David Reimer

David Reimer
Born	Bruce Reimer August 22, 1965(1965-08-22) Winnipeg, Manitoba, Canada
Died	May 5, 2004(2004-05-05) (aged 38) Ottawa, Ontario, Canada
Spouse	Jane
Parents	Janet Reimer, Ron Reimer

David Reimer (August 22, 1965 – May 4, 2004) was a Canadian man who was born as a healthy male, but was sexually reassigned and raised as female after his penis was accidentally destroyed during circumcision.^[1] Psychologist John Money oversaw the case and reported the reassignment as successful, and as evidence that gender identity is primarily learned. Academic sexologist Milton Diamond later reported that Reimer failed to identify as female since the age of 9 to 11,^[2] and that he began living as male at age 15. Reimer later went public with his story to discourage similar medical practices. Eventually he committed suicide, due to suffering years of severe depression, financial instability and a troubled marriage.

History

David Reimer was born as a male identical twin in Winnipeg, Manitoba. His birth name was Bruce; his twin was named Brian. At the age of 6 months, after concern was raised about how they both urinated, the boys were diagnosed with phimosis. They were referred for circumcision at the age of 8 months. On April 27, 1966, a urologist performed the operation using the unconventional method of cauterization. The procedure did not go as doctors had planned, and Reimer's penis was burned beyond surgical repair.^[3]

The parents, concerned about their son's prospects for future happiness and sexual function without a penis, took him to Johns Hopkins Hospital in Baltimore to see John Money, a psychologist who was developing a reputation as a pioneer in the field of sexual development and gender identity, based on his work with intersex patients. Money was a prominent proponent of the 'theory of Gender Neutrality'; that gender identity developed primarily as a result of social learning from early childhood and could be changed with the appropriate behavioral interventions. The Reimers had seen Money being interviewed on the Canadian news program This Hour Has Seven Days, where he discussed his theories about gender. He and other physicians working with young children born with abnormal genitalia believed that a penis could not be replaced but that a functional vagina could be constructed surgically, and that he would be more likely to achieve successful, functional sexual maturation as a girl than as a boy.^[4]

They persuaded his parents that sex reassignment surgery would be in Reimer's best interest, and, at the age of 22 months, orchidectomy was performed to remove his testes. He was reassigned to be raised as a female and given the name Brenda. Psychological support for the reassignment and surgery was provided by John Money, who continued to see Reimer annually for about ten years for consultations and to assess the outcome. This reassignment was considered an especially valid test case of the social learning concept of gender identity for two reasons. First, Reimer's twin brother, Brian, made an ideal control since the two not only shared genes and family environments but had shared the intrauterine environment as well. Second, this was reputed to be the first reassignment and reconstruction performed on a male infant who had no abnormality of prenatal or early postnatal sexual differentiation.

Dr. Money forced the twins to rehearse sexual acts involving "thrusting movements" with David playing the bottom role.^[4] As a child, David Reimer painfully recalled having to get "down on all fours" with his brother, Brian Reimer, "up behind his butt" with "his crotch against" his "buttocks".^[4] In another sexual position, Dr. Money forced David to have his "legs spread" with Brian on top.^[4] Dr. Money also forced the children to take their "clothes off" and engage in "genital inspections".^[4] On at "least one occasion", Dr. Money took a "photograph" of the two children doing these activities.^[4] Dr. Money's rationale for these various treatments was his belief that "childhood 'sexual rehearsal play'" was important for a "healthy adult gender identity".^[4]

For several years, Money reported on Reimer's progress as the "John/Joan case", describing apparently successful female gender development, and using this case to support the feasibility of sex reassignment and surgical reconstruction even in non-intersex cases. Money wrote: "The child's behavior is so clearly that of an active little girl and so different from the boyish ways of her twin brother." Notes by a former student at Money's lab state that during the followup visits, which occurred only once a year, Reimer's parents routinely lied to lab staff about the success of the procedure. The twin brother, Brian, later proved to be schizophrenic.

Reimer had experienced the visits to Baltimore as traumatic rather than therapeutic, and when Dr. Money started pressuring the family to bring him in for surgery during which a vagina would be constructed, the family discontinued the follow-up visits. From 22 months into his teenaged years Reimer urinated through a hole surgeons had placed in the abdomen. Estrogen was given during adolescence to induce breast development. Having no contact with the family once the visits were discontinued, John Money published nothing further about the case to suggest that the reassignment had not been successful.

Reimer's account, written with John Colapinto two decades later, described how - contrary to Money's reports - when living as Brenda, Reimer did not identify as a girl. He was ostracized and bullied by peers, and neither frilly dresses (which he was forced to wear during frigid Winnipeg winters) nor female hormones made him feel female. By the age of 13, Reimer was experiencing suicidal depression, and told his parents he would commit suicide if they made him see John Money again. In 1980, Reimer's parents told him the truth about his gender reassignment, following advice from Reimer's endocrinologist and psychiatrist. At 14, Reimer decided to assume a male gender identity, calling himself David. By 1997, Reimer had undergone treatment to reverse the reassignment, including testosterone injections, a double mastectomy, and two phalloplasty operations. He also married Jane Fontaine and became a stepfather to her three children.

His case came to international attention in 1997 when he told his story to Milton Diamond, an academic sexologist who persuaded Reimer to allow him to report the outcome in order to dissuade physicians from treating other infants similarly. Soon after, Reimer went public with his story and John Colapinto published a widely disseminated and influential account in Rolling Stone magazine in December 1997.^[5] They went on to elaborate the story in a book, As Nature Made Him: The Boy Who Was Raised as a Girl.^[4]

Death

In addition to his lifelong difficult relationship with his parents, Reimer had to deal with unemployment and the death of his brother Brian from an overdose of antidepressants in 2002. On May 2, 2004, his wife Jane told him she wished to temporarily separate. Reimer stormed out of the house. On May 5, Jane Reimer received a call from the police that they had located her husband but he did not want his location revealed. Two hours later they called again, informing her of his suicide. Reimer had returned home while she was out and retrieved a shotgun, sawing off its barrel before leaving. On that morning of May 5, he drove to the parking lot of a nearby grocery store, parked his car and fatally shot himself in the head.^[6]

Social effect of David Reimer's story

The report and subsequent book about Reimer influenced several medical practices and reputations, and even current understanding of the biology of gender. The case accelerated the decline of sex reassignment and surgery for unambiguous XY male infants with micropenis, various other rare congenital malformations or penile loss in infancy.

It supported the arguments of those who feel that prenatal and early-infantile hormones have a strong influence on brain differentiation, gender identity and perhaps other sex-dimorphic behavior. The applicability of this case to appropriate sex assignment in cases of intersex conditions involving severe deficiency of testosterone or insensitivity to its effects is more uncertain. For some people, the inability to predict gender identity in this case confirmed skepticism about doctors' abilities to do so in general, or about the wisdom of using genital reconstructive surgery to commit an infant with an intersex condition or genital defect to a specific gender role before the child is old enough to claim a gender identity.

The Intersex Society of North America, which opposes involuntary sex reassignment, treats the story of David Peter Reimer as a cautionary tale about why the genitals of unconsenting minors should not be needlessly modified.^[7]

Colapinto's book described unpleasant childhood therapy sessions, implying that Money had ignored or concealed the developing evidence that Reimer's reassignment to female was not going well. Money's defenders have suggested that some of the allegations about the therapy sessions may have been the result of false memory syndrome^[8] and that the family was not honest with researchers.

In popular culture

• The Chicago Hope season 6 episode "Boys Will Be Girls" (2000) was based on Reimer's life and the child's right to be raised as a male.^[9]
  
• The Law & Order: Special Victims Unit season 6 episode "Identity" (2005) was based on David and Brian Reimer's lives and their treatment by Money.^[9]
  
• On their 2007 album Reunion Tour, a song by The Weakerthans entitled "Hymn of the Medical Oddity" was inspired by the story of David Reimer.^[10]
  
• The documentary BBC TV series Horizon based two episodes on his life, "The Boy who was Turned into a Girl" (2000)^[11] and "Dr. Money and the Boy with No Penis" (2004).^[12][1]
  
• A chapter titled Doing Justice to Someone: Sex Reassignment and Allegories of Transsexuality from the 2004 book Undoing Gender, by the feminist philosopher Judith Butler, addresses the case of David Reimer.
  
• The eighth episode of Mental, "House of Mirrors" (2009) deals with Reimer's story.^[9]
• A Brazilian Novel called Chocolate com pimenta had a character based on his life.
  

See also

• Penectomy
• History of intersex surgery

References

1. ^ ^{a b} Dr. Money And The Boy With No Penis Retrieved 24 December 2010.
2. ^ Diamond, M., Sigmundson, K. (1997). Sex Reassignment at Birth: Long-term Review and Clinical Implications. Archives of Pediatrics & Adolescent Medicine, 151(3), 298-304
3. ^ "David Reimer: The boy who lived as a girl". CBC News. July, 2002. http://cbc.ca/news/background/reimer/. Retrieved 2006-01-20. 
4. ^ ^{a b c d e f g h} Colapinto, J (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Harper Perennial. ISBN 0-06-092959-6.  Revised in 2006
5. ^ Colapinto, John (1997-12-11). "The True Story of John/Joan". Rolling Stone: pp. 54–97. http://infocirc.org/rollston.htm. 
6. ^ Colapinto, J (2004-06-03). "Gender Gap: What were the real reasons behind David Reimer's suicide?". Slate. http://slate.com/id/2101678/. Retrieved 2009-02-13. 
7. ^ Intersex Society of North America | A world free of shame, secrecy, and unwanted genital surgery
8. ^ Burkeman, Oliver (2004-05-12). "Being Brenda". London: Guardian Unlimited. http://www.guardian.co.uk/g2/story/0,,1214525,00.html. Retrieved 2010-05-01.  Retrieved December 19, 2005
9. ^ ^{a b c} "Treatment of Circumcision on TV". http://www.circumstitions.com/TVSitcomsA-M.html. Retrieved 2009-02-01. 
10. ^ Barclay, M. "The Weakerthans: Time is on John K. Samson’s side". SOCAN. http://www.socan.ca/jsp/en/word_music/Winter07_TheWeakerthans.jsp. Retrieved 2009-02-01. ^{[dead link]}
11. ^ "The Boy who was Turned into a Girl". BBC. http://www.bbc.co.uk/science/horizon/2000/boyturnedgirl.shtml. Retrieved 2009-10-06. 
12. ^ "Dr Money and the Boy with No Penis". BBC. http://www.bbc.co.uk/sn/tvradio/programmes/horizon/dr_money_prog_summary.shtml. Retrieved 2009-10-06. 

External links

• Dr. Money And The Boy With No Penis
• "Sex: Unknown (transcript)". NOVA (TV series). 2001-10-30. http://www.pbs.org/wgbh/nova/transcripts/2813gender.html. 

Persondata
Name	Reimer, David
Alternative names
Short description
Date of birth	1965-08-22
Place of birth	Winnipeg, Manitoba, Canada
Date of death	2004-05-05
Place of death