A George Rekers Case Study: Where Is “Paul”?
July 20th, 2011
Our next case history from the Rekers files involves eight-year-old “Paul,” who was treated at the Gender Identity Clinic at UCLA’s Neuropsychiatric Institute sometime in the early 1970s. As with Kirk Murphy — Rekers’s most famous case history — and with “Carl,” “Paul’s” treatment was paid for by grants from the National Institute of Mental Health. Paul and his two brothers, ages five and nine, had been living with foster parents for four years. Paul’s case (with Kirk and “Carl”) was one of fifteen cases discussed briefly in a 1976 paper comparing “Sex-typed play in feminoid boys versus normal boys and girls,” as the paper’s title put it. Crude measures were created on “percent femininity” scale based on observed play behaviors of boys being treated at UCLA and a control group of students from a nearby elementary school. “Normal” boys scored in the 20% range while “normal” girls scored in the 80% range. “Paul” scored at somewhere below 50%, making him still more “masculine” than “feminine” according to Rekers’s categorizations.
That paper however doesn’t describe much about any of the children individually though. “Paul’s” biographical debut would come a year later in a paper published by Rekers and four other researchers at UCLA, including Alexander Rosen (who was involved with Kirk’s case) and Benson P. Low (who was a co-author of “Carl’s” case, and who would go on to work with Rekers later while at the Fuller Theological Seminary in Pasadena).” The paper, “Assessment of Childhood Gender Behavior Change,” appeared in the January 1977 issue of the Journal of Child Psychology and Psychiatry. By then, Rekers had added an another affiliation to his name: director of Logos Research Institute, a Christian-based research think tank that he founded in the 1970s which would serve as a model for later when he co-founded the Family Research Council. The paper introduced Paul this way:
Paul had a 4-yr history of playing with his foster mother’s jewelry and cosmetics. He often improvised feraale clothing by wrapping towels around his waist to make skirts, or by tying ribbons in his hair to simulate long hair. He repeatedly asked for a girl’s dress to wear, he cross-dressed, and he played with girls’ dolls. He obsessively changed his clothing several times daily to remain clean, and expressed strong avoidance of masculine games that involved “rough-and-tumble” action or getting dirty. In fact, he appeared unable to play masculine-like games proficiently. Paul regularly avoided play with his brothers and boys in the neighborhood, complaining “they call me girly and sissy”. The foster parents observed that Paul’s peers rejected him because he exhibited effeminate gait and arm movements and cross-gender voice inflection. The extent of Paul’s adoption of a female sex-role is reflected in his frequent statements to his foster mother: “I want to be a girl so that I can have a baby”. In addition to the gender disturbance, Paul had a 3-yr history of encopresis and the behavior problems of non-compliance to parental requests and excessive temper tantrums. He was characteristically unhappy and sought to cooperate with professional assistance. Paul complained that all the boys and many of the girls his age would not play with him. He described himself as being shy and lonely and told us that his foster mother brought him to see us in order to help him be happier. He asked us if we could help him be happier, and be like the other boys. He asked questions such as “Why do the boys call me a sissy?” and “Why don’t the boys play with me?” We assured him that we would try our best to help him with these problems.
Rekers and his colleagues, by this point, had sought to distinguish between different degrees of severity of gender-nonconformity. For patients like Kirk, “Joan,” and “Carl,” Rekers felt that they were so severely “disturbed” that he diagnosed them with “cross-gender identification.” Paul’s case, according to Rekers, wasn’t so profound:
The data suggested that the problem was a gender-role disturbance and effeminate behavior rather than a profound childhood cross-gender identification. In the absence of treatment, the boy would be a high risk for transvestism or sexual orientation disturbance, and a moderate-to-low risk for transsexualism.
By the mid-1970s, Rekers had introduced new methods for treatment. During the play-time in the clinic, “Paul” was videotaped through the one-way mirror. After play time was over, “Paul” was shown the video and asked to identify each instance of feminine behavior. If he identified them correctly, he was awarded a penny. This was to get him used to identifying every instance of girlish behavior, some of which he was apparently unaware. After several sessions, the game changed. “Paul” was awarded 25 pennies, but as he played with a therapist he would lose a penny any time he made a feminine gesture or verbal inflection. He was also put on the red chip/blue chip program at home. In addition, he was given athletic training, ensuring that he didn’t throw like a girl while playing ball. After about a year, Rekers, once again, had claimed another success:
At termination of treatment, Paul’s sex-role behaviors had changed markedly. Our clinical observations, which were corroborated by the foster mother and other friends and relatives, indicated that Paul now looked and acted like most other boys his age. He was wearing jeans and T-shirts exclusively and no longer avoided rough-and-tumble games for fear of getting dirty or hurt. He also appeared to be much more comfortable in a male role, and rarely asked his foster mother for girls’ toys and clothing. Our follow-up observations indicated occasional cross-gender behavior, although at a much lower frequency than before treatment. The 2-yr follow-up observation indicated no feminine mannerisms in the home, as indicated by session “F” on Fig. 6. There has been no recurrence in his verbal expressions of wanting to be a girl, and the encopresis has not recurred.
Little additional information is available about “Paul.” It would appear that his follow-ups ended by the time he was eleven years old, which would still be before puberty. If there were any follow-up investigations after that, Rekers never published the results, not even in a cursory two-sentence form that he used in assuring readers that Kirk Murphy was still heterosexual at the age of fifteen. Rekers’s two-sentence follow-up descriptions for Paul ended much earlier for reasons that remain unknown. If “Paul” is still out there, he is probably approaching fifty years old, and very likely unaware that his case has been published in the professional literature. I wonder what a follow-up investigation forty years after the fact would tell us.