| Background On Dr. John Money |
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| Medicine - Medical Horizons | |||
| Written by TS-Si News Service | |||
| Sunday, 09 July 2006 08:22 | |||
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Further Information On The Johns Hopkins Gender Researcher
 Remembering who we are. A wide variety of adults with a history of Harry Benjamin Syndrome (HBS) report early and vivid memories of the misalignment between their innate neurobiological properties and anatomical sex.
Early self-knowledge, universal across all class and social distinctions, forms an intrinsic indicator of those born HBS. It crosses national boundaries and religious training. The reports can mix
• very early and direct recollection
("I have always known I'm a ...")
with
• memories of memories
("I remember that I recalled ...").
Significant research effort in recent years deals with the means used by children to organize and report on their experiences, and measures to determine their veracity.
Mounting evidence suggests that using adult standards to assess such reports is an error.
Harry Benjamin Syndrome (HBS) is a birth condition that appears to occur randomly in all human populations.
Arbitrary social constructions — such as class, race, and social status — have no bearing on the HBS incidence rate, nor do other characteristics (such as intelligence or physical dimensions).
Moreover, modern scientific assessments indicate that HBS has no connection with sexual orientation. Dr. Money was born in New Zealand in 1921 and moved to the United States in 1947 to study at the Psychiatric Institute of the University of Pittsburgh. He entered the relatively new field of psychology and emigrated to America. He attended Harvard University, earning a doctorate in 1952, then moved to Baltimore.
Sexual Ambiguity. Money dedicated research to the then virtually unexplored topic of infants born with ambiguous sex organs.
 Gender Studies. In 1955, Money introduced a distinction between "sex" and "gender", contributing to a more sophisticated discussion of the differences between men and women. The distinction became important in sexology and Women's Studies.It also blurred lines between innate biology and presentation, resulting in an enduring debate over whether there are any innate differences. This latter point became progressively more important for transsexuals with the passage of time.
Money coined the term "gender role" and offered theories that challenged 1950s-era sexuality taboos that did not account for gender roles and identity. Both terms were critical in the development of modern gender studies.
Money’s use of the term gender redefined the concept into a much broader and more synthetic concept than one of male and female. Under his formulation, gender included an individual’s status as a man or a woman, along with personal recognition of social assignment and legal determination.
Thus, in Money's work, gender transcended one’s genitalia but largely minimized internal biological states in favor of external descriptions that emphasized behavioral criteria.
In Money’s usage, gender identity became a self-categorization of one's personal individuality as male, ambivalent, or female. It is based on the personal experience or self-awareness of one's own mental processes and of one's own actual behavior.
So, gender role became the public manifestation of one's gender identity. Identity, in this case, consisting of presentation that provides a basis for other people to infer whether one is male, female, or fits a different, unknown, categories.
Money coined a new term: Gender-Identity/Role (G-I/R) to stress that gender identity and gender role are two aspects of the same thing, but the formulation did not gain widespread acceptance by the scientific community.
Psychohormonal Research. Dr. Money did groundbreaking research as director of the Psychohormonal Research Unit at The Johns Hopkins University Hospital. As the principal pediatric clinical psychologist, and assisted by his partners, John and Joan Hampson, the program attemped to learn the timing and sources of gender identity.
According to the team's results, gender identity followed the sex of assignment and rearing more closely than it did genes or hormones. This apparent primacy of social learning over biology in their patients underpinned the 1960s feminist movement.
The basic thesis was that sex was a many-faceted social construction that could influence the management of ambiguous genitalia from determination of the baby's real sex to determination of what sex should be assigned. In that period, sex determination typically involved checking gonads or chromosomes and did not involve the much more sophisticated zoological techniques common in today's scientific practice.
Money also developed hormonal treatment thought at the time to help sex offenders improve their self-control, an approach all but abandoned in contemporary jurisprudence.
Sex-change Operations. Money also helped establish Johns Hopkins as the first hospital in the country to perform adult sex-change operations for patients characterized as "confused" over their gender. His work, while memorable, was severely criticized by other colleagues who favored counseling over the surgery.
The operations, now known as Sex Reassignment Surgery (SRS), were eliminated by Johns Hopkins in 1979 following a period of turbulent controversy that helped define issues still under discussion today.
Gender Assignment. Money believed that infants were born gender-neutral and gender could be assigned to a child before age 3 (a descendent of the "tabula rasa"). He thought that gender was determined by several complex factors, including environment, upbringing, and biology.
"We shouldn't ask whether it's heredity or environment; that was a 19th-century way of looking at it. Today we know it's both," Dr. Money said in a 1982 newspaper article that appeared in the Baltimore Sun. "It seems that every child is born with some predisposition to go both ways. Which way it will finally go is determined by its environment."
However, Money never defined the interrelationships in a quantitative fashion, depending instead on a doctor’s specialized training and intuition to make the appropriate choices.
To apply and prove his theorization, Dr. Money conducted a radical experiment on a boy who had lost his penis during a botched circumcision, but with devastating results for the child and Money himself.
The Canadian parents of twin boys consulted Dr. Money's in 1967 after a botched circumcision on one of their sons. Money advised hormones and sexual reassignment to raise the boy as a girl. By the time the child, then named "Brenda" reached the teenage years, it was clear the plan had failed. Brenda became known as David Reimer, a boy.
 John Colapinto published abook about the case in 2002, entitled As Nature Made Him: The Boy Who Was Raised as a Girl. Mr. Reimer spoke in the book of his anguish and decried the experiment. Mr. Reimer subsequently committed suicide in 2004.
"I think it devastated him," Dr. Lehne said. "The controversy led to him being kind of withdrawn and somewhat bitter after seeing himself as misinterpreted and not being able to do anything about it."
Dr. Money refused to comment publicly on the subject.
More on the Johns Hopkins sex-change program. Transsexuals and a small group of medical/caring professionals had been critical of the Johns Hopkins approach to SRS. The behavioral psychologists and medical personnel at Hopkins viewed sex change as the last resort for individuals with incurable emotional disturbances. Hopkin's staff professionals believed that mental illness lay at the core of transsexualism, an "incorrectly formed gender identity" and an irreversible psychological condition.
The Hopkins' Surgeons used a variant of methods used by a Georges Burou, M.D., who had been performing such operations for 15 years in Morocco.
To qualify, only MtF transsexuals could be surgical candidates and had to lie within physical parameters that could ensure the candidate could “replicate” a female’s appearance and “pass” without undue notice. The image of an acceptable female replica derived from the male cultural assumptions imposed by the hospital leadership. Moreover, the candidates were expected to sever family ties and move to distant locations where they could start life anew in what transsexuals refer to as “stealth”.
 Dr. Paul McHugh became chairperson of the psychiatric department at Johns Hopkins in 1979. He ordered follow-up evaluations on their former transsexual patients, finding that most of the patients claimed happiness in their target sex. Nonetheless, department investigators concluded that the patients’ psychological functioning had not sufficiently improved. McHugh concluded that physical reassignment cooperated ". . . with a mental illness” rather than trying for a cure [of the “illness”]. Johns Hopkins closed its clinic and has not performed any SRS surgeries since that time.
McHugh's conclusions have been widely criticized, saying that the purpose of reassignment is to help transsexual people become happy and content with their bodies. Improvements in psychological functioning is seen as a different issue. The consequences of Hopkins’ qualification policies were not included in the departmental review ordered by McHugh. Undocumented rumors abound concerning the fate of those transsexuals who failed to meet the Hopkins criteria for inclusion and were expelled from the program.
Many medical textbooks still say that "significant psychological problems often persist after surgical and hormonal sex reassignment." However, very little — and notably incomplete — research has been done on transsexuality. Other orphan conditions receive far more attention. Transsexuals, in particular, express the view that SRS is highly effective and far better than any psychological attempt to "change the mind to match the body".
But about John Money, "... he taught us gender is much more significant than having two sexes," Dr. Lehne said on Saturday. "He identified what it means to be male and what it means to be female, and what it means to be in-between."
 The notable GLBT pioneer, Vern Bullough (State University of New York) , who died on 23 June 2006, called John Money "one of the great pioneers of American sexology in the last part of the 20th century" who should "be included in the pantheon of pioneer researchers."Bullough made the remarks in the August 2003 issue of the Journal of Sex Research. After listing his view of Money's contribution to sexology, Bullough blamed the failed case of David Reimer on non-compliance with all treatment protocols. This placed responsibility with the the parents. He also cited the doctor who initially performed the circumcision.
Bullough said Mr. Reimer “. . . undoubtedly suffered from the attempts to change him, but the real suffering was caused by the physician who botched the circumcision, not by Money who was later sought out by the parents".
Dr. Eileen Higham, a clinical psychologist who worked for Dr. Money for several years in the 1970s, said: "As a person, I found him an outstanding intellect but not easy to get along with. I think he was widely misunderstood because he did not fit into the mainstream."
For more than 40 years, Dr. Money lived within walking distance of the Johns Hopkins medical campus (Baltimore). He kept a large collection of anthropological art in his house, amassed from world travels that included time studying aboriginal communities. The John Money wing at the Eastern Southland Gallery (Gore, New Zealand) houses much of the collection. The Kinsey Institute for Research in Sex, Gender and Reproduction (Indiana University) holds a substantial portion of Money's professional writings. The complete text of The Transsexual Phenomenon by Harry Benjamin, M. D. is available online as an eBook.
Also see Lisa Jain Thompson’s comments in her opinion column, Global Warning, entitled "John Money: A Remembrance".
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| Last Updated on Wednesday, 19 December 2007 01:48 |
Early Johns Hopkins announcements and publications paralleled publication of 
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The TS-Si News Service is a collaboration of TS-Si staff, contributors, and corresponding institutions. Contents do not necessarily convey official positions of TS-Si, its partners, or affiliates