The David Reimer Case Study – Paul Okami

Freeze Frame: excerpted from Chapter 16: Sex, Gender, and Sexual Behavior in Psychology: Contemporary Perspectives by Paul Okami

In 1965 twin boys were born to Janet and Ron Reimer. In a freak accident, the penis of one of the twins, Bruce, was so badly burned that it literally fell off after several days. The medical team offered to attempt reconstructive surgery, but the chances of success were small. While they were weighing the possibility of surgery, the Reimers happened to see a controversial but respected sex researcher named John Money on a television program. Dr. Money had recently coined the term gender identity to refer to a person’s inner sense of being male or female, and he expressed the view—unsubstantiated by scientific evidence—that the genetic sex of an individual was not a critical factor in determining the person’s gender identity. The critical factor, according to Money, was socialization—how the person was reared by parents and viewed by society. Ultimately, this view was to assume the status of gospel in the profession. More important, Money was a pioneer in procedures known as sex reassignment surgery that could allow a person to alter his or her genital sex if desired.

The Reimers consulted Money, and he suggested sex reassignment for Bruce. Surgery was performed to create external female genitals, the child was renamed Brenda, and she was reared as a girl—without ever being told of her birth history. Following the surgery, Janet and Ron Reimer struggled hard to enforce gender differences between Brenda and her brother Brian. Brian was allowed to shave with his father, whereas Brenda was made to play with makeup and wear dresses. She was given dolls and told to be neat and tidy.

However, these efforts appeared to be in vain. There was nothing feminine about Brenda. By age 2 she was angrily tearing off her dresses. She refused to play with her dolls, and would repeatedly steal her brother’s toy cars and guns, beating him up for good measure. She acted like a boy in the way she spoke, sat, moved, and played. As Brenda’s teachers reported, she simply seemed to be a boy “by nature.”

When she turned ten, Brenda began to exhibit sexual attraction to girls, and at age eleven the pubertal changes associated with being a boy kicked in—including increased muscle mass in the upper torso and lowered vocal frequency. She was ridiculed at school and given the name “Cavewoman.” Her school life deteriorated. Compelled to undergo hormonal therapy by Money and her parents, she started to develop breasts and fat deposits around her hips as a result of the injections—but she used overeating and weight gain as a strategy to try to hide this feminization of her figure.

Bruce/Brenda’s case was unveiled to the world by Money in a 1972 book in which Brenda’s obvious lack of adaptation to life as a female was strangely mischaracterized, perhaps to make it appear that Money’s theory and strategy were correct. But the book had wide appeal because it fit well with the zeitgeist, or social climate, of the time—when many activists were struggling against sexism and sought to assert the idea that there were no biological bases for sex differences. Money’s version of David Reimer’s story found its way into textbooks on psychology, sociology, child development, and human sexuality. This version strongly influenced the way people thought about sex and gender.

But the family’s troubles were escalating. Brenda dropped out of school, and her mother was admitted to a psychiatric ward to prevent suicidal behavior. Her father was drinking heavily. Brenda’s psychiatrist decided it was time for Brenda’s parents to tell her the truth. In a highly emotional conversation, Brenda’s father tearfully told Brenda the facts, step by step. Brenda reported that she felt anger, amazement and disbelief. But, above all, “I was relieved. Suddenly it all made sense why I felt the way I did. I wasn’t some sort of weirdo. I wasn’t crazy.” (Colapinto, 2000, p. 180).

Brenda Reimer changed her name to David, began life as a boy, and after a seemingly endless series of painful surgeries successfully grew into a fairly handsome man who ultimately married and raised a step-family for many years—until his life took a downward turn, and he committed suicide in May of 2004.

This story is compelling and tragic. But the details of David Reimer’s life, originally published by medical sex researcher Milton Diamond and psychiatrist Keith Sigmundson (1999) and later elaborated upon by journalist John Colapinto (2000), raise a great many questions: What is sex? What is gender? To what extent do our genes, genitals, hormones, societies, and cultures shape the way we see ourselves and others see us as sexual beings? How do they influence sexual behavior?

It might be tempting to conclude from the details of David Reimer’s life that biological factors such as genes and hormones are primarily responsible for whether we see ourselves as male or female, and whether we are attracted to men or women as sexual partners. However, as emphasized in the first chapter of this book, drawing general conclusions from one case study or anecdote is a dangerous endeavor. And, as it turns out, the issue is even more complicated than the story of Bruce/Brenda/David might indicate. This is demonstrated in long-term studies of dozens of genetic males who were raised as females because they had been born with various rare conditions which prohibited them from developing normal male genitals. As would be expected on the basis of David Reimer’s story, these studies do show that as many as 2/3 of these individuals never adjusted, and ultimately identified as men. However, a substantial number did adjust and continued to identify themselves as female (Cohen-Kettenis, 2005; Meyer-Bahlburg, 2005). Thus, genes and hormones cannot fully account for how we come to view ourselves as male or female.

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