David Reimer Case: The Botched Circumcision, John Money Experiment and India's Intersex Surgery Debate

Sex reassignment surgery has always been controversial in society, especially when it involves infants and young children. The iconic case of Bruce Reimer was initially used by sexologist John Money to support his theories. However, after the classic exposé it became evident that this was not a successful gender reassignment surgery. Instead,  the experience was  traumatic for Reimer, which eventually contributed to his suicide in 2004. 

What Happened to David Reimer After the Botched Circumcision?

Bruce Reimer and Brian Reimer were twins born to Janet Schultz and Ronald Reimer in Winnipeg on 22 August 1965. Both brothers were diagnosed with phimosis (foreskin of the penis cannot be retracted over the head of the penis) at the age of 8 months. Reportedly, the older twin, Bruce, underwent a circumcision procedure by electrocauterization, which went wrong and resulted in the destruction of his penis. The parents then cancelled Brian’s surgery.

Why Did John Money Recommend Raising David Reimer as a Girl? 

Reimer’s parents consulted John Money, a psychologist and a sexologist at Johns Hopkins Hospital. His views strongly favoured the idea that gender identity had more to do with nurture rather than nature. Money directed the parents to get a castration done and raise Reimer as a girl and renamed him Brenda. He advised them to get a vaginal canal constructed and prescribed Brenda estrogen pills at puberty. Following this, he started experimenting on the twins, compelling them to participate in activities mimicking sexual intercourse. Money published and presented the case as evidence of a successful female gender assignment, while later accounts from Reimer and the 1997 follow-up study documented a very different outcome.  

What Happened During John/Joan Study?

In reality, Reimer struggled to identify himself as a girl. He refused to wear dresses, preferred his brother’s toys, refused vaginal construction surgery, and by age ten, he told people that he intended to grow up and marry a woman according to John Colapinto's 1997 Rolling Stone investigation. At 15, Reimer’s father told him the truth about his birth and the surgery, following which he took the name David and returned to living as male. He subsequently underwent penis reconstruction and received testosterone therapy. He married a woman with three children and tried living a normal life.²

A 1997 follow-up study by psychologists Milton Diamond and H. Keith Sigmundson, which was published in Archives of Pediatrics & Adolescent Medicine, showed how far Money’s claims deviated from Reimer’s own account of events. Reimer described years of abuse during his childhood visits to Money’s clinic. He died in 2004 by suicide. His death was partly attributed to the lasting psychological trauma from the case, though according to another source, he was also coping with job loss and a marital separation at the time.

Medbound Times connected with Dr. Talat Fatema, PhD, a consultant child psychologist and a sexologist at One Health Assist for her insights on the David Reimer case. When asked regarding what secrecy and repeated genital examinations that Reimer went through can do psychologically, Dr. Talat explained, “The child may experience anxiety, shame, confusion, helplessness, or loss of control over their body. If the child later discovers that important information was hidden from them, they may also feel betrayed and have difficulty trusting parents, caregivers, or professionals.”

Nature vs. Nurture: The Two Schools of Thought Behind the Case

Money’s recommendation was based on the theory that a child is psychosexually neutral at birth and that gender identity can be formed largely through upbringing and social reinforcement rather than biology. This view, sometimes known as gender-neutrality theory, was widely accepted in mid-20th-century psychology and influenced how doctors approached infants with damaged or atypical genitals.

Another school of thought came from Milton Diamond, a biologist and sexologist, who challenged this theory even before Reimer’s case became public. Diamond argued that prenatal (before birth) exposure to hormones organizes the brain toward a gender identity before birth. The Reimer case challenged the assumption that gender identity could be reliably reassigned through surgery and upbringing alone. 2

Current research suggests that factors such as genetics, prenatal hormones, and environmental factors,  can influence gender identity.

Dr. Talat said, “A child’s inner sense of gender can develop in ways that may not match how they were raised. Gender identity is influenced by a combination of biological, psychological, and social factors, rather than being something that can simply be taught or changed.”

Is Intersex Surgery on Infants Legal in India?

Under India's Transgender Persons (Protection of Rights) Act, 2019, a "person with intersex variations" is defined as someone who, at birth, shows variations in primary sexual characteristics, external genitalia, chromosomes, or hormones from normative standards of male or female bodies. The law includes persons with intersex variations within its definition of transgender persons and requires governments to take measures relating to healthcare access and medical care. 

India's Transgender Persons (Protection of Rights) Act, 2019 provides legal recognition and healthcare-related protections for transgender persons, including persons with intersex variations, but it does not itself create a nationwide blanket ban on sex reassignment or genital surgeries performed on intersex infants and children.

What Is the Current Legal Position on Intersex Surgery in India?

The Reimer case still influences how doctors and lawmakers approach gender transition surgery on children whose genitals have an atypical male or female pattern. In India, Tamil Nadu is the only state to have banned sex reassignment surgery on intersex infants with exceptions for life-threatening situations.4 The court noted that the consent of parents cannot be treated as consent of the child according to the order reported by The News Minute. This traced back to the Supreme Court's 2014 judgment in National Legal Services Authority v. Union of India, which held that no one should be forced into sex reassignment surgery, though that judgment never became binding national legislation.

The issue also remains legally unsettled at the national level. In 2024, the Supreme Court issued notice on a public interest litigation filed by intersex activist Gopi Shankar M seeking legal protection for intersex children and restrictions on sex reassignment surgeries performed on them. The case represents an ongoing effort to establish a clearer national legal framework rather than a final Supreme Court ruling on the issue. A 2022 editorial in the Journal of the Indian Association of Pediatric Surgeons noted that the Tamil Nadu’s 2020 guidelines still leave surgical decisions to local multidisciplinary committees with a life-threatening exception. It called for uniform national and state-level protocols, since the criteria for what is considered as life-threatening continue to vary by condition and by hospital.¹ 

When asked regarding informed consent for such an irreversible procedure, Dr. Talat explained, “The child should be given age-appropriate information about what will happen, possible risks, long-term effects, and available alternatives. Their feelings, understanding, and wishes should also be taken seriously. From a psychological perspective, developmental maturity and decision-making ability are important when considering a child's participation in such decisions.”

The Reimer case predates all of this by half a century, but the underlying question, whether a child can meaningfully consent to irreversible gender reassignment surgery, is still underway in Indian courts.

References

1. Babu, Ramesh. "Changing Paradigms in Intersex Management: Legal, Ethical, and Medical Implications." Journal of the Indian Association of Pediatric Surgeons 27, no. 4 (2022): 372–375. https://pmc.ncbi.nlm.nih.gov/articles/PMC9552657/.

2. Diamond, Milton, and H. Keith Sigmundson. "Sex Reassignment at Birth: Long-Term Review and Clinical Implications." Archives of Pediatrics & Adolescent Medicine 151, no. 3 (1997): 298–304. https://doi.org/10.1001/archpedi.1997.02170400084015.

3. Gaetano, Phil. "David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case." Embryo Project Encyclopedia. Arizona State University, November 15, 2017. https://embryo.asu.edu/pages/david-reimer-and-john-money-gender-reassignment-controversy-johnjoan-case.

4. Government of Tamil Nadu, Health and Family Welfare Department. Government Order Banning Sex Reassignment Surgeries on Intersex Infants and Children. August 13, 2019. https://www.hrw.org/sites/default/files/supporting_resources/tn_order_august_2019.pdf.

5. Justice K.S. Puttaswamy (Retd.) v. Union of India, (2017) 10 SCC 1 (Supreme Court of India). https://digiscr.sci.gov.in/admin/judgement_file/judgement_pdf/2017/volume%2010/Part%20I/justice%20k%20s%20putiaswamy%20(retd.),_union%20of%20india%20and%20ors._1700550294.pdf.