Reevaluating Sex Reassignment

Graphic: Cathleen Heard

Results of two studies from the Johns Hopkins Children's Center challenge accepted medical practice of "sex reassignment"--surgically converting XY males with absent or minuscule penises into anatomical females, then raising them as girls. The investigations, which are the first to go beyond individual case reports, reveal outcomes that are remarkably consistent with rare instances of infants who lost their penises in accidents and who were reassigned as females. Both clinical trials and case reports powerfully argue for nature over nurture in establishing gender identity.

William Reiner, a child and adolescent psychiatrist and urologist at the Johns Hopkins Children's Center, reported the studies at the Lawson Wilkins Pediatric Endocrine Society meeting in Boston on May 12, 2000. "These children demonstrate that normal male gender identity can develop not only in the absence of the penis, but even after the removal of the testicles and unequivocal rearing as...