THE CASE OF JOHN/JOAN
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Indeed, the account portrayed the experiment as an unqualified success - a conclusion bolstered by what Money pointed out was an “extreme unusualness” to the case. He was referring, of course, to the existence of the identical male twin, whose interest in “cars and gas pumps and tools” was contrasted to his sister’s interest in “dolls, a doll house and a doll carriage” – a sharp division of tastes along gender lines that seemed to provide compelling evidence that boys and girls are made, not born. The significance of the case to the then-burgeoning women’s movement was obvious, since feminists had been arguing against a biological basis for sex differences for years. Indeed, Money’s own papers from the 1950’s on the total psychosexual flexibility of newborns were cited by Kate Millett in her best-selling, seminal 1970 feminist text, Sexual Politics. Money’s new twins case buttressed the feminist claim that the observable differences in the tastes, attitudes and behaviors of men and women are attributable solely to cultural expectations.

“This dramatic case,” Time duly reported in its Jan. 8, 1973, edition, “provides strong support for a major contention of women’s liberationists: that conventional patterns of masculine and feminine behavior can be altered. It also casts doubt on the theory that major sexual differences, psychological as well as anatomical, are immutably set by the genes at conception.” The New York Times Book Review hailed Man Woman Boy Girl as “the most important volume in the social sciences to appear since the Kinsey reports” and praised Money for producing “real answers to that ancient question: Is it heredity or environment?” But it was on the pediatric wards of hospitals around the world that the twins case would have its most lasting impact.

“It was the hallmark case,” says Dr. William Reiner a child psychologist at Johns Hopkins. “It was the hallmark because it was followed and written up a number of times by Money and then essentially was the source of his statements – and subsequent statements in any of the pediatric textbooks in endocrinology, urology, surgery and psychology – that you can reassign the sex of a child because it’s the social situation that is the most important.” The undisputed success of the twins case legitimized the practice of infant sex reassignment globally, says Reiner. Once confined principally to Johns Hopkins, the procedure soon spread and today is performed in virtually every major country, with the possible exception of China and India. While no annual tally of infant sex reassignments has ever been made, Reiner makes a rough, “conservative” estimate that three to five cases crop up in every major American city each year – giving the U.S. alone a total of 100 to 200 sex reassignments a year. Globally, he puts the figure at perhaps 1,000 per year. In the 25 years since Money’s twins case was first published, as many as 15,000 similar sex reassignments may have been performed.

Dr. Mel Grumbach, a pediatric endocrinologist at the University of California, San Francisco, and a world authority on the subject, confirms that the findings detailed in Money’s twins case were the decisive factor in the widespread acceptance of the practice. “”Doctors] were very influenced by the twin experience.” he says. “John Money stood up at a conference and said, ‘I’ve got these two twins, and one of them is now a girl, and the other is a boy.’ They were saying they took this normal boy and changed him over to a girl. That’s powerful. That’s really powerful. I mean, what is your response to that? This case was used to reinforce the fact that you can really do anything. You can take a normal XY male and convert it into a female in the neonatal period and it won’t make any difference.” Grumbach adds, “John Money is a major figure, and what he says gets handed down and accepted as gospel by some.”

But not all. In the seven years since he had first published his challenge to Money, Mickey Diamond, who had been hired as a biology professor at the University of Hawaii, continued his laboratory research into how the sexual nervous system is organized before birth. His studies had further convinced him that neither intersexes nor normal children are born psychosexually undifferentiated – a conviction that made him view with alarm the expanding practice of infant sex reassignment. And he was more convinced than ever that converting a non-intersexual infant from one sex to the other would be impossible. “But I didn’t have any proof at the time,” Diamond says. “I didn’t have anything except a theoretical argument to challenge the case.”

Diamond vowed to follow the case of the sex-changed twin closely – a decision, he says, that was affected by purely scientific motives. But if, by now, Diamond also felt a degree of personal involvement in his dispute with Money, that was perhaps understandable: In the chapter directly following his account of the twins case in Man Woman, Boy Girl, Money lashed out at Diamond and his colleagues, characterizing their work as “instrumental in wrecking the lives of unknown numbers of hermaphroditic youngsters.”

In 1967, at the time of John’s castration, Money stipulated that he see the child once a year for counseling. The trips, which were sometimes separated by as many as 18 months, were, as Money put it in his letter to the Thiessens’ lawyer, meant to “guard against the psychological hazards” associated with growing up as a sex-reassigned child. But according to the Thiessens and to contemporaneous clinical notes, the trips to the Psychohormonal Research Unit at Johns Hopkins only exacerbated the confusion, fear and dread that Joan was already suffering.

“You get the idea something happened to you,” John says of those mysterious annual visits to the unit, “but you don’t know what – and you don’t want to know.” Kevin, who was also required on each visit to submit to sessions with Dr. Money, found the trips equally bewildering and unsettling: “For the life of me, I couldn’t understand why, out of all the kids in my class, why am I the only one going with my [sister] to Baltimore to talk to this doctor? It made us feel like we were aliens.” The twins developed a conviction that everyone, from their parents to Dr. Money and his colleagues, was keeping something from them. “There was something not adding up,” Kevin says. “We knew that at a very early age. But we didn’t make the connection. We didn’t know.”

All they did know was that from the time they were 6 years old, Dr. Money wanted to talk to them, both singly and together, about subjects that, as Joan would later complain to an outside therapist, “I can’t even talk to my mom about.”

“Dr. Money would ask me, ‘Do you ever dream of having sex with women?’ ” Kevin recalls. “He’d say, ‘Do you ever get an erection?’ And the same with Joan. ‘Do you think about this? About that?’ ”

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