CHICAGO (Reuter) -- A boy surgically altered and raised as a
girl after his penis was burned off as an infant rebelled and
became a man, researchers said Thursday, casting doubt on long-held
medical theories that gender can be "reassigned" after
birth.
The unidentified man, now in his 20s, was the basis in the past
two decades for most theories of "sex reassignment"
-- the approach surgeons take when male genitals are badly mutilated
at birth.
But in a lengthy report in the March issue of the Archives of Pediatric and Adolescent Medicine, researchers reported that the man called "John" was now married and that those theories were questionable.
Penis destroyed during surgery
The case first appeared in medical literature in 1972 after the
boy, at 8 months, lost his penis during an attempted cauterizing
repair. It was "accidentally burned to ablation," the
report said.
He was studied at Johns Hopkins Hospital in Baltimore where,
according to accepted theory, it was decided to surgically alter
him and raise him as "Joan," a girl, alongside his twin
brother. "John/Joan" was castrated and preliminary surgery
followed.
At first it seemed to work. In 1973, Time magazine said the oft-cited
case "provides strong support ... that conventional patterns
of masculine and feminine behavior can be altered. It also casts
doubt on the theory that major sex differences, psychological
as well as anatomical, are immutably set by the genes at conception."
But the newly published report said: "The evidence seems
overwhelming that normal humans are not psychosexually neutral
at birth but are, in keeping with their mammalian heritage, predisposed
and biased to interact with environmental, familial, and social
forces in either a male or female mode."
The new report was written by Milton Diamond of the John A. Burns School of Medicine in Honolulu and H. Keith Sigmundson of the Ministry of Health in Victoria, British Columbia.
'Joan' becomes 'John'
Their study said the child had trouble from the start. His mother
reported "Joan" rebelled at wearing dresses, preferred
his brother's toys to dolls, tried to urinate standing up, liked
to play soldier and went for rough-and-tumble games.
Between the ages of 9 and 11, the study said, "Joan"
realized she was male. At age 12, "Joan" rejected hormone
therapy designed for feminization. At 14, "Joan" decided
to become "John," undergoing a mastectomy and phallus
construction in the next two years.
At 16 he obtained a windowless van with a bed and bar. Girls
had crushes on him and at 25 he married a woman several years
his senior, adopting her children.
The researchers said they believe the case shows that any male
child with a normal nervous system "should be raised as a
male" and that genital surgery, however difficult, should
be conducted to assure that is possible.
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