical brother: “She’d get a skipping rope for a gift, and the only thing we’d use that for was to tie people up, whip people with it.” And of course, we all know that schoolchildren can be cruel, and she spent her early years being made fun of and called names.

Around the age of 14, David/Brenda’s father decided to come out with the truth–which according to the mother ultimately brought contentment to her child. At the age of 16, David had his breasts surgically excised and a rudimentary penis was constructed: having identied with males for his entire life, David intended to live like one. He eventually married, but fought the shame of his situation and the torment he had endured as a child in each day of his life. He became famous himself, having been on Oprah to explain the situation to help others avoid making the same mistake with their child. Biology, it seemed, could not be fooled. Unfortunately, David committed suicide in 2004.

We’ve learned in our human development course that gender tendencies are not something that are completely socially contructed. During prenatal development, the brain defaults to feminimity, but can be masculinized by the presence of androgens. In David’s case, the brain had been fully developed into a “male brain,” and no amount of dress-wearing and playing with dolls was going to change that.

This case was specfically about castration taking place AFTER birth; however, 1/2,000 births result in babies with ambiguous genitalia. And as we discussed in class, what is the FIRST question always asked?      “Boy or girl?”

Sometimes there’s just not an accurate answer to give. The old way seemed to be “pick one” and we’ll make it work–a procedure that has been debunked. The recommendation is now to hold off on assigning a gender, and to essentially let the child pick for his/herself based on the gender to which they identify. This may be difficult in the short-term for the parents, but in the long-run should be very beneficial to the child.

For more on the David/Brenda case, check out this youtube clip from the CBC news:

http://youtube.com/watch?v=pZNjX5j6dNQ

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