As Nature Made Him (16 page)

At the same time, Heather was not blind to what she calls Brenda’s “oddity.” Partly this was a feature of what Heather describes as Brenda’s acute anxiety. “Brenda was always nervous about doing things that were the least bit unusual—like cutting through the university grounds on our bikes, which I did all the time. She was very nervous, very unsure of herself.” Heather says that this nervousness even affected Brenda’s speech. “Just making a sentence sometimes seemed hard for her.”

And there was something still more odd about Brenda. “As far as I knew, Brenda was a girl—physically,” Heather explains. “But from everything that she did and said, she indicated that she didn’t want to be a girl. The other girls in our group were competitive against the boys; we wanted to prove we could do whatever they could do. We wanted to
show
them. We might get in arguments with the guys, but we wouldn’t have gone as far as to fight with them physically. I wouldn’t want a bruise on my face, for example. But Brenda fought with the boys. Brenda would take the bruises.” Heather pauses and thinks about this for a moment. “I myself was a tomboy,” she resumes, “but I never wanted to
be
a boy. Brenda did.”

Heather’s impression was only strengthened when, one day on the school playground, she noticed a small bald patch near the crown of Brenda’s head. The hairless area was the result of an accident when Brenda was a baby—she’d pulled the cord of the electric frying pan while her father was cooking and been hit by hot grease. But that’s not the story Brenda told to Heather. “She said she had deliberately taken a hot frying pan to her head to burn off the hair,” Heather recalls, “because she ‘wanted to be bald like a man.’ ”

It was through her friendship with Heather that Brenda became increasingly aware of a new and perilous undercurrent in the life of the classroom. She first noticed it when overhearing bits of conversation among the other girls—talk of “crushes” and “going steady” and “kissing.” Then she saw boys and girls passing notes when the teacher’s back was turned. Once she saw one. It was a love note, and it was signed “xoxoxox.”

Brenda recognized in these developments a fertile field for fresh embarrassments and humiliations. She had resolved to give wide berth to the burgeoning dating scene—a resolution that she did not think would be difficult to keep, since none of the boys showed any romantic interest in her. Still, it soon became clear to her that she could not avoid the awakening sexuality of her peers entirely. That fall Heather took Brenda along to a birthday party for one of their classmates. The party began innocuously enough. With their host’s parents acting as chaperones, the children dutifully played games of pin the tail on the donkey and Twister while a children’s album played on the stereo. But when the parents left the room and went downstairs, everything changed.

“One of the kids took the record off—
zzzzt!
—and put on a makeout tune,” David recalls. “Another guy put the lights out. Suddenly everyone’s slow dancing and making out. I’m looking at Heather, and Heather was looking at me. We were the only two left over.” The pair beat a quick retreat downstairs. “But you could hear through the vents,” David says. “I could sense what was going on.”

I asked David how he had felt as Brenda, watching his classmates pair off romantically. He thought for a moment. “I guess envious,” he said finally. “These people looked like they knew where they belonged. There was no place for me to feel comfortable with anybody or anything.”

Brenda’s escalating alienation was clear in her sessions with Dr. Ingimundson, who continued doggedly to try to get Brenda to open up and discuss her genitals and to agree, finally, to surgery. But Brenda could not be budged.

“Not responsive to my efforts to engage,” the psychiatrist wrote, when she and Brenda were three months into their sessions. “Silent . . . staring off into space—head turned away. . . . Telling me she feels trapped in office—wants to get out—or feels trapped inside self.”

9

I
N THE SUMMER OF 1977
, Brenda suddenly had to fend off an attack on a new front. On her last several trips to Baltimore, Dr. Money had spoken to her about the medication she would soon need in order to become a “normal girl.” He was talking about estrogens, the female hormones that would simulate the effects of female puberty on Brenda’s broad-shouldered, narrow-hipped boy’s physique. Like the vaginal surgery, the prospect of growing breasts struck Brenda as a nightmare. So she was suspicious when one day soon after the end of her sixth-grade year at Agassiz Drive, her father produced a package of pills and told her to start taking them.

“What’s this medicine for?” she asked.

Ron, struggling for the best way to put it, finally came up with, “It’s to make you wear a bra.”

“I said, ‘I don’t wanna wear a bra!’ ” David recalls. “I threw a fit.”

The depths of Brenda’s resistance to the hormones was clear in her dealings with the doctor whose specific job it was to prescribe and regulate her estrogen therapy—a pediatric endocrinologist named Jeremy Winter. A thirty-four-year-old professor at the Children’s Hospital of Winnipeg, Winter had trained in Philadelphia under the respected endocrinologist Alfred Bongiovanni, who himself had trained at Johns Hopkins under Lawson Wilkins.

Given this academic pedigree, it was perhaps not surprising that Winter was the Winnipeg doctor least inclined to question the methods or conclusions of Money’s twins case. Before meeting Brenda, he anticipated no problems with the treatment.

“I got the chart and looked at all the background information that was available,” says Winter. “I read
Man & Woman, Boy & Girl
, and I believed it. I said, ‘That makes sense, and everything fits, and I’m going to see this kid, and this is what we’re going to do’ ”—namely, put the child on a course of estrogens and commence vaginal surgery immediately. But things did not work out that way.

“It was easily the most frustrating case we had in the clinic,” Winter says. “We prided ourselves on excellent rapport with patients, being able to sit down with kids and talk and listen in a warm atmosphere. And here was this absolutely silent, angry child who didn’t want to be there. I’d ask, ‘Will you allow a blood test?’ ‘No.’ ‘Will you allow me to examine you?’ ‘No.’ So I would have these monologues about the importance of taking the estrogen and having the vaginal surgery and how successful and wonderful this was going to be.”

According to Winter, Brenda was especially adamant about never returning to Johns Hopkins. “I’d never seen a patient in my life who behaved that way about going to another doctor—who showed that depth of emotion,” Winter recalls. Meanwhile, Winter had no choice but to try to get her to take the estrogen pills—an increasingly urgent need, since her twelfth birthday was approaching in late August.

Brenda continued trying to resist, but after continued entreaties from Winter, her parents, and Dr. Ingimundson (not to mention the threat that Dr. Money had once introduced into Brenda’s head, that she would grow disproportionate limbs if she failed to take the drugs), she finally—on the eve of her twelfth birthday—began to take the pills. Or rather, she pretended to. When her parents were not looking, she would throw the small tablets into the toilet. “I remember the pink dye running out of them,” David says. “I had to flush fast before my parents saw.” Ron and Janet soon caught on, however, and took to standing over Brenda while she swallowed the daily medication—0.02 milligrams of ethinyl estradiol, later increased to 0.75 milligrams.

Soon enough, a pair of breasts sprouted on Brenda’s chest along with a padding of fat around her waist and hips. The changes caused her deep mortification. In a bid to disguise the increasing feminization of her figure, she began prodigious bouts of eating. With several ice cream cones every day, her waistline swelled to forty inches. The added fat helped to camouflage her breasts and hips, but no amount of binge eating could hide certain other physiological changes that began to accelerate within her that fall. “Spontaneously expressed anxiety about her voice,” Ingimundson wrote in her September session notes. “Starting to crack.”

The dramatic deepening of Brenda’s voice was a phenomenon endocrinologist Winter was at a loss to explain. Given her absence of testicles (the prirliary male hormone-secreting endocrine gland) and her estrogen therapy, her voice, by all known medical criteria, should not have undergone a virilizing change at puberty. Today Winter suggests that Brenda’s vocal cords and larynx were perhaps thickening because of increased androgen secretion from her adrenal glands. Whatever the cause, one thing was not in doubt. Brenda’s voice now began to change in a manner identical to her brother Brian’s. She asked her mother why.

Thinking fast, Janet mentioned the deep-voiced actress Mario Thomas from the TV situation comedy
That Girl
. “She has a raspy voice,” Janet told her daughter. “It’s normal for some girls to have voices like that.”

Armed with this explanation, Brenda started seventh grade that fall at her new school: Glenwood Junior High, a large public school some five minutes’ walk from her house. She was instantly exiled to the farthest periphery of Glenwood’s social life, where she took her place among a haphazard collection of the school’s misfits. One girl was an intersex. Another wore a complicated metal leg brace and built-up shoe to accommodate a right leg some three inches shorter than the left. Another, Esther Haselhauer, suffered from Poland’s syndrome, a congenital birth anomaly that had stunted her growth, partially withered one hand, and completely retarded the growth of her right breast. Esther remembers that she sensed an immediate kinship with Brenda.

“She was hard to connect with,” Esther says. “But there was something that I just responded to. It was . . . I don’t know, a sadness. She reminded me of
me
.” At the same time, Esther was aware that there was a big difference between the two of them, and indeed, between Brenda and any other girl she’d ever met. “Brenda wasn’t a
girl
girl,” Esther says. Furthermore, being with Brenda evoked a feeling in her that was curiously like that of being with a member of the opposite sex. “It was a feeling of security,” Esther says. “When I was with Brenda, I felt so safe. Kids would beat me up because I was so small. But when I was with Brenda, if anyone tried picking on me, she let them have it.”

David says that he was grateful for Esther’s friendship, but that their differences made it impossible for them to get close. “She was always talking about guys,”, David says. Asked if Brenda ever expressed interest in romance with boys, Esther laughs. “Oh no!” she says. “That would be unthinkable; as unthinkable as me, at four feet tall, going out for the basketball team.”

Six months after Brenda began seventh grade, Dr. Ingimundson received a letter from John Money requesting a progress report. Money’s letter arrived at a particularly inopportune moment—just two days after a disastrous family session Ingimundson had held with the Reimers. Her notes on the 20 February 1978 session make it clear that Brenda’s resistance to the surgery had abated not at all in the fourteen months since she had begun psychiatric treatment in Winnipeg. Refusing to utter a word, Brenda had pulled up the hood of her winter coat and folded her arms across her chest. Pressed to say something about the surgery, she finally burst into tears, while the adults looked on helplessly. “Parents & I at a loss for words,” Ingimundson wrote in her session notes. The session ended soon after that.

With this fraught scene still fresh in her mind, Ingimundson wrote back to Money. She explained that despite their success in getting Brenda to take hormones, the local team had made no further progress in the case. “[N]o plans for surgery have been formalized,” she wrote, “nor, for that matter, have they been discussed in a tentative fashion.” She added that Brenda remained “resistant to medical attention” and was “still refusing examination of her genitals.”

How Money greeted this letter is difficult to tell. His reply was written by his secretary—and it was brief. “Dr. Money has asked me to write you thanking you for your letter of March 8, 1978 giving a progress report on Brenda Reimer. We are very pleased to have it,” the note read in its entirety.

A more expansive articulation of Money’s opinion on the case soon appeared in a chapter of the book
Biological Determinants of Sexual Behavior
, an anthology of writings on gender identity published later that year in Britain. Once again the outlook was sunny. A full-page photograph of Brenda and Brian (taken at their last visit to the Psychohormonal Research Unit) showed them standing side by side against a white background. Brenda wears a short patterned dress with cap sleeves, her long, well-brushed hair falling to her shoulders; Brian is dressed in a boy’s short-sleeved shirt and dark jeans, his close-cut hair exposing his ears. A pair of large black dots cover their faces, obscuring all but their identical jaws, chins, and eyebrows. Nothing in the accompanying text suggested that, beneath the black dots, either child was anything but smiling and happy. “Now prepubertal in age,” Money wrote, “the girl has . . . a feminine gender identity and role, distinctly different from that of her brother.”

An attentive reader might have noticed in this update certain evidence to suggest a less sanguine prognosis for the sex-changed twin. Elsewhere in the chapter, Money wrote of further research he had done into the role played by excessive testosterone exposure in genetic females in the womb. Money now revealed that there was reason to think that such exposure affected not only masculinization of play preference, toy preference, and career goals (as he and Ehrhardt had reported eleven years earlier), but other behavior as well. “The preliminary evidence indicates the possibility,” Money wrote, “that there is a greater incidence of bisexuality and homosexuality [among such girls] than would be expected by chance.”

That Money’s famous sex-reassigned twin had spent her entire prenatal life awash in a full complement of testosterone produced by the fetal testicles (a complement of testosterone some ten times the amount experienced by normal female fetuses) might have led some readers to conclude that the twin, at puberty, would in all likelihood manifest an erotic attraction to females; but on the all-important question of Brenda’s sexual orientation, Money (perhaps forgetting what he had told Ron and Janet about her lesbianism) professed himself unable to venture even an educated guess as to what her partner preference might one day be. He wrote in his concluding remarks on Brenda’s gender identity, “The final and conclusive evidence awaits the appearance of romantic interest and erotic imagery.”