Ethics: The Case of David Reimer

Introduction

On August 22, 1965, a pair of identical twin boys were born to parents, Ron and Janet Reimer. One was named Bruce and the other, Brian. On April 27, 1966, the boys went in for circumcision in order to correct phimosis (a problem with urination) that both boys had. Instead of performing the “routine” circumcision with normal surgical tools for the procedure, Bruce Reimer’s physician used cauterization, a technique to burn skin tissue. The result was irreparable damage to Bruce Reimer’s penis. Brian Reimer did not undergo his circumcision. A year later, in 1967, Ron and Janet Reimer requested the help of John Money (a well-known sexologist and psychologist who researched intersex children and gender identity). Money advised that they raise Bruce as a girl, and thus, Bruce underwent surgery to remove his penis and testes and construct basic female genitals. After the sex reassignment surgery, Bruce (now named Brenda), was given estrogen and continued to see John Money with his brother Brian (who was not told that Brenda used to be Bruce despite the surgery, hormones, and dressing like a female, Bruce experienced gender dysphoria and bullying at school. In 1980, Ron Reimer told his son the truth about what had happened when he was older. Subsequently, Bruce Reimer, reassumed his male identity and changed his name to David (the name this paper will use from here on). He began taking testosterone and had other surgeries to construct a penis and remove his breasts. Unfortunately, David’s life was anything but normal in the years following his revelation. While he spoke out about what had happened in his childhood, it is safe to say he never recovered and was severely depressed. Life events (including his brother’s suicide and his wife’s filing for divorce) contributed to his suicide in 2004 (Gaetano et al., 2015). This paper will attempt to dissect and discuss the ethics of the David Reimer case, specifically the actions of John Money.

What Is Ethics?

Psychology is defined as the “scientific study of the mind and behavior” (Spielman et al., 2020). David Reimer’s case certainly falls under psychology as John Money studied the effects of raising a biological male as a female, asking two fundamental questions:

1. Does this child’s mind work like a female? (mind)
2. Does this child act like a female? (behavior)

According to Money, if these two questions were a resounding yes, then that child was female by social construct.

However, to analyze John Money and his experiment, one must explore ethics. Ethics is generally defined as “a set of moral principles” and “the principles of conduct governing an individual or a group” (Merriam-Webster, 2025). However, in psychology, ethics becomes a strictly regulated process that experiments must pass through. The multifaceted parts of ethics include (but is not limited to) the following:

1. Informed consent, which is the “process of informing a research participant about what to expect during an experiment, any risks involved, and the implications of the research, and then obtaining the person’s consent to participate” (Spielman et al., 2020).
2. Strict guidelines that “ensure that the experiment does not result in harm” (Spielman et al., 2020).

While there are many parts of the David Reimer experiment that were unethical, this paper will focus on proving that the experiment was unethical by the two dilemmas; (1) there was no process of informed consent specifically with David Reimer, the sole participant; and (2) the experiment did, in fact, cause harm.

Informed Consent

David Reimer’s experiment was a case or clinical study, which is distinguished from others because of its emphasis on “one person or just a few individuals” (Speilman et al., 2020). In this paper, the case focused on one person, David Reimer. However, it is interesting to note that this case study would’ve been increasingly appealing to Dr. Money because of the presence of a control group which “serves as a basis for comparison and controls for chance factors that might influence the results of the study” (Spielman et al., 2020). The control group in this case was Brian Reimer, David’s identical twin brother. For Money, this was the perfect control group. Two people that share the same genetic makeup and biological gender, except one was reassigned a new sex and one remained the same biological gender.

As stated before, informed consent in simple terms is relaying all the information to the participants in the study and then allowing them to agree or disagree. Today this seems obvious, one can insert first-person in any experiment example and say, “if I was about to do…then I’d like to know…so that I can say yes or no…”. Of course, while this is a basic concept for experiments today, John Money either ignored or was ignorant of the simple fact of informed consent. That said, David Reimer’s case, by all means, was a tricky one.

In today’s society, often when one hears “sex reassignment surgery” or “transgender,” it is probably going to be an adult, or at least a person old enough to express the desire for the said surgery, or hormone replacement therapy. The assumption is that they understand the procedure, including the side-effects, and after knowing all of that, they either continue or do not. With those circumstances, the individual participating in the actual treatment makes all the decisions and thus, if they experience negative side effects that they were informed of previously, the responsibility is on themselves.

The problem with the David Reimer case was that all the life-changing decisions made regarding his gender (namely, the surgery) were done when he was a baby and thus, he could not give or deny his consent. The hormone replacement surgeries were again, beginning when he was a toddler again, putting him in a position where he could neither give nor deny his consent. It was not until he was a teenager that he was even told his true biological sex.        Some would argue that because David Reimer was so young he could not have made an informed decision and thus his parents made the best decision they could for him. However, there are several reasons why the previous statement should not be considered. First of all, David’s parents did not have to live with the decisions they made for David. Secondly, there was no pressing reason to make a life-altering decision when David was a baby, namely, there was no threat to David’s life itself if they did not proceed with sex-reassignment surgery. Additionally, there was no reason why they could not have waited until David was old enough to make an informed decision, that of course would have been contingent on them at some point telling David about the disastrous circumcision (a conversation David may have brought up himself).

All of the ins and outs of informed consent should not have fallen directly on the parents instead, it was on the professional, John Money, who knew all the intricate details to advise the parents in a fair, ethical way. Of course, this was not how it went, which brings us to the next point of harm.

Harm

As stated before, under ethical guidelines, no experiment should ever produce or culminate in harm for the participant. Unfortunately, for the case of David Reimer, it did. Not only did it culminate in David Reimer’s suicide but also in the suicide of the control group. While Brian’s suicide may not be as closely related to the case, it seems odd that the twin brothers who participated in the experiment would both terminate life via suicide and it not be a coincidence.           Because that is what this case study truly was, an experiment. John Money could not prove beforehand that the experiment would not end in harm towards the participants. Extra precautions should have been taken because the outcome was unknown and uncertain. Furthermore, the signs that the experiment was causing harm were showing up at early stages from bullying to gender dysphoria. Money should have seen the signs and intervened in a safe way.

Instead, Money participated in what is known as experimenter bias in which “researcher expectations skew the results of the study” (Speilman et al., 2020). This is where researchers ignore the actual data in front of them, in order to prove that their hypothesis/theory is actually true; or, where they simply ignore certain facts of the case in order to prove that their hypothesis/theory is true. In this case study, Money did more of the latter. Obviously, David Reimer’s transition from biological male (Bruce) to structurally “female” (Brenda) was a “success” in the terms of, the reassignment surgery was “successful”, the hormone replacement therapy was “successful”, Reimer wore dresses and grew out his hair. Money mentioned that “Brenda” had a more female inclination then Brian. However, the research failed to mention severe bullying and gender dysphoria. It failed to mention that David did think he was a female. So, while on the outside the transition was a “success”, internally and mentally it was a complete failure.

The next question then becomes, why did Dr. Money skew the data? The answer would simply be that he wanted to prove that gender was a social construct. That gender norms are constructed from what society thinks females/males should act/think/appear like. Of course, that is not true (proven by this experiment). Dressing/acting/appearing as a girl, did not stop David Reimer from knowing deep down that he was male. Ethically, Dr. Money should have known the dangers of this experiment and acted accordingly.

Past to Present

David Reimer’s case is one that makes people squirm even today where gender dysphoria, reassignment surgery, and hormone replacement therapy are becoming increasingly normal. I beg to suggest the reason why is because we all should have an ethical standard, and this case does not meet it even halfway through. It was a horrible beginning (the botched circumcision) to end (in the culmination of his suicide) and everything in between, stemming mainly from Dr. Money who should have never even been allowed to proceed with the experiment the way he set it up.

However, in doing my best to sympathize and empathize, I understand there is a concerning factor when it comes to people born with intersex conditions, a factor not to be taken lightly. And here is where I beg the reader to allow me to disclose the way I would have handled the case of David Reimer.

From my understanding, when a child is born intersex, one gender will usually be more dominant than the other, perhaps not from birth but as the child grows. In the case of David Reimer, had I been the psychologist/sexologist in his case, I would have advised the parent to let the child grow and see which gender he most corresponds with. Most likely, knowing the outcome of the case and knowing the fact that he was born biologically male (not intersex), he would have grown up normally male. Most likely, there would have been questions (probably about the state of his penis), and perhaps when he was of age to decide, he would have undergone surgery to reconstruct his penis.

Had the child been born intersex, I would most likely act the same way. Whichever physical structures dominated the body combined with the way the person felt would be the way I would advise to carry on. I think this is the best course of action when it comes to ethically handling a situation of such delicacy and sensitivity.

Although a horrible misuse of experimental science, hopefully, the case of David Reimer proves a lesson and testament to doing things always for the benefit of the person at the receiving end and considering their life and how it will be lived following the experiment.

References

Gaetano, B. P., 2017-11-15, P., Nunez-Eddy, C., Gaetano, Arizona State University. School of Life Sciences. Center for Biology and Society. Embryo Project Encyclopedia., & Saturday. (2015). David Reimer and John Money Gender reassignment controversy: The john/joan case. David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case | Embryo Project Encyclopedia. https://embryo.asu.edu/pages/david-reimer-and-john-money-gender-reassignment-controversy-johnjoan-case

Merriam-Webster. (n.d.). Ethic definition & meaning. Merriam-Webster. https://www.merriam-webster.com/dictionary/ethic

Spielman, R., M., et al. (2020). Psychology 2e. https://openstax.org/books/psychology-2e/pages/1-introduction