As Nature Made Him: The Boy Who Was Raised as a Girl , by John Colapinto. Harper Collins, 279 pages, $26.
Sexing the Body: Gender Politics and the Construction of Sexuality , by Anne Fausto-Sterling. Basic Books, 473 pages, $35.
Circumcision: The History of the World’s Most Controversial Surgery , by David L. Gollaher. Basic Books, 260 pages, $26.
By now, you’ve probably heard the story of John-Joan: Back in 1966, a twin boy had his penis singed off in a hospital circumcision accident so unpleasant it can’t be described in a family newspaper. Under the care of pioneering Johns Hopkins psychologist John Money, he was sex-changed to female. For a quarter of a century, the case was trumpeted as proof that gender was plastic. Joan, crowed Dr. Money, was a perfect little lady: neat, doll-loving and meek, in contrast to her snails-and-puppy-dog-tails brother.
Then in 1996, the truth came out–triggering an ethical firestorm and a re-evaluation of the right of doctors to mess with children’s genitals at all. David (a.k.a. Bruce, then Brenda, the Joan of John-Joan) Reimer had reverted back to male. Taunted as “cavewoman” by his peers, “Brenda” never felt like a girl, and twice attempted suicide. The treatment the child had received from Dr. Money was sickeningly cruel: The doctor peppered Brenda and her twin with prying sexual questions, showed them pornography and even pressured the siblings to act out sexual postures, presumably in an attempt to cement their feminine and masculine identities.
To those hearing it for the first time, the story had the queasy horror-show quality of a Victorian nightmare. And to most, the implication seemed clear: If the John-Joan case had once proved that gender was malleable, it now showed the opposite to be true. Gender was irrevocably lodged in the brain and the body, a ghost in the machine that could not be exorcised by plastic surgery and frilly nightgowns.
But to other observers, the lessons of the John-Joan debacle were subtler and more far-reaching–touching on ethics and interpretation. For Dr. Money’s theories have had their most sweeping application not with genetic males who suffered accidental ablatio penis –a rare enough circumstance–but with a subset of patients few people are even aware exist, intersexual infants, that is, hermaphrodites. Such children, born at a startling rate of one out of 2,000 births, have conventionally been “normalized” through cosmetic surgery, mostly made female and lied to about the body they were born with. But in the last decade, a movement of adult intersexuals has begun to lobby the medical establishment. Children with ambiguous anatomies, they argue, have the right to maintain their healthy, if unusual, genitals, until they are old enough to state their gender and make medical decisions. Being deceived is intrinsically traumatic, and surgery harms the potential for orgasm.
Two new books stir the pot in this debate: John Colapinto’s As Nature Made Him and Brown University biologist Anne Fausto-Sterling’s Sexing the Body: Gender Politics and the Construction of Sexuality . The authors aim at very different audiences: Mr. Colapinto has appeared on Dateline and Oprah , while Ms. Fausto-Sterling’s book is one-third footnotes and academic to the core. But together the pair bookend a potent humanistic response to the John-Joan revelations. Gender, the authors imply, may be a simple matter–or brain-bendingly complex. But either way, the same conclusion emerges: Children outside the boxes of male and female should be loved and supported, not cut. Together with David Gollaher’s leg-crossingly comprehensive Circumcision: The History of the World’s Most Controversial Surgery (sample fact: Until recently, mohels used a sharpened fingernail to remove the foreskin), these books represent a new literature of surgical restraint. We should keep our hands off, they urge, and our minds open.
Mr. Colapinto’s As Nature Made Him , a memoir of David Reimer, is at base a martyr’s tale. In heartbreaking detail, Mr. Colapinto documents the story of desperate parents and a brave, confused child–a boy who sensed all along that something terrible had happened to him but could only guess at what. In an act of unfortunate serendipity, David’s mother and father turned to Dr. Money at precisely the moment the doctor was seeking a test case. The flamboyant psychologist comes across, in this portrait, as a devious and charismatic figure, a tantrum-throwing egotist who was a Jekyll-and-Hyde to the vulnerable family and a bully to skeptical junior colleagues. It’s little wonder that “Brenda” ended up changing her name to David–an homage, in part, to the tiny figure who slew a giant. Indeed, David’s stubborn courage is staggering. He stonewalled doctors and spat out hormone pills; ducked a campaign to pressure him into vaginal surgery; and finally insisted on dressing as he wished and urinating standing up. When “Brenda’s” parents finally gave in and confessed the truth, the 14-year-old felt shock, but also relief: “Suddenly it all made sense why I felt the way I did. I wasn’t some sort of weirdo. I wasn’t crazy .”
With remarkable concision, Mr. Colapinto has telescoped this medical scandal, brilliantly weaving the perspectives of David, his family, friends, doctors, and wife. (Mr. Reimer ended up marrying a woman with three children from other men, and works in a slaughterhouse.) The book’s structure is that of a mystery–one that reveals not only the identity of Mr. Reimer (who, with the publication of the book, has gone public) but that of Dr. Money. Indeed, in the final chapters, it becomes apparent that the psychologist made a dramatic shift early in his career, one akin to Freud’s turn from the seduction hypothesis: In his graduate thesis, Dr. Money celebrated the resilience of intact intersexuals, but he went on to gain fame advocating surgery for these same infants.
While Mr. Colapinto makes a complex tale accessible, Ms. Fausto-Sterling takes the opposite tack–seeking to complicate deceptively simple notions. A biologist and feminist theorist best known for her groundbreaking essay “The Five Sexes,” Ms. Fausto-Sterling’s aim is generous and utopian: to articulate a theory of gender that will enable the social constructionists to lie down with the surgeons, hard-core Darwinians to join hands with Foucaultian queer theoreticians.
The task may be too much for any one book. But Ms. Fausto-Sterling’s weighty tome is an impressive swing of the rhetorical ax over an icy sea of sociobiological cliché. For the last century, she argues, scientists have shunted aside nuanced interpretations in favor of reflexively stamping data male and female. But the resulting blueprints–chromosomes, hormones, gonads, gray matter–are not so clear-cut. Testosterone and estrogen, for example, are present in both sexes and affect much more than the reproductive system. The distinction between a “megaclitoris” and a “microphallus” is in the eye of the medical beholder. When scientists reflexively view such bodily structures as opposites, she argues, their notion of gender devolves to a toggle switch–rather than a set of continuums. In this system, Ms. Fausto-Sterling points out, intersex bodies are inevitably perceived as violations rather than variations, and a boy without a penis can never be a man.
Both Mr. Colapinto and Ms. Fausto-Sterling gloss William C. Young’s famous experiments: Pregnant guinea pigs, their wombs injected with testosterone, produced female offspring who mount their experimental blind dates, rather than extending their hindquarters in feminine “lordosis.” In Mr. Colapinto’s telling, these findings confirm the biology behind David Reimer’s tale–brains are dyed blue or pink in the womb, foreshadowing gender and sexual orientation. But Ms. Fausto-Sterling raises an analytical eyebrow. Like humans, she points out, guinea pigs display a rainbow of sexual behaviors: Female guinea pigs sometimes hump other females without hormonal trickery, for example. But in order to get clear data, researchers cut out anything that blurs categories–always invoking Ellen DeGeneres and never Anne Heche. Hormones organize the brain, but so does sexual experience. (In one chapter, she uses herself as an example.) David Reimer’s experience doesn’t mean male and female are simple categories. It means children should be listened to and granted bodily integrity.
If this reader’s experience is any guide, once you start thinking about these issues, you can’t stop. Female genital mutilation, infant sex reassignment, even the common procedure to shift the urinary hole on hypospadiac males so that they’re able to pee standing up–who are these operations for? Cheryl Chase, the founder of the Intersexual Society of North America, who was clitoridectomized in infancy, puts it one way: “My position is that my genitals are for my pleasure.” She and her allies aim to change the medical culture that carves out difference with a scalpel, whatever the personal cost. It’s a radical suggestion. But if Mr. Reimer’s public coming out has any effect, she may yet get her wish.