THE CASE OF JOHN/JOAN
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Dr. Money was, indeed, listening. But then, Linda’s cry for help was one that he might have been waiting for his entire professional life.

At the time that the Thiessen family’s plight became known to Dr. Money, he was already one of the most respected, if controversial, sex researchers in the world. Born in 1921 in New Zealand, Money had come to America at about age 26, received his Ph.D. in psychology from Harvard and then joined Johns Hopkins, where his rise as a researcher and clinician specializing in sexuality was meteoric. Within a decade of joining Hopkins, he was already widely credited as the man who had coined the term “gender identity” to describe a person’s inner sense of himself or herself as male or female, and was the world’s undisputed authority on the psychological ramifications of ambiguous genitalia. “I think he’s a thoroughly ethical and professional person,” says John Hampson, a child psychiatrist who co-authored a number of Money’s groundbreaking papers on sexual development in the mid-1950s. “He was a very conscientious scientist when it comes to collecting data and making sure of what he’s saying. I don’t know very many social scientists who could match him in that regard.” According to Hampson, Money’s ability to persuade others to adopt his point of view is one of the psychologist’s chief strengths: “He’s a terribly good speaker, very organized and very persuasive in his recital of the facts regarding a case.” Indeed, Hampson admits that Money is almost too good at the art of persuasion. “I think a lot of people were envious,” says Hampson. “He’s kind of a charismatic person, and some people dislike him. As a person, he was a little bit . . . oh . . . flamboyant; he might have been a little glib.”

Money’s often-overweening confidence actually came to him at some cost. His childhood and youth in rural New Zealand had been beset by anxieties, personal tragedies and early failure. The son of an Australian father and an English mother, he was a thin, delicate child raised in an atmosphere of strict religious observance – or what he has called “tightly sealed, evangelical religious dogma.” At age 5 he was bullied by his classmates and took shelter with a female cousin in the girls’ play shed, where no boy would be caught dead. “My fate was sealed,” he wrote in an anthology titled How I Got Into Sex. “Having not measured up as a fighter, I was set on the pathway of outwitting other kids by being an intellectual achiever. That was easier for me than for most of them.”

He was 8 years old when his father, after a long illness, died. “His death was not handled very well in our family,” Money wrote. Three days after watching his father get mysteriously carried off to the hospital, the boy was told that his father had died. His shock was compounded by the trauma of being informed by an uncle that now he would have to be the man of the household. “That’s rather heavy duty for an 8-year-old.” Money wrote. “It had a great impact on me.” Indeed. As an adult, Money would forever avoid the role of “man of the household.” After one brief marriage ended, he never remarried, and he has never had children.

Following his father’s death, Money was raised by his mother and spinster aunts. A solitary adolescent with passions for astronomy and archaeology, he also harbored ambitions to be a musician. His widowed mother could not afford piano lessons, so Money worked as a gardener on weekends to pay for music classes and used every spare moment to practice. It was an ambition doomed to disappointment, partly because Money had set the bar so high for himself: “It was difficult for me to have to admit that, irrespective of effort, I could never achieve in music the goal that I wanted to set for myself. I would not even be a good amateur.”

Upon entering Victoria University, in Wellington, Money discovered a new passion into which he would channel his thwarted creativity: the science of psychology. Like so many drawn to the study of the mind and emotions, Money initially saw the discipline as a means of solving certain gnawing questions about himself. His first serious work in psychology, the thesis for his master’s, concerned “creativity in musicians”; in it, Money writes, “I began to investigate my relative lack of success in comparison with that of other music students.”

His later decision to narrow his studies to the psychology of sex had a similarly personal basis. Having lost his religious faith in his early 20s, Money increasingly reacted against what he saw as the repressive religious strictures of his upbringing and, in particular, the anti-masturbatory, anti-sexual fervor that went with them. The academic study of sexuality, which removed even the most outlandish practices from moral considerations and placed them in the “pure” realm of scientific inquiry, was for Money an emancipation. From now on, he would be a fierce proselytizer for sexual exploration. According to journalist John Heidenry, a personal confidant of Money’s and author of the recent book What Wild Ecstacy, which traces Money’s role as a major behind-the-scenes leader of the sexual revolution of the 1960s and ’70s, the psychologist’s sexual explorations were not confined to the lab, lecture hall or library. An acknowledged but discreet bisexual, Money engaged in affairs with a number of men and women – “some briefly,” Heidenry writes, “others over a longer duration.” Indeed, by the mid-1970s, with the sexual revolution in full rampage, Money would step out publicly as a champion of open marriage, nudism and the dissemination of explicit pornography. His promotion of the culture’s sexual unbuttoning seemed boundless. “There is plenty of evidence that bisexual group sex can be as personally satisfying as a paired partnership, provided each partner is ‘tuned in’ on the same wavelength,” he wrote in his 1975 pop-psych book, Sexual Signatures. A former patient who was treated by Money in the 1970’s for a rare endocrine disorder recalls the psychologist once casually asking him if he’d ever had a “golden shower.” The patient, a sexually inexperienced youth at the time, did not know what Money was talking about. “Getting pissed on,” Money airily announced with the twinkling, slightly insinuating little smile with which he delivered such deliberately provocative comments.

According to colleagues and other former patients, such sexual frankness in conversation is a hallmark of Money’s personal style. Dr. Fred Berlin, a professor of psychiatry at the Johns Hopkins School of Medicine and a colleague who considers Money one of his most important mentors, agrees that Money is aggressively outspoken. “Because he thinks it’s important to desensitize people in discussing sexual issues, he will sometimes use four-letter words that others might find offensive,” says Berlin. “Perhaps he could be a little more willing to compromise On that. But John is an opinionated person who isn’t looking necessarily to do things differently from the way he’s concluded is best.”

But while Money’s conclusions about the best approach to sexual matters merely raised eyebrows in the mid-1970’s, they provoked outrage at the dawn of the more conservative 1980’s. Undaunted, Money continued to push on into uncharted realms. In an April 14, 1980, article in Time, Money was sharply criticized for what looked dangerously like an endorsement of incest and pedophilia. “A childhood sexual experience, such as being the partner of a relative or of an older person, need not necessarily affect the child adversely,” Money told Time. And according to a right-wing group critical of his teachings, Money reportedly told Paidika, a Dutch journal of pedophilia, “If I were to see the case of a boy aged 10 or 12 who’s intensely attracted toward a man in his 20s or 30s, if the relationship is totally mutual, and the bonding is genuinely totally mutual, then I would not call it pathological in any way.”

Money’s response to criticism has been to launch counterattacks of his own, lambasting his adoptive country for a puritanical adherence to sexual taboos. In an autobiographical essay included in his book Venuses Penuses, Money describes himself as a “missionary” of sex – and points out, with a lofty and defiant pride, “It has not been as easy for society to change as it had been for me to find my own emancipation from the 20th-century legacy of fundamentalism and Victorianism in rural New Zealand.”

Money’s experimental, taboo-breaking approach to sex was paralleled in his professional career. Eschewing the well-traveled byways of sex research, Money sought out exotic corners of the field where he could be a pioneer. He found just such a relatively undiscovered realm of human sexuality while in the first year of his Ph.D. studies in psychology at Harvard. In 1948, in a social-relations course, he learned of a 15 year-old male who was born not with a penis but with a tiny, nublike phallus resembling a clitoris and who, at puberty, developed breasts. It was Money’s first exposure to hermaphroditism – also known as intersexuality – a condition that, in its extreme or its milder forms, is estimated to occur once in every 2,000 births. Characterized by ambiguities of the external sex organs and the internal reproductive system, intersexuality is caused by any of a wide variety of genetic and hormonal irregularities, and can vary from a female born with a penis-sized clitoris and fused labia resembling a scrotum to a male born with a penis no bigger than a clitoris, undescended testes and a split scrotum indistinguishable from a vagina.

Money became fascinated with intersexuality and wrote his doctoral dissertation on the subject, which led to his invitation, in 1951, to join Johns Hopkins, where the world’s largest clinic for the study of intersexual conditions had been established. Up until then, the syndrome had been studied solely from a biological perspective. Money came at it from a psychological angle and would make a name for himself as a pioneer in examining the mental and emotional repercussions of being born as neither boy nor girl. At Hopkins, he enlisted Hampson and Hampson’s wife, Joan, to help him study some 105 intersex children and adults. Money claimed to have observed a striking fact about people who had been diagnosed with identical genital ambiguities and chromosomal makeups but who had been raised as members of the opposite sex: More than 95 percent of these intersexes fared equally well, psychologically, whether they had been raised as boys or as girls. To Money, this was proof that the primary factor that determined an intersexual child’s gender identity was not biological traits but the way that the child was raised. He concluded that these children were born psychosexually undifferentiated.

This theory was the foundation on which Money based his recommendation to pediatric surgeons and endocrinologists that they surgically and hormonally stream intersexual newborns into whichever sex the doctors wished. Such surgeries would duly range from cutting down enlarged clitorises on mildly intersexual girls to performing full sex reversals on intersexual boys born with testicles but a penis deemed too small. Money’s only provisos were that such “sex assignments” be done as early as possible – preferably within weeks of birth – and that once the sex was decided on, doctors and parents never waiver in their decision, for fear of introducing dangerous ambiguities into the child’s mind. In terms of the possible nerve destruction caused by the amputation of genital appendages, Money assured doctors that according to studies he had conducted with the Hampsons, there was no evidence of loss of sensation. “We have sought information about erotic sensation from the dozen non-juvenile . . . women we have studied,” he wrote in a 1955 paper. “None of the women . . . reported a loss of orgasm after clitoridectomy.”

Money’s protocols for the treatment of intersexual children hold to this day. Placing the greatest possible emphasis on the child’s projected “erotic functioning” as an adult and taking into account that medical science had never perfected the reconstruction of injured, or tiny, penises, Money’s recommendations meant that the vast majority of intersexual children, regardless of their chromosome status, would be turned into girls. Current guidelines dictate that to be assigned as a boy, the child must have a penis longer than 2.5 centimeters; a girl’s clitoris is surgically reduced if it exceeds 1 centimeter.

By providing a seemingly solid psychological foundation for such surgeries, Money had, in a single stroke, offered physicians a relatively simple solution to one of the most vexing and emotionally fraught conundrums in medicine: how to deal with the birth of an intersexual child. As Money’s colleague Dr. Berlin points out, “One can hardly begin to imagine what it’s like for a parent when the first question – ‘Is it a boy or a girl?’ – results in a response from the physician that they’re just not sure. John Money was one of those folks who, years ago, before this was even talked about, was out there doing his best trying to help families, trying to sort through what’s obviously a difficult circumstance.”

But Money was not interested solely in intersexes. As he has stated often in his writings, he saw intersexual syndromes, which he called “experiments of nature,” chiefly as a way to learn about the sexual development of so-called normal humans. Thus, he immediately generalized his theories about intersexes to include all children, even those born without genital irregularities. “In the light of hermaphroditic evidence ” he wrote in a 1955 paper that would become a classic in the field of sexual development, “it is no longer possible to attribute psychological maleness or femaleness to chromosomal, gonadal or hormonal origins. . . . The evidence of hermaphroditism lends support to a conception that, psychologically, sexuality is undifferentiated at birth and that it becomes differentiated as masculine or feminine in the course of the various experiences of growing up.” In simple terms, Money was advancing the view that all children form a sense of themselves as male or female according to whether they are dressed in blue or pink, given a masculine or feminine name, clothed in pants or dresses, given guns or Barbies to play with.

In a retrospective essay written in 1985 about his career as a sex researcher, Money offered crucial insight into the way he arrived at some of his more unusual theories about human sexual behavior. “I frequently find myself toying with concepts and working out potential hypotheses,” he mused. “It is like playing a game of science fiction. . . . It is as much an art as the creative process in painting, music, drama or literature.”

Money’s theory that newborns are psychosexually neutral was both unorthodox and against the current climate of science, which for decades had centered on the critical role of chromosomes and hormones in determining sexual behavior. But if his colleagues considered Money’s ideas to be science fiction, they weren’t prepared to say so publicly. His papers outlining his theory became famous in his field, helping not only to propel him to international renown as a sex researcher but also to speed his rise up the ladder at Johns Hopkins, where he ascended from assistant to associate professor of medical psychology, teaching his theory of infant sexual development to generations of medical students. By 1965, the year of John and Kevin Thiessen’s birth, Money’s reputation was virtually unassailable. He had for more than a decade been head of Hopkins’ Psychohormonal Research Unit (his clinic for treating and studying intersex kids), and he was shortly to help co-found Hopkins’ groundbreaking Gender Identity Clinic – a coup that helped earn him a reputation, says John Hampson, as “the national authority on gender disorder.”

There was, however, at least one researcher who was willing to question Money. He was a young graduate student at the University of Kansas. The son of struggling Ukrainian-Jewish immigrant parents, Milton Diamond, whom friends call Mickey, was raised in the Bronx, where he had sidestepped membership in the local street gangs for the life of a scholar. As an undergraduate majoring in biophysics at City College of New York, Diamond became fascinated by the role of hormones in the womb and their possible role in defining a person’s gender identity and sexual orientation. In his late 20s, as a grad student in endocrinology at Kansas, he conducted animal research on the subject, injecting pregnant guinea pigs and rats with different hormone cocktails to see how pre-birth events would affect later sexual behavior. The evidence in Diamond’s lab suggested a link between the hormones that bathe a developing fetus’s brain and nervous system and its later sexual functioning. It was in an effort to raise funds for his continued research that Diamond applied for a grant from the National Science Foundation Committee for Research in Problems of Sex an application that required the submission of a research paper. For his topic, Diamond decided to write a response to Money’s now-classic papers on sexual development.

Diamond’s critique appeared in The Quarterly Review of Biology in 1965. Marshaling evidence from biology, psychology, psychiatry, anthropology and endocrinology to argue that gender identity is hardwired into the brain virtually from conception, the paper was an audacious challenge to Money’s authority (especially coming from an unknown grad student at the University of Kansas). First addressing the theory about the psychosexual flexibility of intersexes, Diamond pointed out that such individuals suffer “a genetic or hormonal imbalance” in the womb. Diamond argued that even if intersexuals could be steered into one sex or the other as newborns, this was not necessarily evidence that rearing is more influential than biology. It might simply mean that the cells in their brains had undergone, in utero, an ambiguity of sexual differentiation similar to that of the cells in their genitals. In short, intersexes have an inborn, neurological capability to go both ways – a capability, Diamond hastened to point out, that genetically normal children certainly would not share.

Even a scientist less thin-skinned than John Money might have been stung by the calm, relentless logic of Diamond’s attack – which, near the end, raised the most rudimentary, Science 101 objection to the widespread acceptance of Money’s theory of psychosexual malleability in normal children. “To support [such a] theory,” Diamond wrote, “we have been presented with no instance of a normal individual appearing as an unequivocal male and being reared successfully as a female.”

It was a year and a half after Diamond had thrown down the gauntlet that Dr. Money received Linda Thiessen’s letter describing the terrible circumcision accident that had befallen her baby boy.

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