In a post at Women Born Transsexual a few days ago, Suzan reposted an article that appeared in the Minneapolis News on the third of March 2009. In it was this little gem of a quote by Paul McHugh:

“Families and people who encourage young people to take hormones are, in my opinion, hurting that child, and not helping them see the reality of this world,” says Paul McHugh, a physician at Johns Hopkins and an outspoken critic of sexual reassignment surgery. “Your sex is in your cells—every cell in your body has either two X chromosomes or an X and Y chromosome.”

And allowing a child to live as the other gender?

“Well, that’s terrible,” he says. “That’s a form of child abuse.”

I was livid. Dr. McHugh tramples all over the biology of transsexualism, not to mention disregarding the entire spectrum of intersex people with his statements. He enforces the idea that humankind is purely binary and that “hermaphrodism” as intersex used to be called, is a rare and tragic medical anomaly, where people are even aware that it exists.

The reality is that intersex conditions are very common, and incidences are on the rise. Accoding to the Intersex Society of North America, up to as many as one in every 100 births exhibit some sort of intersex condition, and as they points out:

How small does a penis have to be before it counts as intersex? Do you count “sex chromosome” anomalies as intersex if there’s no apparent external sexual ambiguity?

The question becomes even more of a topic for controversy when you add transsexualism, which is a demonstrably neural intersex condition, and the question of whether gender-variant conditions such as being transgender, androgyne or neutrois are biological in origin is still up in the air, simply because there’s been so little research focussing on these individuals.

The only reason that intersex has largely fallen out of public knowledge is because of surgical intervention. This has been accepted practice since the 60’s when Dr. John Money seemingly “proved” the theory that gender is a purely social construct with his work on the case of David Reimer. In brief, he convinced David’s parents to raise him as a girl after young David’s penis was destroyed during a botched circumcision, the belief being that David would develop as a girl through social conditioning. On the basis of that work, thousands of intersex children have since been arbitrarily assigned either male or female with surgery and hormone replacement therapy, a practice that continues to this day.

But Money was wrong. He used David’s case to push his own ideological beliefs, and even after it became clear that he was wrong when David’s male gender identity eventually asserted itself, he misreported his findings or simply didn’t report them at all. He went on to fame and fortune, and for thirty years intersex people were abused. David finally came forward with his story in the late 1990’s, but Money still has his ardent followers and defenders, most of them in positions of power and influence in the medical establishment.

There is a veritable laundry-list of prominent mental-health and medical professionals that cherry-pick from biology and psychology to construct theories consistent with their own beliefs. Individuals like J. Michael Bailey and Kenneth Zucker, organisations such as NARTH and the Clarke Institute all push their ideologies as science, and because they seemingly have the credentials, people listen to them. Most recently, Dr. Joseph Nicolosi of NARTH appeared on Dr. Phil, billed as an “expert”. Dr. Phil is watched regularly by over 4.5 million people in the United States alone, and gets broadcast on over 20 major networks world-wide. Meanwhile, Dr. Kenneth Zucker, who routinely forces gender-variant children into reparative therapy in order to “cure” them has been placed at the head of the committee tasked with authoring the DSM review on Sexuality and Gender.

Of course, one might argue that these people have a right to say and believe what they want to. This is in fact a favourite argument from groups such as these, and I would agree – rights to freedom of speech and of belief are vital, and I would defend theirs as strongly as I’d defend my own. But they cross a line into malpractice and misinformation when they pass those beliefs off as science. Where their theories and statements do not reflect scientific understanding, they have a responsibility to say so.

Medical professionals and academics have positions of perceived knowledge and authority, and all too often they abuse it to push ideology. Because of that perceived “scholarly authority”, they have an enormous impact on how intersex and gender-variant people are perceived by the media, and subsequently the public. We need to start holding them to account for their statements.


David Reimer was born in 1965 in Winnipeg, Manitoba. One of a pair of identical twins, his birth-name was Bruce and that of his brother Brian. The following year at 8 months old, both brothers were referred for circumcision at a local hospital after it emerged that they suffered from phimosis, a condition where the foreskin does not retract fully from the head of the penis.

Bruce’s procedure went tragically wrong and most of his penis was cauterised beyond repair.

The family was referred to John’s Hopkins Medical Center to see Dr. John Money, who at the time was quickly developing a reputation based on his work with intersex patients. Dr. Money was a vocal proponent of the idea of gender plasticity, believing that gender developed purely as a result of learning, and was well-known for advocating that intersex children with ambiguous genitalia be reassigned and raised as girls.

Naturally, he immediately suggested that the family raise Bruce as a little girl, and at 22 months old, Bruce’s testes were removed. He was reassigned female and given the name Brenda. Dr. Money would continue to see Brenda and her brother Brian for psychological counselling and assessment, and she would be given female hormones to aid her physical development as a girl. In many ways this was an ideal … experiment to determine the validity of gender plasticity as a theory: Brenda had a twin, Brian, who could serve as a control subject, and Bruce had also been born a perfectly healthy, non-variant male. If anything could prove that gender was purely a social construct, this was it.

Throughout her early childhood and into puberty, Brenda grew up and developed as a young girl. She visited with Dr. Money regularly, and he reported the case a fantastic success. On the basis of the case, sex-reassignment in the case of children born with ambiguous genitalia was adopted as standard practice, one that has continued to the present-day in many places.

Sadly, the reality of the situation was very different from what Dr. Money was reporting.

As early as the age of two, Brenda was insisting that he was a boy like his brother Brian, whom he would regularly beat up so he could take his toys to play with. As he grew older, he was regularly bullied at school for his unfeminine behaviour, masculine walk and his insistence to both teachers and parents that he felt like a boy. He hated his visits with Dr. Money, finally threatening suicide if he had to go one more time, and finally, upon the advice of a different psychologist, Brenda’s mom and dad told him the truth in 1980. Brenda assumed a male identity and started living as David.

Unfortunately the damage had been done.

Neglected and confused, scarred by highly questionable “therapy” techniques Dr. Money had employed and struggling to process his new relationship with his “sister”, Brian eventually fell into a pattern of clinical depression, drug abuse and crime that finally culminated in his apparent suicide from a lethal overdose of drugs and alcohol in 2002. David’s parents did not fare much better, his mother attempting suicide and his father eventually sliding into alcoholism.

David also did not cope well. He tried to commit suicide twice in his 20’s, having done so repeatedly in his teens, both before and after learning the reality of his gender. Given to dark moods, fears of abandonment and explosive anger preying on his mind constantly, he believed that he would never be able to form a lasting relationship and marry.

Despite all this, he did meet and eventually marry Jane, and his life seemed to start approaching something like normal. They raised three children together, and after he went public with his story in 2000, sales from the book he had authored with John Colapinto, gave the family financial security.

Sadly it wasn’t to last. Feeling guilty over the death of his brother and haunted by his childhood, David made a string of bad investments, became estranged from his wife and family, and eventually committed suicide in 2004 at the age of 38. Dr. Money’s grand “experiment” was a tragic, terrible failure.

David’s life was an unhappy one, and the circumstances around that life touched the lives of everybody around him with devastating effect. But he left behind a powerful legacy that has given intersex people their most convincing argument in preventing doctors and parents from “fixing” intersex children. Indeed, it was only after he learned from Dr. Milton Diamond how his case had been used to push “surgical correction” of intersex people that he went public with his own story.

His case also dealt a critical blow to the theory that gender is a learned behaviour, instead pointing at one’s sense of one’s own gender being an innate characteristic as fundamental as whether we are naturally right or left-handed. In this, his life also helped the cause of transsexual people enormously, something for which I owe him and his family a profound debt.


To read more about David, his life and his legacy:

1. [John Colapinto] The Case of John/Joan (dec 1997, Rolling Stone Magazine)

2. [John Colapinto] Why Did David Reimer Commit Suicide? (jun 2004, Slate Magazine)

3. [Burkeman and Younge] Being Brenda (2004, The Guardian Newspaper, UK)

4. [uncredited] David Reimer: The boy who lived as a girl (may 2004, CBC News Online)

5. [John Colapinto] As Nature Made Him: The Boy Who Was Raised as a Girl. (2001, Harper Perennial. ISBN 0-06-092959-6)

6. Wikipedia Article on David Reimer (accessed 14 feb 2009)

7. [Hannah Rosin] A Boy’s Life (nov 2008, TheAtlantic)

8. [BBC Horizon] Dr. Money and the Boy with No Penis (2004, BBC2 Documentaries)