1D: The John/Joan Case

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Introduction to Human Behavioral Genetics

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University of Minnesota

Introduction to Human Behavioral Genetics

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Behavioral genetic methodologies from twin and adoption studies through DNA analysis will be described and applied to address longstanding questions about the origins of individual differences in behavioral traits.

From the lesson

1

Unit # 1: Course Introduction and OverviewOverview: Unit # 1 provides an overview to the field of human behavioral genetics and to this course. We will begin by discussing the early history of the field and how behavioral genetic research influenced and was influenced by the eugenics movement. Once this historical context has been established, we will define the field of behavioral genetics and use this definition to provide an overview of the course. This week’s lectures will end with two case studies that illustrate the importance of behavioral genetic approaches. The first is the famous John/Joan case, where one member of a monozygotic twin pair was raised as a boy and the other as a girl. The second is the human genetic disorder Phenylketonuria (PKU), which has been recognized as a paradigm of human genetic disease since its discovery in 1934.Unit Objectives: At the end of this unit you should know• The history of the founding of the field of behavioral genetics• What the eugenics movement was and how it impacted psychology and behavioral genetics• What the field of behavioral genetics covers• How the John/Joan case represented the extreme of the “Blank Slate” mentality within psychology• Why Phenylketonuria is considered a public health success and model of human genetic diseaseLecture Modules:A. The Nature-Nurture Debate and Founding of Behavioral GeneticsB. The Eugenics MovementC. What is Behavioral GeneticsD. The John/Joan CaseE. Phenylketonuria (PKU) F. Huntington Disease (Supplemental)

1A: The Nature-Nurture Debate and Founding of Behavioral Genetics 14:42

1B: The Eugenics Movement 15:50

1C: What is Behavioral Genetics? 7:11

1D: The John/Joan Case 17:34

1E: Phenylketonuria (PKU) 15:49

1F: Huntington Disease - Supplementary 18:54

Unit 1 Office Hours Video 20:22

Meet the Instructors

Matt McGue
Regents Professor
Psychology

Welcome back, this is the fourth module of the

first lecture unit of an introduction to human behavioral genetics.

Today, we'll talk about a case study, a remarkable twin study, but

a twin study of one pair of twins called the John/Joan case.

The goals for this module is to first

understand the John/Joan case, and the reason I'm going to

talk about it is that I think it

represents the height of Blank Slate thinking within psychology.

And also, to talk about the life of a person who

actually is a personal hero of mine, David Reimer, a remarkable man.

In his life, a very difficult life.

But a man who led that life with a great grace.

If you remember from the end of when we were talking about the eugenics movement,

and my argument that the impact of the eugenics movement on psychology

was to really undermine Galtonian thinking, behavioral genetic thinking,

by the late 1930s and early 1940s. And

to replace that belief about the importance of genetics

a blank slate mentality had come about in psychology.

The belief that we were born blank slates, ready

to be written on by our parents, by our teachers.

And the genetics mattered for very, very, very little.

And the John/Joan case as you'll see here in a little bit, really represents I

think, the apex of thinking of us as really being born as completely malleable.

And really what the John/Joan case involves is gender behavior.

If you think about when a baby is born,

what's the first question we normally ask about the baby.

Usually the first question most people ask,

maybe not everybody, but most people ask.

Is is it a boy or is it a girl?

We don't ask about the health of the mother or the health of the baby.

We want to know if it's a boy or a girl.

And the reason we want probably want to know if it's a boy or a girl is because

the way we interact with other people is largely

determined by what we perceive their gender to be.

We treat boys differently from girls and we

treat them differently from virtually the moment they're born.

And that different treatment by others certainly socializes gendered behavior.

We behave differently as men and women, boys and girls in part

because of the treatment that we receive from our parents and our teachers.

In this treatment the way we treat men and women,

males and females, differently, is almost unconscious, it's almost automatic.

And it's very pervasive.

Some of you may have heard about

this, I think, really remarkable family in Toronto.

Where the

parents in the family have decided to raise their third child genderless.

Baby Storm.

They wanted to allow their child to develop in a genderless world.

Ultimately, they'll have to reveal the, the sex of the child.

But not until he or she, I think, is five or sex years old.

To try to break out of that.

But is it really the case that you could take a baby at birth and if you dressed

that baby in a dress and put that baby in a pink room, you'd end up with a girl.

Or alternatively, taking the same baby, dressing that baby in pants

and putting that baby in a blue room, you'd get a boy.

Do we really believe that that's all there is to gender behavior?

That our biology have nothing to do with it?

In fact, there were some very influential scientists that did once believe that.

The most prominent among these was a psychologist named John Money,

one of the most famous sex researchers of the 20th century.

He started out at Harvard and ultimately ended up at Johns Hopkins University.

For Money, he didn't

think that gender behavior had an innate component.

He called this theory the theory of gender neutrality.

For Money, he believed that we were born gender neutral.

And that we became male and female based upon the interactions we had with others.

Not a reflection of our biology. That if we

were socialized female, we would become female.

And if we were socialized male, we would become male.

Now Money did various type of research.

He did research with transvestites. But the most convincing demonstration

of Money's gender neutrality theory, was a pair of monozygotic twins.

The pair known in the literature is John and Joan.

Now we know the true names of the twins today, so I use those here.

John and Joan refer to a pair of male twins, Bruce and Brian Reimer,

who were born to Rob and Janet Reimer, 1965,

in Winnipeg, Canada. Rob and Janet were working

class Canadian parents had these

monogyzotic genetically identical twins.

And, at about six or seven months, they developed a urinary infection.

And the prescription for the infection was to circumcise the twins.

So Janet took her babies to the local hospital to have them circumcised.

Now normally circumcision is done surgically, with a knife.

But for some reason, the hospital was

experimenting with a new procedure for circumcism.

Some sort of electrical device.

And unfortunately when they went to circumcise Bruce, the

electrical device malfunctioned, and it burned away his penis.

As you might imagine, Rob and Janet Reimer were devastated.

They had no idea what to do. They weren't highly educated people.

And they didn't know what to do for their

son, Bruce, whose penis had been born away, burned away.

Until one night they turned on the TV

and on CBC Television, somebody was interviewing John Money.

And here's a little video clip of their discovery of John Money.

>> A few weeks ago Johns Hopkins

Hospital in Baltimore announced that it was

opening a gender identity clinic especially for

people who wanted to change their sex.

Dr. John Money a psychologist.

>> Then several months later, the Reimer family saw something on television

that made them feel hopeful for the first time since the accident.

Doctor John Money, originally from New Zealand, was

a pioneer in the astonishing new field of

sex change surgery.

>> Doctor Money, it's still a pretty drastic procedure, isn't it?

>> Well it's a drastic procedure by your standards

and mine, but for the people who are living in

desperation perhaps the best way to understand it is,

that it seems no more drastic to them than circumcision.

>> We just happened to be watching TV.

And, Dr. Money was on there and he was very charismatic.

He was very, he seemed ver, highly intelligent

and very confident of what he was saying.

>> Dr. Money had brought a transsexual with him.

A man who had been changed into a woman.

>> The transsexual, certainly made an impact.

Because [INAUDIBLE] feminine seeming woman.

And I thought, here's our answer, here's our salvation, here's our hope.

[MUSIC]

>> Janet wrote to Doctor Money after the show ended.

[MUSIC]

He replied promptly. When they met, Doctor

Money suggested that the Reimer's could turn their baby son into a baby girl.

[MUSIC]

It looked as if Ron and Janet had solved the problem.

It wasn't just that Dr. Money was the answer to the Reimer's prayers.

They were the answer to his.

[BLANK_AUDIO]

On July the 3rd, 1967, when Bruce Reimer was almost two

[MUSIC]

>> He was castrated by a surgeon at John Hopkins Medical Hospital.

Without his testicles, Bruce could no longer produce male hormones.

The surgeon also created a rudimentary vulva for him.

>> It made sense at the time that he became a daughter.

[MUSIC]

Maybe it is a matter of nurture over nature, and

I thought if it was simply a matter of nurture,

I could nurture my child into being feminine.

[MUSIC]

As Doctor Money suggested, the Reimers changed Bruce's

name, to Brendan, and dressed her as a girl.

Doctor Money also gave Janet and Ron very strict instructions.

He said that if they ever revealed the truth to their daughter the sex

change would fail.

>> John Money [INAUDIBLE] to us was don't

let her think that she was ever a boy.

Keep that secret.

>> So that's a short clip from a BBC documentary and we'll give

you the link on the webpage for the full documentary if you're interested.

It might seem remarkable today but really people back 40,

50,60 years ago believed, that we were blank slates.

That you could produce a male or a female

just depending upon the way you raise that individual.

For John Money what was critical, was that,

and it's reflected in the video you just saw.

What was critical for him

was that the decision to raise an individual as a male or

female had to be made before that individual was two years old.

That was the first thing.

And, if you caught in the video Bruce Reimer was castrated just

prior to his second birthday which was a critical thing for many.

The second thing. Was that the socialization post

assignment, had to be unequivocal as money

told Janet and Rob Reimer. That the success of this experiment

depended critically on them, that they had to never let on to their daughter.

That she was initially born a boy.

So Janet and Rob Reimer, picked up and started a new life with

their twin offspring, Brenda and Brian Reimer.

Over the years, John Money would report on this case and

thi, and this is where the pseudonym John and Joan comes from.

Because Money, when he described the case in the literature, used

John and Joan rather than the true names of the individuals involved.

In fact, when I took introductory psychology many

years ago, I heard about the John/Joan case.

And I heard about it as a demonstration of how powerful socialization could be.

Here's a quote from Money from 1972, that

argues that what money was doing again, nobody

knew about this particular case because they had

to keep the identity confidential otherwise that the

experiment if nothing else, would be destroyed.

Not the true experiment, but the, the, the successful socialization of Brenda.

But what Money was reporting over the time

was that Brenda was developing as a normal girl.

And what better proof of gender neutrality than taking a pair of identical,

genetically identical twins, and producing one as a male, and another as a female.

It was an extraordinarily in-, influential case in psychology's history.

It also was extraordinarily influential in the broader public.

Here's a quote from Time magazine from 1973.

The they talked about the impact of this case.

That showed that really our gender was a matter, not

of our biology, but of the way we were reared.

Mysteriously Money stopped writing about the John/Joan case, sometime

in the, the late 1970s and early, early 1980s.

And some people began to question whether

or not this experiment was really, truly successful.

And most significant was a psychology, psychologist

from the University of Hawaii named Milton Diamond.

Who had a hard time believing

that you could take a pair of identical twins

and make one a male and one a female.

And so he worked hard to try to actually get more details about the case.

In fact things weren't going that well for Brenda Reimer.

And ultimately, Brenda Reimer's case was

reported in a book, but originally actually

was reported in a Rolling Stone article, by this author here, John Colapinto.

That, that, who subsequently wrote a book about the case.

As Brenda was growing up, she was extremely unhappy.

And here's a picture of her with brother Brian at about the age of 14.

She didn't know the source of her unhappiness.

When she reached the age of puberty they

gave her female hormones to stimulate breast development.

And that made her very uncomfortable.

And as a result she gained a lot of weight.

You can see she's a little heavy here in the photograph.

She gained a lot of weight to try to mask the breast development.

She became suicidal.

And again Janet and Rob didn't know what

to do, with now their suicidal daughter, Brenda.

Money had told them that they could never let on

that she was born a boy, and so they feared revealing

maybe what was the source of her suicidal behavior.

But ultimately, she was so suicidal that they decided that they had to tell her.

And so at about the age of 15, they told

Brenda about the circumstances of her birth and the botched circumcision.

Her immediate reaction of course was bewilderment.

But not so much anger, as relief.

Relief that finally, there was an explanation for the way she felt.

And rather rapidly, Brenda Reimer changed back into a

boy and took the name David Reimer. And she took the name David.

Because she felt that

at this point that he felt that his life had been like David versus Goliath.

And here's a picture of him at the age of 15.

Change back to boy.

David Reimer went public with his story in order to try to help other people.

Who might be in similar circumstances, maybe not identical to

his, but similar circumstances, may be born with ambiguous genitalia.

Ultimately David married at the age of a I think

in his early 30's he married and became a father.

He couldn't biologically become a father because he

had been castrated, but he married a woman

who had children. And he became a father.

And by all accounts, was a good father.

Sadly, in 2004, at the age of 38, David Reimer committed suicide.

He never really spoke poorly or negatively of John Money.

And it's not clear what it led him to commit suicide at the age of 38.

He felt that his life was a struggle

but he felt that his struggle could help others.

It certainly an illustration of the extent to

which, the blank slate mentality did dominant within psychology.

Next time we'll talk about another case illustration.

In this case, a very important human genetic condition called phenylketonuria.

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