In 1965 David Reimer was born a boy. Eight months later during a botched circumcision his penis was burned off. Concerned about David’s psychological well being David’s parents went to Johns Hopkins Medical Center and consulted psychologist John Money. John Money, a bit of a maverick in his field, suggested that David undergo a sex change operation. Under his parents consent David was given strong estrogen doses, genitalia reassignment surgery, and raised as a female.
The more despicable aspects of the gender reassignment are prevalent in the details. Dr. Money’s main goal was not to help David but instead to prove his psychological hypothesis that gender roles and attributes result from nurture not nature. He thought that if David looked like a girl and was treated like a girl then he would become a perfectly normal girl. He did not inform David’s parents that he was treating David as an experiment. David had a twin brother to use as a control and he gained consent from the parents during a time of duress.
David discovered that he was born a male at age 14 and promptly decided to assume a male identity. Despite what Dr. Money’s published reports might say, the experiment failed miserably. David never felt like a female. His peers ostracized him along with experiencing suicidal depression. In 1997 he elected to reverse the treatment and married a woman.
In 1997 he also publicized the failures of the treatment with the help of sexologist Milton Diamond. Diamond published a book on David’s life with the intention of discouraging other family’s from using similar treatments on infants.
The general question of gender reassignment is a difficult topic to conquer in a blog post. However, I would like to focus on the circumstances under which these parents agreed to have gender reassignment surgery. Their son of eight months underwent a relatively common procedure (the means of circumcision were somewhat untested) that rarely had complications. My question is how did this unfortunate situation lead to a much more horrific one. Dr. Money obviously had a large role to play, but in this case the parents should have been able to protect their child. If gender reassignment surgery was a feasible solution for this case, then how is it that repairing the existing ‘equipment’ was not another solution? This would have been a much better solution to the problem that the parents should have seen, but they didn’t. Why not? The parents were not in a position to be making the decision for their child despite their legal prerogative. Sometimes parents can be too close to a situation to make an objective decision. Their views are distorted during times of particular duress as reported during this experiment. It’s a stick situation though. If an objective third party rules against the will of the parents, then who makes the final decision? I say that there are times in which a third party can make the final decision or, especially when time is not a factor, where decisions must be delayed for significant periods of time in order to give the family perspective on the situation lest they hastily make a rash decision.
The other important thing to note in this case is that it took over thirty years for this case to surface to the public. Why so long? I would say because the issue was particularly psychologically difficult. What does that mean? It dealt with sex and sexuality. Many advancements have been made in medicine, but an area that continues to lag behind are areas relating to sex and sexuality. There exists a social stigma in publicizing sexual matters. But should a social stigma prevent advancement? I do not think that anyone can force another person to publicize their private lives without their consent; however, there are few situations in the medical field in which sharing knowledge leads to bad consequences. Perhaps we should recognize and attempt to tackle some of the social issues stopping medical advancements. Tackling does not mean throwing aside, but it means that the issues must be met head-on instead of avoiding them.
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2 comments:
The fact that the result of the botched circumcision is his penis being burned off make this a horrifying case all on its own.
However, Dr. John Money is a fabulous name.
(This is not my comment, and should not be graded as such.)
I think there are two major issues that come to the surface in David Reimer’s situation. The first issue is that Dr. Money deceived David’s parents by persuading them to treat David like a girl without telling them that his motivation was to test one of his hypotheses. He apparently failed to notify the parents of this, which meant that the parents were probably not properly informed, so they were not giving “informed” consent. The second issue that arises is that of attempting to change the sex of dependents.
Firstly, Dr. Money’s advice was, for the most part, selfish and deceptive. According to Matt, Dr. Money failed to inform David’s parents that the procedure was experimental. If the parents had known this, they probably would have taken a step back and realized that it would not have been a safe decision to raise him as a girl. His doctor took advantage of his status as a physician, whose job is to protect the patient, according to the Physician’s Oath in the Declaration of Geneva, and so David’s parents naively consented to his advice.
The second issue that arises is that of gender reassignment. Is it ethical to reassign a child’s gender when there are complications with reproductive organs? I think it is most certainly unethical in any scenario to reassign a dependent’s gender. In David’s case, clearly the emotional and psychological consequences of the procedure were severe, considering that David was ostracized and later threatened suicide, and caused the relationship between David and his parents to deteriorate rapidly. Evidently this gender reassignment was a massive mistake that ruined David’s early life and had lasting effects.
So the main issue that Matt raised was that sometimes it takes a third party to make a sober decision in a trying situation. I think that it is important to seek the advice of an outside individual, especially when that individual is supposedly more knowledgeable about the topic pertinent to the decision. However, David’s parents were probably thinking the same thing, seeking the advice of a professional in search for answers to their very unique and very trying situation. As observed in hindsight, however, the advice and opinion of one other individual may not necessarily be the best decision. In light of the tragic outcome of David’s situation, I think it is the responsibility of guardians to seek second opinions, and other sources before making such a solemn, life changing decision. No matter how stressed, anxious, or worried David’s parents were, they should have consulted with other professionals about this gender reassignment idea, getting more information from multiple source. Perhaps if they had consulted a psychologist and other doctors unrelated to Dr. Money, they would have been dissuaded to reassign David’s gender.
While some people have less time to make these trying decisions than others, it is always important to seek other opinions and get advice from more than one individual. When the ideas of two parties differ, it is time to do some research. While it was outrageously unethical for Dr. Money to deceive the parents by conveniently withholding the fact that he was using David for an experiment, it was still the parents’ responsibility to seek the advice of multiple sources in regard to this outlandish and cruel upbringing. After all, such a huge decision probably shouldn’t be left in the hands of one “maverick”.
In general, when people are faced with a daunting ethical dilemma, they should not resort to just one or two outside opinions but should seek the advice of various different professionals.
Sources:
http://www.cbc.ca/news/background/reimer/#top
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