The Icepick Surgeon

by Sam Kean

  John Money once called the penis “the mark of man’s vile sexuality,” and added that “the world might really be a better place for women if not only farm animals but human males were gelded at birth.” If those comments startled you, well, mission accomplished. Whether it was zealous loyalty or sputtering hatred, no one was ever neutral about John Money. He always got a reaction.

  Money grew up in the 1920s in a strict Christian community in New Zealand. His father beat him for minor transgressions, and his mother suffered even worse abuse. She and her sisters grew to hate the toxic men in their lives, and Money said they filled him with their biases.

  At age twenty-five he fled New Zealand for graduate school in psychology at Harvard, where his colleagues included Henry Murray. He wrote his Ph.D. thesis on the psychological health of hermaphrodites (now called intersex people). Contrary to expectations—even medical textbooks tossed around words like “freak” and “misfit” and “it”—Money found that most hermaphrodites were perfectly normal and had no more psychological hang-ups than the general public. This willingness to normalize hermaphrodites (worldwide, they’re as common as people with red hair) made him a hero in the intersex community.

  Money soon won an appointment at the Johns Hopkins University hospital in Baltimore, where he made his most enduring contribution to sexual psychology. In human beings, several different factors contribute to sexual identity: hormones, anatomy, sexual orientation, cultural expectations, and so on. But beyond all that, Money recognized an additional factor—whether individuals felt masculine or feminine inside.

  While masculinity and femininity usually aligned with genitals and hormones, they didn’t always. You can have male genitalia but feel feminine, or vice versa, among other permutations. Money wanted a term to describe this feeling, so he looked to linguistics. Native English speakers often struggle with the fact that, in other languages, bridges are suddenly “masculine” or tables “feminine,” a feature called the gender of a word. Money borrowed that term and applied it to people. In Money’s schema, “sex” covered chromosomes and anatomy—physical things—while “gender” covered behaviors and feelings. In short, sex was biology, gender psychology.

  “Gender” soon entered the general lexicon, and Money reveled in his fame as the coiner of the term. He then parleyed that fame into greater notoriety by taking provocative stands on social issues. Some of these stands seem quaint nowadays. People gasped when he advocated for nudism and open marriages and defended S&M. Other stands still seem reckless. During public lectures, he showed graphic slides of bestiality and feces-eating, fetishes he supported as perfectly wholesome. He also endorsed pedophilia in some cases, and got exasperated when people treated incest as a black-and-white issue. In fact, he said, stepfathers preying on stepdaughters was usually a good thing, since the mother was “glad to have [the husband] off her back.”

  It’s hard to know whether Money believed this crap. He loved getting a rise out of people, and once described his method of theorizing about sexuality as “playing a game of science fiction.” But once he carved out a position, he defended it to the death. Those who challenged him weren’t just wrong or misguided, either. They were hateful, small-minded bigots hopelessly mired in the past.1

  Beyond a brief marriage, Money had virtually zero personal life. People at Hopkins loathed him as a cheap S.O.B. with a volcanic temper. He made his students peel the stamps off envelopes so he could reuse them, and he raided the buffet at the hospital at night and packed the leftovers into plastic bags. Colleagues who dared point out his mistakes quickly learned to never do so again, lest they face his wrath a second time.

  The infamous psychologist and gender theorist John Money, in his office with tribal art and a mysterious boiling cauldron. (From the Collections of the Kinsey Institute, Indiana University.)

  Instead of developing friends, Money mostly sought out sex partners. He looked like a groovy ’60s swinger with his mustache and turtleneck, and he eagerly played the part, cruising parks and bathhouses to hook up with men or women, whoever was game. At scientific conferences, he organized orgies with other attendees. (I must admit I have never been to a scientific conference like that.)

  Money’s notorious private life only boosted his popularity in the media, of course. And more than any other sexologist of the last century (Kinsey, Masters and Johnson, Dr. Ruth), Money helped usher in the sexual revolution of the 1960s with his Playboy magazine interviews and raucous appearances on television. One TV spot in particular, on the Canadian Broadcasting Corporation, would have epochal consequences.

  In 1965, at Money’s urging, Johns Hopkins opened the first surgical unit in the United States for transsexuals.2 (Before that, they often went to Casablanca.) Most psychologists at that time considered transsexualism a mental disorder, and operating on transsexuals was sometimes compared to giving lobotomies. Opening a clinic to encourage transsexualism therefore seemed outrageous even for John Money. So in February 1967, the CBC brought Money on to defend the clinic, along with a male-to-female transsexual.

  The host attacked Money from the get-go, asking several dumb questions. (“Isn’t it a fact that a homosexual will come to you and say, ‘I want to be castrated’?”) But however belligerent in private, Money was always smooth on camera and easily parried the attacks. When the host accused him of playing God, Money smirked and asked, “Would you like to argue on God’s side?”

  At one point, Money took questions from the audience, including one about intersex children with ambiguous genitalia. Money had long pushed for operating on such children, to “fix” their genitals before they suffered psychological trauma. Why he took this stance isn’t clear. After all, his own research had shown how well-adjusted most hermaphrodites were. Regardless, he assured the studio audience that surgeons could sculpt intersex babies into either boys or girls, whichever sex seemed most appropriate. Parents could then raise the child as either sex, and he or she would grow up perfectly normal.

  It just so happened that a young couple in Winnipeg was watching the show. Being provincial, they didn’t recognize Money’s accent—they thought he sounded British. Nor did they grasp all the psychosexual jargon3 he deployed. But their eyes went wide when he mentioned fixing children’s genitals. Here was someone who could help their little Bruce.

  To understand the disaster that unfolded, it’s necessary to step back a bit and explore a longstanding debate about the so-called blank slate theory of human nature.

  There were two camps here. One side argued that a person’s character and personality were set at birth, and that culture couldn’t alter that essential, inborn nature. The other side argued the reverse: that human beings were blank slates at birth, and that culture alone shaped us. With regard to human sexuality, the debate came down to this: Which factor dominated—biological sex or psychological gender?

  For Money, gender trumped sex. Why? Because he knew from his research on intersex and transsexual people that gonads and X/Y chromosomes don’t always determine gender. Most of the time, gender, sex, chromosomes, and anatomy align. But some people feel male or female despite their gonads and chromosomes. In other words, gender can override anatomy and physiology.

  That’s true as far as it goes, but Money then took things further. The occasional mismatch between anatomical sex and psychological gender in some people led him to conclude that gender was fluid in all people, especially in infancy.4 Indeed, human beings were sexual blank slates at birth. In his own words, “Sexual behavior and orientation as male or female does not have an innate, instinctive basis.”

  This in turn led to other, edgier conclusions. Statistically, most people with a penis and XY chromosomes are erotically attracted to women. But Money downplayed the idea that biology had anything to do with this.5 Rather, society conditioned people with penises and XY chromosomes to find women attractive, little different than Pavlov’s dogs drooling when a bell rang. The same went for people with ovaries and XX chromosomes. Again
, statistically speaking, most people with ovaries and XX chromosomes find men erotically attractive. But that’s not because of hundreds of millions of years of biological heritage as animals. Rather, these people with ovaries were simply empty-headed automatons doing the bidding of a patriarchal society.

  Perhaps Money was playing another “science fiction game” here. But many people took his pronouncements seriously, and went even further than he did in dismissing the biological basis of sexuality. Indeed, the idea that gender and sexuality were mere social constructs dovetailed perfectly with the revolutionary politics of the 1960s. In short, Money’s science was politically trendy—which, historically, is a warning flag for abuse.

  Now, Money and his allies weren’t wrong to claim that some aspects of gender are socially constructed. No one really thinks that preferring pink over blue has a genetic or hormonal basis. In addition, stereotypes about women have (obviously) been wielded to deny them opportunities for many millennia. But the claims by Money’s most radical disciples that chromosomes and hormones never play any role in making anyone masculine or feminine is, frankly, garbage—a view no more grounded in reality than Trofim Lysenko’s efforts to grow lemon trees in Siberia.

  To be clear, these radicals—most of whom were social scientists—weren’t simply carving out some exceptions here and there, or arguing that men can have a feminine side and women a masculine side. All that’s true. Rather, like fundamentalist Christians, they essentially denied that evolution applied to human beings. Homo sapiens were somehow magically exempt from the laws of nature that have shaped the sexual behaviors of every other animal in Earth’s history. Culture trumped chromosomes, period.

  Now, it’s one thing to play such “games” in academia. (To paraphrase George Orwell, there’s nothing so stupid that some intellectual won’t believe it.) Money’s real sin was applying his theories in the clinic, to actual human beings. Whenever he came across an intersex baby with ambiguous genitalia, he pushed for surgery to make them look more conventionally male or female. It didn’t matter which. Because if gender dominated biology, all parents had to do was raise their surgically altered child as masculine or feminine and, presto chango, that upbringing would override everything else and produce a perfectly normal boy or girl.

  Still, even though children could theoretically swing either way, in practice Money usually recommended chopping down intersex infants into females. Why? A Freudian might recall his remark about gelding men and raise an eyebrow. But in practical, surgical terms, it was also far easier to construct a vagina than a penis (often by using sections of colon). As one surgeon crudely put it, “You can make a hole but you can’t build a pole.” And again, as long as the surgery took place early enough, before about thirty months, parents could allegedly raise a child as either male or female.

  By the 1960s, Money’s views on gender and sex fluidity dominated academic psychology—“a consensus,” one historian noted, “that is rarely encountered in science.” But he did face some pushback. In the late 1950s, scientists at the University of Kansas performed a series of experiments on guinea-pig fetuses. In the womb, the brains of mammals are washed with either male or female hormones, depending on which gonads they possess. To mimic these conditions, the Kansas scientists took some female guinea-pig fetuses and flooded them, in utero, with male-typical levels of testosterone. When these females grew up and matured sexually, they acted like males: they mounted other females in an aggressive manner and began thrusting their hips. Similar experiments, in which males were exposed to female-typical hormones in utero, produced males who would lie prone and raise their rumps to facilitate penetration (an instinctive behavior called lordosis). In all, hormones alone—a biological factor—seemed to determine whether guinea pigs behaved in male-typical or female-typical ways. And unlike with humans, it was hard to argue that guinea pig culture was somehow indoctrinating them.

  Money dismissed these findings as mere “rodent” research, and he had a point. As we saw earlier, results in animals don’t always translate to human beings. That’s especially true with something as complicated as human sexuality. Couple that fact with Money’s formidable status and power, and the challenge from the Kansas lab might have died out quietly—if not for one thing. In 1965, a bravado graduate student in the lab, Milton Diamond, decided to go after Money, penning a paper in which he picked apart the blank-slate theory of human sexuality.

  Rather than ignore him, Money went on the attack, and not just in print. At a conference on gender a few years later, a drunken Money spotted Diamond at a cocktail party and screamed, “Mickey Diamond, I hate your fucking guts!” He then stalked over and allegedly (accounts differ) clocked Diamond in the jaw.

  One line in Diamond’s paper especially irked Money. Hermaphrodites had both male and female sex characteristics, and Diamond conceded that perhaps gender was flexible in such cases. But it didn’t follow that gender and sex were flexible in all human beings. As Diamond protested, “We have been presented with no instance of a normal individual appearing as [i.e., who was born as] an unequivocal male and… reared successfully as a female.”

  Twenty months later, Money appeared on the CBC. A few days after that, a letter arrived from Ron and Janet Reimer in Winnipeg about their mutilated baby boy, Bruce.

  It was a godsend. Money had once lamented how medical ethics limited the “rights of clinical investigators” to experiment on human beings. Suddenly, though, a perfect natural experiment had fallen into his lap. Raising Bruce as a girl would answer that sniveling twit Diamond’s challenge and prove once and for all that sexuality was a blank slate. Why, the boy even had an identical twin brother to serve as a control.

  Money grabbed a pen and wrote a letter to the Reimers, urging them to bring Bruce to Baltimore. His experiment in what one critic called “psychosexual engineering” was about to begin.

  Two newspapers in Winnipeg had gotten ahold of the botched circumcision story and run big articles on it. Miraculously, the Reimers’ name never leaked, but Ron and Janet grew paranoid about being outed. They were scared to even hire a babysitter and have a night out to decompress. What if Bruce’s diaper needed changing and the babysitter peeked? Instead, they sat around and brooded. Janet railed against God for allowing her son to be maimed. Ron began drinking heavily, and had tumultuous dreams in which he strangled the doctor responsible.

  Then, during yet another night in, they saw Money on the CBC. They wrote to him in desperation—and to their joy, the famous television scientist wrote back. They left for Baltimore soon after.

  The décor in Money’s office startled them—especially the tribal art with gaping vaginas and freakish phalluses. (Their surprise no doubt titillated him.) Once they’d settled in, Money outlined his plan to remake Bruce into a female. He assured them that the surgeons at Hopkins had performed the necessary operation many times and could craft a perfect vagina for Bruce, one capable of orgasm even. Bruce would never bear children (no uterus), and would need supplemental estrogen later, but beyond that, he’d be a perfectly normal woman.

  Still, Ron and Janet hesitated. Surgery, at such a young age? They returned to Winnipeg to think things over.

  Their indecisiveness over the next few months annoyed Money. If they didn’t play ball, his perfect experiment would fall apart. He began writing letters to them, explaining that their inaction was dooming Bruce to a life of torment. What Money didn’t explain—a clear breech of ethics—was that his proposed treatment was highly experimental. Doctors at Hopkins had indeed performed vaginal-construction surgeries before, but only on children of indeterminate sex. No one had ever raised an anatomically typical boy as female before.

  Eventually, the Reimers gave in: surgery seemed the best way to minimize the humiliation for Bruce—and for themselves. In July 1967, they flew back to Baltimore and let their baby go under the knife. Surgeons propped his tiny legs into stirrups, and set about castrating him and refashioning his empty scrotal sac into a vulva.
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  Now came the hard part. Before Bruce went home, Money drilled Ron and Janet on the importance of two things: secrecy and consistency. Bruce could never know that he’d been a boy, and his parents could never treat him as anything but a girl. That meant a new name—Ron and Janet chose Brenda—as well as dresses and long hair and girly toys. Brenda needed to be completely socialized as female.

  Brenda, alas, had other ideas. The first few months after surgery were uneventful; babies are largely oblivious. But as a toddler, Brenda began throwing tantrums about her clothing. As a sort of coming out party for their new girl, Janet made a lacy dress for Brenda out of the satin from her own wedding gown; Brenda responded by tearing it off her body. Brenda also hated being left out of male activities. One morning, when the twins were watching their parents get ready at the sink, she had an absolute fit when Brian got to learn how to shave while she had to learn how to apply makeup.

  Toys were another battleground. In grade school Brenda secretly spent her allowance on plastic guns at the store, and when Ron and Janet gave her a toy sewing machine once, she stole Ron’s screwdriver and took the machine apart. To be sure, many a budding female engineer or soldier might have done the same. But Brenda was hardly the sugar-and-spice-and-everything-nice little girl that Money had promised.

  The most chronic problem involved urinating: Brenda refused to sit down to pee on a regular basis. She wanted to stand instead, which would have been messy enough for a girl. But because she was peeing out of a former penis hole, the urine stream shot out horizontally from her body, spraying everywhere. Brenda insisted on standing anyway, even at school, which disgusted her classmates.

  That was just the start of her trouble at school. From kindergarten forward, Brenda’s classmates rejected her; even teachers looked askance. To be sure, Janet did her best with Brenda, tying ribbons into her curly hair and making her balance books on her head to improve her slouch. Still, while Brenda looked convincingly girly, as soon as she started walking or talking, she betrayed herself as most unladylike.