It has long been believed by the scientific community that the gender identity of a child was determined by the child’s upbringing, surrounding environment, and the way the child was treated during growth. This idea was only enforced more in the 1960’s when Dr. John Money published his John/Joan case, claiming that a child’s gender was constructed through nurturing, not nature.

The John/Joan case was an experiment that occurred after two twin boys, two months old, were sent in for a routine circumcision, but after a mechanical malfunction, one of the boy’s external genitalia was extremely damaged. The boy’s parents, counseled by Dr. Money, were encouraged and assured that if they surgically made their son appear feminine, with the help of administering hormones and their nurturing, they could raise the child successfully as a girl. While Dr. Money published this experiment as a great success, years later, a man named David Reimer stepped forward and identified himself as the object of the John/Joan case. Apparently, the John/Joan case that was published was riddled with observer bias and skewed results, and in reality, David was a troubled, depressed, sometimes suicidal girl growing up and immediately reassumed his male identity as soon as his parents told him the truth of his birth at age 14, but eventually committed suicide in his late 30’s in relation to the trauma and emotional distress incurred during his childhood.

Brenda Reimer growing up

David Reimer after reassuming his male identity

This begs the question, is gender identity nature and innate or is it, as Dr. Money would have led us to believe, entirely based on cultural and nurturing factors?

Research at the Johns Hopkins Children Center has shown that gender identity is almost entirely based on nature and is almost exclusively predetermined before the birth of the baby. Two studies conducted by William Reiner, a child and adolescent psychiatrist and urologist, have confirmed that the amount of exposure to male hormones and androgens in utero almost exclusively decides whether the child identifies as masculine or feminine.

In the first study, Reiner followed 14 children whose testicles and male hormone levels were completely normal at birth, but who were born without a penis — 12 of the children were surgically reconstructed to appear female. Today, all 12 of the children raised as females are strongly male a-typical in their behaviors, attitudes, friends and play and 6 of the 12 have already reassumed their male gender identities at the ages of 5, 6, 7, 8, 9, 11, and 12 respectively. The 2 children who did not undergo sex reassignment surgeries as infants developed far more normally and more similarly to their normal male peers and were much more psychologically well adjusted that the sex-reassigned children.

In the second study, Reiner followed 12 genetically male children who were born with a similar defect, in that they lacked a penis at birth. All of these children underwent a sex reassignment surgery to appear female in infancy. Since then, 8 of the 12 have reassigned themselves back to a male identity. Of the the 4 who remain female, 3 of the sets of parents plan to tell their child about their genetic sex at birth “soon” and all 3 sets of parents expect that their children will switch back to a masculine identity after learning about their birth sex.

Reiner comments on the results of the studies stating, “These studies suggest that male gender identity is directly related to normal male patterns of male hormone exposure in utero. These children demonstrate that normal male gender identity can develop not only in the absence of the penis, but even after the removal of testicles or castration at birth, and unequivocal rearing as female. Rather than the environment forming these children’s gender identity, their identity and gender role seem to have developed despite a total environment telling them they were female.” These and consequent other studies have caused the scientific community to reevaluate their belief that gender identity is constructed through “nurture”. Most scientists now believe that gender identity is something that is predetermined by a biological aspect and cannot be chosen for a child.

This new outlook has called for the reevaluation of sex reassignment surgeries on infants and parents who are considering one for their child are urged with extreme caution to consider letting their child decide on their own at a later age. Reiner believes, “These studies indicate that with time and age, children may well know what their gender is, regardless of any and all information and child-rearing to the contrary. They seem to be quite capable of telling us who they are.”

http://www.hopkinsmedicine.org/press/2000/MAY/000512.HTM

http://www.bbc.co.uk/sn/tvradio/programmes/horizon/dr_money_prog_summary.shtml