Sex and child health

In the past year, congressional critics have demanded to know why the National Institute for Child Health and Human Development (NICHD) is funding sex research projects.

Among other things, the NICHD spent $147,000 in taxpayer money for a study that paid women to watch porn flicks while measuring their arousal levels with a device called a plethysmograph.

But the head of NICHD — a division of the National Institutes of Health (NIH) — says the federal agency has been involved in sex research since its creation.

“The earliest [federally funded] research involving sex, sexual development and so forth … actually started before NICHD was established,” Dr. Duane Alexander said in an interview, noting that the institute is celebrating its 40th anniversary this year.

“We inherited from the National Institute of Mental Health a grant looking at psychosexual development and various influences on it … whether development proceeds as male or female based on chromosomal sex, gonadal sex, physical appearance sex, or sex of assignment and rearing.

“This was very important research. It was a whole new field that was opening up. And why was it important? There are kids born with what we call sex errors of the body, or another term for it is ambiguous genitalia.”

That original “inherited” research grant sought to determine appropriate treatment for such disorders and “really has been continuously funded ever since,” Dr. Alexander said.

“Basically, what this research showed — that has determined the management of these kids ever since — was that the most important factor wasn’t the chromosomes, wasn’t the gonad, it wasn’t just the appearance, it was how the kid was raised by the parents,” he said. “And if the parents accept this child as a female and raised it as a female consistently, gender identity was female. If they accepted it as male, raised it as male consistently, gender identity almost always was male.”

Yet that earliest NICHD sex research also has been the subject of intense criticism in recent years. Many of those born with “ambiguous genitalia,” who prefer to be called “intersex,” say they have been victimized by childhood sex-reassignment surgeries performed without their knowledge or consent, and which have left them with impaired sexual functioning.

One of the most famous cases involves a Canadian boy who was severely injured as the result of a botched circumcision. At 19 months, he underwent treatment directed by John Hopkins University researcher John Money — a major NICHD grant recipient — designed to make him a girl.

Though Mr. Money reported the case as a success that proved his theories of sex identity, the subject — David Reimer — never accepted his assigned female identity and instead sought treatment to become a man.

Profiled three years ago in a best-selling book, “As Nature Made Him,” by John Colapinto, the Reimer case has been viewed by many as discrediting Mr. Money’s theories. Dr. Alexander defends the NICHD-funded research.

“There are no 100 percents in medicine … but 80 to 90 percent success in medicine is really good,” Dr. Alexander said, acknowledging that the Reimer case is “one that did not turn out well.”

A major reason for that, he said, is that Mr. Reimer’s parents “never made the switch in their minds. They were not consistent in raising him as a female instead of a male, and there’s really lots of explanation for why this didn’t turn out well.”

Story Continues →