TBR: As Nature Made Him

In a comment on my last post on gender differences in children, Darleen urged me to read As Nature Made Him: The Boy Who Was Raised as a Girl, by John Colapinto.  I had heard good things about the book before, but I hadn’t read it, so I added it to my list.

The book is about David Reimer, the man who was one of the most famous medical "cases" ever, a touchstone in the debates about gender identity and the roles of biology and culture.  As an 8-month-old baby boy, his penis was totally destroyed in a freak circumcision accident.  (Lesson one of the book: don’t let anyone circumcise your kids with an electrocautery machine.)  Following the advice of Dr. John Money, a respected psychologist, the Reimers had the baby castrated and a rudimentary vagina created surgically and raised her as a girl, "Brenda."  Brenda would have been a subject of scientific interest in any case, but the fact that she had an identical twin brother, Brian, turned her into close to the holy grail for researchers, an experimental case with a control.  Dr. Money featured her in dozens of articles, arguing that her successful transformation into a normal girl was proof that nurture, not nature, was the dominant factor in determining gender identity.

Unfortunately for Dr. Money’s argument, John Colapinto shows that Brenda was a desperately unhappy little girl who rejected all traditionally girl-ish pursuits, in spite of her parents’ frantic efforts to make her conform to her new gender identity.  She resisted all attempts to convince her to have the plastic surgery needed to complete her genital transformation, and as soon as she learned her true story, insisted on changing her name and living as a boy. He eventually had surgery to recreate male genitals, as well as a double mastectomy to remove the breasts that he had grown from taking female hormones.  While David had a period of deep depression as a young man, today at the time the book was written, he is appeared to be content in his life, happily married and a father through adoption.  [Edited to reflect the fact that he later committed suicide, as Fred informed me in his comment.]

The other major strand in the book is Colapinto’s damning portrait of Dr. Money.  He makes a convincing case that Money consistently ignored the growing evidence that Brenda’s sex transformation was a disaster, because it was contradictory to his theory, continuing to cite the case as a success long past the point when such a claim was reasonable.  Moreover, he suggests that Money’s treatment of Brenda was essentially sexual abuse, as he pushed the young girl to discuss her fantasies and even role play sexual situations with her brother.  (Because Money totally refused to cooperate with the writing of the book, there is no attempt to portray his side of the story.)

So, it’s a fascinating human-interest story, and Colapinto does a good journalistic job of laying it out for the reader.  But where does it leave us in the endless nature-nurture debate?  While I enjoyed reading the book, at times I yearned for a more acute scientific guide, someone who would probe further into the contradictions of what we mean by gender, who didn’t take Brenda’s willingness to throw a punch and her desire to pee standing up as proof positive that she was meant to be male. 

The one piece of solid scientific ground is that Money’s pure nurturist hypothesis seems to have been pretty much totally discredited, in part because of the case of David Reimer.  The more we learn about fetal brain development and its sensitivity to a variety of environmental influences, the less reasonable it becomes to think that powerful hormones like estrogen and testosterone would have such fundamental effects on other aspects of fetal development, but none on the brain.

But I think it’s fair to say that we simply don’t have a theory of gender identity that really makes sense of — and listens to with respect — the experiences of both David Reimer and biologically normal transsexuals like Jennifer Boylan.  We don’t even have a language to talk about gender identity that doesn’t fall back on such caricatures as ascribing all concern about appearance and relationships to femininity and all interest in mechanics and competition to masculinity.  And without such a language, we spend a lot of time talking past each other.

6 Responses to “TBR: As Nature Made Him”

  1. Fred Vincy Says:

    Unfortunately, it did not end happily. Reimer eventually committed suicide.

  2. bj Says:

    “We don’t even have a language to talk about gender identity that doesn’t fall back on such caricatures as ascribing all concern about appearance and relationships to femininity and all interest in mechanics and competition to masculinity”
    I’ve also felt this was a critical flaw in our discussion of the gender/nature/nurture debate.I am perfectly comfortable with discussions, scientific ones about the issue. But, inevitably, a reasonable discussion, will turn to 1) the report of specific anecdotes (which “Brenda’s” story is) and 2) an acceptance of gender norms that are so clearly culturally determined that I don’t understand why we’re discussing them. My favorite example of this is the color “pink” as a girl color. Even if there were robust and large sex differences in the brain (which there aren’t) it is impossible to come up with a reasonable explanation of why those difference would favor “pink”. And, there’s cultural evidence that the assignment of pink to girls is aribtirary, and fairly recent. But, I still have friends tell me how their daughter’s clearly have girl characteristics because they like the color pink.
    bj

  3. nerdlet Says:

    It’s been a while since I read the book, but a big thing that stood out to me was the way Brenda was described as “masculine” in comparison to her brother, who was gentler and more “feminine” – despite being genetically male and raised male. One little boy is raised as a girl but strongly feels traditionally male, the other little boy with basically identical genes is raised as a boy but is significantly less “masculine” than his twin – but the one raised as a girl is the only one who’s noticed, because something must have gone wrong with that one.
    IIRC, the brother had serious issues with depression as well, though most likely for different reasons.

  4. Darleen Says:

    I’m glad you found the book as fascinating and poignant as I did.
    Certainly gender and orientation issues are much more complicated than the nature/nurture argument might hold. If you recall, there is a whole section of the book that explores the issue of ambiguous genitalia, which we sometimes erroneously call “hermaphroditism”. I believe there is a lot of insight into the true tangled skeins that result in the hardwiring of a person’s gender identity and sexual orientation. By moving away from the ‘pure’ nuture approach..that somehow our gender id or sexual orientation is nothing but a “product” of the culture we live in, countless children will not endure the horrors that David did. Parents are being counseled to not make any surgical alteration to their children but to allow the child to chart the course of what they find as their ‘true nature’.
    Dr. Money, a man who not only was unethical, but I believe upon reading, someone with deepseated sexual issues of his own (his “treatment” of David/Brenda is the kind of child sexual abuse that gets people long state prison sentences), dismissed and fought against any peer review of his work and anyone that challenged it.
    BJ — the color ‘pink’ as a girl color is definitely a culture thing.. I very much doubt Romans decorated the nursery of their daughters in pink. But ‘gender norms’ are anything but culturally imposed as I think the David/Brenda case illustrates.
    No, this is not an ‘either or’ thing. Gender “norms” are NOT two single points in space, but arcs of a spectrum where infinite points cluster along the curve. MOST females will be in a range }here{ while most males will be in a range }there{ with outliers finding points in the range between the two genders. There are tomboy girls and sport-hating boys, but in the majority of cases, they still would be aghast if you tried to tell them they were really the other gender. Indeed, most gay men I know gender identify AS men. They’d no more cotton to a gender change as a straight man.
    Boys and girls are inherently different. Call it yin/yang or harmony in the great circle of life, but Nature/God over untold millions of years evolution has found a successful way of perpetuating the species. Men and women compliment each other. I don’t know why such a recognition causes such angst in people.

  5. Greag Says:

    Why David was depressed-
    He had put a huge investment into that book ‘As Nature Made Him: The Boy Who Was Raised as a Girl’ and had made a fair amount of money from it but the person who he had worked with had ran away + his brother had somehow killed himself which made him depressed and David’s wife left him.Also he had lost his job and had trouble finding a new one due to his qualifications. Either it was the stolen money or everything horrible that had made David go out into the center of an empty field with a shotgun.

  6. Greag Says:

    Why David was depressed-
    He had put a huge investment into that book ‘As Nature Made Him: The Boy Who Was Raised as a Girl’ and had made a fair amount of money from it but the person who he had worked with had ran away + his brother had somehow killed himself which made him depressed and David’s wife left him.Also he had lost his job and had trouble finding a new one due to his qualifications. Either it was the stolen money or everything horrible that had made David go out into the center of an empty field with a shotgun.
    Sorry, I forgot to mention that his partner for the book had ran away with the money…and by the way, when the book was published he made a good sum of money and was everywhere on TV that includes Oprah and Montel

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