The strange story began in 1952 when the patient was born. From early childhood John considered himself to be a girl. His gender confusion was probably the result of family problems. His mother and father, who raised their family in Tennessee, were thirty-two and forty-five years old respectively, and they didn’t get along very well. They finally separated when the boy was eight, by which time John’s transsexualism was already fairly ingrained. The couple were already the parents of two other children (a boy and a girl) before John came along, so he was the baby of the family. He was a pampered child, too, for his mother was very protective and wouldn’t let him engage in any rough- and-tumble boys’ play. She instead kept him at home, where he occupied his time—with his mother’s encouragement—cleaning and performing other household work.

When he was four years old, John began to imitate his mother openly by putting on makeup and dressing in his sister’s clothes. This behavior continued even after he started school, and he often made excuses to stay home to indulge his feminine fantasies. The only physical trauma John suffered during these early years came when he broke his leg when he was six. The broken leg didn’t bother him very much, but the cast he was forced to wear prevented him from cross-dressing, which he found a constant source of frustration.

John’s feminine traits and identification soon pervaded his entire life. He refused to participate in gym while at grammar school, while his growing effeminacy caused the other boys at school to make life miserable for him. His older brother often had to come to his defense. John’s greatest personal satisfaction came when his mother took a job and he took over full responsibility as family housekeeper, a role he enjoyed immensely.
The next phase in John’s ever-increasing gender dysphoria came during adolescence. By this time he was going to high school, but was doing only passably well. His main preoccupation was still his family’s home, where he could engage in his favorite pastime, domestic work.

But when he was fifteen, something happened that permanently changed his life. He read a magazine article about transsexualism, learned about sexual reassignment surgery, and began corresponding with experts at Johns Hopkins Hospital in Baltimore. Surgery seemed to be the obvious course of action for him, so he began to prepare for it. To achieve this goal, the teenager dropped out of school and began studying the literature on transsexualism. He became so versed on the subject that he successfully conned a physician into giving him estrogen by claiming that he needed it to treat a previously diagnosed endocrine disorder. His real purpose, of course, was to prepare himself physically for the change-of-sex surgery.

Soon the oral doses and injections took effect, and his body hair began to thin while his breasts enlarged. The estrogen also affected him psychologically, and he later reported that it made him feel more tranquil than he had ever felt before.

It is impossible to determine how far the young man would have gone with this self-therapy were it not for an automobile accident that disrupted his life in 1969. He was then sixteen. His use of estrogen was discovered by the doctors who treated him after the accident, and they informed his family about the situation. They were shocked by the revelation, as might be expected.

The disruption these revelations caused within John’s family can’t be overestimated, and seemed to exacerbate his previously disturbed relationship with his mother. She resolutely insisted that he seek psychiatric treatment, and she even threatened suicide should he refuse. John eventually gave in to his mother’s histrionics and committed himself to a state hospital, but there was nothing the therapists could do for him. Since he was well in touch with reality and was not psychotic, he was merely formally diagnosed as a transsexual and discharged. This conveniently allowed John to go to work at a fast-food restaurant and once again plan for change-of-sex surgery. The hospital psychiatrists felt, however, that their patient could benefit from psychotherapy, and they encouraged him to see Dr. David H. Barlow at the University of Tennessee Medical School. (Dr. Barlow would later help bring the case to public attention. He is a renowned pioneer in the use of behavior modification techniques for the treatment of sexual disturbances.) This course of action didn’t strike John as unreasonable. He began taking estrogen again, but this time under the supervision of a private psychiatrist. He also went back to cross-dressing.

While personally satisfied with the way his life was going, the only real problem still facing him was his mother’s possessiveness. He complained that she continually tried to smother him while at the same time she fiercely rejected his transsexualism. To escape the situation, the young man—with his psychiatrist’s blessing—joined the Navy in 1972, but he was rejected for psychiatric reasons. His mother tried to take advantage of the circumstances and even tried to move into his apartment with him, much to his annoyance. The situation between John and his mother became so intolerable that finally he tried to commit suicide by overdosing on his medication.

This unsuccessful suicide attempt brought him back to the hospital and back to the attention of Dr. Barlow and his colleague Dr. Gene G. Abel, who had also previously worked extensively with transsexuals. They counseled the patient, agreed with him that surgery would probably resolve his gender dysphoria and began preparing him. This entailed giving him full therapeutic dosages of estrogen and electrolysis and subjecting him to a complete psychiatric examination for gender identity, gender role behavior, and sexual arousal patterns. These standard objective psychological tests, which are always given before change-of-sex surgery is seriously considered, were conducted by Drs. Barlow and Abel.
The results of every one of the tests were consistent with a diagnosis of transsexualism. Even the way John moved and walked was typically feminine, according to a test that the researchers used to check for masculine and feminine motor behavior. For all practical purposes, John was really a woman trapped in a man’s body. For this reason the therapists did not hesitate to continue recommending a change-of-sex operation.

The process leading up to this radical surgery is very slow, however. For two years the researchers kept continual tabs on John, repeatedly giving him tests for gender identity and masculine versus feminine motor behavior. The results consistently came up feminine, which constituted further evidence that change-of-sex surgery was warranted in his case.

By this time John was living openly as a woman and was going by the name Judy. He successfully adapted to his new lifestyle, and no one who casually knew him realized he was a pre-op transsexual. His therapists even stated when they wrote up the case that he “was successfully wearing a bikini having progressed to bra size 38B.”

By the summer of 1973, John was ready for his change-of-sex operation, to which he was looking forward eagerly. Both of his therapists agreed that his adjustment would probably be successful and that he wouldn’t suffer later conflicts over his decision. They suggested that he have the surgery at a medical center in a nearby state, and he duly checked in.

Then came the shock. The therapists never received word back about the surgery, and several silent months passed before they heard from John again. When he resurfaced the following fall, he had been remarkably transformed.

“One day in late fall,” report Drs. Barlow and Abel, “a research assistant who had worked with the case came back from a half-finished lunch of fried chicken and shouted, ‘Judy is back at the restaurant, but she’s not Judy anymore, she’s John!’ Other reports quickly confirmed the report, and John was invited back to our offices for a session which occurred in early January of 1974. He entered the office in a three- piece business suit with polished shoes, neatly cut short hair, clipped fingernails, and consistently masculine motor behaviors. Even to trained eyes, the only sign of his former feminine role was the almost complete absence of facial hair, which in view of his light complexion and in the context of his total masculinity would normally go unnoticed. ”

The story he told was as remarkable as his transformation. While he was working at the fast-food restaurant, he had grown very attached to his employer, who was a Christian fundamentalist. She refused to be judgmental about her employee’s transsexualism, but she did ask that he consult with a physician she knew in town before undergoing the final surgery. This physician was also a fundamentalist. Although John considered himself a Southern Baptist, neither he nor anyone else in his family was religious. But he went to see the doctor anyway as a favor to his boss. The doctor examined him and spoke with him for some time and even agreed that his change-of-sex adjustment would probably be good. He then told John that his real problem was possession by evil spirits! John was astounded by this announcement, even more when the physician asked if he could perform an exorcism. For some reason John agreed.

The exorcism lasted from two to three hours, and it involved prayer, the laying-on-of-hands, and exhortations against the evil spirits possessing the patient. John later explained to his therapists that he fainted several times during the ritual, but when the ordeal was over, the physician assured him that twenty-two spirits had been driven from his body.

(The physician later explained to Dr. Barlow that one of these entities had been female and was the cause of John’s problem.)

The result of the exorcism was nothing short of amazing. When the ritual was over, John announced that it had worked! Now, for the first time in twenty years, he perceived himself as a man. His desire to cross-dress ceased instantly and he immediately went to a barbershop to have his hair cut short. This conversion to a totally masculine identity lasted for two weeks, during which time he lived back with his mother. But then he began to feel his old tendencies returning, so he and his employer visited a fundamentalist faith healer at a public meeting in town. They were able to talk with her and she agreed to pray over John. Once again he fainted dead away. He fainted again after regaining consciousness for a few moments, which ended the treatment. It was at this point that John realized that another miracle had transpired. While leaving the public platform where he had been treated, he saw that his breasts— fully formed from the estrogen treatment—had returned to normal. He had now fully returned to his male gender, although the effects of estrogen are long-lasting and his claim medically impossible. (While checking into the story, Dr. Barlow received confirmation of the “miracle” from the young man’s employer.)

Even though they could plainly see that their former patient’s feminine characteristics had completely and mysteriously disappeared, Dr. Barlow and his colleagues were incredulous about their patient’s story and spent considerable effort in verifying it. The story consistently checked out. But to be sure of their personal observations, the therapists asked John to retake the same battery of psychological tests that they had used to diagnose him a transsexual. This time the test results all came out consistent with a masculine identity . . . which was a total reversal of the prior results he had given while being monitored over the previous two years. Even his gait and body movements were now firmly masculine, possibly for the first time in his life.

The two therapists followed John’s life for the next two and a half years to see if the cure would be permanent. It certainly seemed to be, for John’s transsexual tendencies never returned. By 1975 he was dating women but had not engaged in premarital sex because of his new-found religious beliefs. They learned that he still occasionally felt fleeting homosexual urges, but their former patient assured them that he was perfectly capable of banishing these from his mind when they arose. His adjustment to his masculine life seemed as perfect as it was inexplicable.

What is a psychiatrist to make of such a bizarre case? Does it prove the existence of spirit possession, or could the exorcism have produced some sort of psychological miracle akin to hypnotic suggestion?
It is clear from their report that neither Dr. Barlow nor Dr. Abel feels competent to explain why and how this unexpected cure came about. Writing in the Archives of Sexual Behavior in 1977, they noted that “what is important in this case is that no psychotherapeutic procedure of any kind with whatever element of suggestion or persuasion, has - been effective for transsexualism, with the possible exception of behavior modification in one case. But even the most facile operant conditioner would be hard pressed to explain the sudden and massive behavioral change observed and objectively measured in this case.” They add that the one reported case of a patient cured through behavior modification responded only after months of treatment. That patient only learned to behave “masculinely” by practicing new behavioral strategies for walking and acting. The patient had to be carefully taught these strategies, while John’s cure had been instantaneous.

“What cannot be denied,” the two researchers conclude, “. . . is that a patient who was very clearly a transsexual, by the most conservative criteria, assumed a long-lasting masculine gender identity in a remarkably short time following an apparent exorcism. ”

Dr. Barlow was in a position to know, too, since he has personally specialized in the “cure” of gender dysphoria. He had invariably found that the process takes an extremely long time to complete.
No matter how one chooses to interpret this case, the fact remains that conventional psychiatry cannot explain why John grew up with the internal feelings that he was a woman and not a man, why counseling and therapy accomplished nothing by way of a cure, or how the young man accomplished a 100 percent change in behavior almost instantaneously.

But let’s go back in time a bit, to an era before the contemporary development of the behavioral sciences. During the Middle Ages, it was widely believed that some people who acted strangely were possessed either by evil spirits or by spirits of the dead. This belief was most eloquently promoted by Michael Psellus, a church scholar of the eleventh century. The belief has withstood the test of time, for it is still taught in many technologically unsophisticated societies, where the mentally ill are treated by shamans instead of physicians. The cosmology of primitive shamans teaches that madness occurs when the soul has been torn away from the body, thereby allowing spirit possession or psychological dysfunction to occur. The shaman—like the psychiatrist—heals through the use of special rituals and by virtue of his “special” knowledge concerning the workings of the body and the soul. His success rate easily rivals that of even the best Park Avenue psychiatrist, as psychiatrist E. Fuller Toney was forced to admit after he studied shamanism around the world. (He published his findings in his celebrated book The Mind Game before returning to conventional psychiatry to work with schizophrenics at St. Elizabeth’s Hospital in Washington, D.C.)

So it seems to me that there is plenty of reason to consider all sorts of seemingly bizarre theories about the nature of human behavior. The rest of this book will consider the possibility that some cases of deviant behavior are not due simply to the dysfunction of the brain or mind, but that certain unseen influences might be a complicating factor. Since John’s cure by exorcism was psychiatrically inexplicable, would it be too outrageous to suggest that perhaps some sort of foreign influence had been responsible for the youth’s feminine behavior? We can at least explain his cure by adopting this provisional view.

For several years, some enlightened psychiatrists and psychologists have believed that within the bizarre hallucinations and delusions of the mentally disturbed, there might lurk some level of paranormal perception. For instance, take a patient who believes he is being persecuted by spirits of the dead. What if that patient started coming up with obscure and verifiable information about real people whom he never knew and who died years before—the very people he claimed were persecuting him? Such a case would suggest that the patient’s delusions were based on some glimmer of reality. In fact, there are several such cases buried within the literature on the paranormal. During the course of the next several chapters, we will take a detailed look at these cases— and at what they have to teach us about the nature of the mind and life itself.

“Gender identity change in a transsexual: an exorcism.” is an extract from The Infinite Boundary: Spirit Possession, Madness, and Multiple Personality by D. Scott Rogo.