1 00:00:06,665 --> 00:00:11,115 - Over the last six episodes of My Butterfly Arose podcast, 2 00:00:11,945 --> 00:00:15,275 I've begun talking about what I am learning about sex, 3 00:00:15,945 --> 00:00:18,355 sexuality, and gender through the lenses 4 00:00:18,775 --> 00:00:21,075 of both biology and culture. 5 00:00:22,185 --> 00:00:25,435 This has included books about gender through the eyes 6 00:00:25,455 --> 00:00:28,515 of a primatologist, the experiences 7 00:00:28,575 --> 00:00:32,075 of a person born intersex, and a broader 8 00:00:32,255 --> 00:00:33,555 and deeper view of 9 00:00:33,575 --> 00:00:37,035 how intersex people in particular have been seen 10 00:00:37,415 --> 00:00:41,235 and treated by society, by medical professionals, 11 00:00:41,735 --> 00:00:44,315 and how intersex people see themselves. 12 00:00:45,235 --> 00:00:48,635 I also did an episode about some of my own experiences 13 00:00:48,775 --> 00:00:50,075 as a transgender woman. 14 00:00:51,255 --> 00:00:53,795 In this episode, I will talk about the case 15 00:00:53,935 --> 00:00:58,195 of a person whose life got caught up in a confluence 16 00:00:58,375 --> 00:00:59,555 of medical mistakes 17 00:00:59,695 --> 00:01:04,275 and errors that took place in a cultural space where sex 18 00:01:04,415 --> 00:01:07,795 and gender are surrounded by outdated belief systems. 19 00:01:08,935 --> 00:01:11,795 The outcome was very harmful to the patient 20 00:01:12,055 --> 00:01:15,795 and their family, and I think it offers a challenge 21 00:01:16,055 --> 00:01:17,155 on two fronts. 22 00:01:18,295 --> 00:01:22,195 One is to not look away from painful experiences in 23 00:01:22,435 --> 00:01:26,435 medicine, but to use them as a way to improve our system 24 00:01:26,535 --> 00:01:28,035 of medical care delivery. 25 00:01:29,175 --> 00:01:32,515 The other is the challenge of being recognized 26 00:01:32,655 --> 00:01:36,395 as an expert in medicine while maintaining a sense 27 00:01:36,395 --> 00:01:39,595 of humility in the face of a complex reality. 28 00:01:40,815 --> 00:01:43,875 To prepare for this episode of Butterfly Arose, 29 00:01:44,595 --> 00:01:47,355 I read the Kindle edition of the book 30 00:01:48,055 --> 00:01:51,875 as Nature Made him the boy who was raised as a girl 31 00:01:52,855 --> 00:01:54,355 by John Lopinto. 32 00:01:54,905 --> 00:01:56,115 That boy was given 33 00:01:56,415 --> 00:02:00,075 or referred to by different names over his lifetime, 34 00:02:00,695 --> 00:02:04,075 but ended up claiming the name David Rimer, 35 00:02:04,495 --> 00:02:06,395 and that is the name I will use here. 36 00:02:07,535 --> 00:02:11,995 He was born in identical twin in August, 1965. 37 00:02:12,815 --> 00:02:17,035 His young parents, John and Janet Reimer, lived in Canada 38 00:02:17,535 --> 00:02:19,995 and had moved to the city to escape 39 00:02:20,025 --> 00:02:23,595 what they felt was a limited worldview they grew up in 40 00:02:25,015 --> 00:02:26,075 in their first months. 41 00:02:26,205 --> 00:02:27,635 Their mother, as Mr. 42 00:02:28,115 --> 00:02:32,715 Cola Pinto says, examined their son's penises 43 00:02:33,175 --> 00:02:35,675 and noticed that their foreskins seemed 44 00:02:35,855 --> 00:02:37,475 to be sealing up at the tip 45 00:02:38,015 --> 00:02:40,875 and making it difficult for the boys to pass water. 46 00:02:42,015 --> 00:02:45,795 She took the babies to see her pediatrician who explained 47 00:02:45,865 --> 00:02:49,675 that they were suffering from a condition called theosis. 48 00:02:50,575 --> 00:02:52,035 It was not rare, he said, 49 00:02:52,335 --> 00:02:55,275 and was easily remedied by circumcision 50 00:02:55,775 --> 00:02:58,115 or removal of the for of the penis 51 00:02:59,525 --> 00:03:03,685 Circumcision when done is usually performed on newborn 52 00:03:03,685 --> 00:03:08,325 babies, but by this time the boys were eight months of age. 53 00:03:09,235 --> 00:03:11,925 This meant that they had to be anesthetized 54 00:03:12,115 --> 00:03:15,005 because at this age, they would likely feel 55 00:03:15,305 --> 00:03:16,845 and react more strongly 56 00:03:17,025 --> 00:03:19,325 to the operation than a newborn baby. 57 00:03:20,545 --> 00:03:24,165 The doctor who did the operation on David is described 58 00:03:24,265 --> 00:03:27,085 by K Pinto as a general practitioner 59 00:03:27,505 --> 00:03:31,005 who was less experienced at doing circumcisions than 60 00:03:31,005 --> 00:03:32,285 knows who usually did them. 61 00:03:33,885 --> 00:03:35,165 Apparently none 62 00:03:35,165 --> 00:03:37,885 of the more experienced practitioners were available. 63 00:03:39,185 --> 00:03:42,925 For some reason, she used an electric cauterizing machine 64 00:03:42,985 --> 00:03:46,165 rather than a scalpel to remove David's foreskin. 65 00:03:47,105 --> 00:03:48,885 The machine was set at the minimum, 66 00:03:49,225 --> 00:03:51,125 but failed to cut through the skin 67 00:03:52,255 --> 00:03:54,965 after increasing the amount of heat going 68 00:03:54,965 --> 00:03:56,125 through the needle twice. 69 00:03:56,785 --> 00:03:59,605 The result was a botched circumcision. 70 00:04:01,025 --> 00:04:02,405 You could read the book yourself 71 00:04:02,465 --> 00:04:03,925 to see the horrible details, 72 00:04:04,625 --> 00:04:08,645 but in the end, David's penis was completely destroyed. 73 00:04:10,065 --> 00:04:12,525 So right away we have two mistakes. 74 00:04:13,545 --> 00:04:16,045 Having a doctor do the circumcision 75 00:04:16,105 --> 00:04:17,565 who was less experienced, 76 00:04:18,145 --> 00:04:21,125 and then that doctor would, her first attempt failed, 77 00:04:21,755 --> 00:04:25,125 just kept increasing the heat rather than stopping 78 00:04:25,265 --> 00:04:27,365 and figuring out a better way to proceed. 79 00:04:28,735 --> 00:04:32,755 The ability of surgeons in the 1960s to create a new penis 80 00:04:33,135 --> 00:04:35,595 so that at least David could urinate through. 81 00:04:35,595 --> 00:04:38,155 It was in the very early days 82 00:04:38,935 --> 00:04:41,995 and hope that even that could be successful were 83 00:04:42,095 --> 00:04:44,675 as Kop Pinto quotes, the doctors as saying, 84 00:04:45,205 --> 00:04:46,635 quite optimistic, 85 00:04:48,595 --> 00:04:52,695 the older brother's FAMs problem later cleared up on his own 86 00:04:53,075 --> 00:04:55,055 and he never got a circumcised. 87 00:04:55,835 --> 00:04:58,895 An article I read from the National Institutes of Health 88 00:04:59,485 --> 00:05:02,135 says that studies from 1949 89 00:05:02,235 --> 00:05:04,575 and 1968 showed 90 00:05:04,575 --> 00:05:08,575 that circumcision was not needed in most cases of FAMs. 91 00:05:09,605 --> 00:05:12,135 Perhaps watchful waiting could have been used, 92 00:05:12,475 --> 00:05:15,815 but the doctor who operated on David might not have known 93 00:05:15,815 --> 00:05:18,415 that, or maybe she was reacting 94 00:05:18,415 --> 00:05:21,495 to the mother's distress over her son's difficulties 95 00:05:21,795 --> 00:05:23,815 and thinking that she was being supportive 96 00:05:24,035 --> 00:05:27,455 by doing the operation immediately rather than waiting, 97 00:05:29,295 --> 00:05:31,195 but both boys were taken home 98 00:05:31,535 --> 00:05:34,195 as David's parents worried about what to do 99 00:05:34,695 --> 00:05:36,635 and how this would affect his life. 100 00:05:38,175 --> 00:05:40,035 He was evaluated by Dr. 101 00:05:40,355 --> 00:05:43,755 GL Adamson, head of the Department of Neurology 102 00:05:43,895 --> 00:05:46,435 and Psychiatry at a nearby clinic. 103 00:05:47,375 --> 00:05:50,155 Mr. Lopinto quotes the doctor as saying 104 00:05:51,545 --> 00:05:54,765 he will be unable to live a normal sexual life from the time 105 00:05:54,825 --> 00:05:58,765 of adolescence that he will be unable to consummate marriage 106 00:05:59,065 --> 00:06:03,285 or have normal heterosexual relations in that he will have 107 00:06:03,285 --> 00:06:07,405 to recognize that he is incomplete, physically defective, 108 00:06:07,785 --> 00:06:09,325 and that he must live apart. 109 00:06:11,115 --> 00:06:13,645 Just note those last words of the doctor. 110 00:06:14,665 --> 00:06:17,965 Of course, without a penis, David would not be able 111 00:06:17,965 --> 00:06:20,485 to experience penile vaginal sex, 112 00:06:21,025 --> 00:06:23,965 and that was a physical fact he would have to live with. 113 00:06:25,345 --> 00:06:29,685 But saying that he will be incomplete is a definition of him 114 00:06:29,715 --> 00:06:33,685 that imagines his whole self as being defined 115 00:06:34,025 --> 00:06:35,285 by the lack of a penis 116 00:06:36,345 --> 00:06:40,365 and saying he will have to live apart has truth, 117 00:06:40,915 --> 00:06:44,965 only insofar as the society around him chooses 118 00:06:45,065 --> 00:06:48,005 to treat him negatively rather than embracing him 119 00:06:48,025 --> 00:06:49,365 as a fellow human being 120 00:06:49,905 --> 00:06:53,205 who just has a challenge not of his own making. 121 00:06:54,675 --> 00:06:57,365 What if the doctor had instead said something like the 122 00:06:57,365 --> 00:07:02,225 following, your beautiful son has experienced a 123 00:07:02,225 --> 00:07:04,225 serious medical error by the doctor, 124 00:07:04,885 --> 00:07:07,265 and it will be a real challenge for both him 125 00:07:07,445 --> 00:07:11,425 and the medical world to deal with, but we are here for you. 126 00:07:11,965 --> 00:07:15,265 We will try to connect you with researchers, surgeons, 127 00:07:15,525 --> 00:07:18,385 and doctors who are working on a fix for this problem. 128 00:07:20,445 --> 00:07:23,895 This presumes a world more like today where patients 129 00:07:23,915 --> 00:07:26,695 and families have more input into improving 130 00:07:26,835 --> 00:07:28,175 how healthcare is delivered. 131 00:07:29,085 --> 00:07:32,535 What if there had been a group supporting those whose sons 132 00:07:32,565 --> 00:07:33,895 experienced this trauma? 133 00:07:34,725 --> 00:07:36,215 What a difference either one 134 00:07:36,215 --> 00:07:38,415 of those could have made in the life of this family. 135 00:07:39,485 --> 00:07:42,785 Mr. Lopinto, in many ways does a good job 136 00:07:42,805 --> 00:07:45,185 of describing the dilemma of David's parents 137 00:07:45,805 --> 00:07:47,985 as they grappled with what to do for their son. 138 00:07:48,855 --> 00:07:52,065 They wondered whether he would be ostracized and bullied 139 00:07:52,175 --> 00:07:55,545 because he could not stand and pee like the other boys. 140 00:07:56,525 --> 00:07:59,705 How would the family, including their other son be treated? 141 00:08:00,685 --> 00:08:04,225 The local newspapers soon printed stories about their case, 142 00:08:05,015 --> 00:08:07,785 even though no names were given in the stories, 143 00:08:08,375 --> 00:08:11,825 this publicity left them feeling even more isolated. 144 00:08:12,765 --> 00:08:15,905 The parents stopped going out very much afraid 145 00:08:15,905 --> 00:08:17,905 that a babysitter would spread gossip 146 00:08:18,075 --> 00:08:19,785 after changing David's diaper. 147 00:08:20,685 --> 00:08:24,225 In addition, his father, when he mentioned what happened 148 00:08:24,225 --> 00:08:28,835 to friends at work was treated to jokes for the parents. 149 00:08:29,695 --> 00:08:31,235 All this was disheartening. 150 00:08:32,505 --> 00:08:34,915 John and Janet Rimer took their boys home 151 00:08:35,375 --> 00:08:38,235 and did the best they could with their situation. 152 00:08:38,905 --> 00:08:40,755 They worried that there was no fix 153 00:08:40,815 --> 00:08:42,355 for David's destroyed penis. 154 00:08:43,985 --> 00:08:47,575 Everything seemed to reinforce John and Janet's fears 155 00:08:47,595 --> 00:08:49,095 and feelings of isolation. 156 00:08:50,155 --> 00:08:53,735 The words of Dr. Adamson, for example, are riddled 157 00:08:53,735 --> 00:08:55,215 with unexamined beliefs. 158 00:08:56,645 --> 00:08:59,415 What is the definition of a normal sex life? 159 00:09:00,285 --> 00:09:03,735 Even the idea that a marriage needs to be consummated 160 00:09:03,835 --> 00:09:06,855 by vaginal penetrating sex is filled 161 00:09:06,855 --> 00:09:08,255 with cultural assumptions. 162 00:09:09,005 --> 00:09:12,135 Many people enjoy sexual pleasures in ways 163 00:09:12,205 --> 00:09:16,295 that do not solely depend on penile vaginal intercourse, 164 00:09:17,075 --> 00:09:20,455 and this worldview leaves out the ways gays 165 00:09:20,455 --> 00:09:24,215 and lesbians can have full sexual lives without 166 00:09:24,565 --> 00:09:26,375 what the doctor is claiming is normal. 167 00:09:27,855 --> 00:09:30,155 In addition, the work mate's reaction 168 00:09:30,215 --> 00:09:33,275 of making jokes rather than offering sympathy 169 00:09:33,295 --> 00:09:37,235 or support perhaps reflects their own fear of being seen 170 00:09:37,255 --> 00:09:40,275 as different or at least a way of dealing with something 171 00:09:40,275 --> 00:09:41,795 that made them uncomfortable. 172 00:09:43,275 --> 00:09:45,835 I believe this is an example of when lack 173 00:09:45,835 --> 00:09:47,835 of scientific knowledge can combine 174 00:09:47,835 --> 00:09:52,035 with negative cultural beliefs to make it harder for people 175 00:09:52,175 --> 00:09:54,675 to be just accepted as they are 176 00:09:55,335 --> 00:09:57,955 or to find good solutions to hard problems, 177 00:09:58,935 --> 00:10:01,995 but the Rhymers thought they had found a potential solution. 178 00:10:03,325 --> 00:10:07,185 One evening in February, 1967, they happened 179 00:10:07,185 --> 00:10:10,225 to be watching a popular current affairs program 180 00:10:10,765 --> 00:10:13,425 on the Canadian Broadcasting Corporation. 181 00:10:13,935 --> 00:10:16,105 When they saw an interview with Dr. 182 00:10:16,215 --> 00:10:19,425 John Money, they listened as Dr. 183 00:10:19,475 --> 00:10:22,785 Money talked about his work doing gender affirming 184 00:10:23,105 --> 00:10:26,345 surgeries, and at one point a transgender woman was 185 00:10:26,435 --> 00:10:29,105 introduced in Mr. 186 00:10:29,335 --> 00:10:33,495 Coop Pinto's words quote until four years ago. 187 00:10:33,675 --> 00:10:38,455 Her name was Richard Ron and Janet Gaped at the TV screen. 188 00:10:39,075 --> 00:10:42,135 It was their first glimpse ever of a transsexual. 189 00:10:42,795 --> 00:10:44,295 It was one thing to hear Dr. 190 00:10:44,465 --> 00:10:47,215 Money talk about sex change in the abstract. 191 00:10:47,715 --> 00:10:50,095 It was another to see it with their own eyes. 192 00:10:51,595 --> 00:10:55,255 Ron and Janet could hardly believe it if they hadn't 193 00:10:55,255 --> 00:10:56,415 been told that Mrs. 194 00:10:56,575 --> 00:10:59,895 Baranski was born a man. They would never have guessed it. 195 00:11:00,525 --> 00:11:02,695 Even knowing it, it was hard to believe 196 00:11:03,435 --> 00:11:06,615 she looked like an attractive even sexy woman. 197 00:11:07,235 --> 00:11:11,215 The way she moved, walked, sat, even her voice 198 00:11:11,725 --> 00:11:15,615 despite an ever so slight Huskiness had the timber 199 00:11:15,675 --> 00:11:19,455 of a woman's as she said hello to her host and fellow guest. 200 00:11:20,605 --> 00:11:23,575 Soon after the show, they contacted Dr. 201 00:11:23,575 --> 00:11:25,335 Money who agreed to meet with them. 202 00:11:26,895 --> 00:11:29,775 I just want to note a couple of things at this point. 203 00:11:30,755 --> 00:11:32,535 One is that the description in Mr. 204 00:11:33,055 --> 00:11:37,295 Op Pinto's books uses the terms trisexual and sex change. 205 00:11:38,445 --> 00:11:41,975 Most people I know who are transgender or her work 206 00:11:41,995 --> 00:11:44,975 and gender affirming care today would not use this 207 00:11:44,975 --> 00:11:49,015 terminology because we know that it is possible 208 00:11:49,355 --> 00:11:50,735 for your gender identity 209 00:11:51,035 --> 00:11:54,645 and physical sex characteristics at birth to not match. 210 00:11:56,495 --> 00:12:00,285 While gender affirming care can change your external sex 211 00:12:00,285 --> 00:12:03,765 characteristics and certain hormone levels in your body, 212 00:12:04,385 --> 00:12:06,685 it does not change your chromosomes 213 00:12:06,905 --> 00:12:09,925 or how you developed physical sex characteristics 214 00:12:09,945 --> 00:12:10,965 in the womb. 215 00:12:12,305 --> 00:12:17,075 Another thing to note is that in 1967, as it was 216 00:12:17,245 --> 00:12:20,115 until very recently, doctors 217 00:12:20,375 --> 00:12:23,515 and surgeons just assumed that for babies 218 00:12:23,735 --> 00:12:26,795 and young children who were born with a variation 219 00:12:26,795 --> 00:12:28,395 of sex characteristics 220 00:12:28,455 --> 00:12:32,115 or intersex, the right thing to do was 221 00:12:32,135 --> 00:12:36,275 to operate on their bodies to make them fit what the doctors 222 00:12:36,875 --> 00:12:39,155 believed would be their true sex. 223 00:12:40,385 --> 00:12:43,355 Happily, this assumption has been challenged 224 00:12:43,735 --> 00:12:44,915 by intersex people 225 00:12:45,015 --> 00:12:48,475 and supporters active in working for the rights 226 00:12:48,595 --> 00:12:52,115 of intersex people and in many hospitals 227 00:12:52,115 --> 00:12:53,275 and healthcare systems. 228 00:12:53,485 --> 00:12:57,045 Today, this would not be done. Dr. 229 00:12:57,055 --> 00:13:00,245 Money was one of those who arranged such surgeries 230 00:13:00,265 --> 00:13:01,685 for people born intersex 231 00:13:02,145 --> 00:13:04,325 and did some of the early research into people 232 00:13:04,325 --> 00:13:06,965 who had come out as transgender as well. 233 00:13:07,985 --> 00:13:10,005 He wrongly applied his beliefs 234 00:13:10,145 --> 00:13:12,565 and assumptions about people born intersex 235 00:13:12,665 --> 00:13:14,005 to David's situation. 236 00:13:15,415 --> 00:13:18,725 Let's also note that David was not born either 237 00:13:18,915 --> 00:13:21,125 with a variation of sex characteristics 238 00:13:21,125 --> 00:13:23,365 that would fit the classification of intersex 239 00:13:23,905 --> 00:13:26,445 or as transgender or non-binary. 240 00:13:27,825 --> 00:13:32,525 As he began to claim agency for his own life as a teenager 241 00:13:32,665 --> 00:13:34,925 and adult, he came out 242 00:13:35,225 --> 00:13:39,165 as the cisgender heterosexual male he was from birth, 243 00:13:41,045 --> 00:13:44,425 but David's parents were trying to figure out how 244 00:13:44,425 --> 00:13:47,545 to raise their son in a world not very friendly 245 00:13:47,645 --> 00:13:49,025 to boys without a penis 246 00:13:49,765 --> 00:13:53,065 or even those with a penis very much shorter than the 247 00:13:53,065 --> 00:13:57,305 average, a world with very negative beliefs about people 248 00:13:57,445 --> 00:14:00,905 who did not fit the image of two absolutely 249 00:14:01,505 --> 00:14:03,785 distinct categories of male 250 00:14:03,965 --> 00:14:07,305 and female with no significant variations 251 00:14:08,005 --> 00:14:10,785 or who are not heterosexual in their love 252 00:14:10,785 --> 00:14:12,145 lives and attractions. 253 00:14:13,415 --> 00:14:16,705 This is why the TV show and their conversation with Dr. 254 00:14:16,715 --> 00:14:19,185 Money turned out to be convincing for them. 255 00:14:20,045 --> 00:14:22,665 He offered the hope that their child could be raised 256 00:14:22,725 --> 00:14:24,385 as a heterosexual girl. 257 00:14:25,335 --> 00:14:28,425 This seemed to them under the existing cultural 258 00:14:28,425 --> 00:14:33,145 circumstances to offer the possibility of David being seen 259 00:14:33,285 --> 00:14:35,825 as a normal child living a normal life. 260 00:14:37,375 --> 00:14:38,585 When they spoke with Dr. 261 00:14:38,595 --> 00:14:41,145 Money in person, his words 262 00:14:41,285 --> 00:14:44,905 and body language exhibited great confidence about his 263 00:14:44,905 --> 00:14:46,225 theories and practices. 264 00:14:47,485 --> 00:14:49,705 As John Lopinto says at his book, 265 00:14:50,715 --> 00:14:55,445 after so many months of grim predictions, bleak prognosis 266 00:14:55,465 --> 00:14:57,325 and hopelessness, Dr. 267 00:14:57,515 --> 00:15:01,285 Money's words, Janet says, felt like a balm. 268 00:15:01,995 --> 00:15:05,125 Someone she says was finally listening. 269 00:15:06,915 --> 00:15:08,225 After talking with him 270 00:15:08,325 --> 00:15:09,905 and thinking about it for a while, 271 00:15:10,055 --> 00:15:11,665 they decided to follow Dr. 272 00:15:11,775 --> 00:15:15,825 Money's advice. In July of 1967, 273 00:15:16,355 --> 00:15:18,505 David was operated on by Dr. 274 00:15:18,615 --> 00:15:21,625 Money's colleague at his clinic, Dr. Howard Jones. 275 00:15:22,695 --> 00:15:24,305 David's testicles were removed 276 00:15:24,725 --> 00:15:29,185 and scrotum fashioned into a rudimentary exterior vagina. 277 00:15:30,285 --> 00:15:34,185 Dr. Money told David's parents that they must dress David 278 00:15:34,365 --> 00:15:36,985 and treat him like a girl starting immediately, 279 00:15:37,565 --> 00:15:40,785 and they must not tell him about the medical error 280 00:15:40,855 --> 00:15:42,305 that destroyed his penis 281 00:15:42,645 --> 00:15:44,665 or even that he was born with a penis. 282 00:15:45,415 --> 00:15:47,025 They must talk about him 283 00:15:47,325 --> 00:15:49,705 and treat him like a girl consistently 284 00:15:50,005 --> 00:15:51,705 for the process to be successful. 285 00:15:51,765 --> 00:15:56,745 He said ultimately it was not successful for David 286 00:15:57,325 --> 00:16:00,705 and in several ways his experience has similarities 287 00:16:00,735 --> 00:16:01,865 with that of Pigeon. 288 00:16:02,195 --> 00:16:05,745 Bogus Pigeon was born with a variation 289 00:16:05,745 --> 00:16:08,585 of sex characteristics that we call intersex. 290 00:16:09,325 --> 00:16:12,745 As I reported in episode six of Butterfly Arose 291 00:16:13,405 --> 00:16:16,105 pigeon was also operated on as a baby 292 00:16:16,525 --> 00:16:19,305 and their parents were told to raise them as a girl. 293 00:16:20,825 --> 00:16:24,745 I see four important similarities between their stories. 294 00:16:26,725 --> 00:16:31,145 In both cases, these babies were operated on for conditions 295 00:16:31,175 --> 00:16:33,185 that were not life-threatening. 296 00:16:34,525 --> 00:16:38,505 In both cases, the doctors were motivated in part by 297 00:16:38,505 --> 00:16:41,265 what they believed they knew in terms of medical 298 00:16:41,485 --> 00:16:43,345 and psychosocial knowledge. 299 00:16:44,445 --> 00:16:48,545 In both cases, the parents were told to dress their children 300 00:16:48,805 --> 00:16:51,625 as girls and treat them like they were girls 301 00:16:52,045 --> 00:16:55,065 and to never tell them about their actual condition, 302 00:16:56,355 --> 00:16:58,535 and in both cases, the doctors 303 00:16:58,755 --> 00:17:01,335 and the parents of these children were trying 304 00:17:01,675 --> 00:17:04,935 to navigate a culture in which Iex people 305 00:17:05,355 --> 00:17:08,095 and boys born with very short penises 306 00:17:08,475 --> 00:17:10,215 or who lost them to accident 307 00:17:10,275 --> 00:17:12,975 or medical error were seen through lenses 308 00:17:13,155 --> 00:17:14,895 of very negative stereotype. 309 00:17:17,095 --> 00:17:20,875 As Katrina Caris says in her book, fixing Sex 310 00:17:21,345 --> 00:17:24,715 that I reported on in episode seven quote, 311 00:17:25,735 --> 00:17:27,955 far from existing outside culture 312 00:17:28,985 --> 00:17:31,155 biomedicine is a cultural entity 313 00:17:31,425 --> 00:17:34,235 that not only has unparalleled discursive 314 00:17:34,295 --> 00:17:36,835 and practical powers to define 315 00:17:36,935 --> 00:17:40,075 and determine what it is to be normatively human, 316 00:17:41,015 --> 00:17:44,515 but also to withstand alternative constructions 317 00:17:44,815 --> 00:17:48,635 and challenges to its version of normativity unquote. 318 00:17:50,395 --> 00:17:54,935 Ms. Cartis goes on to say that historically, the effort 319 00:17:54,995 --> 00:17:56,615 to enforce the sex binary, 320 00:17:57,045 --> 00:18:00,975 even when a specific person's body did not conform to it, 321 00:18:01,755 --> 00:18:04,415 was also bound up with cultural fears 322 00:18:04,595 --> 00:18:08,215 and negative stereotypes about same sex attraction. 323 00:18:09,995 --> 00:18:11,015 Pigeon Pagon 324 00:18:11,235 --> 00:18:14,575 and David Rimer had bodies that were seen as 325 00:18:14,765 --> 00:18:18,535 outside the boundaries of normal for very different reasons, 326 00:18:19,475 --> 00:18:23,215 but they experienced similar and very harmful treatments. 327 00:18:24,285 --> 00:18:27,215 Both courageously faced their circumstances 328 00:18:27,435 --> 00:18:29,735 as they grew older and built lives 329 00:18:29,805 --> 00:18:31,975 that reflected their true selves. 330 00:18:33,165 --> 00:18:36,335 Both went on to rebuild emotional connection 331 00:18:36,435 --> 00:18:38,175 and trust with their families. 332 00:18:40,195 --> 00:18:44,175 In later life, David Reimer developed a remarkably nuanced 333 00:18:44,245 --> 00:18:47,535 view about the world He lived and grew up in. 334 00:18:48,795 --> 00:18:52,725 Colapinto quotes David Rimer on his experiences facing male 335 00:18:52,775 --> 00:18:57,245 chauvinism at work on page 263 of the Kindle Edition. 336 00:18:59,185 --> 00:19:01,445 The guys at work don't know what happened to me. 337 00:19:02,005 --> 00:19:03,885 I mean, I work in a slaughterhouse. 338 00:19:04,225 --> 00:19:07,605 All men can you imagine there's the freak 339 00:19:07,665 --> 00:19:09,085 who wore dresses as a kid. 340 00:19:09,265 --> 00:19:11,965 He imagines them saying They give you 341 00:19:11,965 --> 00:19:14,165 that male chauvinist crap all the time, 342 00:19:14,675 --> 00:19:17,005 like they're always saying that they're the boss at home. 343 00:19:17,515 --> 00:19:19,525 They look at me and ask me, who's the boss? 344 00:19:20,485 --> 00:19:24,285 I say, look, man, in my home, it's a partnership. 345 00:19:24,865 --> 00:19:26,725 It doesn't mean I wimp out. 346 00:19:27,075 --> 00:19:30,485 Sometimes I get my way and sometimes I don't get my way, 347 00:19:31,465 --> 00:19:33,285 but either way, it's a partnership. 348 00:19:35,245 --> 00:19:37,245 I mean, who wants a woman with no brains 349 00:19:37,245 --> 00:19:38,365 who follows you blindly? 350 00:19:38,825 --> 00:19:41,005 That's more like a slave than a wife? 351 00:19:42,025 --> 00:19:43,205 You don't want a slave. 352 00:19:43,625 --> 00:19:46,845 You want somebody with their own opinions, somebody 353 00:19:46,905 --> 00:19:49,085 who puts you on the right track, someone 354 00:19:49,225 --> 00:19:50,765 to show you the right direction. 355 00:19:51,835 --> 00:19:54,885 It's very hard to talk to somebody who's stone cold stupid 356 00:19:54,945 --> 00:19:56,165 who follows you blindly. 357 00:19:58,835 --> 00:20:01,845 Then Op Pinto further quotes David as saying, 358 00:20:02,835 --> 00:20:05,575 but you know, if I had had a normal life 359 00:20:05,995 --> 00:20:07,855 and none of this had ever happened to me, 360 00:20:08,595 --> 00:20:11,775 I'd probably be one of these chauvinistic kind of guys 361 00:20:12,345 --> 00:20:15,215 where the guy goes to work, breaks his back, comes home 362 00:20:15,475 --> 00:20:17,895 and sucks down a beer and watches sports, 363 00:20:19,115 --> 00:20:21,695 and if I saw someone like me out on tv, 364 00:20:22,515 --> 00:20:25,655 I'd sit there saying, oh God, that's sick. 365 00:20:27,075 --> 00:20:31,495 That's how I would be so knowing that this person is me, 366 00:20:31,995 --> 00:20:33,815 you could realize how sick I feel. 367 00:20:33,845 --> 00:20:36,495 Looking back on all this, you wish 368 00:20:36,495 --> 00:20:39,055 to God you could switch places with anybody. 369 00:20:41,325 --> 00:20:44,575 David's and pigeon stories were both hard for me to read, 370 00:20:45,595 --> 00:20:47,965 yet it is important that they were written. 371 00:20:49,035 --> 00:20:50,365 Part of the motivation 372 00:20:50,385 --> 00:20:54,365 for change in my experience comes from real life stories, 373 00:20:55,385 --> 00:20:58,685 but stories of individual people are just one facet 374 00:20:58,685 --> 00:21:02,085 of the information we need to create a better, more just 375 00:21:02,085 --> 00:21:04,005 and compassionate healthcare system. 376 00:21:05,825 --> 00:21:09,365 We are complex beings and much of who we are 377 00:21:09,465 --> 00:21:12,805 and how we develop defies simple answers. 378 00:21:14,705 --> 00:21:16,285 One thing that David's 379 00:21:16,285 --> 00:21:20,845 and pigeon stories reflects is an ongoing argument over the 380 00:21:20,845 --> 00:21:25,165 role of our biological processes versus environmental 381 00:21:25,235 --> 00:21:29,165 factors in our development from inception to adulthood. 382 00:21:30,635 --> 00:21:34,445 This has been called the nature versus Nurture debate. 383 00:21:35,865 --> 00:21:38,285 Dr. Money was one of several researchers 384 00:21:38,285 --> 00:21:42,325 and doctors who argued for a stronger role of nurture. 385 00:21:43,475 --> 00:21:46,605 This is part of the reason he gave the rhymers the advice 386 00:21:46,665 --> 00:21:48,245 to raise their son as a girl. 387 00:21:50,095 --> 00:21:52,275 On page 280 of his book, 388 00:21:52,745 --> 00:21:55,635 John Lopinto talks about David's courage 389 00:21:56,135 --> 00:21:58,595 and lets us know a reason why writing it was 390 00:21:58,645 --> 00:21:59,715 meaningful to him. 391 00:22:00,735 --> 00:22:04,965 He says, indeed, it was this very courage 392 00:22:04,985 --> 00:22:06,765 of David's, which was my prime 393 00:22:06,855 --> 00:22:08,565 motivation in writing the book. 394 00:22:09,555 --> 00:22:14,085 Despite its medical scientific context, I've always believed 395 00:22:14,155 --> 00:22:18,685 that this story transcends the incessant quibbling over the 396 00:22:18,685 --> 00:22:20,365 nature nurture debate. 397 00:22:21,755 --> 00:22:25,645 David's is a story about identity in its largest sense, 398 00:22:26,225 --> 00:22:27,965 not simply sexual identity. 399 00:22:29,105 --> 00:22:32,765 His story for all its uniqueness is a universal one 400 00:22:33,265 --> 00:22:36,205 and reminds us how it is every person's individual 401 00:22:36,465 --> 00:22:40,405 responsibility to define for himself who he is 402 00:22:41,385 --> 00:22:43,885 and to assert that against the world 403 00:22:43,915 --> 00:22:48,565 that often opposes ridicules, oppresses or undermines him. 404 00:22:50,025 --> 00:22:52,205 In the next episode of Butterfly Arose, 405 00:22:52,605 --> 00:22:54,845 I will go more deeply into what I've learned 406 00:22:55,065 --> 00:22:58,445 so far about the challenges medical researchers 407 00:22:58,465 --> 00:23:00,525 and doctors face as they work 408 00:23:00,525 --> 00:23:02,605 to develop knowledge about we humans 409 00:23:03,115 --> 00:23:05,125 that can help us live healthier lives 410 00:23:05,785 --> 00:23:08,205 and the role our existing cultural beliefs 411 00:23:08,225 --> 00:23:10,725 and human frailty can play in that work. 412 00:23:12,135 --> 00:23:13,365 Thank you for listening. 413 00:23:13,985 --> 00:23:16,245 Please remember, you can find the books 414 00:23:16,385 --> 00:23:18,845 and articles I reference in my podcasts 415 00:23:19,385 --> 00:23:20,885 on my emily p 416 00:23:20,965 --> 00:23:24,965 newberry.substack.com website. 417 00:23:25,605 --> 00:23:29,325 I have two pages with links for both of my podcasts.