THE CASE OF JOHN/JOAN
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Joan sat immobile, silent, apparently listening. But the words reached her through a clamoring, rising panic in her mind: “I was thinking, ‘I’m gonna end up like that?’ ”

Today, John cannot remember bolting from the room. “I remember running,” John says. “That’s all.”

Joan ran, blindly, until she reached a set of stairs, which she dashed up. She emerged onto a rooftop, where she tried to hide. But the transsexual had followed – only increasing Joan’s panic. Coaxed down from the roof, Joan told her mother that if forced to return to see Dr. Money, she would kill herself.

But Dr. Money was, it seemed, not inclined to lose contact with this unique patient so easily. In early 1979, roughly eight months after Joan’s last trip to Hopkins, Money wrote to Linda, saying that he would soon be passing through her city to give a talk at the local university and medical center. He said he would like to drop by the house and see the Thiessens.

On a gray day in mid-March 1979, Money arrived at their doorstep carrying only a single knapsack. The twins, aware of Money’s arrival, disappeared into the basement and refused to come upstairs. The adults engaged in small talk. Money had said that he was catching a flight later in the day. But both Frank and Linda noticed that he was showing no symptoms of being in a hurry. On a tour of the small house, Money complimented Linda’s ink drawings, which decorated the walls, and looked at a wooden wall cabinet that Frank had made. He reminisced about his childhood in New Zealand. Finally, Dr. Money announced that he had missed his flight. Frank and Linda looked at each other and felt that it was the right thing to do to invite Dr. Money to stay over, although they had only a foam air mattress in the front room for him to sleep on. To their surprise, the eminent psychologist from Johns Hopkins accepted the offer. In order to accommodate their unexpected house guest, the Thiessens phoned out for a bucket of chicken. The children continued to hide in the basement.

“We didn’t want to come up,” Kevin recalls. “We were forced into it. They said, ‘Come up,’ so we came up.”

“I wound up being Mr. Polite,” John says, recalling the stiff encounter. Kevin remembers that Dr. Money asked “general questions” about how the twins were doing in school. Kevin asked how Dr. Money liked their city and how long he was staying. “Then,” Kevin says, “we wanted to go.” But before the two retreated back into the basement, Dr. Money pulled out his wallet and, saying something about how he would have spent the money on a hotel room anyway, bestowed on the children $15 each. The kids fled to the basement and did not emerge until the next morning, when the world-famous sexologist had left for the airport. It was the last that the family and Dr. Money would ever see of each other.

By the time she turned 14, in August 1979, Joan had been on female hormones for almost two years. But the drugs were now in competition with her male endocrine system, which, despite the absence of testicles, was now in the full flood of puberty – a fact readily apparent not only in her loping walk and the angular manliness of her gestures, but also in the dramatic deepening of her voice, which, after a period of breaking and cracking, had dropped into its current rumbling register. Physically, her condition was such that strangers turned to stare at her (as was noted by her therapist in contemporaneous clinical notes). But to the close observer, it was Joan’s mental state that would have drawn particular scrutiny and pity. For as photographs from this period reveal, Joan, for all her attempts to drag a smile onto her face, had the wounded eyes of a shamed and hunted animal.

It was at this point that Joan took the matter of her sexual destiny into her own hands and simply stopped living as a girl. Therapy notes from November 1979 reveal that she refused to wear dresses and now favored a tattered jean jacket, ragged cords and work boots. Her hair was unwashed, uncombed and matted. “I was at that age where you rebel,” John says. “I got so sick to death of doing what everyone wanted me to do. I got to that point in my life, I knew I was an oddball, I was willing to live my life as an oddball.... If I wanted to wear my hair in a mess, I wore it in a mess. I wore my own clothes the way I wanted to.”

And Joan had more private ways of rebelling. Since childhood she had been instructed, both by her parents and by her doctors, to urinate in the sitting position – despite a strong, overriding urge to address the toilet standing up. For years she had tried to adhere to this stricture on her bodily function. But no longer. “If no one was around, I’d stand up,” John recalls. “It was no big deal; it was easier for me to do that. Just stand up and go. I figured, what difference did it make?”

But it made a difference to her peers. That fall, Joan had transferred to a technical high school, where she enrolled in an appliance-repair course. There she was quickly dubbed Cave-woman and Sasquatch and was openly told, “You’re a boy.” But it was her inclination to urinate in the male posture that caused the greatest friction between her and her schoolmates. The girls barred her from using their bathroom. She tried sneaking into the boys’ room but was kicked out and threatened with a knifing if she returned. With nowhere else to go, Joan was reduced to urinating in a back alley. By December, she simply refused to go to school.

By now, it was impossible for the local treatment team to ignore the obvious. After almost four years of fruitlessly trying to implement Dr. Money’s plan, several physicians experienced a change of heart. Among those who believed that Joan would never submit to vaginal surgery was Dr. McK., a particularly empathetic female psychiatrist, then in semi-retirement, who had taken over Joan’s case in the winter of 1979. Joan’s endocrinologist, Dr. W., was among the last holdouts for the surgery, since he remained certain that it was the appearance of Joan’s uncompleted vagina that formed the stumbling block to her psychological acceptance of herself as a girl. But now, even he began to waver. “Early on I had . . . pushed for early surgery,” he wrote in a letter to Dr. McK. “I am not as convinced now that this is a good idea and therefore at the present time have no specific plans or opinions as to the proper time for the operation.”

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