THE CASE OF JOHN/JOAN
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Reiner says that both the John/Joan case and the trend in his study support the findings that have emerged since Diamond’s early-1960s research into the neurobiological origins of gender identity and sexual orientation. A 1971 study done at Oxford University showed anatomical differences between the male and female brain in rats – and six years later, at UCLA, researchers narrowed these differences to a cluster of cells in a gland in the brain called the hypothalamus. A study done in the mid-l980s in Amsterdam located the corresponding area in the human hypothalamus, noting that it is twice as large in homosexual men as it is in heterosexual men. Further studies done by others in the early 1990s support this finding. Then, in 1993 and again in 1995, researcher Dean Hamer announced a breakthrough on the genetic front: He was able, in two separate studies of gay male brothers, to find a certain distinctive pattern on their X chromosomes. The finding suggests that male homosexuality may have a genetic origin.

While many of these studies still need to be replicated, few sex researchers today dispute the mounting evidence of a strong inborn bias for sex and sexuality. “Which is why,” Reiner says, “I have been advising physicians to be very prudent when prescribing sex reassignment for infants. Because it’s quite clear that the vast majority of boys born with functioning testicles have masculine brains.” Reiner endorses Diamond and Sigmundson’s recommendation (published in a recent journal article) that in cases of injury or intersexuality, the assignment of sex be made socially, in terms of hair length, clothing and name, but any irreversible surgical intervention be delayed until the children are old enough to know, and are able to say, which gender they feel closest to. “We have to learn to listen to the children themselves,” Reiner says. “They’re the ones who are going to tell us what is the right thing to do.”

Well before Diamond and Sigmundson’s journal article appeared in the Archives of Adolescent and Pediatric Medicine last March, the American Medical Association’s PR department alerted the media that something explosive was coming. “The AMA knew it was a big deal,” Diamond says, “so they notified the big newspapers in advance.” On the day of the article’s publication, the New York Times ran a front-page story headlined SEXUAL IDENTITY NOT PLIABLE AFTER ALL, REPORT SAYS, which described John Thiessen’s life as having “the force of allegory.” Time (24 years after publishing news of the case’s success) now ran a story declaring, “The experts had it all wrong.” Similar news accounts appeared around the world – and soon Diamond was deluged with calls from reporters in several countries seeking interviews with the young man now known simply as John/Joan.

I met John for the first time in New York City in June 1997. Dr. Diamond, with whom I had spent months corresponding and whom I had visited in Hawaii, made the introduction. At that first meeting, John spoke bluntly about his difficulty in trusting strangers, but he quickly decided to talk to me for publication. His decision was based on his desire to warn people about the perils of infant sex reassignment. Over a beer at the Hard Rock Cafe on 57th Street, he began our conversation by telling me that he owes his survival to his family, his sole comfort in a childhood that he called “a pit of darkness.” But a formidable sense of humor also clearly played a role in John’s ability to rise above his sufferings. Describing the physical differences between him and his heavier, slightly balding twin, he shouted over the pounding music: “I’m the young, cool Elvis. He’s the fat, old Elvis.” But the strongest impression I was left with after that first meeting was of John’s intense, unequivocal masculinity. His gestures, walk, attitudes, tastes, vocabulary – none of them betrayed the least hint that he had been raised as a girl. And, indeed, when asked whether he thought that his extraordinary childhood had given him a special insight into women, he dismissed the question. Like the sex-reassigned boys in Reiner’s study, John had apparently never been a girl – not in his mind, where it counts.

John’s story, as told by Diamond and Sigmundson, loosed a flood of coverage on television and in magazines and newspapers on the heretofore unexamined phenomenon of infant sex reassignment. With this coverage, another set of voices in the debate began to be heard. These are the voices of those intersexes born after the publication of Money’s 1955 protocols. Once cloaked in shame and silence, they had already begun to emerge, largely because of the efforts of one person: a San Francisco activist named Cheryl Chase.

At her birth, in 1956 in New Jersey, Chase presented a classic case of ambiguous genitalia – with a somewhat vaginalike opening behind the urethra and a phallic structure of a size and shape that could be described as either an enlarged clitoris (if she was assigned as a girl) or a micropenis (if assigned as a boy). After three days of deliberation, the doctors assigned Chase as a boy. She was christened Charlie. But a year and a half later, her parents, still troubled by Charlie’s unusual appearance, consulted another team of experts, who (partly on the basis of her fairly normal vagina) reassigned her as a girl. Her name was changed from Charlie to Cheryl, and her phallus was amputated.

Like John Thiessen, Chase was then raised without knowledge of her true birth status (though her entire family knew). Thus, like John, she suffered a childhood punctuated with mysterious, unexplained surgeries and genital and rectal exams. Also like John, she grew up confused about her gender. “I was more interested in guns and radios,” Chase says, “and if I tried to socialize with any kids, it was generally boys, and I would try to physically best my brother.” As a pre-adolescent, she recognized that her erotic orientation was toward females.

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