The circumcision that went wrong

 
A study that is in every textbook on gender, is one by Money,⁽¹⁾ published in 1974, which concerned a pair of identical twins, where there was no reason to suggest that biological sex was in doubt. During circumcision by cautery, an accident occurred and the penis of one of the twins was almost totally destroyed. Following the theory that a child can adopt an assigned gender role, if the change occurs within the first three years, the little boy was castrated at 17 months and he was given estrogen. Perhaps the results were distorted in that as much as possible was done to enhance female, and retard male, biological maturation.

He was dressed and treated as a little girl by his parents and at the age of four, 'preferred dresses to trousers' and was 'proud of his long hair.' He reported to be much neater and cleaner than his brother, and was more ready to help around the house. Although he was tomboyish, he was less 'rough and tough' than his brother, who was protective of him. What is interesting is that he had always been the dominant one of the pair, at nine he expressed it by being the "fussy little mother" to his brother, while the brother continued the protective male role.

Critics of the study point out that the study was largely based on subjective reports by the mother. Others point out that, even though social learning can override biological beginnings, there still has to be a bias to be overcome.,

The child was lost to follow-up as she approached teenage, among rumours of severe emotional problems. As we know now the child flatly refused any more contact with Dr. Money.

The first hint that all was not well came in 1982, with a BBC television documentary in the Horizon series.⁽²⁾ but it was not until 1997 that the case resurfaced in a paper by Diamond,⁽³⁾ and the person concerned gave interviews to the media.

The story had changed: "Yet by the age of five, his parents knew otherwise. 'It was a disaster,' his mother says now. 'I put this beautiful dress on him and he immediately tried to rip it off.' Joan also rejected Barbie, asked if she could shave like her father, insisted on urinating standing up and, when her twin brother refused to share, saved her pocket money to buy a toy gun."⁽⁴⁾

It has become standard practice in the more serious cases of ambiguous genitalia to reassign male babies as female, since it is possible to create a pseudo-vagina, but not a fully functional penis. It is possible that some psychiatrists are likely to take Diamond's findings uncritically, applying them generally to all cases of ambiguous sexual development, and insisting that all such babies should be brought up as male.

For example. Dr. Emily Hancock, in the Guardian says that "John's case suggests irrefutably that boys are created in the womb. Playing with Barbie and wearing pink dresses can never, she says, undo the power of the XY chromosome." - a classic journalistic soundbyte you might think. She goes on to say "If you subscribe to the nurture theory, you can ignore genes and socialise the child to develop a certain way. But I think John shows that you can't, and trying to alter genetic (sic) identity only leads to disaster."

The central theme of this website is that it isn't as simple as that.

Dr. William Reiner of Johns Hopkins Hospital, Baltimore, is quoted as saying that clinical decisions about a child's sex must be based on his or her most likely psychosexual development.⁽⁵⁾

This would be acceptable if there was an reliable way of predicting it. More recently there has been pressure for clinicians to nothing beyond preserving good health

Bibliography.

1. Money, J., (1975) Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl. Archives of Sexual Behaviour, Vol 4, No. 1 pp65-71
2. Diamond. M., (1982) Sexual Identity, Monozygotic Twins Reared in Discordant Sex Roles and a BBC Follow-Up. Archives of Sexual Behavior, 11(2), 181-185
3. Diamond, M., Sigmundson, H.K., (1997) Sex Reassignment at birth: A Long Term Review and Clinical Implications, Archives of Paediatric and Adolescent Medicine, 151, 298-304
4. The Guardian, 31st., March, 1997
5. The Daily Telegraph, Saturday, 15th., March, 1997

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