Books selected and reviewed by James Park.
The sections in black
are intended to be
objective reports of the contents of these books.
The sections in red
are the evaluative opinions of this reviewer.
These books are organized by quality, beginning with the best.
Copyright
©
2018 by James Leonard Park
1. John Money
Sex Errors of the Body and Related Syndromes:
A Guide to Counseling Children,
Adolescents, and Their Families
(Baltimore, MD: Paul H. Brooks Publishing Company, 1994—2nd
edition) 132 pages
(ISBN: 1-55766-150-2; hardcover)
(Library of Congress call number: RC881.5.M66 1994)
(Medical call number: WJ712M742s 1994)
John Money—foremost
sexologist of the 20th
century—
presents in a small book of only 130 pages
all the basic information about sexual birth defects
and the means of dealing with these variations.
This book can be understood by every parent of
an intersex baby
and by all who deal with persons
having some chromosome or hormone defects
that lead to a body somewhere between female and male.
Money deal with the following anomalies:
gonads, fetal hormones, internal sex organs,
external sex organs, & pubertal hormones.
He also discusses:
Sexual orientations for persons born intersex.
Assignment problems: Is it a boy or a girl?
Explaining the problems to children at age-appropriate levels.
The emergence and development of sexual responses
—both
usual and unusual.
All-in-all, this is a good place to begin
reading
about the various intersex
conditions.
This book presents in a very brief
form
themes that are explored more
comprehensively
in other books by John Money.
2. John Money
Biographies of Gender and
Hermaphroditism
in Paired
Comparisons:
Clinical
Supplement to the Handbook of Sexology
(Amsterdam, Netherlands: Elsevier, 1991) 375 pages
Detailed case studies of
22 intersex individuals,
most followed from infancy thru adulthood.
Main themes:
(1) sex assignment confusions, problems, mistakes, & later
corrections;
(2) hormonal problems before birth and at puberty
—and their
correction when possible;
(3) surgical correction to make the body more male
or more female;
(4) family histories of coping with sexual birth
defects;
(5) male/female self-designation struggles for all intersex
individuals;
(6) sexual histories, romantic histories, marriage,
adoption of children,
adjustment, & maladjustment.
This book is recommended for all intersex individuals,
their families, & all
professionals who deal
with them.
3. John Colapinto
As
Nature Made Him:
The Boy
Who Was Raised as a Girl
(New York: HarperCollins, 2000)
279 pages
(ISBN: 0-06-019211-9; hardcover)
(Library of Congress call number: RC560.G45C65
2000)
This book
is journalism
rather than science.
But it has introduced thousands of people to sexology
who would never have read more technical book.
Colapinto tells the story
of David Reimer,
who lost his penis in a circumcision accident at
age 8 months.
After his parents saw a television program featuring John Money,
they decided to explore the possibility of raising
their son as a girl.
In consultation with John Money
and other psychological and medical professionals,
they decided to raise Bruce (David's original name)
as a girl (Brenda) beginning at age 19 months.
The infant's testicles were removed at age 22 months.
In retrospect, this might have been too late to change
the sex of a child.
Male/female self-designation ("I am a boy." or "I
am a girl.")
is probably set—imprinted—by
age 18 months,
by the time a child begins to speak.
David Reimer's story is
a psychological experiment that failed.
After some troublesome years as a girl, at age
14 years,
when David learned that he was born a boy
(just like his identical twin brother),
he decided to begin living as a male once again.
And as of the publication of this book,
he has lived more than half of his life as a male
again.
He married a woman who already had three children,
thereby becoming an instant father.
Hormone treatments and
a new constructed penis
have helped him to cross the sex-line for a second
time.
Psychologically he seems well adjusted to being
a male,
even tho he spent his childhood (ages 2-14) as
a girl.
As
Nature Made Him is based mainly on interviews with David,
when he was an adult male in his early thirties,
and as many other people as John Colapinto could
find
three decades after the story began.
When depending on recollections
years after
the events,
it now appears obvious that it was
never a good
decision
to try to raise David as a girl.
But David might have remembered
mainly
the facts
that supported his decision to
live as a male again.
(In reading the life-stories of
many sex-changed
people,
we often note that their
recollections of childhood
almost always support the later
decision to change
sex.)
Here the adult David Reimer might want to
remember
that he was always a boy,
even tho everyone around him tried
to raise him
as a girl.
However, we do have some
good records from her childhood
that show that Brenda always resisted having a
vagina constructed.
She believed that she was a girl, but she did not
want any more surgery.
Her sexual attractions (such as they were) were
toward 'other' girls.
To this
reviewer's knowledge,
John Money never responded to this book,
which is highly critical of his role in advising
the Reimer parents
to raise their damaged boy as a girl.
John Money is familiar with other cases of failed
sex-changes,
in which the individual later decides to go back
to the original sex.
In this case, there are three possible explanations for the failure:
(1)
Perhaps 19 months was
too late for switching the sex of a child.
If the child has already begun to speak
and has heard itself referred to as either a "he"
or a "she",
the imprinting of male/female self-designation might already have
occurred.
David Reimer might have had an unarticulated awareness
of being a boy
from his early life before he was switched to being a
girl at age 19 months.
(2) Even
more important,
his parents and other adult relatives
were already very accustomed to thinking of Bruce
as a boy.
Even tho they were all told to treat the new Brenda
as a girl,
they knew the truth of his birth as a normal boy
and the circumcision accident that destroyed his
penis,
and they might have communicated this family secret
unconsciously.
David's father reports that he knew the experiment
was a failure
when Brenda was 7 or 8 years old.
(3) Even
without testicles
to supply testosterone (the male hormone),
Brenda developed in ways that were remarkably like
her identical twin brother, Brian.
So Brenda's body may have compensated,
still producing a boy, because all his cells said
XY,
rather than XX, which is the genotype for a normal
girl.
If this was the case, his body was pulling one
way,
even tho his socialization
was pulling in the other
direction.
When David learned the
secret of his birth, he was relieved
—and immediately
set out plans for becoming a boy again.
He was given all the necessary hormonal and surgical
treatments,
which helped him to be nearly a normal male
as of the year 2000.
All in
all, this is a very
interesting case study.
But even the author admits at the end
that one case is not a sufficient basis for scientific
conclusions,
John Colapinto was able to convince David Reimer
to go public
at least in part because his case was being misused
to show the ease with which children could be raised
as either sex.
Now that
one person has
been willing to tell the whole story,
others will doubtless come forward with other case
histories,
some confirming that nurture
cannot easily overcome nature
and some showing that people can successfully switch
from one sex to the other.
It will be an interesting time for sexology.
Postscript 2004: David Reimer ultimately
killed himself in 2004,
two years after the suicide of his
twin brother.
We might never know whether his
sex-change problems
were a factor in his decision to
end his life at age 38.
4. Suzanne J. Kessler
Lessons from the Intersexed
(New
Brunswick, NJ: Rutgers University Press,
1998) 193 pages
(ISBN: 0-8135-2529-2; hardcover)
(ISBN: 0-8135-2530-6; paperback)
(Library of Congress call number: RC883.K47 1998)
At birth, intersex people were physically ambiguous:
They were born neither clearly
male nor clearly
female.
And since it became possible in the 20th century,
they were usually given medical treatments
to make them more definitely one sex or the other.
But the author of this book takes a different stand:
Kessler believes that doctors should
not interfere with what nature has
created.
She believes that 'gender' is a social construct.
Her consistent use
of the word "gender"
to refer to the sex of an individual
—whether that person is a male or a
female—
continues the confusion so common
in our everyday thinking about sex and gender.
When we discuss the gender-personality
of an individual person,
whether that person has 'masculine' or 'feminine' character traits,
we are clearly dealing with learned
emotional responses.
Likewise, when we refer to the sex-role of an individual,
we a discussing external behavior expected in any society
because the individual is either a male or a female.
Both gender-personalities
and sex-roles are
fluid and flexible.
These are cultural
constructs—the results of experiences since birth.
But the biological sex of any animal organism is not a social construct.
Most animals are clearly male or female.
Only a few have any ambiguity with respect to their biological sex.
These are the intersex individuals.
This book is written
from the perspective
of the organized groups of intersexuals.
Most babies born with some sexual ambiguity
are now diagnosed and treated from birth
making them as close as possible to whichever sex they most
resemble.
The parents of these intersex babies make a decision based on science.
And their children are raised as either boys or girls.
They grow up wanting to be as 'normal' as possible.
Because they fade into the general population as regular men or
women,
they have no use for the political movement of intersexuals.
Such individuals do not figure in this book.
Before medical
treatments for sexual birth defects became possible
or when the facts were not recognized early enough,
some people grew into adulthood as intersex individuals.
Each was forced to cope with his or her body as given.
And sometimes they joined social and political groups
with others who have some variation of biological sex.
Some of the interviews for this book took
place in 1985.
They reflect the experiences
of
the interviewees some years earlier.
Kessler describes a rudimentary
method for treating intersex babies:
Sex was assigned on the basis of the external genitals alone:
If it is large enough and can be enlarged, it is called a penis.
And the baby is a boy.
If it is small and can be reduced, it is called a clitoris.
And the baby is a girl.
The family doctor of decades ago had no way to discover
whether the baby was XX (female) or XY (male),
or some other patterns of genes that created an intersex baby.
But if they join groups for
intersexuals,
they will usually have developed
their own mythologies,
which explain what they are and how they should live.
In the USA, some
state laws deal with sex-change operations:
The sex of an individual is defined by reproductive capacity:
When a born-male is changed into a female,
he must lose the capacity to father
children.
Likewise, when a born-female is changed into a male,
she must lose the capacity to bear
children.
Intersex individuals
who have grown into adulthood
with little or no physical modifications
might also adopt the same convention:
Their male/female self-designation
might depend on their reproductive
capacities.
Are they closer to normal
biological males or normal
biological females?
When unusual imprinted sexual fantasies
and homosexual variations are
added,
the situation becomes even more complex.
See Variations
of
Sex & Gender: Six Phenomena Frequently Confused.
However, we do have
experience with the 'do nothing' option:
Thru-out most of human history (and pre-history),
it was simply not possible to do anything about birth defects.
People learned to live with whatever abnormalities they had from
birth.
The 'default' decision for most of the human race was do nothing.
Until the middle
20th century, there was no way to
investigate
the causes and prognosis of any abnormality.
But now doctors can carefully compare each variation
with what is known about that variation in other individuals.
A good scientific
research project would be a follow-up survey
of all children who
received some medical treatment
because of various sexual birth-defects.
What percentage had each identified defect?
What percentage of each class was pleased with the results as
adults?
What percentage of each class was displeased with the results
—and in what specific ways were they
dissatisfied?
There are now probably thousands of adults in the US
who were treated for birth-defects related to sex.
The author mostly
ignores the underlying
genetic and hormonal causes of the birth abnormalities.
About 70 different variations from normal biological males or females
have now been identified.
These are really mistakes of nature,
not distortions caused by doctors.
Doctors seek to correct
these mistakes of nature,
not force all people to be conventional men or women.
Is the author
worried that medical science
might once again be turned toward 'curing' homosexuality?
The people
interviewed for Lessons from
the Intersexed
mostly see themselves as victims
and part of the sex-and-gender
minority.
But most intersex babies were 'corrected' soon after birth.
And they went on to live unremarkable lives as men or women.
Some do not even know
they were abnormal in any way.
And most learn to live with whatever physical differences they
have.
After all, exact genital appearance is not a matter of public concern.
Scientific follow-up
for such individuals would not be easy.
How would a researcher find them?
Those who know about their birth-defects
usually do not think of themselves as socially or sexually different.
And they might not want to be reminded of their birth-defects.
Nevertheless, this
book was needed.
It discusses many problems concerning intersex
individuals.
This reviewer agrees that some of the surgeries were not needed.
They were done mainly because of lack of tolerance of sexual ambiguity.
In some cases, surgery was
done because it could
be done.
Some surgeries can
be delayed
until the child is old enough to participate in the decisions.
For example, why construct a vagina that will never be used?
Kessler points out that some
female-to-male transsexuals
do not need a penis for sex.
They want to continue having sex
with women
while believing that they are men.
Surgeons are content with good-looking
results.
But the parents and the patients have to cope with other
problems
created when the child is not normally a male or a female.
This book does not deal with
intersex individuals having children.
This seems a serious omission
since having children
is one of the most important
meanings-of-life for some people.
Some intersex persons are surely more concerned about parenthood
than about the external appearance of their genitals.
A more complete (and
accurate) title for this book might have been:
Lessons from Intersexed
Individuals
Who Disagree with the
Treatment Decisions
Taken for Them When They Were Children.
Created
April 22, 2001; revised
5-30-2004; 4-29-2008; 5-8-2008; 12-10-2008;
1-9-2009; 1-22-2009;
4-23-2009; 9-25-2010; 6-3-2011; 4-11-2018;
Related Bibliographies
This bibliography is related
to several others in sexology.
Here is the complete list:
Sex-Script
Hypothesis
B-SEX-SC
Variations
of
Sex and Gender B-V-SG
1. Intersex
B-CRIT
2. Transsexualism
B-TS
Transsexual
Autobiographies B-TS-AB
3. Sex-Roles
B-ROLE
4. Gender-Personality
B-GEND
5. Sexual
Orientation
B-ORNT
6. Cross-Dressing
B-TV
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