As Nature Made Him: The Boy Who Was Raised as a Girl

Epilogue

IT IS ONE OF THE FIRST MAXIMS of science that no theory can be based on a single experiment. This truism applies as much to Milton Diamond’s revelations about the failure of the twins case as it does (or should have) to Money’s original reporting of its success. While it is also true that Diamond cites David’s case not as an isolated one (he has repeatedly presented evidence to the same effect, both clinical and theoretical, in cases involving intersexes), it is only through continued study and follow-up on cases of developmentally normal boys turned into girls that medical science can confidently proclaim whether it is nature or nurture that predominates in the making of men and women, boys and girls.

Such cases, which rely exclusively on genital accidents resulting in loss of the penis, are necessarily rare. Yet with the high-profile debate generated by David’s case, there are already signs that what cases do exist are being followed up and reported on with a greater rigor than previously. In February 1998 the Urology Times published a report by Dr. Bernardo Ochoa, former chief of pediatric and urologic surgery at the University of Antioquia in Medellín, Colombia, on the case of a baby boy who, like David, lost his penis in an injury and was subsequently reassigned to girlhood by castration, vaginal surgery, and hormone treatment—with results strikingly similar to David’s. “She and her family received extensive psychosocial assistance,” Ochoa reported. “However, when she became an adolescent, 14 years later, she demanded to be reassigned as a boy because she didn’t feel she was a girl.”

In pursuit of further data, doctors and researchers will almost certainly pay particularly close attention to events that began at Atlanta’s Northside Hospital in 1985, when on a single day two developmentally normal newborn boys suffered severe penile burns from bungled electrocautery circumcisions. One boy lost his penis entirely, the other a significant portion. The parents of the child in the former case agreed to sex reassignment of their child as a female; the other parents opted to have their child receive plastic surgery to create an artificial penis.

Here was another of those one-in-a-million chances, another unplanned experiment of fate, in which two children became ideal matched controls in a living laboratory experiment, this one offering researchers a unique comparison study of how best to deal with the calamity of penile loss: sex reassignment or phalloplasty ? With the children currently on the eve of their fourteenth birthdays, privacy issues have prevented much information on their condition from being released, and I was able to glean only minimal reports when I spoke with the several lawyers who represented the parents in their lawsuits against Northside Hospital.

Thomas Sampson is the lawyer who won a $2.2.8 million settlement for the parents of Antonio, the boy who is being raised as a male. According to Sampson, Antonio is doing better today than was ever expected at the time of his injury. He experienced a period of difficulty in his early school years, when he underwent several operations for phalloplasty and experienced some cruelty, both intentional and otherwise, from his peers. But now in tenth grade, his social situation is considerably better. He displays no difficulties with his identity as a male, though whether he will ever feel confident enough to have sexual intercourse with his artificial penis and to father his own children, only time will tell.

The fate of the other child is less well known and more carefully guarded. Castrated and converted to girlhood at less than two weeks of age, she is known in court documents simply as “Baby Doe.” For the last year and a half, I have sought word of her mental and emotional state from her lawyers and physicians, but they have refused all comment. What few facts I was able to verify independently did not augur particularly well. Her parents divorced while she was still young. Doe lives with her mother—although in a relationship whose future is unsure. According to a lawyer involved in her case, she was recently placed under the care of a court-appointed guardian.

I spoke to David about Baby Doe during my last trip to see him in Winnipeg in the summer of 1998. Deeply upset, he insisted on dictating a letter to the child’s parents, in which he offered himself for advice or support to them or their daughter. His letter went unanswered. “I wasn’t surprised,” David says. “I’ve been there, and so have my parents. They just need time.”

Since then David has found himself dreaming of Doe, who has appeared to him in his sleep as a mute younger sister desperately trying to communicate something through enigmatic scribblings on a child’s chalkboard. That David should feel a special kinship with Doe is not surprising, for not only has she undergone the same accident and treatment that have shaped David’s life, she also shares other uncanny similarities with him. Remarkably enough, both children injured at Atlanta’s Northside Hospital in 1985 happen to have been born on 22 August—twenty years to the day after David and Brian Reimer came into the world. The psychologist who consulted on Baby Doe’s case—five years after David announced his decision to live as a male—was Dr. John Money.