This strangely titled book makes an important contribution to the histories of medicine, psychiatry and sexology. It contextualizes John Money’s studies on intersex, transsexualism, paraphilia and hermaphroditism in the ethos of the era, when humanism peaked and when Western science held that plasticity and humanity were equivalent.   This book shows how Money’s contention that one can “be want you want to be” (and forget about biology) was consistent with the Civil Rights and feminist thrust of the times.    

Money was a New Zealand-born psychologist who spent most of his controversial and high profile career in the U.S.A., mostly at Johns Hopkins School of Medicine, where he headed the Gender Identity Clinic and his self-styled Psycho-hormonal Research Unit. Before making his mark at Hopkins, and becoming the preeminent voice in his field until he was dethroned, Money did doctoral research at Massachusetts General Hospital, affiliated with Harvard Medical School.

Those who wonder how these three essayists and editors coined the title of their book will be reassured to learn that they appropriated the term from Dr. Money himself, who half-seriously described his nascent field as “f**kology.” The lead author credits Money for his mastery of linguistics and nuances of language as well as sexology, and apparently admires his neologism.

If we read between the lines, we wonder if the triad who contributed to this book is sending a sotto voce message to their deceased subject through their irreverent and readily misappropriated title. Is this a way of saying, “F U,” to a man whom they do not admire and whose methods they decry? Money died in 2006, having shaken the study of gender identity and gender preference at a time when feminism challenged gender norms, and expressed special ire for Freud’s insistence that “anatomy is destiny.” As we learn, feminists found no friend in Money, and vice versa.

Even more importantly, as one contributor explains in the collections’ most important essay, the “human potential movement” of the 1970s and the American Civil Rights movement of the 1960s promoted belief in the primacy of individual choice and in culture’s ability to trump biological inclinations (even if those two goals are sometimes at odds). Just as King dreamed that men would not be judged by the color of their skins, Money likewise held that humans would not be defined by their birth genitalia. The book’s essays reveal contradictions in Money’s conclusions, but point out his pivotal role in research at a pivot-point in American social history.

The authors present conflicts between Money’s biologically grounded research and the ideology advocated by feminists, who were gaining ground as he wrote. Money’s studies on adreno-genital syndrome’s influence on gender role and preference captivated the feminist press but did not gain allies in that camp. Money made other enemies as well. Money became so identified with biologically based intersex syndromes that many did not realize that he earned his doctorate in pyshcology and that he held a doctor of philosophy degree ratehr than an M.D. degree.   

Rather than detailing Money’s pioneering studies, his flawed methodology and the inherent limitations of studying such small samples, this book elaborates on the tragic case of a boy who was born in 1967 but ultimatedly suicided in 2004. As an infant, Bruce Reimer suffered a surgical accident that left him without a functioning penis. Money consulted on the Reimer case when Bruce (soon to become Brenda) was still young, and when the befuddled parents expected experts to recommend a better life course for their injured infant. Money had already been criticized for extrapolating from persons who were born with endocrine anomalies, and whose developing brains were exposed to qualities and quantities of gonadotropins that differed from gonadotropins secreted under ordinary circumstances. Some said that Money saw baby Reimer as an opportunity to offset scathing critiques of his research methodology. Here was a baby boy, born witout a genetic or endocrinoloigcal abnormality, who was the unfortunate victim of a circumcision accident that left him with “aphallia,” a condition otherwise encountered in conjunction with endocrine or genetic abnormalities. He could be Money’s “control study”—which was all the better, because Bruce/Brenda had a twin brother who could be monitored.   

At Money’s recommendation, the Reimer family agreed to alter their child’s gender surgically, and to rear Bruce as a girl. Phalloplasty was not advanced enough in those years to attempt to reconstruct the lost phallus, and so they chose the route of least resistance. Bruce became Brenda, with the advanced knowledge that Brenda (nor Bruce) would not conform to full gender expectations or reproduce naturally. Brenda received estrogens, still unaware of her past. Most of her doctors and both of her parents believed that gender identity remained malleable at that age.

However, Brenda was never comfortable in her female guise and never lost normative gender-specific interests. As a teen, Brenda chose to live as a male. He eventually married a woman and adopted her children. “Brenda” became David, but not for as long as he should have. David took his own life at the age of thirty-eight. A few years earlier, he collaborated on a 2000 biography that contradicted Money’s written reports. Money objected to David’s accounts.

I do not want to lend the impression that this book is a pastiche of tearjerker stories like Reimer’s. Nor is it an expose of medical-ethical breeches that were not deemed unethical in their own era, when there were no precedents and when medical ethics as we know it was not on the radar.  These diverse essays incorporate diverse data, including comparisons with ethologist Konrad Lorenz and psychoanalyst Robert Stoller, who studied the psychodynamics of  “intersex,” transvestism and transsexualism. Krafft-Ebbing and names of other 19^th century theorists of sex (including Freud) appear on these pages, along with more contemporary sex researchers, such as Masters and Johnson, Kinsey and Pomeroy. Money’s nemesis, the biologist Milton Diamond, who vehemently opposed Reimer’s irreversible surgery, gets ample attention.   

The three authors’ backgrounds are as diverse and fluid as their subject matter. Lead author Lisa Downing is Professor of French Discourses (and perhaps that explains the emphasis on Foucault). Iain Moreland is a British musical technologist who writes on gender and sexuality, medical ethics, and science. Nikki Sullivan is an Honorary Researcher, Department of Media, Music, Communication, and Cultural Studies at the University of South Australia, where she teaches. It is unclear to me if the authors anticipated just how timely their topic would become post-publication. This book may not receive as much attention as Vanity Fair’s cover photo of the transformed Caitlyn Jenner, but it surely deserves attention from medical historians and ethicists as well as gender theorists and psychiatrists who treat persons with gender concerns.

© 2015 Sharon Packer

Sharon Packer, MD is a psychiatrist who is in private practice in Soho (NYC) and Woodstock, NY. She is an Asst. Clinical Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine. Her books includeDreams in Myth, Medicine and Movies (Praeger, 2002), Movies and the Modern Psyche (Praeger, 2007) and Superheroes and Superegos: The Minds behind the Masks (Praeger/ABC-Clio, 2010). In press or in production are Sinister Psychiatrists in Cinema (McFarland, 2012) and Evil in American Pop Culture (ABC-Clio, 2013, co-edited with J. Pennington, PhD.) She can be contacted at drpacker@hotmail.com .