A George Rekers Case History: Where Is “Wayne”?

Jim Burroway

July 21st, 2011

George Rekers described treating three children in his 1972 doctoral these while a grad student at UCLA. Two of them we’ve already discussed. The first, of course, was Kirk Andrew Murphy, who was just shy of five years old when he began therapy at the Gender Identity Clinic at UCLA’s Neuropsychiatric Institute under the direction of behavioral therapist O. Ivar Lovaas, Rekers’s mentor. It was this 1974 paper by Rekers and Lovaas describing Kirk under the pseudonym of “Kriag” became one of the more widely cited papers in the 1970s, and it launched Rekers’s career.

The second case described in detail in Rekers’s dissertation was that of 8½-year-old “Carl.” His case appeared in the professional literature at the same time as Kirk’s in 1974. His case didn’t achieve the same level of notice as Kirk’s, but because “Carl’s” treatment extended to the home, he case gained some measure of attention in the educational and guidance counseling literature.

Today’s case is the third child that Rekers described in his dissertation, that of seven-year-old “Wayne,” who was probably treated sometime in 1970 or 1971, at about the same time as Kirk. Here is how Rekers described “Wayne”:

Wayne was seven years old, from a black welfare family. His mother was separated from two former husbands. Wayne, his mother and one-year-old sister lived in the maternal grandmother I s home. The grandmother lived with a “boyfriend,” so there was a man in the house. As reported by the mother, Wayne regularly exhibited feminine arm and hand mannerisms, body gestures and gait. He modeled in front of a mirror in a feminine way, and habitually remarked, “I’m cute,” etc. Wayne had a history of secretly playing with his mother’s cosmetics in the bathroom. (His mother frequently found her cosmetics messed up and occasionally caught Wayne in the act of using them.)

Wayne played with dolls, whenever they were available. His peer preference was girls both at school and at his home neighborhood. He avoided play with boys his age. He frequently engaged in “play-acting.” While he exhibited no feminine voice inflection, he would dwell on feminine content in his speech. In the home he played daily with k1tchen articles.

Wayne was overly obsessive about the neatness of his own clothing. He had a number of “nervous” behaviors such as nail-b1ting. He was a chronic bed-wetter. The mother characterized him as unhappy, and reported frequent crying. Mother complains that Wayne demands an excessive amount of her attention, but that he is emotionally aloof.

“Wayne’s” treatment program in the clinic was similar to that of Kirk and “Carl.” But unlike the other two, the treatment didn’t extend into the home with the red chip/blue chip program, nor was it extended into “Wayne’s” school as it was with “Carl.” Rekers wrote, “Wayne could not be treated in the home and school settings because his mother could not cooperate with the investigator …Over several month’s time, the mother became more overtly uncooperative. Therefore we terminated Wayne as a client.” But before “Wayne’s” treatment was terminated, Rekers reported to his doctoral committee that he was able to coerce a change in “Wayne’s” play preferences and mannerisms in the clinic when other adults were around, but those changes didn’t hold up when “Wayne” played alone. In the last two sessions when “Wayne” was observed playing alone, he “played exclusively feminine.”

Since “Wayne” wasn’t one of Rekers’s greater success stories, he missed the kind of fame that “Kraig” and “Carl” achieved in the professional literature. But that didn’t mean that “Wayne” faded into obscurity. In 1975, Rekers published a paper in the Journal of Experimental Child Psychology with data from “Wayne’s” play sessions at UCLA, along with data from Kirk and three others. The purpose of the paper was to demonstrate the methods for recording and assessing “masculine” and “feminine” play behaviors under certain settings, and to show how the presence of other people in the room can affect children’s play behaviors. Since the paper didn’t discuss treatment programs, it was safe to present “Wayne’s” case along with the others.

But in 1978, Rekers would go back and claim success with Wayne after all. In a non-peer reviewed chapter published in the clinical text book Handbook of Treatment of Mental Disorders In Childhood and Adolescence (Englewood Cliffs, NJ: Prentice-Hall, 1978), Rekers described “Wayne’s” treatment much as he did in his dissertation, but with this addition:

Recently, a 3-year follow-up of this boy in his natural environment found predominantly masculine play behavior, and an independent clinical psychological evaluation of the boy and an interview with the mother yielded no evidence for a gender disturbance.

Again, as with all the other claims of follow-ups with Kirk, this claim is a single sentence with description of the evaluation, no details, no test results, and no peer review.

Rekers presented “Wayne’s” case again in 1979, in a paper published in the Journal of Psychology, which is a very low ranked and rarely-cited journal. Here, Rekers presented new information that wasn’t present in his dissertation. “Athletic games,” he wrote, “appeared to present an aversive and threatening situation for him. Consequently, the boys in his neighborhood and at school teased him and called him such names as “sissy” and “queer.” And so while the playroom experiment was underway, Rekers decided to launch a second set of experiments to try to teach “Wayne” athletic skills in order to “build gender-appropriate behaviors.” A token reinforcement system was used to encourage “Wayne’s” participation and improvement, with tokens being exchangeable for candy. Rekers reported that “Wayne” achieved the skill levels established for “sockball” and kickball. The question of how this was supposed to make him straight however remained unanswered.

This 1979 paper made no mention of a three-year follow-up. Instead, there is a cursory mention of one at fifteen months:

At 15-month follow-up, the mother reported that Wayne “looks just like any other boy now.” According to her reports, there has been no reoccurrence of his previous feminine behaviors, and he has developed positive peer relationships both in the neighborhood and at school.

This report description of a follow-up managed to reach to a record-tying pace of two whole sentences. But again, there are no details: no test descriptions, no data, no independent evaluation. All we have is Rekers’s word for it. Nevertheless, he concluded this report by saying, “This study contributes to the accumulating evidence this study contributes to the accumulating evidence that behavioral intervention procedures are effective in treating boyhood gender disturbances.”

“Wayne,” if you think you recognize yourself in these reports, please let us know how you’re doing.

See Also:
“Carl,” age 8½
“Joan,” age 14
“Paul,” age 8
“Wayne,” age 7
And, of course, “Kraig” (Kirk Murphy), age 4

John

July 21st, 2011

While these portrayals are horrific, it needs to be pointed out that these occurred before the APA and other professional organizations changed their viewpoints on homosexuality. Prior to that time, this was common practice. The continued horror is that those on the right continue to use a viewpoint that has been totally discredited by every legitimate professional organization.

Amicus

July 21st, 2011

This report description of a follow-up managed to reach to a record-tying pace of two hole sentences. But again, there are no details: no test descriptions, no data, no independent evaluation.

If I remember your reporting correctly, Jim, the head researcher, who went on to distance himself from therapy of this type for homosexuals, noted that quite often ‘feminine’ behaviors dissipated post-adolescent, on their own.

So, another factor, again, is no control group. That is, even in the presence of the data you rightly note is missing, e.g. independent eval, it is entirely possible that any given case would have turned out with exactly the same result, including doffing of feminine behaviors, if NO therapy had been done.

Finally, these considerations also give a moral insight into the public question about this therapy (which is often wrongly framed as individual rights).

You have a therapy that might help 1 in 6, say (even with my being generous here, the point stands).

At the same time, that therapy might damage up to 1 in 4 or perhaps as much as 1 in 5, with *increased* anxiety or worse, exacerbation of borderline feelings (or conflicted emotions/”values”), something that might be akin to aggravating a borderline personality disorder. At their worse, exacerbation might result in heightened risk of death (suicide), in some percentage of cases.

Is it ethical to offer such a treatment?

Amicus

July 21st, 2011

“perhaps as much as 1 in 5”

should be

“perhaps as much as 1 in 3 (or worse, depending on the measure used)”

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