Classification: News

: 12 July 1998

John/Joan redux in Pediatrics

A new article in the Electronic Pages of the journal Pediatrics
presents a second case of a Canadian infant whose penis was accidentally
destroyed during circumcision, and whom doctors "reassigned as a female"
by removing his testes. In contrast to "John/Joan", whose case
was widely reported last year, this individual is reported to have developed
a female gender identity, though rather atypical.

Bradley, Susan J., Gillian D. Oliver, Avinoam B. Chernick, and Kenneth
J. Zucker. 1998.  Experiment of Nurture: Ablatio Penis at 2 Months,
Sex Reassignment at 7 Months, and a Psychosexual Follow-up in Young Adulthood.
Pediatrics (Electronic Pages) 102 (1):E9.

The report received widespread attention in the popular press.

Because these cases have been used as "evidence" about whether
or not children with ambiguous genitals can successfully be assigned and
raised as either sex (as asserted by, for example,

the American Academy of Pediatrics), we would like to present a sampling
of comments on the article by intersex people, many of whom were subjected
to surgeries motivated by interpretations of cases like "John/Joan."

The following were assembled by Kiira Triea,


Max Beck (Re: Experiment of Nurture):

     Thanks for the fascinating (if disturbing) URL.
I tend to avoid things medical and academic, particularly those bearing
the label "pediatric," simply to spare myself the inevitable pain.
(Call me an

 ostrich...) The mention of J/J caught my attention, however, since 
Diamond and Sigmundson's work - and, more importantly, John's courage 
- have played a key role in my moving away from pain and into healing.

     I find it interesting that the authors of this
study do not  investigate the possible effects of "negative nurture"
- or reverse  psychology - which seem to leap right off the page: While
John had a

 well-adjusted male twin and a supportive, loving father, Bradley's 
patient had an alcoholic father who left when she was 3-4, in part "because
of the father having had a greater difficulty than the mother  in dealing
with the 'loss' [With what arrogance do the authors suggest  a loss
*hasn't* occurred?!!] of his son," followed by an alcoholic stepfather.
No wonder she "denied ever feeling that she had wanted to be a male"!

     More importantly, however, I find the positive
slant given the patient's desire for further corrective surgery naive and
misguided, and I can only agree with Lee's comments re. time and healing:
At 26, I was - ostensibly - happily, heterosexually married to a man; had

 team of doctors shown up to ask me how I was, that is most certainly 
what I would have told them. 2 years later, at 28, I was divorced, and pursuing
further corrective surgery to normalize my genitalia

 (specifically, to reduce or remove a "palpable, thick cord of
erectile tissue running from the glans," which, I "specifically
complained," became quite engorged "with sexual arousal")
- a normalizing surgery I  requested because previous experience had
shown me that while male

 partners rarely offered commentary, my desired partners - females
- inevitably did, i.e., I wanted to be more "normal" so I could
be comfortably "deviant"!

     4 years later, I am infinitely thankful that
an accepting and appreciative lover appeared on the horizon mere weeks before
the scheduled surgery, which I immediately cancelled. I have been living

 as a male (and on the Big T) since March of 1998, and had I proceeded 
with surgery, where would my wonderfully engorged phalloclit - more than
double its pre-testosterone size - be today?!  It is *so* very important
to move away from these snapshot case histories toward a  bigger picture!
Think of the damage this study might do if it had been published just a
few years ago, with the patient (valiantly, one supposes...) still struggling
to "right" her body for heterosexual





Lee Brown (Re: Experiment of Nurture):

 I think the paper is a reasonably transparent attempt to challenge
the Diamond's findings of the J/J case.  Showing that the Money paradigm
has some validity in this person's case takes away some of the 'blame/guilt'
which can be targeted at psychologists and other specialists involved in
intersexual medicine.  It does this by re-enstating the necessity of
very early intervention (7 months  against 17-21 months for J/J (p.4.l)
and echoing the old demon 'parential ambivalence' (p2r;3l).  This is
what gets me most about the paper -- the person is presented as a showpiece. 
At least in Diamond's work we do get to hear a lot from John (something
which is very uncommon in any of the sexology literature it seems).

 I agree with all the points which Heike says are problems with
the paper ... I would add however some of my general concerns. First intersexuals
are trained to be good patients and to say what the

 'white-coats' want to hear.  There are some rebels in the ranks
but many (including myself) seem to

 internalise those doubts and feelings while they continue to play
the good patient (at least I did then -- I tend to be a slow learner, even
of  rebellion ;-) ).

 My second problem is the question of age.  I know that at
26 I was still busy trying to deny my pain and gender confusion to myself
-- acknowledge it or finally find 'names' for it rather than wonder is

 this what life is?  -- my breakdown / burst-through was still
some years off.

 My third point is that the paper seems to suggest very little hospitalisation
(although whether that's the case or not is impossible to tell) whereas
medical intervention in the J/J case, if the Rolling

 Stone article was correct, was Analoguous to Childhood Sexual Abuse
(to borrow the title of (Tamara Alexander's paper)).

 BTW This is also my difficulty with Diamond's paper on the case
-- what is read as the rejection of being regendered could also be the rejection
of a traumatic situation vis a vis 'being intimately

 studied.'  I do know that in my case the trauma of being regendered
by the "caring professions" locked me out of myself for many years
(see above).

 It is actually very interesting to note that Slijper, ["Long-Term
Psychological Evaluation of Intersex Children", *Archives of Sexual
Behavior* 27(2):125-144, 1998] mention in passing that

 hospitalisation can be a traumatic experience for children but do
not follow it up at all.  They, like the papers mentioned above, remained
focused on the question of gender identity order/disorder rather than questions
of personal bodily integrity and violation.

 In a sense I don't think the paper is a study of the question of
gender identity, rather it is interesting to read it as study of the politics
of sexology.


Heike Boedeker (a world w/out love):

 the focus on "fuckability" is something I always experienced
as abysmally awful, and, indeed, a form of extreme violence. I experienced
it as an "aversion therapy" that, despite my obvious sexual curiosity
and several crushes I had on males (as well as females, I'm not the type
to miss too many things :-)) in my teens, *forced* me to pursue an asexual
lifestlye until my mid 20s, as I just

 couldn't allow the last remnants of my personal integrity to be destructed.
The pathetic irony being that if I could have felt loved this had been the
form of sexuality that I had wanted (I know I'm

 boring :-)). But a world in which my bodly integrity constantly was
at  stake, and in which my genitals were something people took upon
themselves to exploit, was a world w/out love. And everyone who had told
me something different I only could have called a liar :-((


Jeannine Howe (Re: a world w/ out love):

 Sorry Hon I couldn't get through the article. The abstract made me 
want to puke. It was patently obvious IMNSHO that they don't know enough
to fucking go cutting on babies and if they want to slice off a dick they
should begin with the one that belongs to them.


Kiira Triea (Babes in Genderland):

 It's funny how one's perspective on these surgical issues changes
eh? I think over the past five years I've gone from near suicide over my
surgical results to "Since I was treated like crap at the PRU I think
it is appropriate that my genitals *look* like crap. I'm *proud* of my crappy
looking genitals!" In fact during those episodes of Naivety Psychosis
when I sought help from Hopkins they tried to convince me that they could
_improve_ upon Jones' 1974 efforts... in essence I think trying to buy my
availability again. Thankfully, my fear protected me. <sigh>

 It's also interesting how we differ in our preconceptions and experiences
with partners. I never even attempted sex with men or women for fear of
being "discovered" and also shame of my body and

 history. But when I acquired a sense of sexuality I imagined myself
first to be heterosexual because of the nature of my sexuality, then bisexual
and finally "empirical lesbian" seemed to fit best. This was

 at age 32 ... I knew *nothing* of any of this at age 26! Yes.. if
the "white-coats" had asked me did I want sex with men I would
have answered yes. But I believe very strongly that tied up in my ability

 to be sexual with women and not men is simply the belief that women
were less likely to hurt me over my "difference". I am not surprised
considering that my father abandoned me, my stepfather abused me verbally
and physically after surgery and most of the trauma incurred at Hopkins
was inflicted by men. Am I likely to expose my innermost emotional and physical
self under these circumstances?

 What pisses me off is that we ourselves try to believe this stuff
- then when it all crashes we have no one to turn to. We have each other
but I'm betting this kid has no one.


Martha Coventry (URL?):

 I, like Max, am tired of snapshot cases and endless words and paper
being spilled out in overanalyzing one case. I hate the practice of the
medical/academic world of extrapolating theories and whole treatment paradigms
from one or two or even a handful of cases. Look what that practice did
to the clits of America starting in the 50s!! Anyway. I appreciated your
comments, Max, and will read them again after I read the entire piece. They
made me think of my own body and

 what I did to be a woman who could finally be fucked by a man -- only
to see my desire for women find its natural course less than a year later.
Ah, lucky there is self-forgiveness in the world.... (sigh and smile).