Transgenderism has apparently been around long before it was diagnosed in the 19th century.

However, modern diagnosis started back in the 1880s in Germany, where the fledgling field of sexology was being created. In 1886, a German doctor by the name of Richard von Krafft-Ebing began studying the prevalence of gender divergence among the homosexual population. He coined a term, "gynandry" to describe the phenomenon. Later, in 1902, he described something he called, "metamorphosis sexualis paranoia", wherein a homosexual truly believed him or herself to be one of the opposite sex. However, Krafft-Ebing believed this, in addition to homosexuality, was purely a delusion, and a mental illness.

Though Krafft-Ebing's work was the first to touch upon transgendered topics, the first true pioneer in the field was Dr. Magnus Hirschfeld. As a gay physician, he devoted his studies to the fields of sex and gender. Hirschfeld was the first to coin two of the most popular terms to describe transgenderism: transvestism and transsexualism. In 1910, he wrote a two volume monograph entitled, Die Transvestiten: Eine Untersuchung ueber den erotischen Verkleidungstrieb mit umfangreichem casuistischem und historischem Material. In it, he detailed the biographies of several gender variant individuals, who would likely be classified as transsexuals today. In 1923, Hirschfeld first labeled the phenomenon as what he called "psychic transsexuality" in Die intersexuelle Konstitution. Jahrbuch für sexuelle zwischenstufen, 23: 3-27.

he and Norman Haire founded The World League of Sex Research. Later. In 1930. Hirschfeld reported in Sexuelle Zwischenstufen: Sexualpathologie that the first incomplete sex-reassignment surgeries in female-to-male patients were performed in Berlin in 1912. Eugen Steinach (who later penned the 1940 book. and Feminization of Males and Masculinization of Females) detailed his experiments with transplantation on guinea pigs. the blooming field of endocrinology would discover androgens and estrogens. He was the first to theorize that the sex glands contained secretions that made men act like men. THE SURGICAL SOLUTION In the 1910s. the world's first sexological institute. In 1916. addressing the Association for the Advancement of Psychotherapy. and women act like women. Sex and Life. His early papers (Arbitrary Transformation of Male Animals into Animals with Pronounced Female Sex Characteristics and Feminine Psyche. Hirschfeld began to explore the idea of a surgical solution to some of these cases. Hirshfeld founded the Institut füer Sexualwissenschaft (The Institute for Sexual Science) in Berlin.In 1919. Forty years of biological and medical experiments). In 1918. Hirschfeld delivered the first scientific lecture on transsexualism. Hirschfeld began working with a Vienna physician. Max Marcuse published an article on . Steinach had experimented with gonadal transplantation in attempts to cure a variety of sexual disorders (ranging from homosexuality to transvestism). Nine years later. in Copenhagen. in the 20s and 30s.

and it was performed based on Hirschfeld´s recommendation by two of his co-workers in his institute. Initially vaginoplasty was performed using skin grafts from the legs and/or lower abdomens. Rudolph Richter. Dr. Felix Abraham. Muehsam reported (in Chirurgische Eingriffe bei Anomalien des Sexuallebens: Therapie der Gegenwart 67: 451455) that in 1920. Abraham reported the details of two men undergoing sex reassignment surgery in his 1931 article Genitalumwandlung an zwei maenlichen transvestiten. the first private surgeon. Gohrbandt. Hirschfeld referred the first male-to-female patient to a surgeon. Most notable were the first attempts at vaginoplasty. In (Zeitschrift fur Sexualwissenschaft 18:223-226) A translation of his article can be read at http://www. The first complete male-to-female SRS was reported in 1931. Levy-Lenz. usually entailing simply the removal of the sexual organs of the patient. Dr. Richter underwent castration. Dr. Also that year. In 1922. R. later living with the female first name Dorchen. Further enhancements would not come along for over twenty years. followed in 1931 with a penectomy and the construction of an artificial vagina.Geschlechtsumwandlungstrieb. These initial attempts at SRS were incomplete. lived and worked in Hirschfeld´s institute for more than 10 years as a housemaid (R. and Dr.symposion. . In 1926. Herrn (1995) Vom Geschlechtsumwandlungswahn zur Geschlechtsumwandlung. Further enhancements to the procedure were developed in the following years. The patient. Felix Abraham.htm. began to practice early forms of sexual reassignment in Berlin. the desire of some to have their sex changed. pro famila magazin 23(2): 14-18).

Soon. However.In the Spring of 1930. Clinics in Denmark and Norway resume some of the work halted by Germany. but not before being heralded as the world's first transsexual. Einar Wegener). 1933. even Hirschfeld's World League of Sex Research was disbanded. SRS was placed on a back burner. Some early female-to-male transexuals include Claire Schreckengost and Henri Acces (formerly Alice Henriette Acces). Gohrbandt in Dresden. In 1937. had SRS under Dr. It was at this time that the first estrogens became available. was published two years after her death. Due to the political events in Europe. Magnus Hirschfeld's Institute for Sexual Science was raided and destroyed by Nazis. TRANSSEXUALISM IN WWII On May 6th. with the introduction . in exile. and sexologists were persecuted. the early years of WWII were also a time of medical advancement which would help future transexuals. Lili Elbe (formerly the Dutch painter. and her posthumous autobiography. referred by Hirschfeld. Hirschfeld. performing theraputic penectomies and castration. a Czechoslovakian runner by the name of Zdenka Koubkova became Zdenek Koubkov. Only a handful of sex reassignment operations would be performed until the next decade. She died the following year of complications from the surgery. Dutch newspapers began reporting the news at the end of 1930. Writings on sexology were burnt. Belgian cycling champion Elvira de Brujin became Willy de Brujin. British athlete Mary Edith Louise Weston became Mark Weston in the mid-1930s. died two years later. In 1935. Man into Woman (under the pseudonym of Niels Hoyer).

Roberta Cowell. Hedy Jo Star. which proved to be a crucial advancement for FTM surgery. a prominent transsexual in the UK. performed some initial operations on Michael Dillon (formerly Laura). That happened when the first American. In 1944-5. and Premarin in 1941. I Changed My Sex. it wasn't until the late 40s and early 50s that transsexualism moved into the public spotlight. the New York Daily News broke the story with the headline: Ex-GI Becomes Blonde Beauty! Aside from the news articles. However. Christine Jorgensen wrote her autobiography in 1967. wrote one of the earliest. also wrote an autobiography. several stories appeared about Edward Richards. Michael Dillon (a female-to-male transsexual) described his case in Self: A Study of Ethics and Endocrinology in 1946. following the trend started by Lili Elbe in 1933. Richards travelled overseas to have sex change surgery. Later. where surgeons Paul Fough-Anderson and Erling Dahl-Iversen performed her initial SRS. On December 1 of that year. but none truly caught the public limelight. Christine Jorgensen. PUBLIC AWARENESS Occassional articles appeared throughout the 1930s detailing various transsexual operations. had sexreassignment surgery in 1952. In 1941. He used the wartime technique of flap surgery. Harold Gillies. Striptease artists. She traveled to Copenhagen. a British surgeon. transsexuals began telling their own stories. .of Di-Ethyl Stilbesterol in 1938 (originally for use in chicken feed!). who went to court to legally become Barbara Ann Richards.

The one movie which attempted to capitalize on transsexualism at this time. among the scientific community. a mere handful in the first half of the century. word continued to spread. was a resounding flop. and is widely considered to be one of the worst movies of all time. Dr. which is used up to this day. In 1953. In the journal. However. the number of sex reassignment surgeries. Still. separate from issues involving intersexuality. it remained a mystery to the general public. (Sexology 16: 274280). Transvestism and Transsexualism. even though transsexuality was more prevalent. Notable clinics opened in Tijuana. However. The latter was where a surgeon by the name of Dr. As a direct result of the Jorgensen publicity. Dr. Psychopathia Transsexualis. Glen or Glenda. Surgeons outside of Europe begand to offer SRS. Its occasional excursions into the public eye were still marred by sensationalism and incredulity. and Casablanca. Harry Benjamin authored the article. Cauldwell was a fervent opponent of a surgical remedy. in the International Journal of Sexology (7: 12-14). In 1949. Benjamin had begun to treat transexuals with hormone therapy in 1949. Cauldwell wrote an article. grew dramatically. He pioneered the penile inversion form of vaginoplasty. except in intersex cases. David O. SRS IN AMERICA . and is often incorrectly credited with creating the term "transsexual". Georges Burou began to practice SRS in 1953. Cauldwell did create "psychopathia transexualis" as an alternate sexological category.

Robert Stoller). Harry Benjamin wrote his penultimate work. as over the next couple years several universities opened gender clinic: Stanford (under Psychiatrist Norman Fisk and surgeon Donald Laub). the Johns Hopkins Gender Clinic announced its success to the New York Times. SRS finally came to America with the help of a FTM. Robert Stoller. In addition. after receiving permission from a Baltimore court. There. that year Dr. and began transitioning to live as a male under the supervision of Dr. UCLA (headed by Dr. Without an officially recognized diagnosis making SRS a valid medical cause. The Transsexual Phenomenon. the floodgates opened. Reid Erickson. Reid inherited a fortune from his father. The Erickson Educational Foundation. to become Phyllis Wilson.Despite its growing prevalence in Europe. Born female. in 1965. Doctors John Money. Erickson formed an organization. Phillip Wilson underwent the first SRS in the U. Harold Garfinkel and Alexander Rosen. Harry Benjamin.S. it could be seen as being the crime of "medical mayhem" (the permanent maiming or mutilating of an individual. both civil and criminal. Now. In 1958. primarily for fear of prosecution. a group of UCLA doctors. In 1966. rendering that individual partly or wholly defenseless). Northwestern. and the University of Minnesota . to promote the study of transsexualism. A group of doctors at Johns Hopkins University were among the first to benefit from the generosity of the EEF. surgeons in the United States were hesitant to perform the operation. performed feminization surgery on an intersexual woman named Agnes. Howard Jones and Milton Edgerton started America's first Gender Identity Clinic.

Hastings?). In 1967. Stanley Biber. Yugoslavia . His practice was seen as an alternative to the gender clinics. In 1971. and advances in phaloplasty techniques. the first private practicioner began performing SRS in America: Dr. SRS OVER THE WORLD Other countries soon became more relaxed about SRS. Léon Pérel performs the first sex reassignment at the Saint-Francois hospital in Paris. In 1972. a change in British law allowed Charing Cross Hospital to begin performing SRS.1977.1975. Dr.1971. the AMA first officially sanctions SRS as the treatment for transsexualism.1979. in 1969. where prospective transsexuals were expected to meet sometimes strict criteria before being awarded with SRS. under Dr. In 1969. Phillip. Future meetings took place in Denmark . and in 1969. Stanford .1973. The Stanford clinic in particular was noted for its pioneering work. working from drawings from the Johns Hopkins Clinic. The first was held in London. The Erickson Educational Foundation began sponsoring a series of International Symposia on Gender Identity. Germany decriminalized the procedure. involving both the sigmoid colon resection vaginoplasty. BREAKDOWN . Norfolk . and finally in San Diego . "Gender Dysphoria Syndrome" was coined a year later by Norman Fisk.(Dr.

were removed from the university. leaving even the ISGE with an uncertain future. she criticized TSs for reenforcing gender roles. where the chairman of the Psychiatry department. Sensing political pressure. McHugh saw SRS as unnecessary mutilation. A prime example was the 1979 publication of Janice Raymond's book The Transsexual Empire: The Making of the She-Male. Transsexuals came under fire at this time from both the lesbian/gay community and feminist groups. the climate began to change. Paul McHugh. In short. John Meyer to do a long-term follow-up study of 50 transsexuals who underwent SRS at Johns Hopkins. Some were discontinued completely. He assigned Dr. Others. such as Stanford's. and set out to kill the program. and the loss of support from the EEF indicated a fundamental shift in the way transgender . wherein she attacked transsexuals from a feminist angle. it led to the October 1979 closing of the Johns Hopkins Gender Identity Clinic. Although the paper was widely criticized as flawed. The downfall of the gender clinics. was replaced by Dr. Joel Elkes. Dr. claimed that SRS confers no objective advantage in terms of social rehabilitation for transsexuals. The first signs were seen at Johns Hopkins. and complained that men (the TSs) were only transitioning to dominate and further oppress "true" women. STANDARDS OF CARE During its 1977 and 1979 meetings. the ISGE began to plan its future. the Erickson Educational Foundation dissolved. Meyer's report. In 1977.In the late 1970s. however. becoming non-affiliated. other universities began to taper off their own gender programs. nonprofit foundations. issued in 1977.

In 1980. the use of scrotal tissue for additional vaginal grafts. the American Psychiatric Association listed transsexualism as an official disorder in the would be offered. the HBIGDA adopted a group of guidelines called The Standards of Care. and February 2001). and urethral mucosal flaps for providing lubrication. The Standards of Care were revised five times since (in January 1980. more private surgeons began taking up the mantle of SRS. March 1981. . in 1979. Under the guidance of Paul Walker. June 1998. Through the 1980s. the ISGE reformed itself as the Harry Benjamin International Gender Dysphoria Association. January 1990. such as the ascending colon vaginoplasty. To provide its members with a consistent standard for treatment of transgender issues. Additional innovations were made. The diagnosis was changed to "gender identity disorder" in the DSMIV.

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