In the mid-1960s, David Reimer, who was born with a penis and assigned male at birth, suffered a severe injury to his penis during a botched circumcision. After encouragement from John Money, a psychologist, and other doctors, David’s parents authorized a sex-reassignment surgery along with an early iteration of hormone replacement therapy and raised him as a girl. David wasn’t told as a child that he was born with a penis. With his twin brother as a control subject, Reimer became the subject of a Money’s study of sexual reassignment surgery, called the John/Joan case (figure 4.1). The results were then used for decades to defend non-consensual surgeries on innersex children that were not medically necessary (Gaetano, 2017).

Figure 4.1. The Reimer Twins. The Boy Who Was Raised as a Girl [Youtube]. Standard YouTube license.

Contrary to Money’s published reports, David claimed that he always felt like a boy in spite of medically and socially transitioning into girlhood. This early account of gender dysphoria illustrates the very real distress children can experience when they are forced to assume gender that does not align with their internal sense of gender. At the age of 13, David threatened to commit suicide if his parents took him to Money again. At the age of 15, David’s father finally told him the truth about his birth and the subsequent procedures. After this, David de-transitioned back to his masculine gender identity. He experienced severe depression throughout his life and committed suicide at 38 years old. David’s story challenges the effectiveness and ethicalness of non-consensual sex reassignment surgeries performed on infants and children (Gaetano, 2017).

Let’s start with a thought exercise. Consider these questions:

1. Why did the medical community pressure the Reimers’ parents to agree to this?
2. Why were David’s concerns not considered by Dr. Money?
3. Why was there little to no oversight of the methodology in this “experiment”?
4. What were the long-term consequences of that authority being unchecked?

A social institution is an organized and established social system that meets a basic need of a society (Benokratis, 2019). Systems of power, then, socially constructed beliefs, practices, and cultural norms that produce and normalize arrangements of power in social institutions. They are rooted in social constructions of race and gender and embedded in history and shape our present-day policies and practices (Benokratis, 2019). These systems of power reinforce White supremacy, patriarchy, and heteronormativity as defining power structures in the United States and other countries around the world. Systems of power also feed and reinforce structural barriers that are the root causes of inequity for groups in a society (Systems of Power and Young Women of Color, n.d.). In this chapter, we’ll look at how systems of power affect individuals, like David’s, and social institutions.