A Canadian man who was raised as a girl after a botched circumcision is being hailed as a crusader whose tragic life may spare other children from gender manipulation surgery.
He committed suicide at age 38 earlier this month after living first as Bruce, then Brenda and later David, and enduring a string of woes, including lastly seeing his life savings evaporate in a friend's investment scheme.
David Reimer was born a boy but was turned into a girl when he was 2 after his penis was burned off in a circumcision by an inexperienced practitioner using a cauterizing machine.
In what is believed to be the first documented study of sexual reassignment of a child whose sex, hormones and chromosomes were all male, Reimer's life was initially held up as a success story.
For more than two decades, he was described in medical texts as living proof that gender can be determined by how a child is raised -- a triumph of nurture over nature.
But Reimer shocked the world when he went public in 1997 with the story of his painful journey back to becoming the man he always felt he should have been.
"He slowed down the mythology that all you have to do is put someone in a blue room or a pink room and they become a boy or a girl," said Milton Diamond, a sex researcher at the University of Hawaii who was first to document the depths of the failed experiment.
"He was a hero, and he put up with so much crap, but managed to come through. At least, I thought he was coming through," Diamond told Reuters.
PENIS RECONSTRUCTION
After sex researcher John Money of Johns Hopkins Hospital in Baltimore first published in 1972 the results of his work with Reimer, surgery and conditioning became standard for children whose genitalia had been damaged or were ambiguous due to chromosomal or hormonal conditions.
Activists believe as many as 2 percent of children are born with some of the reproductive traits of both sexes, conditions that make it difficult or impossible to definitively determine whether they are male or female.
Reimer spent 14 years as a girl named Brenda, but constantly balked against a gender that didn't feel right. "I thought I was an 'it'," he told Reuters in an interview in 2000.
After his parents told him the truth when he was 15, Reimer began to dress as a boy and had in subsequent years surgeries to reconstruct a penis and remove breasts that he had developed by taking hormones. He changed his name to David.
"It reminded me of the guy with the odds stacked against him, the guy who was facing up to a giant 8 feet tall," Reimer told John Colapinto in his 2000 book "As Nature Made Him: The Boy Who Was Raised as a Girl."
Reimer lived a quiet life for years in Winnipeg centered around family. He married and, although he was not able to father children, he adopted his wife's three children.
But he was stunned when he learned other children had been through similar trauma, in part because of the supposed success of his own experience.
"When I first met him, he didn't realize ... what he represented in the scientific, medical world," Diamond said. "He was overwhelmed and said, 'We've got to do something to stop this.'"
HIS MISSION: SPARE OTHERS THE KNIFE
Reimer spoke about his story to reporters and researchers, trying to save others from surgery. Diamond and a colleague published the first account of how Reimer's treatment had failed in a 1997 medical journal article. Other articles including one by Colapinto in Rolling Stone magazine followed.
"That was his mission in life: to enlighten the world, for doctors to keep away the knife, at least until the child is old enough to make their own decision," his mother Janet said in an interview with CBC television this week.
Family and friends knew Reimer had been depressed since the suicide of his identical twin brother two years ago. He had recently separated from his wife and had lost his savings in an investment scheme.
But when he last spoke to Diamond just days before he shot himself to death last week, he spoke only of flashbacks from his childhood.
"(The depression) was more due to the old stuff than the new. The new just was ... the straw that breaks the camel's back," Diamond said.
Doctors are more cautious today about undertaking surgery, Diamond said, but he has called for a complete moratorium, as have activist groups.
"My attitude is yes, bring people up as boys or girls, whatever you think is best, but keep your goddamn knives away," he said.
Over the years, specialists have become more skilled at diagnosing and treating children whose gender is ambiguous, said Melvin Grumbach, a pediatric endocrinologist at the University of California at San Francisco.
"We're much less dogmatic and much more aware of the limitations of trying to predict a deterministic factor" in gender identity, Grumbach told Reuters.
Grumbach believes sexuality is now less of a taboo topic, making it easier for specialists and families to discuss options, he said. In some cases, sexual assignment surgery is best done during infancy, he said.
"We're trying to do the best we can for these infants, but it's complicated," he said.
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