Friday, May 14, 2004

Yup, it's been a while. Been traveling, mostly for professional reasons. Glad to be back.

Having read John Colapinto's As Nature Made Him a few years back, I was distressed to hear about the recent suicide of David Reimer. There are few more disturbing stories in the lore of medicine and psychology, and Reimer’s story was especially egregious.

For those just tuning in: David Reimer (born Bruce, raised as Brenda) lost his penis during a “routine” circumcision at the age of eight months, when a piece of surgical equipment malfunctioned in the hands of an inexperienced practitioner. (The circumcision was, most likely, medically unnecessary, although at the time it was a standard treatment for a minor urinary problem sometimes experienced by infant boys.) A prominent sex researcher then pressured his family to compound the error by removing the child’s testicles and then raising him as a girl. The “experiment” was a horrific failure; the boy was miserable until he found out the truth. Eventually, he was able to have reconstructive surgery, to live as a man, and even to marry a woman and become a stepfather to her children. But, after his marriage broke up while he struggled through financial difficulties, he apparently ran out of whatever resilience had carried him through 38 angry years.

The saddest part of the story of what was done to David Reimer: It followed from a pet theory of a researcher who may have been perceptive in some other ways, but was too damned arrogant to realize when he was not only dead wrong, but was abusing a child and an entire trusting family through his own tenacity of belief. Whatever else happened to David Reimer, one thing was certain: He was a heterosexual male at the age of eight months, and he remained a heterosexual male for the rest of his life. He may have been forced to dress as a girl while he was growing up, but it didn’t make him identify as a female, nor did it make him gay. The torment inflicted on David Reimer proved nothing whatsoever about feminism and very little about science. (No reputable biologist accepts a hard dichotomy between “nature” and “nurture”. Our genes and our environments interact in uncountable ways – and the human environment includes many factors – chemical exposures, for example – besides culture, social cues, and family pressures.)

What a surprise. A spectacular effort by an authority figure, combined with hormone treatments and other pressure that long passed the threshold of bullying, could not and did not change a person’s gender identification. Is it too much of a reach to conclude that the cruelty often inflicted on kids who are growing up gay, lesbian, bisexual, transgendered, or with intersex conditions does absolutely zero to change that person’s gender identity -- but everything imaginable to induce grief and rage? Perhaps there is some fluidity, some flexibility, to sexuality and gender identity in some individuals. But, there’s often a huge chasm between self-determination and someone else’s idea of one’s own good.

I wonder what David Reimer’s life would have been like if he had been left to experience childhood as a boy, and then offered reconstructive surgery as soon as the techniques became available. It wouldn’t have been easy, but maybe it wouldn’t have been the horror that it was. By all accounts, his family did everything they thought was best for their children, first acquiescing to and then rebelling against manipulation by a supposed expert with more ego than common sense. David’s twin also battled mental illness and was also a suicide. I feel for their parents. And I hope that somewhere, somehow, a few more doctors with strong opinions about others’ “best interests” will spend more time listening to what their patients have to say.