THE CASE OF JOHN/JOAN
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The Thiessens made their first trip to Johns Hopkins early in 1967, within weeks of first seeing Dr. Money on TV. The young couple were awestruck by the vast medical center dominating the top of a rise on Wolfe Street. Dr. Money’s Psychohormonal Research Unit was located in the Phipps Clinic, a gloomy Victorian building tucked away in a courtyard; the unit’s offices, located on an upper floor, were reached by way of a rickety turn-of-the-century elevator. Money’s own inner sanctum (where most of his meetings with the Thiessens would take place during the ensuing 12 years) was furnished with a couch, Oriental rugs and potted plants – reminding Frank more of a living room than of an office. There was also a collection of carved aboriginal sculptures of erect phalluses, vaginas and breasts that adorned a mantel. But if these artifacts were unsettling, Money himself, with his smoothly confident, professional manner – not to mention the diplomas on his wall – made the Thiessens feel that they were in the best possible hands. “I looked up to him like a god,” says Linda, who at the time was not yet out of her teens. “I accepted whatever he said.” And what Dr. Money had to say was exactly what the Thiessens ached to hear.

In his many published versions of this first interview, Money has recounted how he spelled out to the young couple the advantages of sex reassignment for baby John – “using nontechnical words, diagrams and photographs of children who had been reassigned.” What is not clear from Money’s accounts is whether Linda and Frank, whose educations at the time did not go beyond the sixth grade, understood that such a procedure was, in fact, purely experimental – that while such surgeries had been performed on intersexual children, no such sex changes had ever been attempted on a child born with normal genitals and a normal nervous system. Today, Frank and Linda say that this was a distinction they did not fully grasp until later. The crucial point that they gleaned from Dr. Money was his conviction that the procedure had every chance for success. “I see no reason,” Linda recalls him saying, “that it shouldn’t work.”

Indeed, Money’s eagerness to begin is evident in a description of the interview written almost 10 years later. In Sexual Signatures, he wrote: “If the parents stood by their decision to reassign the child as a girl, surgeons could remove the testicles and construct feminine external genitals immediately. When she was 11 or 12 years old, she could be given the female hormones.”

If Dr. Money seemed to be in a hurry, he was. He explained to Frank and Linda that they would have to make up their minds quickly. For according to one of the finer points of his theory, the “gender identity gate” – Money’s term for that moment after which a child has locked into an identity as a male or a female – comes a little after 2 years of age. John was now 17 months. “The child was still young enough so that whichever assignment was made, erotic interest would almost certainly direct itself toward the opposite sex later on,” Money wrote, “but the time for reaching a final decision was already short.”

Frank and Linda, however, needed time to decide on something as momentous as having their child undergo a surgical sex change. They went home to think about it. Linda says that Dr. Money made no secret of his impatience with the delay. “He wrote in a letter that we were ‘procrastinating,’ ” Linda recalls. “But we wanted to move slow, because we had never heard of anything like this.”

Back home, they canvassed opinions. Their pediatrician recommended against such drastic treatment, and so did their parents. But finally, Frank and Linda realized that they alone had to decide. They alone were the ones living with the reminder, at each diaper change, of John’s terrible injury. After months of indecision, they made up their minds.

That summer, five months after their first meeting with Money, they returned to Baltimore with their baby. Now 22 months old, the child was still within the window of 30 months that Money had established as safe for an infant sex change. And so, on July 3, 1967, the baby underwent surgical castration. According to the operating-room record, Dr. Howard W. Jones Jr. slit open the baby’s scrotum along the midline and removed the testes, then reclosed the scrotal tissue so that it resembled labia. The urethra was lowered to approximate the position of the female genitalia, and a cosmetic vaginal cleft was made by forming the skin around a rolled tube of gauze during the healing. It was also during this visit to Johns Hopkins, says Linda, that the promised chromosome test was conducted on the twins to determine if they were, indeed, identical. They were.

Linda and Frank say that by the time they decided to have their baby undergo clinical castration, they had eradicated any doubts they might have had about the efficacy of the treatment – a crucial turnabout, since, according to Dr. Money, it was a “vital consideration” that the parents of a sex-reassigned child harbor no second thoughts. “For any lingering doubts whatsoever in their minds,” Money wrote, “would weaken the child’s identification as a girl and woman.”

Whether Money himself was able to eradicate his own doubts about the child’s future development is debatable. In a letter he wrote a few weeks after the castration, his tone admitted of considerable caution regarding the prognosis. But then this was perhaps to be expected, since the letter was addressed to the lawyer whom Frank and Linda had hired to sue the hospital that botched the circumcision.

“The reassignment of a baby’s sex is usually undertaken only in cases of a birth defect of the genitalia,” Money wrote. “Then one usually expects that the child’s psychosexual differentiation will be congruous with the sex of rearing. In any given case, however, it is not possible to make an absolute prediction.”

Central to Money’s program for sex reassignment of hermaphrodites was his edict that the children, when very young, know nothing of their ambiguous sexual status at birth. Money put the same stricture into effect in the case of the Thiessens’ baby, whom they now called Joan. “He told us not to talk about it,” Frank says. “Not to tell Joan the whole truth and that she shouldn’t know she wasn’t a girl.”

Linda had sewn dresses and bonnets for her new daughter. It was shortly before Joan’s second birthday when Linda first put her in a dress. “It was a pretty, lacy little dress,” Linda recalls. “She was ripping at it, trying to tear it off. I remember thinking, ‘Oh, my God, she knows she’s a boy and she doesn’t want girls’ clothing. She doesn’t want to be a girl.’ But then I thought, ‘Well, maybe I can teach her to want to be a girl. Maybe I can train her so that she wants to be a girl.’ ”

Linda and Frank did their best to do just that. When Joan’s brother, Kevin, at age 4, was watching Frank shave and asked to shave, too, Frank gave him an empty razor and some shaving cream to play with. But when Joan also clamored for a razor, Frank refused. “I told her that girls don’t shave,” Frank recalls. “I told her girls don’t have to.” Linda offered to put makeup on her. But Joan didn’t want to wear makeup.

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