A Taste of History

US - Newsweek, December 5, 1966...
OCR'd text


MEDICINE


A Change of Gender


What is sexual identity? Physical maleness and femaleness, of course, are
both set at conception, dictated by the chromosomes. But, in fact, the
distinction between the sexes is more than physiological. Each parent
establishes a psychological pattern of gender identity that makes a boy
become a man and a girl a woman. The boy, for example, follows his father's
image and develops m aggressive personality and an interest in sports; the
girl plays with dolls and helps in the kitchen. But some apparently normal
boys and girls*whether through a subtle imbalance in their hormone systems
or the inability to identify with the proper patent*become transsexuals,
victims of a seemingly uncontrollable desire to live as members of the
opposite sex.


The best-known example of transsexualism is the slender ex-GI named George Jorgensen who shocked the world fourteen years ago when he went to Denmark for surgery to change his sex from male to female. Jorgensen was castrated, a procedure that some physicians and psychiatrists regarded as an act of mutilation. But today, many doctors are convinced that if the transsexual cannot be cured psychiatrically, then his or her desire for change should be achieved surgically. And last week, The New York Times revealed that Johns Hopkins one of the nation's most reputable medical institutions, had opened a Gender Identity Clinic which was making a thorough study of transsexualism and had already "converted" two physiologically male men into women. "If the
mind cannot be changed to fit the body," explained plastic surgeon Dr. John
E. Hoopes after the story appeared, "then perhaps we should consider
changing the body to fit the mind."

Suicide: Hoopes, who heads the Hopkins clinic, estimated that there are
several thousand transsexual men and women in the U.S. at present. While
nearly all transsexuals appear to be physically normal members of their sex,
the abnormality in behavior often becomes apparent at the age of 4 or 5.
Transsexuals are distinct from transvestites; while transvestites derive
erotic pleasure from donning the clothes of the opposite sex, transsexuals
do so simply to carry out their desire to switch sexes. "You would probably
never recognize a transsexual as such," says Hoopes. "I cannot state too
emphatically how completely these people assume the role of the opposite
sex." Since the role is not reality, he adds, perhaps three in every ten
transsexuals commit suicide, and many others, unable to obtain surgical
help, mutilate their sexual organs.


The Hopkins Gender Identity Clinic offers a way out for some of these
unfortunates. Before establishing the clinic, Hoopes and his nine clinic
associates ( including two psychiatrists, two psychologists, a gynecologist,
another plastic surgeon, a urologist and a pediatrician) cleared their plan
with clergymen and lawyers. The surgery is considered legal on the ground it
is necessary for treatment of a pathological condition. The patients merely
sign the usual surgical release before the operation.


Crusader: The clinic opened last July with no publicity. Most of the
patients it sees are referred by the Harry Benjamin Foundation, an
organization established by New York endocrinologist Harry Benjamin, author
of the definitive text "The Transsexual Phenomenon" and a longtime crusader
for more realistic attitudes toward the problem. Funds for the clinic come
from the Erickson Educational Foundation of Baton Rouge, La.


Currently, the clinic staff screens two applicants a month*nine out of ten
of them males who wish to become females. Each applicant receives exhaustive
physical and psychological testing. (As part of the clinic's research into
the causes of transsexuality, the family histories of the applicants are
also studied in detail.) Only those who show no evidence of psychosis and
who have long lived as transsexuals are accepted as candidates for
treatment. There is already a waiting list of more than 100.


Those selected for sex change receive regular doses of sex hormones; the
female hormone estrogen, for example, will diminish a man's body hair and
usually helps develop breasts and rounded hips, while male hormones have the
opposite effect on the female transsexual. Surgery for male transsexuals
involves a three- to four-hour, operation during which the testes and penis
are removed and an artificial vagina constructed, often from the sensitive
skin of the penis. Later, the breasts may be artificially enlarged by
injecting polyethylene plastic ( the same procedure used by some topless
dancers to build up their measurements ) . According to the clinic, men who
have been surgically transformed often marry, and claim to have orgasms,
although they are, of course, unable to conceive. So far, at Hopkins, five
females have undergone surgery to become males. In these cases, a
hysterectomy is carried out and, in a later operation, the breasts are
removed. A penis may be constructed by means of a skin graft from the
patient's abdomen, but it cannot fulfill a normal sexual function.


Clinic Aims: In the last few months at Hopkins, sex-change surgery has been
performed on two men in their 20s, one white and one Negro. Both are
planning to marry men who are aware that the operations were performed.
"They are pleased with the surgery and have no regrets," says Hoopes. (
Ex-GI Jorgensen, a neatly coiffed blonde who calls herself Christine, now
lives quietly in Massapequa, N.Y., and is writing her autobiography. )


Despite this apparent initial success, the clinic aims to determine the
underlying causes of transsexuality and whether sex-change operations are
the best method of handling this disorder. For this reason, patients treated
at Hopkins will be followed for years to determine how well they adjust to
society.


Some psychiatrists object to sex-change surgery because they believe
transsexuals are deeply disturbed homosexuals who wish to change gender to
resolve their conflict. Says Dr. Charles W. Socarides, a New York
psychoanalyst*specializing in the treatment of homosexuality: "Such
operations are doomed to ultimate failure because they do not change the
basic underlying conflict." For his part, Hoopes still is not sure, in his
words, that "these people are happier and more useful citizens following
surgery and other therapy than they were before." He is open-minded about
transsexual surgery; he hopes other hospitals and the public will be too.



TRANSSEXUAL RESOURCES IN PORTLAND