Talk to the hand. Photo by L.J. May.
Watchwords
The David Reimer Case: A Cautionary Tale for Clinicians
From
Transgenders and Intersexuals: Everything You Ever Wanted to Know but Couldn't Think of the Question
© Lois May 2005
PROLOGUE
Who owns your body? In the democratic West this seems a rather odd question. After all – we own our own bodies, don't we? If anyone attacks our body they may be charged with assault and jailed.
Young children are told that their bodies are 'private' and no-one is allowed to touch them without their consent. Teenagers are assured that it is all right to say ‘no'.
This is not necessarily the case in other cultures. In some societies it is considered that a woman's body belongs to her family. They take a prurient, social and economic interest
in it. A woman's body may be given away, sold, or have a marriage arranged for it. If a woman in such a society falls in love and does anything about it she may be stoned to death.
If she runs away or is raped (even if the perpetrator is a member of her own family) she is then considered to be worthless and a male member of her family is appointed by other family members to murder her. This is called an 'honour killing', although
it's difficult to see anything honourable in it.
In northern Bangladesh, a rejected suitor attacked twenty-two-year-old Popy Rani Das and her best friend Tahmina Islam
(also a nurse at the clinic where Das worked). The perpetrator emerged from the shadows and threw what they thought was a bucket of hot water over them. It was acid.
Das's
scalp was burned off and so were her eyebrows. Her left eye melted. Her nose twisted upside down and her swollen, purple lips now droop below her chin. She has the use of only one arm and she no longer has breasts. Her friend Tahmina Islam was also severely
injured.
Das's story is not uncommon. According to the Bangladesh National Women Lawyers Association, there were at least two hundred and ten acid attacks on women in Bangladesh
during 1999. Guns are expensive and rare, but it only takes seven taka (less than 1¢) to buy a cup of acid, and this is readily available. Neither a domestic violence law enacted in 1983, nor the death penalty for acid attacks, has proved to be an effective
deterrent to this type of attack on women.
The West has had its own share of possessive and violent behaviour. The origins of the chastity belt are obscure but it is thought
that it was introduced to Europe sometime between the twelfth and fourteenth centuries – possibly by Crusaders importing the idea from the East. Women were often compelled to wear these belts for years while their lord and master was away.
The girdle encircled the waist and a sheath made of metal or bone was stretched tightly between the legs and attached to the belt. Only two small rigid apertures allowed the passage
of waste, which made going to the toilet rather messy. The holes were not even large enough to admit a finger but to prevent anyone from trying they were often surrounded by small, sharp metal spikes. Chastity belts were still being advertised in surgical
instrument catalogues in the 1930s.
It was only a few short years ago, after an Australian woman's husband was charged with rape within marriage, that the presiding judge
informed the Australian public that a man was justified in using more than usual rough handling in order to obtain his marital rights.
To say that there was an uproar in
response to this pronouncement is an understatement. The general opinion was that the judge in question was woefully out of touch with current reality but, unfortunately, surveys carried out since that time reveal that a large number of Australian men still
think this way.
A man's main enemies, on the other hand, are usually other males. Male society is hierarchical and often tyrannical, with a great deal of ostracism and favouritism
practiced in both the workplace and social situations.
A male's woes often start in infancy. He is born, and then, kicking and squalling, is delivered into the hands of those
whose business it is to provide him with nourishment and a safe haven. Then, without warning (and usually without anaesthetic) someone places him on an operating table – if he's lucky – and slices off part of his penis.
It's an astonishing thing to do to an infant. Some people call it circumcision: others call it child abuse. Several medical organisations, including the American Academy of Pediatrics, have found that there is
no medically valid reason for routinely circumcising newborns.
In short, many members of the human race do not have a very good track record in dealing well with other people's
bodies. The above scenarios all have one thing in common – they show a total lack of respect for an individual's body and a person's right to decide for themselves who has access to it. They also indicate that a great deal of abuse is targeted at sex
and gender and whether or not a person fulfils other people's expectations of them in those roles. Even greater abuse is directed at people whose sex or gender is unclear.
The
David Reimer story has it all – arrogance, apathy, ignorance, carelessness, greed, lack of ethics, the use of people as a commodity and a passport to fame and status and, most of all, an appalling lack of empathy and compassion. Extractions from this
case have impacted enormously on the treatment of intersexed children around the world and ruined many lives in the process – all because of a medical fad.
WHOSE BODY IS IT ANYWAY?
David Reimer was born Bruce Reimer to Ron and Janet Reimer on 22 August 1965 in Winnipeg,
Canada. He was one of identical twin boys and the delighted parents (who were barely out of their teens) named their sons Bruce and Brian.
All went well until the boys were
about seven months old. At that time both youngsters seemed to be in a great deal of distress when urinating and Janet couldn't stop them screaming. She took the twins to see a paediatrician who diagnosed phimosis (a condition in which there is constriction
of the orifice of the prepuce so that it cannot be drawn back over the glans). The doctor told Janet that it was a fairly common condition and easily treated by circumcision.
Acting
on this advice, Ron and Janet Reimer booked the twins into St Boniface Hospital on the 27 April 1966 to undergo the operation. For some reason, the doctor who usually performed circumcisions at the hospital was not available, and a general practitioner, Dr
Jean-Marie Huot, was appointed to undertake the task.
Bruce was taken to the theatre first and Dr Huot elected to use a Bovie cautery machine to cut away the foreskin rather
than a scalpel. What happened next is still unclear but the result was not – Bruce Reimer's penis was left a black, smoking ruin, which dried up and fell to pieces within a few days.
A parade of specialists examined Bruce in hospital with a view to phalloplasty (penile reconstruction), a procedure that was in its infancy at the time. It was eventually decided that such an operation would not be helpful.
Dr G. L. Adamson (Head of the Department of Neurology and Psychiatry at the Winnipeg Clinic) wrote in his report that: 'One can predict that he [Bruce] will be unable to live a normal sexual
life from the time of adolescence, that he will be unable to consummate marriage or have normal heterosexual relations…he will have to recognise that he is incomplete, physically defective and that he must live apart'.
Is that all there is to a man?
The horrified parents could not accept this sentence on their child and began to search desperately
for a solution.
Enter John Money PhD!
John Money was born in New Zealand in 1921 and
had come to America at the age of twenty-five, where he studied and received his PhD in psychology from Harvard. He joined Johns Hopkins University in Baltimore, Maryland, and established the pioneering Johns Hopkins Clinic, which carried out some of
the earliest sex reassignment surgery on transsexuals.
In 1952 an American ex-GI, George Jorgensen, had undergone a 'sex change' operation in Denmark and emerged as Christine
Jorgensen. The operation was widely criticised around the world and American hospitals refused to perform the surgeries. In the mid-sixties, however, Johns Hopkins announced that not only had the first clinic in the world been established to convert adults
from one sex to another, but that two male-to-female (M2F) sex change operations had already been performed.
In 1967 John Money appeared as a guest on the Canadian Broadcasting
Corporation's current affairs television program This Hour Has Seven Days to talk about his theories and work on gender transformation.
The elegant, bespectacled
Money (then in his late forties) fielded the increasingly belligerent and probing questions of the interviewer, Alvin Davis, with fluency and confidence. Interviewer Davis demanded to know why the work was not being done in Canada and why so many psychiatrists
were opposed to it. Money implied that it was probably because they were a bit behind the times, and in response to Davis's pointed question, 'And you're the pioneer?' Money replied modestly, 'Well – perhaps in a small way'.
The doctor's self-assurance (plus the appearance of Mrs Diane Baransky, a transsexual who declared herself to be complete in mind and body after her sex reassignment) made a great impression
on the Reimers who were watching the program.
In desperation Janet wrote to John Money wanting to know if he could help Bruce. Money's reply was prompt and optimistic.
Not only could he see a chance to prove his theory that nurture triumphs over nature but Bruce Reimer was one of a pair of identical twins – the Holy Grail for researchers. It was enough to put a gleam in any researcher's eye.
The David Reimer Case continues - click here for more David Reimer Case P2
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