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January 25, 2004

The Failure of Sex Reassignment After Cloacal Exstrophy

NEJM just published an article concerning research that should be familar to all those who read Bailey's The Man Who Would be Queen. Here is the link: Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth

Here is a news report:

In a new twist on the age-old question of nature vs. nurture, Johns Hopkins scientists following 14 boys who were surgically altered as infants and raised as girls found that the majority grew up identifying strongly as males.

Some of the patients spontaneously took on boys' names and began wearing male clothing before anyone told them the circumstances of their births - while others decided to live as boys once they found out.

Warning against sweeping conclusions about the foundations of gender identity, the researchers noted that the study was limited to boys who were "assigned" to the female gender because of a severe birth defect involving the abdominal organs and penis.

But the doctors said their finding casts further doubt on a theory, made popular in the 1960s by a Hopkins sex researcher, that gender is largely a function of how you look and how you're raised....

As a group, the patients ranged in age from 5 to 16.

Five of the patients were happily living as girls when questioned. Three were unclear about their sexual identity, though two had declared themselves as male. The remaining six had reassigned themselves, taking on boys' names and dressing in masculine clothes.

"Even though mom and dad had told them they were girls and they had girls' names, they still always felt they were male," Gearhart said. In two cases, the patients had begun to live as boys before their parents told them the truth.

One child who had grown up feeling like a boy fought the doctor who tried to inject him with estrogen, a treatment designed to spur development of breasts, soft hair and other feminine traits.

"They tried to hold her down but that wasn't possible," said Reiner. "The endocrinologist was exasperated and said, 'Why are you making it so difficult to give you these estrogen shots?' "

"I'm not a girl. I'm a boy," was the patient's reply.

Posted by Thrasymachus at 03:43 PM