Archive for category: Biology

Gender reassignment

Part I – A Tragic Error

In 1965, Janet Reimer of Winnepeg gave birth to twin boys named Bruce and Brian (Colapinto, 2004; CBC, 2004). Both infants were normal and healthy, but because they had difculty urinating doctors recommended that they undergo circumcision (i.e., surgical removal of the foreskin of the penis) at six months of age. Although this is a routine operation, the doctors who performed this procedure used an unconventional method that resulted in the destruction of Bruce’s penis. Mr. and Mrs. Reimer sought the advice of numerous specialists, but all agreed that Bruce would have to live without a penis.

At the time that the Reimers were coping with the mutilation of their son’s genitalia, a Johns Hopkins University psychologist was receiving considerable attention for his ideas on the biology of gender and sexuality. He promoted the theory that a child’s gender identity (i.e., the identifcation of the self as male or female) was determined by environmental variables such as the social conditions in which the child is raised. This idea is a form of the “nurture theory” of development. A competing view is the so-called “nature theory”; that is, the idea that a person’s innate qualities are determined solely by biological mechanisms.

The psychologist was essentially advocating the view that a feminine identity could be developed simply by rearing a child as a girl. This possibility, together with the fact that the surgical construction of a vagina is less risky and less difcult than construction of a penis, compelled the Reimers to explore the possibility of changing Bruce’s gender and raising him as a girl. The Reimers arranged an appointment with the Johns Hopkins psychologist who concluded that Bruce was an ideal candidate for gender re-assignment. At 21 months of age, Bruce was subjected to castration (i.e., removal of the testicles) and his parents were told to raise him as a girl, but not to divulge this information to anyone including their sons. Following surgery, the Reimers returned home with their “new daughter,” who they named Brenda. They proceeded to raise her as a girl and not tell her about her medical history.

Questions

1. Some people have argued that the Johns Hopkins psychologist used this opportunity as an experiment to test his nurture theory of gender identity. What are the expected results of this experiment, assuming that the nurture theory is valid?
2. According to the nurture theory, predict the gender identity Bruce would express if he were not subjected to gender re-assignment surgery and raised as a boy?

Part II – A Boy Living as a Girl

The Reimers faithfully adhered to the gender re-assignment protocol, accepted their child as their daughter, and attempted to raise her as a “gentle lady.” In spite of their eforts, Brenda resisted this treatment and eventually became unmanageable (Diamond and Sigmundson, 1997a; 1997b). For example, Brenda frequently rejected girls’ toys, activities, and clothing. She would also mimic her father’s behaviors (e.g., shaving) as opposed to her mother’s behaviors (e.g., applying makeup). On the other hand, her mother reported that at times Brenda could act quite “feminine,” referring to the fact that the child was “neat and tidy.” As she grew older, Brenda complained that she felt like a boy and viewed her physical characteristics as more masculine than feminine. Her brother appears to have shared her impression, recalling that “The only difference between him [Brenda] and I was he had longer hair.”

Brenda’s rejection of the feminine identity continued in middle school. In her fantasies she was a “big guy” with “lots of muscles” and a “slick car.” Even though she lacked a penis, Brenda repeatedly tried to stand while urinating and frequently tried to use the boys’ bathroom in school. The other girls prevented her from using the girls’ bathroom.
In response to teasing and harassment by other girls, Brenda fought back and was repeatedly punished for fighting.

When Brenda was nine years old, the Johns Hopkins psychologist urged the Reimers to have Brenda undergo surgery to construct a vagina to replace her mutilated genitalia. The child protested strongly and threatened to kill herself if forced to submit to this treatment. She also resisted repeated attempts by doctors to force her into accepting a feminine identity. By the time Brenda was 14 years old, her behavior had become so destructive (several suicide attempts) that a local psychiatrist convinced the Reimers to divulge the truth to their daughter. Upon hearing the details of her early childhood, Brenda cut her hair and began living as David.

In order to re-capture the physical aspects of his masculine identity, David agreed to undergo a double mastectomy to remove breasts that had developed from estrogen treatments, a series of surgeries to construct male genitalia (a penis with plastic prosthesis and artifcial testicles), and regular injections of testosterone to restore masculine body features.

Questions

1. What, if any, aspects of David’s experiences support the nurturetheory of gender identity?
2. What, if any, aspects of David’s experiences support the naturetheory of gender identity?