Becoming Nicole: Chapter 14 Summary & Analysis

Humans have long held fanciful theories on how to control the outcome of a baby’s sex. In Ancient Rome, it was thought that a pregnant woman carrying a chicken egg would ensure a boy. Ancient Greek physician Galen believed that if a woman bound her right foot with a child’s white ribbon before sexual intercourse, she would conceive a male child.

Today, those theories are only slightly more sophisticated: because sperm carrying X chromosomes swim slower and longer than those carrying Y chromosomes, the odds of having a daughter are thought to increase if intercourse takes place several days before ovulation, giving male sperm more time to die off. Nutt writes that humans all begin life essentially genderless. Our chromosomes make us either genetic males (XY) or females (XX), but at least 50 genes play a part in sexual identity.

Sexual anatomy, on the other hand, is determined largely by hormones. All humans begin in utero with an opening next to the anus and a genital “bud.” The addition of testosterone allows for a penis and scrotum to develop and an inhibiting hormone prevents the development of internal female reproductive organs. Without testosterone, the opening becomes the vagina and the bud becomes the clitoris.

The sexual differentiation of the genitals happens at about six weeks, but the sexual differentiation of the brain, including gender identity is at least partly a distinct process. Hormones again play a crucial role, causing subtle differences in brain structure. For example, the straight gyrus, which is highly correlated with interpersonal awareness, is 10 percent larger in women than men. But scientists caution that differences in biological sex are not absolute—regardless of biological sex, the larger the straight gyrus, the more “feminine” the behavior.

In addition, for most males, male hormones are crucial to the development of male gender identity. A mutation of the receptors for these hormones can cause “androgen insensitivity syndrome, in which virilization of the brain fails.” In this case, a baby will be born chromosomally male and will have testes but will also have a short vagina and will outwardly appear female. Its gender identity is nearly always female. In other words, genitals and gender identity are not the same. There are “dozens of biological events that can affect the outcome of the latter and can cause an incongruence between the two.”

Some individuals have chromosomes of one gender but the sex organs of the opposite. Others are born with male genitals and testes, but internally have a womb and fallopian tubes. Some people have atypical chromosomal configurations, like XXX or XXY. Still others have different chromosomal arrangements in different tissues. Regardless of chromosomes, any change in the balance of hormones will tip the sexual development of a fetus in one direction or another.

“No one thing determines sex,” and small changes can lead to “nonbinary” results. As many as one in 100 infants are born with sexual anatomy that differs in some way from standard male and female anatomy. Historically, doctors decided gender at birth based on cultural expectations and stereotypes, chiefly the length of genitalia. A baby born with a penis smaller than 2.5 centimeters was assigned female. But in the case of ambiguity, infants were assigned a sex and then surgeons “corrected” the confusion.

In August 1956, a baby was born who had either a very small penis or an enlarged clitoris. Doctors were extremely unsure of the baby’s sex, but finally they suggested the parents assign the infant a male identity. The parents did so and named the baby Brian. Eighteen months later, however, doctors discovered that Brian had a uterus and ovotestes (containing both ovarian and testicular tissue). Doctors told the parents that their initial advice was wrong and surgically removed the microphallus. They parents renamed the child Bonnie and were told raise the child as a girl, throw away photographs of Bonnie as a boy, and move out of the state.

When Bonnie turned eight, she underwent surgery to (unbeknownst to her) remove the testicular part of her gonads. At 10 years old, she was told the truth and was deeply disturbed by what her parents had done. She grew up and graduated from MIT with a math degree. Later she formed the Intersex Society of North America under the name Cheryl Chase, and advocated that doctors not do surgery on intersex babies but let them make a decision themselves when they are of an appropriate age.

Chase stood in opposition to proponents of behaviorism like Dr. John Money, who believed that gender identity was a social construct. He believed that in cases like Chase’s, parents should simply choose the gender they wanted to raise they child and given that encouragement the child would adopt that gender.

Money’s most well-known example was a child born in August 1965: a baby boy named Bruce. A cauterization to correct an obstruction accidentally burned off Bruce’s penis as an infant. Money convinced the parents to raise Bruce as “Brenda,” and so his testicles were removed, he was dressed and treated as a girl, and was unknowingly administered female hormones during puberty. Brenda neither felt nor acted female, however, and became depressed and suicidal as a teenager. His parents told him the truth, and he transitioned at 14 to being male.

Brenda renamed himself David Reimer and had a mastectomy, testosterone injections, and phalloplasty surgeries to rebuild a penis. He married and adopted children but remained tortured by what had happened and committed suicide in 2004, at 38 years old. Throughout this process, Money published articles extolling the success of the experiment, until the 1990s when the psychiatrist who treated Brenda exposed the truth about Money.

Gradually, it became more accepted that gender is innate, but Reimer’s case did not explain how there could be a disconnect between anatomy and gender identity. The idea that someone born a male would want to be female was (and often still is today) considered a psychiatric problem, not a medical one. Transgender people were regarded as “scientifically inexplicable.”

Only in the past decade has gender come to be regarded as a spectrum. The first institutions to adopt nonbinary gender classifications have been mostly academic. Yet despite gender being regarded as a spectrum, transgender people can still be firmly rooted in one gender identity or another. Transgender people “may agree that gender is a spectrum, but they also know exactly where they fall on it.” In a test meant to measure gender identity, there is no difference between the answers of transgender (biologically male) girls and cisgender (biologically female) girls.

For transgender people, whose bodies are at odds with their ideas of themselves, the only way out of the alienation is to make the body congruent with the mind. But often in the past (and still today) doctors prescribe intensive therapy. Some parents, however, believe that forcing their child to go through puberty in a body that is foreign to them would be deeply damaging.

Prior to the 21st century, all sex reassignment surgeries were performed on fully developed men and women, and often the psychological consequences of doing so as a fully-grown adult can be devastating if the results do not meet expectations. On April 26, 2007, 50-year-old Mike Penner, a veteran sports journalist at the Los Angeles Times announced that he would be leaving for a few weeks’ vacation and would return as Christine Daniels. He confessed to his readers that he was “transsexual.”

Although Christine’s public declaration was liberating, the adoption of a life as a woman was difficult. After Christine’s first appearance at a sporting event with her new identity, another journalist wrote in his own blog, “I hate to be judgmental about these things, but Christine is not an attractive woman. She looks like a guy in a dress, pretty much.” This was cruel and devastating to Christine.

Later, Christine agreed to do a story about her transition with Vanity Fair magazine. But when the photo shoot became a disaster, the reporter pulled the plug. Meanwhile, Daniels’ wife filed for divorce and she lost friends. Mired in depression, Daniels stopped taking female hormones and decided to revert to being male. Thus, it was as Mike, dressed in male clothes, that Penner took his life on November 27, 2009.