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The True Story of John / Joan

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."


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Last Updated: 21 April 2017
Reviewed by Harry Croft, MD

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