SAN JOSE MERCURY NEWS • People/News • FRIDAY MARCH 14 1997

New study rebuts evidence babies are sexually neutral

New York Times

	A classic case of a gruesome surgical accident and its consequences that was long used as evidence of the pliability of sexual identity turns out, in follow-up, to suggest the opposite: that a sense of being male or female is innate, immune to the interventions of doctors, therapists and parents.
	In 1973, researchers published an account of an infant boy whose penis had been accidentally cut off and who was subsequently reared as a girl. The child reportedly appeared to have accepted the new identity and to be happy with life as a female.
	Reported by the sexologist Dr. John Money of Johns Hopkins University in Baltimore, the case became famous and entered the textbooks as proof that infants its are more or less sexually neutral at birth, establishing sexual identification only with socialization and exposure to the binary world of boys and girls, blue and pink, guns and Barbies.
	Now, Dr. Milton Diamond of the University of Hawaii-Manoa in Honolulu and Dr. H. Keith Sigmundson of the Ministry of Health in Victoria, British Columbia, have presented an indepth follow-up that challenges the initial reports of a glowing success. They report that far from being satisfied with his reassignment to girlhood, the boy renounced his female. identity at the age of 14 and chse to live as a man, even undergoing extensive surgery to attempt a reconstruction of his ablated genitals.
	The patient, whose identity is being kept secret, is now in his 30s and married, and is as welladjusted as can be expected in one who has been through such an extraordinary ordeal, the two researchers report in the current issue of the Archives of Pediatric and Adolescent Medicine.
	In recounting the case of a patient variously referred to as Joan or John, Diamond and Sigmundson say they seek not only to set the record straight, but to argue that the case underscores the importance of prenatal events like hormone exposure in building a sexual self.
	"Despite everyone telling him constantly that he was a girl," Dr. William Reiner of Johns Hopkins Hospital said in an interview, "and despite his being treated with female hormones, his brain knew he was a male. It refused to take on what it was being told." Reiner wrote in an editorial to go with the report.

	Money's secretary said Thursday he could not discuss the case because he did not have the patient's consent.
	Diamond and his colleague use the case study to call for changes in the treatment of babies born with ambiguous genitalia, a condition found in about 1 in every 1,000 births, which results from a variety of chromosomal and hormonal abnormalities. As it is now, the majority of such infants are designated female, largely because it is considered surgically easier to turn ambiguous genitals into a vagina than into a penis.