john money experiment on twins

John Money Gender Experiment: Reimer Twins

Julia Simkus

Editor at Simply Psychology

BA (Hons) Psychology, Princeton University

Julia Simkus is a graduate of Princeton University with a Bachelor of Arts in Psychology. She is currently studying for a Master's Degree in Counseling for Mental Health and Wellness in September 2023. Julia's research has been published in peer reviewed journals.

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Saul McLeod, PhD

Editor-in-Chief for Simply Psychology

BSc (Hons) Psychology, MRes, PhD, University of Manchester

Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.

Olivia Guy-Evans, MSc

Associate Editor for Simply Psychology

BSc (Hons) Psychology, MSc Psychology of Education

Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.

The John Money Experiment involved David Reimer, a twin boy raised as a girl following a botched circumcision. Money asserted gender was primarily learned, not innate.

However, David struggled with his female identity and transitioned back to male in adolescence. The case challenged Money’s theory, highlighting the influence of biological sex on gender identity.

• David Reimer was born in 1965; he had a MZ twin brother. When he was 8 months old his penis was accidentally cut off during surgery.
• His parents contacted John Money, a psychologist who was developing a theory of gender neutrality. His theory claimed that a child would take the gender identity he/she was raised with rather than the gender identity corresponding to the biological sex.
• David’s parents brought him up as a girl and Money wrote extensively about this case claiming it supported his theory. However, Brenda as he was named was suffering from severe psychological and emotional difficulties and in her teens, when she found out what had happened, she reverted back to being a boy.
• This case study supports the influence of testosterone on gender development as it shows that David’s brain development was influenced by the presence of this hormone and its effects on gender identity was stronger that the influence of social factors.

What Did John Money Do To The Twins

David Reimer was an identical twin boy born in Canada in 1965. When he was 8 months old, his penis was irreparably damaged during a botched circumcision.

John Money, a psychologist from Johns Hopkins University, had a prominent reputation in the field of sexual development and gender identity.

David’s parents took David to see Dr. Money at Johns Hopkins Hospital in Baltimore, where he advised that David be “sex reassigned” as a girl through surgical, hormonal, and psychological treatments.

John Money believed that gender identity is primarily learned through one’s upbringing (nurture) as opposed to one’s inborn traits (nature).

He proposed that gender identity could be changed through behavioral interventions, and he advocated that gender reassignment was the solution for treating any child with intersex traits or atypical sex anatomies.

Dr. John Money argued that it’s possible to habilitate a baby with a defective penis more effectively as a girl than a boy.

At the age of 22 months, David underwent extensive surgery in which his testes and penis were surgically removed and rudimentary female genitals were constructed.

David’s parents raised him as a female and gave him the name Brenda (this name was chosen to be similar to his birth name, Bruce). David was given estrogen during adolescence to promote the development of breasts.

He was forced to wear dresses and was directed to engage in typical female norms, such as playing with dolls and mingling with other girls.

Throughout his childhood, David was never informed that he was biologically male and that he was an experimental subject in a controversial investigation to bolster Money’s belief in the theory of gender neutrality – that nurture, not nature, determines gender identity and sexual orientation.

David’s twin brother, Brian, served as the ideal control because the brothers had the same genetic makeup, but one was raised as a girl and the other as a boy. Money continued to see David and Brian for consultations and checkups annually.

During these check-ups, Money would force the twins to rehearse sexual acts and inspect one another’s genitals. On some occasions, Money would even photograph the twins doing these exercises. Money claimed that childhood sexual rehearsal play was important for healthy childhood sexual exploration.

David also recalls receiving anger and verbal abuse from Money if they resisted participation.

Money (1972) reported on Reimer’s progress as the “John/Joan case” to keep the identity of David anonymous. Money described David’s transition as successful.

He claimed that David behaved like a little girl and did not demonstrate any of the boyish mannerisms of his twin brother Brian. Money would publish this data to reinforce his theories on gender fluidity and to justify that gender identity is primarily learned.

In reality, though, David was never happy as a girl. He rejected his female identity and experienced severe gender dysphoria . He would complain to his parents and teachers that he felt like a boy and would refuse to wear dresses or play with dolls.

He was severely bullied in school and experienced suicidal depression throughout adolescence. Upon learning about the truth about his birth and sex of rearing from his father at the age of 15, David assumed a male gender identity, calling himself David.

David Reimer underwent treatments to reverse the assignment such as testosterone injections and surgeries to remove his breasts and reconstruct a penis.

David married a woman named Jane at 22 years and adopted three children.

Dr. Milton Diamond, a psychologist and sexologist at the University of Hawaii and a longtime academic rival of John Money, met with David to discuss his story in the mid-1990s.

Diamond (1997) brought David’s experiences to international attention by reporting the true outcome of David’s case to prevent physicians from making similar decisions when treating other infants. Diamond helped debunk Money’s theory that gender identity could be completely learned through intervention.

David continued to suffer from psychological trauma throughout adulthood due to Money’s experiments and his harrowing childhood experiences. David endured unemployment, the death of his twin brother Brian, and marital difficulties.

At the age of thirty-eight, David committed suicide.

David’s case became the subject of multiple books, magazine articles, and documentaries. He brought to attention to the complications of gender identity and called into question the ethicality of sex reassignment of infants and children.

Originally, Money’s view of gender malleability dominated the field as his initial report on David was that the reassignment had been a success. However, this view was disproved once the truth about David came to light.

His case led to a decline in the number of sex reassignment surgeries for unambiguous XY male infants with a micropenis and other congenital malformations and brought into question the malleability of gender and sex.

At present, however, the clinical literature is still deeply divided on the best way to manage cases of intersex infants.

Colapinto, J. (2000). As nature made him: The boy who was raised as a girl. New York, NY: Harper Collins.

Colapinto, J. (2018). As nature made him: The boy who was raised as a girl. Langara College.

Diamond, M., & Sigmundson, H. K. (1997). Sex reassignment at birth: Long-term review and clinical implications . Archives of pediatrics & adolescent medicine, 151(3), 298-304.

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

Money, J., & Tucker, P. (1975). Sexual signatures: On being a man or a woman.

Money, J. (1994). The concept of gender identity disorder in childhood and adolescence after 39 years . Journal of sex & marital therapy, 20(3), 163-177.

David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case

In the mid-1960s, psychologist John Money encouraged the gender reassignment of David Reimer, who was born a biological male but suffered irreparable damage to his penis as an infant. Born in 1965 as Bruce Reimer, his penis was irreparably damaged during infancy due to a failed circumcision. After encouragement from Money, Reimer’s parents decided to raise Reimer as a girl. Reimer underwent surgery as an infant to construct rudimentary female genitals, and was given female hormones during puberty. During childhood, Reimer was never told he was biologically male and regularly visited Money, who tracked the progress of his gender reassignment. Reimer unknowingly acted as an experimental subject in Money’s controversial investigation, which he called the John/Joan case. The case provided results that were used to justify thousands of sex reassignment surgeries for cases of children with reproductive abnormalities. Despite his upbringing, Reimer rejected the female identity as a young teenager and began living as a male. He suffered severe depression throughout his life, which culminated in his suicide at thirty-eight years old. Reimer, and his public statements about the trauma of his transition, brought attention to gender identity and called into question the sex reassignment of infants and children.

Bruce Peter Reimer was born on 22 August 1965 in Winnipeg, Ontario, to Janet and Ron Reimer. At six months of age, both Reimer and his identical twin, Brian, were diagnosed with phimosis, a condition in which the foreskin of the penis cannot retract, inhibiting regular urination. On 27 April 1966, Reimer underwent circumcision, a common procedure in which a physician surgically removes the foreskin of the penis. Usually, physicians performing circumcisions use a scalpel or other sharp instrument to remove foreskin. However, Reimer’s physician used the unconventional technique of cauterization, or burning to cause tissue death. Reimer’s circumcision failed. Reimer’s brother did not undergo circumcision and his phimosis healed naturally. While the true extent of Reimer’s penile damage was unclear, the overwhelming majority of biographers and journalists maintained that it was either totally severed or otherwise damaged beyond the possibility of function.

In 1967, Reimer’s parents sought the help of John Money, a psychologist and sexologist who worked at the Johns Hopkins Hospital in Baltimore, Maryland. In the mid-twentieth century, Money helped establish views on the psychology of gender identities and roles. In his academic work, Money argued in favor of the increasingly mainstream idea that gender was a societal construct, malleable from an early age. He stated that being raised as a female was in Reimer’s interest, and recommended sexual reassignment surgery. At the time, infants born with abnormal or intersex genitalia commonly received such interventions.

Following their consultation with Money, Reimer’s parents decided to raise Reimer as a girl. Physicians at the Johns Hopkins Hospital removed Reimer’s testes and damaged penis, and constructed vestigial vulvae and a vaginal canal in their place. The physicians also opened a small hole in Reimer’s lower abdomen for urination. Following his gender reassignment surgery, Reimer was given the first name Brenda, and his parents raised him as a girl. He received estrogen during adolescence to promote the development of breasts. Throughout his childhood, Reimer was not informed about his male biology.

Throughout his childhood, Reimer received annual checkups from Money. His twin brother was also part of Money’s research on sexual development and gender in children. As identical twins growing up in the same family, the Reimer brothers were what Money considered ideal case subjects for a psychology study on gender. Reimer was the first documented case of sex reassignment of a child born developmentally normal, while Reimer’s brother was a control subject who shared Reimer’s genetic makeup, intrauterine space, and household.

During the twin’s psychiatric visits with Money, and as part of his research, Reimer and his twin brother were directed to inspect one another’s genitals and engage in behavior resembling sexual intercourse. Reimer claimed that much of Money’s treatment involved the forced reenactment of sexual positions and motions with his brother. In some exercises, the brothers rehearsed missionary positions with thrusting motions, which Money justified as the rehearsal of healthy childhood sexual exploration. In a Rolling Stone interview, Reimer recalled that at least once, Money photographed those exercises. Money also made the brothers inspect one another’s pubic areas. Reimer stated that Money observed those exercises both alone and with as many as six colleagues. Reimer recounted anger and verbal abuse from Money if he or his brother resisted orders, in contrast to the calm and scientific demeanor Money presented to their parents. Reimer and his brother underwent Money’s treatments at preschool and grade school age. Money described Reimer’s transition as successful, and claimed that Reimer’s girlish behavior stood in stark contrast to his brother’s boyishness. Money reported on Reimer’s case as the John/Joan case, leaving out Reimer’s real name. For over a decade, Reimer and his brother unknowingly provided data that, according to biographers and the Intersex Society of North America, was used to reinforce Money’s theories on gender fluidity and provided justification for thousands of sex reassignment surgeries for children with abnormal genitals.

Contrary to Money’s notes, Reimer reports that as a child he experienced severe gender dysphoria, a condition in which someone experiences distress as a result of their assigned gender. Reimer reported that he did not identify as a girl and resented Money’s visits for treatment. At the age of thirteen, Reimer threatened to commit suicide if his parents took him to Money on the next annual visit. Bullied by peers in school for his masculine traits, Reimer claimed that despite receiving female hormones, wearing dresses, and having his interests directed toward typically female norms, he always felt that he was a boy. In 1980, at the age of fifteen, Reimer’s father told him the truth about his birth and the subsequent procedures. Following that revelation, Reimer assumed a male identity, taking the first name David. By age twenty-one, Reimer had received testosterone therapy and surgeries to remove his breasts and reconstruct a penis. He married Jane Fontaine, a single mother of three, on 22 September 1990.

In adulthood, Reimer reported that he suffered psychological trauma due to Money’s experiments, which Money had used to justify sexual reassignment surgery for children with intersex or damaged genitals since the 1970s. In the mid-1990s, Reimer met Milton Diamond, a psychologist at the University of Hawaii, in Honolulu, Hawaii, and an academic rival of Money. Reimer participated in a follow-up study conducted by Diamond, in which Diamond cataloged the failures of Reimer’s transition.

In 1997, Reimer began speaking publicly about his experiences, beginning with his participation in Diamond’s study. Reimer’s first interview appeared in the December 1997 issue of Rolling Stone magazine. In interviews, and a later book about his experience, Reimer described his interactions with Money as torturous and abusive. Accordingly, Reimer claimed he developed a lifelong distrust of hospitals and medical professionals.

With those reports, Reimer caused a multifaceted controversy over Money’s methods, honesty in data reporting, and the general ethics of sex reassignment surgeries on infants and children. Reimer’s description of his childhood conflicted with the scientific consensus about sex reassignment at the time. According to NOVA , Money led scientists to believe that the John/Joan case demonstrated an unreservedly successful sex transition. Reimer’s parents later blamed Money’s methods and alleged surreptitiousness for the psychological illnesses of their sons, although the notes of a former graduate student in Money’s lab indicated that Reimer’s parents dishonestly represented the transition’s success to Money and his coworkers. Reimer was further alleged by supporters of Money to have incorrectly recalled the details of his treatment. On Reimer’s case, Money publicly dismissed his criticism as anti-feminist and anti-trans bias, but, according to his colleagues, was personally ashamed of the failure.

In his early twenties, Reimer attempted to commit suicide twice. According to Reimer, his adult family life was strained by marital problems and employment difficulty. Reimer’s brother, who suffered from depression and schizophrenia, died from an antidepressant drug overdose in July of 2002. On 2 May 2004, Reimer’s wife told him that she wanted a divorce. Two days later, at the age of thirty-eight, Reimer committed suicide by firearm.

Reimer, Money, and the case became subjects of numerous books and documentaries following the exposé. Reimer also became somewhat iconic in popular culture, being directly referenced or alluded to in the television shows Chicago Hope , Law & Order , and Mental . The BBC series Horizon covered his story in two episodes, “The Boy Who Was Turned into a Girl” (2000) and “Dr. Money and the Boy with No Penis” (2004). Canadian rock group The Weakerthans wrote “Hymn of the Medical Oddity” about Reimer, and the New York-based Ensemble Studio Theatre production Boy was based on Reimer’s life.

• Carey, Benedict. “John William Money, 84, Sexual Identity Researcher, Dies.” New York Times , 11 July 2006.
• Colapinto, John. "The True Story of John/Joan." Rolling Stone 11 (1997): 54–73.
• Colapinto, John. As Nature Made Him: The Boy who was Raised as a Girl . New York: HarperCollins Publishers, 2000.
• Colapinto, John. "Gender Gap—What were the real reasons behind David Reimer’s suicide?" Slate (2004).
• Dr. Money and the Boy with No Penis , documentary, written by Sanjida O’Connell (BBC, 2004), Film.
• The Boy Who Was Turned Into a Girl , documentary, directed by Andrew Cohen (BBC, 2000.), Film.
• “Who was David Reimer (also, sadly, known as John/Joan)?” Intersex Society of North America . http://www.isna.org/faq/reimer (Accessed October 31, 2017).

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David Reimer And The Tragic Story Of The ‘John/Joan Case’

David reimer was born a boy in winnipeg, canada in 1965 — but following a botched circumcision at the age of eight months, his parents raised him as a girl..

Facebook Although David Reimer’s story was initially seen as a success by his family and Dr. John Money, his story would eventually prove to have a tragic end.

David Reimer’s parents just wanted to do the right thing for him.

What was supposed to be a routine circumcision in 1965 turned into a life-altering nightmare for the Reimer family when the doctor performing his surgery accidentally singed the infant’s penis.

The damage was irreparable. Concerned that their son’s injury might cause him mental anguish as an adult, Reimer’s parents consulted with famed sexologist Dr. John Money after seeing him on television.

Money consequently suggested that Reimer undergo sex reassignment surgery and instead be raised female. Desperate, Reimer’s parents took his advice and changed their son’s name from “Bruce” to “Brenda.”

YouTube/Facebook David Reimer, born Bruce Reimer and biologically male, began an imposed gender transition as an infant.

Reimer appeared to take easily to his imposed gender identity as a female, and his case was initially seen as a success story by those physicians like Money who believed that gender was a matter of learned or taught behavior and not nature.

But in reality, Reimer struggled even as a child with his gender identity. Once he discovered the truth about his birth as a teenager, Reimer began a painful journey to return to his biological sex.

However, he could never fully recover. Finally, in 2004, David Reimer took his own life at the age of just 38.

David Reimer’s Future Is Decided By Sexologist John Money

In Memory of David Reimer/Facebook At 14, David Reimer (right) chose to live as a male.

David Reimer was born Bruce Reimer in Winnipeg, Canada, in 1965. He had a twin brother named Brian, and the two were the first children of a rural teenage couple, Janet and Ron.

The baby boys were healthy but, at about eight months old, showed signs of difficulty with urinating. They were diagnosed with phimosis, a condition in which the foreskin cannot retract.

The Reimers took their children to be circumcised at the hospital, but after Bruce Reimer’s surgery went horribly awry because the surgeon used an electrocautery needle instead of a blade, Brian was not subjected to the same surgery and his phimosis healed naturally.

David Reimer’s parents desperately sought solutions for him until they saw psychologist John Money speak about his work on TV.

Money was considered one of the top sex researchers in the United States, and he specialized in the experiences of intersex children who, according to the UN Office of the High Commissioner for Human Rights, “do not fit the typical definitions for male or female bodies.”

Reimer’s mother wrote to Money explaining the horrible accident her son had endured. Within a few weeks, the young parents were on their way to see the doctor at Johns Hopkins Hospital in Baltimore, Maryland.

Diana Walker/The LIFE Images Collection via Getty Images Psychologist John Money claimed his gender experiment on the Reimer twins was a success — despite early warning signs that proved otherwise.

Money believed that a person’s gender identity was a social construct and the result of their upbringing. As such, he proposed that someone could be “taught” to identify differently than their biological sex.

Money thought that children were “gender-neutral” until about the age of two and theorized that parents had a period of time that he called the “gender gate” during which they could influence the sex of their child behaviorally.

The doctor thus made the radical proposition to reassign Bruce Reimer’s gender surgically, which would involve castrating his penis and giving him a prosthetic vagina instead. He would then be raised as a girl and not told of his former identity. Reimer’s parents agreed to the procedure and the infant’s imposed transition began shortly before his second birthday in 1967.

To Money, this situation also provided him with an opportunity to investigate his theory about gender identity. But his medical advice would prove fatally wrong in the case of David Reimer.

Reimer’s Troubled Childhood And The Eventual Reveal Of The Truth

In Memory of David Reimer/Facebook Despite his tumultuous life, David Reimer found love with his wife Jane.

Upon John Money’s recommendation, Bruce Reimer began life as Brenda Reimer.

In addition to his sex reassignment surgery, Reimer was given estrogen supplements to help “feminize” his body. The Reimers returned to Money’s office every year so that the doctor could monitor both Brian and Brenda’s growth as a boy and a girl. The radical study became known as the John/Joan case.

Money noted that the twin sister, a.k.a. Brenda, was “much neater” than her twin brother Brian. Money also noted that Brenda was the more stubborn and dominant personality, which he dismissed as “tomboy traits.”

In 1975, when the twins turned nine, Money published his study in a book called Sexual Signatures where he described Reimer’s forced transition to Brenda as a success:

“The girl already preferred dresses to pants enjoyed wearing her hair ribbons, bracelets, and frilly blouses, and loved being her daddy’s little sweetheart. Throughout childhood, her stubbornness and the abundant physical energy she shares with her twin brother and expends freely have made her a tomboyish girl, but nonetheless a girl.”

But nothing could be further from the truth. Indeed, Reimer recalled his childhood as far more distressing.

“I never quite fit in,” David Reimer said in a 2000 interview on Oprah . “Building forts and getting into the odd fistfight, climbing trees — that’s the kind of stuff that I liked, but it was unacceptable as a girl.”

According to author John Colapinto who worked with Reimer on his book As Nature Made Him: The Boy Who Was Raised as A Girl , the frequent visits Reimer made to Money’s office were also traumatic.

Reimer was shown pictures of naked adults to “reinforce Brenda’s gender identity” and pressed by Money to endure more surgeries that would make him more feminine. Both of the twins would later accuse Money of making them pose in various sexual positions which, according to Money, was just another element of his theory that involved “sexual rehearsal play.”

Janet Reimer reportedly wasn’t blind to her child’s discomfort with his female gender identity, either. She recalled the first time that Reimer was put in a dress he angrily tore it off. “There were doubts along the way,” Janet confessed on Oprah . “But I couldn’t afford to contemplate them because I couldn’t afford to be wrong.”

Problems at home extended to school. Reimer was teased by classmates for his “masculine gait” and his standing to pee in the girl’s bathroom. When Reimer complained about feeling like a boy, his parents and other adults convinced him that it was just a phase.

Reimer’s secret disrupted the family. His father sunk into alcoholism and his mother attempted suicide. Reimer’s twin sibling, Brian, later descended into substance abuse and petty crime.

It wasn’t until the twins entered their teens that other doctors convinced the Reimers that it was time to tell their children the truth. After picking up Brenda from a psychologist appointment in 1980, Ron Reimer drove both his children to an ice cream parlor where he told them the whole story.

“Suddenly it all made sense why I felt the way I did,” Reimer said of the revelation. “I wasn’t some sort of weirdo. I wasn’t crazy.”

The Tragic End Of David Reimer’s Story

After discovering the truth, Reimer chose to live as a boy and assumed the name “David.”

He endured multiple surgeries to restore his gender to male, including a double mastectomy to remove the breasts that had grown from years of estrogen therapy and attaching an artificial penis in place of his artificial vagina. He also took testosterone supplements.

But the physical stress wore on his mental health. By his early 20s, Reimer had attempted suicide twice and remained deeply depressed for years after.

Despite his anguish, however, Reimer found love and married a woman named Jane. They were together for 14 years. He was a stepfather to her three children and developed hobbies like camping, fishing, antiques, and collecting old coins.

In Memory of David Reimer/Facebook David Reimer took his own life in May 2004. He was 38.

Reimer later agreed to work with a second sexologist named Milton Diamond on the expectation that speaking about his experience might prevent physicians from making similar decisions for other infants.

Diamond criticized Money’s study for its lack of evidence and worked with Reimer to debunk Money’s theory that gender identity could be totally taught or learned. In 1997, around the time Reimer began speaking publicly about his childhood ordeal, Diamond’s study was published in Archives of Pediatrics and Adolescent Medicine .

The breakthrough paper laid the foundation against performing sex reassignment surgery on intersex infants, which was once considered a “fix” for their gender non-conforming biology.

But the validation of the study wasn’t enough for Reimer to overcome his traumatic childhood. In May 2004, two years after his twin brother succumbed to a drug overdose, David Reimer killed himself. He was 38.

Reimer’s case was complex. His first gender transition was based on a medical accident and a scientific theory. As a result, he experienced gender dysphoria, which is the feeling that one’s biological sex differs from their gender identity. People who identify as transgender often experience gender dysphoria early in life as well.

Reimer may no longer be alive, but his journey to reclaim his gender identity contributed to a better understanding of the relationship between gender and biological sex.

After this look at the story of David Reimer, meet Maryam Khatoon Molkara , the transgender Iranian activist who helped legalize gender-confirming surgeries in Iran. Then, learn about Christine Jorgensen , America’s original transgender celebrity.

PO Box 24091 Brooklyn, NY 11202-4091

• Women / transfeminine
• Men / transmasculine
• Gender diverse / nonbinary +
• For gender questioning people
• For allies & supporters
• For everyone else
• For young visitors
• For parents
• For educators
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John Money vs. sex and gender minorities

John Money (1921–2006) was a New Zealand psychologist and sex researcher known for many ethical controversies:

the Reimer twins scandal (the “John/Joan case”)

• ordering surgical sex reassignment on 22-month-old infant David Reimer (1967)
• posing the Reimer twins in simulated sex acts and photographing it
• falsifying and covering up the outcome of the case
• contributing to the adult suicides of both brothers (Brian in 2002, David in 2004)

exploiting people with differences of sex development

• Hermaphroditism: An Inquiry into the Nature of a Human Paradox (1952)

coining or popularizing numerous terms and concepts:

• gender role (1955)
• gender identity (orginally proposed by Robert Stoller in 1964)
• sexual orientation
• amative orientation (2002)
• paraphilia (Krauss 1903; Robinson 1913; Stekel 1930)
• vandalized lovemaps (1989)
• gendermaps (1995)
• bodymind (1988)

outlining variables of sex (1955):

• assigned sex and sex of rearing
• external genital morphology
• internal reproductive structures
• hormonal and secondary sex characteristics
• gonadal sex
• chromosomal sex
• gender role and orientation as male or female, established while growing up

making biased claims about trans women:

• Transsexualism and Sex Reassignment (1969)
• “devious, demanding and manipulative” and incapable of love (1970)

John Money should have died in prison along with other “leading lights” of late 20th-century sexology. The astonishing lack of accountability or responsibility makes him easily the most unethical sexologist in history.

John Money vs. J. Michael Bailey

Takes one to know one, they say.

John Money was an ethically-challenged sexologist at Johns Hopkins whose work led to the woes of untold intersex people around the world until his “science” was  debunked  and his  academic misconduct  exposed.

Mike Bailey is an ethically-challenged sexologist at Northwestern whose work nearly led to the woes of untold transgender people around the world until his “science” was  debunked  and his  academic misconduct  exposed.

John Money put out a book in May 1990 with the title:

Gay, Straight, and In-Between

Mike Bailey’s publicist did an article in March 2003 titled:

Gay, Straight or Lying? Science has the answer  [1]

The similarities in titles certainly beg a comparison, as do the remarkable similarities in the lives of the two well-known sexologists.

Why would Bailey and friends replace “in-between” with “lying”? Below is a very interesting passage from pages 108-110 of John Money’s  Gay, Straight, and In-Between: The Sexology of Exotic Orientation .

“Gender Crosscoding”

by John Money

Among adolescents who circumvent homosexual activity or who quit in panic, there are some who coerce themselves into heterosexuality, only to find as husbands and fathers (or wives and mothers, in the case of females) that the lid on Pandora’s box springs open. These are the people who, when young adulthood advances into midlife, begin the homosexual stage of sequential bisexuality. For some the transition is to homosexual relations exclusively, whereas for others heterosexual relations also may continue. The transition may take place autonomously, or it may be a sequel to the divorce or death of the spouse or to sexual apathy in the marriage. When the youngest child leaves home, there may be a degree of freedom hitherto unavailable. The bisexualism of a parent is not transmitted to the offspring, and is not contagious. However, to avoid offending a heterosexual child, a bisexual parent may be self-coerced into suppressing homosexual expression.

The late expression of homosexuality in sequential bisexuality may be associated with recovery from illness and debilitation (e.g., recovery from alcoholism) that had masked the homosexual potential. Hypothetically, it might, conversely, be associated with premature illness and deterioration from brain injury or disease, as in temporal lobe trauma and Alzheimer’s disease. However, although brain pathology may release the expression of sexuality formerly strictly self-prohibited as indecent or immoral, it is not especially associated with releasing bisexuality.

In sequential bisexuality, the transition from homosexual to heterosexual expression is also known to occur autonomously in adulthood. Since this transition is socially approved and not registered as pathological, it is not likely to be recorded. If the individual were at the time in some type of treatment, the transition might be wrongly construed as a therapeutic triumph.

More than sequential bisexuality, concurrent bisexuality may be jocularly considered as having the best of two possible worlds. But it has a dark and sinister potential also. Its most malignant expression is in those individuals in whom it takes the form of a Dr. Jekyll and Mr. Hyde. The split applies not simply to heterosexuality and homosexuality, but to good and evil, licit and illicit, as well. The two names are not gender-coded as male and female as they are in the two names of the tranvsvestophile, nor are the two personalities and the two wardrobes. Instead, the two names, wardrobes, and personalities are both male (or in the less likely case of women, female), but one, the given name with its wardrobe and personality, is for the heterosexual, and the other, an alias or a nickname, for the homosexual. The heterosexual personality is the servant of righteousness and the acolyte of a vengeful God. The homosexual personality is the servant of transgression and a fallen angel in the legions of Lucifer. The heterosexual personality has the pontificating mission of a sadistic grand inquisitor, bent on the exorcism of those possessed of homosexuality, himself included. The homosexual personality has the absolving mission of officiating indulgences in the place of masochistic penances for homosexuality, but only for himself and nobody else.

The absolute antithesis of homophobia and homophilia in this malignant form of bisexuality takes its toll in self-sabotage and the sabotage of others. Self-sabotage is an ever-present threat that materializes if there is a leakage of information from those in one antithetical world to those in the other. The greater danger is, of course, that knowledge of the illicit homosexual existence will leak out to the society that knows only of the heterosexual existence. The ensuing societal abuse and deprivation, legal and social, may be extreme.

The sabotage of others is carried out professionally by some individuals with the syndrome of malignant bisexualism. Their internal homophobic war against their own homosexuality becomes externalized into a war against homosexuality in others. The malignant bisexual becomes a secret agent, living in his own private and secret homosexual world, while spying on its inhabitants, entrapping them, assaulting and killing them, or, with less overt violence, preaching against them, legislating against them, or judicially depriving them of the right to exist.

The malignant bisexual is the perfect recruit for the position of homosexual entrapment officer or decoy in the employ of the police vice squad. Supported by clandestine operations, blackmail, and threats of exposure, in espionage or in the secret police of government surveillance, he may achieve legendary power, such as that attributed to J. Edgar Hoover of mythical FBI fame.

People in high places may have the power to keep under cover for a lifetime, with the homosexual manifestations of their bisexuality never exposed. Others have their career blown, as did the bisexual former U.S. congressman from Maryland, Robert E. Bauman, a fanatical homophobic ultraconservative of the religious new right, who subsequently published a biography of his own downfall (Bauman 1986).

Bauman was exposed by a combination of surveillance and the testimony of a paid informant and blackmailer. Nowadays there is a hitherto nonexistent way of being suspected or exposed, namely by dying of AIDS. This is what happened to Roy Cohn (New York Times, August 3, 1986), the malignantly bisexual legal counsel for the homosexual witch hunter from Wisconsin, U.S. Senator Joseph McCarthy, himself suspected of malignant bisexuality. Together, they destroyed the lives of many American citizens, simply by publicly accusing them of being homosexual, falsely or otherwise.

Scratch the surface of the self-righteous and find the devil. This is a maxim of widespread acceptability, not only to the self-righteous in high places of homophobic power, influence, and authority, but also to the homophobic, gay-bashing hoodlums who, as in the case with which this section began, pick up or are picked up by a gay man, have sex with him, and then exorcise their own homosexual guilt by assaulting and maybe killing him. Both versions of homophobia are manifestations of malignant bisexuality that, in an interview with the journalist, Doug Ireland, for New York Magazine (July 24, 1978), I called the exorcist syndrome.

There must be a very widespread prevalence of lesser degrees of the exorcist syndrome in the population at large. If it were not so, otherwise-decent people would not persecute their homosexual fellow citizens nor tolerate their persecution. Instead they would live and let live those who are destined to have a different way of being human in love and sex. They would tolerate them as they do the left-handed. Tolerance would remove those very pressures that progressively coerce increasing numbers of our children and grandchildren to grow up blighted with the curse of malignant bisexuality.

1.  Pinnel , Robin (March 21, 2003). Gay, straight, or lying? Science has the answer.  Joseph Henry Press

Bullough, Vern L. “The contributions of John Money: a personal view.”  The Journal of Sex Research , vol. 40, no. 3, 2003, pp. 230–236.  https://doi.org/10.1080/00224490309552186

John Money and John G. Brennan, “Heterosexual vs. homosexual attitudes: male partners’ perception of the feminine image of male transsexuals,” The Journal of Sex Research , 6, 3 (1970): 193–209, 201, 202. https://doi.org/10.1080/00224497009550666

John Money, John L. Hampson, Joan G. Hampson. Hermaphroditism: Psychology & Case Management April 1, 1960  https://doi.org/10.1177/070674376000500214

Ehrhardt, Anke A. ‘John Money, PhD’  Journal of Sex Research  44.3 (2007): 223–224.

Downing, Lisa; Morland, Iain; Sullivan, Nikki (26 November 2014).  Fuckology: Critical Essays on John Money’s Diagnostic Concepts .  Chicago, Illinois :  University of Chicago Press .

Goldie, Terry (2014).  The Man Who Invented Gender: Engaging the Ideas of John Money . Vancouver, British Columbia: University of British Columbia Press.

Tosh, Jemma (25 July 2014).  Perverse Psychology: The pathologization of sexual violence and transgenderism . Routledge. ISBN 9781317635444.

Diamond, M; Sigmundson, HK (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

John William Money, PhD, 1921–2006

https://web.archive.org/web/20150724204551/http://www.sexualhealth.umn.edu/education/john-money/bio

Brewington, Kelly (9 July 2006).  “Dr. John Money 1921–2006: Hopkins pioneer in gender identity” .  Baltimore Sun . http://articles.baltimoresun.com/2006-07-09/news/0607090031_1_gender-johns-hopkins-john-money

Money, John; Hampson, Joan G; Hampson, John (October 1955). “An Examination of Some Basic Sexual Concepts: The Evidence of Human Hermaphroditism”.  Bull. Johns Hopkins Hosp . Johns Hopkins University.  97  (4): 301–19. PMID 13260820.

Colapinto, John (11 December 1997).  “The True Story of John/Joan” .  Rolling Stone : 54–97. Archived from  the original  on 15 August 2000. Retrieved 27 September 2014.

“David Reimer, 38, Subject of the John/Joan Case” .  The New York Times . 12 May 2004. Retrieved 27 September 2014. https://www.nytimes.com/2004/05/12/us/david-reimer-38-subject-of-the-john-joan-case.html

Carey, Benedict (11 July 2006).  John William Money, 84, Sexual Identity Researcher, Dies ,  The New York Times https://www.nytimes.com/2006/07/11/us/11money.html

John Money, Ph.D. Kinsey Institute https://kinseyinstitute.org/collections/archival/john-money.php

Man and woman, boy and girl: Differentiation and dimorphism of gender identity from conception to maturity.

J Money, AA Ehrhardt – 1972 

Imprinting and the establishment of gender role

J Money, JG Hampson… – AMA Archives of Neurology …, 1957 

Sexual signatures: On being a man or a woman.

J Money, P Tucker – 1975 –

  Gay, straight, and in-between: The sexology of erotic orientation

J Money – 1988 – 

Lovemaps: Clinical concepts of sexual/erotic health and pathology, paraphilia, and gender transposition in childhood, adolescence, and maturity

J  Money  – 2012 

Complete androgen insensitivity syndrome: long-term medical, surgical, and psychosexual outcome

…, GD Berkovitz, TR Brown, J  Money  – The Journal of …, 2000 –

Ablatio penis: normal male infant sex-reassigned as a girl

J  Money  – Archives of sexual behavior, 1975 –

The concept of gender identity disorder in childhood and adolescence after 39 years

J  Money  – Journal of sex & marital therapy, 1994 –

Ambiguous genitalia with perineoscrotal hypospadias in 46, XY individuals: long-term medical, surgical, and psychosexual outcome

…, TR Brown,  SJ Casella , A Maret, KM Ngai, J  Money … – Pediatrics, 2002 

Adult erotosexual status and fetal hormonal masculinization and demasculinization: 46, XX congenital virilizing adrenal hyperplasia and 46, XY androgen-insensitivity …

J  Money , M Schwartz, VG Lewis – Psychoneuroendocrinology, 1984 – 

Apotemnophilia: two cases of self‐demand amputation as a paraphilia

J  Money , R Jobaris, G Furth – Journal of Sex Research, 1977

Paraphilias: Phenomenology and classification

J  Money  – American journal of psychotherapy, 1984 

Gender role, gender identity, core gender identity: Usage and definition of terms

J  Money  – Journal of the American Academy of Psychoanalysis, 1973 

Forensic sexology: Paraphilic serial rape (biastophilia) and lust murder (erotophonophilia)

J  Money  – American Journal of Psychotherapy, 1990 

Progestin‐induced hermaphroditism: IQ and psychosexual identity in a study of ten girls∗

AA Ehrhardt, J Money – Journal of Sex Research, 1967 – 

Sin, sickness, or status? Homosexual gender identity and psychoneuroendocrinology.

J Money – American Psychologist, 1987 –

Sex errors of the body: Dilemmas, education, counseling.

J Money – 1968 – psycnet.apa.org

Homosexual outcome of discordant gender identity/role in childhood: Longitudinal follow-up

J Money, AJ Russo – Journal of Pediatric Psychology, 1979 

Gendermaps: Social constructionism, feminism and sexosophical history

J Money – 2016 

Sex errors of the body and related syndromes: A guide to counseling children, adolescents, and their families

J Money – 1994 – 

Gender: history, theory and usage of the term in sexology and its relationship to nature/nurture

J Money – Journal of sex & marital therapy, 1985 

Use of an androgen‐depleting hormone in the treatment of male sex offenders

J Money – Journal of Sex Research, 1970 –

Vandalized lovemaps: Paraphilic outcome of seven cases in pediatric sexology.

J Money, M Lamacz – 1989 – 

Sex research: New developments.

JE Money – 1965 

46, XY intersex individuals: phenotypic and etiologic classification, knowledge of condition, and satisfaction with knowledge in adulthood

…,  JA Rock , HFL Meyer-Bahlburg, J Money… – Pediatrics, 2002 

Incongruous gender role: nongenital manifestations in prepubertal boys.

R Green, J Money – Journal of Nervous and Mental Disease, 1960 –

Fetal feminization and female gender identity in the testicular feminizing syndrome of androgen insensitivity

DN Masica, J Money, AA Ehrhardt – Archives of Sexual Behavior, 1971

Sexual dimorphism and homosexual gender identity.

J Money – Psychological Bulletin, 1970 –

Iatrogenic homosexuality: Gender identity in seven 46, XX chromosomal females with hyperadrenocortical hermaphroditism born with a penis, three reared as boys …

J Money, J Dalery – Journal of Homosexuality, 1976 

Effeminacy in prepubertal boys: Summary of eleven cases and recommendations for case management

R Green, J Money – Pediatrics, 1961 – 

Hermaphrodism: recommendations concerning case management

JG Hampson, J Money… – The Journal of Clinical …, 1956 –

Sexual dimorphism and dissociation in the psychology of male transsexuals.

J Money, C Primrose – Journal of Nervous and Mental Disease, 1968 –

Gynemimesis and gynemimetophilia: Individual and cross-cultural manifestations of a gender-coping strategy hitherto unnamed

J Money, M Lamacz – Comprehensive psychiatry, 1984 

Genital examination and exposure experienced as nosocomial sexual abuse in childhood.

J Money, M Lamacz – Journal of Nervous and Mental Disease, 1987 

Stage-acting, role-taking, and effeminate impersonation during boyhood

R Green, J Money – Archives of General Psychiatry, 1966 

The True Story of John / Joan

J o h n / joan.

By John Colapinto The Rolling Stone, December 11, 1997. Pages 54-97

In 1967, an anonymous baby boy was turned into a girl by doctors at Johns Hopkins Hospital. For 25 years, the case of John/Joan was called a medical triumph — proof that a child's gender identity could be changed — and thousands of "sex reassignments" were performed based on this example. But the case was a failure, the truth never reported. Now the man who grew up as a girl tells the story of his life, and a medical controversy erupts.

In late June 1997, I arrive at an address in a working-class suburb in the North American Midwest. On the front lawn, a child's bicycle lies on its side; an eight-year-old secondhand Toyota is parked at the curb. Inside the house, a handmade wooden cabinet in the corner of the living room holds the standard emblems of family life: wedding photos and school portraits, china figurines and souvenirs from family trips. There is a knockoff-antique coffee table, a well-worn easy chair and a sofa - which is where my host, a wiry young man dressed in a jean jacket and scuffed work boots, seats himself. He is 31 years old but could pass for a decade younger. Partly it's the sparseness of his beard - just a few blond wisps that sprout from his jaw line; partly it's a certain delicacy to his prominent cheekbones and tapering chin. Otherwise he looks, and sounds, exactly like what he is: a blue-collar factory worker, a man of high school education whose fondest pleasures are to do a little weekend fishing with his dad in the local river and to have a backyard barbecue with his wife and kids.Ordinarily a rough-edged and affable young man, he stops smiling when conversation turns to his childhood. Then his voice - a burred baritone - takes on a tone of aggrievement and anger, or the pleading edge of someone desperate to communicate emotions that he knows his listener can only dimly understand. How well even he understands these emotions is not clear: When describing events that occurred prior to his 15th birthday, he tends to drop the pronoun I from his speech, replacing it with the distancing you - almost as if he were speaking about someone else altogether. Which, in a sense, he is.

"It was like brainwashing," he is saying now as he lights a cigarette. "I'd give just about anything to go to a hypnotist to black out my whole past. Because it's torture. What they did to you in the body is sometimes not near as bad as what they did to you in the mind - with the psychological warfare in your head."

It's a fame that derives not only from the fact that his medical metamorphosis was the first sex reassignment ever reported on a developmentally normal child but also from a stunning statistical long shot that lent a special significance to the case. He was born an identical twin, and his brother provided the experiment with a built-in matched control - a genetic clone who, with penis intact, was raised as a male. That the twins were reported to have grown into happy, well-adjusted children of opposite sex seemed unassailable proof of the primacy of rearing over biology in the differentiation of the sexes and was the basis for the rewriting of textbooks in a wide range of medical disciplines. Most seriously, the case set a precedent for sex reassignment as the standard treatment for thousands of newborns with similarly injured, or irregular, genitals. It also became a touchstone for the feminist movement in the 1970s, when it was cited as living proof that the gender gap is purely a result of cultural conditioning, not biology. For Dr. John Money, the medical psychologist who was the architect of the experiment, this case was to be the most publicly celebrated triumph of a 40-year career that recently earned him the accolade "one of the greatest sex researchers of the century."

But as the mere existence of this young man in front of me would suggest, the experiment was a failure, a fact revealed in a March 1997 article in the Archives of Adolescent and Pediatric Medicine. Authors Milton Diamond, a biologist at the University of Hawaii, and Keith Sigmundson, a psychiatrist from Victoria, British Columbia, documented how the twin had struggled against his imposed girlhood from the start. The paper set off shock waves in medical circles around the world, generating furious debate about the ongoing practice of sex reassignment (a procedure more common than anyone might think). It also raised troubling questions about the way the case was reported in the first place, why it took almost 20 years for a follow-up to reveal the actual outcome and why that follow-up was conducted not by Dr. Money but by outside researchers. The answers to these questions, fascinating for what they suggest about the mysteries of sexual identity, also bring to light a 30-year rivalry between eminent sex researchers, a rivalry whose very bitterness not only dictated how this most unsettling of medical tragedies was exposed but also may, in fact, have been the impetus behind the experiment in the first place.

But what for medicine has been a highly public scandal involving some of the biggest names in the world of sex research has been for the young man sitting in front of me a purely private catastrophe. Apart from two short television appearances (his face obscured, his voice disguised), he has never spoken on the record to a journalist and has never before told his story in full. For this article, he granted more than 20 hours of candid interviews and signed confidentiality waivers giving me exclusive access to a voluminous array of legal documents, therapists' notes, Child Guidance Clinic reports, IQ tests, medical records and psychological work-ups. He assisted me in obtaining interviews with his former therapists as well as with all of his family members, including his father, who, because of the painfulness of these events, had not spoken of them to anyone in more than 20 years.

The young man's sole condition for talking to me was that I withhold some details of his identity. Accordingly, I will not reveal the city where he was born and raised and continues to live, and I have agreed to invent pseudonyms for his parents, whom I will call Frank and Linda Thiessen, and his sole sibling, the identical twin brother, whom I will call Kevin. The physicians in his hometown I will identify by initials. The young man himself I will call, variously, John and Joan, the pseudonyms given for him by Diamond and Sigmundson in the journal article describing the macabre double life he has been obliged to live. No other details have been changed.

"My parents feel very guilty, as if the whole thing was their fault," John says. "But it wasn't like that. They did what they did out of kindness , and love and desperation. When you're desperate, you don't necessarily do all the right things."

The irony was that Frank and Linda Thiessen's life together had begun with such special promise. A young couple of rural, religious backgrounds, they grew up on farms near each other and met when Linda was just 15, Frank 17. Linda, an exceptionally pretty brunette, had spent much of her teens fighting off guys who were too fresh. Frank, a tall, shy fair-haired man, was different. "I thought, 'Well, he's not all hands,' "Linda recalls." 'I can relax with him.' " Three years later, at ages 18 and 20, they married and moved to a nearby city. Linda remembers Frank's joy soon after, upon learning that he was going to be the father of twins - and his euphoria when the brothers were born, on Aug. 22, 1965. "The nurse asked him, 'Is it boys or girls?' " Linda recalls. "And he said, 'I don't know! I just know there's two of 'em!' "

Shortly before the births, Frank had landed his highest-paying job ever, at a local unionized plant, and the couple now moved with their newborns into a sunny one-bedroom apartment on a quiet side street downtown. But when the twins were 7 months old, Linda noticed that their foreskins were closing, making it hard for them to urinate. Their pediatrician explained that the condition, called phimosis, was not rare and was easily remedied by circumcision. He referred them to a surgeon. The operations were scheduled for April 27, 1966, in the morning. Because Frank needed the family car to get to his job on the late shift, they brought the kids in the night before. "We weren't worried," Linda says. "We didn't know we had anything to worry about. "

But early the next morning, they were jarred from sleep by a ringing phone. It was the hospital. "There's been a slight accident," a nurse told Linda. "The doctor needs to see you right away."

In the children's ward, they were met by the surgeon. Grim-faced, businesslike, he told them that John had suffered a burn to his penis. Linda remembers being shocked into numbness by the news. "I sort of froze," she says. "I didn't cry. It was just like I turned to stone." Eventually she was able to gather herself enough to ask how their baby had been burned. The doctor seemed reluctant to give a full explanation - and it would, in fact, be months before the Thiessens would learn that the injury had been caused by an electro-cautery needle, a device sometimes used in circumcisions to seal blood vessels as it cuts. Through mechanical malfunction or doctor error, or both, a surge of intense heat had engulfed John's penis. "It was blackened," Linda says, recalling her first glimpse of his injury. "It was like a little string. And it went right up to the base, up to his body." Over the next few days, the burnt tissue dried and broke away in pieces.

John, with a catheter where his penis used to be remained in the hospital for the next several weeks, while Frank and Linda, frantic, watched as a parade of the city's top local specialists examined him. They gave little hope. Phallic reconstruction, a crude and makeshift expedient even today, was in its infancy in the 1960's - a fact made plain by the plastic surgeon when he described the limitations of a phallus that would be constructed from flesh farmed from John's thigh or abdomen: "Such a penis would not, of course, resemble a normal organ in color, texture or erectile capability," he wrote in a report to the Thiessens' lawyer. "It would serve as a conduit for urine, but that is all."

Even that was optimistic, according to a urologist: "Insofar as the future outlook is concerned," he wrote, "restoration of the penis as a functional organ is out of the question." A psychiatrist summarized John's emotional future this way: "He will be unable to consummate marriage or have normal heterosexual relations; he will have to recognize that he is incomplete, physically defective, and that he must live apart...."

Now desperate, Frank and Linda took baby John on a daylong train trip to the Mayo Clinic, in Rochester, Minn., where he was examined by a team of doctors who merely repeated the dire prognoses delivered by the Thiessens' local physicians. Back home, with nowhere to turn, the couple sank into a state of mute depression . Months passed during which they could not speak of John's injury even to each other. Then one evening in December 1966, some seven months after the accident, they saw a TV program that jolted them from their despondency.

On their small black-and-white television screen appeared a man identified as Dr. John Money. A suavely charismatic and handsome individual in his late 40s, bespectacled and with sleekly brushed-back hair, Dr. Money was speaking about the wonders of gender transformation taking place at the Johns Hopkins medical center, where he was a medical psychologist. Also on the program was a woman - one of the satisfied post-operative transsexuals who had recently been converted at Johns Hopkins.

Today, with the subject of transsexualism a staple of daytime talk shows, it's difficult to imagine just how alien the concept seemed on that December evening in 1966. Fourteen years earlier, a spate of publicity had attended the announcement by American ex-GI George Jorgensen that he had undergone surgical transformation to become Christine. But that operation, performed in Denmark, had been roundly criticized by American doctors, who refused to perform such surgeries. The subject had faded from view - until now, when Johns Hopkins announced that it had not only performed two male-to-female sex changes (a first in America) but also established the world's first Gender Identity Clinic, devoted solely to the practice of converting people from one sex to the other. Along with gynecologist Howard W. Jones Jr., the driving force behind Hopkins' pioneering work in the study and treatment of transsexuals was the man on the Thiessens' television screen: Dr. John Money.

"He was very self-confident, very confident about his opinions," Linda recalls of her first glimpse of the man who would have such a lasting effect on the Thiessen's lives. "He was saying that it could be that babies are born neutral and you can change their gender. Something told me that I should get in touch with this Dr. Money."

She wrote to him soon after and described what had happened to her child. Dr. Money responded promptly, she says. In a letter, he expressed great optimism about what could be done for her baby at Johns Hopkins and urged her to bring John to Baltimore without delay. He also happened to inquire, Linda says, about the twin brother whom she had mentioned in passing. "He asked if they were identical twins," Linda says. She informed him that they were. Dr. Money replied that he would like to run a test on the babies at Johns Hopkins, just to make sure.

After so many months of grim predictions, bleak prognoses and hopelessness, Dr. Money's words, Linda says, felt like a balm. "Someone," she says, "was finally listening. "

Dr. Money was, indeed, listening. But then, Linda's cry for help was one that he might have been waiting for his entire professional life.

At the time that the Thiessen family's plight became known to Dr. Money, he was already one of the most respected, if controversial, sex researchers in the world. Born in 1921 in New Zealand, Money had come to America at about age 26, received his Ph.D. in psychology from Harvard and then joined Johns Hopkins, where his rise as a researcher and clinician specializing in sexuality was meteoric. Within a decade of joining Hopkins, he was already widely credited as the man who had coined the term "gender identity" to describe a person's inner sense of himself or herself as male or female, and was the world's undisputed authority on the psychological ramifications of ambiguous genitalia. "I think he's a thoroughly ethical and professional person," says John Hampson, a child psychiatrist who co-authored a number of Money's groundbreaking papers on sexual development in the mid-1950s. "He was a very conscientious scientist when it comes to collecting data and making sure of what he's saying. I don't know very many social scientists who could match him in that regard." According to Hampson, Money's ability to persuade others to adopt his point of view is one of the psychologist's chief strengths: "He's a terribly good speaker, very organized and very persuasive in his recital of the facts regarding a case." Indeed, Hampson admits that Money is almost too good at the art of persuasion. "I think a lot of people were envious," says Hampson. "He's kind of a charismatic person, and some people dislike him. As a person, he was a little bit . . . oh . . . flamboyant; he might have been a little glib."

He was 8 years old when his father, after a long illness, died. "His death was not handled very well in our family," Money wrote. Three days after watching his father get mysteriously carried off to the hospital, the boy was told that his father had died. His shock was compounded by the trauma of being informed by an uncle that now he would have to be the man of the household. "That's rather heavy duty for an 8-year-old." Money wrote. "It had a great impact on me." Indeed. As an adult, Money would forever avoid the role of "man of the household." After one brief marriage ended, he never remarried, and he has never had children.

Following his father's death, Money was raised by his mother and spinster aunts. A solitary adolescent with passions for astronomy and archaeology, he also harbored ambitions to be a musician. His widowed mother could not afford piano lessons, so Money worked as a gardener on weekends to pay for music classes and used every spare moment to practice. It was an ambition doomed to disappointment, partly because Money had set the bar so high for himself: "It was difficult for me to have to admit that, irrespective of effort, I could never achieve in music the goal that I wanted to set for myself. I would not even be a good amateur."

Upon entering Victoria University, in Wellington, Money discovered a new passion into which he would channel his thwarted creativity: the science of psychology. Like so many drawn to the study of the mind and emotions, Money initially saw the discipline as a means of solving certain gnawing questions about himself. His first serious work in psychology, the thesis for his master's, concerned "creativity in musicians"; in it, Money writes, "I began to investigate my relative lack of success in comparison with that of other music students."

His later decision to narrow his studies to the psychology of sex had a similarly personal basis. Having lost his religious faith in his early 20s, Money increasingly reacted against what he saw as the repressive religious strictures of his upbringing and, in particular, the anti-masturbatory, anti-sexual fervor that went with them. The academic study of sexuality, which removed even the most outlandish practices from moral considerations and placed them in the "pure" realm of scientific inquiry, was for Money an emancipation. From now on, he would be a fierce proselytizer for sexual exploration. According to journalist John Heidenry, a personal confidant of Money's and author of the recent book What Wild Ecstacy, which traces Money's role as a major behind-the-scenes leader of the sexual revolution of the 1960s and '70s, the psychologist's sexual explorations were not confined to the lab, lecture hall or library. An acknowledged but discreet bisexual, Money engaged in affairs with a number of men and women - "some briefly," Heidenry writes, "others over a longer duration." Indeed, by the mid-1970s, with the sexual revolution in full rampage, Money would step out publicly as a champion of open marriage, nudism and the dissemination of explicit pornography. His promotion of the culture's sexual unbuttoning seemed boundless. "There is plenty of evidence that bisexual group sex can be as personally satisfying as a paired partnership, provided each partner is 'tuned in' on the same wavelength," he wrote in his 1975 pop-psych book, Sexual Signatures. A former patient who was treated by Money in the 1970's for a rare endocrine disorder recalls the psychologist once casually asking him if he'd ever had a "golden shower." The patient, a sexually inexperienced youth at the time, did not know what Money was talking about. "Getting pissed on," Money airily announced with the twinkling, slightly insinuating little smile with which he delivered such deliberately provocative comments.

According to colleagues and other former patients, such sexual frankness in conversation is a hallmark of Money's personal style. Dr. Fred Berlin, a professor of psychiatry at the Johns Hopkins School of Medicine and a colleague who considers Money one of his most important mentors, agrees that Money is aggressively outspoken. "Because he thinks it's important to desensitize people in discussing sexual issues, he will sometimes use four-letter words that others might find offensive," says Berlin. "Perhaps he could be a little more willing to compromise On that. But John is an opinionated person who isn't looking necessarily to do things differently from the way he's concluded is best."

But while Money's conclusions about the best approach to sexual matters merely raised eyebrows in the mid-1970's, they provoked outrage at the dawn of the more conservative 1980's. Undaunted, Money continued to push on into uncharted realms. In an April 14, 1980, article in Time , Money was sharply criticized for what looked dangerously like an endorsement of incest and pedophilia. "A childhood sexual experience, such as being the partner of a relative or of an older person, need not necessarily affect the child adversely," Money told Time . And according to a right-wing group critical of his teachings, Money reportedly told Paidika , a Dutch journal of pedophilia, "If I were to see the case of a boy aged 10 or 12 who's intensely attracted toward a man in his 20s or 30s, if the relationship is totally mutual, and the bonding is genuinely totally mutual, then I would not call it pathological in any way."

Money's response to criticism has been to launch counterattacks of his own, lambasting his adoptive country for a puritanical adherence to sexual taboos. In an autobiographical essay included in his book Venuses Penuses , Money describes himself as a "missionary" of sex - and points out, with a lofty and defiant pride, "It has not been as easy for society to change as it had been for me to find my own emancipation from the 20th-century legacy of fundamentalism and Victorianism in rural New Zealand."

Money's experimental, taboo-breaking approach to sex was paralleled in his professional career. Eschewing the well-traveled byways of sex research, Money sought out exotic corners of the field where he could be a pioneer. He found just such a relatively undiscovered realm of human sexuality while in the first year of his Ph.D. studies in psychology at Harvard. In 1948, in a social-relations course, he learned of a 15 year-old male who was born not with a penis but with a tiny, nublike phallus resembling a clitoris and who, at puberty, developed breasts. It was Money's first exposure to hermaphroditism - also known as intersexuality - a condition that, in its extreme or its milder forms, is estimated to occur once in every 2,000 births. Characterized by ambiguities of the external sex organs and the internal reproductive system, intersexuality is caused by any of a wide variety of genetic and hormonal irregularities, and can vary from a female born with a penis-sized clitoris and fused labia resembling a scrotum to a male born with a penis no bigger than a clitoris, undescended testes and a split scrotum indistinguishable from a vagina.

Money became fascinated with intersexuality and wrote his doctoral dissertation on the subject, which led to his invitation, in 1951, to join Johns Hopkins, where the world's largest clinic for the study of intersexual conditions had been established. Up until then, the syndrome had been studied solely from a biological perspective. Money came at it from a psychological angle and would make a name for himself as a pioneer in examining the mental and emotional repercussions of being born as neither boy nor girl. At Hopkins, he enlisted Hampson and Hampson's wife, Joan, to help him study some 105 intersex children and adults. Money claimed to have observed a striking fact about people who had been diagnosed with identical genital ambiguities and chromosomal makeups but who had been raised as members of the opposite sex: More than 95 percent of these intersexes fared equally well, psychologically, whether they had been raised as boys or as girls. To Money, this was proof that the primary factor that determined an intersexual child's gender identity was not biological traits but the way that the child was raised. He concluded that these children were born psychosexually undifferentiated.

This theory was the foundation on which Money based his recommendation to pediatric surgeons and endocrinologists that they surgically and hormonally stream intersexual newborns into whichever sex the doctors wished. Such surgeries would duly range from cutting down enlarged clitorises on mildly intersexual girls to performing full sex reversals on intersexual boys born with testicles but a penis deemed too small. Money's only provisos were that such "sex assignments" be done as early as possible - preferably within weeks of birth - and that once the sex was decided on, doctors and parents never waiver in their decision, for fear of introducing dangerous ambiguities into the child's mind. In terms of the possible nerve destruction caused by the amputation of genital appendages, Money assured doctors that according to studies he had conducted with the Hampsons, there was no evidence of loss of sensation. "We have sought information about erotic sensation from the dozen non-juvenile . . . women we have studied," he wrote in a 1955 paper. "None of the women . . . reported a loss of orgasm after clitoridectomy."

Money's protocols for the treatment of intersexual children hold to this day. Placing the greatest possible emphasis on the child's projected "erotic functioning" as an adult and taking into account that medical science had never perfected the reconstruction of injured, or tiny, penises, Money's recommendations meant that the vast majority of intersexual children, regardless of their chromosome status, would be turned into girls. Current guidelines dictate that to be assigned as a boy, the child must have a penis longer than 2.5 centimeters; a girl's clitoris is surgically reduced if it exceeds 1 centimeter.

By providing a seemingly solid psychological foundation for such surgeries, Money had, in a single stroke, offered physicians a relatively simple solution to one of the most vexing and emotionally fraught conundrums in medicine: how to deal with the birth of an intersexual child. As Money's colleague Dr. Berlin points out, "One can hardly begin to imagine what it's like for a parent when the first question - 'Is it a boy or a girl?' - results in a response from the physician that they're just not sure. John Money was one of those folks who, years ago, before this was even talked about, was out there doing his best trying to help families, trying to sort through what's obviously a difficult circumstance."

In a retrospective essay written in 1985 about his career as a sex researcher, Money offered crucial insight into the way he arrived at some of his more unusual theories about human sexual behavior. "I frequently find myself toying with concepts and working out potential hypotheses," he mused. "It is like playing a game of science fiction. . . . It is as much an art as the creative process in painting, music, drama or literature."

Money's theory that newborns are psychosexually neutral was both unorthodox and against the current climate of science, which for decades had centered on the critical role of chromosomes and hormones in determining sexual behavior. But if his colleagues considered Money's ideas to be science fiction, they weren't prepared to say so publicly. His papers outlining his theory became famous in his field, helping not only to propel him to international renown as a sex researcher but also to speed his rise up the ladder at Johns Hopkins, where he ascended from assistant to associate professor of medical psychology, teaching his theory of infant sexual development to generations of medical students. By 1965, the year of John and Kevin Thiessen's birth, Money's reputation was virtually unassailable. He had for more than a decade been head of Hopkins' Psychohormonal Research Unit (his clinic for treating and studying intersex kids), and he was shortly to help co-found Hopkins' groundbreaking Gender Identity Clinic - a coup that helped earn him a reputation, says John Hampson, as "the national authority on gender disorder."

There was, however, at least one researcher who was willing to question Money. He was a young graduate student at the University of Kansas. The son of struggling Ukrainian-Jewish immigrant parents, Milton Diamond, whom friends call Mickey, was raised in the Bronx, where he had sidestepped membership in the local street gangs for the life of a scholar. As an undergraduate majoring in biophysics at City College of New York, Diamond became fascinated by the role of hormones in the womb and their possible role in defining a person's gender identity and sexual orientation. In his late 20s, as a grad student in endocrinology at Kansas, he conducted animal research on the subject, injecting pregnant guinea pigs and rats with different hormone cocktails to see how pre-birth events would affect later sexual behavior. The evidence in Diamond's lab suggested a link between the hormones that bathe a developing fetus's brain and nervous system and its later sexual functioning. It was in an effort to raise funds for his continued research that Diamond applied for a grant from the National Science Foundation Committee for Research in Problems of Sex an application that required the submission of a research paper. For his topic, Diamond decided to write a response to Money's now-classic papers on sexual development.

Diamond's critique appeared in The Quarterly Review of Biology in 1965. Marshaling evidence from biology, psychology, psychiatry, anthropology and endocrinology to argue that gender identity is hardwired into the brain virtually from conception, the paper was an audacious challenge to Money's authority (especially coming from an unknown grad student at the University of Kansas). First addressing the theory about the psychosexual flexibility of intersexes, Diamond pointed out that such individuals suffer "a genetic or hormonal imbalance" in the womb. Diamond argued that even if intersexuals could be steered into one sex or the other as newborns, this was not necessarily evidence that rearing is more influential than biology. It might simply mean that the cells in their brains had undergone, in utero, an ambiguity of sexual differentiation similar to that of the cells in their genitals. In short, intersexes have an inborn, neurological capability to go both ways - a capability, Diamond hastened to point out, that genetically normal children certainly would not share.

Even a scientist less thin-skinned than John Money might have been stung by the calm, relentless logic of Diamond's attack - which, near the end, raised the most rudimentary, Science 101 objection to the widespread acceptance of Money's theory of psychosexual malleability in normal children. "To support [such a] theory," Diamond wrote, "we have been presented with no instance of a normal individual appearing as an unequivocal male and being reared successfully as a female."

It was a year and a half after Diamond had thrown down the gauntlet that Dr. Money received Linda Thiessen's letter describing the terrible circumcision accident that had befallen her baby boy.

The Thiessens made their first trip to Johns Hopkins early in 1967, within weeks of first seeing Dr. Money on TV. The young couple were awestruck by the vast medical center dominating the top of a rise on Wolfe Street. Dr. Money's Psychohormonal Research Unit was located in the Phipps Clinic, a gloomy Victorian building tucked away in a courtyard; the unit's offices, located on an upper floor, were reached by way of a rickety turn-of-the-century elevator. Money's own inner sanctum (where most of his meetings with the Thiessens would take place during the ensuing 12 years) was furnished with a couch, Oriental rugs and potted plants - reminding Frank more of a living room than of an office. There was also a collection of carved aboriginal sculptures of erect phalluses, vaginas and breasts that adorned a mantel. But if these artifacts were unsettling, Money himself, with his smoothly confident, professional manner - not to mention the diplomas on his wall - made the Thiessens feel that they were in the best possible hands. "I looked up to him like a god," says Linda, who at the time was not yet out of her teens. "I accepted whatever he said." And what Dr. Money had to say was exactly what the Thiessens ached to hear.

In his many published versions of this first interview, Money has recounted how he spelled out to the young couple the advantages of sex reassignment for baby John - "using nontechnical words, diagrams and photographs of children who had been reassigned." What is not clear from Money's accounts is whether Linda and Frank, whose educations at the time did not go beyond the sixth grade, understood that such a procedure was, in fact, purely experimental - that while such surgeries had been performed on intersexual children, no such sex changes had ever been attempted on a child born with normal genitals and a normal nervous system. Today, Frank and Linda say that this was a distinction they did not fully grasp until later. The crucial point that they gleaned from Dr. Money was his conviction that the procedure had every chance for success. "I see no reason," Linda recalls him saying, "that it shouldn't work."

Indeed, Money's eagerness to begin is evident in a description of the interview written almost 10 years later. In Sexual Signatures , he wrote: "If the parents stood by their decision to reassign the child as a girl, surgeons could remove the testicles and construct feminine external genitals immediately. When she was 11 or 12 years old, she could be given the female hormones."

If Dr. Money seemed to be in a hurry, he was. He explained to Frank and Linda that they would have to make up their minds quickly. For according to one of the finer points of his theory, the "gender identity gate" - Money's term for that moment after which a child has locked into an identity as a male or a female - comes a little after 2 years of age. John was now 17 months. "The child was still young enough so that whichever assignment was made, erotic interest would almost certainly direct itself toward the opposite sex later on," Money wrote, "but the time for reaching a final decision was already short."

Frank and Linda, however, needed time to decide on something as momentous as having their child undergo a surgical sex change. They went home to think about it. Linda says that Dr. Money made no secret of his impatience with the delay. "He wrote in a letter that we were 'procrastinating,' " Linda recalls. "But we wanted to move slow, because we had never heard of anything like this."

Back home, they canvassed opinions. Their pediatrician recommended against such drastic treatment, and so did their parents. But finally, Frank and Linda realized that they alone had to decide. They alone were the ones living with the reminder, at each diaper change, of John's terrible injury. After months of indecision, they made up their minds.

That summer, five months after their first meeting with Money, they returned to Baltimore with their baby. Now 22 months old, the child was still within the window of 30 months that Money had established as safe for an infant sex change. And so, on July 3, 1967, the baby underwent surgical castration. According to the operating-room record, Dr. Howard W. Jones Jr. slit open the baby's scrotum along the midline and removed the testes, then reclosed the scrotal tissue so that it resembled labia. The urethra was lowered to approximate the position of the female genitalia, and a cosmetic vaginal cleft was made by forming the skin around a rolled tube of gauze during the healing. It was also during this visit to Johns Hopkins, says Linda, that the promised chromosome test was conducted on the twins to determine if they were, indeed, identical. They were.

Linda and Frank say that by the time they decided to have their baby undergo clinical castration, they had eradicated any doubts they might have had about the efficacy of the treatment - a crucial turnabout, since, according to Dr. Money, it was a "vital consideration" that the parents of a sex-reassigned child harbor no second thoughts. "For any lingering doubts whatsoever in their minds," Money wrote, "would weaken the child's identification as a girl and woman."

Whether Money himself was able to eradicate his own doubts about the child's future development is debatable. In a letter he wrote a few weeks after the castration, his tone admitted of considerable caution regarding the prognosis. But then this was perhaps to be expected, since the letter was addressed to the lawyer whom Frank and Linda had hired to sue the hospital that botched the circumcision.

"The reassignment of a baby's sex is usually undertaken only in cases of a birth defect of the genitalia," Money wrote. "Then one usually expects that the child's psychosexual differentiation will be congruous with the sex of rearing. In any given case, however, it is not possible to make an absolute prediction."

Central to Money's program for sex reassignment of hermaphrodites was his edict that the children, when very young, know nothing of their ambiguous sexual status at birth. Money put the same stricture into effect in the case of the Thiessens' baby, whom they now called Joan. "He told us not to talk about it," Frank says. "Not to tell Joan the whole truth and that she shouldn't know she wasn't a girl."

Linda had sewn dresses and bonnets for her new daughter. It was shortly before Joan's second birthday when Linda first put her in a dress. "It was a pretty, lacy little dress," Linda recalls. "She was ripping at it, trying to tear it off. I remember thinking, 'Oh, my God, she knows she's a boy and she doesn't want girls' clothing. She doesn't want to be a girl.' But then I thought, 'Well, maybe I can teach her to want to be a girl. Maybe I can train her so that she wants to be a girl.' "

Linda and Frank did their best to do just that. When Joan's brother, Kevin, at age 4, was watching Frank shave and asked to shave, too, Frank gave him an empty razor and some shaving cream to play with. But when Joan also clamored for a razor, Frank refused. "I told her that girls don't shave," Frank recalls. "I told her girls don't have to." Linda offered to put makeup on her. But Joan didn't want to wear makeup.

"I remember saying, 'Oh, can I shave, too?' " John says of this incident, which forms his earliest childhood memory. "My dad said, 'No, no. You go with your mother.' I started crying, 'Why can't I shave, too?' " Kevin says that the incident was typical of the way their parents tried to steer them into opposite sexes - and how such efforts were, inevitably, doomed to failure.

"I recognized Joan as my sister," Kevin says, "but she never, ever acted the part. 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. Never used it for what it was bought for. She played with my toys: Tinkertoys, dump trucks. Toys like this sewing machine she got just sat."

Today, with the twins having rejoined each other on the same side of the gender divide, the stark physical differences between them eerily testify to all that John has been through. At 32, Kevin is a dark-bearded, bearlike man with the thickly muscled arms and shoulders of a manual laborer. To see him standing alongside his scarecrow-thin, scantily bearded brother, you would never guess that every cell in their bodies bears identical DNA - until you compare their eyes, noses and mouths, which are indistinguishable from one twin to the other.

As children, their physical differences were, if less pronounced, equally deceptive. Photographs of them as preschoolers show a puppy-eyed little boy with a crew cut and a slim, brown-eyed girl with wavy chestnut hair framing a face of delicate prettiness. But by all accounts, this illusion of two children occupying opposite sexes disappeared the second that Joan moved, spoke, walked, gestured. "When I say there was nothing feminine about Joan," Kevin laughs, "I mean there was nothing feminine. She walked like a guy. She talked about guy things, didn't give a crap about cleaning house, getting married, wearing makeup.... We both wanted to play with guys, build forts and have snowball fights and play army." Enrolled in Girl Scouts, Joan was miserable. "I remember making daisy chains and thinking, 'If this is the most exciting thing in Girl Scouts, forget it,' " John says. "I kept thinking of the fun stuff my brother was doing in Cubs."

Linda and Frank were troubled by Joan's masculine behavior. But they had been told by Dr. Money that they must not entertain any doubts about their daughter, and they felt that to do so would only increase the problem. Instead, Frank and Linda seized on those moments when Joan's behavior could be construed as stereotypically feminine. "And she could be sort of feminine, sometimes," Linda says, "when she wanted to please me. She'd be less rough, keep herself clean and tidy, and help a little bit in the kitchen."

Kevin didn't question his sister's boyish ways until they went off to school. "I was in grade one or two," he says, "and I saw all the other girls doing their thing - combing their hair, holding their dolls. Joan was not at all like that. Not at all." At that time, Joan had voiced the ambition to be a garbage man. "She'd say, 'Easy job, good pay,' " Kevin recalls. "She was 6 or 7 years old. I thought it was kinda bizarre - my sister a garbage man?" Indeed, Kevin would finally grow so perplexed with his sister's unconventional behavior that he went to his mother about it. "Well, that's Joan being a tomboy," Linda told him. "I accepted that," Kevin says and shrugs.

That was not an explanation Joan's schoolmates were prepared to accept. Upon entering kindergarten, she became the object of instant ridicule from classmates, both male and female. "As you'd walk by, they'd start giggling," John remembers. "Not one, but almost the whole class. It'd be like that every day. The whole school would make fun of you about one thing or another."

"They were cruel," says Kevin, who witnessed his sister's humiliation at school. "Teased every day. It wasn't a weekly thing. Or a monthly thing. This was a daily thing. They'd call her names, ignore her, not involve her in the groups."

"It started the first day of kindergarten," Linda says. "Even the teacher didn't accept her. The teachers knew there was something different."

By then, Joan also knew that there was "something different" about her. But she didn't know what. "You know generally what a girl is like," John says, "and you know generally what a guy is like. And everyone is telling you that you're a girl. But you say to yourself, 'I don't feel like a girl.' You think girls are supposed to be delicate and like girl things - tea parties, things like that. But I like to do guy stuff. It doesn't match. So you figure, 'Well, there's something wrong here. If I'm supposed to be like this girl over here but I'm acting like this guy, I guess I gotta be an it .' "

Joan's personal difficulties were obvious in her functioning in the classroom. Though tests had revealed her to be in the normal intelligence range, she seemed unable, or unwilling, to master the skills required in kindergarten. When the school threatened to hold Joan back, Linda complained to Dr. Money. He wrote a letter to the school, urging that Joan, despite her emotional difficulties, be promoted to first grade. But her problems only got worse. On Oct. 29, 1971, a few weeks after she started first grade, her behavior prompted a teacher to file a report with the district's Child Guidance Clinic. The teacher noted that Joan "has been doing just the opposite of anything the other children do" and described the girl as "very negativistic."

It was at a December 1972 meeting of the American Association for the Advancement of Science in Washington, D.C. that John Money unveiled, for the first time, his "twins case." Time magazine ran a full-page story on the debut, which happened to coincide, that same week, with the release of Money's book Man Woman, Boy Girl . Co-authored with his colleague Dr. Anke Ehrhardt, the book contained his first written account of the extraordinary twins case.

Man Woman, Boy Girl made mention of Joan's "tomboyish traits" in passing but focused on the ways in which she conformed to the stereotypes of female behavior - examples of which were culled from Linda's hopeful cataloging, over the years, of Joan's fitful attempts to act more like a girl. "One thing that really amazes me is that she is so feminine," Linda is quoted as saying. "I've never seen a little girl so neat and tidy as she can be when she wants to be." No mention was made of the problems Joan had been having in school.

Indeed, the account portrayed the experiment as an unqualified success - a conclusion bolstered by what Money pointed out was an "extreme unusualness" to the case. He was referring, of course, to the existence of the identical male twin, whose interest in "cars and gas pumps and tools" was contrasted to his sister's interest in "dolls, a doll house and a doll carriage" - a sharp division of tastes along gender lines that seemed to provide compelling evidence that boys and girls are made, not born. The significance of the case to the then-burgeoning women's movement was obvious, since feminists had been arguing against a biological basis for sex differences for years. Indeed, Money's own papers from the 1950's on the total psychosexual flexibility of newborns were cited by Kate Millett in her best-selling, seminal 1970 feminist text, Sexual Politics . Money's new twins case buttressed the feminist claim that the observable differences in the tastes, attitudes and behaviors of men and women are attributable solely to cultural expectations.

"This dramatic case," Time duly reported in its Jan. 8, 1973, edition, "provides strong support for a major contention of women's liberationists: that conventional patterns of masculine and feminine behavior can be altered. It also casts doubt on the theory that major sexual differences, psychological as well as anatomical, are immutably set by the genes at conception." The New York Times Book Review hailed Man Woman Boy Girl as "the most important volume in the social sciences to appear since the Kinsey reports" and praised Money for producing "real answers to that ancient question: Is it heredity or environment?" But it was on the pediatric wards of hospitals around the world that the twins case would have its most lasting impact.

"It was the hallmark case," says Dr. William Reiner a child psychologist at Johns Hopkins. "It was the hallmark because it was followed and written up a number of times by Money and then essentially was the source of his statements - and subsequent statements in any of the pediatric textbooks in endocrinology, urology, surgery and psychology - that you can reassign the sex of a child because it's the social situation that is the most important." The undisputed success of the twins case legitimized the practice of infant sex reassignment globally, says Reiner. Once confined principally to Johns Hopkins, the procedure soon spread and today is performed in virtually every major country, with the possible exception of China and India. While no annual tally of infant sex reassignments has ever been made, Reiner makes a rough, "conservative" estimate that three to five cases crop up in every major American city each year - giving the U.S. alone a total of 100 to 200 sex reassignments a year. Globally, he puts the figure at perhaps 1,000 per year. In the 25 years since Money's twins case was first published, as many as 15,000 similar sex reassignments may have been performed.

Dr. Mel Grumbach, a pediatric endocrinologist at the University of California, San Francisco, and a world authority on the subject, confirms that the findings detailed in Money's twins case were the decisive factor in the widespread acceptance of the practice. ""Doctors] were very influenced by the twin experience." he says. "John Money stood up at a conference and said, 'I've got these two twins, and one of them is now a girl, and the other is a boy.' They were saying they took this normal boy and changed him over to a girl. That's powerful. That's really powerful. I mean, what is your response to that? This case was used to reinforce the fact that you can really do anything. You can take a normal XY male and convert it into a female in the neonatal period and it won't make any difference." Grumbach adds, "John Money is a major figure, and what he says gets handed down and accepted as gospel by some."

Diamond vowed to follow the case of the sex-changed twin closely - a decision, he says, that was affected by purely scientific motives. But if, by now, Diamond also felt a degree of personal involvement in his dispute with Money, that was perhaps understandable: In the chapter directly following his account of the twins case in Man Woman, Boy Girl , Money lashed out at Diamond and his colleagues, characterizing their work as "instrumental in wrecking the lives of unknown numbers of hermaphroditic youngsters."

In 1967, at the time of John's castration, Money stipulated that he see the child once a year for counseling. The trips, which were sometimes separated by as many as 18 months, were, as Money put it in his letter to the Thiessens' lawyer, meant to "guard against the psychological hazards" associated with growing up as a sex-reassigned child. But according to the Thiessens and to contemporaneous clinical notes, the trips to the Psychohormonal Research Unit at Johns Hopkins only exacerbated the confusion, fear and dread that Joan was already suffering.

"You get the idea something happened to you," John says of those mysterious annual visits to the unit, "but you don't know what - and you don't want to know." Kevin, who was also required on each visit to submit to sessions with Dr. Money, found the trips equally bewildering and unsettling: "For the life of me, I couldn't understand why, out of all the kids in my class, why am I the only one going with my [sister] to Baltimore to talk to this doctor? It made us feel like we were aliens." The twins developed a conviction that everyone, from their parents to Dr. Money and his colleagues, was keeping something from them. "There was something not adding up," Kevin says. "We knew that at a very early age. But we didn't make the connection. We didn't know."

All they did know was that from the time they were 6 years old, Dr. Money wanted to talk to them, both singly and together, about subjects that, as Joan would later complain to an outside therapist, "I can't even talk to my mom about."

"Dr. Money would ask me, 'Do you ever dream of having sex with women?' " Kevin recalls. "He'd say, 'Do you ever get an erection?' And the same with Joan. 'Do you think about this? About that?' "

While attempting to probe the twins' sexual psyches, Money also tried his hand at programming Kevin's and Joan's respective sense of themselves as boy and girl. One of his theories of how children form their different "gender schemes" - Money's term - was that they must understand, at an early age, the differences between male and female sex organs. Pornography, he believed, was ideal for this purpose. "Explicit sexual pictures," he wrote in his book Sexual Signatures , "can and should be used as part of a child's sex education"; such pictures, he said, "reinforce his or her own gender identity and gender role."

"He would show us pictures of kids, boys and girls, with no clothes on," Kevin says. John recalls that Dr. Money also showed them pictures of adults engaged in sexual intercourse: "He'd say to us, 'I want to show you pictures of things that moms and dads do.' "

During these visits, the twins discovered that Money had two sides to his personality. "One when mom and dad weren't around," Kevin says, "and another when they were." When their parents were present, they say, Money was avuncular, mild-spoken. But alone with the children, he could be irritable or worse. Especially when they defied him. The children were particularly resistant to Money's request that they remove their clothes and inspect each other's genitals. Though they could not know this, such inspections were central to Money's theory of how children develop a sense of themselves as boy or girl - and thus, in Money's mind, were crucial to the successful outcome of Joan's sex reassignment. As Money stressed in his writings of the period: "The firmest possible foundations for gender schemes are the differences between male and female genitals and reproductive behavior, a foundation our culture strives mightily to withhold from children. All young primates explore their own and each others' genitals . . . and that includes human children everywhere.... The only thing wrong about these activities is not to enjoy them."

But the children did not enjoy these enforced activities, which they were instructed to perform sometimes in front of Dr. Money, sometimes with as many as five or six of his colleagues in attendance. But to resist Money's requests was to provoke his ire. "I remember getting yelled at by Money because I was defiant," John says. "He told me to take my clothes off, and I just did not do it. I just stood there. And he screamed, 'Now! ' Louder than that. I thought he was going to give me a whupping. So I took my clothes off and stood there, shaking." In a separate conversation with me, Kevin recalls that same incident. " 'Take your clothes off - now! ' " Kevin shouts.

As early as age 8, Joan began to resist going to Baltimore. Dr. Money suggested to Linda and Frank that they sweeten the pill of the annual visits by blending the trip to Hopkins with a family vacation. "Soon," Linda says, "we were promising Disneyland and side trips to New York just to get her to go."

It was also around Joan's eighth birthday that Dr. Money began increasingly to focus on the issue of vaginal surgery. At the time of her castration at 22 months, Joan was left with only a cosmetic exterior vagina; the surgeon had elected to wait until Joan's body was closer to full grown before excavating a full vaginal canal. For Dr. Money, there was now an urgent need for Joan to prepare for this operation. Because genital appearance was critical to Money's theory of how one "learns" a sexual identity, Money believed that Joan's psychological sex change could not be complete until her physical sex change was finished.

There was only one problem: Joan was determined not to have the surgery - ever. The child's increasingly stubborn refusal was not only a result of her deep-seated fear of hospitals, doctors and needles. It also had to do with the realization that she'd made around the time of grade two - that she was not a girl and never would be, no matter what her parents, her doctor, her teachers or anyone else said. For when Joan daydreamed of an ideal future, she saw herself as a 21-year-old male with a mustache and a sports car, surrounded by admiring friends. "He was somebody I wanted to be ," John says today, reflecting on this childhood fantasy. By now Joan was ever more certain that submitting to vaginal surgery would lock her into a gender in which she felt increasingly trapped.

She quietly told Dr. Money that she did not want to have the surgery. But the psychologist did not seem to want to hear this. Instead, Dr. Money would once again break out his cache of photographs of naked women. He would focus Joan's gaze on the labia, vulva, clitoris. "Can't you see that you're different?" he would say. "That's why you need the surgery."

Joan, frightened but adamant, would simply refuse to lift her eyes. "Don't you want to be a normal girl?" Dr. Money would ask repeatedly. "Don't you want to be a normal girl?"

Dr. Money also continued to probe for the content of Joan's sexual fantasies. She tried to keep this information secret from the psychologist, and she believed herself successful. But, according to Frank and Linda, she was wrong. By the time Joan turned 9, Dr. Money had informed them that something had come up in his private sessions with Joan. "Money told us that he had asked Joan what partner she would rather have, a boy or a girl," Frank recalls. "Joan had said, 'A girl.' " Frank recalls that Dr. Money wanted to know how they felt about raising a lesbian. At a loss as to how to respond to this news but relieved that Money did not seem to think it significant, Frank said what he honestly believed about homosexuality: "It's not the most important thing in life."

Money evidently agreed, for this clinical finding was not included in his next report on the twins, which appeared in 1975, when they were 10 years old. Published in the Archives of Sexual Behavior , the update was, if anything, a more glowing report than the one from three years before. After recapping the earlier findings and adding a new example of the girl's happy femininity, Money concluded: "No one [outside the family] knows [that she was born a boy]. Nor would they ever conjecture. Her behavior is so normally that of an active little girl, and so clearly different by contrast from the boyish ways of her twin brother, that it offers nothing to stimulate one's conjectures."

That same year, Money published yet another account of Joan's successful metamorphosis. But this time the intended audience was not only Money's scientific and medical colleagues but also the general public. Sexual Signatures , co-authored with journalist Patricia Tucker, was Money's bid for a wider audience. Stripped of the often-impenetrable psychological jargon that characterizes his earlier reports of the sex reassignment, the book offered Money's most unrelievedly upbeat, almost triumphant, account of the case yet. Describing Joan's sex reassignment as "dramatic proof that the gender-identity option is open at birth for normal infants," Money went on to say of baby John's castration as an infant, "The girl's subsequent history proves how well all three of them [parents and child] succeeded in adjusting to that decision."

Up to the age of 11, Joan's only psychological therapy was her annual visits to Dr. Money at John Hopkins. But this changed in the fall of 1976, when she entered a new school, where her anxiety, social isolation and fear immediately drew the attention of teachers, who, once again, notified the Child Guidance Clinic. "Joan's interests are strongly masculine," a teacher wrote in her report. "She has marvelous plans for building treehouses, go-carts with CB radios, model gas airplanes . . . and appears to be more competitive and aggressive than her brother and is much more untidy both at home and in school." A session with the clinic's psychologist revealed that Joan had "strong fears that something [had] been done to her genital organs" and that she had had "some suicidal thoughts."

Her case was referred to the unit's head of psychiatry, Dr. Keith Sigmundson, an amiable, self-deprecating 34-year-old whose career ascent had been rapid. "Because I was just ahead of the baby boomers, I got a position that I was too young for and probably didn't deserve in the first place," he says. From his very first meeting with Joan, Sigmundson was struck by the child's appearance. "She was sitting there in a skirt with her legs apart, one hand planted firmly on one knee," Sigmundson says. "There was nothing feminine about her." But despite strong misgivings, he decided that in overseeing Joan's psychiatric treatment, he would support the process that Money had begun. It had gone too far to turn back, Sigmundson decided, so he attempted to persuade the child to accept herself as a girl and to submit to vaginal surgery. To increase Joan's female identification, he referred her case to a woman psychiatrist, Dr. M.

As Dr. M.'s clinical notes reveal, early in her sessions Joan voiced her conviction that she was "just a boy with long hair in girl's clothes" and that people looked at her and said she "looks like a boy, talks like a boy." She also opened up about how she dreaded the trips to Baltimore, where people looked at her and "a man show[ed] her pictures of nude bodies." But the psychiatrist reassured Joan that she was, indeed, a girl and impressed upon her the necessity that she undergo surgery on her genitals.

Troubled nonetheless by the case, the psychiatrist wrote to Dr. Money and told him of Joan's emotional difficulties and school problems. Money wrote back in January 1977 that he was very pleased that Dr. M. was willing to become involved in treating Joan. He explained that the second stage of Joan's vaginal surgery had not yet been performed due to the child's "fanatical fear of hospitals" - a fear, Money wrote, "that I have encountered on only one other occasion in 25 years of work at Johns Hopkins." He added that mention of hormone treatments or surgery induced in Joan a "panic so intense that it's impossible to broach any conversation on such matters without the child fleeing the room, screaming." Nevertheless, Money continued, there was now an "urgency" that Joan's fears be overcome, because the need for hormone therapy and surgery was rapidly increasing with her approaching adolescence. "It will be one of the best things you can do for her," Money wrote to the psychiatrist, "if you can help her break down this extraordinary veto."

Despite all efforts, Joan continued to hold out against surgery. Nine months passed, and she remained unmovable - refusing even to permit her pediatric endocrinologist to conduct a physical exam of her genitals. Then, in the late summer of 1977, when Joan turned 12, she suddenly had to fend off an attack on another front. On her last several trips to Baltimore, Dr. Money had spoken about the medication she would soon need in order to become a "normal girl." He was talking about estrogen, the female hormone needed to simulate the effects of female puberty on Joan's broad-shouldered, narrow-hipped boy's physique. Like vaginal surgery, the prospect of developing a female figure struck Joan as nightmarish. So she was suspicious when, one day, her father produced a bottle of pills and told her to start taking them.

"What's this medicine for?" Joan asked.

Frank, struggling for the best way to put it, finally came up with: "It's to make you wear a bra."

"I said, 'I don't wanna wear a bra!' " John recalls. "I threw a fit."

But after repeated entreaties from her parents and the endocrinologist (not to mention the threat, which Dr. Money had introduced, that she would grow disproportionate limbs if she failed to take the drugs), Joan finally, and with great reluctance, began to take the pills.

It was around this time that Dr. Money authored another update on the twins. The report would appear in a 1978 journal. Once again, the outlook was sunny. "Now prepubertal in age, the girl has . . . a feminine gender identity and role, distinctly different from that of her brother," he reported. Perhaps forgetting what he had told Joan's parents four years earlier about her sexual orientation, he wrote: "The final and conclusive evidence awaits the appearance of romantic interest and erotic imagery."

Though Joan often only pretended to take her estrogen pills, by May 1978, three months prior to her 13th birthday, the effects were visible. A pair of small but distinct breasts had appeared on her chest, along with a padding of fat around her waist and hips. But she remained stubbornly opposed to further surgery - a fact that became dramatically clear during her visit that spring to Johns Hopkins. It would prove to be the last time Joan would ever consent to go to Baltimore.

That something remarkable had occurred during Joan's visit is obvious from a letter that Dr. Money wrote in August 1978, some weeks after the encounter. He said that Joan was still determined to avoid talk of sex or surgery and, when she was pressed on those points, she left the room to join her brother. "I followed," Money wrote, "and, in bringing the session to a close, put my hand on her shoulder in what most youngsters would accept as a reassurance. She fled in panic." Money then described how one of his students followed Joan to help her recover her composure. "They walked, saying little, for about a mile." In concluding his oddly elliptical-sounding account of these events, Dr. Money referred to the student as a woman.

What he did not mention was that the woman had begun life as a man. She was a male-to-female transsexual one of many readily available from the Johns Hopkins Gender Identity Clinic. She had apparently been enlisted by Money to speak to Joan about the positive aspects of surgical construction of a vagina.

"Dr. Money said, 'I've got someone for you to talk to who's been through what you're going to be going through,' " John recalls.

Joan was then ushered into the presence of a person whom she immediately identified as a man wearing makeup, dressed in women's clothing, with a woman's hairstyle. When the person spoke, it was in a breathy, artificially high-pitched voice.

"He's telling me about the surgery," John says, "how fantastic it was for her and how her life turned out beautifully."

Joan sat immobile, silent, apparently listening. But the words reached her through a clamoring, rising panic in her mind: "I was thinking, 'I'm gonna end up like that?' "

Today, John cannot remember bolting from the room. "I remember running," John says. "That's all."

Joan ran, blindly, until she reached a set of stairs, which she dashed up. She emerged onto a rooftop, where she tried to hide. But the transsexual had followed - only increasing Joan's panic. Coaxed down from the roof, Joan told her mother that if forced to return to see Dr. Money, she would kill herself.

But Dr. Money was, it seemed, not inclined to lose contact with this unique patient so easily. In early 1979, roughly eight months after Joan's last trip to Hopkins, Money wrote to Linda, saying that he would soon be passing through her city to give a talk at the local university and medical center. He said he would like to drop by the house and see the Thiessens.

On a gray day in mid-March 1979, Money arrived at their doorstep carrying only a single knapsack. The twins, aware of Money's arrival, disappeared into the basement and refused to come upstairs. The adults engaged in small talk. Money had said that he was catching a flight later in the day. But both Frank and Linda noticed that he was showing no symptoms of being in a hurry. On a tour of the small house, Money complimented Linda's ink drawings, which decorated the walls, and looked at a wooden wall cabinet that Frank had made. He reminisced about his childhood in New Zealand. Finally, Dr. Money announced that he had missed his flight. Frank and Linda looked at each other and felt that it was the right thing to do to invite Dr. Money to stay over, although they had only a foam air mattress in the front room for him to sleep on. To their surprise, the eminent psychologist from Johns Hopkins accepted the offer. In order to accommodate their unexpected house guest, the Thiessens phoned out for a bucket of chicken. The children continued to hide in the basement.

"We didn't want to come up," Kevin recalls. "We were forced into it. They said, 'Come up,' so we came up."

"I wound up being Mr. Polite," John says, recalling the stiff encounter. Kevin remembers that Dr. Money asked "general questions" about how the twins were doing in school. Kevin asked how Dr. Money liked their city and how long he was staying. "Then," Kevin says, "we wanted to go." But before the two retreated back into the basement, Dr. Money pulled out his wallet and, saying something about how he would have spent the money on a hotel room anyway, bestowed on the children $15 each. The kids fled to the basement and did not emerge until the next morning, when the world-famous sexologist had left for the airport. It was the last that the family and Dr. Money would ever see of each other.

By the time she turned 14, in August 1979, Joan had been on female hormones for almost two years. But the drugs were now in competition with her male endocrine system, which, despite the absence of testicles, was now in the full flood of puberty - a fact readily apparent not only in her loping walk and the angular manliness of her gestures, but also in the dramatic deepening of her voice, which, after a period of breaking and cracking, had dropped into its current rumbling register. Physically, her condition was such that strangers turned to stare at her (as was noted by her therapist in contemporaneous clinical notes). But to the close observer, it was Joan's mental state that would have drawn particular scrutiny and pity. For as photographs from this period reveal, Joan, for all her attempts to drag a smile onto her face, had the wounded eyes of a shamed and hunted animal.

It was at this point that Joan took the matter of her sexual destiny into her own hands and simply stopped living as a girl. Therapy notes from November 1979 reveal that she refused to wear dresses and now favored a tattered jean jacket, ragged cords and work boots. Her hair was unwashed, uncombed and matted. "I was at that age where you rebel," John says. "I got so sick to death of doing what everyone wanted me to do. I got to that point in my life, I knew I was an oddball, I was willing to live my life as an oddball.... If I wanted to wear my hair in a mess, I wore it in a mess. I wore my own clothes the way I wanted to."

And Joan had more private ways of rebelling. Since childhood she had been instructed, both by her parents and by her doctors, to urinate in the sitting position - despite a strong, overriding urge to address the toilet standing up. For years she had tried to adhere to this stricture on her bodily function. But no longer. "If no one was around, I'd stand up," John recalls. "It was no big deal; it was easier for me to do that. Just stand up and go. I figured, what difference did it make?"

But it made a difference to her peers. That fall, Joan had transferred to a technical high school, where she enrolled in an appliance-repair course. There she was quickly dubbed Cave-woman and Sasquatch and was openly told, "You're a boy." But it was her inclination to urinate in the male posture that caused the greatest friction between her and her schoolmates. The girls barred her from using their bathroom. She tried sneaking into the boys' room but was kicked out and threatened with a knifing if she returned. With nowhere else to go, Joan was reduced to urinating in a back alley. By December, she simply refused to go to school.

By now, it was impossible for the local treatment team to ignore the obvious. After almost four years of fruitlessly trying to implement Dr. Money's plan, several physicians experienced a change of heart. Among those who believed that Joan would never submit to vaginal surgery was Dr. McK., a particularly empathetic female psychiatrist, then in semi-retirement, who had taken over Joan's case in the winter of 1979. Joan's endocrinologist, Dr. W., was among the last holdouts for the surgery, since he remained certain that it was the appearance of Joan's uncompleted vagina that formed the stumbling block to her psychological acceptance of herself as a girl. But now, even he began to waver. "Early on I had . . . pushed for early surgery," he wrote in a letter to Dr. McK. "I am not as convinced now that this is a good idea and therefore at the present time have no specific plans or opinions as to the proper time for the operation."

Ultimately, Joan forced the endocrinologist to come down off the fence. During an appointment in his office, Joan refused to remove her hospital gown for a breast exam. The doctor asked again. She refused. The standoff lasted 20 minutes. "It comes to a point in your life where you say, 'I've had enough,' " John says. "There's a limit for everybody. This was my limit."

But Dr. W. had reached his limit, too. "Do you want to be a girl or not?" he demanded. It was a question Joan had heard before - a question that Money had been asking her since the dawn of her consciousness, a question the local doctors had badgered her with for four years, a question she'd heard once too often.

She raised her head and bellowed into his face: "No!"

The doctor left his office for a moment, then returned. "OK," he said. "You can get dressed and go home."

Only later would John learn that Dr. W. had, in stepping out into the hallway, spoken with Dr. McK. He told her that in his opinion, it was time that the teenager was told the truth of who she was and what had happened to her.

It was Frank's custom to pick up Joan in the car after her weekly sessions with the psychiatrist. The afternoon of March 14, 1980, was no exception. But when Joan climbed into the car that day, Frank said that instead of driving straight home, they should get an ice-cream cone.

Immediately, Joan was suspicious. "Usually, when there was some kind of disaster in the family, good old dad takes you out in the family car for a cone or something," John says. "I was thinking: 'Is mother dying? Are you guys getting a divorce? Is everything OK with Kevin?' "

"No, no," Frank said to Joan's nervous questioning. "Everything's fine."

And, indeed, he couldn't find the words to explain until Joan had bought her ice cream and Frank had pulled the car into the family's driveway.

"He just started explaining, step by step, everything that had happened to me," John says.

"It was the first time," Linda says, "that John ever saw his father cry."

Joan herself remained dry-eyed, staring straight ahead through the windshield, the ice-cream cone melting in her hand.

"She didn't cry or anything," Frank says almost two decades after this extraordinary encounter between father and child. "She just sat there, listening, real quiet. I guess she was so fascinated with this unbelievable tale that I was telling her."

Today, John says that the revelations awoke many emotions within him anger, disbelief, amazement. But he says that one emotion overrode all the others. "I was relieved ," he says, blinking rapidly, his voice charged. "Suddenly it all made sense why I felt the way I did. I wasn't some sort of weirdo."

Joan did have a question for her father. It concerned that brief, charmed span of eight months directly after her birth, the only period of her life that she ever had been, or ever would be, fully intact.

"What." she asked. "was my name?"

Joan's decision to undergo a sex change was immediate. She changed her name to John and demanded male-hormone treatments and surgery to complete her metamorphosis back from girl to boy. That fall, he had his breasts surgically excised; the following summer, a rudimentary penis was constructed. The operation was completed one month prior to his 16th birthday.

Socially, John says, it proved relatively easy to effect the change to his true status. Joan's lifelong social rejection had guaranteed that no one had ever gotten close enough to her to remark on her sudden vanishing. Still, John did take the precaution of lying low for several months in his parents' basement. "Watching TV, that's all I did," says John. "I wasn't really happy; I wasn't really sad." But gradually he began to emerge, hanging out at the local fast-food joints, the roller rink and bars with Kevin and his friends, who immediately accepted him as one of the guys.

It was in John's relations to girls that complications developed - and they were only exacerbated by the fact that by age 18 he was not merely a passably attractive young man but an arrestingly handsome one. His sudden popularity with what was now the opposite sex introduced a terrible dilemma, because he knew that his penis neither resembled nor performed like the real thing (it was incapable of becoming erect). "How do you even start dating?" John says, recalling this period of his life. "You can't . You're in such an embarrassing situation. At the same time, if you're not honest with them . . . they're gonna want to start getting frisky with you."

Eventually, he did date a girl two years his junior, a pretty but flighty 16-year-old. Several months into the relationship, John entrusted her with his secret, telling her that he had suffered an "accident." Within days, John says, "everyone knew." Just as in his childhood, he was suddenly the object of muttered comments, giggling, ridicule. Days later, he swallowed a bottle of anti-depressants and lay down on his parents' sofa to die. His parents discovered him unconscious. "Me and Linda looked at each other," Frank recalls, "and we were wondering if we should wake him up."

Linda recalls her doubts: "I said to Frank, 'I wonder if we should just leave him, because that kid has done nothing but suffer all his life. He really wants to die.' Then I said, 'No, no, I can't let him die. I have to try to save him.' " They lifted him and rushed him to the hospital, where his stomach was pumped. On his release a week later, he tried it again. This time, Kevin saved him.

John withdrew from the world. He spent sojourns of up to six months at a time alone in a cabin in the woods, winter or summer. Unable to face people, he fantasized about committing a crime that would land him in solitary confinement for the rest of his days. "I despised myself; I hated myself," he says. "I hated how my life turned out. I was frustrated and angry, and I didn't know who I was angry at."

At age 21, he underwent a second operation on his penis that yielded a significant improvement over his first phalloplasty (his penis resembled a real one, and nerve grafts from his arm supplied the organ with sensation), but it would be two years before John used it for sex. The delay had less to do with his feelings of confidence about his penis, he says, than with the legacy of what had been done to him by Dr. Howard W. Jones in the operating room at Johns Hopkins when he was 22 months old. "I kept thinking, 'What am I going to say to the woman I meet who I want to marry?' " John remembers. " 'What am I going to say to her when she says she wants children and I can't give her children?' "

His brother, Kevin, had by that time married and become a father - everything that John had wanted for himself since high school. "I got so terribly lonely," John says. "I decided to do something I'd never done before. I wound up praying to God. I said, 'You know, I've had such a terrible life. I'm not going to complain to you, because you must have some idea of why you're putting me through this. But I could be a good husband if I was given the chance; I think I could be a good father if I was given a chance.' "

Two months later, Kevin and his wife introduced John to a young woman they had met. At age 26, she was three years John's senior - a pretty, loving single mother of three children by three separate fathers. "By the time I met John," she says with a rueful laugh, "I'd come to the end of my rope with men. I kept trusting them - then it was, 'You're pregnant? I'm out of here.' " She says that John's condition did not make a difference to her. "It probably would have if I didn't already have kids. But after what I'd been through with men, I figured, 'What does it matter what he's got between his legs? If he's good to me and the kids that's all that matters.' "

The two immediately hit it off. She liked John's old-fashioned gallantry. "He still sends me flowers and writes me notes," she says. "How many people have that after nine years together?" John fell in love with what he calls her "true heart."

Less than a year after they started going out, John asked her to marry him. She accepted, and when John was 25, they wed. John landed a well-paying factory job, bought a house in a trim and tidy middle-class neighborhood near his parents, and settled down with his wife and three adopted children into a life of domestic anonymity.

For years, Keith Sigmundson had been seeing the advertisements. They appeared like clockwork every year in the American Psychiatric Society Journal , and they always said the same thing: "Will whoever is treating the twins please report." Below this entreaty was always the same address: Dr. Milton Diamond, University of Hawaii. "I would see it," Sigmundson says, "but I couldn't bring myself to answer."

In the past, Sigmundson himself had toyed with the idea of publishing the true outcome of John's case. But he hadn't done it - and for a very simple reason. "I was shit-scared of John Money," he admits. "He was the big guy. The guru. I didn't know what it would do to my career." So he would put the idea out of his head. Diamond's annual ad was an awkward reminder. A couple of times, he'd almost answered it. But he'd always resisted the urge.

Diamond, however, was not one to give up so easily. At 63, he's a sad-eyed man with the white beard of a scholar, his intensity hidden behind soft-spokenness. Diamond is the author of more than a hundred journal articles and eight books on sexuality. The majority of Diamond's time in Honolulu during the past 30 years has been spent hunched over his computer in the cluttered, windowless office he calls his "cave," his work habits obvious to anyone who has seen his pale skin. It was from his cave that Diamond, in early 1991, decided to redouble his efforts to locate, and learn the fate of, the famous twins. That spring, he managed to track down Dr. M., the psychiatrist who had treated Joan Thiessen almost 21, years earlier. She had moved from the Thiessens' hometown soon after referring Joan to a new psychiatrist and thus knew nothing of the girl's sex change. She did, however, offer to give Diamond a phone number for the man who had overseen Joan's psychiatric treatment: Keith Sigmundson.

"It's funny," Diamond says with a chuckle, "I remember the first words Sigmundson said to me [when I called]. It was to the effect of, 'I was wondering how long it would take for you to get here.' "

Sigmundson shakes his head at the memory of the call he'd been half hoping for, half dreading

"Mickey said, 'Keith, we gotta do this,' " Sigmundson recalls. "I said, 'Well, I haven't really got the time and the energy....' So Mickey kept on badgering me a little bit."

As someone who had himself seen firsthand the disastrous results of a so-called "successful" sex reassignment, Sigmundson was inclined to agree with Diamond's argument that the procedure is wrongheaded. But Sigmundson admits that some of his reservations about joining Diamond in a long-term follow-up on John's case derived from colleagues who had warned him that Diamond was a "fanatic" with an ax to grind regarding Dr. Money. Further conversations with Diamond, and a reading of his journal articles on sexual development, convinced Sigmundson otherwise: "I came to see that Mickey is a serious researcher and a caring guy who really believed that Money's theory had caused - and was continuing to cause - great harm to children." Sigmundson agreed to contact John Thiessen and to ask if he would be willing to cooperate with a follow-up article on his case.

By then, John had been married for two years and wanted nothing more than to put his tortured past behind him. He, at first, refused to participate. But in a later meeting with Dr. Diamond - who flew in from Hawaii, John learned, for the first time, about his fame in the medical literature and how his reportedly successful switch from boy to girl stood as the precedent upon which thousands of sex reassignments had since been performed - and continued to be performed at an estimated rate of five a day globally. "There are people who are going through what you're going through every day," John recalls Diamond telling him, "and we're trying to stop that."

That was good enough for John. In the spring of 1994, and over the course of the following year, John, his mother and his wife sat for a series of interviews with Diamond and Sigmundson in which they recounted John's harrowing journey from boy to girl and back again. Using these interviews, plus the detailed clinical records that Sigmundson had kept on Joan's case, Diamond wrote up the results in a paper in which John's life was cast as living proof of precisely the opposite of what Money had said it proved 25 years earlier. Diamond wrote that John's case is evidence that gender identity and sexual orientation are largely inborn, and that while rearing may play a role in helping to shape a person's sexual identity, nature is by far the stronger of the two forces so much so that even the concerted 12-year efforts of parents, psychologists, psychiatrists, surgeons and hormone specialists could not override it.

The paper, powerful as it was as anecdotal evidence of the neurobiological basis of sexuality, was also a clear warning to physicians about the dangers of sexual reassignment - and not just for children like John, who are born with normal genitals. Diamond argued that the procedure is equally misguided for intersexual newborns, since physicians have no way of knowing in which direction, male or female the infant's gender identity has differentiated. To stream such children, surgically, into one sex or the other, Diamond argued, is guesswork that consigns a large percent of them to lives as tortured as John Thiessen's.

It took nearly two years for Diamond and Sigmundson to find a publisher for their paper. "We were turned down by all these journals that said it was too controversial," says Sigmundson. " The New England Journal, American Psychiatric, American Pediatric. " The article was finally accepted for publication by the American Medical Association's Archives of Adolescent and Pediatric Medicine in September 1996, with publication set for March 1997. In the intervening seven months, Diamond and Sigmundson felt considerable apprehension as they waited for their bombshell to go off. "We were basically telling all these physicians that they'd been doing the wrong thing for the past 30 years," Sigmundson says. "We knew we were going to be pissing a lot of people off."

They were not wrong. One pediatric endocrinologist who has attended medical meetings on the subject since the article's publication has reported that the discussions cannot even be termed debates: "It's like screaming fights in these medical conventions at the moment." Some critics of the article have attempted to dismiss it on the grounds that Diamond is simply using John's history to embarrass a scientific rival. But Dr. Melvin Grumbach, the eminence grise of pediatric endocrinology, offers a more measured response. "I think Diamond does have a case," he says. "I think testosterone in utero and an XY-chromosome constitution does do things to you. But the question is: Is it invariable ?"

Grumbach points out that sex reassignment is always done as a last resort and only when every other treatment option has been ruled out. And while he admits that sex reassignments are not foolproof, Grumbach insists that they can, and do, work "with good support." But asked to offer up a "satisfied customer," Grumbach voices the Catch-22 of every pediatric specialist contacted for this article. "I really lose track of all my patients after young adulthood," he says.

Astonishingly, in the four decades since the first sex reassignments were performed, no comprehensive, long-term follow-up study of the patients has ever been conducted. Such a study was, finally, launched at the Johns Hopkins medical center in June 1995. Child psychiatrist (and former pediatric urologist) Bill Reiner has been following the lives of 16 reassigned people, focusing on six genetic males who were born without penises, castrated in infancy and raised as girls. Two years into his study, Reiner says that all six are closer to males than to females in attitudes and behavior. Two have spontaneously (without being told of their XY male chromosome status) switched back to being boys. "These are children who did not have penises," Reiner points out, "who had been reared as girls and yet knew they were boys. They don't say, 'I wish I was a boy,' or 'I'd really rather be a boy,' or 'I think I'm a boy.' They say, 'I am a boy.' " Reiner (who wrote a supportive editorial to accompany Diamond and Sigmundson's John/Joan paper) points to the parallel between the children he is studying and Joan Thiessen, who also "knew," against all evidence to the contrary, that she was a he.

Reiner says that both the John/Joan case and the trend in his study support the findings that have emerged since Diamond's early-1960s research into the neurobiological origins of gender identity and sexual orientation. A 1971 study done at Oxford University showed anatomical differences between the male and female brain in rats - and six years later, at UCLA, researchers narrowed these differences to a cluster of cells in a gland in the brain called the hypothalamus. A study done in the mid-l980s in Amsterdam located the corresponding area in the human hypothalamus, noting that it is twice as large in homosexual men as it is in heterosexual men. Further studies done by others in the early 1990s support this finding. Then, in 1993 and again in 1995, researcher Dean Hamer announced a breakthrough on the genetic front: He was able, in two separate studies of gay male brothers, to find a certain distinctive pattern on their X chromosomes. The finding suggests that male homosexuality may have a genetic origin.

While many of these studies still need to be replicated, few sex researchers today dispute the mounting evidence of a strong inborn bias for sex and sexuality. "Which is why," Reiner says, "I have been advising physicians to be very prudent when prescribing sex reassignment for infants. Because it's quite clear that the vast majority of boys born with functioning testicles have masculine brains." Reiner endorses Diamond and Sigmundson's recommendation (published in a recent journal article) that in cases of injury or intersexuality, the assignment of sex be made socially, in terms of hair length, clothing and name, but any irreversible surgical intervention be delayed until the children are old enough to know, and are able to say, which gender they feel closest to. "We have to learn to listen to the children themselves," Reiner says. "They're the ones who are going to tell us what is the right thing to do."

Well before Diamond and Sigmundson's journal article appeared in the Archives of Adolescent and Pediatric Medicine last March, the American Medical Association's PR department alerted the media that something explosive was coming. "The AMA knew it was a big deal," Diamond says, "so they notified the big newspapers in advance." On the day of the article's publication, the New York Times ran a front-page story headlined SEXUAL IDENTITY NOT PLIABLE AFTER ALL, REPORT SAYS, which described John Thiessen's life as having "the force of allegory." Time (24 years after publishing news of the case's success) now ran a story declaring, "The experts had it all wrong." Similar news accounts appeared around the world - and soon Diamond was deluged with calls from reporters in several countries seeking interviews with the young man now known simply as John/Joan.

I met John for the first time in New York City in June 1997. Dr. Diamond, with whom I had spent months corresponding and whom I had visited in Hawaii, made the introduction. At that first meeting, John spoke bluntly about his difficulty in trusting strangers, but he quickly decided to talk to me for publication. His decision was based on his desire to warn people about the perils of infant sex reassignment. Over a beer at the Hard Rock Cafe on 57th Street, he began our conversation by telling me that he owes his survival to his family, his sole comfort in a childhood that he called "a pit of darkness." But a formidable sense of humor also clearly played a role in John's ability to rise above his sufferings. Describing the physical differences between him and his heavier, slightly balding twin, he shouted over the pounding music: "I'm the young, cool Elvis. He's the fat, old Elvis." But the strongest impression I was left with after that first meeting was of John's intense, unequivocal masculinity. His gestures, walk, attitudes, tastes, vocabulary - none of them betrayed the least hint that he had been raised as a girl. And, indeed, when asked whether he thought that his extraordinary childhood had given him a special insight into women, he dismissed the question. Like the sex-reassigned boys in Reiner's study, John had apparently never been a girl - not in his mind, where it counts.

John's story, as told by Diamond and Sigmundson, loosed a flood of coverage on television and in magazines and newspapers on the heretofore unexamined phenomenon of infant sex reassignment. With this coverage, another set of voices in the debate began to be heard. These are the voices of those intersexes born after the publication of Money's 1955 protocols. Once cloaked in shame and silence, they had already begun to emerge, largely because of the efforts of one person: a San Francisco activist named Cheryl Chase.

Like John Thiessen, Chase was then raised without knowledge of her true birth status (though her entire family knew). Thus, like John, she suffered a childhood punctuated with mysterious, unexplained surgeries and genital and rectal exams. Also like John, she grew up confused about her gender. "I was more interested in guns and radios," Chase says, "and if I tried to socialize with any kids, it was generally boys, and I would try to physically best my brother." As a pre-adolescent, she recognized that her erotic orientation was toward females.

At 19, Chase understood that she'd been subjected to a clitoridectomy. She began an investigation into her medical history but was thwarted by her doctors, who refused to reveal her past. It took three years for her to find a doctor who would show Chase her medical records. Only then did she learn that she had been born a "true hermaphrodite" - a person with both ovarian and testicular tissue - and that the operation she had undergone at age 8 (to relieve "stomachaches") had actually been to cut away the testicular part of her gonads.

Horrified and angered at the deception perpetrated upon her, and aggrieved at the loss of her clitoris, which has rendered her incapable of orgasm, Chase began to seek out others like her for emotional support. Through Internet postings and mailings, she established a network of intersexes in cities across the country and, in 1993, dubbed the group the Intersex Society of North America, a peer-support, activist and advocacy group.

To meet with Chase and members of ISNA - as I did last spring, when they held a peaceful demonstration outside Columbia Presbyterian Hospital, in New York, where Chase's clitoral amputation was conducted - is to enter a world where it is impossible to think of sex with the binary, boy-girl, man-woman distinction we're accustomed to. There's Heidi Walcutt (genetically female but born with uterine, ovarian and testicular tissue and a micropenis, she describes herself as a "true American patchwork quilt of gender") and Martha Coventry, who was born with a penis-sized clitoris but a fully functioning female reproductive system and is the mother of two girls. Kira Triea was assigned as a boy at age 2 and did not learn of her intersexuality until puberty, when she began to menstruate through her phallus. She was a patient of Dr. Money's at the Johns Hopkins Psychohormonal Research Unit from age 14 to 17; this was in the mid-1970s, concurrent with John Theissen.

They have never met, but Triea's story bears striking parallels to his. She describes how Dr. Money, evidently attempting to ascertain whether she had assumed a male or female gender identity, questioned her about her sex life - in the frank language for which he was well known. "Have you ever fucked somebody?" she remembers Dr. Money asking. "Wouldn't you like to fuck somebody?" She also describes how Dr. Money showed her a pornographic movie. "He wanted to know who I identified with in this movie," she says. Contrary to Money's theory that an intersex reared as a boy will likely develop a male gender identity, Triea's sexuality and sense of self were far more complicated than that. At 17, she agreed to undergo feminizing surgery to create female genitals, but when she became sexually active for the first time, at age 32, her erotic orientation was toward women.

Impossible to classify as simply male or female, Chase and her colleagues want to, she says, "end the idea that it's monstrous to be different."

Chase emphasizes that ISNA's aim is to abolish all cosmetic genital surgery on infants - whether it be the full castration and sex reversal of microphallus boys or the supposedly less intrusive process of reducing a girl's enlarged clitoris. Chase says that such procedures are equally invasive. She denounces as "barbaric" the medically unnecessary treatments on newborns, who are not in a position to authorize surgery that may have an irreversible effect on their erotic or reproductive functioning. And Chase strongly endorses Diamond and Sigmundson's new recommendation against operating on newborns with ambiguous genitalia.

The medical establishment, she says, has shunned ISNA. According to Chase, she has tried for six years to gain an audience with the leading pediatric endocrinologists and surgeons at Johns Hopkins and elsewhere. They have refused to speak to her. Indeed, in a 1996 New York Times article on Chase and ISNA, Dr. John Gearhart, head of pediatric urology at Hopkins, dismissed the group as "zealots." In a conversation with me, he addressed ISNA's complaints. He maintained that sex reassignment is a viable option for boys who are born with micropenises or who lose their penises to injury although he adds that advances in penile reconstruction make him more hesitant to recommend the procedure today. "If John/Joan happened today," he says, "I would sit down with those parents and say, 'The child has testicles; it's a normal male child; and we can now make penises, and they're pretty functional and pretty cosmetic' - and I would probably not give them the option. I would suggest that you could change the child's gender, but I would not recommend that, because reconstructive genital surgery has come light years since John/Joan's accident."

Gearhart insists that advances in medicine render ISNA's concerns obsolete. "When these people in ISNA were operated on, 25 and 30 years ago, there weren't really children's reconstructive surgeons around," he says. "So most of [these babies] had their clitoris or their penis amputated. That was wrong. OK? That was wrong. But the surgeons didn't know any better. Nowadays, people in modern reconstructive surgery are not cutting off little babies' clitorises or penises, or anything along those lines." Gearhart says that modern microsurgery retains sensation. "And if sensation is important to orgasm," he says, "then we retain orgasm."

Chase disputes this and says that Gearhart's electric-diagnostic test of sensation, which is administered immediately following genital surgery, doesn't prove anything. "How this [test] relates to sexual function 15, or 20 years later is anybody's guess," she says.

Chase says she understands why the medical establishment has resisted listening to ISNA. As she once wrote: "Our position implies that they have unwittingly at best and through willful denial at worst - spent their careers inflicting a profound harm from which their patients will never fully recover." So she does not expect doctors like Gearhart to change their views unless forced. "I think a context will open up for surgeons who keep doing this to be vulnerable to lawsuits," Chase says. "But it's going to take a while to create that context. Right now, we can't sue, because it's standard practice and parents give permission. The first thing that we want to have happen is that when they recommend this to parents, they tell them it's experimental and there's no evidence that it works and that there's plenty of people who've had it done to them who are mad as hell."

Other large changes will have to take place. Anne Fausto-Sterling, an embryologist at Brown University, endorses Diamond and Sigmundson's recommendation for delaying surgery but says that the medical establishment will have to provide education and emotional support to help parents with the difficult task of raising an infant whose genitals are atypical.

"A different kind of support system has to start getting built," Fausto-Sterling says. "At the moment there is no ongoing counseling done by people skilled in psychosexual development." Currently, she points out, counseling is done neither by experts trained in gender issues or psychology nor by intersexual peer-support counselors - it's handled by surgeons or endocrinologists, who conduct only cursory follow-up exams once a year. "If there was really a wholesale change in this," she continues, "the medical profession would have to do something like what they've done with genetic counseling - which is to develop a specialty of people who would work with these families long-term and help them resolve both emotional and practical questions. The practical questions are very real: 'What do I do when it comes to undressing in gym? How do I intervene with the school system?' There are a lot of things that have to happen to make what I'm arguing or Cheryl's arguing or Mickey's arguing work. There's a different infrastructure that has to get built and put into place. I think it's the responsibility of the medical profession to do it."

Now 76 years old and in semi-retirement, John Money has nevertheless remained a prolific and opinionated writer on the subject of sex and sexuality. His latest book, called Principles of Developmental Sexology , came out this year. Through the 1980s, his books and articles continued to appear with regularity - although his later work showed a shift from his earlier extreme position on the primacy of rearing over biology in the making of boys and girls. Indeed, in a May 1988 Psychology Today profile publicizing the publication of his book Gay, Straight and In-Between , Money characterized himself as a longtime champion of the role of biology in psychological sex differentiation. Money is quoted saying that in the 1950s, when he was publishing papers on the behavioral influence of prenatal sex hormones, "many people in various branches of the social sciences were just enraged at the idea that hormones in the bloodstream before you were born could have a sex-differentiating influence on you." In the same article, Money reiterated his claim that male babies with undeveloped penises and fully formed testicles can, with surgery and hormone treatment, be turned into heterosexual women.

To the many news organizations that requested comment from Money about the now-infamous John/Joan case, the psychologist refused to speak, citing confidentiality laws.

But he did speak with me briefly on the phone in early November, after six months of appeals. Though he refused to discuss John Thiessen directly, Money claimed that the media's reporting of the case has reflected a conservative bias. "It's part of the antifeminist movement," he said. "They say masculinity and femininity are built into the genes, so women should get back to the mattress and the kitchen." As to his failure to report the case's outcome, Money was unapologetic, saying that he had lost contact with the Thiessens when they did not return to Johns Hopkins and that the opportunity to conduct a follow-up had been denied to him. He stood by his original reporting of the case and dismissed my suggestion that he "misperceived" what was going on with the child. Furthermore, he implied that John's sex change to male at age 15 may not have been entirely his own decision. "I have no idea," Money said, "how much he was coached in what he wanted, since I haven't seen the person." He also hinted that the Diamond-Sigmundson paper had a hidden agenda. "There is no reason I should have been excluded from the follow-up, was there?" he asked. "Someone had a knife in my back. But it's not uncommon in science. The minute you stick your head up above the grass, there's a gunman ready to shoot you." (Diamond insists that there was "nothing personal" in his decision to publish the outcome of John's case.)

When I asked Money about Diamond's appeal to delay surgery on intersexual babies until they are old enough to speak for themselves, Money emphatically rejected the idea. "You cannot be an it," he declared, adding that Diamond's recommendations would lead intersexes back to the days when they locked themselves away in shame or worked as circus freaks.

I reminded Money that his book Man Woman, Boy Girl is still in print and that it reports the John/Joan case as a success. Asked if it would not be worthwhile for him to make changes in the text for a future edition, Money said flatly, "I'll be dead by then."

John Thiessen's final contact with Dr. Money was almost 20 years ago, when the famous sexologist slipped him $15 in his parents' living room. In the intervening years, John has often imagined what he might say, or do, to the psychologist if they were ever to meet face to face. As a younger man, his fantasies, he admits, ran to violence. But no more. "What's done," John says, "is done." He refuses to dwell on a past that he cannot change. In their paper, Diamond and Sigmundson describe John as a "forward-looking person." In conversation, Diamond calls him a "true hero." John's life today defies the dire prognosis of the local psychiatrist who, 31 years ago, declared that John would never marry and "must live apart." John's second phalloplasty allows him to have intercourse with his wife, and he is a strict but loving father to their three children, ages 15, 12 and 9. He has even mustered the emotional maturity to tell his eldest child about his painful history. And he prefers to focus on the positive changes that have resulted from his speaking out in public. For despite the brave four-year efforts of Cheryl Chase, despite the 30 years that Mickey Diamond spent trying to warn the medical establishment about the dangers of the current protocols for treatment of ambiguous or injured genitals, and despite the long-term follow-up of sex-reassigned youngsters in Bill Reiner's study, the medical establishment remained unwilling to address the issue until John went public.

His story has shaken to its foundations the edifice constructed on John Money's theories from the 1950s. And it has exposed a central flaw in a theory that has held sway for most of the 20th century. It was Sigmund Freud who first stated that a child's healthy psychological development as a boy or a girl rests largely on the presence, or absence, of the penis - the notion central to Money's theory of sexual development and the ultimate reason that John Thiessen was converted to girlhood in the first place. It is a notion that, today, has also been called into question by neurobiological research that, in the sexual realm, is leading scientists toward the conclusion that, as Dr. Reiner puts it, "the most important sex organ is not the genitals; it's the brain."

John Thiessen puts it another way when he speaks of his pride in his role as husband, father and sole breadwinner in the family that he never believed he would be lucky enough to have. "From what I've been taught by my father," he says, "what makes you a man is: You treat your wife well. You put a roof over your family's head. You're a good father. Things like that add up much more to being a man than just bang bang bang - sex. I guess John Money would consider my children's biological fathers to be real men. But they didn't stick around to raise the children. I did. That, to me, is a man."

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APA Reference Staff, H. (2007, August 9). The True Story of John / Joan, HealthyPlace. Retrieved on 2024, September 9 from https://www.healthyplace.com/gender/inside-intersexuality/the-true-story-of-john-joan

Medically reviewed by Harry Croft, MD

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Title: Mythbuster: The scientist who exposed the greatest sexology hoax of the 1970s is back

Author: Jocelyn Guest

Published in: www.nerve.com/regulars/lifeswork/miltondiamond

When David Reimer was born in 1965, he looked exactly like his identical twin brother, Brian – until his circumcision was botched at birth, and his entire penis had to be amputated. Dr. John Money, a sexologist at Johns Hopkins known for conducting audacious human experiments, heard of the mishap and jetted in. With David now neither anatomically male nor female (and his identical twin providing the perfect control group), Money saw an opportunity to prove his theory that gender was entirely a cultural construct. He convinced David's parents to give him sex-reassignment surgery and raise him as a girl named Brenda. In the following years, under Dr. Money's supervision, Brenda appeared to take to femininity naturally, completely unaware he'd ever been male.

Money instantly became famous for proving that gender was merely a state of mind. The number of sex-change surgeries skyrocketed, and feminists trumpeted the experiment as proof that women were equal to men. But as she got older, Brenda was plagued with confusion. She couldn't put her finger on why, but she knew she felt like a boy. By age fourteen, her voice was deepening and her features were becoming masculine. She related to boys as friends and felt sexually attracted to girls. But Dr. Money had stopped following her development. Brenda grew up and fell out of the public eye, the widespread belief that gender was non-biological firmly in place.

That belief might still be gospel today if not for a scientist in Hawaii named Dr. Milton Diamond, who had been following what became known as the "John/Joan experiment" since Dr. Money announced it. Suspicious of its merits, Diamond tracked down the now-adult Brenda in the mid-'90s. After studying and interviewing her extensively, he concluded that she was essentially a man trapped in a woman's body. Diamond published a paper in 1997 exposing the experiment as a failure and a hoax. Dr. Money was accused of a cover-up, and the takedown rocked the medical world. The New York Times , which twenty-four years earlier had called Money's experiment the most important leap forward in sexology since the Kinsey Report, ran a page-one reversal declaring that Brenda's life a woman was based on "the force of allegory." After learning about her past, Brenda had a second sex-change operation and changed her name to John. He married and lived quietly as a man again for several years, but committed suicide in 2004. Dr. Money, who continued to experiment and publish as a sexologist for years, died last July, one day shy of his eighty-fifth birthday.

Diamond, 72, continues to work in the field, conducting new and groundbreaking studies. His latest project has taken him to Japan and Croatia, where he's been studying the effects of porn on sexual violence and aggression. His findings seem to deflate the theory that porn leads to an increase in sex crimes. He spoke to Nerve from his home in Hawaii about those studies, and his legacy as a debunker of myths. — Jocelyn Guest

Everyone knows you for your role in exposing the John/Joan experiment as a failure. It's been almost ten years since you did that.

It has been a long time. With that case, it was so sad to see a young man manipulated like that. In that kind of situation, you find something out and want to set it right.

Do people come to you now asking for help regarding sex changes?

Yeah, of course, all the time. They come for advice and for guidance. I really believe that counseling is a big part of any sex-reassignment process.

What kind of counseling?

Every patient is required to undergo two years of psychiatric counseling. I always tell my patients, "Okay, if you want to be a man, do it. Try it out. Dress as a man when you go to work, when you go to school and get on the bus." Some people won't do it, and you know they're not serious about it.

In addition to debunking a study that the feminist movement had embraced, you've also had public spats with people like Germaine Greer. Do you always find yourself butting heads with feminists?

The feminists who have criticized my work just don't understand what I do. Judith Butler and others were all very supportive of John Money because he was saying what they wanted to hear. He was saying that, if you start early enough, a boy can be socialized as a girl. But he wasn't accounting for pre- and perinatal hormones, which predispose babies to act characteristically male or female. It isn't just about giving them a pink or blue blanket.

I don't think that everyone is the same. These feminists who criticize me think I'm saying everyone is hard-wired to be one way or another. That's not what I'm saying. I just believe you can't rely on how you raise a child to determine whether he's a boy or a girl. If there are two people training together for an event, for the same amount of time and the same routine, the man would probably win. It's just the physical nature of things.

Do you consider yourself a feminist?

Of course! I have six daughters and a wife. How could I not be?

Let's talk about your porn studies in Japan and Croatia.

We studied the frequency of sex crimes after there was a loosening of laws about pornography. In Japan there are zero restrictions. A kid can pick up a comic book with explicit S&M scenes on every page. People always point a finger at porn for promoting sexual violence, but that just isn't the case. Some crimes actually went down when porn laws were relaxed.

What about the studies surprised you?

In Japan, we thought the increased availability of porn would negatively affect younger rapists. Just the opposite was true though. Rape isn't a solely sexual act, and porn can even help people deal with their urges.

Is there good porn and bad porn?

Not at all. Having different kinds of porn is just like giving someone a choice of different breakfast cereals in the morning. People watch porn for different reasons because different things are pleasurable to them.

These days you write a lot about the importance of sex ed and how ridiculous George Bush is for pushing abstinence-only programs. Did you have any sex education?

I'm a very old man. They didn't teach us that in those days.

What did you do then?

Do you mean how did I learn how to screw? [ laughs ] We just sort of figured it out. If you wanted to find out about sex, you went to a prostitute or to your friends, and of course, most of your friends didn't know any more than you did. The problem with today's education is very simple in my mind. The Bush administration is making it illegal to teach anything but abstinence in the classroom. That's as ridiculous as teaching someone to drive without telling them where the brake is.

Because what happened with David Reimer still occurs — often at the suggestion of the doctor — what do you think it will take to keep doctors from telling parents to hide the sex of their children?

The law. It has to be the law. Until there is legislation protecting newborn children with ambiguous genitalia, doctors will continue to compromise the health of these children. These parents are scared of disappointing the child's grandparents or being embarrassed in front of the nanny, but they're doing serious damage to their children. They will never be able to experience orgasm, never be able to fully live their lives.

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David Reimer, 38, Subject of the John/Joan Case

By The Associated Press

• May 12, 2004

Correction Appended

David Reimer, a man who was born a boy but raised as a girl in a famous medical experiment, only to reassert his male identity in the last 20 years of his life, died on May 4. He was 38. His family says he committed suicide.

Mr. Reimer shared his story about his life in the pages of a book and on Oprah Winfrey's television show.

His mother, Janet Reimer, said she believed that her son would still be alive had it not been for the devastating experiment, which led to much emotional hardship.

''He managed to have so much courage,'' she said Sunday. ''I think he felt he had no options. It just kept building up and building up.''

After a botched circumcision operation when he was a toddler, David Reimer became the subject of a study that became known as the John/Joan case in the 60's and 70's. His mother said she was still angry with the Baltimore doctor who persuaded her and her husband, Ron, to give female hormones to their son and raise him as a daughter.

As he grew up as Brenda in Winnipeg, he faced cruelty from the other children. ''They wouldn't let him use the boys' washroom or the girls','' Ms. Reimer recalled. ''He had to go in the back alley.''

His sexual reassignment was then widely reported as a success and proof that children are not by nature feminine or masculine but through nurture are socialized to become girls or boys. David's identical twin brother, Brian, offered researchers a matched control subject.

But when, as a teenager, he discovered the truth about his past , he resumed his male identity, eventually marrying and becoming a stepfather to three children.

In 2000, John Colapinto wrote ''As Nature Made Him: The Boy Who Was Raised as a Girl,'' providing David an opportunity to tell his story. He wanted to save other children from a similar fate, his mother said.

While he had spoken anonymously in the past, he entered the public eye after the book was published, beginning with an appearance on ''Oprah'' in February 2000.

His mother said he had recently become depressed after losing his job and separating from his wife. He was also still grieving over the death of his twin brother two years earlier, she said.

Correction: May 18, 2004, Tuesday Because of an editing error, an erroneous credit appeared on Wednesday on the obituary of David Reimer, who was reared as a girl after botched surgery in a famous medical experiment but reclaimed his male identity. It was by The Canadian Press, not The Associated Press.

Janet and Ron had twin boys. As an experiment, doctors convinced them to raise one as a girl.

Mamamia's  Extraordinary Stories series  deep dives into the kind of tales you will keep thinking about long after you've read them. From unexplained mysteries to moments that have changed history, Extraordinary Stories will take you down the rabbit hole and make you never want to leave.

Warning: The following mentions suicide, which may be triggering for some readers. 

For years, it was known in the medical community only as the "John/Joan" case, a hugely controversial experiment in psychology, anthropology, neuroendocrinology and medicine.

Articles were published in academic journals and the press, making the Canadian child at its centre one of the most famous patients in modern medicine. Yet it was years before that child even knew the experiment had taken place, and longer still before he was able to share the real story.

It all started with a medical accident.

The true story of the "John/Joan" case.

In April 1966, eight-month-old identical twins, Bruce and Brian Reimer, underwent a circumcision to treat phimosis, a condition which prevents the foreskin from retracting. Bruce's procedure failed. He suffered extensive damage to his penis caused by a cauterising needle, a tissue-burning device rarely used during circumcision.

Concerned for his future physical and psychological health, the child's parents sought the advice of psychologist Dr John Money at the prestigious Johns Hopkins Hospital in the US state of Maryland. Dr Money had developed a reputation as a pioneer of gender psychology and sexual behaviour through his work with intersex patients. 

He was among the first to distinguish gender identity from biology, and advocate for the theory that gender is a social construct.

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The injured child presented the ideal experiment to further his work; not only was he an infant, his identical twin could serve as a 'control' case.

Penile reconstruction was in its infancy then, and so Dr Money and his team came to a conclusion that would alter the course of Bruce's life: that he should be raised as a girl.

Janet placed her trust in the doctors, and Bruce underwent surgery to remove his male genitalia and construct a vulva. He was also given a new name — Brenda Lee — and later, as he approached puberty, was administered female hormones.

Throughout their childhood, the twins were assessed by Dr Money and his team without knowing why. They were forced to participate in strange activities that involved examining each other's genitals and simulating sexual positions while thrusting — practices that, at the time, the research team justified as healthy means by which children explore a sense of themselves as a boy or girl.

They were reported in the literature to grow into well-adjusted children, and the apparent success of the "John/Joan" experiment is believed to have informed the standard for treating many intersex or genitally injured children around the world.

But the Reimer family later revealed their twins' upbringing was anything but happy.

Brian told Rolling Stone, "For the life of me, I couldn’t understand why, out of all the kids in my class, why am I the only one going with my [sibling] to Baltimore to talk to this doctor? It made us feel like we were aliens."

Their mother, Janet Reimer, noticed Bruce's struggles with gender dysphoria from an early age. He went to the bathroom standing up, shunned games or activities that seemed stereotypically 'girly', and when Janet put a dress on him for the first time, he tore it off in distress.

"During the whole journey of trying to feminine being, there were doubts along the way," she told Oprah in ... "But I couldn't afford to contemplate them because I couldn't afford to be wrong."

He became a social outcast, bullied and threatened by his peers who perceived some kind of indeterminate difference.

Learning the truth.

When Bruce turned 13, doctors discussed vaginoplasty: an operation to create internal female genitals. He fled from the room, and hid on the roof of the hospital building.

He threatened suicide if he was forced to see the doctors again.

And so, after years of being robbed of the chance, his parents told him the truth about the accident, about the experiment, the hormones. Finally, he was allowed to determine his own identity.

He shunned the feminine persona that had been thrust upon him, and chose to live as a boy with the name David.

"My parents feel very guilty, as if the whole thing was their fault," David told Rolling Stone . "But it wasn’t like that. They did what they did out of kindness and love and desperation. When you’re desperate, you don’t necessarily do all the right things."

Though he was able to live by his own definition of self, to find love, marry become an adoptive father, he remained in the grips of mental ill-health. As did his twin brother.

Brian Reimer died of a drug overdose in 2002. Two years later, David took his own life. He was 38 years old.

Note:   The case is occasionally cited by anti-trans activists as 'proof' that gender and biological sex are indistinguishable and that medical interventions are harmful. However, to most, it affirms the opposite. After all, what is this case if not evidence of the harm caused by forcing someone to perform a gender with which they don't identify?

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The Intersex Society of North America closed its doors and stopped updating this website in 2008. ISNA’s work is continued by interACT: Advocates for Intersex Youth , who proudly preserves this website as a historical archive. For current information, links to intersex support groups, and to connect with intersex advocates, please head to interACT: Advocates for Intersex Youth .

# Who was David Reimer (also, sadly, known as John/Joan)?

David Reimer was born an identical (non-intersex) twin boy in 1965. At the age of 8 months, David and his brother each had a minor medical problem involving his penis, and a doctor decided to treat the problem with circumcision. The doctor botched the circumcision on David, using an inappropriate method and accidentally burning off virtually all of David’s penis. At the advice of psychologist John Money at Johns Hopkins University, David’s parents agreed to have him “sex reassigned” and made into a girl via surgical, hormonal, and psychological treatments—i.e., via the system Money advocated for intersex children .

For many years, John Money claimed that David (known in the interim as “Brenda”) turned out to be a “real” girl with a female gender identity. Money used this case to bolster his approach to intersex —the approach that is still used throughout much of the U.S. and developed world—one that relies on the assumption that gender identity is all about nurture (upbringing), not nature (inborn traits), and that gender assignment is the key to treating all children with atypical sex anatomies.

As it turns out, Money was lying. He knew Brenda was never happy as a girl, and he knew that as soon as David found out what happened to him, David reassumed the social identity of a boy.

The case of David Reimer has been used by the proponents of the “gender is inborn” (nature) theory as proof that they are right. We like to point out that what the story of David Reimer teaches us most clearly is how much people are harmed by being lied to and treated in inhumane ways. We don’t think we can ever predict, with absolute certainty, what gender identity a person will grow up to have. What we can predict with a good degree of certainty is that children who are treated with shame, secrecy, and lies will suffer at the hands of medical providers who may think they have the best of intentions and the best of theories.

To read more about David Reimer, see:

• David Reimer: The Boy who Lived as a Girl at Canada’s __CBC News__.
• John Colapinto’s excellent biography, As Nature Made Him , available at our bookshelf .
• John Colapinto’s original article about David Reimer in Rolling Stone .
• The Death of David Reimer: A tale of sex, science, and abuse by Jesse Walker, at __Reason__.

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Dr. John Money Discovered

By Elizabeth Newton ~ The vast collections of the National Library of Medicine encompass a startling variety of topics and materials. I recently spent two months interning in the Historical Audiovisuals program of the library’s History of Medicine Division, researching and writing film abstracts, taking inventory in the film vault, and examining audiocassette, phonograph, and slide collections whose contents needed documentation. In this work, I learned that it is not uncommon to find unprocessed, undescribed material in archival collections, and part of the archivist’s job is to identify, arrange, and describe it.

“I have a kind of image in my mind of, five to seven thousand years or more ago, a conclave of priestly rulers who were extraordinarily clever. They came out of their conclave, having discovered the principle that the way to gain power over their people was to make them guilty about the functioning of the body with regard to sex. The power to make people guilty is also the power to make them conform.” Dr. John Money, 1971.

A couple of documents in the NLM box indicated that the material was transferred to NLM in the mid-1990s from the University of Pittsburgh. Inside the box was a variety of medical slides and pamphlets, and also a transcript of a Money lecture at Johns Hopkins University with the provocative title “Pornography in the Home,” accompanied by 118 slides. A published version of the lecture appeared in1973 in Contemporary Sexual Behavior: Critical Issues in the 1970s based on the proceedings of the sixty-first annual meeting of the American Psychopathological Association .  It appears there was a sound recording of the lecture as well, but the audio was not in the box. Despite its startling title, the February 17, 1971 lecture was not solely about pornography, but about the importance of frank sex education in the home and in school settings. Sex education, or its lack in many cases, is still a contentious topic in the United States today.

In his lecture, Dr. Money addressed contemporary issues and problems in sex education, with possible solutions. While he was primarily focused on the matter of visual imagery in sex education, he addressed other issues, which, 45 years later, still ring true, such as the absence of the concept of love in sex education courses.

“The verdict of history, so far as the 19th century is concerned, is that the seed of absurdity housed the plant of reasonable change.” The Destroying Angel, John Money (75)

Money further explored the history of this persistent phenomenon of anti-sexualism in America in his book, The Destroying Angel . When one is consistently punished or silenced for asking questions about or exhibiting a natural drive, problems arise. Growing up in Mississippi many decades after Money’s critiques were published, I have first-hand experience with sex education courses that were seriously lacking in substance, and the correlating social issues. Mississippi currently has the second highest rates of teen pregnancy and gonorrhea in the U.S., as well as one of the most conservative sex-education policies. According to Mississippi House Bill 494, as of 2016 the state requires that school districts choose from one of two sex education programs: abstinence plus or abstinence only.  While public schools are, in fact, required to teach sex education courses, they hardly scrape the surface of human sexuality. For example, in the abstinence plus program, the teacher may discuss birth control and sexually transmitted diseases such as HIV/AIDS, but can in no way provide demonstrations on how to effectively use condoms. In Money’s Destroying Angel , he argued that rather than being protected, “children are victimized by lack of education on explicit sex and pornography. They are deprived not only of the actual knowledge but also of the opportunity to learn the moral principles that apply to…sex…in their own lives”.

During my time at NLM, I developed a strong interest in Dr. Money and his contributions to sex education. Controversies both thoughtfully acknowledged and set aside for the moment, it seems that one of his genuine goals was to help people to become more open-minded and better understand those with sexual tendencies that are not within the “norm” of society. I think it is important to note the difficulties that come with exploring a field of medicine with such a strong cultural taboo. John Money had a complex mind, and he held extremely progressive, even shocking, ideas for the time period in which he was working. I hope to continue my research on Dr. Money and the history of human sexuality—an area I likely would not have known anything about had I not been assigned to explore, describe, and better understand one of the NLM’s “hidden collections.”

“One becomes better able to help others by achieving a position, and I want to weigh this word very carefully, of nonjudgementalism.” John Money

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Failed to mention his experiments we complete failures.

The author egregiously fails to mention that Money’s experiments were essentially equivalent to some of Joseph Menegele’s. The damage to the lives of countless boys is a tragedy of monumental proportion. It’s vastly greater than a mere “controversy,” as this article suggests.

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‘Don’t You Want to be a Normal Girl?’ John Money, the Reimer Twins, and Intersex Autonomy

Despite case histories that show sometimes horrific results, surgically altering the sex of infants born with ambiguous genitalia – intersex – is still common.

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There are between 1,800 and 2,500 births every year in the United States alone that are classified as intersex , that is, when an infant’s sex cannot be clearly discerned at birth. Historically termed hermaphroditic , this human variation is defined by the presence of sex organs of both biological sexes. It’s estimated there are approximately 230,000 intersex individuals now living in the U.S.

This is the story of those thousands of children born intersex, and of one, David Reimer, who was not. And it’s the story of one professional, John Money, a psychologist but not a physician or surgeon, who sought to advance his career by treating children who were born intersex – and treating one who was not.

This is also a cautionary tale of what can happen when a man with near-absolute power attempts to turn children into test subjects in order to “prove” his ultimately discredited theory about gender determination, and the damaging and damning legacy he left behind.

For more on the lives of intersex individuals, check out the MagellanTV documentary  Intersexion .

John Money and ‘Nature vs. Nurture’ in Intersex Children

John Money was a man on a mission. Trained as a psychologist in the 1940s, he took a keen interest in infants and was especially intrigued by a very uncommon occurrence: children born with ambiguous genitalia. He developed a theory concerning these kids’ treatment that challenged nature’s role in shaping children’s “gender identity” – their innate sense of being boys or girls.

In a 1955 paper , Money postulated that “sexuality is undifferentiated at birth.” He asserted that children are born devoid of sex or gender awareness and that their gender characteristics, associated with masculinity or femininity, develop solely through their upbringing – in other words, through nurture. Further, he proposed that a child’s gender identity could be changed through a combination of medical and psychological intervention.

He was not first to the “nurture theory.” Philosophers including John Stuart Mill and 20th-century feminists including Simone de Beauvoir had proposed similar ideas. It was Money’s claim that one’s gender could be determined that brought him attention.

Today, intersex advocates, activists, and members of the transgender community  vehemently contest Money’s provocative theory. In the 21st century, this has been debunked by advances in scientific research and by the lived experiences of trans and intersex people, who understand that gender identity – self-identity – cannot be manipulated by a team of “experts.”

During the mid-20th century, unfortunately, these voices were absent. Money built his career and wielded substantial influence through his “gender determination” theory. At the time, few scientists had conducted comprehensive studies on those born intersex, giving Money an open field to propagate his treatment methodology for intersex infants.

Money’s Interests Take Root at Johns Hopkins’ Gender Identity Clinic

While serving on the faculty of Johns Hopkins University in Baltimore, Maryland, Money played a pivotal role in founding  the university’s Gender Identity Clinic in 1966. This was the nation’s first treatment center for individuals seeking to align their sex with their gender identity, specifically adult transgender men and women. While not a doctor, Money guided the medical team conducting what is now called “gender-affirming” surgery to complete the transformation from male to female and vice versa.

John Money’s work helped psychologists develop and understand the meaning of “gender identity,” thus playing a significant role in establishing the importance of acknowledging one’s sense of gender.

Through it all, Money’s primary fascination lay with the early development of intersex infants and children. Recognizing an opportunity to explore an under-researched field, he became engrossed in the medical care of these children from the neonatal stage until what he dubbed the “gender identity gate” had opened. Money contended that this gate, the point at which children begin to form their gender identities, typically occurs around age two. Before this age, he believed children to be entirely “gender-fluid,” susceptible to imprinting in either gender direction based on environmental cues.

Give children toy guns, cowboy attire, and trucks to play with, and they would assimilate into boys, he theorized. Encourage toddlers with frilly pink attire, baby dolls, and maternal objects, and they would gravitate toward girlhood.

Money Develops Protocols for Treating Intersex Infants and Children

Recognizing that parents might be shocked that doctors could not determine the sex of their children, Money  developed protocols for hospitals. These protocols aimed to “adjust” children’s sex organs to resemble either male or female bodies. For intersex children judged to be girls, this involved castration, removal of testes, and construction of a rudimentary vulva. For infants deemed to be male, a larger-than-average clitoris could be molded into a rudimentary penis, with internal female organs removed.

But Money was not content with these practices alone. He was resolute in his quest to find a case that would help him prove his theory regarding the “gender identity gate.” One day in early 1967, seemingly perfect test subjects were dropped in his lap when the parents of identical twin boys reached out to Money in desperation.

One of their twins had suffered a horrifying medical accident during circumcision to correct  phimosis , a condition that had caused the closure of both boys’ foreskins, leading to difficulties with urination. During the first child’s circumcision, doctors used a cauterizing knife rather than the standard scalpel. An electrical discharge occurred, resulting in the incineration of the boy’s penis. The circumcision for the second boy was swiftly canceled. The parents, residing in rural Canada and grappling with the outcome of the botched procedure, soon stumbled upon a televised interview with Money in December 1966. In this interview, Money outlined his surgical remedy for intersex children.

Money Seeks to Prove His Theory on the Reimer Twins

The boy, whom we’ll call by his adult name, David Reimer, was not intersex; his sex organs were unequivocally male at birth. It was only due to the tragic medical accident that he lost his penis. Nevertheless, David’s parents, yearning for a set of normal, healthy twins, contacted Money seeking his assistance.

At birth, David’s given name was Bruce. Because his parents changed his name at such an early age, David never used his birth name. For this reason, he is called by his preferred name, David, in this article.

Money seized the opportunity. Having been  publicly criticized in 1965 by sexologist Milton Diamond , who refuted Money’s all-nurture/no-nature theory, Money was in dire need of a scientific experiment that would substantiate his claim regarding children’s lifelong gender identity. In 1967, when the Reimers first visited Money in Baltimore, David and his twin Brian were 22 months old.

During their initial session, Money outlined his medical and behavioral objectives for the Reimer family, refraining from mentioning any potential downsides, perhaps because he genuinely believed there wouldn’t be any. Money proposed an experiment, raising David as a girl and implementing surgeries and hormone therapy on the child.

Thus, at 22 months, David became “Brenda.” The experiment included an immediate bilateral orchiectomy , surgically removing his penis and testes while constructing labia around his urethra. Money was persuasive in convincing the Reimers that this was not only the best but the only way to ensure Brenda’s happiness. The Reimer family felt they had no choice but to agree.

The Traumatic Effect of Money’s Experiments on the Reimer Twins

[Editor’s note: This section of the article includes explicit descriptions that might not be suitable for all readers, especially children.]

Money also suggested regular check-ins with the twins, so the Reimers traveled to Maryland annually, handing the twins over to Money for his behavioral sessions. It was during these sessions that the trauma deepened for Brenda and Brian.

In these sessions, the twins were  instructed to undress and closely examine each other’s genitals. Money showed them explicit photos of naked adult women and even films depicting sexual intercourse. He went so far as to coerce the children to simulate sex acts with each other. Over a 10-year period of annual visits, before the twins reached puberty, they were instructed to thrust their exposed genitals at each other under Money’s stern direction. “Don’t you want to be a normal girl?” Money shouted at the petrified Brenda. On at least one occasion, as David later recalled, Money invited colleagues to observe and even photograph the sessions.

Life at the Reimer home was no better. The parents never disclosed Brenda’s life prior to surgery. The child was dressed as a girl and provided toys such as a baby carriage and a tea set. However, Brenda resisted these efforts from a preschool age. She yearned to play with Brian’s toys, but the parents, adhering to Money’s instructions, redirected their child toward girls’ play.

Money Misrepresents the Results of His Experiment

Challenges intensified when Brenda began attending school. Neither teachers nor peers ever accepted Brenda as a girl. According to Brian, the bullying and abuse were relentless. Brenda did not look or act like a girl, and the hurtful nickname “ Gorilla ” became a persistent reminder of this.

Nonetheless, the Reimer family remained committed to Money’s program. Money, in turn, published paper after paper proclaiming the success of the transition. In his papers, he  misrepresented his findings in order to present the human experiment as a long-term success story. He declared that the transformation from David to “Brenda” was exemplary, demonstrating the unassailable proof of his “all-nurture” theory.

David, who never felt comfortable with a girl’s name, resisted from the outset. As he approached puberty, he adamantly refused to take female hormone pills provided by Money’s clinic. David’s parents resorted to disguising the pills to deceive him into taking them. The pills did their work, and David soon developed breasts and acquired additional fat around his lower abdomen and hips. This pushed David to the brink. At the age of 13, when it was time for another trip to Baltimore, he threatened to take his own life.

Faced with David’s grave declaration, his parents broke their silence and revealed the truth about the gender experiment. Unsurprisingly, David was furious, but he was also relieved to learn that his inner feelings had been correct all along: He never was a girl. He immediately took steps to reclaim his boyhood, demanding surgeries to remove his breast tissue and rebuild male genitalia.

However, David’s life did not significantly improve. A girl he dated disclosed his unfortunate genital situation to acquaintances, leading to further ostracizing by his peers. Years later, he married a woman with children, harboring hopes of becoming a husband and father, roles in which he believed he would excel.

This newfound life proved untenable. His deeply rooted trauma rendered family life challenging, and employment was unsustainable. In 2004, a few days after his wife informed him she was leaving with their children, David committed suicide in a parking lot near their home. In a somber reminder of Money’s effect on the twins, David’s brother Brian had died two years earlier from a barbiturate overdose.

Money’s Legacy – and an Alternative Approach to Intersex Protocols

In 1997, an extensive story  published in Rolling Stone exposed Money’s discredited work. Money then blamed his rivals for conspiring against him and never took responsibility for the harm he had caused. He died of natural causes in 2006.

The medical procedures applied to David Reimer may seem cruel and profoundly insensitive by people who acknowledge and accept individuals who exist outside the standard confines of gender and sex. Yet, astonishingly, these practices, initiated in the 1960s, continue to be applied as standard procedure in many hospitals and medical practices across the United States and around the world. It remains quite common for doctors to inform distraught parents that their children will be happier with surgical interventions. Worse, some U.S. state legislatures are considering laws that would require such surgery for intersexual children without considering the trauma it often causes.

This intersex-inclusive LGBTQIA+ pride flag was designed by Valentino Vecchietti in 2021. (Source: Nikki, via Wikimedia Commons )

There is an alternative approach gaining ground. Sexologist Milton Diamond, an ally of the intersex community, has advocated for  25 guidelines that aim to eliminate surgeries the intersex community views as invasive, unnecessary, and unethical . For nonprofessional readers, the guidelines can be distilled to three clear recommendations:

• Physicians should refrain from performing surgery on intersex infants, instead referring the parents and children to long-term counseling.
• As they develop, assign intersex children to the gender they seem naturally inclined toward.
• Promote openness and avoid shame when dealing with the issue, and, when possible, encourage intersex children to socialize with others who share the condition.

What is the Future for Intersex and Trans People?

In our current polarized era, it is distressing that issues surrounding intersexuality have been politicized as part of the ongoing “ culture wars .” What is urgently needed is the recognition that intersex people have the same rights as others to make informed choices regarding their lives. These include the timing of and decisions related to sex-assignment surgery. Milton Diamond’s guidelines should be adopted by all medical professionals to replace the outdated and often callous protocols established by John Money.

The tragic story of David Reimer and his family is an extreme example of the consequences of those practices, but it is far from the only instance in which intersex children have been traumatized by doctors’ adherence to inhumane – and medically unwarranted – “treatment” regimens. The way to a brighter future lies in acceptance, patience, and compassion for children who come into the world as intersexual, along with medical and psychological protocols based on the best currently available science.

Suicide is a public health issue. If you or someone you know is exhibiting warning signs of suicide, call the U.S. National Suicide Prevention Lifeline at 800-273-TALK (8255) or seek out similar services in the country where you live.

Kevin Martin is Senior Writer and Associate Editor for MagellanTV. Having had a long career as a journalist and communications specialist, he writes on various topics, many in the areas of Art and Culture, Current History, and Space and Astronomy. He is the co-editor of My Body Is Paper: Stories and Poems by Gil Cuadros (forthcoming from City Lights). He resides in Glendale, California. 

Title Image credit: Transgender symbol on color background by Pixel-Shot from  Adobe Stock

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John Money, 84; Doctor Pioneered Study of Gender Identity in 1950s

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Dr. John Money, a leading sex researcher who pioneered the study of gender identity and helped establish Johns Hopkins Hospital as the first one in the United States to perform adult sex-change operations, has died. He was 84.

The controversial scholar, who coined the term “gender role,” died Friday at St. Joseph Medical Center in Baltimore of complications from Parkinson’s disease.

As director of the Psychohormonal Research Unit at Johns Hopkins Hospital in Baltimore, Money did groundbreaking research. He developed hormonal treatment to improve self-control of sex offenders and dedicated research to the virtually unexplored topic of infants born with ambiguous sex organs.

“People never thought about that. Before, you had male animals and female animals, and that was it,” said Dr. Gregory K. Lehne, an assistant professor of medical psychology at Hopkins and a protege of Money.

“But he taught us gender is much more significant than having two sexes,” Lehne said. “He identified what it means to be male and what it means to be female, and what it means to be in-between.”

Money’s theories also challenged taboos of 1950s-era sexuality, establishing the notion of gender roles and gender identity -- terms that helped shape modern gender studies.

His most memorable and criticized work was advocating sex-change operations for patients confused over their gender -- a position that was denounced by some colleagues who favored counseling instead of surgery. In 1979, Hopkins announced that it no longer would perform the operations.

Money’s belief that gender could be assigned to a child before age 3 played out in a radical experiment that became devastating for him and the child on whom it was performed.

Canadian parents of twin boys sought Money’s advice in 1967 after one of their sons had a botched circumcision. Money advised them that with hormones and sex-change surgery, the boy could be raised as a girl.

But by the time Brenda was a teenager, it became clear that the plan wasn’t working. Brenda became known as a boy, David Reimer, who later was the subject of the 2000 book “As Nature Made Him: The Boy Who Was Raised as a Girl,” by John Colapinto. In the book, Reimer condemned the experiment and spoke of his anguish. He committed suicide in 2004.

“I think it devastated” Money, Lehne said. “The controversy led to him being kind of withdrawn and somewhat bitter after seeing himself as misinterpreted and not being able to do anything about it.”

Money led an eccentric lifestyle, friends said. He bought his clothes from secondhand stores and rarely threw away anything that he thought could be reused. He was married but quickly divorced in the 1950s, and had no children.

Eileen Higham, a clinical psychologist who worked for Money for several years in the 1970s, said: “As a person, I found him an outstanding intellect but not easy to get along with. I think he was widely misunderstood because he did not fit into the mainstream.”

Born in New Zealand in 1921, Money moved to the United States in 1947 to study at the Psychiatric Institute of the University of Pittsburgh.

He left Pittsburgh for Harvard University, where he earned a doctorate in 1952.

In Baltimore, he lived within walking distance of the Johns Hopkins medical campus for more than 40 years. Money’s house had an eclectic collection of anthropological art he had amassed from traveling around the world, including a stint studying aboriginal communities.

Much of Money’s collection now sits in a gallery in the town of Gore, New Zealand, in a wing named after him.

A collection of Money’s professional writings is housed at the library of the Kinsey Institute for Research in Sex, Gender and Reproduction at Indiana University.

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John Money, Ph.D.

Dr. John William Money (July 8, 1921–July 7, 2006), internationally known for his work in psychoendocrinology and developmental sexology, defined the concepts of gender role and identity.

Dr. Money's gifts to the Kinsey Institute include his archives which comprise the John Money Collection , and funds to establish the Scholars of Sexology Fellowship to support graduate students and young scholars.

About Dr. Money

Born in Morrinsville, New Zealand, John William Money emigrated to the United States in 1947 and received his Ph.D from Harvard University in 1952. In 1966, Dr. Money founded the Gender Identity Clinic at Johns Hopkins University and started an extensive research program on the psychohormonal treatment of paraphilias and on sex reassignment. Money formulated, defined, and coined the term "gender role" and later expanded it to gender-identity/role (G-I/R). In 1961, he proposed the hypothesis that androgen is the libido hormone for both sexes.

Extending his research from the clinic to clinical history, Dr. Money wrote about the 18th century origins and present consequences of antisexualism in  The Destroying Angel: Sex, Fitness, and Food in the Legacy of Degeneracy Theory, Graham Crackers, Kellogg's Corn Flakes, and American Health History  (1985).  Venuses Penuses: Sexology, Sexosophy, and Exigency Theory  (1986) is an anthology of his theoretically significant writings. His publications also cover the philosophy and methodology of science in the practice of clinical psychoendocrinology and sexology, including Unspeakable Monsters in All Our Lives: The Complete Interviewer and Clinical Biographer ,  Exigency Theory and Sexology , and many other monographs.

The John Money Collection

The Kinsey Institute Library houses John Money's lifelong work, including:

• Professional correspondence (1950-2004)
• Lectures, presentations, and audiovisual materials (1960s-2004)
• Articles and clippings (1973-2000), including thousands of reprints and pamphlets on a broad range of sex education and research topics
• Scientific journals and erotic magazines (1940s-2000)
• Manuscripts and publications (complete holdings)
• Scientific, erotic and pornographic journals and magazines (1949-1985)
• Conference programs and papers, photo albums, and information, and materials relating to sex research organizations and conferences

Visit the Kinsey Institute Library Catalog to search through the John Money Collection online.

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