As Nature Made Him

“At the Mayo Clinic the baby was examined by a team of doctors. They recommended that Bruce have an artificial phallus constructed at some time shortly before he began school.” 

This initial recommendation matters because it diverges from John Money’s suggestion. If Money’s word had not spread, through the media, to Canadian television, then Bruce’s sex reassignment surgery might never have happened. 

“It was in his first published papers at Johns Hopkins that Money generalized the theory of psychosexual neutrality at birth from hermaphrodites to include all children, even those born without genital irregularity.” 

Money’s overall theory, supported by the medical practice and significant funding, spreads quickly once he gains prestige in his field. This basic theory is the same one that he defends for the next decades. It is the theory that Brenda/David’s case is intended to prove.

“Ron gave him an empty razor and some shaving cream to play with. When Brenda also clamored for a razor, Ron refused. ‘I told her girls don’t shave,’ Ron says. ‘I told her girls don’t have to.’ Janet offered to put makeup on Brenda, but Brenda didn’t want to wear makeup.” 

This example depicts Ron’s and Janet’s efforts to follow Dr. Money’s orders to assert gender norms for their children. Though Brenda’s desire for a male future seems dominant, Janet seeks to offer a stereotypically feminine replacement. As a middle school student, Brenda uses makeup, a reflection of this acknowledged desire of her mother’s.

“By all accounts of family, teachers, guidance clinic workers, and relatives, this illusion of two children of opposite sexes disappeared the second Brenda moved, spoke, walked, or gestured.” 

Colapinto summarizes the overall opinions that he hears from those who interact with Brenda as a child. Even before puberty, her physical features and behaviors signal a gender identity other than the one she is assigned.

“In comparison with her twin brother, Brenda provided what Money variously described as an ‘extraordinary’ and a ‘remarkable’ contrast.” 

In a departure with the overarching opinion of all those who know Brenda, Money’s depiction of Brenda is of contrast with her brother. His language, in writing and in speeches, diverges entirely from the testimonies and written documents that Colapinto gathers as he reconstructs Brenda’s childhood.

“Today David recognizes that if he had told his parents what went on between Brenda and the psychologist behind closed doors—the pressure tactics, cajoling, pornography, and unorthodox inspections and posings—Janet and Ron would never have made her return to Johns Hopkins.” 

David recognizes the important role his silence plays in preventing his deliverance from Dr. Money’s studies. Assuming that his parents are aware of Money’s approaches, David remains silent, and that silence shapes his exposure to difficult experiences. In this way, David understands that blame for his condition is distributed in many complicated directions—he does not attribute all of his silence, or its consequences, to just one party.

“Ron and Janet were almost completely estranged. That summer Janet drifted into an affair with one of the local men to spite Ron. He found out and was devastated. Janet, guilt-ridden, swallowed a bottle of sleeping pills. Ron found her in time to drive her to the hospital in Enderby. Upon Janet’s release, the couple talked about divorce but decided to soldier on somehow together.”

Ron and Janet’s relationship falls apart as their financial situation and Brenda’s struggles become more palpable. Their eroding relationship is a key figure in Brenda’s increasing silence and desire to please her parents. Mentioning Janet’s suicide attempts is also a critical groundwork for her children’s’ later suicide attempts—suggesting that depression and suicidal thoughts can emerge from family biology and circumstance.

“‘All the documentation claimed that this child had accepted her gender identity as a female,’ Ingimundson says. ‘Yet my one visual memory of this youngster is of kind of a’—she curls her hands into fists and bends her elbows in a boxer’s pose—‘tough girl. A rather boyish-looking girl. Rugged.’” 

Brenda’s doctors’ numerous memories of Brenda, recorded carefully by Colapinto, show the contrast between the written word and the visual, lived experience of the medical world. The visual descriptions, and later videos, of Brenda contribute to a picture that reaches beyond the neat (or vague) conclusions of journal articles. Colapinto suggests that diverse forms of evidence are necessary in discussing complex ethical cases.

“Little that Brenda said in her sessions contradicted Ingimundson’s first impression. Though at times Brenda said what she thought the psychiatrist wanted to hear (‘I want to be pretty; I’m a girl, not a boy’), in the same breath she would inevitably reveal contradictory feelings about herself.” 

Brenda’s contradictions are part of her psychiatric history, especially in her prepubescent years. Her inconclusive statements show a difficulty in speaking or representing her constructed self: She works to find a space to emerge with some kind of identity, even if her gender feels inconclusive.

“There people looked like they knew where they belonged. There was no place for me to feel comfortable with anybody or anything.” 

In early puberty, Brenda starts to make friends. She also starts to recognize distinct societal roles that, developmentally, she should belong in. Increasingly, her alienation feels total.

“Reunited finally with her parents and brother in their hotel room, Brenda told Janet that if ever again forced to see Dr. Money, she would kill herself.” 

On their last visit to Johns Hopkins, the Reimers must recognize that Brenda cannot work with Dr. Money any further. Her desperation to avoid his physical grip, his forced control and trapping, reaches its peak. After this point, Dr. Money’s influence over the family wanes.

“After taking a look at Brenda’s medical records and Child Guidance Clinic reports and having one joint session with Brenda and her parents, Cantor abruptly announced to the Reimers that Brenda’s sex reassignment was a dismal failure and that the child must be allowed to switch sex immediately to boyhood.”

Dr. Cantor is the boldest of Brenda’s doctors. Though she is, in retrospect, correct, it is difficult for the Reimers to accept her judgment, especially because she has not built up their trust. Trust between doctors and patients emerges as vital at this point in the text.

“However, Brenda was now living a life in which every instinct had to be denied, repressed, hidden: at dances, at parties, in the classroom, and on the street.” 

As Brenda’s body hits puberty and begins to assert itself, her sexual desires and physical manifestations of masculinity (especially her voice) are hard to hide. In order to exist, though, she must work hard to disguise them. This double trap is increasingly dangerous and difficult.

“‘I was testing her,’ David says. ‘She passed the test.’ Brenda dropped her provoking tactics and began actually looking forward to her psychiatric sessions with McKenty. ‘We didn’t see each other as patient and doctor,’ David says. ‘It was a friendship.’” 

Brenda’s need to “test” Dr. McKenty is part of her way of establishing trust. Critically, Brenda having some power equal to McKenty’s in “friendship” is part of what enables Brenda to speak with the doctor.

“I got so sick to death of doing what everyone wanted me to do. I got to that point in my life, I knew I was an oddball, I was willing to live my life as an oddball. If I wanted to wear my hair in a mess, that’s how I wore it. I wore my clothes the way I wanted to.” 

Brenda’s decision to exist as an “oddball,” effectively presenting herself as a boy, is a marked change of independence in her teenage years. Clothing, and outer representations of masculinity, shift for Brenda before she has the story that seems to give her license to take hold of a distinctly male identity.

“Brenda, dressed in tattered jeans and a torn jacket, her unwashed hair falling in tangles around her face, stalked into the living room and said an awkward hello in her deep voice, then quickly disappeared. Her appearance seemed to make a strong impression on the reporters. ‘When Brenda left the room,’ Janet says, ‘the woman got up and said, “We’re going to get to the bottom of this!” She seemed quite angry.’” 

The BBC crew’s fascination with Brenda mirrors the media fascination with gender and sexuality studies across Brenda/David’s lifetime. When a complete outsider meets Brenda, curiosity blooms. Colapinto’s own interest in the story in some ways mirrors the BBC producer’s: Both are motivated by emotional responses to Brenda’s plight.

“‘I was relieved,’ he says. ‘Suddenly it all made sense why I felt the way I did. I wasn’t some sort of weirdo. I wasn’t crazy.’ Brenda did have a question for her father. It concerned that brief charmed span of eight months directly after her birth, the only period of her life when she had ever been, or ever would be, fully intact. ‘What,’ she asked, ‘was my name?’” 

Brenda’s relief, when she learns the truth about her genital area, is not as emotional as Ron’s. Instead, it offers her a kind of logic, an assurance that she is not “crazy,” as she seemed to believe. The freedom that Ron feels to tell Brenda the truth changes Brenda’s perception of reality.

“He had no choice now but to tell her. He explained that he had suffered an ‘accident.’ Within days, he says, everyone knew. Just as in his childhood, he was suddenly the object of muttered comments, giggling, and ridicule. For David, this proved unbearable. The next day, he swallowed a bottle of his mother’s antidepressants and lay down on his parents’ sofa to die.” 

When David’s girlfriend reveals his phalloplasty to others, David loses the will to live. The delicacy of his masculine life becomes immediately apparent, as his shame stays with him even after transitioning, surgically, to a male life. Despite all the physical pain of that transition, the worst part is the psychic pain of lacking control over his intimate relationships. 

“Citing the Kansas team’s classic work from the late 1950s, Diamond wrote that David’s case was evidence that gender identity and sexual orientation are largely inborn, a result of prenatal hormone exposure and other genetic influences on the brain and nervous system, which set limits to the degree of cross-gender flexibility that any person can comfortably display.” 

Diamond’s argument, which he continues to prove by following up on David’s transition, shifts away from Dr. Money’s theory. This work gradually reshapes the medical field’s vision of infant sex reassignment after David’s case becomes renowned.

“But the strongest impression I was left with was of David’s unequivocal masculinity. His gestures, walk, attitudes, tastes, vocabulary—none of them betrayed the least hint that he had been raised as a girl.” 

Colapinto’s impression of David affirms, for the reader, the achievement and success of his return to a male life. His behaviors and appearance suggest the masculinity that those who knew him as Brenda identified, and they are strong enough to suggest that biology is more influential than nurture in determining gender identity.

“Perhaps the biggest change that will have to take place is in the medical profession’s current view of what it means to be reared with ambiguous genitals, since the Money and Hopkins guidelines are predicated on the belief that such a childhood would be psychologically and psychosexually devastating.” 

At the end of his text, Colapinto suggests the change in the medical field that he imagines in the wake of the release of David’s story. The “devastating” nature of David’s sex reassignment, which he depicts through many stories of its effects, is an important factor in the urgency of this outcome.

“Money insisted that surgical intervention at the earlier opportunity after birth was the only guarantee of the child’s future happiness. ‘You cannot be an it,’ he declared, adding that Diamond’s recommendations would lead intersexes back to the days when they locked themselves away in shame and worked ‘as circus freaks.’” 

Money’s insistence, until his death, upon his own conclusion is confirmed in his conversation with Colapinto in 1999. His language of “it” and “circus freaks” shows his evident bias against intersex existence, though he studied it and found individuals happy in that life in his 1950s dissertation.

“You know, if I had lost my arms and my legs and wound up in a wheelchair where you’re moving everything with a little rod in your mouth—would that make me less of a person? It just seems that they implied that you’re nothing if your penis is gone. The second you lose that, you’re nothing, and they’ve got to do surgery and hormones to turn you into something. Like you’re a zero.” 

David’s comprehension of his missing phallus is one that he likens to a change in physical ability. He wonders why sex organs, and differences in them, become so meaningful, especially surrounding a child. The idea of being a “zero” is comparable to Money’s clear bias in calling someone an “it”: The societal bias surrounding genital difference is one that David aspires to clarify and question.