University of Southern California Dissertations and Theses

To be seen: transsexuals and the gender clinics

(USC Thesis Other)

To be seen: transsexuals and the gender clinics

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content

TO BE SEEN:

TRANSSEXUALS AND THE GENDER CLINICS

by

Emmett Harsin Drager

A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(AMERICAN STUDIES AND ETHNICITY)

August 2022

Copyright 2022 Emmett Harsin Drager

ii
Acknowledgements

This dissertation is for trans elders, for the first generation of transsexuals who passed
through the gender clinics, and for those who were never able to access care. I owe so much to
your vision, fight, tenacity, and love.
It’s impossible to adequately express my gratitude for all of the people who have helped
make this project a reality, from mentors to friends to colleagues to archivists and reading room
staff. Thank you first and foremost to my mentor Nayan Shah, whose seminar “Archives and
Subcultures” changed the trajectory of my research and also my life. Everything I know about
archives and my love for historical inquiry is because of you. Your extensive feedback was, at
times, maddening, but made me a better thinker and scholar. Thank you, with so much love and
gratitude, to my dissertation committee members Jack Halberstam, Neetu Khanna, and Sarah
Gualtieri. And thank you to the other mentors I have had over the years: C. Riley Snorton, Susan
Stryker, Seema Sohi, Danika Medak-Saltzman, and Emma Pérez.
Thank you to all of the faculty, students, and staff in the Department of American Studies
and Ethnicity at the University of Southern California and the Department of Ethnic Studies at
the University of Colorado at Boulder for being my intellectual home and community. A special
thank you to Kitty Lai, Jujuana Preston, and Sonia Rodriquez—you are the engine behind our
department. Thank you to the Race, Gender, and Sexuality (RAGES) research cluster at USC.
This project has been, is, and will continue to be the product of shared conversations with
friends, colleagues, and intellectual interlocutors. Enormous gratitude to Bekah Park, Quinn
Anex-Ries, Divana Olivas, Sarah Fong, Nic Ramos, Andrea Long Chu, Lucas Platero, Andréa
Becker, Chase Joynt, Zackary Drucker, Jeanne Vaccaro, Hil Malatino, Beans Velocci, Ximena

iii
Keogh Serrano, Cassandra Flores-Montaño, Nicole Richards, Huan He, Christopher Chien, K.
Avvirin Berlin, Athia Choudhury, Vanessa Villareal, and Muriel Leung.
A special thank you to Jules Gill-Peterson, for answering all of my late night text
messages (“quick question…”), talking through ideas, sharing documents, reading drafts, and
being the best accomplice I could ask for.
I could not have completed this project without the love and support of my dear friends
and community: Ali Bibbo, Breck Alverson, Adrienne Caminer, Brittni Laura Hernandez, Bethy
Leonardi, Sara Staley, Meaux Staley-Leonardi, Lindsey Shively, Jamie Keene, Hillary
Montague-Asp, Jordan Beyer, Chris Downs, Jean Wyrick, Kim Abcouwer, Sammie Downing,
Emma Hall, Kelissa Huber, Luis Jimenez Isac, Sol Escribano, Paula Liaño, Laura Martinez
Madroño, Klara Perez, Kaitlyn “Fargo” Teske, Kaitlin Owens, Eli Schaller, Micah Hartman,
Laura Clark, Julie Peterson, Frédérique “Sister Fred” Chevillot, and Lisa Nigrelli.
Thank you to the undergraduate students I had the opportunity to teach and learn from at
USC. Your questions and insights helped me to grow as both a scholar and teacher.
Thank you to Ashley Shively and Will Bailey for their endless generosity in hosting me
on many archive trips. Without you and your sweet home, this project could not have been
possible.
Thank you to the archivists and library staff who have helped me along the way: Shawn
Wilson at the Kinsey Institute, Ramon Silvestre and Isaac Fellman at the GLBT Historical
Society, Ms. Bob Davis at the Louise Lawrence Transgender Archive, Drew Bourn at the
Stanford Medical History Center, and all of the wonderful undergraduate reading room staff at
UCLA Special Collections. This project was made possible thanks to the ONE Archives

iv
Foundation LGBTQ Research Fellowship and the James and Sylvia Thayer Short-Term
Research Fellowship in UCLA Special Collections.
Immense love to my parents Paula and Jeff and my sister Hannah. Your love and support
is the greatest gift in my life.
And finally, with so much love, thank you to my partner Lanie Novack.

v
Table of Contents

Acknowledgements………………………………………………………………………………..ii

List of Figures…………………………………………………………………………………….vi

Abstract…………………………………………………………………………………………..vii

Introduction: To Be Seen…………...……………………………………………………………..1

Chapter 1: Writing Transsexual History…………………………………………………………28

Chapter 2: Racing for An Etiology:
Involuntary Patients and the Psychiatric Clinic (1958-1966)……………..………………..……63

Chapter 3: Getting the Story Right:
Transsexual Autobiographies and the Surgical Clinic (1966-1979) ……………………..……...89

Chapter 4: Looking Back:
Secrets, Scandals, and the End of the Gender Clinics (1979-1980)……………………...…….125

Chapter 5: Transsexual Knowledges…………………………………………………………...162

Without Conclusion: The Legacies of the University-Based Gender Clinics………………….200

Bibliography...……………………………………………………………………………….…208

vi
List of Figures

Figure 2.1 Delissa Newton, 1966……………………………………………………………64

Figure 3.1 Letter from Linda, 1966………………………………………………………….91

Figure 3.2 Rosy Son of Rosa Snapshot…………………………………………...………..118

Figure 3.3 Jean Daley’s Autobiography……………………………………………………123

Figure 4.1 Robert J. Stoller, 1977………………………………………………………….128

Figure 4.2 Robert J. Stoller and Richard Green……………………………………………129

Figure 4.3 List of Expenses………………………………………………………………...152

Figure 4.4 Check to Mrs G., 1971………………………………………………………….153

Figure 5.1 Types of Homosexuality………………………………………………………..172

Figure 5.2 Erickson Education Foundation Pamphlets…………………………………….159

vii
Abstract

Examining the history of the U.S. university-based gender clinics of the 1960s and 70s,
“To Be Seen: Transsexuals and the Gender Clinics,” charts the development of transsexuality
and trans therapeutics. Although the clinics operated for less than two decades, they had a
profound effect on the trajectory of trans medicine and trans identity both in the United States
and globally. Coining terms like “gender role” and “gender identity” researchers carefully parsed
apart the social and material dimensions of bodies, acts/behaviors, and desires. The clinics were
instrumental in establishing sex, gender, and sexuality as discrete categories of difference—an
epistemological formation essential for the production of the category of the “transsexual.” The
dissertation utilizes case studies, trans autobiographies and narratives, gender clinic records, and
grassroots queer archives, to demonstrate that clinicians used medical knowledge to constellate a
new hierarchy of bodies and lives that privileged white middle class patients as “successful trans
subjects” while rendered poor patients and patients of color as less authentic, legible, and valid
forms of transness. “To Be Seen: Transsexuals and the Gender Clinics,” argues that a thorough
examination of transsexuality—as a category, an identity, and an act—can teach trans studies
about the racialized history of (trans)gender, how norms operate, what it feels like to have a body
that is seen and mis-seen, and how the production of knowledge is a complicated, dynamic
process that occurs from both above and below.

1
Introduction: To Be Seen

In 1958, a white woman known under the pseudonym “Agnes” approached doctors at the
UCLA gynecologic clinic with what was considered at the time a medical anomaly.
1
She was a
beautiful young woman with a pair of testes and a penis. Her insistence on the fact that she had
never taken any medication or hormones confounded professors from the departments of
gynecology, urology, endocrinology, and psychiatry, leading to her sex reassignment surgery—
UCLA’s first—in 1959, paving the way for the establishment of the Gender Identity Research
Clinic. Agnes’ case would go on to be regarded as an extraordinary example of testicular
feminization syndrome and a model for how to medically manage intersex conditions.
2

Seven years later, in 1966, she revealed that the medical history she gave had not been
the whole truth. Since adolescence she had been sneaking her mother’s estrogen pills. For the
doctors, this revelation would shift the story, which had been about gender passing and intersex
patients, to a story about trans deviance and deception. Indeed, reflecting on the case years later,
Los Angeles urologist Elmer Belt would write: “Unfortunately this is not an isolated instance of
deception. Deception runs through every aspect of the lives of these people to such an extent that
most of them simply cannot tell a straight story.”
3

That same year, a Mexican-American trans man known in the psychiatric literature under
pseudonym “C.K.” was arrested for assault and battery after a domestic dispute with his wife.
4

1
Robert J. Stoller, “Psychiatric Note,” 24 June 1966, Box 25, Harry Benjamin Collection, Kinsey Institute,
Bloomington, Indiana.
2
Robert J. Stoller, Harold Garfinkel, and Alexander C. Rosen, “Passing and the Maintenance of Sexual
Identification in an Intersexed Patient,” AMA Archives of General Psychiatry 2, no. 4 (1960): 379–84.
3
Elmer Belt to Burton H. Wolfe, 24 March 1969, Box 3, Harry Benjamin Collection, Kinsey Institute, Bloomington,
Indiana.
4
It is unclear where C.K. was arrested. He is described as being from a “big Western city” (68). Because of his court
referral to the University of Oregon medical school, we can surmise his arrest was in Oregon, most likely Portland.
Ira B. Pauly, “Adult Manifestations of Female Transsexualism,” in Transsexualism and Sex Reassignment, ed.
Richard Green and John Money (Baltimore: Johns Hopkins Univ. Press, 1969), 59–87.

2
During his booking at the jail, it was discovered that C.K. was “female,” something that even his
wife had not known. C.K. regularly bound his chest and wore a homemade packer in his pants,
made from a sock stuffed with paper. C.K. was sent to a court psychiatrist who then referred his
care to the University of Oregon medical school for psychiatric and chromosomal evaluations.
Ira Pauly, a psychiatrist at the university was interested in transsexualism and evaluated the
patient during his twenty-eight-day hospital stay. At the time, Pauly was one of the few doctors
in the country researching gender disorders who recommended surgery for transsexual patients.
5

After nearly a month in the hospital’s psychiatric ward, C.K. was released, given
testosterone, and told to come back in a few weeks for surgery. When C.K returned two months
later for a bilateral mastectomy, the hospital administration ultimately rejected him for the
operation, because of concerns that C.K. would regret the operation and sue. More so, they
feared that inevitably C.K.’s surgery would be publicized, and it would open the proverbial flood
gates for more patients like him to demand treatment from the university hospital. In the late
1960s, the university hospital’s rejection of C.K.’s surgery revealed the contradictions and
tensions in medical diagnoses and therapeutic options for individuals living cross-gender lives.
As more university clinicians and researchers found surgery to be a viable treatment option, they
debated how to determine who to recommend for medical transition.
In the years following C.K.’s rejection, an ideal patient profile would take shape. By
1979, when Louis Sullivan, a white gay trans man mailed his application to the Stanford Gender
Dysphoria Program, gender clinic doctors had a rubric for determining who to accept and who to
reject. Completing the fourteen-page application required Sullivan to write a one-page
autobiography about his life, describe his relationship with is parents and siblings, provide his

5
Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge: Harvard
University Press, 2002), 125.

3
work history, and recount his sexual experiences and fantasies. He wrote, “I am really sick and
tired of sitting on the fence between male and female.”
6
Despite being aware of the clinic’s
preference for post-operative heterosexuality, Sullivan was forthright about his desire to live as a
gay man. Thus, he was not surprised when he received a rejection: “We have carefully reviewed
your patient summary sheet and based on the information you provided, we have decided that we
cannot be of assistance to you… The history which you presented was not typical for the
majority of the persons who, in our program, have made successful adjustments with gender
reorientation and who have been helped, not harmed, by sex reassignment.”
7

After receiving the rejection from Stanford, Sullivan sought out private practice doctors
to prescribe hormones and perform surgery. Being able to find such clinics in the United States
was a new phenomenon. In the prior decades, individuals like Agnes and C.K. would have had to
travel abroad to find someone outside of the university clinics who offered trans therapeutics. By
1980 when Sullivan was rejected from Stanford, all of this was changing.
These three individuals’ lives intertwine with the university-based gender clinics and
university research on transsexualism albeit to different extents and with different outcomes.
Agnes’s success in convincing the doctors to operate was based on a falsified medical narrative
of organic transition, claiming that her intersex body required medical intervention. Her
subsequent honesty embarrassed the UCLA physicians who presented and published professional
research based on an incorrect appraisal of her body as intersex and her surgery as a solution of
binary gender for intersex patients. Alarmed by her withholding of key details, the clinicians
were quick to see deception when working with transsexual patients and to redouble their

6
Lou Sullivan, “Stanford University Gender Dysphoria Program,” October 1976, Box 2, Folder 45, Louis Graydon
Sullivan Papers, GLBT Historical Society, San Francisco, California.
7
Judy Van Maasdam to Louis Sullivan, 12 March 1980, Box 2, Folder 45, Louis Graydon Sullivan Papers, GLBT
Historical Society, San Francisco, California.

4
scrutiny. The doctors rejected C.K. for surgery in part due to the perception of trans people as
untrustworthy. If C.K. could fool his wife about his true gender, he too could fool them. They
feared legal retribution if they operated on the wrong patient. Furthermore C.K. came to the
notice of university medicine because of his arrest. Throughout the course of the gender clinics,
many other people would find themselves in the position of “patient” after becoming entangled
with the criminal justice system. And finally, Sullivan’s rejection from Stanford’s Gender
Dysphoria Program due to his expressed homosexuality speaks to the rigidity of diagnosis and
treatment protocols that the clinics developed. Strict adherence to an ideal patient profile meant
that many transsexuals, due to their homosexuality, were deemed undesirable candidates for
surgery and hormones.
In the early-to-mid 1960s, gender clinics began opening at universities across the country.
These clinics were housed in different departments, which reflected their different approaches to
treating the so-called problem of transsexuality. For example, the UCLA Gender Identity
Research Clinic was primarily affiliated with the department of psychiatry, the Stanford Gender
Dysphoria Program was housed in the department of surgery, and the University of Michigan
Gender Identity Clinic was in the department of obstetrics and gynecology. The first clinic to
open was UCLA’s in 1962.
8
Their psychiatric approach to transsexuality is emblematic of the
early days of the clinics in which clinicians and researchers were primarily focused on
understanding the etiology (cause) of transsexuality in order to treat the problem psychiatrically.
As the decade progressed, with no clear theory of transsexual etiology, gender clinics shifted to a
nosological approach—aiming to develop a classificatory system, or differential diagnoses, for

8
The Johns Hopkins Gender Identity Clinic is generally cited as the first university-based gender clinic because it
was the first to provide sex reassignment surgery (1966). However, I think about the university-based gender clinics
not only as places to access surgical treatment, but sites in which the transsexuality, as a category, identity, and act
became consolidated into a diagnosis and set of treatment protocols. UCLA was central to this knowledge project.

5
determining who was a true transsexual and therefore a good candidate for surgery. While their
treatment methods switched—from psychiatric to surgical and hormonal—the goal was
consistent: to “cure,” that is, eradicate gender deviance. By 1980, the majority of these clinics
had closed or their clinicians had cut ties with the university to go into private practice.
Despite the fact that the clinics operated for less than two decades, they had a profound
effect on the trajectory of trans medicine both in the United States and globally. When the clinics
opened, the epistemology of sex, gender, and sexuality as discrete categories of difference had
not been solidified. However, for much of the first half of the twentieth-century, there was a
heterogeneity of ideas about sex, gender, and sexuality.
9
The university-based gender clinics
were instrumental in crafting these categories of difference which we now take as common
sense. Coining terms like “gender role” (John Money, Johns Hopkins Gender Identity Clinic)
and “gender identity” (Robert Stoller, UCLA Gender Identity Research Clinic), researchers
carefully parsed apart the social and material dimensions of bodies, acts/behaviors, and desires.
They proliferated new categories for understanding the biology of the body such as hormonal
sex, chromosomal sex, and gonadal sex and invented terms to explain the social dimensions of
gender such as “sex feel” and “gender presentation.” They used these categories of sex and
gender to classify individuals as transvestites, true transsexuals, and (effeminate) homosexuals.
Their research would culminate with the publication of the treatment protocols know and the
“Standard of Care” (1979) and the addition of “gender identity disorder” to the Diagnostic and

9
For examples of the definitional instability of categories of sex, gender, and sexuality in the early part of the
twentieth century see: Benjamin Kahan, The Book of Minor Perverts: Sexology, Etiology, and the Emergences of
Sexuality (Chicago: The University of Chicago Press, 2019); George Chauncey, Gay New York: Gender, Urban
Culture, and the Making of the Gay Male World, 1890-1940 (New York, NY: Basic Books, 1994).

6
Statistical Manual of Mental Disorders (DSM) in 1980, a moment that Jules Gill-Peterson
describes as, “inaugurat[ing] the medical matrix in which we still live today.”
10

The Figure of the Transsexual
When Agnes approached doctors at UCLA’s gynecological clinic in the late 1950s,
transsexuality was a fairly new concept, and its cause was purely speculative. The term
“transsexual” first appeared in the English language in 1949 in the journal Sexology in an article
titled, “Psychopathia Transexualis,” written by D.O. Cauldwell.
11
The word combination was a
play on Richard von Krafft-Ebing’s “psychopathia sexualis,” the title of his 1886 book on sexual
pathology.
12
In the article, Cauldwell differentiates the category of transsexualism from
transvestism, homosexuality, and pseudo-hermaphroditism, laying the groundwork for a new
sexological category. He describes transsexuality as a form of psychological deficiency, which,
in addition to manifesting as a desire to live in a gender other than the one assigned at birth,
presents itself through other psychopathic characteristics such as: “seduction, parasitism,
violation of the social code in numerous ways, frequently kleptomania and actual thievery,
pathological lying, and other criminal and unsocial tendencies.”
13
Cauldwell states that
transsexuality usually arises from poor heredity, an unfavorable childhood environment, and
over-indulgent parents.
14
These original traits and causes that Cauldwell describes, along with his

10
Jules Gill-Peterson, Histories of the Transgender Child (Minneapolis: University of Minnesota Press, 2018), 11.
11
The term “transsexual” was first used in a 1923 lecture by Magnus Hirshfeld in which Hirshfeld referred to the
desire to change sex as “transsexualismus.” Despite this earlier usage, not until Cauldwell and Benjamin began
regularly writing about transsexuality did the term enter popular usage.
Annette F. Timm and Michael Thomas Taylor, “Historicizing Transgender Terminology,” in Others of My Kind:
Transatlantic Transgender Histories (Calgary: University of Calgary Press, 2020), 251–65.
12
Richard von Krafft-Ebing, Psychopathia Sexualis (Philadelphia and London: F.A. Davis Co, 1892).
13
D.O. Cauldwell, “Psychopathia Transexualis,” Sexology 16 (1949): 280.
14
Cauldwell, 275.

7
express goal of rehabilitation and prevention, shaped sexological research on transsexuality for
years to come.
The idea of transsexuality and what it could mean for an individual was introduced to the
global public through the story of Christine Jorgensen, a Bronx-born photographer and veteran
who travelled to Denmark for sex reassignment surgery. Her story broke in the popular press in
December of 1952 when the New York Daily News ran the headline “Ex-GI Becomes Blonde
Beauty.”
15
Jorgensen’s story captivated the world, making her the most written-about topic in the
media in 1952.
16
Exposed to the idea that sex change was in fact possible, thousands of people
from all across the world would write to Jorgensen hoping to gain information about how they
too could change their sex. As Jorgensen wrote in her autobiography, she became so famous that
a letter addressed to “Christine Jorgensen, United States of America,” would reach her.
17

C. Riley Snorton notes that Jorgensen was not the first person living a cross-gender life to
fill the pages of newspapers and magazines, for years prior to Jorgensen’s story, the Black press
had written about Black trans figures, using their narratives “to meditate on intramural black life,
not simply as it related to matters of gender and sexuality but also as it pertained to the concept
of value and shifting notions of human valuation.”
18
At times, these stories from the Black press
would get picked up by mainstream outlets, however as Emily Skidmore has argued, with
Jorgensen, “the subject position of the transsexual was sanitized in the mainstream press and
rendered visible through whiteness.”
19
In addition to Jorgensen’s whiteness, the press crafted her

15
Ben White, “Ex-GI Becomes Blonde Beauty,” Daily News, December 1, 1952.
16
Susan Stryker, Transgender History (Berkeley: Seal Press, 2008), 47.
17
Christine Jorgensen, Christine Jorgensen: A Personal Autobiography (San Francisco: Cleis Press, 2000), 178.
18
C. Riley Snorton, Black on Both Sides: A Racial History of Trans Identity (Minneapolis: University of Minnesota
Press, 2017), 143.
19
Emily Skidmore, “Constructing the ‘Good Transsexual’: Christine Jorgensen, Whiteness, and Heteronormativity
in the Mid-Twentieth Century Press,” Feminist Studies 37, no. 2 (2011): 271.

8
story in relation to nationalistic values and modern American identity.
20
Furthermore, just as the
popular press made Jorgensen into an exceptional figure of American ingenuity and self-
fashioning, scholars of gender/sex, sexuality, and popular culture have invoked Jorgensen to
make sense of not only the transsexual phenomenon but also post-war cultural anxieties about
shifting gender roles, the emergence of medical consumerism, and the postmodern condition.
21

As more people sought hormones and surgery, doctors needed a set of criteria for
screening patients. Dr. Harry Benjamin laid the groundwork for this process with the publication
of his 1966 book, The Transsexual Phenomenon, which cemented the idea of “transsexuality” as
its own discrete category, different from homosexuality and transvestitism.
22
According to
Benjamin, a transsexual is an individual pursuing permanent bodily transformation by medical
means like hormones and surgeries, such as an orchiectomy, vaginoplasty, mastectomy, or
phalloplasty. As the university-based gender clinics further developed their differential diagnosis
based on Benjamin’s nosology, a true transsexual was said to not experience sexual satisfaction
from cross-dressing, and perhaps not experience sexual satisfaction at all. A true transsexual was
asexual but could assimilate to heterosexual behaviors and roles. A transsexual should want to
pass and disappear into in their chosen gender as an ordinary and unremarkable man or woman.
In the early 1990s, the term “transsexual” would fall out of favor in the United States
with the rise of “transgender.” Transgender, intended to be a non-medicalized term/identity, is
generally regarded as an umbrella category which encompasses many different non-normative

20
David Serlin, Replaceable You: Engineering the Body in Postwar America (Chicago: University of Chicago Press,
2004), 161-162.
21
See: David Serlin, Replaceable You; Susan Stryker, “Christine Jorgensen’s Atom Bomb: Mapping Postmodernity
Though the Emergence of Transsexuality,” in Playing Dolly: Technocultural Formations, Fictions, and Fantasies of
Assisted Reproduction, ed. E. Ann Kaplan and Susan Squier (New Brunswick, NJ: Rutgers University Press, 1999),
157–71; Joanne Meyerowitz, “Sex Change and the Popular Press: Historical Notes on Transsexuality in the United
States, 1930–1955,” GLQ: A Journal of Lesbian and Gay Studies 4, no. 2 (January 1998): 159–87.
22
Harry Benjamin, The Transsexual Phenomenon (New York: Julian Press, 1966).

9
gender identities such as nonbinary, genderqueer, and agender.
23
As David Valentine documents
in his ethnography of transgender, in the 1990s, the term became widely deployed as a category
of collective identity by social service and public health organizations, activists, legislators, and
academics, in order to disarticulate gender from sexuality.
24
He writes, “transgender
identification is understood across these domains to be explicitly and fundamentally different in
origin and being from homosexual identification, a distinction referred to in the social sciences
as ontological” (emphasis his).
25
In this regard, transgender and its practical application as a
means of distinguishing between sex, gender, and sexuality, comes to serve a similar purpose as
transsexual. Transgender is not a new formation but rather a continuation of the nosological
logics of the gender clinics.
26
In this regard, we see how Gill-Peterson’s statement about the
medical matrix—predicated on a differential diagnosis in which an individual’s physical body,
social behaviors, and erotic desires are parsed apart and correlated to identity labels—holds true,
even as terminology shifts.
In light of the fact that “transgender,” as an umbrella category, shores up the ontological
separation of gender and sexuality which “transsexual” began, some trans studies scholars have
proposed separating “trans” from “gender,” conceptualizing “trans” as more open-ended, capable

23
Nonbinary and genderqueer refer to individuals who define their gender as existing outside of the traditional
categories of man and woman, as well as traditional ideas about what constitutes femininity and masculinity.
Nonbinary and genderqueer people generally cite gender as a spectrum, in/on which they reside somewhere in-
between. Agender generally refers to people who say they do not identify as having a gender. Nonbinary,
genderqueer, and agender people may identify as transgender or trans, but not always.
24
David Valentine, Imagining Transgender: An Ethnography of a Category (Durham: Duke University Press,
2007).
25
Valentine, 4.
26
I would add that while transsexuality is a highly discriminating category, referring only to a strict type of person
(one who medically transitions) and transgender is meant to disarticulate cross-gender practices from
medicalization, in practice, this distinction does not hold. As social service, public health, and medical providers
took up the term “transgender” to encompass all gender variant people, medically transitioning or not, transgender
too became a medical category.

10
of attaching itself to a variety of suffixes such as national, species, and racial.
27
This move, in
theory, allows for trans to divorce itself from the logics of separation and division which
underpin transgender and transsexual. Deploying “trans” as crossing, connects “trans” to other
experiences of in-betweeness. However, I argue that the problem with this is that as trans studies
has moved towards more open-ended and proliferating models of gender variance, the field has
had to reframe “transsexual” as a retrograde and anachronistic category, bound to a paradigm in
which trans hinges on gender. In trans studies, “transsexual” has too often become a stand-in for
outdated modes or being or bad politics.
An illustrative example of this can be found in Aren Aizura’s Mobile Subjects:
Transnational Imaginaries of Gender Reassignment.
28
In a close reading of Jennifer Finney
Boylan’s memoir She’s Not There and Deirdre McCloskey’s Crossing, Aizura states that he
understands these texts to be “transsexual, not transgender, memoirs.”
29
Despite the fact that
both Boylan and McCloskey self-identify as transgender throughout their memoirs, which were
written in 2003 and 1999, Aizura labels them as “transsexual” because he deems their transition
stories to be traditional, old-fashioned, normative, and anachronistic.
30
It’s interesting that Aizura
would use “transsexual” in such a way, considering that Mobile Subjects claims to be attuned to
the (neo)colonial logics of trans medical tourism. As trans studies scholars focusing on trans
communities outside of the U.S. have argued, transsexual remains a central identity category in

27
See: Eva Hayward, “Lessons from a Starfish,” in The Transgender Studies Reader 2, ed. Susan Stryker and Aren
Z. Aizura (New York: Routledge, 2013), 178–88; Susan Stryker and Paisley Currah, and Lisa Jean Moore,
“Introduction: Trans-, Trans, or Transgender?,” WSQ 36, no. 3–4 (n.d.): 11–22.
28
Aren Z. Aizura, Mobile Subjects: Transnational Imaginaries of Gender Reassignment (Durham: Duke University
Press, 2018).
29
Aizura, 81.
30
Deirdre N. McCloskey, Crossing: A Transgender Memoir (Chicago: The University of Chicago Press, 1999);
Jennifer Finney Boylan, She’s Not There: A Life in Two Genders (New York: Broadway Books, 2003).

11
many parts of the world.
31
When Aizura uses “transsexual” to mean old-fashioned, retrograde,
and anachronistic, he is relegating transsexuals outside of the U.S. to what Dipesh Chakrabarty
calls “the waiting room of history.”
32
In this colonial and stagist theory of history, we are all
headed to a post-transsexual “trans” destination, U.S. and western trans people have just arrived
there first.
As Gill-Peterson, Lucas Platero and I argued in “The Transsexual/Transvestite Issue” of
Transgender Studies Quarterly, the category and diagnosis of transsexuality may have originated
in the United States at the university-based gender clinics but it has since been exported around
the world.
33
Transsexuality, as a category and identity, has come to organize trans experience
across a wide array of geographies, genders, and racial and class coordinates, even as it recedes
into the background of Anglo academia and activism. Responding to this shift, Gill-Peterson
asks, “How has an implicit geopolitics of trans as a colonial marker of modernity—or post
modernity, depending on whom you ask—relegated the transsexual and the transvestite to the
global South?”
34
Transsexuality is thus deemed not only backwards temporally, but
geographically.
As we see a surge of institutionally supported trans scholarship within universities and
academic publishing, trans studies is at a pivotal moment of shaping its epistemological

31
Some examples of contemporary scholarship which address the use of “transsexual” outside of the U.S.: Afsaneh
Najmabadi, Professing Selves: Transsexuality and Same-Sex Desire in Contemporary Iran (Durham: Duke
University Press, 2014); Dora Silva Santana, “Mais Vida! Reassembling Transness, Blackness, and Feminism,”
TSQ: Transgender Studies Quarterly 6, no. 2 (2019): 210–22; Patricio Simonetto and Johana Kunin, “Mariela
Muñoz: Citizenship, Motherhood, and Transsexual Politics in Argentina (1943-2017),” TSQ: Transgender Studies
Quarterly 8, no. 4 (2021): 516–31; Vek Lewis, “Thinking Figurations Otherwise: Reframing Dominant Knowledges
of Sex and Gender Variance in Latin America,” in The Transgender Studies Reader 2, ed. Susan Styker and Aren Z.
Aizura (New York: Routledge, 2013), 457–70.
32
Dipesh Chakrabarty, Provincializing Europe: Postcolonial Thought and Historical Difference (Princeton:
Princeton University Press, 2000), 9.
33
Jules Gill-Peterson, “General Editor’s Introduction,” Transgender Studies Quarterly 8, no. 4 (2021): 413–16;
Emmett Harsin Drager and Lucas Platero, “At the Margins of Time and Place: Transsexuals and the Transvestites in
Trans Studies,” TSQ: Transgender Studies Quarterly 8, no. 4 (2021): 417–25.
34
Gill-Peterson, “General Editor’s Introduction,” 414.

12
investments.
35
I ask, what will be its relationship to transsexuality? To be clear, trans studies
deploying “trans” as a prefix to attend to various modes of crossing is useful for thinking about
in-betweenness and provides a way out of the ontological separation of categories like gender
and sexuality.
36
However, I want to caution the field against dismissing transsexuality as
outdated, backward, or parochial. Transsexuality, as a category, has much to teach us about how
knowledge projects occur, how they come to materially impact the world in which we live, and,
to borrow a term of Dean Spade, the distribution of life chances.
37
Transsexuality, as an identity,
allows us to better understand norms and how they function (more on that in a moment). And
finally, transsexuality, as an act of medically changing one’s body, can provide us a grammar for
articulating the grounded and sensorial experience of having a body—a body which moves, is
moved, is read, and mis-read.
This dissertation thinks critically about transsexuality, as a category, an identity, and an
act.
38
Grounded in the specific material, historical, and geographic conditions that gave rise to
transsexualism as a medical diagnosis, along with its proliferation as an identity, this project also
attempts to imagine how the specificity of transsexuality and the act of medically changing one’s
body can be useful for the burgeoning field of trans studies in its attempt to understand power,

35
Examples of this include the development of trans studies departments, majors, and minors (see: the University of
Arizona’s Trans Studies Research Cluster), academic conferences devoted to trans studies (see: UCLA’s 2022
Thinking Gender Conference), and trans studies book series and journals (see: Duke University Press’s Transgender
Studies Quarterly journal and their new book series, ASTERISK).
36
To unravel the distinction between sex, gender, and sexuality we can also think about expressions and
instantiations of trans desire. Here, I am thinking about when Andrea Long Chu, in her essay “On Liking Women,”
said, “I have never been able to differentiate liking women from wanting to be like them.” Also see TSQ’s t4t Issue.
Cameron Awkward-Rich and Hil Malatino, eds., “The t4t Issue,” TSQ: Transgender Studies Quarterly 9, no. 1
(2022); Andrea Long Chu, “On Liking Women,” N+1, Winter 2018.
37
Dean Spade, Normal Life: Administrative Violence, Critical Trans Politics, and the Limits of Law (Brooklyn, NY:
South End Press, 2011), 9.
38
When I describe transsexuality as an act, I refer to the fact that the category/identity is contingent on medical
transition. While there are an array of trans people who do not choose to medically transition, definitionally,
transsexuality is teleologically bound to the act/action of having surgery and taking hormones. However, one may
engage in these acts without personally identifying as transsexual.

13
norms, and embodiment. I argue that trans studies, as a field, must contend with the category of
transsexuality—how it emerged, who it was made to encompass, and how it manifests in the
present.
To write about those who self-identified as transsexual or were diagnosed/classified as
such requires a more nuanced understanding of trans medicalization than trans studies has
produced in recent years. I do not think about transsexuality as medical category imposed on
trans people, but rather as a category, an identity, and an act that emerged out of many people’s
genuine desire to surgically and hormonally change their bodies in pursuit of a “normal” life.
Transsexuality is not a top-down category.
39
Rather I argue that it, emerged dialectically and in
conversation with trans people. This argument is detailed in Chapter 5, “Transsexual
Knowledges,” which spotlights trans people who were instrumental to the university-based
gender clinics—intellectually, socially, and financially.
Furthermore, this dissertation eschews the notion that the transsexual pursuit of a “normal
life” translates to normativity or transnormativity. As Andrea Long Chu argues about Agnes’s
life, the lies she told the doctor were not an attempt to undermine the epistemology of sex,
gender, and sexuality or to challenge the clinics’ notions of who was worthy of treatment. Agnes
lied to get what she wanted: “a cunt, a man, a house, and a normal fucking life” (emphasis

39
In Janice Raymond’s 1979 book, The Transsexual Empire: The Making of the She-Male, she made the claim that
transsexualism is an ideology advanced by “the medical empire to generate a unique group of medical consumers”
(19). She sought to expose how “medical-psychiatric” institutions created the ideology of transsexualism to advance
stereotypical and normative ideas about gender which further oppress women. Sandy Stone responded to Raymond
in her field-building essay, “The Empire Strikes Back: A Posttranssexual Manifesto,” debunking the idea that
transsexual people are reinscribing normative gender. However, in many ways, Stone upheld the idea that
transsexuality was imposed on trans people and erased “emergent polyvocalities of lived experience” (163). I agree
with Stone that a heterogeneity of gender expressions became pathologized under one title “transsexuality,” but I do
not agree that trans people did not have a role in the process of developing transsexuality as a category and identity.
Many trans people worked tirelessly to advance clinicians’ understanding of the desire to change sex, to create a
clinical category which legitimized this desire as not a perversion but a medical condition, and to expand access to
medical interventions.

14
hers).
40
As Chu argues, this desire for a normal life is not normativity. “The desire for the norm
consists, in terms of its lived content, in nonnormative attempts at normativity. Agnes was a
nonnormative subject, but that wasn’t because she was ‘against’ the norm; on the contrary, her
nonnormativity was what wanting to be normal actually looked like. Like most of us, Agnes was
making do in the gap between what she wanted and what wanting it got her.”
41
Grappling with
the transsexual as a figure with a complex set of desires, motivations, political or apolitical
investments, life circumstances, and transition stories pushes back against the notion that sex
reassignment surgery, hormone replacement therapy, and “passing” exist under the hegemonic
and colonial rubric of the gender binary.
42
As Jack Halberstam has argued, “transsexual is not
simply the conservative medical term to transgender’s transgressive vernacular; instead, both
transsexuality and transgenderism shift and change in meaning as well as application in relation
to each other rather than in relation to a hegemonic medical discourse.”
43
While trans as prefix is
useful for undermining the sexuality/gender divide and exploring overlapping, intersecting, and
enmeshed forms of crossing, a focus on transsexuality demands a rigorous investment in
understanding norms, materiality, desire, and embodiment.

40
Andrea Long Chu and Emmett Harsin Drager, “After Trans Studies,” Transgender Studies Quarterly 6, no. 1
(2019): 107.
41
Chu and Harsin Drager, 107.
42
Here, I am not arguing that the figure of the transsexual is more non-normative or radical than other trans identity
categories––following the lead of thinkers such as Nikki Sullivan, my argument is not based in a binary of “good”
versus “bad” body modification. Rather, my argument is simply that transsexuality has, at times, been dismissed as
“normative” (i.e. bad) body modification and/or as “false consciousness” and that it should not be.
Nikki Sullivan, “Transmogrification: (Un)Becoming Other(s),” in The Transgender Studies Reader (New York:
Routledge, 2006), 552–564.
43
Jack Halberstam, In a Queer Time and Place: Transgender Bodies, Subcultural Lives (New York: New York
University Press, 2005), 54.

15
The Racial History of Trans Therapeutics
Just as this dissertation attends to the figure of the transsexual to reconsider
norms/transnormativity in trans studies, it also offers a more complex racial history to
transsexuality and the gender clinics. Christine Jorgensen has loomed so large as a successful
and iconic transsexual – white, middle-class, glamourous, and heterosexual. Jorgensen was cast
as a figure of freedom and American exceptionalism. As Snorton argues, Jorgensen was the
silhouette to the shadow of unfreedoms such as “criminalization, colonialisms, imperial
conquest, internment, and Jim Crow” which “figured black life in the United States and around
the globe.”
44
Jorgensen’s exceptional status was rooted in her performance of white femininity
and heterosexuality, further marginalizing nonwhite forms of gender deviance.
I examine how the institutions of American and global unfreedom that Snorton flags were
central to the development of trans therapeutics in the US. In the early 1960s, as clinicians and
researchers sought to determine the cause of transsexuality, they followed Cauldwell’s gesture to
“poor heredity.” Because one of the prevailing theories of transsexuality etiology, which I refer
to as “mother theory,” in Chapter 2, posited that transsexuality was caused by an over-bearing
mother who does not allow her child to differentiate, researchers claimed that Black “mother-
centering” was to blame for higher-than-average rates of nonnormative gender in Black

44
While Snorton mentions colonization and imperial conquest, his analysis remains focused on Black life in the
U.S. We can also think about Jorgensen as a foil for other forms of transness from around the globe whose
unfreedom stands in stark contrast to Jorgensen’s exceptional figuration. Culturally and geographically specific
expressions of “third gender,” such as muxe, hijra, māhū, fa'afafine, and two spirit, have been violently disciplined
under colonization, imperialism, and Western hegemony, both past and present. Examples of scholarship on this
topic include: Qwo-Li Driskill, Asegi Stories: Cherokee Queer and Two-Spirit Memory (Tucson: University of
Arizona Press, 2016); Alfredo Mirandé, Behind the Mask: Gender Hybridity in a Zapotec Community (Tucson:
University of Arizona Press, 2019); Gayatri Reddy, With Respect to Sex: Negotiating Hijra Identity in South India
(Chicago: University of Chicago Press, 2005).
Snorton, 141.

16
communities.
45
Following this logic, professors at Case Western Reserve University argued that
transsexuality is more accepted in the Black community because there is “much less intense
family and social pressures to follow appropriate gender roles.”
46

At university-based gender clinics, researchers found nonwhite patients to be ideal
candidates for etiological research. They assessed nonwhite patients as the products of “poor
heredity,” bad parenting, and pathological family structures. Researchers and physicians
presumed evolutionary and eugenicist beliefs that gender deviance was more prevalent in
communities of color—because nonwhite persons were seen as less evolved and thus less
sexually differentiated. The university-based gender clinics often found and recruited nonwhite
patients from institutions of unfreedom—from police arrests and psychiatric institutions—similar
to C.K.’s experiences at the University of Oregon hospital. My research documents how many
patients came to the gender clinics through incarceration, psychiatric detention, and court-
mandated treatment referrals.
Framing Black gender as inherently pathological and nonnormative, clinicians and
researchers doubted whether Black patients could “successfully” pass post-surgery and
assimilate into heteronormative, capitalist U.S. culture. With both the racialized etiology and
racialized criteria of successful transition into normative heterosexuality and citizenship, the
gender clinics studied non-white gender and sexual pathology but essentially barred most
nonwhite patients from surgical and hormonal treatment.
Following Snorton’s framework of silhouettes and shadows, nonwhite patients are
shadows in trans history “that disrupt the teleology of medicalized transsexuality as corporeal

45
John Money and Geoffrey Hosta, “Negro Folklore of Male Pregnancy,” The Journal of Sex Research 4, no. 1
(1968): 34–50.
46
Paul K. Jones and Susan L. Jones, and Ann Keller, “Sociological Distinctions Among Gender Dysphoria Patients:
A Comparison by Race,” Journal of Psychiatric Treatmemt and Evaluation 3 (1981): 449.

17
freedom.”
47
Individuals like C.K. were involuntarily held for evaluation.
48
Their life stories
became evidence of the gender deviance of communities of color and the pathologization of the
racialized family. And then, ultimately, they were rejected from the therapeutics they sought
because they were not seen as incorporable into the national heterosexual imaginary and white
citizenship. Their stories foreground how psychiatric detention and unfreedom were necessary
conditions for the production of modern sex and (trans)gender.

Optics and Care
As the title of the dissertation suggests, this is a project that thinks critically about the
visual components of the gender clinics, historical archives, and trans history writing. In Western
epistemology, the visual has long been privileged as the site of truth. Indeed, the Greek word for
knowledge, eidenai, translates to “the state of having seen.”
49
In The Birth of the Clinic, Michel
Foucault argues that modern medicine is formulated by a particular type of looking—what he
deems the “gaze.”
50
A clinical professional is assumed to hold the ability to keenly observe the
body as an object, and subsequently relay the truth of that body in objective language.
51
In
modern medicine, pathology is understood to be observable if only the doctor knows how and
where to look.

47
Snorton, 143.
48
For more on the history of trans and queer people being held, involuntary, in psychiatric institutions, see Regina
Kunzel’s forthcoming book on the encounter of queer and gender-variant people with psychiatric treatment,
authority, and thinking.
Andrew Giambrone, “LGBTQ People Suffered Traumatic Treatments at St. Elizabeths Hospital for the Mentally
Ill,” Washington City Paper, May 31, 2018.
49
Martin Jay, Downcast Eyes: The Denigration of Vision in Twentieth-Century French Thought (Berkeley, Calif.:
Univ. of California Press, 1994), 24.
50
Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (New York: Vintage Books,
1994).
51
Foucault, xiv.

18
The gender clinics operated primarily on a visual economy. For example, in the case of
intersex infants, despite the clinic’s obsession with determining gonadal sex, chromosomal sex,
and hormonal sex, clinicians would often make decisions about gender assignment based on
genital appearance. As Katrina Karkazis writes in Fixing Sex: Intersex, Medical Authority, and
Lived Experience, “Perhaps the most important factor influencing clinicians’ decisions is their
own view of gender theories and etiologies: that is, their own beliefs about what makes us male
or female.”
52
Because the majority of clinicians were heterosexual men, they were deeply
concerned with penis size and the ability to engage in penile-vaginal intercourse, often deciding
to reassign an intersex infant based on phallus size alone.
53

When it came to selecting transsexual patients for surgery, clinician’s decisions were
highly informed by how they imagined the patient would look afterwards, that is, based on their
perceived ability to pass in their chosen gender post-surgery. A trans woman who was tall, had
broad shoulders, or was deemed too hairy would be denied on appearance alone. A prospective
patient who arrived in feminine attire, who carefully plucked her facial hair, and had a small
stature was much more likely to be approved. As stef shuster notes, “Appearance was taken so
much for granted in the patient intake process that therapists rarely offered explanations for how
appearance mattered in making their psychological assessments.”
54
Perhaps even more than the
psychological evaluation or the patient’s childhood history, appearance and the future ability to
pass, were what determined one’s access to treatment.

52
Katrina Karkazis, Fixing Sex: Intersex, Medical Authority, and Lived Experience (Durham: Duke University
Press, 2008), 99.
53
Karkazis, 100.
54
stef m. shuster, Trans Medicine: The Emergence and Practice of Treating Gender (New York: New York
University Press, 2021), 57.

19
Throughout this dissertation, I consider what it was like to be seen as a patient—to be
examined and scrutinized inside and out, diagnosed and treated, and recorded in case files and
referenced in scientific papers. Or, in case of patients who were rejected from treatment, what it
was like to be seen as a problem, as unworthy of care, and as a duplicitous trickster. I also think
critically about what the contemporary researcher can see in the archives of the gender clinics
and what is obscured due to restriction, redaction, and destruction of documents and case files.
Interestingly, the individuals who were seen as patients at the university-based gender clinics are
often hidden from view in the archives, with their files protected by patient-physician
confidentiality. Whereas the rejected patients’ attempts to access treatment, whether through
applications or letters, are visible to the contemporary researcher.
As a trans historian, I must grapple with the impetus to see parts of myself in the trans
patients I find in the archive. As María Elena Martínez writes, despite claims to objectivity,
historians ultimately decide what things to focus on, who to include, and the narrative structure
of the argument, not solely based on their training but through their life experiences and “the
memories, conceptual categories, and world understandings archived, living, and fluctuating in
the historian’s own body and psyche.”
55
For Martínez, writing history is an interpretive and
imaginative process that comes to reflect the embodied knowledges of the author. While this
project is undoubtedly shaped by my own experiences and perspectives, I also strive to see mid-
century transsexuals in their own terms, in all of their complexity and personhood.
Moreover, I am interested in a practice I refer to in Chapter 4 as “reversing the gaze.”
Visual studies scholar Nicholas Mirzoeff describes visuality as processes and mechanisms of

55
María Elena Martínez, “Archives, Bodies, and Imagination: The Case of Juana Aguilar and Queer Approaches to
History, Sexuality, and Politics,” Radical History Review 2014, no. 120 (2014): 171.

20
seeing that order and organize the world.
56
Visuality classifies, separates, and aestheticizes. It
first defines different types, then sorts these types into groups, and finally, makes these
classifications seem natural and right. We can think about the gender clinics engaging in their
own practice of visuality: establishing a nosology of sexual and gender difference/deviance
(differential diagnosis), sorting people into categories—true transsexual, transvestite, effeminate
homosexual, pseudohermaphrodite—and subsequently making these groupings seem like natural
categories of difference that clinicians were simply describing rather than producing. The gaze of
the clinic performs this discursive practice to regulate bodies and difference, creating real-life
material consequences for trans and gender diverse people. For Mirzoeff, the antidote to the
complex of visuality is the right to look—to return the gaze, to look back. Gender clinic doctors
held the authoritative power to look at, scrutinize, and classify so-called gender deviant patients.
Reversing the gaze is about looking back at the clinicians and scrutinizing their actions.
Finally, the right to look is defined by a kind of mutual seeing and recognition.
57
While
visuality is authoritarian, deciding who has the power to see, the right to look is about autonomy
and collectivity. “To Be Seen” enacts the right to look through what I call a methodology of care,
which is fully elaborated in Chapter 1. I ask readers to consider the implications of looking for
someone in the archive. What are the ethics of exposing stealth trans life? What are the benefits
of revealing/telling/preserving? A methodology of care is what Kara Keeling has described as
“looking after” rather than “looking for.”
58
For Keeling, “looking after” is a temporal process.
While looking for asks where someone is, looking after asks when someone might be. Looking
for invokes the scrutiny and surveillance of the gender clinics. Looking after is a creative and

56
Nicholas Mirzoeff, “The Right to Look,” Critical Inquiry 37, no. 3 (2011): 473–96.
57
Mirzoeff, 473.
58
Kara Keeling, “Looking for M—: Queer Temporality, Black Political Possibility, and Poetry from the Future,”
GLQ: A Journal of Lesbian and Gay Studies 15, no. 4 (2009): 565–82.

21
interpretive question which strives to imagine a different world in which someone’s visibility is
not fraught with violence and harm. A methodology of care honors the fugitivity and secrets of
gender clinic patients. It is a reading practice which allows archival actors to disappear in order
to be found.

A Note on Mrs. G (and Me)
Throughout the dissertation, in Chapters 1, 2, and 4, there is the reoccurring character of
Mrs. G (pseudonym), a transmasculine woman with a multi-decade relationship to UCLA’s
Gender Identity Research Clinic. Mrs. G is an exemplary case in the sense that her encounters
with UCLA align with the broader trends/habits of the gender clinics: involuntary (court-
mandated) treatment, racialized gender pathology, unethical research practices, and severe
patient/clinician power imbalances. Through Mrs. G, the larger themes I found across various
archives and geographies become grounded in a tangible story about a real person who lived and
survived the scrutiny and surveillance of the gender clinics. As I followed the archival grain, I
was brought back to her time and again.
Furthermore, Mrs. G is a central figure in this project because, on a personal level, she
captivated me. This dissertation is not a project without an author. As a white, queer, and
transmasculine scholar based in the U.S., my own story, interests, and investments shape this
text. In researching and writing this project, I felt a connection or kinship with Mrs. G. I am
reminded of Carolyn Dinshaw’s concept of the queer historical impulse, “an impulse toward
making connections across time between on the one hand, texts, lives, and other cultural

22
phenomena left out of sexual categories back then and, on the other hand, those left out of
current sexual categories now.”
59

The intricacies and details of Mrs. G’s life produced an affective response in me.
60
I
admired the way that, for years, she refused to surrender her masculinity despite Robert Stoller’s
best attempts to reform her. I saw myself in her recalcitrance. I also acknowledge that Mrs. G
remains elusive to me, that I only know what she told medical authorities. I don’t know her as
her children or friends did. Her clinical encounters cannot convey her joy or deepest wishes or
plans for the future. She kept secrets and told lies. She is always slipping away from me.
Finally, I will add that, after much consideration, I decided to use the pseudonym Mrs. G
rather than her legal name. In keeping with the ethos of “looking after,” it felt important to tell
Mrs. G’s story without exposing her true name. She was a person with a multitude of secrets,
many of them unknown to me. As she once said to Dr. Stoller, “If you knew everything about
me, you would be taking from me the things that have made it possible for me to survive.”
61
For
me, omitting her name is a gesture of care and a nod to her fugitivity.

Chapter Overview
This dissertation tells stories about the university-based gender clinics, from the patients
to the clinicians and researchers to the rejected patients. This is not an exhaustive or
comprehensive history of the gender clinics. Instead, it considers how transsexuality emerged out
of research linked to institutions of unfreedom. It connects transsexual etiology to racial and

59
Carolyn Dinshaw, Getting Medieval: Sexualities and Communities, Pre- and Postmodern (Durham: Duke
University Press, 1999), 1.
60
I understand affect to be not just feelings or emotions, but a sensory experience. Affect helps us make sense of the
world through a kind of body-based (rather than mind-based) knowing.
61
Robert J. Stoller, Splitting: A Case of Female Masculinity (New Haven: Yale University Press, 1997), 36.

23
evolutionary science, eugenics, and racial segregation logics. It appraises how stories about
transsexuality are reproduced and attempts to assert the utility of transsexuality for trans studies’
understandings of understanding norms, materiality, desire, and embodiment. The dissertation is
bookended by two chapters which explore methods and theories for trans studies. The middle
three chapters move semi-chronologically through the gender clinics: from the early years and
the emphasis on etiology (1958-1966), to the middle years and the shift to surgery (1967-1979),
and final to their eventual closing (1979-1980).
Chapter 1, “Writing Transsexual History: Methods and Approaches,” is about the
challenges that come with trying to write transsexual history from medical archives. I explore
questions of archival optics—of form and interpretation, of what makes it into official archives
and what gets excluded. I consider the practices of archival restriction, redaction, and destruction
as they relate to patient/physician confidentiality laws. The chapter takes seriously questions of
privacy asking, who is denied privacy and under what conditions? Who has the authority to do
that denying? And finally, who is protected by institutional privacy practices? In order to
understand where practices of institutional and personal privacy converge and diverge, the
chapter pays close attention to strategic secret-keeping, the institutional pressure to pass, and the
practice of living stealth.
“Writing Transsexual History” is about the rejected patients of the university-based
gender clinics and the paper trails they left behind alongside the accepted patients who left
nothing behind, pursing surgery at all costs—which often required a commitment to a secret and
stealth post-operative life. This chapter is a reflection on the project of writing trans history, or
searching for community across time, and of trying to constitute a “we” from an unruly and
heterogeneous group of people.

24
Chapter 2, “Racing for an Etiology: Involuntary Patients and the Psychiatric Clinic
(1958-1966),” is about the early days of the university-based gender clinics when doctors were
most concerned with finding a cause of transsexuality and a psychiatric treatment. The chapter
puts UCLA psychiatrist and gender researcher, Robert J. Stoller, in conversation with Daniel
Patrick Moynihan’s essay, “The Negro Family: The Case for National Action.” to highlight the
racial and colonial logics of the university-based gender clinics and their quest for an etiology. In
Stoller’s 1968 book, Sex and Gender: The Development of Masculinity and Femininity, he
proposes a theory of transsexual etiology in which a particular mother/child relationship results
in cross-gender identity. Both Stoller and Moynihan thought about pathology as a multi-
generation process and problem, understanding treatment to extend beyond the individual and
into the family structure and culture more broadly.
“Racing for an Etiology” provides examples of patients of color who made their way to
the gender clinics through institutions of unfreedom such as incarceration and psychiatric
detention. This chapter makes three key arguments. First, gender clinic patients were not all
white and middle class and many of them did not come to the gender clinics voluntarily. Some
clinic patients were detained in psychiatric facilities or court-mandated to receive treatment.
Second, understanding the prolonged, multi-generational temporality of Stoller’s theory of
transsexual etiology makes clear the connections between transsexual medicine, evolutionary
and eugenic theory, and racial science. And finally, Stoller’s theory of transsexual etiology
emerges alongside essays like Moynihan’s reveals the shared genealogy of U.S. sexology and
racial segregation.
Chapter 3, “Getting the Story Right: Transsexual Autobiographies and the Surgical Clinic
(1966-1979),” focuses on the gender clinics’ shift away from psychiatric treatment to a surgical

25
and hormonal model of treatment. While the early days of the clinics were about trying to find an
etiology, the later days of the clinics were about nosology, that is, establishing a clear differential
diagnosis for classifying and sorting patients. Clinicians and researchers, having failed to come
up with a clear cause of transsexuality and therefore unable to cure or prevent its onset, had to
adapt to a new approach—treating transsexuality after the fact.
In this chapter, I outline how the diagnostic criteria developed by the university-based
gender clinics relied on four factors: temporality (how long the person was cross-gender
identified), sexuality (with a preference for post-transition heterosexuality), risk (a broad
category defined by the doctors’ concerns about a patient’s potential to sue or harm them), and
success (the ability to live a productive and passing post-transition life). Through a reading of
transsexual autobiographies, I demonstrate how the racial demographics of the patient population
at the clinics shifted from patients of color to white patients because they were deemed more
likely to “succeed” by assimilating into heterosexual society and living productive lives under
racial capitalism.
Chapter 4, “Looking Back: Secrets, Scandals, and the End of the Gender Clinics (1979-
1980),” is about how, by 1980, the majority of the university-based gender clinics were no longer
operational. It provides an account of why the clinics closed, focusing on four main themes:
changing cultural attitudes towards medicine and psychiatry, doctor in-fighting, financial
problems, and the rise of private practice clinics. In each of these sections, I explore publicly
documented reasons for the clinics closing, as well as behind-the-scenes scandals and gossip
which offer complementary and/or contradictory accounts of what really happened.
This chapter traffics in gossip, telling stories about interpersonal conflicts between the
doctors, allegations of child abuse, and misuse of research. I take seriously gossip as a legitimate

26
form of discourse which subvert binaries such as legitimate and illegitimate and objective and
subjective. By focusing on the clinics’ scandals, I reverse the gaze, turning the eye of scrutiny so
often applied to patients back on the practices and motivations of doctors themselves.
Chapter 5, “Transsexual Knowledges,” argues that trans people were active participants
in the production of medical knowledge about transsexuality. Following the stories of three
influential mid-century trans individuals, this chapter thinks about transsexuals as sexologists.
Michael Dillon, widely known as the first trans man to undergo a phalloplasty, was also a doctor
who authored the textbook, Self: A Study in Ethics and Endocrinology, which, in addition to
providing an overview of endocrinology, offers a forceful appeal for gender-self determination.
Dillon creating a nosological schema for understanding sex, gender, and sexuality well before
Benjamin’s Transsexual Phenomenon. Louise Lawrence, a transvestite activist in San Francisco,
was a social hub for connecting trans people and doctors, through pen pal programs, support
groups, and hosting people in her house. She also collected and transcribed case histories for
Alfred Kinsey and gave lectures to doctors at the Langley Porter Clinic. Reed Erickson, a
wealthy trans man and philanthropist, operated the Erickson Education Foundation which
referred trans people to doctors in their local area, published informational pamphlets, and
interfaced with the media to expand knowledge about trans issues. Erickson was personally
responsible for funding some of the university-based gender clinics (e.g. Johns Hopkins) or
individual doctors who worked at them (e.g. Donald Laub at Stanford).
This chapter asks, what happens to our understanding of trans medicine/therapeutics
when we see transsexuals as active participants in and authors of the diagnoses and treatment
protocols that still dominate trans medicine? When transsexuality is understood as a knowledge
project created by white colonial cisgender men in the service of bad projects (segregation,

27
racialization, disenfranchisement), a generation of transsexuals came to be seen as the dupes of
said project.
62
Believing that trans medicine was created and imposed on trans people also erases
the direct efforts and struggles of individuals like Dillon, Lawrence, and Erickson who worked to
shape trans therapeutics and medical access.
“To Be Seen: Transsexuals and the Gender Clinics,” argues that a thorough examination
of transsexuality—as a category, an identity, and an act—can teach trans studies about the
racialized history of (trans)gender, how norms operate, what it feels like to have a body that is
seen and mis-seen, and how the production of knowledge is a complicated, dynamic process that
occurs from both above and below. Through the history of the university-based gender clinics, I
endeavor to trace the development of transsexuality and its many manifestations and meaning.
This project holds dearly trans ancestors—transcestors—and labors to make their stories of
resistance, fugitivity, survival, and brilliance known.

62
Cisgender is a term used to refer to people who identify with and live as they gender they were assigned at birth,
as opposed to transgender people who may identify with or live as a gender different than the one they were
assigned at birth. Cisgender is sometimes shorted to “cis.”

28
Chapter 1
Writing Transsexual History

“What would convince a biologically normal woman that she had a penis? How does one go
about finding out? How reliable is the information one collects?” ––Dr. Robert J. Stoller
1

This story begins with a woman named Judy Van Maasdam. In 1969, she arrived in the
California Bay Area.
2
She was a young mid-western woman trained in medical social work.
Through a referral from a friend, she was interviewed by Dr. Donald Laub for a position at
Stanford University. Laub had just founded Stanford’s Gender Dysphoria Program (GDP) and
needed a program coordinator. Van Maasdam had no past experience working with transsexual,
transvestite, or gender-deviant patients. She was offered the job. She would work with Laub for
the next twenty-five years, following him into private practice. For decades, the two worked side
by side, selecting and rejecting trans patients for surgery and treatment. When historians describe
the gatekeeping practices of transgender medicine in the mid-twentieth century, they are
describing individuals like Van Maasdam. I have chosen to begin this story with her because my
own story begins with her.
In 2013, I began looking around the internet for information about surgeons who perform
what is colloquially known as gender-affirming “top surgery”—in my case, a bilateral
mastectomy and nipple reconstruction. After sleuthing through countless blogs, I decided to
contact Brownstein & Crane Surgical Services in Marin County, California. Before confirming
my surgery date, the receptionist informed me that there was just one little thing missing from
my file: a psychiatric evaluation. At that time in my life, I was not seeing and had never seen a
psychiatrist or psychologist. Who would write my letter? The receptionist told me to contact the

1
Robert J. Stoller, Splitting: A Case of Female Masculinity (New York: Quadrangle Books, 1973), xiii.
2
Judy Van Maasdam, June 13, 2017.

29
Gender Dysphoria Program, Inc. “They do psychological evaluations for most of our patients,”
they told me. I called the number the receptionist provided and there was no answer. The strange
thing was that the answering machine was for a woman named Judy Van Maasdam. Confused, I
googled “Gender Dysphoria Program, Inc.” and sure enough, the number the receptionist had
provided matched the number listed online. When Van Maasdam returned my call, she informed
that she was all that remained of the Gender Dysphoria Program. What used to be a full clinic for
trans healthcare was now only her, providing psychological evaluations from her home in
exchange for a $75 donation to the program.
Van Maasdam emailed me an eleven-page evaluation, which included questions such as
“Briefly describe what you think your problem is” and “What were your earliest fantasies about
sex?” I filled out the form, carefully communicating a sense of certainty about my gender. I
knew it was important to emphasize the longevity and ever-present aspects of my gender
identity.
3
I do not know where this knowledge came from—perhaps from my young-adult years
spent on transition blogs, learning through other people’s experiences of navigating the gender-
affirming medical matrix. Maybe it was something that I instinctively surmised from the
speculative question—“Is it just a phase?”—that haunts popular discourse on transness. By
pointing to my early childhood and adolescent masculinity, I was providing the clearest evidence
possible that this was, in fact, not just a phase. Following the written evaluation, Van Maasdam
and I had an hour-long Skype interview. I smiled a lot, trying my best to convey myself as a
well-adjusted, stable person—no need to worry about me. I mailed her a check, and in turn, she
mailed a letter of support for my surgery. My appointment was confirmed.

3
This technique is common in trans autobiographies, with the author including childhood photographs or stories in
which they are dressed “as the opposite sex” or engaged in activities that suggests gender expressions/mannerisms/
tendencies that differ from the gender they were assigned at birth. These early forms of childhood gender play
captured in vignettes or photographs are offered as “evidence” of the author’s true gender.

30
The surgery took place after the first semester of my PhD. I had given little thought to the
procedure ahead of time, too preoccupied with end-of-semester papers and deadlines. I expected
to feel nothing other than relief—this is what I had always wanted. But, in a twist of
(transsexual) irony, what came wasn’t quite relief; it was something akin to, but not exactly, joy.
4

In some moments, for example, as I looked down at my chest to see the incision lines the
surgeon had marked in purple prior to surgery, I felt sadness. I did not know who to share this
melancholy feeling with—it felt like a misplaced emotion.
5
Lacking the words to describe the
contradictions and complexities I was feeling, along with the fact that I had few people in my life
who shared this experience with me, I began to write about the pursuit and experience of altering
one’s body through surgical and/or hormonal means. I was pulled by some impulse to understand
more about the story of medicalized sex change—of what happens in the operating room, what
precedes it, and all that follows it.
6
This was the beginning of a new direction for my work, and
one that would become a project leading me right back to Van Maasdam.

4
For more on transsexual irony and satire see: Andrea Long Chu and Emmett Harsin Drager, “After Trans Studies,”
Transgender Studies Quarterly, 103-116, 6, no. 1 (2019).
5
Following the publication of Andrea Long Chu’s opinion piece “My New Vagina Won’t Make Me Happy” in the
New York Times, debates broke out on the internet (Twitter, blogs, etc.), about how much trans people should share
their complex emotions and experiences around transition. The bulk of the critique of Chu was about the fact that
she had chosen to publish this piece in a mainstream newspaper with large circulation and readership. Trans folks
argued that it is okay to have these conversations amongst ourselves, but that it is best not shared with the rest of the
world, in case our conflicting feelings about surgery are used as a means to deny us treatment. See: Katelyn Burns
“It’s Time to Retire the Media’s Sad Transgender Trope” and Julia Serano’s twitter thread from November 24, 2018.
Andrea Long Chu, “My New Vagina Won’t Make Me Happy,” The New York Times, November 24, 2018; Julia
Serano (@JuliaSerano), “Gonna Write More about This Soon,” Twitter, November 24, 2018,
https://twitter.com/JuliaSerano/status/1066506913704099840; Katelyn Burns, “It’s Time to Retire the Media’s Sad
Transgender Trope,” Rewire.News (blog), November 26, 2018, https://rewire.news/article/2018/11/26/its-time-to-
retire-the-medias-sad-transgender-trope/.
6
The idea of being pulled or compelled to reach out and touch the past is inspired by Carolyn Dinshaw’s “queer
historical impulse.”
Carolyn Dinshaw, Getting Medieval: Sexualities and Communities, Pre- and Postmodern (Durham: Duke
University Press, 1999).

31
Form and Meaning
As a trans
7
studies scholar, my archival and historical research is always entangled with
questions about the possibilities and limits of searching for “trans” in the past. “Trans” holds a
variety of meanings. It is an identity, a descriptor of certain kinds of bodies, an umbrella term for
gender variance, an analytic, and a movement of crossing. Because of the relatively recent
emergence of “transgender” in the early 1990s and “transsexual” only a few decades before that,
the project of looking for trans in the past requires us, as scholars, to be self-reflexive about what
exactly we are looking for.
8
K.J. Rawson explains: “In the context of historical research, this
very recent and geographically specific emergence of transgender means that we must always be
mindful of how we are imposing an identity category onto pasts in which that identity is
anachronistic and onto places where that identity is foreign.”
9
I recognize the impulse of trans
scholars to search for people in the past who may have looked and lived like us; however, in this
impulse to excavate trans pasts, we must remain cognizant of the fact that this project of looking
is always about looking for ourselves. We look in order to be found.
This chapter is about challenges that come with trying to write transsexual history from
medical archives. I explore the practices of archival restriction, redaction, and destruction as they
relate to patient/physician confidentiality laws and the trans practice of stealth.
10
I probe
questions of archival form and interpretation, and I consider the role of secrecy and secret-

7
Throughout this chapter, I will be using “trans” as an umbrella term to encompass genders that exceed the colonial,
cisheteropatriarchal, two-gender binary system (e.g., trans studies, trans scholars). Terms like “transgender,”
“transsexual,” or “genderqueer” are used to refer to specific identity categories with their own sets of meanings. I
use “transsexual” to refer to individuals who seek medical forms of transition (e.g., sex reassignment surgery,
hormone replacement therapy, and facial feminization surgery).
8
Cristan Williams, “Transgender,” Transgender Studies Quarterly 1, no. 1–2 (2014): 232.
9
K.J. Rawson, “Introduction: An Inevitably Political Craft,” Transgender Studies Quarterly 2, no. 4 (2015): 544–
552.
10
Stealth is a term that refers to when trans people pass and conceal their trans identity. While “passing” has a
shorter temporality—one can pass for an afternoon, on a certain occasion, in a moment of danger—stealth implies
living long-term with your trans status concealed, potentially from employers, friends, coworkers, lovers, etc.

32
keeping in trans history. In order to understand where practices of institutional and personal
privacy converge and diverge, I am attentive to which items make it into official archives and
which ones do not. I consider the rejected patients of the university-based gender clinics and the
paper trails they left behind alongside the accepted patients who left nothing behind, pursuing
surgery at all costs—which often required a commitment to a secret and stealth post-operative
life. This chapter is about when archives get destroyed and lost, and then perhaps found again.
I am interested in these questions of privacy—of who is denied privacy and under what
conditions, of who does the denying, and who is protected by institutional privacy practices. I
ask readers to the consider the implications of looking for someone in the archive. What are the
ethics of exposing stealth trans life? What are the benefits of revealing/telling/preserving? In this
extended meditation on archival methods, I reflect on this project of writing trans history, of
searching for community across time, and of trying to constitute a “we” from an unruly and
heterogeneous group of people.
In the case of gender clinic archives, the individuals who are rendered visible are
generally those who did not receive care or treatment. Once individuals were accepted into a
gender clinic program, their files became protected by a web of medical privacy policies. In
addition to official laws, gender clinics oftentimes mandated that a patient live a secret and
stealth post-operative life in order to qualify for treatment. Official gender clinic archives, such
as the Robert J. Stoller papers, have removed patient files and restricted them from public access.
Archives that have remained in private possession have mostly been destroyed. The patients
disappear from the archive, only known to us if their stories are published in books under
pseudonyms or if they wrote an autobiography of their own. What we are left with in the
archives are the rejected patients, the not-quite-fit-for-treatment, the pathologically devious.

33
In Along the Archival Grain, Ann Stoler argues for regarding archive-as-subject, rather
than archive-as-source—that is, attending to the form and function of archives as much as to
their content.
11
In order to do so, she suggests we treat archival research as a kind of ethnography
in which we pay attention to the form of the archive, reading along its grain. Being attentive to
the form of the archive requires us to ask questions about why certain documents were produced,
what purposes they served, and how they contribute to the workings of the structure in question
(e.g., a colonial administration, a gender clinic). When we mine archives simply for their content,
we tend to overemphasize exemplary documents, missing the broader patterns and habits of
documentation and what they can teach us.
The practices of restriction, privacy, stealth, and destruction have led to an archival optics
in which some individuals are rendered invisible while others are made hypervisible, on display
for interpretation. In my work, I try to remain attentive to form, to the contours of the archive, to
what it both reveals and conceals. I search for larger patterns of documentation, following along
the archival grain. Throughout this dissertation, I highlight certain individuals and case files not
because of their sensationalism, but because of how they capture broader trends in the archive.
I argue that transgender studies is in need of a fresh set of reading practices that can
account for the challenges that come with archives full of secrets, mediations, and intentional
evasions. Transsexual archives are unruly—like a prospective patient in an intake interview, they
may tell one story while living an entirely different one. This chapter is an attempt to think
through what an effective reading practice might look like, along with providing examples of the
ways that our taken-for-granted assumptions about trans pasts are challenged when we read
differently.

11
Ann Laura Stoler, Along the Archival Grain: Epistemic Anxieties and Colonial Common Sense (Princeton, NJ:
Princeton University Press, 2009).

34

The Case File
In 1957, Dr. Robert J. Stoller and Dr. Robert Geertsma, both professors of psychiatry at
the University of California Los Angeles (UCLA), walked into the L.A. County Hospital to film
interviews with psychiatric patients to use for medical students’ clinical evaluations.
12
One of the
patients they would interview was a young, twenty-something-year-old woman with an already-
thick medical and legal case file that included check fraud, car theft, homicidal thoughts, and
armed robbery. In addition to her run-ins with the law, her gender appearance and
comportment—men’s clothes, a short haircut, and an insistence that she possessed both a penis
and a vagina—interested the doctors. The clinical relationship between Stoller and this woman,
sometimes referred to as “Mrs. B” and other times as “Mrs. G,” would continue for the next
fourteen years, with Mrs. G’s history providing the “evidence” for many of Stoller’s theories on
female masculinity, transsexual etiology, and gender identity.
13

After meeting Mrs. G, Stoller founded the UCLA Gender Identity Research Clinic
(GIRC) in 1962 with his colleagues Ralph Greenson and Richard Green.
14
This clinic, along with
many other university-based gender clinics, operated throughout the 1960s and 1970s, an era that
trans historian Susan Stryker refers to as the “big science period of transgender history.”
15
The
GIRC generally did not recommend or approve surgical interventions, except in rare cases, often

12
Stoller, Splitting, 1.
13
When writing about Mrs. G, I have struggled to decide which pronouns and gender descriptors to use. From Mrs.
G’s therapy transcripts, it seems like she most identified as a woman with a penis. For this reason, I will be using the
pronouns she/her/hers throughout.
14
Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge: Harvard
University Press, 2002), 126.
15
Susan Stryker, Transgender History (Berkeley: Seal Press, 2008), 93.

35
when the clinicians (falsely) believed the patient to have an intersex condition.
16
Using a
psychiatric approach, the GIRC was focused on reforming non-normative gender expressions in
childhood in order to prevent transsexuality in adulthood. While the majority of the clinic’s
patients were effeminate young boys, UCLA was unique in the fact that the GIRC was also
interested in female-to-male (FTM) transsexuals, or as Stoller referred to them, “female
transsexuals.” In Joanne Meyerowitz’s history of transsexuality in United States, How Sex
Changed, she writes about the uniqueness of UCLA’s interest in FTMs:
At the end of the 1960s, doctors at UCLA’s Gender Identity Research Clinic debated
privately as to whether FTMs even qualified as transsexuals. From 1968 to 1970 they
held at least fifteen meetings devoted to FTMs. Stoller wondered ‘whether there should
be such a diagnosis as transsexualism for females.’ After twelve years of treating FTMs,
he could not find ‘etiological events which hold from case to case or even a very
consistent clinical picture, other than the raging desire to become a male.’
17

Mrs. G was one of the primary case histories that shaped Stoller’s scholarship on female
transsexualism.
18
During this time period, from 1968 to 1970, he was working on a manuscript
that would become his book Splitting: A Very Masculine Woman. Mrs. G is the central character
of the text.
The Stoller Papers comprises 90 linear feet of materials that span the thirty-plus years
Stoller worked in the department of psychiatry at UCLA. Because of the untimeliness of
Stoller’s death, he was not involved in organizing his materials into an official archive, which is

16
In the early days of gender clinics, aspiring patients would often mislead doctors to believe that there was a
biological (e.g., hormonal or gonadal) reason for their cross-gender identification. By claiming intersex status, their
cross-gender identity was framed as an error of nature rather than a personal deficiency or defect.
17
Meyerowitz, 149.
18
The great paradox of Mrs. G is that she was likely not a transsexual, in the sense that there are no indications that
she pursued sex-reassignment surgery, wished to live full time as a man, or self-identified with the term. However,
her case study was highly influential for Stoller’s theories of both MTF and FTM transsexuality. Over the years,
Stoller referred to Mrs. G in many different ways: “a very masculine woman,” “a bisexual mother,” “a female
transsexual.” The identity of “woman with a penis” defied and exceeded researchers’ understandings of sex and
gender.

36
evident in this unredacted collection’s abundance and disorganization.
19
The sheer size of the
archive, paired with the scarcity of information provided on the finding aid, left me randomly
selecting boxes from the library storage facility during my research. One afternoon, while sifting
through a cardboard box full of unfiled papers, I came across one of Stoller’s drafts of Splitting.
As I pored over the recalcitrant transcripts of Mrs. G’s therapy sessions, I felt like I had found
pieces of myself—of my masculinity and my gender certainty and my defiance. I spent the next
few months reading every file I could on Mrs. G. I wanted to make a timeline out of the bits and
pieces of her life that I could gather from the transcripts. However, the more time I spent with the
transcripts, the farther away from Mrs. G I felt.
The case file as a genre symbolizes the intervention of institutions and the state in the
lives of people “with the purpose of supervising, treating, punishing, servicing, and/or reforming
individuals or groups deemed in some way deviants or victims.”
20
The modern clinical case file
emerged during the eighteenth century, in tandem with European state-formation and population
growth.
21
The need to discipline and regulate the population led to an increase in record-
keeping.
22
This record-keeping occurred not only on an institutional level, but also on an
individual level through the case file. As Mike Featherstone writes, “This was a new form of
power, based not on the ideology of individualism, but the actuality of individuation, as whole
populations, their bodies and life histories became documented, differentiated and recorded in

19
Chase Joynt and Kristen Schilt, “Anxiety at the Archive,” Transgender Studies Quarterly 2, no. 4. (2015): 639.
20
Franca Iacovetta and Wendy Mitchinson, On the Case: Explorations in Social History (Toronto: University of
Toronto Press, 1998), 3.
21
Mike Featherstone, “Archive,” Theory, Culture & Society 23, no. 2–3 (2006): 591.
22
Michel Foucault, History of Sexuality, Volume 1 (New York: Vintage Books, 1978); Michel Foucault, “17 March
1976,” in “Society Must Be Defended”: Lectures at the Collège De France 1975-1976 (New York: Picador, 2003),
239–64.

37
the archive.”
23
For trans studies scholars, the medical case file is one of the main avenues for
finding out information about trans pasts.
Lauren Berlant has argued that the case file is the primary tool of biopower.
24
For Berlant,
the case file as a genre takes the singular and makes it the general in order to establish the
normative: “It is a genre that organizes singularities into exemplary, intelligible patterns,
enmeshing realist claims (x really is exemplary in this way) with analytic aims (if we make a
pattern from x set of singularities we can derive y conclusions) and makes claims for why it
should be thus.”
25
For Berlant, scholarship on case files should raise questions about the ability
of a single object to be spun into an explanation of something bigger. Berlant operates under the
rubric that the case file must be reworked, and because the case file operates through claims to
realism, we must rework not only the case file, but also realism itself.
However, in the context of psychiatric clinics like GIRC, these case files are not like the
bureaucratic collection of data that one might see in juridical or governmental contexts (e.g.,
census reports, arrest records, and population data); rather they are case studies, what Warwick
Anderson would refer to as “modernist short stories.”
26
For Anderson, it is important to
distinguish between the case file and the case study. While the case file systematically measures
and records information about individuals for bureaucratic administrations, the case study
operates differently—it emphasizes the clinical encounter. By providing a narrative of the
interaction between patient and analyst, the case study has the potential to operate as a counter-
discourse. Anderson writes, “Indeed, these ideographic case studies convey the impression of
resisting, perhaps even subverting, the bureaucratically serviceable, and hence nomothetic, case

23
Featherstone, 592.
24
Lauren Berlant, “On the Case,” Critical Inquiry 33, no. 4 (2007): 663–672.
25
Berlant, 670.
26
Warwick Anderson, “The Case of the Archive,” Critical Inquiry 39, no. 3 (2013): 532–547.

38
file.”
27
Case studies are lengthy, subjective, and full of narrative. They expand the scope of the
file beyond the individual in question, as case studies interpolate an(other): the author/narrator.
What are the complications and issues that emerge when working with transsexual
clinical case studies, specifically in relation to Mrs. G and the UCLA GIRC? Knowing the power
dynamics that are present when institutions intervene in and regulate individual lives, is it
possible for us to reroute these power dynamics by reading against the grain of the case study? If
so, how might we understand this practice in relation to Stoler’s call to read along the archival
grain? What methodological approaches might allow us to read through or across the layers of
mediation? Can a case study such as Mrs. G’s be read as a counter-discourse? I contend with
these questions in order to address some of the main issues—translation, restriction, and
secrecy—that come about when reading a case study.

Restriction and Destruction
In the Stoller Papers collection, there are countless boxes with letters, autobiographies,
and photographs of prospective patients, writing to Stoller in the hopes of being admitted to
UCLA’s GIRC. These individuals often appear desperate for some kind of help. One such person
is Rosy Son of Rosa: “My mother Rosa was born in 1923, and she married an accountant man in
1942 when she was still 19 years old. She was pretty and nice-looking and considered as [sic]
very attractive by the neighborhood. The next year of her marriage in 1943 when she was 20, I
have [sic] born, and they registered me as RAZINE.” She writes about the death of her father at
age ten, about her mother turning to sex work to support the two of them, and eventually, Rosy
turning tricks with her mom to make money. She describes the loss of her virginity and learning

27
Anderson, 535.

39
to find pleasure in, what she calls, her homosexual desire. Parallel to the narrative arc of her life,
Rosy tells the story of her body. She says, “I suffer from a defect in my sexual organs.” She
describes a missing scrotum, undescended testicles, and a too-small penis. She recounts the
process of growing up and growing into a feminine form, with smooth hairless skin and feminine
breasts. Rosy attaches a photograph to her four-page letter as a kind of evidence, as if to say,
“See? Don’t I look like a woman?” She signs her letter as “Rosy Son of Rosa.”
Her letter was given to Dr. Stoller by Dr. Willard E. Goodwin, a urologist at UCLA. The
memo attached to it reads “PERSONAL” in red ink. Stoller’s response to Goodwin was short.
He wrote, “I find it a little hard to believe, though it is not impossible that this person could have
been through all of this. I would be curious to know why ‘she’ wrote to you; if the story is true
this would be quite a patient to investigate psychiatrically.” From the fact that the letter and
photograph remain public in the archive, I can assume that Rosy was never accepted as a patient
of the UCLA GIRC. If she had been, her papers would not be visible in the archive. Instead, they
would be sequestered away in a case file in some restricted box, protected by patient-physician
confidentiality.
In contrast to the story of Rosy Son of Rosa, there are patients like Mrs. G, whose files
have been removed from the collection and placed in restricted boxes. Only a single paper is left
in their place:
Removed from: box 36, folder 1
Transferred to: box 91, folder 1
Date on items: 1969-1982
Patient record, personal financial matter, other: personal
Date processed: 3/31/1997
Processor: RJ

This small notice provides us with a wealth of information. The items were removed because an
archivist, RJ, classified them as official patient records. They were also deemed to be of a

40
“personal” nature, something interesting to consider alongside Rosy’s materials, which were also
labelled as “personal,” presumably by Dr. Stoller’s secretary who wrote the memo on top of the
letter. What makes these two kinds of “personal” different? Why does one prompt restriction and
the other not?
The idea of patient-physician privilege—that is, the mandate that a doctor keep the
identity and details of their patients’ lives and health secret, has been a central tenant of Western
medicine since antiquity.
28
The Hippocratic Oath, a code of Greek medical ethics authored
around 275 AD, continues to be the professional standard for physicians around the world. In
addition to its famous tenant of “do no harm,” the oath also outlines a commitment to patient
privacy. It declares, “Whatever I see or hear in the lives of my patients, whether in connection
with my professional practice or not, which ought not to be spoken of outside, I will keep secret,
as considering all such things to be private” (emphasis mine). At the core of Western medicine,
there has always been the notion that quality care depends upon the patient’s ability to trust their
doctor with the details of their life and health.
Following the violent medical experiments committed by the Nazi Party, the World
Medical Association met in Geneva in 1948 where they adopted the Declaration of Geneva, a
medical oath that outlines a doctor’s duty to provide equal and quality care to patients regardless
of race, class, and creed.
29
The original Declaration of Geneva states: “I will respect the secrets
which are confided in me.” Twenty years later, in 1968, this line was expanded to include the
phrase, “even after the patient has died.” This act of extending the mandate of secrecy beyond

28
John C. Moskop, Catherine A. Marco, Gregory Luke Larkin, Joel M. Gelderman, and Arthur R. Derse, “From
Hippocrates to HIPAA: Privacy and Confidentiality in Emergency Medicine—Part I: Conceptual, Moral, and Legal
Foundations,” Annals of Emergency Medicine 45, no. 1 (2005): 53–59.
29
The Declaration of Geneva and its emphasis on quality and humane treatment for all regardless of race, class, and
creed was a direct response to Nazi Germany’s ideology of racial hygiene, eugenics, forced sterilization, mass
genocide, and inhumane scientific experiments. The Nuremburg Codes were established in the aftermath of WWII
to enforce standards of treatment and informed consent.

41
death has the effect of extending privacy beyond the patient to the doctor. I argue that this
additional phrase broadens notions of patient-physician privilege beyond the original mandate,
which was crafted to protect the reputation of the patient. It now extends into the realm of the
doctor and their reputation.
These oaths and declarations create a category of protected personhood: the patient. In
order to be a patient, one must have access to care, be deemed worthy of care, and/or to be able
to afford that care. In turn, this care comes with a special status of protection. Identities are
concealed through pseudonyms and redaction. But this protection also comes with a form of
erasure.
In June of 2017, two years after my top surgery and four years after my first Skype
meeting with Van Maasdam, I travelled to Mountain View, California, to meet with her in
person. I wanted to interview her about the Stanford GDP, which had severed its ties with the
university in 1980. When the GDP went into private practice, they took their records with them.
For this reason, Stanford has no official archive or repository of information about the clinic.
Van Massdam lives in a one bedroom, one bath apartment. The space is simple and
unremarkable. I see no indication of her travels around the world for transgender health
conferences. There are no souvenirs or tchotchkes on display. There are no photographs on the
wall of children or grandchildren; Van Maasdam has none. The only room with personal flair is
the bathroom, adorned with pink towels and rugs and a Marilyn Monroe poster.
When I arrive, Van Maasdam is frazzled. She is putting away groceries. She opens a Diet
Coke and a package of store-bought sushi that she eats while we chat. She puts on a hip-hop XM
radio channel; she tells me she likes rap. Van Maasdam is a talker. She moves quickly from topic
to topic, never pausing long enough for me to jump in. It’s hard to get a word in, and when I do,

42
it is not uncommon for Van Maasdam to interrupt me mid-sentence to correct or elaborate on
something I am saying.
I ask her to tell me about how she got involved with the Stanford Gender Dysphoria
Program and the history of the early days of the clinic. At one point, during a discussion about
the first sex reassignment surgery she was involved with, Van Maasdam goes to retrieve a white
three-ring binder from her bedroom. She tells me, “I have destroyed most of the records, but I
still have Dr. Laub’s gender cases and my old stuff from the old days, just names. I can check the
year.”
“You said you destroyed most of the files?” I ask.
Van Maasdam’s response is short: “Yeah, I had to. I mean yeah, we had to.”
I clarify, “With all of the patient information?”
“Yeah,” she confirms, “You can’t keep that stuff from the old days.”
I am interested in what compelled Van Maasdam to shred most of the clinic files. Why
did she find this destruction to be necessary? Of course, there are laws about patient privacy, but
none of those laws mandate the destruction of materials. What was the impulse behind erasing
records from a moment in history that, as Van Maasdam and I agree, was groundbreaking? It’s
not that she is unaware of the historical value of these records. She tells me she is regularly
contacted by trans archivists like Aaron Devor, the director of the Transgender Archives at the
University of Victoria, asking her to donate her materials. Van Maasdam constantly sings the
praises of Dr. Laub. Why wouldn’t she want to preserve his legacy?
When it comes to question of privacy as they relate to the patients of the gender clinics, it
is essential to consider Van Maasdam’s claims of benevolent identity protection alongside the
clinical mandate to live a stealth post-operative life. University-based gender clinics in the 1950s

43
and 1960s were invested in creating normatively gendered individuals. Regardless of whether
they approached the problem of gender deviance through psychiatric or surgical approaches, the
intended outcome of therapeutic intervention was to reform what was considered to be an
unacceptable gender identity/expression/body/life. This process of reform and assimilation was
contingent on the silence of the transsexual. For example, if an individual was approved for
surgery at Stanford, they were expected to live a stealth post-operative life in which nobody was
to know of their gendered past. Photographs were to be destroyed, social ties cut, and histories
erased in order for the patient to be able to go forth and live a “normal” life.
30

In the book In Search of Eve: Transsexual Rites of Passage, Anne Bolin conducted two
years of ethnographic research with transsexual women and members of the Berdache Society in
the 1970s.
31
The thesis of her book revolves around the notion that transsexual transition is a
“rite of passage” in which transsexual women make meaning out of their journey from one sex to
the other. Following Arnold Van Gennep’s theory of rites of passage, which outlines three
stages—separation, transition, and incorporation—Bolin asserts that the final act of the ritual is
one of incorporation or, in other words, assimilation: “Their passage is one into normalcy, where
after the surgery, they can disappear into their culture as natural women.”
32
She adds,
“Transsexuals eventually cease affiliation with their transsexual sisters and leave the Berdache
Society.”
33
Because Bolin’s ethnography took place during the years of the university-based

30
In May of 2017, the NPR podcast Hidden Brain published an episode titled “The Fox and the Hedgehog,” which
featured Stanford surgeon Donald Laub. As the episode highlights, the reoccurring theme of Laub’s career was a
dedication to helping people live happy lives. However, his definition of happiness was quite narrow due to his
Catholic, mid-Western upbringing. For Laub, normalcy, conformity, and inconspicuousness are preconditions to
happiness. This informed how he operated the Stanford Gender Dysphoria Program.
Hidden Brain, “The Fox And The Hedgehog: The Triumphs And Perils Of Going Big,” NPR, accessed May 15,
2017, https://www.npr.org/2017/05/15/528041635/the-fox-and-the-hedgehog-the-triumphs-and-perils-of-going-big.
31
Anne Bolin, In Search of Eve: Transsexual Rites of Passage (South Hadley, Mass: Bergin & Garvey, 1988).
32
Bolin, 9.
33
Bolin, 10.

44
gender clinics, I find her insights to be useful in that they highlight the dominant medical
narrative of the time: in order to enter a kind of “natural” or “real” womanhood, the transsexual
was expected to disappear. Indeed, the first step of transformation is separation, premised on the
belief that the transsexual rite of passage demands a severing from the past.
In this context, we can see how patient-physician privilege and the mandate of secrecy
advanced the goal of invisible, unknown, and stealth transsexual life. I am interested in the fact
that silence was not only mandated at the time through rules around post-operative passing and
stealth but continues to be maintained through claims to protected identity. When the revisions to
the Declaration of Geneva were made in 1968, by adding the phrase “even after the patient has
died,” the mandate for transsexual stealth life was extended in perpetuity. Transsexuals were not
to be seen in the present nor in the future. Transsexuals, in fact, were meant to disappear entirely.
One way of measuring the ability of a patient to pass and live stealth came in the form of
what was called the “real-life test” (RLT). The RLT required an individual to live full-time in
their desired gender identity for two years prior to surgery.
34
This test was meant to demonstrate
that the individual could navigate the world in their “new” gender. Most importantly, this
navigation was dependent upon maintaining employment and being self-sufficient. If an
individual could find employment and support themselves pre-operatively, it was assumed that
they would be even more successful after surgery.
In his essay, “Normalized Transgressions: Legitimizing the Transsexual Body as
Productive,” Dan Irving compares the assessments of transsexual viability to discourses of
productivity.
35
Irving argues that when employment, income, and wealth are addressed in trans

34
This would later be reduced to one year and eventually eliminated as a requirement for many care providers and
surgeons.
35
Dan Irving, “Normalized Transgressions: Legitimizing the Transsexual Body as Productive,” Radical History
Review 100 (2008): 38–59.

45
studies literature, it is most often to discuss the abject poverty of the transsexual subject, failing
to acknowledge the entwined histories of transsexual medical intervention and capitalist
discourse. Irving highlights how social recognition is predicated on a productive working body:
The Hippocratic oath extended beyond their professional obligation to heal individual
patients to encompass a broader sense of civic duty. In other words, doctors understood
their professional obligation to restore health to individuals as part of a broader
imperative to act as moral, upstanding citizens. As physicians, their value lay in
contributing to the vitality of the nation. In the case of physicians who adamantly refused
to engage in medical transition processes, this contribution was realized through
relegitimizing the normatively sexed and gendered body (i.e., one biologically genetically
determined) as ‘the’ productive body.
36

What interests me about Irving’s article is the argument that the Hippocratic Oath
understands doctor responsibilities to extend beyond the clinical setting. In this view, it is not
only the doctor’s responsibility to analyze a patient but also to reform the patient into a citizen.
Many times, doctors determined the individual was not worthy of treatment and/or was not
capable of reform, which, under Irving’s rubric, meant the rejected patient was seen to be unfit
for productive citizenship and incorporation into the body politic.
The doctors of early gender clinics came together to write the Standards of Care (SOC), a
guide to “the hormonal and surgical sex reassignment of gender dysphoric persons.”
37
Doctors
from various clinics around the country, including Dr. Laub from Stanford and Dr. Richard
Green from UCLA, authored this document, which was approved in February of 1979 at the
Sixth International Gender Dysphoria Symposium in San Diego, California. The original
document was only twelve pages long; its most current iteration, the Standards of Care 7,
released in 2012, is one hundred and twelve pages long. Despite the many ways that this

36
Irving, 43.
37
Jack C. Berger, Richard Green, Donald R. Laub, Charles L. Reynolds Jr., Paul A. Walker, and Leo Wollman,
“Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons [First Version]”
(Janus Information Facility, 1979).

46
document has grown and changed over the years, there is an element of the original SOC that no
longer remains—an official mention of privacy and the privacy rights of the transsexual patient.
The original SOC comprises thirty-two principles and sixteen standards, and it
enumerates the patient’s right to privacy at the very end of the document:
4.16.1 Principle 32. Gender dysphoric sex-reassignment applicants and patients enjoy the
same rights to medical privacy as does any other patient group.
4.16.2. Standard 16. The privacy of the medical record of the sex-reassignment patient
shall be safeguarded according to procedures in use to safeguard the privacy of any other
patient group.

These sections, now absent in the SOC 7, hardly seem relevant in 2020. After the Health
Insurance Portability and Accountability Act (HIPAA) passed in 1996, a trans patient is
assumedly guaranteed the same privacy rights as any other patient. Title II of HIPAA enumerates
clear privacy rules for protected health information (PHI), which include medical files and
payments. While HIPAA makes clear that any and all patients have rights to protect the privacy
of their health information, when the original SOC were written, this was not the case. The idea
that a gender-deviant person was deserving of privacy needed to be explicitly stated and upheld
by a code of medical conduct.
The curious thing about restricted archival materials is that sometimes they become public.
The privacy has an expiration date, a moment in time in which patient-physician privilege
dissolves. The finding aid of the Robert J. Stoller Papers states, “Papers in Box 91 are closed for
75 years from date on item.” After seventy-five years, the items will be returned to their original
location in the archive. This amount of time practically guarantees that both the patient and
doctor have passed away (with the potential exception of child patients). A seventy-five year
expiration date assures that the documents are released into a new social milieu, one in which
everyone affiliated with that past is gone. Just as the patient-physician privilege mandate of the

47
Declaration of Geneva was extended beyond death, the decision to restrict materials for seventy-
five years is about extending the secrecy of the files beyond the patient and physician to the
entire institution they represent. At the time of this writing, Dr. Robert Stoller has been dead for
thirty years. His patients are most likely also dead, but the materials still have twenty more years
of restriction. This secrecy protects all of those involved in the institutionalization of sex and
gender medicine in the 1960s and 1970s.

Mediation and Translation
Archives obscure. They produce stories that may or may not capture what actually
happened (assuming there is an originary event to be captured in the first place). Archivist and
scholar Verne Harris refers to this as the “archival sliver,” explaining, “The documentary record
provides just a sliver of a window into the event.”
38
Like a game of telephone, each step of
recording, preserving, and organizing serves to distort. The event, person, moment, or story
being captured in the archive is irretrievable. Instead, the information has been passed along
from person to person, only being preserved if someone along the way found it necessary to
record and then if those records were deemed worthy of preservation. Archivists, in the process
of developing and organizing a collection, add their own layer of mediation and meaning,
changing the already-skewed message yet again. The final product—the document, transcript,
collection—can only ever slightly resemble the original.
In the case of Mrs. G, everything we know about her comes through Stoller. As
researchers, we are limited to the moments, conversations, and interactions that Stoller decided
to record, and even then, we are only capable of knowing those that made it into the Stoller

38
Verne Harris, “The Archival Sliver: Power, Memory, and Archives in South Africa,” Archival Science 2, no. 1
(2002): 64.

48
Papers collection. In her essay “Pulp Fictions and Problem Girls,” Regina Kunzel argues that the
case file is a reflection of the questions asked, who was asking, and what was actually recorded
of the answers. Kunzel states, “case records often reveal as much, if not more, about those
conducting the interview as they do about those interviewed.”
39
From the transcripts of Mrs. G’s
therapy sessions, we are able to see the questions Stoller asked, the ways in which he responded
to her answers, and how he directed or reoriented their conversations.
Despite the fact that Stoller claims to have recorded or taken notes on all of his sessions
with Mrs. G, there is no trace of this in the Stoller Papers. We only “hear” Mrs. G in the edited
transcripts that were published in Splitting. Aside from Stoller and Mrs. G’s first interview in
1957, which is printed in its entirety, the therapy transcripts published in Splitting have been
severely pared down in both scope and size. The Stoller Papers archive contains various drafts of
the book manuscript, with different interview transcripts included, but there are no direct notes
from therapy sessions. Stoller is explicit about the editing of the transcripts and his rules for
deciding what to eliminate and what to include:
I simply cannot publish all the typescripts on Mrs. G. No one would read them. So what
can be deleted without distorting the data? The only answer is that I must use my
judgement. Which immediately removes my findings from the realm of science. The best
I can hope is that if the editing is proper, the end result will adequately approximate the
original data-collecting experience, the treatment.
40

The transcripts that remain are a heavily curated version of the original collection. Years
of treatment have been collapsed into one chunk of text, with no indication where one therapy
session ended and a new one began. Stoller continues, “Although I have not indicated how much

39
Regina Kunzel, “Pulp Fictions and Problem Girls: Reading and Rewriting Single Pregnancy in the Postwar United
States,” American Historical Review 100, no. 5 (1995): 1468.
40
Stoller, Splitting, xvii.

49
time has passed between quotations—it may have been days or years—the reader will know that,
within each chapter, there is always a progression of time.”
41

In conversations between Robert Stoller and his book editor, Emanuel Geltman, we can
see a tension about how best to utilize the transcripts in the book. In Geltman’s pre-publication
correspondence with Stoller, he is overly preoccupied with Mrs. G. His letters of editorial
suggestions and book publicity information are littered with tangential questions about Mrs. G’s
masculinity and sexuality. In one letter, dated June 11, 1971, Geltman writes to Stoller about the
publishing company’s concerns as to whether Mrs. G would criticize the book publicly.
42
In the
middle of this discussion, he writes, “I couldn’t help but wonder, now that the penis is gone,
whether she permits women to touch her,” followed by, “Back to the manuscript, an important
point that I almost forgot.” This voyeuristic preoccupation with Mrs. G shapes Geltman’s vision
for the book. In his comments to Stoller, Geltman suggests that the book needs to be more
centrally focused on the transcripts and less on psychoanalytic theory. Geltman also wants to cut
the theory that relates to transsexuality, telling Stoller that his long explanation on transsexualism
at the end of the manuscript “hardly belongs” since “transsexualism is only a hint of Mrs. B’s
case.” Stoller replies:
I know you have felt enthused about Mrs. B’s history (and I have been most grateful to
you for the support your interest has given me), but to me this is not primarily an
interesting case report. I would not want the book accepted on that basis. The case report
is the vehicle for presenting issues about psychodynamic theory, psychoanalytic practice,
but most important of all, it represents a struggle to elaborate ideas concerning early
personality development, especially gender identity. While I do not see how this can
properly be done without case material, I also do not feel that the book should be edited
in order to give the world a fascinating script.
43

41
Stoller, Splitting, xviii.
42
Emanuel Geltman to Robert Stoller, 11 June 1971, Box 32, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.
43
Robert Stoller to Emanuel Geltman, 25 August 1971, Box 32, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.

50
Despite Stoller’s resistance, he accepts Geltman’s vision for the book. In fact, the exact format of
the book, with each chapter based on a different “theme” that arose in treatment (e.g.,
“homosexuality,” “homicide,” “mothering”), is Geltman’s suggestion. Stoller’s theorization of
different types of masculine females and transsexual females is moved to the appendix. From
Stoller’s correspondences with his editor, we can see how the book is not only mediated through
Stoller but also through Geltman.
There are countless layers, then, of translation between Mrs. G and readers of the archive
and/or Stoller’s publications. If we think about these layers of mediation and translation as steps
away from Mrs. G, we can begin to imagine the distance that exists between her and ourselves. I
want to highlight this distance as a prompt to pause and consider whose story, then, the Stoller
Papers are actually telling. As Warwick Anderson says, case histories are “modernist short stories
in which the author becomes the central character.”
44
I quote this as a means to suggest that in
this case history, perhaps we are reading the story of Stoller as much as we are encountering that
of Mrs. G. By understanding Stoller’s omnipresence in the archives, how can we turn our gaze
away from Mrs. G and instead focus our attention on him? Redirecting the gaze to Stoller is not
only about shifting the power dynamics at play, but it is also an opportunity to consider how
looking at Mrs. G might recommit a kind of violence she was subjected to under the clinical
gaze.
45
I wonder, what can this redirection of the gaze teach us about transsexuality and gender
research that we don’t learn from the salacious details of Mrs. G’s life story? Rather than
attempting to understand exactly how Mrs. G identified, what does it mean that her life was

44
Anderson, 535.
45
My concerns about the ethics of historical representation and the dual violence of the clinical gaze and the
historian’s gaze have been highly influenced by Saidiya Hartman. She asks: “How does one revisit the scene of
subjection without replicating the grammar of violence?”
Saidiya Hartman, “Venus in Two Acts,” Small Axe 12, no. 2 (2008): 1–14.

51
enlisted by the GIRC for their project of naming, defining, and classifying types of
transsexuality? This provides rich opportunities for critically analyzing transsexual medical
history without becoming myopically preoccupied with recuperating and exposing already-
objectified patients.

Secrets
In “Secret and Spectral: Torture and Secrecy in the Archives of Slave Conspiracies,”
Greg Childs differentiates between that which is silent in the archive and that which is secret.
46

Childs challenges us to consider the fact that many enslaved and colonized people made
intentional decisions to keep secrets from authorities, and thus from the archive. Such absences
are not accidental but are, rather, intentional. Childs says that he is concerned with “the
production of secrets that were deliberately not spoken or written into the record by historical
actors.”
47
He argues that secrets were fundamental to Black political life and survival.
Similarly, it is important to distinguish between silences and secrets in relation to
archives containing transsexual clinical case files. For many transsexuals seeking surgery,
university gender clinics were the only avenue to access such medical interventions.
48
As Sandy
Stone writes in “The ‘Empire’ Strikes Back: A Posttranssexual Manifesto,” many transsexual
patients at the gender clinics were well-versed in the criteria for a transsexual diagnosis and
knew how to reveal or conceal the correct information in order to access the operations they

46
Greg L. Childs, “Secret and Spectral: Torture and Secrecy in the Archives of Slave Conspiracies,” Social Text 33,
no. 4 (2015): 35–57.
47
Childs, 37.
48
There were clinicians such as Stanley Bieber in Colorado, Georges Burou in Morocco, and Jose Jesus Barbosa in
Mexico (to name a few) who ran private practices and performed surgery on-demand, but their clinics were
financially inaccessible to many transsexuals.

52
desired.
49
After the 1966 publication of Dr. Harry Benjamin’s book The Transsexual
Phenomenon, a more streamlined differential diagnosis of transsexualism was taken up at clinics
across the country. At the time, applicants far outnumbered clinic capacity. Only transsexuals
who perfectly matched the differential diagnosis were considered for surgery. To increase their
chances of being selected, prospective patients would circulate Benjamin’s book as a kind of
“how-to” for being approved for treatment. Because doctors and medical professionals would not
operate on patients with genders outside of the man/woman binary, homosexual patients, married
patients, and patients with kids, transsexuals at these gender clinics learned to access care
through strategic secret-keeping.
In the case of Mrs. G, to speculate about the secrets she may have kept, we have to
understand the trajectory of her treatment. Mrs. G became a patient at UCLA after her interview
with Stoller in the County Hospital in 1957. According to Stoller, “She asked if she could be
transferred to UCLA Hospital for treatment; she feared her path from the county hospital would
lead back to the hospital from which she had run away and to the unavailing experiences she had
had in the past with state hospitals.”
50
After being transferred to UCLA, she worked with various
psychologists for seven years before Stoller took her on as his patient. During those first seven
years, Mrs. G corresponded regularly with Stoller. In 1964, following a string of concerning
letters, Stoller set up a series of appointments with Mrs. G, nearly all of which she cancelled. She
only began to consistently see Stoller after she was arrested for a traffic violation while on
probation and was court-ordered to attend psychiatric treatment.

49
Sandy Stone, “The ‘Empire’ Strikes Back: A Posttranssexual Manifesto,” Camera Obscura: A Journal of
Feminism, Culture, and Media Studies 29, no. 29 (1992): 161.
50
Stoller, Splitting, 12.

53
The letters that sparked Stoller’s concern were about Mrs. G’s son Chris. Chris was born
blind and albino, and he was later diagnosed with autism. At the time of the letters, Chris was
three years old and having severe behavioral issues along with skin rashes. Mrs. G was desperate
to find some sort of treatment; however, doing so would require her to be honest about Chris—he
was not her biological son, but rather a neighbor’s child that she had cared for since birth. One of
her letters to Stoller reads, “I have no legal rights… I’m afraid to tell anyone for fear they’ll take
him away from me and, Dr. Stoller, Chris is my life… I could never imagine the welfare
department allowing me to adopt him, with my background they might even take all three boys
from me. I can’t take that chance…Maybe you can help me to help him.”
51
Stoller helped Mrs. G
get Chris into the UCLA hospital, but after receiving advice that she needed to send him away to
a “mental retardation hospital,” Mrs. G suffered a mental health crisis and threatened to kill both
Chris and herself. This led to a long hospitalization at UCLA, which was the true beginning of
Stoller and Mrs. G’s clinical relationship. During this time, they met six days a week.
When Stoller began to treat Mrs. G in approximately 1964, the GIRC was only two years
old, and Stoller was busy working on what would be his most popular and acclaimed book, Sex
and Gender: On The Development of Masculinity and Femininity.
52
While the narrative in
Splitting makes it seem like Stoller took Mrs. G on as a patient out of genuine concern for her
wellbeing and that of her son, at the time, his research on transsexuality was focused on mother-
son relationships. He took Mrs. G on as a patient because he wanted to test his theory that boys
with bisexual mothers were more likely to be transsexual.
53
Mrs. G was a “masculine woman”

51
Stoller, Splitting, 98–99.
52
Robert J. Stoller, Sex and Gender: On the Development of Masculinity and Femininity (New York: Science
House, 1968).
53
In this context, “bisexuality” refers not to a sexual interest in both males and females, but rather to an individual
who embodies the two sexes of male and female. It is a gender-related, not sexuality-based, term.

54
with three sons between the ages of approximately three and thirteen years old. She was, in many
ways, a perfect test case for Stoller’s theories. Indeed, she does appear in the 1968 book Sex and
Gender in Chapter Fifteen: “A Bisexual Mother: A Control Case.”
54

This distills the exact conflict that would play out during Mrs. G’s time with Dr. Stoller:
She was motivated to see him out of concern for her children, and he was motivated to take her
on as a patient to further develop his theories about gender identity, motherhood, and female
transsexualism. Mrs. G was seeking treatment because she did not want her children to be
impacted by her legal and mental health troubles, but Stoller was most interested in Mrs. G’s
claim to have a penis. As Stoller sought to make her into a “normal female,” Mrs. G resisted. In
the archival documents, she continues to insist that her masculinity and her penis are not the
problem: “Why worry about this one little thing? I am not hurting anybody. I’m not hurting
anybody with it. And it’s not hurting me. It’s not a delusion. It’s inside of me. This is something
I’ve always known, and I’ve always felt; and it’s there, and it’s real, and it’s mine; and you can’t
take it away from me.”
55
Mrs. G made it very clear that her penis had been her protection and
survival strategy through childhood sexual abuse, incarceration, addiction, and sterilization. In
one of her objections to Stoller’s poking and prodding, she forcefully declared her right to
secrecy: “If you knew everything about me, you would be taking from me the things that have
made it possible for me to survive.”
56
Mrs. G wanted to be a better mother, but she was not
interested in having Stoller “fix” her gender.
Mrs. G’s case history highlights the fact that she was a mother who was deeply invested
in her children and was fearful of losing them. Her case history also indicates that, at the age of

54
Stoller, Sex and Gender, 170–175.
55
Stoller, Splitting, 15.
56
Stoller, Splitting, 36.

55
twenty, after five “illegitimate” pregnancies, she was non-consensually sterilized at “R State
Hospital.”
57
As Stoller writes, “Her greatest sense of having been cheated came whenever she
recalled her sterilization.”
58
During Mrs. G’s hospitalization at UCLA and her daily meetings
with Stoller, she asked to have a tubal ligation reversal. Stoller forcefully objected. Her
reproductive rights were in his hands. Eventually, she would convince him that she wanted the
tubal ligation reversal not because she wanted to have another baby, but because she wanted to
be “intact as a female.”
59
Her request for having her reproductive capacities restored, which she
framed as a means to regain proper femininity, appealed to Stoller’s desire to reform her into a
“normal female.” After years of insisting that she was a woman with a penis (invisible to others,
but felt by her), Mrs. G conceited: “I am a woman; I can’t have a penis.”
60
Finally, Mrs. G got
her tubal ligation reversal at the UCLA hospital.

Lack vs. Abundance
While Harris’ concept of the “archival sliver” is useful for understanding the limitations
and impossibilities of archives, I want to be careful to not position the Stoller Papers as solely a
space of lack. Indeed, for researchers, the Stoller Papers often produce feelings of abundance. In
the reading room of the Young Research Library, I have seen other historians and researchers
with slim magazine folders or single files. I, on the other hand, have been working with foot-long
cardboard boxes overflowing with pamphlets, papers, binders, and newspaper clippings. One can
visually register the excess of this process. Without folders or a proper organizing system, I’m
left to carry handfuls of papers back to my desk. This feeling of abundance is unique not only in

57
Stoller, Splitting, 50.
58
Stoller, Splitting, 71.
59
Stoller, Splitting, 72.
60
Stoller, Splitting, 28.

56
comparison to the other archives housed in UCLA’s special collections but also because, as a
trans scholar, I have been led to believe that archives of queer and trans history are typically
characterized by lack and erasure.
In his article “I Am 64 and Paul McCartney Doesn’t Care,” Abram Lewis offers a
compelling critique of queer and sexuality studies’ foundational belief in queer historical erasure.
Because I view Lewis’ claim as essential to my arguments regarding trans history and
methodologies of inquiry into transsexual pasts, I quote him at length:
Scholars have not only maintained but also actively investigated the political and psychic
costs of historical loss which continues to be rendered a primary site of queer injury and
impetus for reparative historical production… Especially in recent years, this problem of
historical loss has been engaged increasingly as a problem of archivization. The archive
emerges recurrently as an original cause of historical deprivation and the ultimate
mechanism by which queer history may be secured or extinguished… In fact,
historiographical claims about queer absence would seem to have begotten an ontology of
the archive that recapitulates a kind of repressive hypothesis: this logic posits the queer
archive as always impoverished and fractured, distinguished by power’s erasures and
disavowals.
61

While we could undoubtedly offer an account of the materials that are absent from the Stoller
Papers archive, focusing on gaps and erasure can prevent us from seeing and valuing what is
right in front of us.
This pervasive paradigm of queer archival absence has already made an imprint in trans
studies scholarship. In November of 2015, Transgender Studies Quarterly (TSQ) released a
groundbreaking special issue on archives and archiving, geared directly at questions of archival
absence. The general editors caution that in contending with the “fragmentary nature of surviving
[transgender] documentation,” we must be careful to avoid treating existing pieces of the archive

61
Abram J. Lewis, “I Am 64 and Paul McCartney Doesn’t Care: The Haunting of the Transgender Archive and the
Challenges of Queer History,” Radical History Review 120 (2014): 15–16.

57
as constituting any kind of whole or complete picture.
62
All archives, by nature, both capture and
fail to capture. They collect some materials and leave others out. What the TSQ editors describe
is the archival sliver, the ontological impossibility of Borges’ Library of Babel in which all things
written and thought are captured. There can be no whole trans archive because there can be no
whole archive. Through a framework of archival lack, we remain trapped in a constant cycle of
recuperation and recovery. As Anjali Arondekar writes, “This movement from archival secrecy to
disclosure echoes what Eve Kosofsky Sedgwick has famously called the ‘epistemology of the
closet.’ Such a movement relies upon the maintenance within the epistemological system of the
hidden, secret term, keeping all binaries intact.”
63
If transness is about defying binaristic thinking
and being, how can we better enact this in our approaches to trans archives?
As Daniel Marshall and Zeb Tortorici suggest in the introduction to the anthology
Turning Archival, when we talk about the archival turn or turning to archives, we must remember
that the act of turning or rotating implies a proliferation of directions.
64
The dynamic, multi-
directional way that archives turn an assortment of materials, paper, and ephemera into a
collection and into a body of knowledge also allows for a proliferation of interpretations. We
must not approach archives through a binary of whole versus fragmentary, or absent versus
present, but rather with the knowledge that trans life abounds in front of us if only we find
creative ways of looking and reading.
In Arondekar’s For The Record: On Sexuality and the Colonial Archive in India, she
writes about the speculation surrounding a report by Sir Richard Francis Burton on pederasty in

62
Susan Stryker and Paisley Currah, “General Editors’ Introduction,” Transgender Studies Quarterly 2, no. 4
(2015): 541.
63
Anjali Arondekar, “Without a Trace: Sexuality and the Colonial Archive,” Journal of the History of Sexuality 14,
no. 1/2 (2005): 16.
64
Daniel Marshall and Zeb Tortorici, “Introduction,” in Turning Archival: The Life of the Historical in Queer
Studies (Durham: Duke University Press, 2022).

58
Sind.
65
This document, often referred to as the Karáchi Report, is deemed by many to be missing,
by others to be destroyed, and by some to have never existed. Rather than concern herself with
the finding of such a report, Arondekar considers the implications for all of the excitement and
speculation about the report. She asks, “What would it mean, then, to abandon our fascination
with the contents of the report and to turn our attention to the secrets encrypted in the sign of the
report itself?”
66

Arondekar’s provocations here interest me, especially as they relate to one particular
archival item in Judy Van Maasdam’s collection, the Stanford patient’s list. When Van Maasdam
brought out the three-ring binder containing a complete list of every patient ever seen at the
Stanford Gender Dysphoria Program, she informed me that her copy was the only one that
remained and that she planned to destroy it. Despite many people’s best attempts to have her
donate her materials to a library or archive, Van Maasdam insisted that she would have the list of
patient names destroyed.
When she told me this, I felt a kind of loss. A feeling as if once her binder was destroyed,
these individuals would be irretrievable. They would disappear into oblivion forever. This is why
when, to my surprise, I found a complete Stanford patient list in the Kinsey Institute Archives, I
was overcome with joy. As I stared at pages and pages of handwritten names, dates, and
addresses, I felt like I had discovered my very own lost Karáchi Report. The Kinsey Institute
does not allow researchers to scan or photograph any documents related to patient information. I
spent a full afternoon hand copying Stanford patient information, barely making a dent in the
fifty-five pages of names. It occurred to me that copying these names, knowing these names, did

65
Anjali Arondekar, For the Record: On Sexuality and the Colonial Archive in India (Durham: Duke University
Press, 2009).
66
Arondekar, For the Record, 32.

59
nothing to advance my understanding of trans medicine in the mid-to-late twentieth century. This
document was collected for a qualitative report. It is bureaucratic document. It catalogues human
life while somehow erasing the human. I had found the holy grail, and as it turns out, it was the
white pages of a phone book. Best case scenario, looking for these individuals might lead to a
collection of rich oral histories. But does the violence of invading someone’s privacy and
exposing them outweigh the potential historical contribution?

A Methodology of Care
In Childs’ essay, he warns against enacting violence through searching for the secrets of
archival actors: “By choosing to agonize over secrets that we cannot know, we may be close to
replicating the violence that some subjects were attempting to avoid in the first place when they
kept secrets from colonial officials.”
67
Rather than embrace narratives of recovery, he argues that
we should honor the secrets for how they may have “aided future subaltern political
formations.”
68
This problem of recommitting the violence of the gender clinic gaze feels most
apparent to me in my quest to know who Mrs. G truly was, or is.
As mentioned above, throughout the Stoller Papers, Mrs. G is given multiple
pseudonyms. One day, as I was reading through Stoller’s personal correspondence, I stumbled
across her legal name. This was due to an error in the archive—a small moment in which
something slipped through the cracks. I had a lead on Mrs. G’s identity. With this name, along
with an approximation of Mrs. G’s date of birth and city of residence, I feel confident that I could
find her in LA County juridical records. A part of me wants to find Mrs. G, to give us one more
name, one more story to tell. Another part of me is hesitant—what becomes of a life turned

67
Childs, 38.
68
Childs, 51–52.

60
lesson? I am reminded of Kara Keeling’s article, “Looking for M—: Queer Temporality, Black
Political Possibility, and Poetry from the Future,” in which Keeling urges us against looking for
the disappeared Black, trans protagonist of Daniel Peddle’s 2005 film The Aggressives. She
insists that M’s disappearance from the film and the public eye is a form of resistance and
survival. She asks, “what are the ethical implications of looking for hir?”
69
Keeling insists, “The
first question that must be asked of M— is not where is s/he but when might s/he be.”
70
Keeling
urges us to consider a queer ethics of looking after rather than looking for. In my research, what
would it mean to look after Mrs. G?
Lisa Lowe also urges us to consider the motivation behind the impetus for recovery. In
“History Hesitant,” Lowe provides us with a methodological approach for resisting the desire to
recuperate.
71
She asks, is archival recovery motivated by an ontological desire for reparation?
How does recovery conceive of the relationship between the past and present? Drawing from
African American social critique, Lowe challenges the ways that recovery frames the present as a
place of freedom and the past as a place of unfreedom. How do we reckon with the fact that
unfreedom is still here in the present? Lowe states, “This critique acknowledges not only that
history and historical knowledge fix and structure the relationship of the past to the present but
also that the meaning it attributes to the past determines what might be imagined as possible,
just, or desirable, now and in the future.”
72
Lowe’s methodological approach is one of hesitation.
Rather than rushing to recovery and perhaps reproducing the violence of the archive, Lowe
proposes pausing and attending to the meaning of our critical approaches. Hesitation allows us to

69
Kara Keeling, “Looking for M—: Queer Temporality, Black Political Possibility, and Poetry from the Future,”
GLQ: A Journal of Gay and Lesbian Studies 15, no. 4 (2009): 575.
70
Keeling, 577.
71
Lisa Lowe, “History Hesitant,” Social Text 33, no. 4 (2015): 85–107.
72
Ibid., 97.

61
tarry in a space of uncertainty, in order to “reckon with the connections that could have been but
were lost and are thus not yet—before we conceive of freedoms yet to come.”
73
This hesitation
requires us to slow down.
74
It necessitates attention, patience, tenderness, and care.
Transsexual case files demand a differentiated reading practice.
75
The various layers of
mediation, translation, and secrecy require us to slow down and sift through not only what is
visibly present in the file, but also what is missing, what is secret, and what cannot be understood
from our present time and place. To look after our trancestors, we must be careful to not subject
transsexual patients to the same kind of scrutiny they experienced at the hands of gender clinic
doctors.
76
Transsexual case histories showcase multi-dimensional moments of encounter. What
would it mean for us to approach these files with an intention of reversing and returning the gaze
upon the gender clinic doctors and psychiatrists? A methodological approach of returning the
gaze moves emphasis away from recovering individual subjects and their secrets.
To read transsexual case files with a hesitation to recuperate furnishes a methodological
approach that responsibly attends to the complexity of the gender clinic archives. It answers K.J.
Rawson’s call for “the need for thoughtfully conceived and ethically executed trans archival
practices.”
77
Rather than projecting ourselves onto the subjects we find in the archive and deem
to be like us, hesitation respects the fugitivity of trans pasts. To read transsexual clinical case
files with an understanding that patients and prospective patients kept intentional secrets from
the medical authorities, and thus from the archives, allows for a more nuanced view of
transsexual narratives. Rather than assume the heterogeneity of trans experience was flattened by

73
Ibid., 98.
74
Lowe’s concept of “hesitation” and Keeling’s question of “when” both gesture to a future- (rather than past-)
oriented temporality of historical inquiry.
75
Crystal Mun-hye Baik, “Sensing Through Slowness: Korean Americans and the Un/Making of the Home Film
Archive,” American Studies 56, no. 3/4 (2018): 5–30.
76
Trancestors is a term that combines trans and ancestors to refer to trans elders.
77
Rawson, 544.

62
medicalized transness, we can understand that transsexual patients found creative ways of
revealing, concealing, and fashioning their life stories to strategically access resources. It extends
a kind of critical generosity, or as Avery Gordon describes it, “a right to complex personhood.”
As Gordon explains, “Complex personhood means that all people (albeit in specific forms whose
specificity is sometimes everything) remember and forget, are beset by contradiction, and
recognize and misrecognize themselves and others.”
78

Mrs. G was not a woman who set out to change the course of transsexual medicine. She
was not a radical nor a gender warrior, but she also was not merely a cog in the transsexual
medical matrix. She was a person who was entangled with various systems of power, trying to
navigate a way forward that would preserve not only her life and personhood but also that of her
children. She told lies, and she also told the truth. Her life was made into an example, and her
life also resisted capture in Stoller’s theories, in diagnostic criteria, and in the archive. As trans
studies engages with transssexual pasts, it is imperative that we enact a methodology of care in
which we look after our transcestors rather than looking for their secrets in the name of recovery
and recuperation.
79

78
Avery Gordon, Ghostly Matters: Haunting and the Sociological Imagination (Minneapolis: University of
Minnesota Press, 2008), 4.
79
For more on trans care practices see: Hil Malatino, Trans Care (Minneapolis: University of Minnesota Press,
2020).

63
Chapter 2
Racing for an Etiology: Involuntary Patients and the Psychiatric Clinic (1958-1966)

On June 12, 1966, The National Insider ran an article titled, “I Ruined My Life When I
Changed Sex.”
1
The article details the life of jazz singer Delisa Newton, often referred to as the
subject of the “first negro sex change.” In the interview, Newton explains the hurdles that
prevent many people from being able to access trans therapeutics. She states:
“There are tough state laws against sex change surgery, unless detailed psychiatric
examination shows it to be necessary. In my case, three years of psychiatric sessions and
an additional 10 months as a psychiatric hospital patient convinced the doctors I should
be transformed into a woman physically. The operations were done at a university
medical school here in California. It was perfectly legal and perfectly successful.”

Newton’s story first broke a year earlier in The National Insider. Newton received sex
reassignment surgery sometime before 1965; if the information she provided about her
psychiatric care in this interview is accurate, one can assume she began pursing medical
transition sometime around 1960. This raises the question of where exactly Newton received
treatment. Between 1960 and 1965, not a single California university was publicly operating a
gender clinic that offered surgical intervention for transsexual patients.
2

This article comes from the Robert J. Stoller Papers in UCLA Special Collections. On the
yellow, faded newspaper clipping, there are annotations made with a blue ball point pen. The
markings bracket the above quoted section, with an arrow pointing to the words “university
medical center here in California.” Was Newton a patient at UCLA? How did she get there?

1
Lois Gould, “I Ruined My Life When I Changed Sex,” The National Insider, June 12, 1966.
2
Stanford’s clinic, often referred to as the first sex change clinic on the west coast, would not officially announce
their surgical program until 1969, with their first surgery performed in December of 1968.
Donald R. Laub to Spyros Andreopolous, 13 November 1968, Folder 1, Donald R. Laub collection, Medical History
Center, Lane Library, Stanford University

64
What was her path from inpatient psychiatric care to a groundbreaking (and secret) medical
operation at a premier university hospital?

Fig. 2.1 Photograph of Delissa Newton from the June 12, 1966 article in The National Insider

While Newton may have figured as an exceptional case in the U.S. American media, it is
likely that many individuals have stories that mirror hers. In this chapter, I argue that in the early
days of university gender research in the U.S., when doctors were most concerned with finding
the etiology of transsexuality, there were many patients who made their way to the clinics via
state psychiatric hospitals and/or the criminal justice system. These patients, often people of
color with stories similar to Newton’s, provided the foundation for early theories on transsexual
etiology. Their stories foreground how psychiatric detention and unfreedom were necessary
conditions for the production of modern sex and gender.

65
I examine the research and writing of Robert J. Stoller alongside the work of U.S. senator
and sociologist Daniel Patrick Moynihan and his famous essay “The Negro Family: The Case for
National Action.”
3
I put these mid-twentieth century thinkers into conversation to highlight the
racial and colonial logics of the university-based gender clinics and their significance for
transsexual life (both then and now). Both Stoller and Moynihan theorized gender pathology as a
multi-generation process and problem, understanding treatment to extend beyond the individual
and into the family structure and culture more broadly.
In this chapter I aim to make clear three things. First, gender clinic patients were not all
white and middle class and many of them did not come to the gender clinics voluntary. Some
clinic patients were ensnarled in the criminal justice system and/or involuntarily detained in
psychiatric facilities. Second, understanding the prolonged, multi-generational temporality of
Stoller’s theory of transsexual etiology makes clear the connections between transsexual
medicine, evolutionary and eugenic theory, and racial science. And third, that Stoller’s theory of
transsexual etiology emerges alongside essays like Moynihan’s reveals the shared genealogy of
U.S. sexology and Jim Crow. These interventions are critical for trans studies’ material
understanding of the shared history of trans medicine and racial subjugation.

Racing for an Etiology
In 1977, Dr. Donald Laub, the chief of Plastic Surgery at Stanford University School of
Medicine, delivered a public lecture about the cause and treatments of transsexualism.
4
In the
talk, Laub outlined two currents of thought which attempt to explain the etiology of

3
Daniel Patrick Moynihan, “The Negro Family: The Case for National Action” (Office of Policy Planning and
Research United States Department of Labor, March 1965).
4
Donald Laub public lecture, 1977, Box 5, Meyer Library Lecture Tapes, Archive of Recorded Sound, Stanford
University.

66
transsexualism: hormones before birth and social environment after birth. Laub proceeded to
describe a study carried out in Boston on a cohort of diabetic women and their sons. These
women, who had problems carrying a child to full term, were given high doses of “female
hormones” in an attempt to prevent miscarriages. Eighteen years later, professors of psychiatry at
Stanford University studied their sons. They wanted to examine whether these boys, who had
been exposed to high levels of “female hormones” in utero were more likely to be homosexual or
transsexual.
To perform this double-blind study, the Stanford psychiatry professors had the boys hit
baseballs with a bat and field ground balls. They recorded the participants doing these athletic
acts to determine whether these subjects were more effeminate than “normal” boys. They also
interviewed the participants and their mothers. According to their analysis, the results were
mixed. They argued that these boys were far more effeminate than their peers, but that none of
them were homosexual nor transsexual. Laub uses this study as a means to suggest that the cause
of transsexuality is “probably a combination” of hormones and environment.
At the time he delivered this lecture in 1977, Laub was considered a leading expert in
transsexuality. What this lecture demonstrates is that even those who were deemed to be
“experts,” had little to no idea what caused transsexuality. To use a baseball metaphor, they were
pitchers unable to find the strike zone. They were batters who couldn’t get on base. They were
doctors trying to treat a problem they knew very little about.
To understand their desire to pinpoint an etiology, it’s important to put the gender clinics
in the broader context of early twentieth century preoccupations with the source or cause of true
sex.
5
Different strands of thought about the cause and nature of sex would crisscross in the early

5
“True sex” is an epistemological category, masquerading as an ontological category. “True sex” is based on the
assumption that despite the various components that make up the sexed body (hormones, chromosomes, primary and

67
part of the century, weaving together a complex sexological tapestry of both nature and nurture.
Throughout the century, ideas about sex would proliferate, however research tended to
complicate rather than clarify. As Harry Benjamin writes: “Ordinarily, the purpose of scientific
investigation is to bring more clarity, more light into fields of obscurity. Modern researchers,
however, delving into ‘the riddles of sex,’ have actually produced—so far—more obscurity,
more complexity.”
6
The origin of true sex became more elusive as the century progressed.
Sexology emerged to address problems of deviance and vice from a medical and
therapeutic perspective. As Siobhan Somerville argues in Queering the Color Line, “What
characterizes the growth of sexology as a field was its attempt to wrest authority for diagnosing
and defining sexual ‘abnormalities’ away from juridical discourse and to place it firmly within
the purview of medical science. Thus what was once considered criminal behavior gradually
came to be described in terms of disease.”
7
Early European sexologists such as Iwan Bloch,
Magnus Hirshfeld, and Sigmund Freud thought that they were better equipped than medical
doctors to understand human sexuality because their scientific study was interdisciplinary and
pulled from fields such as history and anthropology. They saw themselves as capable of
understanding human behavior through a matrix of biology, region, culture, and history.
As Benjamin Kahan outlines in The Book of Minor Perverts: Sexology, Etiology and the
Emergences of Sexuality, the etiology of homosexuality was a central fascination of sexologists
for decades, well into the twentieth century, past the moment when sexuality scholars usually
mark the birth of modern sexuality—an epistemology that centers identities over acts and the

secondary sex characteristics), each individual has a true, binaristic sex (male or female) that can be determined
using empirical science and medicine. This can also be understood through the categories of true hermaphrodites
and true transsexuals.
6
Harry Benjamin, The Transsexual Phenomenon (New York: Julian Press, 1966), 5.
7
Siobhan B. Somerville, Queering the Color Line: Race and the Invention of Homosexuality in American Culture
(Durham: Duke University Press, 2000), 18.

68
idea of congenital sexuality over acquired sexuality.
8
Kahan’s main intervention is that etiology
continued to preoccupy sexology for much longer than scholars such as Michel Foucault, Eve
Sedgwick, and Peter Coviello mark as the ascendance of the modern homo/hetero binary or
immutable models of sexuality.
9
Kahan bookends his study with Carl Westphal’s 1970 article
“Contrary Sexual Feelings” and Alfred Kinsey’s 1948 book Sexual Behavior in the Human
Male.
10
In this chapter, I build on Kahan’s interventions to highlight how questions of etiology
plagued sexology well past 1948, especially as it concerned deviant or nonnormative gender. In
fact, many of the theories and debates that defined homosexuality/same-sex desire etiology
would be carried directly over to questions of transsexuality. Sexology’s preoccupation with
questions of etiology remained very much unsettled, shifting from a preoccupation with object
choice to a preoccupation in gender identity, two categories that were not clearly differentiated in
early sexology.
In Sigmund Freud’s Three Essays on the Theory of Sexuality, he argues that human life
begins as anatomically bisexual—with bisexual referring to blurred sex characteristics rather
than multiple gender attraction—and moves towards one sex over the course of fetal
development.
11
According to this theory, every person has the capacity to develop into any sex,

8
As Michel Foucault writes in the History of Sexuality, Volume 1, “The nineteenth-century homosexual becomes a
personage, a past, a case history, and a childhood, in addition to being a type of life, a life form, and a morphology,
with an indiscreet anatomy and possibly a mysterious physiology... Homosexuality appeared as one of the forms of
sexuality when it was transposed from the practice of sodomy onto a kind of interior androgyny, a hermaphrodism
of the soul. The sodomite had been a temporary aberration; the homosexual was now a species.” Foucault is
describing the shift from sexual acts being a “temporary aberration,” to defining of a person’s whole identity (“a
species”). And with this transformation also comes the homosexual as something to be studied. I note the inclusion
of “a childhood,” in Foucault’s list, because theories of homosexual etiology often relied heavily on the idea that a
certain type of childhood produced the homosexual.
Michel Foucault, History of Sexuality, Volume 1 (New York: Vintage Books, 1978). 43.
9
Peter Coviello, Tomorrow’s Parties: Sex and the Untimely in Nineteenth-Century America (New York: New York
University Press, 2013); Michel Foucault, History of Sexuality, Volume 1 (New York: Vintage Books, 1978); Eve
Sedgwick, Epistemology of the Closet (Berkeley: University of California Press, 1990).
10
Benjamin Kahan, The Book of Minor Perverts: Sexology, Etiology, and the Emergences of Sexuality (Chicago:
The University of Chicago Press, 2019), 14.
11
Sigmund Freud, Three Essays on the Theory of Sexuality (Seaside, Oregon: Rough Draft Printing, 2014).

69
with sex often forming as a mosaic of both masculine and feminine characteristics. There is not a
sex binary, rather gradations of sex with present and latent characteristics. Three Essays is
instructive in terms of what it teaches us about categories of sex and gender in Europe in the
early part of the twentieth century. Despite Freud’s insistence that anatomical bisexuality does
not explain cross-gender behavior or same sex desire, terms such as invert, bisexual, true
hermaphrodite, pseudohermaphrodite, and psychic hermaphrodite overlap and merge in ways
that highlight the uncertainty of the sexed body. For Freud, an “invert” is what would later be
referred to as a homosexual. A bisexual is akin to a true or pseudo hermaphrodite but not a
psychic hermaphrodite. His description of inverts (a male body with a female brain) bumps up
against many modern descriptions of transgender and in Freud’s world we are all bisexual. These
categories comingle, but collectively highlight the indeterminacy of sex.
12

From this sexological soup we can see the unsureness of sex in the first half of the
century as well as the idea that each person has the potential for bisexuality, i.e. the ability to
change sex. These ideas would collide with emerging science about sex hormones. While a
binary model of sex which regards male and female as wholly separate and distinct might turn to
the gonads to determine true sex, in the emerging science of endocrinology sexologists found
examples of how the sexed body exists in varying scales and degrees. Hormone science would be
used to support claims of innate bisexuality. Eugen Steinach experimented with hormones in
animals, removing and swapping the gonads of guinea pigs. He found that regardless of the
animal’s birth sex, the introduction of gonads from the supposed “opposite sex” led to drastic

12
In The Book of Minor Perverts, Benjamin Kahan refers to this long list of categories of gender and sexuality (e.g.
homosexuality, unisexuality, inversion, Uranian, tribadism, etc) as highlighting the “definitional instability of
sexological concepts.”
Benjamin Kahan, The Book of Minor Perverts: Sexology, Etiology, and the Emergences of Sexuality (Chicago: The
University of Chicago Press, 2019), 13.

70
shifts in behavior. This research bolstered the idea that sex was not a clear-cut binary, but rather
the result of varying levels of hormones which manifest as a mosaic of sexes.
As Joanne Meyerowitz argues, transsexual therapeutics emerge not because of
advancements in biomedical technology, but because of changing definitions of sex.
13
In this
claim, Meyerowitz is arguing that ideas such as innate bisexuality or gradations of sex traits were
as instrumental in developing trans therapeutics as were technologies such as synthetic hormones
or anesthesia for elective surgeries. Before the plasticity of gender would be used to justify
medical interventions, it would captivate the imaginations of the university-based gender clinics
as it relates to their attempts to find a psychiatric cure for transsexuality.
European sexology was slow to reach the United Stated.
14
During the years of the
Weimar Republic, European sexologists advocated for the repeal of sodomy laws, widespread
sex education, protection of unmarried mothers, and legal and social reforms to sex work. They
developed theories of innate bisexuality and experimented with hormones. This progressive
agenda would come crashing down with the rise of Hitler and Nazi Germany. Yet, despite the
many so-called progressive pillars of European sexology, in many ways the science was not
more progressive because of its interdisciplinary approach, but rather drew from colonial
anthropology and Darwinian infused history to develop a model of sex that was fully rooted in

13
Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge: Harvard
University Press, 2002), 21.
14
For example, at Johns Hopkins University Hospital, the Brady Urological Institute opened in 1915, over a decade
after theories of human bisexuality began to be published in Europe, however, the institute deployed a rigid
gonadocentric model of sex. Operated by urological surgeon Hugh Hampton Young, the Institute was invested in
producing a binary sex out of an intersex body. As Jules Gill-Peterson writes: “Young was not especially interested
in providing a theoretical explanation for hermaphroditism. His focus was the medical production of binary sex.”
Young approached the problem of hermaphroditism from a surgical approach. Not until pediatric endocrinologist
Lawson Wilkins came to Hopkins in the mid-1930s were hormones considered a viable option for producing a
binary sex out of an intersex body.
Jules Gill-Peterson, Histories of the Transgender Child (Minneapolis: University of Minnesota Press, 2018), 70.

71
racism and eugenics. As these sexological ideas traversed the Atlantic, they would largely lose
the progressive bend in favor of U.S. American racial science.
15

In the U.S., sexology’s eugenic origins would comingle with the U.S. race politics of the
Jim Crow Era in order to make a new branch of sexual research rooted in classifying difference.
As Somerville notes, “Comparative anatomy, which had been the chief methodology of
nineteenth-century racial science, gave sexologists a ready-made set of procedures and
assumptions with which to scan the body visually for discrete markers of difference.”
16
This
chapter embraces Somerville’s work on the connections between a black/white binary in the U.S.
and a hetero/homo binary in U.S. sexology, but argues that U.S. racism was not only present in
the visual economy of sexological classification, but was deeply embedded in all aspects of
sexologist’s quest to understand deviance etiologically.

Racelessness and the Carceral Clinic
Trans studies scholars such as Dan Irving, Dean Spade, and Aren Aizura have pointed to
the ways that transsexual narratives and diagnostic criteria demand a certain type of patient—a
patient capable of meeting standards of productivity and success under racial capitalism.
17
The
clinics’ criteria for surgery always favored white and/or middle-class patients. I do not dispute

15
The scholarship of C. Riley Snorton is important for understanding how (trans)gender and racial science comingle
in U.S. history to create the grounds of the modern science of sex. In Black on Both Sides, Snorton revisits the
history of J. Marion Sims, often regarded as the father of gynecology. In Sim’s research to cure vesicovaginal
fistula, the captive bodies of enslaved women served as “living laboratories.” As Snorton writes, “Captive flesh
figures a critical genealogy of modern transness, as chattel persons gave rise to an understanding of gender as
mutable and as an amendable form of being” (57). The perceived mutability of Black flesh was seen as an ideal site
for experiments on the potential elasticity of sex. What is so instructive about Snorton’s work is how it provides us
with a grammar for understanding how project of trans medicalization are always, already inherently racialized. The
possibility of sex reassignment is imagined out of fungible and ungendered blackness.
16
Somerville, 25.
17
Dan Irving, “Normalized Transgressions: Legitimizing the Transsexual Body as Productive,” in The Transgender
Studies Reader 2 (New York, NY: Routledge, 2013), 15–29; Dean Spade, “Mutilating Gender,” in The Transgender
Studies Reader, ed. Susan Stryker and Stephen Wittle (New York: Routledge, 2006), 315–32; Aren Z. Aizura,
Mobile Subjects: Transnational Imaginaries of Gender Reassignment (Durham: Duke University Press, 2018).

72
these scholars, but rather add a caveat to their analysis. By looking at the patients who were seen
before surgical and hormonal interventions became the norm, we find a cohort of patients of
color who were sought out by gender clinic doctors because of the idea that gender deviance was
hyper-present in racialized populations and family structures. This chapter is concerned with the
ways that early transsexual research hinged on racialized patients and the pathologization of the
racialized family, while simultaneously appearing to be raceless.
18

In a report titled “Case History Data From 392 Male and 71 Female Transsexuals,” Dr.
Harry Benjamin, his secretary Virginia Allen, and psychologist Stanley Krippner assembled a
comprehensive survey of transsexuals seeking treatment at gender clinics. Their report pulled
from the largest patient sample size of any study at the time. Published in October of 1973, the
document carefully outlines demographic and background information on the patients including
age, occupation, religious background, socio-economic background, educational background,
first occurrence of cross-dressing, frequency of cross-dressing, sexual activity, number on the
Kinsey scale, attitudes of parents and spouses, parents’ marital status, siblings, siblings’ marital
status, therapy history, previous neurological diagnoses, pertinent medical operations and
treatments, substance use, veteran status, and history of masturbation. From this list we can see
how the data they collected on each individual was extensive. In the quest to understand the
etiology of transsexuality there was no stone left unturned, except for what is glaringly missing
from this list: race.

18
By not mentioning race and rendering their patients raceless, clinicians and researchers were intentionally
avoiding critiques of engaging in racial and eugenic science. Under the logics of (neo)liberalism, racelessness is
perceived as a kind of neutrality.
Richard Delgado and Jean Stefancic, eds., Critical White Studies: Looking behind the Mirror (Philadelphia: Temple
University Press, 1997).

73
During this period the omission of race also, as we will see, took the form of excision. In
1973, for example, Stoller published Splitting: A Case of Female Masculinity. The book is based
on years of therapy with a transmasculine patient, referred to by the pseudonym Mrs. G. Mrs. G
is described on the first page of Splitting as “a white, divorced housewife in her thirties, living in
a suburb of Los Angeles with two teen-age sons.”
19
In correspondence between Stoller and his
book editor, Emanuel Geltman, there is a short but seismic postscript: “You never mentioned that
her mother was Mexican—something she refers to in this morning’s letter.”
20
Geltman, who had
begun writing letters with Mrs. G to receive her consent for the book’s publication, was pressing
Stoller as to why he never mentioned her Latinidad anywhere in the manuscript. In Stoller’s
reply he writes:
Finally, in reply to your P.S. about her mother being Mexican, I did not realize that there
was no mention of this whatsoever, for it shows up throughout the transcripts that she
speaks Spanish and has Mexican background. In fact, her mother is a very atypical
Chicano [sic] indeed, so much so that it would confuse the reader if she were so
described. So the saga unfolds.
21

Indeed, it is impossible to know what exactly Stoller meant by “atypical Chicano,” but it begs a
series of questions. First, what about her ethnicity would be confusing to readers? If the mother
were a “typical” Chicana would it be deemed necessary to mention her ethnicity? Was this
omission in fact accidental? Despite Stoller’s claim that he did not realize he had failed to
mention her Latinidad, he goes on to justify its omission. Stoller seems to suggest that the topics

19
Robert J. Stoller, Splitting: A Case of Female Masculinity (New Haven: Yale University Press, 1997), 1.
20
Emanuel Geltman to Robert Stoller, 2 February 1972, Box 32, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.
21
Robert Stoller to Emanuel Geltman, 7 February 1972, Box 32, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.

74
of transsexuality and gender deviance are so complicated, to add race and ethnicity into the mix
would only overwhelm the reader.
22

Splitting sensationalizes Mrs G’s criminality and run ins with the law. She’s a serial
criminal whose been arrested for car theft, check fraud, and homicidal thoughts. From Stoller’s
personal papers we can also learn that she was forcefully sterilized by the state and court
mandated to see a therapist.
23
Stoller first met Mrs. G in a Los Angeles County hospital. Stoller
claims that Mrs. G requested a transfer to UCLA to get out of a cycle of arrest and detention at
state/county hospitals.
24
This information tells us a very different history of transsexual
medicine. In addition to how Mrs. G’s identity throws into question the ubiquitous assumption
that early clinic patients were white and middle-class, Mrs. G’s status as a court-mandated
recipient of treatment also teaches us something about the (in)voluntary status of some gender
clinic patients. While Mrs. G may have requested to be transferred to UCLA, it was from the
position of a person ensnarled in the criminal justice and state hospital system.
Mrs. G is not the only patient that challenges received narratives of gender clinic patients.
In an undated report from the University of Michigan Gender Identity Clinic titled, “Varieties of
Male Transsexualism,” there is a short footnote about the cases being examined.
25
It reads: “Age
and racial data on the patients: Case 1: 26 y.o. Negro; Case 2: 25 y.o. Negro; Case 3: 22 y.o.

22
While Mexican Americans have been classified under many different racial categories throughout U.S. history
(e.g. white, Spanish, Mexican, Hispanic, Latino), the description of Mrs. G as a white housewife in the suburbs
smacks of willful erasure.
23
According to Stoller, at the age of twenty-one, Mrs. G was institutionalized at “R State Hospital” after a mental
health crisis (“psychotic episode”) in which she threatened to kill herself and her children. In R State Hospital she
learned she was pregnant with twins. After giving birth she was sterilized. “She says her permission was not asked.
Her mother gave permission for the procedure”
Stoller, Splitting, 71.
24
Stoller, Splitting, 12.
25
The citations for this text have publication dates that range from 1967-1970, leading me to believe that this report
may have been published in the early 1970s.
Robert Hatcher, “Varieties of Male Transsexualism,” no date, Box 9, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.

75
White; Case 4: 29 y.o. White; Case 5: 26 y.o. Negro; Case 6: 26 y.o. Negro.” This data is
noteworthy. Of the six patients being closely examined and quoted in the report, four of them are
Black.
The Michigan Gender Identity Clinic (GIC) was founded in 1968 in the Department of
Obstetrics and Gynecology. The clinic worked closely with faculty in urology, plastic surgery,
and psychiatry to focus on “sex alteration of selected individuals who are unhappy with their
now gender role and cannot be treated by the usual methods.”
26
The department recruited many
of its patients from Wayne County General Hospital (WCGH) in Metro Detroit. WCGH, also
known as Eloise Psychiatric Hospital, opened in the early nineteenth century as a sanatorium and
poorhouse. For years it was the largest psychiatric hospital in the United States.
At the time that the clinic was founded, J. Robert Wilson was chair of the Ob-Gyn
department. During his time as chair, he was invested in the University of Michigan Medical
School strengthening their ties to WCGH, a relationship he viewed as “particularly valuable
because of the volume of indigent patients with many serious complications of pregnancy which
are seldom seen in Ann Arbor.”
27
Not long after Wilson arrived at Michigan in 1964 and ramped
up recruitment from WCGH, the GIC was founded. Knowing the Michigan clinic’s connection
with WCGH in Metro Detroit might help to explain the patient demographic data in the
“Varieties of Male Transsexualism” report. Like Mrs. G and Delisa Newton, these case histories
may have been collected from psychiatric patients who were court-mandated to seek treatment or
entangled in state systems of punishment and correction.

26
Alexandra Stern, “Obstetrics and Gynecology,” in University of Michigan: An Encyclopedia Survey (Ann Arbor,
2015), http://hdl.handle.net/2027/spo.13950886.0003.071, 61.
27
Stern, 36.

76
According to trans elder and activist Miss Major, in the 1950s and 60s, people who were
arrested under cross-dressing laws were commonly sent to psychiatric facilities rather than jails,
a situation she found herself in multiple times.
28
Their detentions were involuntary.
29
Gender
clinic doctors and researchers would visit these facilities looking for potential research subjects,
just as Stoller had done when he encountered Mrs. G or as Wilson advocated for during his
tenure as chair of the Ob-Gyn department. State psychiatric hospitals were fertile ground for the
recruitment of patients with conditions deemed to be unique or complicated. In Mrs. G’s case,
she asked to be transferred from a state psychiatric hospital to the UCLA gender clinic, seeing it
as a potentially more benevolent or therapeutic option. It’s unclear whether all gender clinic
patients from psychiatric facilities consented to their transfer like Mrs. G, or if some became
objects of research without a say in the matter. Without more case histories it is hard to draw a
conclusion. However, from the records available, there is an obvious linkage between the
university-based gender clinic research and the prevalence of involuntary psychiatric treatment
in midcentury trans communities.

Mother Theory
On September 20, 1966 around four in the afternoon, Stoller entered the Roosevelt Hotel
in Hollywood to meet with Dr. Harry Benjamin. Benjamin, often regarded as a bridge figure
between European and U.S. sexology, had just published his groundbreaking book, The
Transsexual Phenomenon. Despite Benjamin’s years of clinical practice with transsexual

28
Miss Major Griffin-Gracy, New York City Trans Oral History Project, December 16, 2017,
http://oralhistory.nypl.org/interviews/miss-major-griffin-gracy-u29vbz.
29
In Clare Sears’ book about cross-dressing laws in San Francisco in the nineteenth century they note that
individuals arrested for cross-dressing often had their case referred to the Insanity Commission which “returned an
insanity verdict in 93 percent of cases.”
Clare Sears, Arresting Dress: Cross-Dressing, Law, and Fascination in Nineteenth-Century San Francisco
(Durham: Duke University Press, 2015), 75.

77
patients, he was unable to determine the cause of transsexuality.
30
Stoller wanted to meet with
Benjamin to get his perspective on his own nascent theory of transsexual etiology: the theory of
too much mother. The theory was based on the notion that a mother who was too close to her
child—shared too much intimacy, coddled too much—was the cause of effeminacy in young
boys. This mother, mixed with an absent or indifferent father, was enough to push a child to
adult transsexualism. While Stoller was basing this theory on his clinical work with only three
patients, he was quite excited about its potential for providing a theory of transsexuality in
general.
31

The idea that a mother was to blame for a child’s pathology was rampant in both U.S.
psychology and popular culture at the time. As Rebecca Jo Plant write in her book, Mom: The
Transformation of Motherhood in Modern America, the interwar/post-WWII era marks a shift
from moral motherhood to scientific motherhood, in which the mother’s role receded, shifting
from an all-encompassing role to the idea of allowing for greater child independence and
individuality.
32
During this cultural shift, overbearing mother love began to be seen as
narcissistic and pathological. Texts like Philip Wylie’s Generation of Vipers argued that mothers
were emasculating U.S. society.
33
The rise of antimaternalism would coincide with the rise of
authority of psychological professionals.
Using John Money’s research on intersex children as a kind of control, Stoller set out to
study individuals who, despite having no known biological cause for gender confusion, had

30
In The Transsexual Phenomenon, Benjamin devotes an entire section to “The Etiology of Transsexualism” in
which he provides an overview of various theories: genetic sources, endocrine sources, and psychological causes.
Like most clinicians at the time, he proposes that the cause of transsexualism is most likely a combination of these
various factors.
31
Harry Benjamin to Robert Stoller, 27 September 1966, Box 25, Harry Benjamin Collection, Kinsey Institute
Library and Special Collections, Indiana University Bloomington.
32
Rebecca Plant, Mom - The Transformation of Motherhood in Modern America (Chicago: University of Chicago
Press, 2012).
33
Philip Wylie, Generation of Vipers (Normal, Ill: Dalkey Archive Press, 1996).

78
developed an abnormal gender identity.
34
If good parenting could ensure an intersex child a
happy and normal life, then surely bad parenting was to blame for pathological gender deviance
in non-intersex children. Adapting Money’s term “gender role,” Stoller began to interrogate the
source of what he called “gender identity,” that is “the knowledge and awareness, whether
conscious or unconscious, that one belongs to one sex and not the other.”
35

In 1968, Stoller published his seminal text Sex and Gender: On the Development of
Masculinity and Femininity. Based on clinical research with adult and child transsexuals, their
mothers, and in some cases their fathers, Stoller’s central argument was that gender is “primarily
culturally determined; that is, learned postnatally” and that the two main factors that impact this
cultural process are one’s society and one’s mother.
36

Stoller develops a clinical picture of the type of mothering that leads to such gender
confusion:
This remarkable identification with women was found in these little boys to be associated
with (1) mothers who acted and dressed like boys until adolescence; (2) fathers who were
almost literally absent from the home, day or night, weekdays or weekends; (3) the
parents’ excessive permissiveness, so that the developing femininity was openly
encouraged by allowing the boys to dress as girls whenever they chose (‘He’s so
beautiful; wouldn’t he look lovely as a girl?’) and especially by (4) excessive and
intimate body contact for many hours, day and night, from birth to the time they were
seen at age 4-5, this delay in mother-infant separation perpetuated by the little boys’
constant touching of their mothers’ nude bodies and clothes.
37

Central to this theory is the idea that too much mother prevents her child from
differentiating and developing a sense of self distinct and separate from her.

34
A biological cause of gender identity was understood to be any kind of intersex condition whether gonadal or
hormonal.
35
Robert J. Stoller, Sex and Gender: On the Development of Masculinity and Femininity (New York: Science
House, 1968), 10.
36
Stoller, Sex and Gender, xiii.
37
Stoller, Sex and Gender, 126-127.

79
This same kind of mothering was also blamed for homosexuality.
38
At the time of the
gender clinics, one of the central pillars of the nascent gay rights movement was the
depathologization of homosexuality. Activists would succeed in removing homosexuality from
the Diagnostic and Statistical Manual for Mental Disorders (DSM) in 1973. Gender Identity
Disorder would be added to the DSM in 1980. In this way we can see how the etiological theory
of homosexuality pathology was directly carried over to the transsexual. As previously stated,
understanding how theories of homosexual etiology were taken up by the gender clinic doctors
as an explanation of gender deviance provides evidence for the fact that etiology was a central
concern of sexologist well into the twentieth century.
Stoller's mother theory explicitly connects such mothering to “primitive societies.”
39

Turning to anthropological studies, Stoller outlines what mothering looks like in “primitive
societies” in which “mother and infant are in a happy, skin-to-skin contact for many hours of the
day and night, and for years, even to the extent that the child urinates and defecates unmolested
on its mothers body.”
40
Stoller suggests that there is not enough data to know if this primitive
mothering leads to primitive gender deviance, suggesting that perhaps one key difference is that

38
In Leonardo da Vinci: A Memory of His Childhood, Freud wrote: “In all our male homosexual cases the subjects
had had a very intense erotic attachment to a female person, as a rule their mother, during the first period of
childhood, which is afterwards forgotten; this attachment was evoked or encouraged by too much tenderness on the
part of the mother herself, and further reinforced by the small part played by the father during their childhood.
Sadger emphasizes the fact that the mothers of his homosexual patients were frequently masculine women, women
with energetic traits of character, who were able to push the father out of his proper place. I have occasionally seen
the same thing, but I was more strongly impressed by cases in which the father was absent from the beginning or left
the scene at an early date, so that the boy found himself left entirely under feminine influence” (48).
Also see: Henry L. Milton, Departing from Deviance: A History of Homosexual Rights and Emancipatory Science
in America (Chicago: University of Chicago Press, 2002) and Heather Murray, Not in this Family: Gays and the
Meaning of Kinship in Postwar North America (Philadelphia: University of Pennsylvania Press, 2010).
39
Later in Stoller’s career he would pursue this line of inquiry more, travelling to Papua New Guinea in 1979 to
study indigenous populations. In a letter to his colleague Jean-Bertrand Pontalis he wrote: “I hope to compare their
child-rearing techniques and their rituals to measure certain aspects of my theories on the development of
masculinity and femininity and erotic behavior.”
Robert J. Stoller to Jean-Bertrand Pontalis, 15 June 1979, Box 32, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.
40
Stoller, Sex and Gender, 106.

80
his subjects are isolated within the home while in primitive societies “they are in the midst of the
bustle of the community life.”
41
In this section, Stoller finds a way of connecting pathological
mothering to primitive or racialized mothering, a connection that unfolds below the surface of
his research despite the preface claiming: “This research lacks controls from other cultures. My
patients have been primarily white, middle-class Americans.”
42

Strikingly, Stoller's mother theory unfolds in time, requiring multiple generations of
pathology before manifesting as adult transsexualism. According to Stoller, a young transsexual
boy develops his gender deviance from a mother who will not allow him to separate. This
overbearing mother clings to her child because in her own childhood she had a mother who was
indifferent to her. In Sex and Gender, the maternal grandmother is described as “empty.” She is
disinterested in her daughter and cannot give her the love she seeks. This experience of having
an absent mother is what leads her to become an overbearing mother for her transsexual son.
Because her mother was absent and empty, she may have sought validation from her father
which led to its own kind of gender pathology: tomboyishness and bisexuality. In this clinical
picture, transsexuality is not an individual illness but rather a familial pathology that plays out
over many generations.
To locate the etiology of transsexualism in many generations of pathological parenting is
to extend the timeline of the development outside the window of post-natal life and into a longer,
more evolutionary scale. An absent mother creates a masculine (gender deviant) daughter who,
seeking to create the maternal connection that she was denied, coddles and smothers her son so
much that he becomes a transsexual. Transsexualism is the result of unfit people procreating over
many generations. This eugenic theory of gender pathology finds the cause of gender deviance to

41
Stoller, Sex and Gender, 107.
42
Stoller, Sex and Gender, xiv.

81
be a societal problem. In addition to extending the timeline of gender deviance, it also expands
the unit of pathology/treatment beyond the individual and even the nuclear family, into many
generations of the family. Thinking about deviance in multi-generational or evolutionary terms is
embedded in many aspects of sexology. According to evolutionary theory, life begins as less
sexually differentiated, and as a species evolves so do two distinct sexes: male and female. As
Somerville writes: “One of the basic assumptions within the Darwinian model was the belief
that, as organisms evolved through a process of natural selection, they also showed greater signs
of sexual differentiation.”
43

In Histories of the Transgender Child, Jules Gill-Peterson writes about G. Stanley Hall’s
theory of adolescence in order to draw out the similarities between ideas of individual/childhood
development and evolutionary/societal development.
44
When Hall created the category of the
adolescent he saw it as the individual example of a pre-evolutionary stage, similar to the ways
that Enlightenment thinkers saw colonial countries and peoples as an un-evolved society, the
living history of present-day Europeans. As Gill-Peterson notes, “Growth was coded as
unidirectional and parallel, at the individual and species level, binding childhood to a highly
charged evolutionary concept of race as inheritable phenotype.”
45
Hall’s theories of the plasticity
of the child mirrored the plasticity of a population, both in need of a particular kind of
cultivation. Perhaps what is most key is that Hall believed that improper childhood development,
or that is, arrested development, led to perversion. In this sense we can see how Stoller’s theory
of the overbearing mother is very much aligned with not only adolescent development but also
ideas about evolution, eugenics, race, and coloniality.

43
Somerville, 29.
44
Gill-Peterson, 47-49.
45
Gill-Peterson, 47.

82

The Pathologization of the Racialized Family
Three years prior to Stoller publishing Sex and Gender, another study about pathological
parenting was released: Daniel Patrick Moynihan's “The Negro Family: The Case for National
Action.” Moynihan's thesis was that, while the civil rights movement demanded equality,
equality would not be possible until the Black community adopted white Euro structures of the
nuclear family with a male patriarch. “In essence,” Moynihan writes, “the Negro community has
been forced into a matriarchal structure which, because it is so out of line with the rest of
American society, seriously retards the progress of the group as a whole.”
46
He attributes
generational poverty, delinquency, addiction, and a myriad of other social ills all to the problem
of the Black family or more specifically, a matriarchal and dominant Black mother figure.
In Moynihan's report, the Black family structure is pathological because of its deviance
from gender norms: “A fundamental fact of Negro family life is the often reversed roles of
husband and wife.”
47
In Black households, he argues, family pathology exists because of deviant
gender roles. In the case of the transsexual, deviant gender identity exists because of family
pathology. These are two sides of the same coin—an attempt to attribute social problems to a
particular type of family. It is a pathology that builds across generations, that is able to survive
because of a perverse society that allows such pathology to germinate, something Moynihan
attributes to social welfare programs which have allowed the Black matriarchal family structure
to continue despite its “unnaturalness.” In both Moynihan's and Stoller’s theories of gender
deviance and family pathology, the problem develops over generations, taking years to fully
manifest. This process not only takes time, but also requires the permissiveness and complicity

46
Moynihan, 29.
47
Moynihan, 30.

83
of a society not intervening. The message is clear: gender deviance is to blame for social ills,
social ills come from the family, and the family is corrupted by gender deviance.
While Stoller's work never sites or references the Moynihan report directly, it is
important to think about these studies as emanating from the same therapeutic milieu: the rise of
family therapy in the 1950s and 60s. Under the family therapy model, pathology shifted from the
individual to the family. The family unit was to blame for fascism, homosexuality, delinquency,
and schizophrenia. As Deborah Weinstein argues in The Pathological Family: Postwar America
and the Rise of Family Therapy, the family became central to understanding “the etiology of
mental illness.”
48
Understanding Stoller’s theory of transsexual etiology as a multi-generational
family pathology and a by-product in the mid-century rise of family therapy and the expertise of
psychological professionals provides a bridge towards understanding how trans therapeutics are
intimately linked with theories of racialized family pathology.
An illustrative example of etiologies of gender difference and theories of family
pathology crisscrossing in the gender clinics can be found in Money’s 1968 article, “Negro
Folklore of Male Pregnancy.” In the article, Money tells of a myth about male pregnancy that he
found circulating around Baltimore's homosexual community during the course of conducting “a
longitudinal study of problems in juvenile gender identity.
49
” The myth of male pregnancy held
that after being penetrated during anal sex, one could become pregnant with a “blood baby” if
the sperm was able to travel deep into the anus and reach internal organs. Money’s sample size
for the paper was five individuals. In the discussion, Money attributes this piece of folklore to the
Negro family structure:

48
Deborah Weinstein, The Pathological Family: Postwar America and the Rise of Family Therapy (Ithaca, NY:
Cornell University Press, 2013), 8.
49
John Money and Geoffrey Hosta, “Negro Folklore of Male Pregnancy,” The Journal of Sex Research 4, no. 1
(1968): 34–50.

84

Since it is a Negro phenomenon, one may look to the dynamics of Negro social and
family life for a possible explanation of the viability of the folklore. The American Negro
family, especially at the lower socio-economic level, is commonly mother-centered (and
grandmother-centered). The father may be completely absent or a periodic visitor. In such
a family framework, there might be considerable predisposition to encourage the
maintenance and transmission of a tradition attributing maternal reproductive powers to
the male. Perhaps the adolescent Negro boy, used to identifying with and imitating his
mother, and having friends who have developed similarly, does not find so strange the
idea that some of the physical aspects of motherhood may be assumed by a man.
50

In this particular case, a study of juvenile gender identity problems in Baltimore’s Black
community lead to a research paper on the folklore of male pregnancy. This folklore was
attributed to the Black family structure which is deemed to be pathological. Money’s article
highlights the Möbius strip nature of theories of gender perversity and pathological, racialized
kinship structures—they feed off one another with no clear beginning or end.
It's also important to accentuate the fact that Money’s research on juvenile gender
identity took him out into the streets of Black Baltimore where the oral history of this myth of
male pregnancy was gathered. Much like the data from the University of Michigan’s GIC and the
revelation that Mrs. G was Latina, this study points to the fact that in the early days of the gender
clinic, racialized patient populations provided the foundation for theories of transsexual etiology.
In the case of Johns Hopkins, if history teaches us that the university was often experimenting on
racialized populations in deeply unethical and violent ways, why would the gender clinic
research be any different?
51

In the University of Michigan GIC report—with four out of six of the case studies being
Black patients—Stoller’s mother theory is taken up as an explanation for some of the patients,

50
Money and Hosta, 48-49.
51
Gill-Peterson, 69: “Research at Hopkins was as often coercive and nontherapeutic as it was curative, and from the
faculty’s opening rumors spread through the Black community in Baltimore that warned of the dangers of ‘night
doctors’ and other medical men who would rob graves, kidnap people off the street, and treat Black patients as
disposable experimental objects rather than as persons.”

85
but the report also proposes a slightly different theory about the role of the mother in transsexual
development. The report argues that while some of their transsexual patients have an overbearing
mother as Stoller describes, there is a second type, a transsexual with an unreliable and
ambivalent mother. In this mother-son configuration, the son does not become feminine because
of over-identification with the mom, rather “the child strengthens his identification with the
mother in order to control the hostile and aggressive components of their relationship.”
52
In this
rendition, the mother’s absence not constant presence is what causes the son to develop gender
deviance. “Identification with the mother seems to be based more on the need to abandon
maleness and to nullify aggression between mother and son, and rather less on early primary
identification.”
53

From this report we see that elasticity of the mother theory, with the common
denominator most often being a Black mother. Because families of color, and most specifically
Black families, were seen as being hotbeds of gender deviance, they provided fertile ground for
researching the cause of such deviance. Racialized mothers are bad mothers because they baby
their children and are overbearing. They are bad mothers because they are aloof. They are both
too affectionate and somehow also emotionally distant. Regardless of the specific cause of their
child’s transness, they are always to blame, always the absolute source of deviance. Highlighting
the similarities between Stoller, Moynihan, and Money’s work and the mid-century rise in
psychiatric theories of family-caused pathology, thus accentuates the relationship between the
development of trans therapeutics and U.S. racial science.

52
“Varieties of Male Transsexualism,” 8.
53
“Varieties of Male Transsexualism,” 12.

86
The Case for Early Action
Despite the fact that race was often omitted from gender clinic research or relegated to a
footnote, there are exceptions. In an article published by professors in the department of
psychiatry and biometry at Case Western Reserve University, race is the central analytic.
54
The
article, titled “Sociological Distinctions Among Gender Dysphoria Patients: A Comparison by
Race,” makes sweeping claims about the differences between transsexualism amongst Black and
white communities in the greater Cleveland area. On a numerical level, the data they report
shows that nearly one third of all clinic patients were Black (30 people out of a sample size of
105). The report begins by highlighting the similarities between the two racial cohorts. Both
groups overwhelmingly came from single parent households with physically or emotionally
absent fathers. Both groups reported similar ages when cross-gender identity and behavior began.
But from there, large differences emerge.
The report makes the claim that Black patients are more likely to go by a chosen name,
be prescribed hormones, and successfully pass. The report argues that the reason for this is
because Black patients, experience “much less intense family and social pressures to follow
gender appropriate roles.”
55
The authors claim that homosexuality and cross dressing are more
acceptable in Black families, neighborhoods, and communities because of a lack of social norms
created by a culture of depravity in which survival is the primary objective. Through this deeply
racist reading of the supposed lack of social norms in Black communities, Black trans women are
imagined to begin transitioning earlier and to pass more successfully. In alignment with the
Moynihan report, researchers said they were less likely to be in heterosexual marriages. They use

54
Paul K. Jones, Susan L. Jones, and Ann Keller, “Sociological Distinctions Among Gender Dysphoria Patients: A
Comparison by Race,” Journal of Psychiatric Treatmemt and Evaluation 3 (1981): 445–50.
55
Jones, Jones, and Keller, 449.

87
this claim to suggest that without the obligations of heterosexual marriage, Black trans folks are
freer to pursue transition without having to consider its impact on others.
The researchers also claim that Black patients were two times more likely to know other
patients at the gender clinics. This perhaps speaks to the number of Black patients at the gender
clinics, far more than trans scholars have ever understood to exist. How do we reconcile the fact
that many Black trans women from this era describe the impossibility of finding a doctor who
would treat them, whereas this data out of Case Western Reserve University makes the claim that
Black patients were more likely to be on hormones than white patients?
56
In the next chapter, I
will examine this contradiction, highlighting how patients of color show up throughout reports
and studies on trans etiology while simultaneously being denied access to many therapeutics,
most notably surgery.
In this chapter, I have demonstrated the connections between U.S. trans therapeutics,
evolutionary and eugenic theory, racial science, and state systems of intervention. The theories of
transsexual etiology that were based on post-natal environment (i.e. nurture over nature) were
grounded in the pathologization of the racialized family. They called for early intervention in
family structures that were deemed to have deviant forms of kinship. And when early
intervention failed, the so-called “deviant subject” often found themselves entangled with other
forms of state intervention in the form of state hospitals and psychiatric wards which served as
patient pipelines to the university-based gender clinics. Racialized patients from state hospitals
and psychiatric facilities were seen as perfect case studies for understanding gender deviance
because of evolutionary theory’s teleological timeline of sexual differentiation. Not

56
As Miss Major says in her NYC Trans Oral History interview in regards to Dr. Harry Benjamin: “He only did
girls he thought would pass. He only did white girls…We tried child. We went there and the receptionist was very
polite and very sweet but very ‘No. He’s not seeing you.’”

88
coincidentally, many of these patients were court-mandated to seek treatment. Entwined with the
criminal justice system, the space of the carceral clinic is where fungibility and sex possibility
collide. Again, unfreedom provides the condition for modern sex.
The next chapter will examine the ways that, as etiology continued to remain elusive,
clinicians would instead turn to nosology in order to develop a differential diagnosis. Doctor’s
would resign themselves to theories of etiology that vaguely gestured to a hybrid of biological
and social factors, although what exactly those biological factors might be remained unknown.
No one theory—whether it was hormonal, chromosomal, gonadal, or environmental—was able
to provide conclusive evidence. In light of this ever-receding horizon of biological truth, doctors
would instead shift towards simply trying to classify the differences between types of gender
deviance.

89
Chapter 3
Getting the Story Right: Transsexual Autobiographies and the Surgical Clinic (1966-1979)

In a letter dated July 15, 1966, a woman named Linda from Inglewood, California writes to
Dr. Stoller at the Gender Identity Research Clinic at UCLA. She has been corresponding with
Stoller who sent her a copy of Virginia Prince’s Transvestia magazine. Linda is careful to tell
him, “I am afraid I do not fit into this group” (i.e., transvestite). Later in the letter, she explains
that she is not a homosexual either: “Every sexual relationship I have had with a male…has been
typically ‘heterosexual’—I am only comfortable in a female role. My lover is always and only
the male—it is to all intents and purposes a man-woman relationship.”
1
In her letter, like many
others that can be found in archival collections related to the gender clinics, Linda is engaging
with medical professionals within the confines of the diagnostic categories and language
available to her at the time. Linda reveals a great deal about herself, about how she understands
her gender and how she relates to her body and sexuality. In this exchange with Stoller, Linda’s
sense of self is being both shaped by and shaping the medical understanding of gender deviance.
Linda counters Stoller’s Transvestia suggestion with a reading recommendation of her
own—Margaret Mead’s Female and Male. “In the many societies she writes about—mainly in
the south seas and the United States—behavior, customs, mores, values and dress vary a great
deal. The way we dress, and according to our sex as well, may be true today in America, but
tomorrow change will have its inevitable effect and the way we dress today will become just
another aspect of this particular culture in this particular place in this time,” states Linda. By
suggesting reading materials to a gender clinic doctor, Linda is challenging the power dynamics
of the clinics, in which knowledge about gender is thought to flow unidirectionally from medical

1
Linda to Stoller. July 15, 1966. Box 9, Robert J. Stoller Papers, UCLA Special Collections.

90
expert to patient. She is strategically and gently pushing back on the idea that her gender is
unnatural, providing an example of how gender norms are culturally and historically contingent.
Pulling from established techniques of portraying oneself as gender ambiguous or
intersex, Linda offers Stoller her measurements: 36, 29, 40. She informs him that hormone
treatment usually changes a masculine body to the feminine measurements of 38, 28, 40. She
uses these numbers to indicate that even without hormones she has a figure as feminine as any
cis woman. These narrative and rhetorical techniques indicate that Linda is not entering this
exchange with Stoller blindly. She has researched, planned, and perhaps even received a bit of
advice from others.
2
Her response to his suggestion that she might be a transvestite is thoughtful,
deliberate. She is both telling Stoller about herself and not telling Stoller about herself.
Strategically choosing the story of her life and gender that she wants to tell.
Linda’s letter and its availability in the Stoller Papers reveals that she was probably never
accepted as a UCLA gender clinic patient and therefore not extended the privacies and
protections of patient-physician privilege. Her letter seamlessly weaves together a string of
tropes common to mid-twentieth century trans narratives. She engages the differential diagnosis,
carefully explaining why other categories do not fit her. She points to other times and places to
challenge the naturalness of the gender binary. She provides evidence that her body does not

2
Sandy Stone writes about how, in the early days of the gender clinics, when doctors were using Harry Benjamin’s
The Transsexual Phenomenon as a guide for diagnosing patients, transsexuals were circulating a copy of the book to
rehearse their intake interviews with clinicians. “It took a surprisingly long time—several years—for the researchers
to realize that the reason the candidates’ behavioral profiles matched Benjamin’s so well was that the candidates,
too, had read Benjamin’s book, which was passed from hand to hand within transsexual communities, whose
members were only too happy to provide the behavior that led to acceptance for surgery.” Miss Major also talks
about this kind of coaching, stating: “You learn how to manipulate the system. Keep yourself safe. You learn what
things they want to hear in order to try to get them to help you. And so, a lot of the girls…would sit and we would
talk together in groups about [what] psychiatrists or doctors or nurses needed to hear from us to not berate
and cast us aside.”
Miss Major Griffin-Gracy, December 16, 2017, NYC Trans Oral History Project,
http://oralhistory.nypl.org/interviews/miss-major-griffin-gracy-u29vbz; Sandy Stone, “The ‘Empire’ Strikes Back: A
Posttranssexual Manifesto,” Camera Obscura: A Journal of Feminism, Culture, and Media Studies 29, no. 29
(1992), 161.

91
meet cultural ideas about size and shape. Linda speaks to both culture and biology. The pages of
her letter are folded in half horizontally, making the correspondence resemble a book or
pamphlet. This aesthetic decision gestures to a published transsexual autobiography.

Fig. 3.1 Photograph of Linda’s letter to Robert J. Stoller on July 15, 1966

This chapter uses trans autobiographies to explore a series of events that occurred
between approximately 1968 and 1980 which changed the therapeutic options available to
transsexual people. These events include: the beginning of surgical treatment at university-based
gender clinics in the U.S., the publication of the trans treatment protocols known as the
Standards of Care in 1979, and the addition of “Gender Identity Disorder” to the DSM-III in
1980. In just over a decade, medical doctors and providers would consolidate disparate ideas
about gender deviance into a concise set of differential diagnoses. I consider how the
autobiographies of trans people shaped this process and how in turn, trans autobiographies were
also shaped by this process.
I argue that in the shift to surgery, the requirements for treatment demanded a certain
kind of patient—one deemed capable of assimilation into mainstream, heterosexual culture and

92
capitalist society. Clinicians tried to teach appropriate gender comportment and presentation in
order for patients to live undetected as post-op transsexuals. Under this pedagogical approach to
gender, some patients—white patients—were seen as more capable of reform and assimilation.
In the previous chapter, I demonstrated how the original goal of the university-based gender
clinics was to find an etiology, that is a cause, of cross-gender identification in order to eradicate
gender deviance and how this etiological project relied on research with nonwhite patients. By
1968, the clinics had been unable to definitively locate a biological (nature) nor an
environmental cause (nurture). Without a way to cure transsexualism before onset, doctors had to
pivot towards curing transsexualism after-the-fact. Surgical transition and assimilation into
heterosexual culture became the goal. In this chapter, I illustrate how as the goal changed, so did
the racial demographics of the gender clinic patient population.

Autobiographies and Diagnosis
Since the birth of modern psychiatry, autobiographies have been a central component of
the clinical case file and a tool for diagnosis. In I, Pierre Riviere, Michel Foucault publishes the
legal and medical dossier of a French peasant accused of murdering his mother, sister, and
brother.
3
Foucault uses the dossier to track the power struggle between medical and legal
discourse in a moment when “mental medicine” was attempting to insert itself in the criminal
justice system. At the birth of modern psychiatry, there was a proliferation of categories of
insanity.
4
In fact, there were so many new categories and their definitions were so opaque that it

3
Michel Foucault, ed., I Pierre Riviére, Have Slaughtered My Mother, My Sister, and My Brother: A Case of
Parricide in the Nineteenth Century (Lincoln: University of Nebraska Press, 1982).
4
In The History of Sexuality, Volume 1: An Introduction, Foucault describes a similar “discursive explosion” as it
relates to sexuality. Foucault describes a “proliferation of discourses concerned with sex.” This eruption of specific
and specialized language is what defines modern sexuality. In this chapter it is important to think about the
proliferation of discourse around sexuality and how it occurred alongside a multiplication of diagnoses that relate to
psychiatry and mental health disorders.

93
was hard for judges and doctors to determine who exactly “counted” as insane and what kind of
insane. In order to make this judgment, legal and medical experts began asking accused mad men
to write their life stories. They hoped that the autobiography would provide clues about the
author’s sanity and help them to make an accurate diagnosis.
This same power struggle between the criminal justice system and medical authority is at
the heart of sexology. Institutions, such as the church and the courts, were invested in
maintaining their authority to interpret and discipline the body. As Benjamin Kahan writes in
The Book of Minor Perverts, “sexology’s broader project [was] to produce sexual knowledge and
classify nonnormative sexual practices in order to shift sex away from the sphere or religious
moral judgement.”
5
Transsexuality was seen as a kind of disease or disorder that sexology aimed
to treat. Rather than arresting individuals for transgressive dress or rejecting them as immoral,
sexologists wanted to cure them.
6
And just as Foucault describes the relationship between
autobiographies and categories of insanity, doctors turned to transsexual’s life stories to
determine the best diagnosis and course of treatment.
Trans theorist Jay Prosser writes in Second Skins: The Body Narratives of Transsexuality,
“Every transsexual, as a transsexual, is originally an autobiographer.”
7
What Prosser means is
that in order to be a transsexual, that is, a person who medically alters one’s body in a way that
troubles the socially constructed (but rigidly enforced) gender binary, one must make a case for
treatment which relies on telling a cohesive narrative about life-long, unwavering cross-gender

Michel Foucault, History of Sexuality, Volume 1 (New York: Vintage Books, 1978), 17.
5
Benjamin Kahan, The Book of Minor Perverts: Sexology, Etiology, and the Emergences of Sexuality (Chicago: The
University of Chicago Press, 2019), 2.
6
See Clare Sear’s Arresting Dress: Cross-Dressing, Law, and Fascination in Nineteenth -Century San Francisco for
a history of cross-dressing laws from the mid-nineteenth to the mid-twentieth century. Sears argues that cross-
dressing laws produced ideas about normative gender, race, and citizenship, policing the boundaries of what kinds of
behavior were allowed in the public sphere.
7
Jay Prosser, Second Skins: The Body Narratives of Transsexuality (New York: Columbia University Press, 1998),
100.

94
identification.
8
Similar to Foucault, Prosser highlights that diagnosis and self-narrativizing
always exist alongside one another. In the case of transsexuals, this self-narrativizing often
happens first in the intake interview but must be repeated again and again as one navigates the
matrix of doctors, psychiatrists, psychologists, and health insurance gatekeepers that make up the
labyrinth of trans affirming care.
However, the life stories of trans people have not been restricted to the examination
room. The genre of autobiography has been central in the writing and remembering of trans
history. From Christine Jorgensen’s sensationalized autobiography all the way up to
contemporary trans memoirs such as Janet Mock’s Redefining Realness, life writing has served
as a central vehicle for trans people to record their own histories and challenge cultural and
political misconceptions/violences.
9
In fact, the three main genres we turn to for understanding
trans pasts are the case file, the autobiography and, as Joanne Meyerowitz writes about, the
newspaper or tabloid expose.
10
Putting the newspaper aside, what we learn from Foucault is that
the case file and the autobiography are always, already intertwined.
Trans studies scholars have tended to view mid-century transsexual autobiographies with
skepticism. These documents are often interpreted as being written exclusively for medical
gatekeepers and deployed to convince a doctor of one’s eligibility for treatment. Because these

8
By saying that every transsexual is an autobiographer, Prosser may also refer to the ways that after transition,
stealth trans folks must be able to tell a cohesive narrative about their life without revealing their trans status.
Additionally, trans people being autobiographers can also be about how one discursively sutures the psychic rupture
of transition, a process that goes hand-in-hand with the material stitches on the body. Whether the self-narrativizing
happens in the intake interview, after transition for employers or acquaintances, or privately for oneself, the
transsexual autobiography emphasizes coherence, congruency, and correlation. It is about alignment, which could
teach us something about the “wrong body” narrative, i.e. the notion that transition brings the soul and the body into
harmony.
9
Christine Jorgensen, Christine Jorgensen: A Personal Autobiography (San Francisco: Cleis Press, 2000); Janet
Mock, Redefining Realness: My Path to Womanhood, Identity, Love & so Much More (New York: Atria Books,
2014).
10
Joanne Meyerowitz, “Sex Change and the Popular Press: Historical Notes on Transsexuality in the United States,
1930–1955,” GLQ: A Journal of Lesbian and Gay Studies 4, no. 2 (January 1998): 159–87.

95
autobiographies were written to persuade clinicians, they are understood to be mimicking the
diagnostic criteria rather than conveying the truth of an individual’s life story or sense of self. In
Sandy Stone’s field-building text, “The ‘Empire’ Stike Back: A Posttranssexual Manifesto,” she
challenges the authenticity of transsexual autobiographies. Stone points to the fact that many of
these intake interviews were pre-scripted and pre-rehearsed narratives that were performed in
order for the person to sneak past the gatekeepers of medical transition. They were not
“authentic” but instead, a single story told again and again in order to access hormones and
surgery. Stone writes, “Emergent polyvocalities of lived experience, never represented in the
discourse but present at least in potential, disappear: the berdache and the stripper, the tweedy
house-wife and the mujerado, the mah’u and the rock star, are still the same story after all, if we
only try hard enough.”
11
In this passage, Stone argues that the heterogeneity of trans experience
has been collapsed into one medicalized narrative. Indeed, the call of Stone’s manifesto is to ask
transsexuals to create a new narrative for ourselves, a different structure for our autobiographies,
a new way of telling our stories aloud.
Many trans studies scholars have answered this call by attempting to diagnose a
narratological shift in trans autobiographies, pinpointing a moment in which they changed from
the pre-rehearsed medical narratives of the 1960s and 70s to something more “truthful” or
“authentic.” In Genny Beemyn’s article “Autobiography, Transsexual,” they argue that authors
such as Leslie Feinberg and Kate Bornstein ushered in a new era of the autobiography, one that
is more, to use their words, “overtly political” and challenging of the gender binary.
12
In the
essay, “Bear Witness’ and ‘Build Legacies” Sarah Ray Rondot writes: “contemporary trans*

11
Stone, 163.
12
Genny Beemyn, “Autobiography, Transsexual,” Glbtq.Com (blog), 2006.

96
autobiographers create a new epistemology of trans* identity.”
13
Rondot credits Jennifer Boylan
and Alex Drummond’s memoirs, both published in the early 2000s, for ushering in this new era
of trans narrative, arguing that their memoirs depict the elasticity of gender and move beyond the
pre/post-op dichotomy of early autobiographies. More recently, Andrea Long Chu published a
book review of Juliet Jacques’ Trans: A Memoir, which credits Jacques for developing a new
paradigm for trans memoir which focuses more on the mundane rather than the sensational
aspects of transition
14
. All of these scholars attempt to find a narrative shift; they want to identify
a moment when autobiographies become more authentic and less about performing a certain
narrative for medical gatekeepers.
Jack Halberstam has argued that transsexual autobiographies allow someone to make
their own life coherent.
15
Transsexual people, as a matter of survival, have meticulously attended
to the details of their lives and how those details circulate. Halberstam argues that the trouble
with trans history work or trans biographies is that an exterior force is trying to create coherence
in someone else’s life. The problem with coherence, in both transsexual autobiographies and
trans history, is simply that being a human is full of messiness and complexity, perhaps the
opposite of coherence.
This chapter provides various examples of autobiographies that shape and are shaped by
the gender clinics’ diagnostic criterion. Rather than rejecting these autobiographies as inauthentic
performances for clinicians, I think about them as complex conversations between doctors and
patients. They lend legitimacy to the doctors’ diagnostic criteria by generally aligning with their

13
Sarah Ray Rondot, “‘Bear Witness’ and ‘Build Legacies’: Twentieth- and Twenty-First-Century Trans*
Autobiography,” Auto|Biography Studies 31, no. 3 (2016): 527-551.
14
Andrea Long Chu, “The Wrong Wrong Body: Notes on Trans Phenomenology,” Transgender Studies Quarterly
4, no. 1 (2017): 141–52.
15
Jack Halberstam, In a Queer Time and Place: Transgender Bodies, Subcultural Lives (New York: New York
University Press, 2005).

97
descriptions, and in turn, are given legitimacy—speaking to the validity of their condition,
challenging cultural ideas of depravity or immorality. They enable patients to make their
disparate life experiences coherent. They allow transsexuals to carefully control the details of
their lives. But they also further marginalize transsexuals with very different stories. Perhaps
most importantly, they produce and reproduce ideas about racial assimilation and normalcy.

Lost Cause: The Failure of Etiology
In the mid-to-late 1960s, gender research in the United States shifted its focus from
etiology to nosology, or from cause to classification. Unable to come up with a clear source of
transsexuality, sexologists and researchers were forced to reimagine treatment. Because doctors
had been unable to decide on a cause, psychological treatment was fruitless. University-based
gender clinics, which had previously tried to reform transsexuals through psychotherapy, began a
new approach of trying to reform transsexuals through surgery. If they could not change the
mind, they could at least change the body.
In 1973 at Stanford University, a group of gender researchers from across the country
gathered to hold the Second Interdisciplinary Symposium on Gender Dysphoria Syndrome. Anke
Ehrhardt, who at the time was working as a clinical psychologist at Johns Hopkins University,
gave a lecture titled “The Etiology of Transsexualism,” in which she outlined the three prevailing
theories about the cause of transsexualism.
16
The first was Stoller’s mother theory, on which she
commented: “If this theory has any validity and Stoller has documented it with various cases,
then other people should find the same kind of history in transsexuals. Very few do.”
17
The

16
Anke A. Ehrhardt, “The Etiology of Transsexualism,” in Proceedings of the Second Interdisciplinary Symposium
on Gender Dysphoria Syndrome, ed. Donald R. Laub and Patrick Gandy (Stanford, California: Division of
Reconstructive and Rehabilitation Surgery, 1973), 44–48.
17
Ehrhardt, 44.

98
second theory is that of adult endocrine function, or more specifically that cis and trans folks
would have noticeably different levels of testosterone and estrogen production.
18
Ehrhardt cites a
few studies that aimed to collect these findings and failed. Finally, the last theory is Ehrhardt’s
own which she developed in her research with John Money. Ehrhardt claims that pre-natal
hormones have an impact on gender behavior, but maybe not gender identity.
19
What this means
is that a female child exposed to high levels of androgens in the womb may enjoy more so-called
boyish activities but that did not mean that she would go on to become a transsexual.
Ehrhardt concludes her comments at the symposium by saying: “To summarize my
comments on the etiology of transsexualism, we have to conclude at this time, the causes of
transsexualism are unknown.”
20
The fact that Erhardt makes this concession is a bit astounding.
This same year, Ehrhardt and Money would publish their book Man & Woman, Boy & Girl,
which uses clinical materials “drawn from the extensive file of longitudinal case and group
studies assembled in the psychohormonal research unit of the Johns Hopkins Hospital and
School of Medicine since 1951.”
21
Which is to say that despite twenty plus years of research,
doctors were still flummoxed when it came to the cause and origins of transsexuality.
The 1973 conference and its location at Stanford University was used as a chance for
Stanford to promote their blueprint for the treatment of transsexuals. This same year Stanford
authored a document titled “A Rehabilitation for Gender Dysphoria Syndrome by Surgical Sex
Change,” which was the collective effort of fourteen doctors, researchers, and clinicians at the
university. As the title suggests, this document argues for transsexual rehabilitation via surgical

18
Ehrhardt does not use the terms “cis” and “trans” but rather “normal control males and females” and “female and
male transsexuals.”
19
Ehrhardt, 45.
20
Ehrhardt, 46.
21
John Money and Anke A. Ehrhardt, Man & Woman, Boy & Girl: Gender Identity from Conception to Maturity
(Northvale, NJ: Jason Aronson, 1973), xvi.

99
sex change, a departure from the treatment conventions of the last couple decades which were
premised on pinpointing transsexuality in childhood and preventing it from developing into adult
transsexualism. Stanford’s document lays the groundwork for a model of treatment that would
come to dominate trans medicine for years to come.
The unveiling of this official document about Stanford’s rehabilitation program was
years in the making. Stanford performed their first sex reassignment surgery on Roberta Malm
on December 6, 1968. Leading up to the operation, surgeon Dr. Laub contacted the Stanford
news bureau, the Stanford Hospital administration, and lawyers representing the university to
inform them of the upcoming “sexual conversion operation.” The lawyers drafted a special set of
consent forms for Malm. In a letter to Spyros Andreopolous, director of Stanford Medicine’s
news and public affairs office, Dr. Laub underscored, quite literally, his desire to avoid
publication. “On December 6 we will perform our first sex conversion operation. We are alerting
you because of the nature of this type of surgery and the controversy involved in sex conversion
cases. Also, the publicity that has accompanied this type of surgery with other institutions
denotes your being forewarned. Naturally, we want to avoid all publicity.”
22

The plan to keep the surgery a secret was short-lived. In late-December of 1968, at the
fall meeting of the American Psychoanalytic Association at the Waldorf Astoria Hotel in New
York City, Dr Charles W. Socarides, a prominent psychoanalyst and promoter of gay conversion
therapy, spilled the beans. In his lecture at the meeting, Socarides derided medical institutions
who were willing to perform surgery on transsexual patients, referring to the operations as
“pathetic and unscientific.”
23
In his tirade against gender reassignment surgery, Socarides
mentioned that Johns Hopkins, University of Minnesota, and Stanford hospitals had performed

22
Laub to Andreopolous. November 13, 1968. Folder 1, Donald Laub Collection, Stanford Medical History Center.
23
Leo, John. “Doctor Raps Transsexual Operations,” New York Times, December 21, 1968.

100
such operations. The New York Times wrote a story about Socarides comments at the American
Psychoanalytic Association meeting, causing Stanford to scramble to put together a press release
for the San Jose Mercury.
In the Donald Laub Collection at the Stanford Medical History Center, the folder with the
newspaper clippings about the beginning of surgery at Stanford contains various drafts of the
statement released to the San Jose Mercury. Laub struggles to explain to people how
transsexuality is both a psychiatric disease (an “abnormality that produced a thinking pattern in
the brain which works as the opposite sex”) and simultaneously not curable through psychiatry
(“It is well known and established from experience that psychiatry has very little or no effect on
this disease.”).
24
He attempts to strike a tone that makes it seem like surgery is the well-
established course of treatment by citing operations performed by Elmer Belt in Los Angeles,
doctors at Johns Hopkins, and doctors abroad. The press release is not interested in framing
Stanford’s new clinic as pioneering a field. In fact, when the article came out, it seemed as if
Stanford was only considering the possibility of gender reassignment surgery. Dr. Laub is quoted
saying, “We have not yet decided if we are going to embark on this program.”
25

By the 1973 symposium at Stanford, the university’s posture has shifted. Rather than
trying to deny or cover up their Gender Dysphoria Program, they were holding a large
conference to present their program and their plan for transsexual rehabilitation through surgery.
The tide had changed from hesitancy to fervor. In the five years between 1968 and 1973,
Socarides had lost the fight for treating transsexuals via therapy. Surgery was becoming the
norm. For the attendees of the Second Interdisciplinary Symposium, the main task at hand was
agreeing on a differential diagnosis and streamlining a system of treatment.

24
Folder 1, Donald Laub Collection, Stanford Medical History Center.
25
Carey, Pete. “Stanford Thinking About Sex Surgery,” San Jose Mercury, January 3, 1969.

101

Birth of a Diagnosis: Gender Identity Disorder
Even as a shift to surgical rather than psychiatric treatment began to take place, the
general ethos of the doctors and gender clinics remained mostly the same. There was no sudden
shift which led to doctors seeing transsexuals as capable of gender self-determination.
26

Clinicians’ paternalistic posture remained very much intact. Transsexuality, transvestism, and
effeminate homosexuality were still seen as pathological disorders, easily confusable with one
another or with schizophrenia, psychosis, and/or sociopathy and psychopathy. Clinicians were
still interested in a cure, a way to eliminate these types of gender deviance.
27
As the Stanford
program plan explicitly states: “our role of investigation may be alteration of the individual
surgically and now behaviorally rather than altering societal norms.”
28
These clinics were not
trying to change society, they were trying to fix people to fit into society as it already was.
29

Harry Benjamin began the process of coming up with a differential diagnosis in his 1966
book The Transsexual Phenomenon.
30
Benjamin outlines his own criteria for distinguishing

26
Gender self-determination is quite simply the freedom to make decisions for and about your own gender.
Additionally, according to Eric Stanley, gender self-determination is also a politics, an investment in multiple
embodiments and their radical potentiality. “Gender self-determination is a collective praxis against the brutal
pragmatism of the present, the liquidation of the past, and the austerity of the future. That is to say, it indexes the
horizon of possibility already here, which struggles to make freedom flourish through a radical trans politics.”
Eric A. Stanley, “Gender Self-Determination,” TSQ: Transgender Studies Quarterly 1, no. 1–2 (2014): 89–91.
TSQ 1, no. 1-2. (Keywords issue)
27
For a critique of the ideology of cure and the ways that trans/gender, disability, racial, sexual, and class justice
intersect with the concept of cure, see Eli Clare’s Brilliant Imperfection: Grappling With Cure.
28
D. Laub, N. Fisk, P. Gandy, R. Siegel, V. Hentz, J. Noe, D. Birdsell, D. Govan, B. Ascough, K. Colombe, J.
Leibman, J. Letts, Ronald Schultz, J. Shulman, “A Rehabilitation Program for Gender Dysphoria Syndrome by
Surgical Sex Change” (Department of Surgery, Stanford University School of Medicine, 1973), 23.
29
When clinicians and researchers say that they are not able to change society so instead they must change the
individual, they fail to recognize the ways they actively create the norms of society they claim to be powerless to
change. I wonder, how would trans healthcare look different today if doctors had seen their job to be both helping
the individual and changing the norms of society?
30
A differential diagnosis differentiates between two (or more) diseases/ailments that may present with similar
symptoms. For example, the symptom of congestion and a runny nose is common to many types of illness. Using a
differential diagnosis, doctors determine if your symptoms are related to flu (fever) or allergies (no fever). In the
process of making a differential diagnosis for transsexuality, the other “diseases” doctors found it important to
differentiate from include: transvestism, effeminate homosexuality, psychosis, and extreme psychopathy and

102
between transsexualism, transvestism, and homosexuality. Benjamin’s diagnostic criteria hinges
on two factors: “sex feel” and sexuality.
31
According to Benjamin these disorders can be teased
apart by figuring out what gender the person truly feels themselves to be (“sex feel”) and the
gender of their sexual attraction and how that sexual attraction is perceived by the patient
(sexuality). While homosexuals and MTF transsexuals may both be attracted to men, their
perception of whether that act is heterosexual or homosexual depends on their “sex feel.” To sum
up how he differentiated between these groups, Benjamin says: “The transvestite has a social
problem. The transsexual has a gender problem. The homosexual has a sex problem.”
32

“Sex feel,” is a category that encapsulates how the patient feels about themselves and
their gender. While a transvestite feels and knows himself to be a man, a transsexual “feels
himself to be a woman (‘trapped in a man’s body’).”
33
Like Alfred Kinsey’s sexuality scale,
Benjamin makes his own scale to chart the intensity of “sex feel.” However, this intensity is hard
to measure. Benjamin states: “We—often—have to take the statement of an emotionally
disturbed individual, whose attitude may change like a mood or who is inclined to tell the doctor
what he believes the doctor wants to hear.”
34
Essentially, Benjamin argues that intensity is
important for deciding whether surgery is necessary, but intensity can only be judged based on
the untrustworthy word of the patient.
In the realm of sexuality, Benjamin and other doctors believed that transvestism—the
practice of periodically dressing up as another gender—was more a sexual perversion than an

sociopathy. For example: If a patient said they felt themselves to be a sex different from the one they had been
assigned at birth, time/temporality became a key component in the differential diagnosis. Is this feeling longstanding
and ongoing? Then it is likely a Gender Dysphoria Syndrome. Is this feeling fairly new? Then perhaps it is
psychosis.
31
Harry Benjamin, The Transsexual Phenomenon (New York: Julian Press, 1966), 19.
32
Benjamin, 28.
33
Benjamin, 19.
34
Benjamin, 21.

103
affliction of identity. Because many transvestites lived as heterosexual married men who chose
to dress up only on occasion, they believed that tranvestism was more of an erotic proclivity than
an identity disorder. Doctors also drew a border line between transsexualism and homosexuality
along the axis of pleasure. They reasoned that, homosexuals who experienced sexual pleasure in
their current embodiment could not be true transsexuals because transsexuals are so afflicted
with disdain for their own bodies that they can not experience arousal or orgasm. As we see from
these two examples, so much of the parsing apart of categories of gender deviance was based
more on sexuality and desire than on gender performance and identity.
When “Gender Identity Disorders” were added to the Diagnostic and Statistical Manual
for Mental Disorder III in 1980, much of Benjamin’s criteria would make its way into the
diagnosis, but “sex feel” would be changed to something more measurable—temporality. In
order for someone to be considered for treatment they had to demonstrate that their cross-gender
identity was long-standing (and preferably immutable). Emphasizing the ongoingness of their
struggle was essential for differentiating between transsexuals, transvestites, and effeminate
homosexuals, and even other disorders such as psychosis or schizophrenia. Much like how the
category of intensity relied on the patient’s description of their condition, in the quest to
demonstrate longevity, the transsexual autobiography would be a central piece of evidence.
Prospective patients would tell stories from their childhood about playing dress up, struggling to
fit in socially with their peers, and cross-gender behavior and play. While this information, like
intensity, was highly subjective, temporality was seen to be more measurable and also more
capable of corroboration by asking the patient’s family or friends.
In the DSM-III, the diagnostic criteria of sexuality would come to take center stage. The
diagnostic code for Gender Identity Disorder included the numbers 302.5X with the final number

104
(“X”) being determined by the individual’s sexuality (1 for asexual, 2 for homosexual, 3 for
heterosexual, and 0 for unspecified).
35
Ideal candidates had a diagnostic code of 302.51, with the
number one for asexuality. While it might seem that pre-transition heterosexuality would be
preferred, if someone was heterosexual before transition, that meant to the doctors that they
would be homosexual after transition. If someone was homosexual before transition, they were
likely to be diagnosed as an effeminate homosexual and not a transsexual. According to the
doctors, it was best to find someone who, sexually speaking, was a blank canvas. True
transsexuals were seen as being people without sexuality, desire, or erotic pleasure. The idea of
being without a sexuality meant that theoretically, transsexuals were capable of incorporation
into the practices of heterosexuality (e.g. marriage and the nuclear family, child rearing, and
domesticity).
While sexuality was used to distinguish between transsexuality, transvestism, and
effeminate homosexuality, temporality has been used to distinguish the “psychosexual disorders”
from other forms of psychosis. Transsexuality is described by the DSM-III as “continuous” and
“persistent.”
36
Transvestism is described as “recurrent” and “persistent.”
37
The DSM-III does not
include temporal descriptions for homosexuality because of its removal in 1973, however,
psychoanalytic theory at the time of homosexuality’s inclusion in the DSM broadly regarded
homosexuality as a form of arrested development, i.e. being trapped in the homosexual “phase”
of normal heterosexual development.
38
This developmental theory of human sexuality is also
about time, about lingering (continuous) in an arrested phase of development and not being able

35
Diagnostic and Statistical Manual of Mental Disorders, Third Edition (Washington D.C.: American Psychiatric
Association, 1980), 18.
36
DSM-III, 261-262.
37
DSM-III, 270.
38
Sigmund Freud, Three Essays on the Theory of Sexuality (London: Imago Publishing Co, 1949).

105
to develop “normal” sexuality (persistent). Because all three of these categories emphasize
ongoingness, temporality was how doctors distinguished a sexual disorder from schizophrenia or
other forms of paranoia.
In their article “The Standards of Care: Uncertainty and Risk in Harry Benjamin’s
Transsexual Classification,” Beans Velocci argues that in the mid-twentieth century medical
milieu of endocrinologist Harry Benjamin, regret and danger were the unofficial criteria in
determining whether someone was eligible for gender affirming surgery. Through the
correspondence of Benjamin with Los Angeles urologist Elmer Belt, Velocci tracks how fears of
retribution and legal exposure, rather than ontological claims about gender and womanhood, had
the final say in the clinical decision-making process. As Velocci writes, "The transsexual
emerged as someone to be feared, not for their potential to unsettle gender norms and hierarchies
but for the hypothetical harm they might cause to medical practitioners who treated them.”
39

Velocci’s analysis allows us to see how the central factors for diagnosis were actually:
temporality, sexuality, and risk.
According to Velocci, risk was a broad and subjectively defined category. Benjamin and
Belt may have found a prospective patient too risky to treat if this patient was, in their words, too
demanding. Demanding, in this context, is a coded word for a person who advocated for
themselves and their right to determine their own sex/gender. A docile and appreciative
transsexual was preferred. A male-to-female patient may have also been deemed a risky case if
their pre-operative appearance was thought to be too masculine. Being tall, having a lot of body
hair, or a broad stature could disqualify a patient because of the “risk” that even after surgery
they would not appear feminine enough to blend into mainstream society. Risk is a broad, wide-

39
Beans Velocci, “The Standards of Care: Uncertainty and Risk in Harry Benjamin’s Transsexual Classification,”
TSQ: Transgender Studies Quarterly 8, no. 4 (2021): 462–80.

106
encompassing category that allowed doctors to reject patients simply because they did not want
to treat them.
In Stanford’s 1973 document, “A Rehabilitation for Gender Dysphoria Syndrome by
Surgical Sex Change,” we can see the influence of this category of risk. For example, Stanford
describes transsexual patients broadly as “difficult to handle” and potentially damaging to a
surgeon’s reputation.
40
In addition to this unspoken diagnostic criterion of risk, Stanford adds
another one of their own: success. As they write: “Perhaps as Gender Dysphorics, patients may
be considered as candidates for rehabilitation efforts not on the basis of the technicalities of the
specific diagnostic sub-groups, but rather on the basis of proven success in living in the gender of
choice” (emphasis mine).
41
The Stanford Gender Dysphoria Program expanded the differential
diagnosis to consider not only temporality, sexuality, and the unspoken category of risk, but now
also the category of “success.” The ability to pass, to be gainfully employed, and to integrate into
cis-heteronormative society became central to the decision-making process about whether a
prospective patient would be approved for surgery or not.
In Dan Irving’s article, “Normalized Transgressions: Legitimizing the Transsexual Body
as Productive,” he remarks that “the majority of gender variant individuals who enlisted medical
experts for substantive assistance were white, middle-class, able-bodied female-to-male trans
people more likely able to finance medical transition.”
42
Irving, making a particular argument
about how class functions in transsexual history and politics, highlight that patients were often
approved or denied for surgery based on their potential to assimilate into the work force and be a
productive member of society after transition. The “real life test” which required prospective

40
Laub et al, 2.
41
Laub et al, 8.
42
Dan Irving, “Normalized Transgressions: Legitimizing the Transsexual Body as Productive,” in The Transgender
Studies Reader 2 (New York, NY: Routledge, 2013), 18.

107
patients to live and work in their desired gender role for one to two years before being approved
for surgery did have the result of approving and selecting more (or perhaps even, mostly) white
patients because of their perceived ability to integrate into systems of racial capitalism.
It is also important to emphasize that the majority of the gender clinic doctors were
heterosexual, white men. The highly subjective category of “success,” was often modeled after
their own ideas of what it means to live a good life. In a 2017 interview for the NPR podcast
Hidden Brain, trans scholar and former Stanford patient, Sandy Stone describes Donald Laub by
saying, “He wanted his people to be totally unremarkable, to just fit in, to be able to live their
lives, to be able to be inconspicuous and just get along.”
43
Laub, like many other gender clinic
doctors, wanted patients who would pass, who would be invisible to everyone around them. The
doctors brought with them into the clinical setting their own racially coded ideas about normalcy
and success, which directly impacted which patients were selected as good patients for surgical
treatment.

Racial Plasticity and Impressibility
In the Stanford program plan they differentiate between three types of prospective
patients: 1.) those already deemed ready for surgery, 2.) those who could possibly achieve
approval for surgery with a little coaching, and 3.) those unlikely to ever receive approval.
Patients who were quickly approved for surgery were generally people who were already living
cross-gender lives and had found ways of successfully integrating into society, perhaps through

43
Podcast host, Shankar Vedantam echoes this by saying, “He had to just help people to essentially live what he
would think of as being a normal life, a life that they're not ostracized and a life that they're not feeling like they're
outcasts, that they're functioning…”
Hidden Brain, “The Fox And The Hedgehog: The Triumphs And Perils Of Going Big,” NPR, accessed May 15,
2017, https://www.npr.org/2017/05/15/528041635/the-fox-and-the-hedgehog-the-triumphs-and-perils-of-going-big.

108
familial acceptance or the ability to hold a steady job in their new gender role. Those deemed
unlikely to ever receive approval were individuals who were seen as suffering from a psychiatric
disorder other than gender dysphoria, such as schizophrenia or psychosis.
I am interested in the patient who was seen to have the potential to be successful, given
the right tutelage. The Stanford clinic opened what they referred to as their charm schools or
grooming schools.
44
Focused on the cultivation of proper femininity or masculinity, the charm
schools were what made the Stanford Gender Dysphoria Program more than just a surgical
clinic. The Stanford charm school taught MTFs techniques for doing their hair, makeup, and
nails, choosing clothes, altering one’s voice and mannerisms, and vocational skills for the
“feminine” professions. They encouraged post-op MTFs to live with pre-op MTFs in a kind of
domestic mentoring program. The school paired FTMs with football coaches and physical
trainers to grow their muscle mass and aggression. It was an education in the gender binary and
how to fit into it. By operating a charm school, the Stanford Gender Dysphoria program
emphasized the pedagogical, rather than ontological aspects of gender.
In Kyla Schuller’s The Biopolitics of Feeling, she argues that the twin concepts of the
“impression” and “impressibility” have been central to Western philosophy from Plato to Kant.
45

An “impression” is something that makes an impact on the bodies it comes into contact with,
leaving a trace. Climate, diet, religious practice, books, and other people are examples of things
that can leave an impression. “Impressibility,” on the other hand, describes a human’s capacity to
respond to, learn from, adapt to, and incorporate such impressions. Under this rubric, white

44
Regarding the Stanford clinic, Sandy Stone writes: “The clinic took on the additional role of ‘grooming clinic’ or
‘charm school’ because, according to the judgment of the staff, the men who presented as wanting to be women did
not always ‘behave like’ women. Stanford recognized that gender role could be learned (to an extent). Their
involvement with the grooming clinics was an effort to produce not simply anatomically legible females but
women... that is gendered females” (160).
45
Kyla Schuller, The Biopolitics of Feeling: Race, Sex, and Science in the Nineteenth Century (Durham, NC: Duke
University Press, 2018).

109
bodies and cultures were seen to be dynamic, plastic, pliable, and radically open to others.
People of color were seen as static, unchanging, and impulsive. Since the nineteenth century
racism has functioned as a kind of scale or gradation of plasticity and the ability to change.
“Impressibility came to prominence as a key measure for racially and sexually differentiating the
refined, sensitive, and civilized subject who was embedded in time and capable of progress, and
in need of protection, from the coarse, rigid, and savage elements of the population suspended in
the eternal state of flesh and lingering on as unwanted remnants of prehistory.”
46
In this regard,
we can see how Stanford’s charm school, was an exercise in determining whether the
prospective patient demonstrated enough “somatic dynamism” to be approved for surgery.
47

The concept of assimilation has historically been used to refer to topics of race, ethnicity,
and immigration.
48
Assimilation, a term used to describe digestion, is about absorption.
Absorption is incorporation (theoretical inclusion) at the cost of self-differentiation. At various
points in history, assimilation theory has posited that different racial and ethnic groups are more
capable of assimilation. Passing, on the other hand, refers to the process by which someone
intentionally or unintentionally loses that self-differentiation, blending into the majority.
Absorbing and blending are different functions with different temporalities. Absorption connotes
permanence while blending can be just temporary. Assimilation refers to a transformation that is
potentially more long-term than the act of passing. These concepts play off one another in the
history of trans medicine, with racial assimilation and gendered passing meeting in the space of
the clinic and determining one’s eligibility for surgery.

46
Schuller, 8.
47
Schuller, 12.
48
Catherine Sue Ramírez, Assimilation: An Alternative History (Oakland, California: University of California Press,
2020).

110
A patient who took well to the charm schools—learned proper feminine mannerisms,
voice modulation, and vocational skills—increased their chances of approval. It’s worth noting
however that some patients were automatically rejected, never given the opportunity to attend
charm schools, because of factors such as height. Understanding that racism functions as
varying degrees of impressibility underscores the racial dimensions of the prospective patients
who were deemed capable of reform. White patients were given the upper hand in the diagnostic
category of “success.” White patients were more likely to be seen as assimilable. As Catherine
Sue Ramírez writes in her history of assimilation in the U.S.: “By the 1980s, African Americans
would by and large be bracketed out of theories of assimilation and cast as unassimilable.” The
Black patients who were sought out for research on transsexual etiology were cast aside as the
treatment paradigm shifted to surgery. Black transsexuals were not seen as assimilable into
heterosexual, mainstream, capitalist society.
Schuller refers to the tutelage of impressibility as a kind of “sensorial discipline” that was
seen as the duty of women to teach.
49
Teaching sensorial discipline, or stated differently,
teaching individuals how to both be impressed upon but not overly open/unbounded/influenced,
took place across an array of discourses and spheres from architecture and interior design, to
public health campaigns and household manuals, to women’s moral reform societies, to vice
squads, and even the realm of the domestic novel and cookbook. Teaching proper impressibility
was essential. And from this list that Schuller creates of places where this was taught/enforced,
we can see its connections to the charm school.

49
Schuller, 18.

111
The Stanford rehabilitation clinic made a variety of services available to “those who
potentially could fulfill all requirements but lacked time in therapeutic gender test, and lacked
certain accomplishments such as employment or passability.”
50
These services included:
a) Employment opportunities with the vocational counselor
b) Job retraining via the State Department of Vocational Rehabilitation
c) A professional model to help with grooming, good taste, and deportment
d) A football coach-physical therapist to direct a body building exercise and
conditioning program (female-to-male)
e) Peer scrutiny via a group therapy type of patient-to-patient development meeting
f) Living with one of the cadre of successful postoperative patients for several months
in order to form behavioral identification patterns, to learn tips for getting along as
well as to obtain food, clothing and shelter
g) Police department liaison to become acquainted with the impersonation laws
h) Professional attorney’s assistance in change of name, school transcript, birth
certificate, and document adjustments
i) Advice from the patient’s assigned counselor regarding insurance, and VA benefits,
apartment rental, how to avoid being labeled by the surgeon as excessively
narcissistic, manipulative or hysterical
j) Endocrine feminization program via an internist
k) General need assessment with an experienced psychiatrist
51

Stanford referred to this list as being a part of their “behavior modification” approach or more
colloquially, the charm schools. The Stanford Gender Dysphoria program was a pioneering
institution of trans therapeutics for the ways that it merged the public and private into a
rehabilitation program focused on the discipling and integration of bodies deemed to be unruly.
Jules Gill-Peterson’s Histories of the Transgender Child describes how ideas about
impressibility, or as she refers to it: racial plasticity, came to dictate the parameters of trans
therapeutics. Gill-Peterson argues that plasticity was understood abstractly as whiteness (much
like impressibility). She defines racial plasticity as “an abstract whiteness that signals the
capacity for the scientific transformation of the body and mind in the broader service of the

50
Laub et al, 10.
51
Laub et al, 11-12.

112
human species.”
52
If sexological concepts such as innate bisexuality speak to the elasticity of
gender, racial plasticity speaks to the assimilability/reformability of whiteness. Gill Peterson is
interested in how the elasticity of gender and the plasticity of whiteness meet in the space of the
gender clinic, dictating which kinds of patients are deemed to be worthy of treatment and capable
of success. Transsexual autobiographies were written to communicate an individual’s conformity
to the diagnostic criterion of temporality and sexuality but perhaps even more importantly,
prospective patients tried to convey the abstract notion of success through white racial plasticity.

The Transsexual Autobiography
In 1952, the New York Daily News published a story: “Ex GI Becomes Blonde Beauty.”
This story, about a U.S. American trans woman named Christine Jorgensen—who medically
changed her sex in Denmark—would captivate the attention of the nation. As trans historian
Susan Stryker writes, “In a year when hydrogen bombs were being tested in the Pacific, war was
raging in Korea, England crowned a new queen, and Jonas Salk invented the polio vaccine,
Jorgensen was the most written-about topic in the media.”
53
Thousands of people all across the
country who were interested in changing their sex would frantically write to Jorgensen. Indeed,
she was so well-known that a person need only write “Christine Jorgensen, USA” on an envelope
and it would be delivered to her.
54
As Styker states, “Christine Jorgensen was arguably the most
famous person in the world for a few short years nearly half a century ago.”
55

In 1967, Jorgensen published her autobiography: Christine Jorgensen: A Personal
Autobiography. The text provides insight into the ways that transsexuals deployed temporality,

52
Gill-Peterson, 100-101.
53
Susan Stryker, Transgender History (Berkeley: Seal Press, 2008), 47.
54
Jorgensen, 178.
55
Jorgensen, v.

113
sexuality, and success (most specifically through assimilable whiteness) in order to be deemed
worthy of treatment. In the pages of Jorgensen’s autobiography we find descriptions of
childhood outside the bounds of gender normativity, descriptions of pre-transition asexuality (or
at least aspirational heterosexuality), and a desire to become a productive and “successful”
member of capitalist society.
Jorgensen is careful to describe her body as naturally, that is, biologically, unable to conform
to the sex she was assigned at birth. She writes: “My body was not only slight, but it lacked other
development usual in a male. I had no hair on my chest, arms, or legs. My walk could scarcely
be called a masculine stride, the gestures of my hands were effeminate and my voice also had a
feminine quality. The sex organs that determined my classification as ‘male’ were
underdeveloped.”
56
She describes herself as “different from other boys.”
57
She’s a “miserable
misfit.”
58
In these descriptions she establishes a long-term temporality to her problem, or under
the Benjamin criteria, a high intensity of mismatched sex feel.
In Jorgensen’s autobiography she establishes herself as a figure of American
exceptionalism: she casts herself as not only the first U.S. American to have gender confirmation
surgery, but also as an exceptional patient—the exact person her Danish doctor Christian
Hamburger has been looking for to help him with his research. “Neither my doctors nor I had
ever advocated these procedures as a solution for other sexual breaches of Nature. Mine was a
single, highly individual case and the doctors had proceeded along the lines they felt would be
most beneficial to me alone…”
59
Jorgensen crafts the narrative of her own life around watershed
moments in U.S. history: the stock market crash of 1929, the death of President Roosevelt, the

56
Jorgensen, 31.
57
Jorgensen, 21.
58
Jorgensen, 27.
59
Jorgensen, 193.

114
bombing of Pearl Harbor, etc. By very deliberately weaving her life story with these moments in
U.S. history, Jorgensen tries to carve out space for herself in United States mythology.
The other way that Jorgensen accounts for the passage of time is through her countless
references to the Christmas holidays, marking her time in Denmark as two Christmases away
from her family, her return to the U.S. and newfound fame as “not going to get in the way of her
Christmas shopping” for her family, the Christmas when the IRS took all of her money, the first
Christmas after her mom’s cancer remission, etc. Christmas is a central character in the memoir,
and as Eve Sedgewick has argued in her essay “Christmas Effects,” Christmas speaks in the
same language and logics as (white) cis-heteronormativity.
60
“The pairing ‘families/Christmas’
becomes increasingly tautological, as families more and more constitute themselves according to
the schedule, and in the endlessly iterated image, of the holiday itself constituted in the image of
‘the’ family.”
61
In this regard, we can see Jorgensen’s constant repetition of Christmas memories
is an attempt to insert herself into the logics of white cis-heteronormativity.
62
Christmas signals
normalcy, the nuclear family, and assimilation.
Jorgensen describes her pre-transition work ethic as lacking. All of her employment is
temporary or short lived. She moves to Hollywood to try her hand at photography before
returning home, having failed to make a name for herself. After beginning to transition her work
life is described as incredibly productive, almost frenetic. She begins shooting a travel film of
Denmark. She does magazine photography. “I was beginning to take my place in the world, and
was happy, productive, and inspired to work…”
63
She describes transition as aiding in her

60
Eve Kosofsky Sedgwick, Tendencies (Durham: Duke University Press, 1993).
61
Sedgewick, 5-6.
62
Sedgewick never mentions in her essay how both ideas about Christmas and ideas about the family are racially
contingent. Sedgewick never names the family she describes as white, but I do.
63
Jorgensen, 97.

115
creativity. “When the male chemistry was inert, I became alive and vigorous and felt fully
capable of meeting my responsibilities and problems with competence.”
64
Jorgensen presents
herself as not only assimilable into the private sphere of the heterosexual home, but also a model
citizen under capitalism, contributing to the public good.
Mario Martino’s 1977 autobiography Emergence, which dubs itself “the first complete
female-to-male story,” is an homage to heterosexual marriage.
65
One of the blurbs on the dust
jacket is written by Martino's wife Rebecca. She states: “Mario has said many times, ‘I want only
to be an ordinary man.’ but he is much more than ordinary. He is an exceptional husband, a man
to be proud of, one who always has time to help others. The struggle was difficult for both of us,
but to be able to emerge and live in society as husband and wife has made it all worthwhile.” The
cover of the book shows the side profile of a man with a pipe. Dressed in a suit and sitting at a
writing desk, everything about the posture, the pipe, the environment oozes masculine authority.
Martino grew up in the Midwest in an Italian family. His stories from childhood are full
of nuclear family dynamics, Catholicism, and suburban life. The Christine Jorgensen story plays
a role in Martino's own autobiography. He writes:
The Christine Jorgensen story broke. How people laughed and made cruel jokes
about the man who had changed into a woman. But I did not laugh. I only cried inside
and started a nightly prayer that someday I, growing into a woman, could be changed into
the man I knew I was meant to be.
How had Christine done it? Over and over I read the news stories I’d secreted in
my room. He had been a soldier and now he was a she. Pa laughed louder than anyone.
Little did he know. And his jokes seemed crueler even than the other ones heard
everywhere.
“Imagine going abroad and coming back abroad!” one of Pa’s cronies
wisecracked.
And the guffaws grew louder and more gross.
As quickly as it began, the public excitement subsided. But not within me. At last
I had hope. There were people like me. And they were doing something about it. Now I

64
Jorgensen, 101.
65
Mario Martino is a pseudonym.
Mario Martino and Harriett, Emergence: A Transsexual Autobiography (New York: Crown Publishers, 1977).

116
had a plan: I must hurry through school, graduate, make a lot of money, go to Denmark.
I’d not tell anyone. I’d simply leave this country as Marie, leave this girl-form in
Denmark, returned to the states as a man with a new name, and lead a new life.
66

Through the challenging years of Martino’s life, the hope that got him through was the idea of
Denmark. Denmark, his North star. Denmark, the destination of his journey.
Martino, Catholic school educated, decided to go to convent school to become a nun in
hopes that the austere life would strip him of his gender affliction. Martino’s extended emphasis
on his time as a nun serves to enforce the idea of pre-transition asexuality. After leaving the
convent, Martino went on to pursue a degree in nursing and later founded an organization called
Labyrinth Foundation Counseling Service to help other female-to-male transsexuals.
Martino’s memoir is divided into two section “The Labyrinth” and “Beyond the
Labyrinth.” The second section is mostly an afterward, which leans heavily on theories of sex
and gender from the time period. Much like Jorgensen, Martino intersperses his own story with
popular science interpretations of his affliction and its meaning, a rhetorical strategy that
provides legitimacy to his story and in turn, legitimacy to the doctors and their diagnostic
criteria. In the section, “The Labyrinth,” Martino tells the story of his life and how he ended up
pursing transition. The entire organizational structure of the life story is geared toward the goal
of heterosexual marriage, not transition. In fact, Martino describes the impetus for his transition
as coming from meeting a woman he knew he wanted to marry: “I knew that first day I wanted
to marry Becky. And now that I found The Woman, I resolved to do everything to make her want
me—and I couldn’t wait for the day that sex-change surgery was to alter my anatomy to that of a
man.”
67
Unlike other trans autobiographies of the time, the climax of the book comes not when

66
Martino, 40.
67
Martino, 124.

117
Martino has surgery, but when he finally is able to be legally recognized as a man and marry
Rebecca.
Both Martino and Jorgensen emphasize their attachment to the nuclear, heteronormative
family. Their transition stories are framed as journeys toward normalcy and suburban
domesticity. While they were outcasts in their childhood, something also emphasized for the
longevity of their struggle, they both find a way to return to the natural order of things. Of
course, the logos of this narrative structure are dependent on Eurocentric standards of home,
family, and the private sphere. They are capable of all these accomplishments because of their
capacity for assimilation, or racial plasticity.

A Certain Kind of Patient
Throughout the gender clinic archives are numerous letters, autobiographies, and
photographs sent to doctors from people all across the country hoping to be seen as patients.
These are the rejected patients whose writings and lives remain public, animating the archive.
Their letters and autobiographies are instructive for understanding the kinds of patients who were
rejected from the clinics. Like Linda, these individuals try their best to convey to doctors that
they meet the temporal and sexuality requirements of transsexual treatment, however they are
unable to convince doctors of their ability to succeed in post-operative life.
In the faded black and white snapshot stands a femme figure in a bikini, Rosy. She is
leaning against a short concrete wall, with one arm rested on it to prop her up. The other arm
falls to her side. Her left leg is extended slightly forward, bent at the knee. Her body stands on
display, but her face is absent—it has been cropped from the frame. As Rosy wrote, “Enclosed
you will see one of my picture in bath suit similar to the bikini. Note my developped [sic]

118
breasts, and my whole general feminine delineations. Note specifically how my small penis is
almost invisivle [sic] through the bikini.”
68
Focusing the lens on the feminine body that Rosy
wishes to describe, the photographer has cropped the head from the frame entirely.
Like Linda’s use of her measurements, Rosy is trying to demonstrate the natural and
innateness of her femininity. Paper clipped to the photo are four typed pages which detail Rosy’s
life. While the letter speaks to the diagnostic criteria of sexuality and temporality, this
photograph is meant to convey something different about her potential for success. She is
making it clear that she could easily pass as a woman. No risk here.

Fig. 3.2 Photograph of Rosy Son of Rosa from letter to UCLA, year unknown

Unfortunately for Rosy, despite her life-long cross-gender identity and aspirational
heterosexuality, her life story does not convince the doctors that she can be assimilated into

68
Rosy Son of Rosa photograph. No date. Box 9, Robert J. Stoller Papers, UCLA Special Collections.

119
heterosexual and capitalist culture. Her letter is riddled with spelling and grammatical errors—
something that conveys information about her education level. She admits to engaging in sex
work, an informal economy that is not accepted as productive nor legitimate under capitalist
wage labor. Rosy’s photograph along with her name/naming practices (birth name: Razine and
chosen name: Rosy Son of Rosa) indicate that Rosy was perhaps not white. Razine comes from
Arabic. Naming practices in Arabic follow the patrilineal line, with names often including “bin”
or “bint” to indicate that one is the son or daughter of someone. Rosy queers this practice by
saying that she is the son of her mother rather than father, following the matrilineal line. Other
evidence in Rosy’s letter might point to Latinidad. Throughout her letter, Rosy often uses the
letter “V” in place of the letter “B,” a common mistake for people whose first language is
Spanish. Rosy’s racial identity is unknown, these are speculations based on clues on her letter,
however, what is clear is that the way Rosy tells her life story fails to align with what the gender
clinic doctors think of as having the potential for success.
In a fifteen-page pamphlet folded to look like a small book, a trans woman named Jean
Daley (pseudonym) types out her life story for Stoller. The pages are folded in half like a book;
this gesture signals the desire to resemble the aesthetics of published autobiographies. Daley
titles her autobiography, “The Unmanly Male.” She states her reasons for writing her story: to
make a more understanding society, to contribute to professional understanding, and to bring
relief to the author, either through an ability to attain manhood or by finding a surgeon to help
her become a woman. The autobiography begins: “The truth the whole truth about oneself is
perhaps the most difficult thing for a man to admit. To face up to the whole truth and tell it
candidly is most painful. The following is a true record.”

120
In two separate sections, written years apart, Daley tells various short stories and
vignettes about her life. Interspersed with these vignettes are meditations on Christianity and
salvation, the history of gender difference, and laws of nature and harmony. The decision to
write under a pseudonym is expressed as a desire to “protect” the author’s family: her mother,
sister, two brothers, son, and two grandsons. Daley’s decision to take on a pseudonym is
interesting, considering she was not sending this pamphlet to a popular newspaper or magazine
but to a doctor’s office. At the time, who did she imagine would view her autobiography other
than Stoller and perhaps other clinic doctors? By using a pseudonym, Daley conceals her identity
just like Rosy’s act of cropping her face from the photograph. It is as if both Daley and Rosy
knew that the protections afforded to patients would likely not be extended to them.
In the first section of the pamphlet she tells about her childhood. The author details a
story of being caught by her father in women’s clothes at the age of twelve and being beaten,
prompting her to run away from home and get a job working concessions for a traveling theatre.
She eventually began acting as a girl in the theatre’s production. She gave away all of her male
clothes and started living full time as a girl, however after eighteen months of traveling and
being away from home she became homesick and decided to return to her family. She did so
dressed as a boy.
Daley’s story, as she writes it, meets the temporal requirements for surgery. By beginning
with her childhood, Daley provides evidence of her life-long cross-gender identification. The
childhood autobiography is followed by the heading “Phase Two.” The author writes, “Two
years have gone by since I wrote the first phase during this time the female pressures within have
steadily increased beyond my endurance, becomming [sic] to [sic] difficult for me to deal with
and fight any longer.” She describes becoming sexually interested in men and finding

121
satisfaction in pleasing them sexually. For Daley, she hoped that somehow this might “cure” her
of her gendered confusion. She tells of moving in with a woman who introduces her to sex work.
The author goes on to describe why, despite her newfound sexual attraction to men, she is
not a homosexual. She writes, “A true homosexual hates women, I love them. He despises
feminine clothing, I adore it. He likes to change roles. I just want to be a girl.” Daley explains
that she has never been sexually attracted to women because of her desire to be, what she calls,
in the role of the woman. In this section, the author is engaging with questions of differential
diagnosis. Daley is directly addressing why she does not fit in the category of homosexual. This
gesture, as well as the decision to write about her life and assemble it in a way that resembles
other transsexual autobiographies points to the fact that Daley must have had some connection to
knowledge about the workings of the clinics and their protocols. However, by mentioning
satisfaction and pleasure in her sexual encounters, she was immediately excluded from the ideal
category of asexual.
Throughout the autobiography, the author has taken a blue pen to make edits to the type-
written text. She adds in words and phrases. She redacts entire paragraphs. This editing gestures
to another time, a third or perhaps fourth temporality layered on top of the described phases one
and two. It indicates that the author returned to her typed text numerous times, making additions
and revisions. At times she crosses out text in blue pen. At other times she covers words by
repeatedly typing a dark line of x’s over them. She is perfecting her text—cutting and adding,
redacting and expanding—the layers of revisions can be seen on the surface. Each edit leaves a
mark, like a suture or a surgery scar. Her story takes shape out of these various moments. The
body of the text is in process like her own body and relationship to gender.

122
The autobiography concludes with an appeal for surgery. Below, I quote at length from
this portion of the narrative in order to allow Daley to speak in her own voice.
The one good thing which has come out of my prostitution is the fact that at long last
I have the confidence and the courage to seek conversion into a female so that I can be a
woman legally and live without fear.
If I knew beyound [sic] a shadow of a doubt that I had another fifty years remaining
in my life. I would more than gladly trade it for a dozen years as the woman I want to be.
This feeling I have is not a whim, not something I can just ignore. It is a compelling,
driving force stronger than anything I know. It can stand up and has stood up many times
to redicule [sic], to abuse and on occasion to violence. I have been beaten, despised, spat
upon and all but stoned because of it. Still it remains in full force. Eating away at my
insides. Torturing me as dope tortures an addict.
What is it all about I’ve asked myself this question a million times. I simply do not
know. I just know that I am driven by a force beyound [sic] comprehension to wear
dresses and all the furbelows that go under them.
There is no sacrifice I would not make to realize my dream except those I love. There
is no work for woman so meanal [sic] that I would not do, only if I could do it as a
woman.
I could write volumes about this life of mine, which encompases tragidy [sic],
comedy, laughter, tears, yes buckets of tears.

The final lines after this are crossed out with blue pen. Through the redaction I can read: “But
there is no reason to write so much when the full story has been told so completely in these other
pages.” The autobiography finally concluded with, “The end.”

123

Fig. 3.3 Photograph of the final page of Jean Daley’s autobiography

Daley’s letter is a forceful appeal for surgery. As the many edits and redactions indicate,
Daley spent a significant amount of time on this life story. She wanted to carefully convey how
she fits the diagnostic criteria for treatment. The closing words indicate the intensity of her cross-
gender identity and desire for transition. However, like Rosy, Daley is open about engaging in
sex work. Sex work is a double disqualifier in the eyes of the clinicians. It speaks not only to
supposed sexual promiscuity and a certain level of comfortability with one’s body, which
undermines the claim to asexuality, but also undermines the belief that these women can
productively engage in wage labor. They have worked in an underground economy, an economy
of cash payments, outside of government oversight or taxation. In the eyes of the doctors, they
are not contributing to economic productivity and in fact are directly undermining it.
These two examples of Daley and Rosy illustrate how even when a prospective patient met
the temporal and sexual requirements for treatment, the elasticity and highly subjective nature of
“success” led to their rejection from the clinics. Their letters, full of spelling errors and

124
references to sex work, raise doubts for the doctors that these women are capable of assimilating
into capitalist culture. Their failure to convey whiteness and heteronormativity marked them as
unfit for treatment.

Getting the Story Right
As the university-based gender clinics shifted to a surgical model of treatment, their focus
changed from etiology to nosology, or cause to classification. In order to decide which patients
were best suited for surgery, they developed a diagnostic criteria with four central pillars:
temporality, sexuality, risk, and success. In this therapeutic model, patients were often asked to
write or tell their life stories. In intake interviews or letters to clinicians, patients needed to “get
the story right,” that is, carefully explain how they fit the four diagnostic criteria while heavily
emphasizing their racial plasticity and assimilability. In this chapter I argue that the category of
“success” was responsible for causing a major shift in the demographics of the patient
population. Patients of color, once preferred for their perceived pathological family structures are
rejected because doctors saw them as unable to assimilate into mainstream heterosexual and
capitalist culture.
During the late 1960s and for most of the 1970s, sex reassignment surgery became the norm
for treating transsexual patients. However, not all gender clinic researchers and clinicians agreed
with this course of action. By the mid-1970s, a conservative backlash, composed primarily of
anti-surgery psychiatrists, would mount an attack which resulted in the closing of the Johns
Hopkins Gender Identity Clinic in 1979. By the following year, most of the university-based
gender clinics had ceased operation. In the next chapter I examine the trends that led to the
closing of the gender clinics.

125
Chapter 4
Looking Back: Secrets, Scandals, and the End of the Gender Clinics (1979-1980)

In October of 1979, Jon K. Meyer, a psychoanalyst in the Department of Psychiatry at
Johns Hopkins University held a press conference to announce that Hopkins would no longer
perform sex-reassignment surgery.
1
Meyer had recently published an article in the Archives of
General Psychiatry titled, “Sex Reassignment: Follow-Up,” in which he claimed that after
conducting follow-up interviews with fifty surgical patients, he had concluded that “sex
reassignment surgery confers no objective advantage in terms of social rehabilitation.”
2
On the
surface, the press conference seemed fairly routine and straightforward: the university had been
offering an experimental treatment, researchers had collected follow-up data on the outcomes of
that treatment, and because the data indicated that it was not beneficial, the practice would be
discontinued. However, this was not the whole truth.
The decision to officially end the practice of treating transsexuals had happened at least
six months prior.
3
The follow-up study that Meyer referenced throughout the press conference as
justification for closing the clinic was based on questionable evidence and listed a co-author who
was unknown to practically everyone but Meyer. In truth, Paul McHugh, the chair of psychiatry
had come to Hopkins in 1975 with the express goal of ending the program.
4
The closure of the
Gender Identity Clinic was years in the making.

1
Jane E. Brody, “Benefits of Transsexual Surgery Disputed As Leading Hospital Halts the Procedure,” New York
Times, October 2, 1979.
2
Jon K. Meyer and Donna J. Reter, “Sex Reassignment: Follow-Up,” Archives of General Psychiatry 36, no. 9
(1979): 1015.
3
Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge: Harvard
University Press, 2002), 268.
4
Melanie Fritz and Nat Mulkey, “The Rise and Fall of Gender Identity Clinics in the 1960s and 1970s,” Bulletin of
the American College of Surgeons, April 1, 2021.

126
This chapter is about how, by 1980, the majority of the university-based gender clinics
were no longer operational. It provides an account of why the clinics closed, focusing on four
main themes: changing cultural attitudes towards medicine and psychiatry, doctor in-fighting,
financial problems, and the rise of private practice clinics. In each of these sections, I explore
publicly documented reasons for the clinics closing, as well as behind-the-scenes scandals and
gossip which offer complementary and/or contradictory accounts of what really happened.
In this chapter, I deploy the concepts of reversing the gaze, gossip, and scandal as a
means to subvert binaries such as legitimate and illegitimate and objective and subjective. I take
seriously the gossip and speculation that surrounded the research happening at the university-
based gender clinics, understanding gossip to be a legitimate form of discourse, one that
challenges and undermines official accounts. Gossip reveals what happens behind the scenes,
between the doctors, and outside of official documentation. By focusing on the clinics’ scandals,
I reverse the gaze, turning the eye of scrutiny so often applied to patients back on the practices
and motivations of doctors themselves.

Reversing the Gaze

During the years I spent regularly visiting the Robert J. Stoller Papers in UCLA Special
Collections, the librarians and reading room staff came to recognize me. One day, as I was
storing my belongings in a locker, a librarian asked, “Have you ever seen a photograph of Stoller
in the collection? Someone called requesting a photo of him, but we haven’t been able to locate
one.” Before then, I hadn’t noticed the lack of images of Stoller. The archive was full of
images—prospective patients, famous transsexuals, newspaper clipping, snapshots of other
doctors—but none of Stoller, at least none that I could remember. In a 1979 letter to the French
philosopher and psychoanalyst, Jean-Bertrand Pontalis, Stoller wrote, “You should know that I

127
never offer my picture for public use, trying always to remain invisible as a person. In that way,
both my research and pleasure in privacy are retained.”
5

In the mid-twentieth century, photography was one of the many imaging tools, including
x-rays and ultrasounds, that doctors used to understand non-normative gender. The clinical gaze
was expanded with the advent of photography, as observations could occur in real time and then
again, via still images.
6
What doctors perceived to be visual indications of deviance could be
captured in photographs, catalogued in archives, and circulated for further research and opinion.
Writing in 1990, Jennifer Terry elaborates that “photographs were explicitly intended to
supplement other physical data and to act as diagnostic instruments for correlating body form
with behavior.”
7
Queer bodies were thought to reveal the truth of both gender and sexual
practices. Photography was a diagnostic tool to visually confirm and capture pathology.
As Hil Malatino writes in their book Queer Embodiment: Monstrosity, Medical Violence,
and the Intersex Experience, medical authority is maintained though a closed circuit or feedback
loop between observation (the gaze) and judgement/adjudication (the word).
8
The perceived
truthful quality of photography was enlisted by medical authority to strengthen this closed
circuit, bolstering the gaze by capturing deviance and pathology on film and through captions. In
this visual economy of capture, the doctor remains faceless. Borrowing from Donna Haraway’s
concept of the “modest witness,” Malatino elaborates that the doctor “must inhabit the space of
the unmarked, must be the witness who is never himself witnessed.”
9
Stoller’s aversion to being

5
Robert J. Stoller to J.B. Pontalis, 16 January 1979, Box 32, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.
6
Benjamin Singer, “From the Medical Gaze to Sublime Mutations: The Ethics of (Re)Viewing Non-Normative
Body Images,” in The Transgender Studies Reader (New York: Routledge, 2006), 601–20.
7
Jennifer Terry, An American Obsession: Science, Medicine, and Homosexuality in Modern Society (Chicago:
University of Chicago Press, 1990), 196.
8
Hil Malatino, Queer Embodiment: Monstrosity, Medical Violence, and Intersex Experience (University of
Nebraska Press, 2019), 135.
9
Malatino, 138.

128
photographed is a perfect example of the modest witness, positioning himself as the doctor who
must remain faceless in pursuit of “objectivity” according to the organizing logics of the medical
gaze.
Despite Stoller’s attempts to remain faceless, I was able to locate two photographs of the
doctor in his archive. The first is a headshot featured on a roster of faculty members in the
Department of Psychiatry and Biobehavioral Sciences. The photograph, when cropped from the
other faculty photos, has a mugshot like quality. The frame only captures Stoller’s head, quite the
opposite of the “medical mugshots” of intersex patients that Malatino describes in which the
head/face is cropped, obscured, or covered by a black bar. The medical mugshot erases the
subjectivity of the individual being photographed, capturing only their body as an object of
study. Stoller, on the other hand, is seen only for his face.

Fig. 4.1 Photograph of Robert J. Stoller from the Department of Psychiatry and Biobehavioral Sciences Faculty
Roster, 1977

The second photo is a snapshot of Stoller and his UCLA colleague and protégé, Richard
Green. Green mailed the photo to Stoller on April 9, 1981 with the note: “Memorialized for the

129
first time since Japan!”
10
To which Stoller replied: “Thanks for the photograph; apparently there
have been changes since the last one in Tokyo…otherwise, you and I look: identically the same
as we did almost 20 years ago.”
11
Despite being close friends and colleagues for decades, this
note seems to indicate that the last time that Stoller and Green were photographed together was
twenty years prior, a fact that speaks to Stoller’s resistance to being captured photographically.

Fig. 4.2 Photograph of Richard Green and Robert Stoller, date unknown

An addition to his avoidance of photographs, Stoller also refused to be interviewed. In
another exchange between Stoller and Green, Green wrote: “Linda told me she’d seen an
interview article with you in the November issue of Human Behavior. I was incredulous. My
mentor would never speak to the press (one cannot speak with the press). Rushing to the mag I

10
Richard Green to Robert Stoller, 9 April 1981, Box 35, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.
11
Robert Stoller to Richard Green, 23 April 1981, Box 35, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.

130
was reassured to see that they had to rely on what you’ve written.”
12
Stoller replied, “The rule
still holds that I not appear as a living presence in any articles…As I have so often mentioned to
you, I cannot express how grateful I am to myself for this policy. We may not win, but we can
delay losing.”
13
The use of “living presence” is an interesting choice. Rather than take on a
dynamic, embodied presence, Stoller prefers a transcendental existence. By remaining invisible
or imperceptible he is able to dodge scrutiny or as he puts it “delay losing.” By avoiding
revealing any details about his personal life it is as if Stoller is trying to quash the authorial “I,”
instead allowing his research to simply appear—absent a human figure—suggesting an objective
or omnipotent quality.
The lack of photographs or interviews with Stoller speaks to the optics of the gender
clinics and their archives. The gaze was unidirectional. While patients were scrutinized for what
they wore, how they behaved, their class status, their race, their childhood, their sexuality, and
countless other categories, doctors managed to avoid inspection. Even with the discovery of
these two photographs of Stoller, he is still a ghostly presence. The photos may put a face to the
name, but the images lack the penetrating quality of clinical photography.
In this chapter, I aim to reverse the unidirectional trajectory of the gaze back on the
doctors themselves who so meticulously (and often violently) attempted to capture trans life in
the mid-twentieth century. Reversing the gaze is a forceful objection to the modest witness
paradigm, refusing to allow the doctor to remain faceless and invisible. It says “no” to the idea
that doctors can escape scrutiny through optical illusions and claims of objectivity.

12
Richard Green to Robert Stoller, 12 October 1978, Box 35, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.
13
Robert Stoller to Richard Green, 18 October 1978, Box 35, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.

131
Doctors entered the clinic and their encounters with patients with a set of ideas about
gender, behavior, comportment, and sexuality. They brought with them interpersonal conflicts
and professional grudges. They were shaped by the factors they so carefully scrutinized in
relation to patients: family background, race, temperament, and marital status. Reversing the
gaze is about refusing to allow doctors’ motivations and practices to remain invisible.

Gossip and Scandal
Buried in a simple administrative document in the Reed Erickson Collection of the ONE
Archives is a stunning accusation. “Jude Patton told me that a legal storm is brewing with some
of Dr. Biber’s surgical patients because he sent samples of their tissue to Dr. Richard Green who
is now at Stony Brook in NY for research on the possible presence of the H-Y antigen to
determine whether there is a genetic basis.”
14
Zelda Suplee, the director of the Erickson
Education Foundation (EEF), a clearinghouse for transgender education and advocacy in the
1960s and 70s, wrote the note for her boss Reed Erickson on a weekly progress report. If
Patton’s gossip is accurate, it would mean that Dr. Stanley Biber, a private practice surgeon in
Trinidad, Colorado had taken the tissue he removed from transsexual patients and mailed it to
Richard Green for analysis, without the consent of the patients—a clear ethics violation.
As Lisa Lowe writes in Immigrant Acts, gossip is extravagant, unregulated, and
“particularly parasitic, pillaging from the official, imitating without discrimination, exaggerating,
relaying.”
15
She continues, “In this sense, gossip requires that we abandoned binary notions of
legitimate and illegitimate, discourse and counter discourse, or ‘public’ and ‘private,’ for it

14
Zelda Suplee to Reed Erickson, 12 July 1981, Box 2, Folder 18, Reed Erickson Collection, ONE Archives, Los
Angeles, CA.
15
Lisa Lowe, Immigrant Acts: On Asian American Cultural Politics (Durham: Duke University Press, 1996), 113.

132
traverses these classifications so as to render such divisions untenable.”
16
Gossip, I contend, does
not have to be factually true in order to present some kind of truth of the matter. By this I mean,
in its mutation, gossip may come to tell a story which is exaggerated, presumptuous, or
scrambled, but its telling and repetition provides us with insights about what the many tellers
found to be important or scandalous. While it’s hard to verify whether Biber was in fact sending
tissue to Green without patient consent, the fact that Suplee heard this gossip from Patton, a trans
man who was embedded in both the medical community—as a physician assistant, community
counselor, and Stanford patient—and trans activist organizations, provides insight into how trans
people regarded medical professionals who were working with trans communities.
According to Foucault, modern medicine is defined by exacting, precise, and empirical
language—the ability to objectively describe what one observed.
17
Despite the masculine and
authoritative tone of clinical description, doctors also participated in the practice of gossip.
Gossip, much like archival translation or mediation, involves mutation and distortion. Take as an
example an anecdote shared with Harry Benjamin by Los Angeles based urologist, Elmer Belt:
One transsexual patient who was operated upon and badly injured in Casablanca, being
left with a recto-perineal fistula and a stenosed urethra with a completely atretic vagina,
brought us news August 30
th
that Dr. and Madame George Burou were arrested in
Casablanca last week. Their hospital was closed down and the patients were slipped into
a hotel. A friend of our patient called her from London and gave our patient this
information. The friend was in Casablanca at the time of the arrest. The doctor was
arrested because of the large amounts of money he was shipping out of the country to the
Swiss banks. I thought you would like to have this for your gossip file.
18

This gossip reaches Belt through multiple steps of transmission. First, a London-based
transsexual who was in Casablanca at the time of the alleged arrest calls her transsexual friend in

16
Lowe, 113-114.
17
Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception (New York: Vintage Books,
1994).
18
Elmer Belt to Harry Benjamin, 3 September 1968, Box 14, Folder 1, Elmer Belt Papers, Library Special
Collections, Louise M. Darling Biomedical Library, UCLA.

133
the U.S., who tells the information to her doctor, who then passes it along to another doctor on
the opposite side of the county. Benjamin responds by saying, “Two of my patients, one from
San Francisco and one from New York, were in Casablanca, accepted for surgery, when the
clinique [sic] was closed by the authorities…Both patients reported the incident after their return
to the U.S. but none mentioned an ‘arrest.’”
19
Benjamin seems to suggest that the idea of a
dramatic arrest is perhaps embellished and the issue was more simply “tax problems.” With no
newspaper articles that corroborate the supposed arrest, it is more likely that Benjamin’s account
is closer to the truth. The exchange speaks to the hyperbolic quality of gossip.
As the example with Belt and Benjamin also makes clear, doctors would gossip with one
another about one another. Researchers and clinicians who publicly sat on panels together,
worked on advisory committees, and published in the same journals would candidly voice their
opinions about one another in private correspondence, offering warnings about whose work was
legitimate and whose was not. Moreover, doctors often tended to gossip with one another about
prospective patients. As Beans Velocci writes in, “Standards of Care: Uncertainty and Risk in
Harry Benjamin’s Transsexual Classifications,” beyond the classificatory rubrics and best
practices, clinicians often decided who to treat or who to deny based on whether they felt the
prospective patient would “ruin [their] lives.”
20
Fears of being shot or sued were central to their
decision-making process. Doctors would write letters to one another, sending warnings about
patients they found to be too confrontational, too demanding, or not appreciative enough.
21
This
gossip about patients was intended to mitigate the doctors’ risk.

19
Harry Benjamin to Elmer Belt, 13 September 1968, Box 14, Folder 1, Elmer Belt Papers, Library Special
Collections, Louise M. Darling Biomedical Library, UCLA.
20
Beans Velocci, “The Standards of Care: Uncertainty and Risk in Harry Benjamin’s Transsexual Classification,”
TSQ: Transgender Studies Quarterly 8, no. 4 (2021): 463.
21
Velocci, 468-469.

134
The fear of patient retribution was not limited to concerns about personal harm. Doctors
and researchers affiliated with the university-based gender clinics were embarking on a
therapeutic project that many in the profession deemed to be absurd. As stef shuster writes in
Trans Medicine: The Emergence and Practice of Treating Gender, clinicians treated trans
patients with experimental surgeries or hormone doses, for example, doctors in Chicago tried to
fashion a vagina from a part of the intestines, a patient in Seattle suffered a permanent rectal
fistula when a doctor attempted to lengthen her vaginal canal, and many patients were subject to
extremely high or low hormone levels as doctors learned the proper dosage through trial and
error.
22
With such experimental therapeutics came a high risk of complications, and thus, the
scrutiny and criticism of other medical professionals, especially those who were already
skeptical of sex reassignment.
In order to dodge scrutiny over their procedures, clinicians invented the trope of the trans
“trickster” to obfuscate responsibility.
23
The trans trickster was multi-faceted. A prospective
patient might be deemed devious or deceitful if they withheld information about their past,
profession, family, children, sexuality, and/or desires. Such a patient was seen as attempting to
trick the doctors into diagnosing them as transsexual to get the surgeries they wanted. On the
other hand, a prospective patient who was able to pass without the help of clinicians and live
stealth lives in their chosen gender were also deemed to be deceitful. They were seen as sneakily
fooling those around them as to their “true” gender.
The figure of the trans trickster cemented the idea of trans people as inherently deceptive
and deceitful and therefore in need of much greater scrutiny than the average or so-called

22
stef m. shuster, Trans Medicine: The Emergence and Practice of Treating Gender (New York: New York
University Press, 2021), 29.
23
shuster, 30.

135
“normal” patient. The trickster became a straw man, the justification for all things from refusing
treatment to accusations of malpractice. If a patient experienced adverse outcomes from the
treatment clinicians provided, doctors could invoke the trope of duplicity: maybe the medical
information they provided ahead of time was inaccurate, maybe they’re not taking the correct
dosage, maybe they didn’t follow the proper post-op care. By creating a stereotype of trans
patients as inherently difficult, lying, and conniving doctors were able to fix the gaze of scrutiny
on the patients while they performed their own kinds of trickery out of view. I argue that the
trans trickster is important for understanding how doctors were able to get up to all kind of
chicanery behind the scenes. It also provides a mirror to the doctors own actions: their
demanding personalities, the way they hid their work from authorities, the way they fooled the
public about the clinic happenings.
In this chapter, I focus on some of the gossip about and amongst doctors because of its
potential to function as a kind of counter-discourse to the official narratives of the clinics. As
Kwame Holmes has argued, gossip functions as an “archive of experience even as it resists
recognition and institutionalization.”
24
For Holmes, gossip gestures to what happens “behind the
scenes,” what someone will not go on record saying.
25
Gossip, because of this off-the-record
quality, often does not make its way into historical projects. It is elusive evidence at the margins
of History (with a capital H), unsubstantiated accusations and whisperings that cannot be verified
and thus go uncited. In this regard, the gossip the doctors shared with one another in written
correspondence or scribbled on notes, never intended to be preserved, offers another version of

24
Kwame Holmes, “What’s the Tea: Gossip and the Production of Black Gay Social History,” Radical History
Review, no. 122 (2015): 56.
25
Holmes, 55.

136
History, both a counter-narrative and an an-archive.
26
While doctors privately participated in the
practice of gossip, this kind of whispered discourse runs counter to the authoritative, objective
voice they used on the published page. Just as this chapter attempts to redirect the gaze, it also
harnesses the power of gossip to undo official narratives of the gender clinics.

Changing Cultural Attitudes Towards Medicine and Psychiatry
“One nods approvingly as the researchers pay liberal lip service to the idea that society
should change in order to accommodate greater expression of effeminacy among males.
But then, they sigh, society will not do this; so it’s up to them to make the gender male
misfit fit into society, for his own good. It all seems terribly logical, until one reflects:
How will society ever change if accommodating psychotechnologists keep changing us to
conform to society?”
27

This quote comes from a 1975 Rolling Stone article titled, “The Gender Enforcers: Seeing
to It that Boys Will Be Boys.” In the article, the author, David M. Rorvik, interviews Dr. George
A. Rekers and Dr. O Ivar Lovaas, professors of psychiatry at UCLA about their efforts to reform
effeminate boys through behavior modification. The “Child Gender Program,” funded by a
National Institute for Mental Health grant, had the express goal of preventing adult transvestism,
transsexuality, and effeminate homosexuality.
28
Their behavior modification techniques involved
encouraging “masculine behaviors”—such as playing with toy soldiers or watching football—
through rewards like candy and TV time. Conversely, parents were taught to ignore their child
when they engaged in “feminine behaviors” such as playing with dolls or dancing.

26
By an-archive, I refer to the underbelly of the archive. In chapter one, I talk about following the archival grain,
paying attention to its form and its habits of documentation. To engage with the an-archive is to read against the
grain of the archive, or as Saidiya Hartman refers to it, “to brush history against the grain” in order to “excavat[e] at
the margins.”
Saidiya Hartman, Scenes of Subjection: Terror, Slavery, and Self-Making in Nineteenth-Century America (New
York: Oxford University Press, 1997), 11.
27
David M. Rorvik, “The Gender Enforcers: Seeing to It That Boys Will Be Boys,” Rolling Stone, October 9, 1975,
53.
28
Rorvik, 53.

137
Rorvik’s article is tongue and cheek, poking fun at the idea that effeminate boys are in
need of reform: “Can they be saved? Yes, for just in the nick of time enter the guys who believe
that when gender is fucked it’s time to start fucking around with gender.”
29
Rolling Stone’s
critical coverage of the UCLA clinic is emblematic of cultural shift happening in the late-1960s
and 70s which contributed to the closing of the university-based gender clinics. During this era,
the anti-psychiatry movement took hold. The 1960s and 70s were a period of mass
deinstitutionalization, as many large state psychiatric institutions closed and were replaced with
community health centers.
30
Former patients organized against psychiatric confinement, starting
the ex-patient or psychiatric survivors movement. Ex-patients established the National Alliance
of Mental Patients, published newspapers like Madness Network News, and hosted radio shows
like “The Madness Network” at WBAI-FM in New York City.
31
Feminist and gay and lesbian
activists critiqued clinicians for being too conservative, for upholding gender norms, and
undermining movements for gender equality.
32

Just two years prior to Rorvik’s article, gay liberation and homophile activists had
successfully organized to remove homosexuality from the Diagnostic and Statistical Manual for
Mental Disorders (DSM). The change was made possible by a series of events, beginning with
the research of Evelyn Hooker. Hooker, a psychology professor at UCLA, began studying
homosexual male communities in the late 1940s. In 1957, she published a groundbreaking paper,
“The Adjustment of the Male Overt Homosexual,” which argued that homosexuals were not
maladjusted but ordinary individuals indistinguishable from heterosexuals. Her research was

29
Rorvik, 53.
30
Norman Dain, “Critics and Dissenters: Reflections on ‘Anti-Psychiatry’ in the United States,” Journal of the
History of the Behavioral Sciences 25 (1989): 9.
31
Dain, 11.
32
Meyerowitz, 265.

138
highly controversial at the time, going against the psychiatric grain in which homosexuals were
deemed to suffer from psychosis and narcissism.
In 1967, the NIMH founded a Task Force on Homosexuality. Hooker was appointed as
chair. In their final report, published in October of 1969, the task force called for the repeal of
laws that criminalized homosexual acts and argued for the end of homosexual employment
discrimination.
33
The Nixon administration buried the report, but in 1970, the homophile
organization ONE, Incorporated, published the task force’s findings in their quarterly
publication, Homophile Studies. For years leading up the report, homophile activists like Frank
Kameny of the Washington D.C. chapter of the Mattachine Society had been articulating
critiques of the pathological model of homosexuality.
34
The depathologization movement picked
up steam after the Stonewall Rebellion of 1969 and the inception of the Gay Liberation Front.
At the 1970 American Psychiatric Association (APA) convention in San Francisco, gay
liberation and homophile activists disrupted the meeting by protesting panels on homosexuality,
declaring “Stop talking about us and start talking with us.”
35
At the 1971 APA meeting, a session
was organized with homosexual activists titled, “Lifestyles of Non-Patient Homosexuals.”
36
At
this convention, activists officially submitted a request to the APA Committee on Nomenclature
to remove “homosexuality” from the APA’s official nosology. By the 1972 APA meeting, it
seemed that the change was actually possible. As Henry Minton writes, “The 1972 panel on
homosexuality marked a turning point. For the first time at an APA convention, members

33
Henry L. Minton, Departing from Deviance: A History of Homosexual Rights and Emancipatory Science in
America (Chicago: University of Chicago Press, 2002), 237.
34
Minton, 245.
35
Minton, 256.
36
Minton, 257.

139
publicly supported the gay cause to depathologize homosexuality.”
37
On December 15, 1973, the
APA board voted unanimously (with one abstention) to remove homosexuality from the DSM.
38

In this atmosphere of anti-psychiatry and depathologization, student activists on the
UCLA campus formed the Coalition Against the Dehumanization of Children (CADOC). The
group organized a demonstration in which they marched through the psychology department’s
Franz Hall to protest the Clinic Program for Evaluation and Treatment of Childhood Gender
Problems.
39
According to an article in the Daily Bruin, CADOC spokesperson Rod Thorson
accused the gender clinic of “eradicating every feminine tendency” and promoting a
stereotypical form of masculinity.
40
CADOC’s criticism of such therapy was twofold. First, they
insisted that none of the children were able to consent to this treatment. While their parents
authorized consent, the young children were not given a choice in the matter. Second, CADOC
objected to the idea that there is a proper masculinity and femininity that must be taught and that
aberrations from the norm were the problem, rather than societal acceptance of difference.
Soon after CADOC formed and began protesting, the story was picked up by The Los
Angeles Free Press. Founded by Art Kunkin in 1964, the Los Angeles Free Press, was one of the
first and most influential underground newspapers in the U.S. The paper, often referred to as
“The Freep,” was modeled after New York’s Village Voice. Freep was influenced by the

37
Minton, 258.
38
It’s important to note that gay and lesbian movements for depathologization often excluded trans people. As
Abram Lewis argues, in the wake of the 1973 APA decision, some gay activists actively worked to disarticulate
homosexuality from gender nonconformity. They emphasized that many transvestites were heterosexual and
therefore gender disorders were a separate issue from homosexuality. In doing so, they effectively threw
transsexuals and transvestites under the proverbial pathologization bus. This contributed to the addition of “Gender
Identity Disorder” to the DSM in 1980.
Abram Lewis, “We Are Certain of Our Own Insanity: Antipsychiatry and the Gay Liberation Movement, 1968-
1980,” Journal of the History of Sexuality 25, no. 1 (2016): 91.
39
Patrick Healy and Geoff Quinn, “Gender Program Rapped,” UCLA Daily Bruin, February 7, 1975.
40
Healy and Quinn, 3.

140
founder’s socialist politics, the Freak Movement, and the New Left.
41
The paper’s contributors
often penned articles that were critical of political institutions and authorities. As Andre Mount
has chronicled, many of the Freep contributors had attended or were in some way affiliated with
UCLA.
42

In an article titled, “‘Clockwork Orange’ Treatment at UCLA,” the author, Jeff Sternberg
wrote:
“Dr. Lovass and Dr. Hutchsnecker are graduates of Max Planck Institute in Germany.
The Max Planck Institute, creators of eugenics (the killing off of entire groups of
mankind, like Jews or people registered with the wrong political party) first developed
the concept used at UCLA in 1936 at a meeting of Interpol and the Gestapo, according to
documents in possession of the Free Press.
As early as 1936, Max Planck was urging governments into the arena of psycho-politics
by placing small children with ‘a social, criminal tendencies, or unconforming sexual
tendencies’ (at the ripe old age of 3) in special camps or detention centers (like the ones
Hutchsnecker established in Germany during the thirties, and like the ones at UCLA
these last three years).”
43

The article goes on to allege that one hundred percent of the children being treated at UCLA are
there involuntarily and draws broader connections to patients being held involuntarily at other
psychiatric institutions. Sternberg also alleges that patient confidentiality laws are being violated
by allowing a wide array of psychologists and school counselors to access treatment records.
The article draws unsubstantiated connections between UCLA doctors, former SS
officers, J. Edgar Hoover, and Interpol—referring to Lovaas and Reker as partners in
“spychiatry.” It also alleges that Lovaas and Reker use cattle prods on the children, something
that the doctors vehemently denied. Sternberg ends the article with the forceful argument that all
psychiatry, since its inception, has only been made possible through violence and involuntary

41
Andre Mount, “Grasp the Weapon of Culture! Radical Avant Gardes and the Los Angeles Free Press,” The
Journal of Musicology 32, no. 1 (2015): 115–52.
42
Mount, 123.
43
Jeff Sternberg, “‘Clockwork Orange’ Treatment at UCLA,” Los Angeles Free Press, February 14, 1975.

141
coercion. While many of the accusation that Sternberg is levying are far-fetched—imagining SS
officers, J. Edgar Hoover, and Lovass being a part of the same psychiatric conspiracy—he is
right to make connections between eugenics and the treatment of gender deviant children. The
article is perhaps most instructive when we consider Freep’s connection to the New Left and the
rise of anti-psychiatry and depathologization movements in the 1970s.
Freep’s representation of the UCLA gender clinics traffics in gossip and scandal. Its
rhetorical style resembles exposés on the conditions in mental hospitals which were popular at
the time.
44
Following a rumor that patient files were not properly protected, Sternberg reports
that a “Free Press investigator” posed as a school counselor was able to infiltrate the clinic and
see patient histories. He claims that the doctors are guilty of physical abuse. Regardless of
whether these facts are true, Sternberg is able to effectively harness the countercultural distrust
of authority to scandalize readers and push for an end to the gender clinics.
The anti-psychiatry movement, ex-patient movement, and movement for the
depathologization of homosexuality contributed to changing cultural attitudes towards medicine
and psychiatry in the 1960s and 70s. University-based gender clinics found them themselves
caught in the crosshairs. As the authority of psychiatrists and psychologists waned, practices of
gender reform, coercion, and correction were increasingly scrutinized. According to Joanne
Meyerowitz, “From the left, feminists and gay liberationists challenged the doctors’ vision of
sex, gender, and sexuality and disparaged the liberal doctors for failing to take more radical
stands.”
45
However, this is not the full story. Meyerowitz continues, “From the right, other
doctors disputed the merits of sex reassignment surgery and denounced the liberal doctors for
their endorsement of unorthodox medical practice.” While changing ideas about medical and

44
Dain, 10.
45
Meyerowitz, 262.

142
psychiatric authority were partially responsible for the shuttering of the gender clinics, a
conservative trend within psychiatry along with doctor in-fighting were also a deciding factor.

Doctor In-Fighting
To understand the conservative backlash against sex reassignment surgery and gender
research, I turn now to perhaps the most highly publicized and long-lasting controversy affiliated
with the gender clinics. The case involves David Reimer, a boy who, after experiencing a
botched circumcision in 1967, found himself under the care of John Hopkins psychiatrist and
clinic founder, John Money. Following Money’s advice, the Reimer parents would raise David
as a girl. Money used the Reimer case, most often referred to as the John/Joan case, to prove that
gender behavior was learned, through a complex socialization process, rather than biologically
innate.
Prior to meeting Reimer, Money had spent over a decade studying intersex infants and
youth. Money had come to believe that gender was the result of multiple factors including
chromosomal sex, gonadal sex, hormonal sex, genital morphology, and gender role.
46
“Gender
role” was a term that Money had coined to describe “all those things that a person says or does to
disclose himself or herself as having the status of a boy or man, girl or woman.”
47
In a 1955
article, co-authored with Joan and John Hampson, Money argued that assigning a sex to an
intersex infant and reinforcing this assigned sex through parenting/rearing was the most
important factor in determining the child’s gender role (what we would now call “gender

46
Katrina Karkazis, Fixing Sex: Intersex, Medical Authority, and Lived Experience (Durham: Duke University
Press, 2008), 53.
47
John Money, J.G. Hampson, and J.L Hampson, “Hermaphroditism: Recommendations Concerning Assignment of
Sex, Change of Sex and Psychologic Management,” Bulletin of the Johns Hopkins Hospital 97, no. 4 (1955): 284–
300.

143
identity,” a term that had not yet been coined by Dr. Robert Stoller). Money’s many studies and
articles about gender role introduced psychological principles into the conversation about how to
treat intersex infants.
48
His guidelines, which involved choosing a sex, performing surgery as
quickly as possible (ideally before 18 months of age), and unequivocally raising the child in this
chosen sex (sometimes not even informing the parents) became the norm.
However, not everyone agreed. In 1965, Milton Diamond, a recent PhD graduate in
anatomy published an article in the Quarterly Review of Biology in which he argued that:
“Primarily owing to prenatal genic and hormonal influences, human beings are definitely
predisposed at birth to a male or female gender orientation. Sexual behavior of an individual, and
thus gender role, are not neutral and without initial direction at birth.”
49
Diamond was arguing
that a fetus’ exposure to prenatal hormones would determine an individual’s gender role,
essentially creating a male or female brain. Diamond took direct aim at Money and challenging
both his theories and the treatment of intersex infants.
50
Thus, when Money was contacted just
two years later by the Reimer family, he saw the case as a perfect opportunity to prove Diamond
wrong.
The Reimer family learned of Money from a television program which featured him
along with a Johns Hopkins transsexual patient. After contacting Money, the family was invited
to come to Baltimore in 1967. Money was particularly enthusiastic about the case for two
reasons. First, Reimer was not born intersex and therefore would provide Money with the
opportunity to test his theories on a so-called “normal” child. Second, Reimer had an identical
twin brother who would serve as a perfect control. In Diamond’s critique of Money he had

48
Karkazis, 55.
49
Milton Diamond, “A Critical Evaluation of the Ontogeny of Human Sexual Behavior,” Quarterly Review of
Biology 40, no. 2 (1965): 167.
50
Diamond, 169.

144
explicitly stated, “To support the theory of psychosexual neutrality at birth we have been
presented with no instance of a normal individual appearing as an unequivocal male and being
reared successfully as a female, or vice versa.”
51
The John/Joan case was Money’s chance to
prove Diamond wrong.
Money advised the family to raise David as a girl. On July 3, 1967, Dr. Howard W. Jones
Jr. performed a surgical castration at the Johns Hopkins medical center. It was determined that
when David was older, he would have a vagina constructed and take estrogen. The Reimer
family returned to Winnipeg to raise their new daughter. For the next few years, the Reimer
family would visit Money annually for follow-ups. In 1997 John Colapinto, published an article
on Reimer for Rolling Stone and later, in 2000, a book titled As Nature Made Him.
52
Reimer
struggled immediately and continually throughout childhood. His family tells stories of social
ridicule, poor performance in school, and depression. Colapinto’s article recounts how Reimer
ripped off his dresses and wanted to grow up to be a garbage man.
53
Despite this, Money
continually reported the case to be a success.
54

In 1980, when Reimer was fourteen years old his parents told him the true story of what
had happened to him. David decided to live full-time as a boy, changing his name, going off
estrogen, and undergoing a phalloplasty operation. Reimer struggled for years with depression,
suicidality, and social isolation.

51
Diamond, 158.
52
John Colapinto, As Nature Made Him: The Boy Who Was Raised as a Girl (New York: HarperCollins Publishers,
2000).
53
John Colapinto, “The True Story of John/Joan,” Rolling Stone, December 11, 1997.
54
John Money, “Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl,” Archives of Sexual Behavior 4, no. I
(1975): 65–71; John Money and Anke A. Ehrhardt, Man & Woman, Boy & Girl: Gender Identity from Conception
to Maturity (Northvale, NJ: Jason Aronson, 1973); John Money and Patricia Tucker, Sexual Signatures on Being a
Man or a Woman (Boston: Little, Brown, 1975).

145
During this period, Diamond was fixated on finding out the outcome of the John/Joan
case. After learning from a 1979 BBC documentary that Joan was struggling, Diamond wanted a
way to access the family and write a follow-up. As Karkazis writes, “Evidencing an ardent
commitment to this case, and the desire to expose it, Diamond sought out the psychiatrists
treating John/Joan by taking out ads in the American Psychiatric Society journal.”
55
Finally,
Diamond would meet Reimer’s psychiatrist, Keith Sigmundson and together, in 1997, they
published, “Sex Reassignment at Birth: A Long Term Review and Clinical Implications.”
56
The
day after Diamond and Sigmundson’s article was published, the front page of the New York
Times read, “Sexual Identity Not Pliable After All, Report Says.”
57

Beyond highlighting the violence of the medical gaze, the case of David Reimer tells a
story about gender clinic doctors who were so embroiled in their own interpersonal conflicts that
they failed to recognize the personhood of their patients.
58
Obsessed with being the first to claim
a new theory of gender, they lost sight of the lives they impacted along the way. When Colapinto
wrote his piece for Rolling Stone, Money refused to comment on the specifics of the case.
Instead he said, “There’s no reason I should have been excluded from the follow-up, was there?

55
Karkazis, 73.
56
Milton Diamond and H. Keith Sigmundson, “Sex Reassignment at Birth: A Long Term Review and Clinical
Implications,” Archives of Pediatric and Adolescent Medicine 151, no. 3 (1997): 298–304.
57
Natalie Angier, “Sexual Identity Not Pliable After All, Report Says,” The New York Times, March 14, 1997.
58
Interpersonal conflicts abound throughout Money’s career. One such incident involved UCLA researcher Richard
Green. In 1978, Green accused Money of unethical and unprofessional research and publication practices when
Money submitted a manuscript for publication which was based on collaborative research but did not cite Green.
Green confronted Money at a professional conference in St. Louis and asked to see the manuscript. Money never
mailed it to him. Months later, at the 1978 APA convention in Toronto, Green heard Anthony Russo deliver a talk
about the research in question, claiming credit as the paper’s co-author. Green wrote to Money: “I am shocked to
find that in addition to not being a co-author, there is no acknowledgement in the text that the cases reported in the
paper are those earlier reported by Green and Money, and not even a citation in the reference list to the earlier
published reports of the cases by Green and Money in 1960, 1961, and 1964.” Green asked Money to settle the
matter privately between them, referencing their twenty plus years or personal and professional friendship. Money
never wrote back and in January of 1979, Green filed an official complaint with the Committee on Scientific and
Professional Ethics and Conduct of the American Psychological Association. The correspondence between Green
and Money highlights the internal tensions playing out between doctors, even those that publicly seemed to be close
collaborators.

146
Someone had a knife in my back. But that’s not uncommon in science. The minute you stick
your head above the grass, there’s a gunman ready to shoot you.”
59

The Reimer story became an international sensation, featured on The Oprah Winfrey
Show, Dateline, and Primetime TV.
60
The story captivated the general public, specifically for the
ways that it seemed to bolster the idea that gender is biological and not socially determined.
Although the Reimer scandal would not be fully exposed until the 1990s, Diamond’s persistence
in trying to expose the story in the late 1970s is emblematic of a more conservative trend taking
hold.
In question was the medical morality of treating trans patients.
61
Despite the fact that the
clinics pivoted to surgery after failing to understand the etiology of transsexuality, conservative
clinicians believed in reformative psychiatric treatment. They worked to end the practice of
treating trans patients by questioning the efficacy of surgery. In this climate, another
interpersonal conflict would rise to the surface—that of Money and his colleague Jon K. Meyer.
You cannot tell the story of Hopkins clinic closing without acknowledging the longstanding
personal and professional hostility between Money and Meyer.
62

In 1975, Johns Hopkins University hired a new chair of the Department of Psychiatry,
Dr. Paul McHugh, a graduate of Harvard Medical School. From the moment McHugh arrived at
Hopkins, he set his sights on disbanding the Gender Identity Clinic. Years later, in 1992,
McHugh would say, “It was part of my intention, when I arrived in Baltimore in 1975, to help
end [the practice known as sex reassignment surgery].”
63
McHugh believed that Hopkins

59
Colapinto, Rolling Stone.
60
Karkazis, 70.
61
Charalampos Siotos, Paula M. Neira, Brandyn D. Lau, Jill P. Stone, James Page, Gedge D. Rosson, and Devin
Coon, “Origins of Gender Affirmation Surgery: The History of the First Gender Identity Clinic in the United States
at Johns Hopkins,” Annals of Plastic Surgery 83, no. 2 (2019): 132–126.
62
Meyerowitz, 268.
63
Paul R. McHugh, “Psychiatric Misadventures,” The American Scholar 61, no. 4 (1992): 501

147
decision to offer surgeries to transsexual patients was a result of the permissive atmosphere of
the seventies (despite the fact that the program began in 1966). “The energy came from the
fashions of the seventies that invaded the clinic…it was all tied up with the spirit of doing your
thing, following your bliss, an aesthetic that sees diversity as everything and can accept any idea,
including that of permanent sex change, as interesting and that views resistance to such ideas as
uptight if not oppressive.”
64
McHugh was not afraid of being perceived as oppressive. He
believed that Hopkins was “fundamentally cooperating with mental illness” by offering sex
reassignment surgery.
65

When McHugh arrived at Hopkins, he found an ally in Money’s rival Meyer. Opposed to
the surgical method that Money championed, in 1974, Meyer co-authored an article with
Hopkins plastic surgeon John E. Hoopes in which they questioned the long-term benefits of
surgery.
66
“The Gender Dysphoria Syndromes: A Position Statement on So-Called
‘Transsexualism’” argued that surgery did nothing to cure the problem of an “unfortunate
emotional state.” The article gained traction amongst gender clinic doctors who too were
skeptical of surgery, including Stoller at UCLA. Meyerowitz notes, “Much of the criticism
focused on follow-up studies or the lack thereof. Although the follow-up studies that existed
indicated that only a tiny minority of patients regretted their surgeries, they did not offer enough
convincing data for the skeptics.”
67

For this reason, in 1977, when Meyer presented his initial follow-up data at the American
Psychiatric Association symposium, arguing that surgery offered no benefits, the anti-surgery

64
McHugh, 503.
65
Amy Ellis Nutt, “Long Shadow Cast by Psychiatrist on Transgender Issues Finally Recedes at Johns Hopkins,”
The Washington Post, April 5, 2017.
66
Jon K. Meyer and John E. Hoopes, “The Gender Dysphoria Syndromes: A Position Statement on So-Called
‘Transsexualism,’” Plastic and Reconstructive Surgery 54, no. 4 (1974): 444–51.
67
Meyerowitz, 267.

148
psychiatrists felt vindicated.
68
Meyer would go on to publish the data in a 1979 article, which
claimed to objectively measure post-op adjustment. Using a subjective rubric similar to
Stanford’s vague diagnostic category of “success,” patients were given higher scores if they were
in a “gender-appropriate” (i.e. heterosexual) relationships, were upwardly mobile with
improvements in job level, had not been arrested, and had not sought psychiatric treatment.
Using this points system, Meyer claimed that post-op patients scored no better than transsexuals
who had not had surgery. “Sex Reassignment: Follow-Up,” was soon widely cited by anti-
surgery doctors as evidence that sex reassignment surgery should be discontinued.
However, Meyer’s follow-up study was not without its own scandal. First, the article
listed Donna J. Reter as the coauthor. Reter was not a doctor nor a researcher, in fact, she had no
background in mental health.
69
She was Meyer’s secretary.
70
From the moment it was published,
the study was criticized for slipshod methods and measurements.
71
Furthermore, many believed
that the timing of the report was expedient, used to justify the halting of surgery at Hopkins.
Years later, speaking under the condition of anonymity, Hopkins doctors would tell Baltimore
City Paper science reporter, Ogi Ogas that Meyer was asked to author the paper to provide
McHugh with justification for closing the gender clinic.
72
Many of them felt blindsided. After
thirteen years of highly acclaimed research, counseling, and surgery, McHugh had orchestrated

68
Meyerowitz, 267.
69
Ogi Ogas, “Spare Parts: New Information Reignites a Controversy Surrounding the Hopkins Gender Identity
Clinic,” City Paper, March 9, 1994.
70
Dallas Denny, a trans activist and author who has sat on the WPATH’s Standard of Care committee, claims that
Reter was listed as a co-author in an attempt to give the paper more credibility, making it seem like the research of
two people.
Dallas Denny, “The Campaigns Against Transsexuals, Part I: The Conspiracy at Johns Hopkins University,” Dallas
Denny (blog), September 5, 2013, http://dallasdenny.com/Writing/2014/03/06/the-campaign-against-transsexuals-
part-i-2013/.
71
Michael Fleming and Carol Steinman and Gene Bocknek, “Methodological Problems in Assessing Sex-
Reassignment Surgery: A Reply to Meyer and Reter,” Archives of Sexual Behavior 9, no. 5 (1980): 451–56.
72
Ogas, “Spare Parts.”

149
the closure of the clinic based on one, poorly calibrated follow-up study. No one was more
blindsided than Money, who, at the time of the press conference, was out of the country.
73

Perhaps, when Money said in 1997 that “someone had a knife in [his] back,” he wasn’t just
referencing Diamond, but also Meyer and McHugh.

Financial Troubles

In addition to closing the Hopkins clinic, the conservative trend to question the efficacy
of surgery would also have impacts on the university-based gender clinics’ finances. In 1970,
when Hopkins was offering surgery for transsexual patients, the average cost was $1,200 and the
fees were split amongst the various clinicians from surgery, gynecology, urology, etc.
74
Many
patients were able to get some of the expenses covered by insurance. For example, Maryland
Blue Cross, a public insurance company paid a portion of some Hopkin’s patients costs for sex
reassignment surgery.
75
However, after Meyer published his 1974 and 1979 articles claiming that
there were no benefits to surgery, insurance companies began to cite anti-surgery studies as
evidence for why the procedures would no longer be covered.
76

A 1972 New York Times article tells a slightly different story about what was happening
at the University of Minnesota clinic. While Minnesota patients often found that their insurance
companies “refused to contribute, contending either that the surgery is ‘cosmetic’ or that the
patient's condition pre‐existed his medical policy,” the clinic was initially funded by a state
research grant.
77
According to the New York Times: “The University of Minnesota, which did the

73
Meyerowitz, 268.
74
Siotos et al., 133.
75
Siotos et al., 133.
76
Meyerowitz, 269.
77
Melanie Fritz and Nat Mulkey, “The Rise and Fall of Gender Identity Clinics in the 1960s and 1970s.”

150
first two dozen operations under a research program almost entirely at the expense of the state,
has decided that the taxpayers should no longer have to support the expensive surgery.” As
taxpayers caught wind of the fact that public dollars were going to transsexual therapeutics, there
was a backlash which led to the gender clinics’ state funding being cut.
Moreover, by the late 1970s the clinics’ private funding was also drying up. Trans man
millionaire and philanthropist Reed Erickson founded the Erickson Education Foundation in
1964, a nonprofit dedicated to providing resources and information to trans people and funding
and support to trans-friendly clinicians.
78
The same year that EEF was founded, Erickson
awarded Dr. Harry Benjamin $18,000 to “investigate the nature, causes, and treatment of
Transvestism and particularly Transsexualism.”
79
Erickson would go on to financially support
the Johns Hopkins Gender Identity Clinic (where he was a patient), Dr. Donald Laub at the
Stanford, Dr. Richard Green at UCLA, and countless others. However, in 1977, the EEF
officially closed their office and eliminating their staff down to one person (Suplee). Around this
time, Erickson’s personal wealth was dwindling. What little charitable contributions he
continued to make were directed to causes not affiliated with trans medicine.
By 1980, with a growing backlash towards trans therapeutics, public funding was cut,
insurance companies were citing anti-surgery research to avoid covering treatment costs, and
private funding from Erickson and the EEF had dried up. In addition to changing cultural
attitudes towards medicine and psychiatry and doctor in-fighting, a lack of funding was to blame
for the university-based gender clinics closing their door. This conflux of conditions would set
the stage for a shift to private practice, which I discuss in the next section, but before moving on

78
Aaron Devor and Nicholas Matte, “Building a Better World for Transpeople: Reed Erickson and the Erickson
Educational Foundation,” International Journal of Transgenderism 10, no. 1 (2007): 47-68.
79
Devor and Matte, 60.

151
I want to pause and consider how clinic funds were used. Reversing the gaze back on to the
doctors, I turn now to a scandal regarding Robert J. Stoller and a special research fund bank
account at the Glendale Federal Savings and Loan.
In the Stoller Papers collection, inside a folder titled “Special Research Fund,” is a
handwritten list with names, dates, and dollar amounts. The dates span from 1969 to 1979. The
handwritten ledger classifies transactions as either “in” or “out,” presumably money deposited,
or money withdrawn. The “in” column is straightforward with most of the dollar amounts being
followed by “RJS,” indicating they were checks or payments made to Robert J. Stoller. “RJS” is
often followed by the entity making the payment in parentheses: UCLA, the APA, Quadrangle
Press, Penn State, the University of Washington. While we can easily assume these payments
were made to Robert J. Stoller for his work, book contracts, and speaking engagements, it’s
unclear why these checks were deposited into the “Special Research Fund” rather than Stoller’s
personal account.
Despite the innocuousness of the “in” portion of the ledger, the “out” payments tell a
different story. The majority of the money spent from the account went to three individuals:
Wyatt, Heller, and Tate (pseudonym). Wyatt refers to Sofia Wyatt, a transcriptionist who was
paid by Stoller to type interviews and therapy tapes. Also included in the “Special Research
Fund” folder are invoices from Wyatt, addressed to either Robert Stoller or Richard Green,
which list the hours it took to transcribe the tape, the rate ($4/ hour), and the total owed. Heller
refers to F. Thomas Heller, a book agent or rare books collector in New York that Stoller would
buy materials from, including first addition Freud texts in German.
80
The final name on the list,
Tate, is none other than Mrs. G.

80
Robert J. Stoller to Harold P. Blum, 31 October 1979, Box 35, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.

152
Between December of 1970 and September of 1975, Stoller paid Mrs. G over thirteen
thousand dollars, much of which was paid in cash. This five-year time span includes years in
which Stoller was writing Splitting (published in 1973), the book about Mrs. G. The “Special
Research Fund” folder also contains scraps of paper with handwritten notes listing expenses.
One, dated November 29, 1971, reads: “rent, gas, electricity, car pmt, loan, insurance, money
borrowed this month, GEMCO, Orange Co, medical center for year of care for family, accident,
phone, new battery.” Next to this column are a list of dollar amounts: “165.00, 5.00, 21.00,
96.00, 43.00, 15.00, 80.00, 27.00, 50.00, 10.00, 36.00, 15.00.” The list totals $663. On
November 30, 1971, Stoller wrote Mrs. G a check for $663.

Fig. 4.3 Scrap of paper with expenses from “Special Research Fund” Folder

153

Fig. 4.4 Check written to Mrs. G (legal name redacted), 1971

These documents do not leave much room for interpretation. Dr. Robert J. Stoller was
paying Mrs. G’s rent, utilities, car payment, insurance, and other life expenses while he was also
providing her with weekly therapy and writing a book about her so-called gender deviance. I
have tried to come up with different ways of making sense of these documents, but there is no
simple explanation. These were not royalty checks for Splitting since the book had not been
published. Even if it had been, royalties go to the author not the research subject. Moreover,
Splitting flopped. It failed to come close to selling out its first printing. Mrs. G was seemingly
not related to Stoller. There’s no evidence that she was his secret or illegitimate daughter. In fact,
he says he first encountered her in a clinical setting. These payments are too large and specific to
be human subjects committee approved payments to a research participant. And even so, there
are no other patients listed on the ledger.
As a reminder, Mrs. G met Stoller in an LA County Hospital in 1957 where she was
being held as a psychiatric patient. Mrs. G had a long history with the criminal justice system
which included check fraud, car theft, and armed robbery. According to Stoller, Mrs. G
requested to have her treatment transferred to UCLA where she saw a therapist other than
Stoller, although she corresponded with him regularly. In 1964, after being arrested for a traffic
violation and court-ordered to attend psychiatric treatment, Mrs. G became a patient of Dr.

154
Stoller’s. Sometime in her mid-twenties, around the time that Mrs. G originally met Stoller, she
has been forcefully sterilized at a state hospital. For years Mrs. G would ask Stoller for a tubal
ligation reversal.
All of this information highlights three key things about Mrs. G. First, she became a
patient of Stoller’s involuntarily because of the court-ordered treatment. Second, Stoller held the
key to Mrs. G regaining her bodily autonomy and reproductive rights. And finally, Mrs. G was
financially dependent on Stoller. When we look at the list of crimes Mrs. G was convicted of:
check fraud, armed robbery, and car theft, we can see that they are crimes with a financial
motivation. Mrs. G was entangled in the criminal justice system because of poverty. Her ability
to pay bills, drive her car, and provide health care to her family was contingent on the money that
Stoller paid to her from his Glendale Federal Savings and Loan “Special Research Fund.”
The practice of paying research participants is highly debated. It’s not uncommon to see
fliers across college campuses with opportunities to make money participating in a study.
However, the compensation is usually a fixed, modest amount. Paying research participants can
be seen as a way of incentivizing participation, giving thanks for their time and contributions,
and/or providing some kind of equity considering that researchers are often compensated for
their work in the form of salaries or grant money.
81
On the other hand, monetary incentives can
be seen as potentially imposing on the principle of free, informed consent.
82
As scholar Emma
Head observes in assessing qualitative research ethics, “potential research participants of low
incomes might feel coerced to participate if the level of ‘reward’ is too high to refuse.”
83
In the

81
Emma Head, “The Ethics and Implications of Paying Participants in Qualitative Research,” International Journal
of Social Research Methodology 12, no. 4 (2009): 335–44.
82
Head, 339.
83
Head, 339.

155
case of Mrs. G, the financial compensation that Stoller was offering her was seemingly not only
too high to refuse, but essential to her family’s stability and survival.
Scholars thinking about the ethics of monetary incentives for research participants also
consider how compensating someone might lead to them telling the researcher what they want to
hear or providing the kind of information they feel the researcher is looking for.
84
In the case of
Mrs. G, we know that she was adamant about wanting her reproductive capacities restored.
When Stoller told her that this was not an option as long as she believed herself to have a penis,
her stance shifted, eventually saying she acknowledged that she did not have a penis.
Stoller’s payments to Mrs. G dry up after 1974, with just one check of $500 in 1975,
however it does not seem like Stoller’s involvement in Mrs. G’s financial affairs ended there. On
March 11, 1974, Judy Czach from the UCLA Grant’s Administration office wrote to Stoller to
clarify “the level of position held by [Laura Tate].”
85
The document narrates a series of events in
which Stoller advocated for the hiring of Mrs. G as a laboratory assistant. He inquired with the
Grant’s Administration office about the pay and was informed that there were two possible levels
and salaries: a Laboratory Helper for $475/month or a Laboratory Assistant I for $551/month.
Czach states: “When the job description and application for Ms. [Tate] were brought to us for
submission, we were told to try for the higher level, Laboratory Assistant I.” Czech continues:
“The position was approved by the Personnel Analyst at the Lab. Asst. I level and your
candidate, Ms. [Tate], was approved by the Employment Division as qualified for this
level. We notified your office that the position and the candidate has been approved at the
Lab. Asst. I level. Ms. [Tate] came to our office and signed the employment documents
effective January 21, 1974.

I now understand that you wanted her appointed at the Laboratory Helper level during a
probationary and training period, then to be promoted to the Lab. Asst. I level. This

84
N. McKeganey, “To Pay or Not to Pay: Respondents’ Motivation for Participating in Research,” Addiction 96, no.
9 (2001): 1237–38.
85
Judy Czach to Robert Stoller, 11 March 1974, Box 47, Robert J. Stoller Papers, Library Special Collections,
Charles E. Young Research Library, UCLA.

156
would be contrary to University staff employment practices and procedures, since the
position was approved at the higher level and the employee qualified for the position. At
this time it would not only be unfair to the employee to demote her to the lower level, but
could also be subject to Affirmative Action inquiry.”

It’s unclear whether Stoller was hiring Mrs. G to be his own lab assistant or whether she was
employed by someone else in his department, regardless, Stoller inserted himself in her hiring
process at all stages: first, by inquiring about job categories, next, by advocating for a certain
position, and finally, by wishing to control her salary and title. Stoller wanted to hire Mrs. G as a
lab helper and be in charge of whether she was promoted and received a salary increase or not.
Again, we see Stoller maintaining control over Mrs. G’s livelihood and financial independence.
All of this begs the question, why was Stoller doing this? What was his motivation?
When presenting this research at academic conferences, an audience member usually suggests or
asks whether Stoller had a sexual or romantic relationship with Mrs. G. There’s nothing in the
archive to confirm nor deny this suspicion. Stoller had a wife of many decades to whom he was
seemingly very devoted. Even so, it is hard to land on a different explanation. Perhaps Stoller
was paying her for her silence. Maybe his depictions of her life and gender were embellished or
inaccurate, altered to serve his theoretical claims. It could be that he did not want his own David
Reimer situation. It’s possible that he came to have an affection and even a friendship with her,
in which case he should have resigned as her therapist and stopped all research with her and her
family. In any case, the Special Research Fund is a window into Stoller’s world, a crack in the
façade of his objectivity. Stoller died unexpectedly in a car accident in 1991. It’s likely that, had
he been given the opportunity to sort through is files, the Special Research Fund ledger and
check stubs would have been destroyed. He did not have this opportunity though. They exist as
an enigma, a scandal, a piece of gossip, and a reminder of the power imbalances at the clinics.

157
I share this information about Stoller and the Special Research Fund because, in addition
to the previously stated reasons that the university-based gender clinics found themselves short
on cash, it seems to suggest that even when research money did exist, it was not always used in
appropriate or ethical ways. If Stoller was able to operate a secret research account on the side,
which made over thirteen thousand dollars in payments to one UCLA patient, it’s likely that
other clinic doctors were using money in secret (and truthfully, scandalous) ways. Next I turn to
the rise of the private practice clinics, which were, in part, the result of doctors trying to turn the
treatment of transsexuality into a lucrative business.

Shift to Private Practice
On December 9 of 1976 or 1977, Dr. Nyla Cole, a professor of psychiatry at the
University of Utah, called the Department of Psychiatry at UCLA to leave a message for the
department chair, Dr. Louis Jolyon “Jolly” West:
“It seems that Dr. Brown is performing surgery on transexuals. Dr. Cole had two patients
who came to Salt Lake for surgery to become females. Dr. Cole and consultants denied
surgery for these two because of their diagnosis. The two patients came to Los Angeles
and supposedly received no consultation with Dr. Brown, but still got their sexual change
with him. Not only did Dr. Brown not contact Dr. Cole or consult these two patients but
he performed the surgery IN HIS OFFICE!! The patients were then transferred to a
nursing home for a few days of recuperation then they left for their ‘New’ lives. Well, the
2 patients came back to Salt Lake to Dr. Cole because of complications (psychiatric). Dr.
Cole is very upset about this Doctor doing these operations. She feels there is something
fishy in Denmark…”
86

Handwritten on the typed phone message memo is an address for Dr. John Ronald Brown on
Wilshire Boulevard in Los Angeles. Brown was not affiliated with UCLA, so it is not entirely
clear why Cole reached out to West, perhaps she figured due to his physical proximity he could

86
“Phone Conversation Record,” 9 December 1976 or 1977, Box 9, Robert J. Stoller Papers, Library Special
Collections, Charles E. Young Research Library, UCLA.

158
investigate or file a complaint with the Medical Board of California. West passed the information
along to Stoller.
Beginning in the late 1960s, Brown saw patients in both Los Angeles and San Francisco,
increasingly known for treating transsexual patients on demand. According to Joanne
Meyerowitz, “Brown sometimes presented himself as the champion of transsexuals, but he also
won a well-earned reputation as the back-alley butcher of transsexual surgery.”
87
As the memo
alleges, Brown often performed surgery in unsanitary conditions from his office to hotel rooms
and even a kitchen table.
88
Meyerowitz writes, “He purposely damaged the vagina of an MTF
who angered him, and left an FTM with raw gaping wounds after a botched mastectomy.”
89
He
allegedly let his business partner, Andrew James Spence, perform surgeries despite having no
medical training.
On December 20, 1977, Brown’s California medical license was revoked for “Gross
negligence and incompetency in transexual surgeries and plastic surgeries; aiding business
manager in unlawful practice of medicine; employing agent to steer business; excessive
treatments; false statements in insurance claim.”
90
It’s unknown if this was the result of Cole
contacting UCLA and the university doctors getting involved. Despite having his medical license
revoked in California, Brown would go on to practice medicine elsewhere, also losing his license
in Hawaii, Alaska, and St. Lucia. Finally, he moved his practice to Tijuana. Brown’s career
would end in 1997 when he was arrested for murder after one of his patients, who requested a leg
amputation to satisfy a sexual fetish, died.
91

87
Meyerowitz, 271.
88
Meyerowitz, 272.
89
Meyerowitz, 272.
90
“Disciplinary Actions: 11/1/77-1/31/78,” Board of Medical Quality Assurance (Sacramento, CA), Box 9, Robert
J. Stoller Papers, Library Special Collections, Charles E. Young Research Library, UCLA.
91
Meyerowitz, 272.

159
In the phone call from Dr. Cole, the two patients are described as sneaking behind her
back to get surgery, in spite of the fact that they had been deemed unfit for treatment. These
trickster patients had shirked the medical professionals by finding a private-practice doctor
willing to perform surgery on demand. By side-stepping the gatekeepers at the gender clinics,
transsexuals were asserting their own kind of protest of psychiatry and pathologization.
The story of Dr. Brown, the back alley butcher, highlights a different trend in trans
therapeutics and medicine more broadly. During the conservative Nixon and Ford
administrations, federal healthcare spending was under attack. As Phil Brown writes, “The anti-
social-service attitude of the new right found harmony with the mainstream attempts to
streamline social programs.”
92
Federal and state governments would reorganize social services,
having them operate more like businesses with an emphasis on cutting costs and improving
efficiency. This would crystalize with the rise of the “health-care consumer” paradigm of the
Reagan administration.
93
Patients became consumers, shopping the health care market for the
best treatment at the lowest cost.
This is how Dr. Brown built his reputation in California. He would operate on anyone, no
questions asked, for a fraction of the cost of other surgeons. Angela Douglas, trans activist and
founder of the Transsexual Activist Organization (TAO), had surgery with Brown in 1977. She
claims to have only paid six hundred dollars. Douglas, a champion of Brown, described him as a
friend to transsexuals. “[He] fed, housed, paid and helped hundreds, and gave free or nearly free
surgery to at least two hundred of us.”
94
Indeed, in 1990, after Brown was arrested for illegally

92
Phil Brown, “Social Implications of Deinstitutionalization,” Journal of Community Psychology 8, no. 4 (1980):
316.
93
Nancy Tomes, “Patients or Health Care Consumers? Why the History of Contested Terms Matters,” in History
and Health Policy in the United States (New Brunswick, NJ: Rutgers University Press, 2006), 83–110.
94
Meyerowitz, 271.

160
practicing medicine by performing surgery on a southern California trans woman, his former
patients showed up in court to support him. As the San Diego Union-Tribune reported, “Several
people dressed in female attire appeared at Brown’s 1990 sentencing in San Diego Superior
Court in a show of support for his handling of their transformation.”
95
Despite Brown’s botched
operations and habit of malpractice, the patient consumers adored him. He accepted everyone
without psychiatric consultation. This stance, while at time reckless, can also be viewed as a
move towards informed consent and depathologization.
As Meyerowitz writes, “By the late 1970s reputable doctors had followed Brown’s lead.
In the 1970s Stanley Biber turned the tiny town of Trinidad, Colorado into the ‘Sex Change
Surgery Capital’ of the United States.”
96
Facing an anti-psychiatry backlash, doctor in-fighting,
and financial strain, private practice became increasingly appealing for the remaining gender
clinic doctors who believed in sex reassignment surgery. While private practice would not solve
the problem of insurance companies refusing to cover the costs of trans therapeutics, in private
practice the surgical fees would be split amongst less clinicians, consultants, and researchers.
Without university oversight, private practice surgeons could see more patients and thus collect
more payments. This business model would be more lucrative for the surgeons and remove them
from the culture of in-fighting which flourished in the university setting.
At the end of 1979, Dr. Donald Laub, one of the founding members of the Stanford
gender clinic announced the resignation of his faculty position.
97
Laub decided to join the Palo
Alto Medical Clinic and take the Stanford Gender Dysphoria Program into private practice. More
and more doctors would come to make the same decision. According to Meyerowitz, by 1980,

95
Bill Callahan, “Ex-Doctor Who Served Time Faces Murder Charge,” San Diego Union-Tribune, May 23, 1998.
96
Meyerowitz, 272.
97
Stanford University Medical Center New Bureau press release, 19 November 1979, Folder 3, Donald R. Laub
collection, Medical History Center, Lane Library, Stanford University.

161
transsexuality had grown into a $10-million-a-year business. “While Richard Green, John
Money, and others fended off their critics, private practitioners used their skills to attract a
national niche market to new local centers for sex-change surgery.”
98
In the private practice, sex
reassignment surgery became a profitable business.
As this chapter demonstrates, the central factors which led to the closing of the
university- based gender clinics were changing cultural attitudes towards medicine and
psychiatry, doctor in-fighting, financial problems, and the rise of private practice clinics. From
Freep’s salacious coverage of UCLA’s spychiatry to interpersonal conflicts between doctors, the
behind-the-scenes happenings at the gender clinics were characterized by gossip and scandal
which stands in sharp contrast to their claims of objectivity and medical professionalism.
Through these stories and vignettes, I have endeavored to reverse the gaze back on to the doctors
themselves, telling a story about deceitfulness and duplicity not on the part of the patients, but by
the medical providers. In the next chapter, I tell the story of three trans individuals who played a
central role in shaping mid-twentieth century trans medicine.

98
Meyerowitz, 271.

162
Chapter 5
Transsexual Knowledges

In spring of 1958, a cargo-passenger ship named City of Bath sat docked in Baltimore.
Two reporters from the Baltimore Sun milled around the wharf, hoping to get a glimpse of the
surgeon on board. The surgeon would later remember it as March, although newspaper reports
confirm the date as Monday, May 12.
1
The surgeon put on his cap, lit his pipe, and walked down
the gangway to confront the reporters. Yes, he had been born a female. Yes, he was now a man.
No, the operations were perfectly legal. The surgeon told the reporters that in his twenties his
voice dropped and his face grew stubble.
2
A slow, organic transformation took place, followed
by a series of operations. The surgeon felt that was all they needed to know. By the next day, the
story would be in papers across the globe, from the Los Angeles Times to the Atlanta
Constitution to the South China Morning Post.
3
By summer, the surgeon, Michael Dillon, would
be in Kalimpong, India, trying to evade the press and prying eyes.
Dillon is perhaps best known in trans history as the first trans man to successfully
undergo phalloplasty operations.
4
Less known is the fact that Dillon wrote what, in 1946, was
perhaps the first endocrinological textbook on trans therapeutics titled, Self: A Study in Ethics
and Endocrinology.
5
Part science textbook, part philosophical treaties, in Self, Dillon argued for

1
Michael Dillon/Lobzang Jivaka, Out of the Ordinary: A Life of Gender and Spiritual Transitions (New York:
Fordham University Press, 2017), 29.
2
“Sex Change Confirmed by Doctor,” Baltimore Sun, May 13, 1958.
3
“British Heir Tells How He Changed Sex,” Los Angeles Times, May 13, 1958; “Doctor Says Sex Changed After
He Was Reared as Girl,” Atlanta Constitution, May 13, 1958; “Sister of Baronet Changes Sex,” South China
Morning Post, May 13, 1958.
4
This fact is repeated again and again on the internet, from Dillon’s Wikipedia page to a variety of blogs written by
trans people. Pagan Kennedy’s biography of Dillon declares this in its title: The First Man-Made Man.
Pagan Kennedy, The First Man-Made Man: The Story of Two Sex Changes, One Love Affair, and a Twentieth-
Century Medical Revolution (New York, NY: Bloomsbury, 2007).
5
Michael Dillon, Self: A Study in Ethics and Endocrinology (London: Heinemann, 1946).

163
the right of trans people to medically transform their bodies.
6
Dillon advocated for a surgical and
hormonal approach to transsexuality, rather than a psychological one. In the text, he makes a
forceful appeal for gender self-determination, the right of an individual to choose their gender
and embodiment for themselves. Dillon’s life and work highlight the key role that transsexuals
would play in the history of medicine—often doing their own research, serving as their own
medical professionals, and crafting theories to influence and shape clinical practices.
7

This chapter is focused on the stories of three trans people whose lives intersected with
early trans therapeutics: Michael Dillon, Louise Lawrence, and Reed Erickson. Focusing on the
contributions that these individuals made to trans therapeutics challenges dominant narratives of
transsexuality as a category created by heterosexual, cisgender doctors and imposed as a
normative force on a heterogeneous world of gender variance.
8
Instead, this chapter demonstrates
that transsexuality, as a category, an identity, and a knowledge project, was created out of the
direct efforts of trans people like Dillon, Lawrence, and Reed. Trans people actively pursued
medical transition and employed medical knowledge to shape what transsexuality looked like
and what it meant. Mid-century transsexuals were both patients and researchers. They were
theorists, gatekeepers, and renegades. I ask, what happens to our understanding of trans

6
Dillon does not use the word “trans,” “transgender,” nor “transsexual.” Instead he uses “homosexual,”
distinguishing six different types of homosexuality, some of which would be most recognizable now under the
umbrella term “transgender.”
7
As Pagan Kennedy writes in her biography of Michael Dillon, The First Man-Made Man: “He had begun to study
medical books that summarized the recent, stunning breakthroughs in the use of hormones. Dillon took notes on his
reading and then elaborated on the themes, spinning out his own theories. His notes would eventually lead to his
groundbreaking book, Self. To become the man he wanted to be, Michael Dillon would have to do more than just
dose himself on testosterone. He would have to invent the very idea of a transsexual—a person who used hormones
to change his sex and then lived happily ever after” (49).
8
For a few examples see: Bernice Hausman’s Changing Sex: Transsexualism, Technology, and the Idea of Gender;
Aren Aizura’s Mobile Subjects: Transnational Imaginaries of Gender Reassignment; Jules Gill-Peterson’s Histories
of the Transgender Child.

164
medicine/therapeutics when we see transsexuals as active participants in and authors of the
diagnoses and treatment protocols that still dominate trans medicine?
Across the lives of Dillon, Lawrence, and Erickson, some distinct themes emerge. First
and foremost, they all embodied an unstoppable capacity for producing and disseminating
information. They were not motivated by ego or accolades but by a desire to build a better world
for trans people. Their projects were forward thinking, establishing infrastructures for long term
changes, primarily as it relates to medicine and the research side of transsexuality. Second, in
addition to being forward thinking, they also directed their attention to the present. Lawrence and
Erickson were invested in making a more livable reality for trans people, building networks of
community and connection. And finally, their work was driven by spirit. By spirit I refer to
passion, yes, but even more so a kind of striving for a different way of existing, of having a
body, of being in relation with others.
The assertion that transsexuality and medical transition were made possible by the direct
efforts of trans people—endeavoring to access tools which allowed them to claim ownership
over their bodies and lives—requires that we reckon with the fact that trans people were, at
times, direct contributors to the violent biopolitical project of sexology. I say that trans people
were central actors in sexological projects not to redeem sexology, but to give credit to the trans
people whose contributions were too often erased because they were made under a pseudonym,
under the direction of a doctor or researcher who was given all the credit, or simply because their
story has been submerged, buried in an archive or a warehouse, concealed from public view. I
am interested in seeing and regarding sexology and the history of research on gender difference
in a way that accounts for the fact that trans people took part in its projects, authored its central
theories, served as gatekeepers, pushed a certain narrative, created infrastructures of biopolitics,

165
fought for gender self-determination, laid their bodies and reputations on the line, and created
structures of trans medicine that were both liberatory and discriminatory.
When thinking about Erickson, Dillon, and Lawrence, it’s useful to consider Avery
Gordon’s theory of complex personhood. In Ghostly Matters: Haunting and the Sociological
Imagination, she writes: “Even those who live in the most dire circumstances possess a complex
and oftentimes contradictory humanity and subjectivity that is never adequately glimpsed by
viewing them as victims or, on the other hand, as superhuman agents.”
9
These contradictions are
what Gordon refers to as “complex personhood.” In this chapter I aim to extend the right to
complex personhood to Erickson, Dillon, and Lawrence, the right to be remembered in with of
their humanity, their genius and error.

Transsexual Knowledges
Dillon, Lawrence, and Reed’s contributions to trans therapeutics dwell within a larger
framework of what I call “transsexual knowledges.” Transsexual knowledges are the survival
strategies, pathways to receiving gender affirming care, and community building ethos that
contemporary trans communities and movements have inherited from mid-century transsexuals.
The contributions of individuals like Dillon, Lawrence, and Reed, along with countless other
transsexuals which remain nameless in the archive or unarchived, are too often forgotten or
under-recognized because of the ways that “transsexual” as a signifier and identity has receded
into the background of anglophone activism and academia.
10
As I have argued elsewhere, “Trans
studies, which has been dominated by US and English based scholarship, has largely moved on

9
Avery Gordon, Ghostly Matters: Haunting and the Sociological Imagination (Minneapolis: University of
Minnesota Press, 2008), 4.
10
Emmett Harsin Drager and Lucas Platero. “At the Margins of Time and Place: Transsexuals and the Transvestites
in Trans Studies,” TSQ: Transgender Studies Quarterly 8, no. 4 (2021): 417–25.

166
from transsexuals in favor of ostensibly more open-ended and proliferating models of gender
variance.”
11
In the shift to transgender, transsexual has come to signify something archaic and
anachronistic, from a distant past, removed from the present. My project enlivens transsexuality
as a category, identity, and an act that reverberates into the present, providing us with a grammar
for articulating the grounded and sensorial experience of having a body—a body which moves, is
moved, is read, and mis-read.
Susan Stryker, riffing on Michel Foucault, has referred to transgender studies as a project
of “the insurrection of subjugated knowledges” or “(de)subjugated knowledges.”
12
In his lectures
at the Collège de France, Foucault outlined a theory of reckoning with subjugated knowledges
which undermine and challenge official accounts and thereby disrupt the hegemony of scientific
knowledges. For Foucault, subjugated knowledges are twofold; they are the pairing of erudite
and scholarly knowledges with disqualified and native knowledges.
13
Subjugated knowledges are
the buried, masked, and obscured vernacular knowledges and worldviews that scholars can
excavate. The insurrection of subjugated knowledges reveals the power struggle of authoritative
knowledge systems over experiential, nonconceptual, and hierarchically inferior knowledges of
the people. Stryker argues that transgender studies inquiry has methodologically come to employ
both, by listening to the speaking subject and their experiential knowledge and by turning to the
historical record to find buried archives of gender difference.
For me, transsexual knowledges are a subset of trans studies (de)subjugated knowledges.
They are the more formal and documented contributions of transsexuals, like Dillon, Lawrence,

11
Harsin Drager and Platero, 417.
12
Susan Stryker, “(De)Subjugated Knowledges: An Introduction to Transgender Studies,” in The Transgender
Studies Reader, ed. Susan Stryker and Stephen Wittle (New York: Routledge, 2006), 17–34.
13
Michel Foucault et al., Society Must Be Defended: Lectures at the Collège de France, 1975-76 (New York:
Picador, 2003), 7.

167
and Reed, to the medico-scientific knowledge project of trans therapeutics and they are also the
localized, survival strategies of countless transsexuals which populate the archive as merely data
points or pseudonyms. Transsexual knowledges refer to Lawrence’s case histories and Dillon’s
textbook, but they also refer to the many unnamed transsexuals who interfaced with clinicians
and researchers, silently shaping their studies. Transsexual knowledges are the strategic ways
trans people have learned to survive in this world—from taking pseudonyms, to lying to doctors,
to telling doctors the truth. Transsexual knowledges teach us about revealing and concealing,
passing and not passing, knowing when to lie and when to tell the truth.
14
This chapter asks
readers to consider what we can learn from transsexual knowledges. What did mid-century
transsexual activists know that we have forgotten? What can we learn from transsexual pasts?

Michael Dillon
Born on May 1, 1915, in London to an aristocratic family, Michael Dillon was raised by
his paternal aunts in Folkestone. After attending Oxford, Dillon began taking testosterone in
1939.
15
The doctor who gave Dillon the testosterone tablets outed Dillon to his colleagues at the
research laboratory where he worked, causing Dillon to resign after much ridicule.
16
Dillon went
to work as a petrol pump attendant during World War II where he began his social transition. At
the petrol pump, Dillon’s coworkers readily referred to him as he/him to avoid confusing the
customers (and also perhaps to assuage their own sense of gender role conformity). Around this
time, he began suffering from “hypoglycemic attacks.”
17
After collapsing one day and waking up

14
In Mobile Subjects, Aren Aizura describes something similar. He writes, “Transgender resistance to medical
authority manifests in myriad forms. It can be individual and collective, or both, directed toward individual care
providers and the institutions they work in; it can be direct and indirect, including strategies aimed at legal
recognition, creative and informal tactics, or affects such as humor and irony” (9).
15
Dillon, Out of the Ordinary, 90.
16
This doctor is never named in Dillon’s memoir.
17
Dillon, Out of the Ordinary, 98.

168
in a hospital, the attending physician brought a plastic surgeon to perform chest surgery and
suggested that Dillon re-register as a man. After changing his legal documents in 1944, Dillon
went to medical school at Trinity College. During this time, Dillon began a series of thirteen
phalloplasty operations with British plastic surgeon, Sir Harold Gilles.
18
Gilles was an army
doctor who oversaw Rooksdown House, a hospital in the English countryside which primarily
operated on soldiers with physical injuries from the Second World War. To perform the
phalloplasty, Gilles adapted techniques that he had learned while treating soldiers who had
sustained genital injuries during wartime.
19

After graduating from medical school, Dillon served as a surgeon for the merchant navy.
In 1953, he contacted the editor of Debrett’s Peerage, an encyclopedia of British titled families,
to change his name and sex in the newest edition, placing him as the next in line to the title of
Baronet of Lismullen. This decision would prove to be life changing. The Baltimore Sun
reporters that came to the dock to write about Dillon had been tipped off by someone who had
noticed the discontinuity between older and newer editions of Debrett’s Peerage. So personally
consequential was Dillon’s outing in the press that he chose to open his autobiography with a
vignette about the experience. Tormented by his exposure, Dillon decided to disappear. During
his time in the merchant navy, Dillon had become enthralled with Buddhist philosophy and the
idea of spiritual transformation. He left Baltimore and headed to India, discarding all of his
possessions in pursuit of an ascetic life.

18
Michael Dillon wrote that he had thirteen operations from 1945-1949 (Out of the Ordinary, 104). Sir Harold
Gilles’ medical notes document seventeen operations from 1946-1955 (Kennedy, 6).
19
Gilles had operated on plenty of soldiers with genital injuries and was capable of making a phallus from skin
grafted from another part of the body. However, Gilles faced a challenge when it came to Dillon: figuring out how
to make the phallus functional for both urination and sex. Gilles would ultimately construct an artificial urethra that
attached to Dillon’s. He opted to leave the clitoris at the base of the phallus to maintain some amount of erotic
sensation and then included cartilage in the phallus, which meant that it was always in a semi-erect state.
Kennedy, 81-82.

169
Dillon travelled to Kalimpong where he studied under the direction of an English monk
named Sangharakshita who practiced Theravada Buddhism.
20
Dillon took the name Jivaka, the
name of the Buddha’s physician.
21
This is where he would begin to write his memoir, Out of the
Ordinary, which went unpublished until 2017. Dillon took his devotion seriously, donating his
savings and inheritance to charity.
22
Eventually, Dillon left Kalimpong and Sangharakshita
because of his teacher’s unwillingness to recognize him as a man, therefore restricting his
possibilities of higher ordination.
23
It’s likely that Sangharakshita leaked the story of Dillon’s
transition to the Hindi-language press.
24
Dillon, once again, found himself trying to escape the
media. He died on May 15, 1962, on his way to Kashmir to obtain a passport for Tibet. The
circumstances of his death remain largely unknown. What seems most likely is that he died of
illness from years of malnutrition in the monasteries, however, at the time a rumor circulated that
he had been poisoned.
25
He was cremated, and his ashes scattered to the Himalayas.
Dillon’s life was defined by a constant attempt to outrun the popular press. He was a man
full of contradictions: captivated by India and Buddhist philosophy, but unable to shake the
racism he learned from British society. He was a theorist of gender self-determination, while also
deeply misogynistic. Dillon desired to rid himself of ego but also cared about his family’s
lineage and wanted to be recognized for his title. Dillon, despite being written about in
newspapers across the globe, is an undertheorized figure in trans history/studies, perhaps because
his autobiography was lost for decades, stored in a warehouse in England.
26

20
Dillon, Out of the Ordinary, 227.
21
Kennedy, 146.
22
Kennedy, 154.
23
Kennedy, 155.
24
Dillon, 18.
25
Kennedy, 187.
26
Before his death, Dillon mailed the manuscript to his literary agent, John Johnson. By the time it arrived, Dillon
had already passed away. His brother Robert objected to the autobiography’s publication, embarrassed to be
associated with Dillon and his transition. Robert wanted the manuscript burned. Johnson was never able to publish

170
After beginning hormones, Dillon began extensively researching endocrinology and
writing, Self: A Study in Ethics and Endocrinology, which was published in 1946 right after
Dillon started medical school. In Self, Dillon explains the glands of the body (thyroid, pituitary,
ovaries, and testes) and the various diseases or anomalies that could arise in these glands. Dillon
develops a classification system for abnormalities that relate to “types of homosexuality.” These
various types would now be parsed into the discrete categories of transsexual, intersex, and
butch/femme homosexuality, but Dillon uses a different taxonomical system of his own making.
In order to make his arguments about gender self-determination, Dillon turns to philosophical
debates over the meaning of free will. At times the text pushes the boundaries of 20th century
conventions, declaring “If God created them male and female, he also created them homosexual
and heterosexual,” and at other times Dillon argues that there is a difference between the rational
male brain and the emotional female brain.
27
As Susan Stryker notes, “Although Dr. Harry
Benjamin is generally credited with developing the ‘logic of treatment’ for transsexual medical
care in his 1966 book The Transsexual Phenomenon, Dillon actually got there first, a full two
decades earlier.”
28

The tone of Self is removed and clinical. Dillon provides examples that are semi-
autobiographical, but they are presented in a way that obscures his connection. In a kind of
foreshadowing of what was to come in his life, Dillon condemns the press that exposes people
who are passing as another gender. He laments that fact that “whether he lives according to a
rigid moral code of his own making, or whether he decides that people are not worth considering,

the manuscript, but it was inherited by his successor Andrew Hewson who made the manuscript available to Dillon
biographers Liz Hodgkinson and Pagan Kennedy. The manuscript was ultimately published by two trans Harvard
divinity students, Jacob Lau and Cameron Partridge, using digital photographs and photocopies they obtained from
Kennedy.
27
Dillon, Self, 55.
28
Susan Stryker, “Foreward,” in Out of the Ordinary: A Life of Gender and Spiritual Transitions (New York:
Fordham University Press, 2017), viii.

171
he is given the same treatment; whether he deprives himself or indulges himself he is condemned
and ostracized.”
29
By writing from the position of a medical authority rather than as a trans
person, Dillon may have hoped that other medical professionals would read his textbook and
consider providing treatment for gender variant patients.
Dillon argues for a merging of psychology and endocrinology in order to best understand
homosexuality. Decades before doctors were arguing for a mixed biological and social etiology
of transsexuality, Dillon outlined a hybrid nature/nurture approach to understanding human
sexuality and gender. Dillon creates a nosological framework for classifying different kinds of
gender variance, or as he classifies them, different types of homosexuality. Homosexuality, for
Dillon, is a catch-all term that encompasses same-sex sexuality, intersex conditions, and cross-
gender life. Dillon's classification relies on a few key distinctions, first: active versus passive, i.e.
penetrating or being penetrated. He also distinguishes between mannish versus masculine and
effeminate versus feminine. For Dillon, mannish and effeminate are ways of behaving, of dress,
of interest/hobbies. Masculine and feminine relate to the material aesthetics of the body: fat
distribution, muscle mass, body hair. With these distinctions in mind, he outlines six homosexual
types: the active male, the passive female, the effeminate passive male, the mannish active
female, the feminine passive male, and the masculine active female.
The active male and the passive female are individuals who take on conventional
heteronormative gender roles during sex, however their sexual partner is of the same sex. Dillon
believes that these individuals fall into a category of situational homosexuality. Perhaps they are
in a homosocial environment like a boarding school, a prison, or a navy ship. Dillon also

29
Dillon, Self, 55.

172
includes survivors of sexual violence in this category. The causes of homosexuality in this “type”
are psychological rather than endocrinological.

Fig. 5.1 Chart of types of homosexuality from Self: A Study in Ethics and Endocrinology

On the other hand, both the passive male (effeminate or feminine) and the active female
(mannish or masculine) are homosexual not for psychological or environmental reasons but for
endocrinological reasons. According to Dillon’s theory, these individuals have irregularities in
their endocrine system. The effeminate or mannish come from post-natal anomalies while the
feminine or masculine come from the neonatal or in utero anomalies. Essentially Dillon lays out
the exact theories that university researchers would outline almost three decades later to explain
the causes of transsexuality—environment, hormones before birth, and hormones after birth.

173
Throughout the book, Dillon highlights his awareness of sexological theories of the time,
referencing concepts like innate bisexuality.
Dillon argues that in cases where the mind cannot be made to fit the body, the body
should be made to fit the mind and that the individual should be the sole decider of their own
embodiment and gender. “If, on the other hand, there is an incompatibility between the mind and
the body, either the body must be made to fit the mind, as we have said, or the mind be made to
fit the body; and that is for the patient himself to judge if he be of age.” In this passage, he
identifies, what to him is, an unresolvable conflict between the body and the mind and unlike
psychologists of the time, argues for surgical and hormonal treatment. Most notable is his belief
in the trans patient’s ability to make medical decisions for themself. Dillon is making a forceful
appeal for gender self-determination at a time when no one else was.
Dillon’s text calls for those who are intolerant to variations in gender to question their
own assumptions. Dillon acknowledges that there are two options for making the world a better
place for gender variant people: “either change the attitude of the people so that that such persons
may regain their self-respect by not being considered freaks, or change the aspect of the person
that no one may know they are of that nature.”
30
Dillon believes that both changes are worth
pursuing. Dillon critiques psychotherapy for taking an individual case (or as he calls it a “type”)
and extrapolating it into a general theory. He forcefully argues that most of the neuroses of men
are causes by life circumstances. Rather than treat the neuroses, we should treat the
circumstances of one’s life. In this way, he diverges from most gender/sexuality researchers and
clinicians. He believes that society (or circumstances) are the problem and not the individual.
While the first half of Self is an appeal to understand types of homosexuality differently and

30
Dillon, Self, 54.

174
therefore allow people to pursue life as they choose, the second half, which focuses on questions
of free thought and free will, ends with a call for people to pursue knowledge, to learn more, and
to dispel ignorance and prejudice.
Self: A Study and Ethics Endocrinology is a text well ahead of its time in terms of the
arguments in makes in relation to gender self-determination and the need for societal change.
What I find to be important about Dillon’s text is that it is written at a moment before the
inception of the gender clinics and the birth of the Gender Identity Disorder diagnosis. The
languages he uses to describe the ethics of gender treatment and gender self-determination was,
as Stryker argues, an “avant la lettre of the ‘transsexual discourse’ that took shape in the mid-
twentieth century.”
31
I say all of this to suggest that medicine developed its diagnosis and
understanding of transsexuality from taking the language and etiological theories of trans people
themselves. Medicine was not an outside force which imposed narratives on trans people, but
rather transsexuality, as a category, developed through dialectical conversation between trans
people and clinicians, or in the case of Michael Dillon, a trans clinician.
In addition to writing his medical theories, Dillon was finding creative ways to sidestep
medical boundaries of the time. After beginning his transition, Dillon became romantically
entangled with Roberta Cowell, a transwoman and former professional racecar driver. Cowell
does not appear in Dillon’s memoir, purportedly because she declined his marriage proposal in
1951 and broke his heart, leading to his decision to join the merchant navy. According to Pagan
Kennedy’s biography on Michael Dillon, the two met because Cowell had read Self and was
seeking the assistance of an open-minded doctor

31
Stryker, “Foreword,” vii-viii.

175
In the mid-twentieth century, many doctors in the U.S. and Britain would not treat
transsexuals because of mayhem statutes, which restricted the removal of “healthy” tissue.
Mayhem statutes, based on English common law, “outlawed the maiming of men who might
serve as soldiers.”
32
For this reason, most doctors refused to perform orchidectomies on trans
women, leading many to self-castrate or go abroad for the operation. After their initial meeting,
Dillon fell head-over-heels in love with Cowell, writing her love notes multiple times a day.
Dillon’s love notes have been preserved and are in the possession of Liz Hodgkinson, another
one of his biographers, but Cowell’s have not. As such, it is unclear how exactly Cowell felt
about Dillon. Regardless, what is clear is that Cowell may have been able to convince Dillon to
perform an orchidectomy on her. Among the love letters in her possession, Hodgkinson found an
undated document that reads:
I, R.C. have, of my own free will asked and persuaded L.M.D. who I am aware is an
unqualified man, a 5
th
year medical student, to perform an orchidectomy upon me. I am also
aware that his operating experience has been confined solely to assisting at operations as a
resident pupil in hospital and to one appendectomy in the presence of a surgeon and that he
has neither seen nor practiced this particular operation. I desire that he be absolved from all
responsibility in this operation, due to possible hemorrhage or sepsis, which I am desirous to
undergo being fully aware that either might, per fortunam, be fatal.
33

If Dillon did in fact perform an orchidectomy on Roberta Cowell, he was not only an early
theorist of trans medicine, but an early practitioner.

Louise Lawrence
To consider the direct connection between trans people, doctors, and scientists, I turn
now to Louise Lawrence, a transvestite activist who was crucial to the development of mid-

32
Joanne Meyerowitz, How Sex Changed: A History of Transsexuality in the United States (Cambridge: Harvard
University Press, 2002), 120-121.
33
Kennedy, 91.

176
century trans medicine. Throughout Lawrence’s life, she used the popular press to find
community, posting personal ads in magazines and regularly reading newspaper police reports to
find people who had been arrested for cross-dressing.
34
Lawrence established a sprawling
network of transvestites, cross-dressers, and transsexuals that she kept up regular correspondence
with, making her an invaluable asset to doctors and researchers interested in studying trans
communities. She used this network to provide case histories to doctors and researchers in the
early 1950s and beginning in 1949, lectured on transvestism and cross-dressing at the Langley
Porter Psychiatric Clinic.
35
It is rumored that both the Harry Benjamin International Gender
Dysphoria Association (now known as WPATH or the World Professional Association for
Transgender Health) and Tri-Ess (Society for the Second Self), a cross-dresser rights
organization, were founded in her kitchen in San Francisco in 1972.
36

Louise Lawrence was born in 1912 in Northern California. At the age of eighteen she
started working as a bank clerk and around the same time married her first wife. Together they

34
Susan Stryker, Transgender History (Berkeley: Seal Press, 2008), 44.
35
Lawrence provided case histories to Kinsey from 1949 until his death in 1956. In the Louise Lawrence Collection,
the first mention of Lawrence giving a talk to doctors at Langley Porter is in 1949. Kinsey sent Lawrence a letter
giving her suggestions of what to focus on during her presentation. He writes: “I am glad that you are going to
educate the doctors at Langley-Porter. I have a few suggestions for you. I do think that they need some help in
understanding what particular interests lead an individual to become a transvestite. Most of all, they need to learn
that these interests are quite different for different people.”
Alfred Kinsey to Louise Lawrence, 10 October 1949, Louise Lawrence Collection, Box 1, Folder 1, Kinsey
Institute, Bloomington, Indiana.
36
This rumor comes from Dana Bevin, a trans woman psychologist, activist, and blogger. Bevin represents a unique
perspective, as both a medical professional that attends WPATH and a member of Tri-Ess, an activist and support
group for straight cross dressers. Bevin blogs regularly on TG Forum, a web 1.0 forum for trans people, with the
slogan “since 1995, all the news you want – all the information you need.” In a blog post on September 9, 2019,
Bevin shared that USPATH (a subsidiary organization of WPATH) is considering the inclusion of non-transitioning
transgender people in their organizational materials, including the Standards of Care. Bevin writes: “The Tri-Ess and
WPATH wings of transgender advocacy have been apart for many years, almost from their beginnings. Ironically
they both started in the kitchen of Louise Lawrence in San Francisco in 1972.” Bevin provides no citations for this
claim.
Dana Bevin, “News From the USPATH Convention,” TG Forum (blog), September 9, 2019,
https://tgforum.com/news-from-the-uspath-convention/.

177
had a daughter.
37
After her first wife passed away of pneumonia, Lawrence married again. Her
second marriage lasted three years, ending because of her wife’s emotional distress over having
to keep Lawrence’s crossdressing secret.
38
After her second marriage ended, Lawrence moved
from Berkeley to San Francisco where she began living full-time as a woman in 1944.
39

Lawrence self-identified as a heterosexual transvestite or permanent transvestite.
40

After moving to San Francisco, Lawrence worked as a property manager and decorator.
She was also an artist. She sold paintings and remodeled apartments. She hung out at Finocchio’s
in North Beach to meet drag performers and cross-dressers and was also involved with the gay
rights organization, the Mattachine Society.
41
In the late-1940s, Lawrence started working with
doctors at the Medical Department of the University of California (later renamed UCSF),
specifically Karl Bowman, Director of the Langley Porter Psychiatric Clinic.
42
Lawrence would

37
Janet Thompson (pseudonym for Louise Lawrence), “Transvestism: An Empirical Study,” The International
Journal of Sexology IV, no. 4 (1951): 216–19.
38
Thompson (Lawrence), 216.
39
Susan Stryker’s Transgender History dates Lawrence’s transition to living full time as a woman to 1942, however,
various other sources cite the year as 1944. In a letter that Lawrence wrote to Christine Jorgensen on February 16,
1953 she states, “I have been living for the past nine years as a female.” From this statement we can assume that
1944 is the year in which Lawrence began living full time as a woman. The Louise Lawrence Collection also houses
a journal of Lawrence’s from 1944, presumably a significant year in her life.
Louise Lawrence to Christine Jorgensen, 16 February 1953, Box 1, Folder 9, Louise Lawrence Collection, Kinsey
Institute, Bloomington, Indiana.
40
Meyerowitz, How Sex Changed, 185.
According to Schaefer and Wheeler, Benjamin thought of Lawrence as a “true transsexual who [did] not require
genital reassignment surgery.”
Leah Cahan Schaefer and Connie Christine Wheeler, “Harry Benjamin’s First Ten Cases (1938-1953): A Clinical
Historical Note,” Archives of Sexual Behavior 24, no. 1 (1995): 90.
41
Rae Alexandra, “The Transgender Community Builder Who Educated Doctors—Including Kinsey,” KQED
(blog), November 26, 2019.
42
The Langley Porter Clinic opened in San Francisco in 1943. The clinic was named after Dr. Robert Langley
Porter, Professor of Pediatrics and Dean of the School of Medicine of the University of California in San Francisco
in the 1930s, who had been instrumental in its conception and establishment. In 1937, Porter had heard that the
California Department of Institutions was planning to allocate five million dollars for the construction of two
psychiatric facilities, one in Northern California and the other in Southern California. Porter wrote to Gordon
Sproul, then President of the University of California, to suggest that the university offer a lot of land they had
purchased for the College of Dentistry to the state of California for the psychiatric facility. According to the UCSF
website, the suggestion was made “based upon the idea that prevention, teaching, and research in the field of mental
disease would be enhanced if the wealth of clinical experience gained from the approximately 29,000 patients than
available in the nine California state hospitals could be combined with the expertise of the staff of a medical school”
[sic]. The idea was approved, and construction began in 1941.

178
give lectures on transvestism and cross-dressing to doctors and medical students at the clinic,
hoping to convince them that cross-dressing was not a mental illness. At the Medical Department
of the University of California she met the postdoctoral researcher and transgender activist
Virginia Prince, with whom she would co-found the newsletter, Transvestia: The Journal of the
American Society for Equality in Dress.
43

In 1948, through her work with Bowman and UCSF, Lawrence was introduced to famed
sexuality researcher, Alfred Kinsey, who had just published Sexual Behavior in the Human
Male.
44
Kinsey had not given much thought to transvestism before meeting Lawrence.
45

Lawrence began to share with Kinsey some of stories of transvestites she had collected in recent
years. Eventually, Kinsey would hire Lawrence to transcribe case histories, transvestite stories,
and other kink materials, specifically stories of ‘petticoat discipline,’ an erotic genre about male
cross-dressers being humiliated.
46
As Louise Lawrence wrote to Alfred Kinsey: “It is one of my
main aims in life, as you probably already know, to get as much information regarding
transvestites into the hands of a responsible person so that possibly something can be done about
the subject.”
47

In 1949, Lawrence introduced Kinsey to a friend of hers, Val Barry (pseudonym).
48

Barry, who had spent most of her life living as a female, had sought sex reassignment surgery in

“Department of Psychiatry and Behavioral Sciences - Department History,” UCSF, https://psych.ucsf.edu/history.
43
Stryker, Transgender History, 46.
44
Joanne Meyerowitz, “Sex Research at the Borders of Gender: Transvestites, Transsexuals, and Alfred C. Kinsey,”
Bulletin of the History of Medicine 75, no. 1 (2001), 74.
45
As Joanne Meyerowitz notes in her article, “Sex Research at the Borders of Gender: Transvestites, Transsexuals,
and Alfred C. Kinsey,” various publication such as the popular psychology magazine, Why, referred to transvestites
as “the men Kinsey forgot” or “Kinsey’s forgotten men” (77).
46
Meyerowitz, “Sex Research at the Borders of Gender,” 76.
47
Louise Lawrence to Alfred Kinsey, 5 May 1951, Box 1, Folder 1, Louise Lawrence Collection, Kinsey Institute,
Bloomington, Indiana.
48
I have opted to use the same pseudonym as Joanne Meyerowitz in How Sex Changed to create continuity for
people tracking individuals across trans history/texts (47). In Leah Cahan Schaefer and Connie Christine Wheeler’s
article, “Harry Benjamin’s First Ten Cases (1938-1953): A Clinical Historical Note,” they refer to this individual as
both “Barry” and “Sally.”

179
Wisconsin but was denied after the Attorney General objected on the grounds that the operation
was illegal due to mayhem statutes. Barry had been institutionalized by the courts.
49
Kinsey then
referred Barry to Benjamin; she was his first transsexual patient.
50
Benjamin administered
hormones to Barry from his San Francisco clinic. During the time that her case was under
consideration, Lawrence and her partner, Gay, housed Barry in one of the apartments they
managed.
51
As Kinsey, Bowman, and Benjamin conferred on the case, Benjamin wrote to
California district attorney Edmund G. Brown to ask about the legality of sex reassignment
surgery. Like the Attorney General of Wisconsin, Brown offered the legal advice that such an
operation would constitute mayhem.
52
This legal advice would have a chilling effect on trans
medicine for years to come.
Much like the story of Val Berry, Lawrence would constantly find herself at the
intersection of trans medical research and trans social words. She served as a bridge between
transsexuals, transvestites, and cross-dressers and the doctors and researchers who wanted to
meet them. She introduced Kinsey to transvestites in Long Beach.
53
She took Benjamin to
invitation-only events at the Beige Room, a female impersonator club in San Francisco, and even
provided him with a literature review on the term “transsexual” for his own research.
54
Lawrence
would meet gender variant people from across the country, record their stories, and send the
materials to Dr. Kinsey. For example, on December 4, 1951 she wrote to Kinsey: “Enclosed are
47 pages of manuscripts which I have finally completed. One is by J.S.T and the other two are by

49
Schaefer and Wheeler, 79.
50
Schaefer and Wheeler, 78.
51
Meyerowitz, “Sex Research,” 79.
52
Stryker, Transgender History, 45.
53
Louise Lawrence to Alfred Kinsey, 5 May 1951, Louise Lawrence Collection, Box 1, Folder 1, Kinsey Institute,
Bloomington, Indiana.
54
Louise Lawrence to Alfred Kinsey, 12 August 1950, Louise Lawrence Collection, Box 1, Folder 1, Kinsey
Institute, Bloomington, Indiana; Louise Lawrence to Harry Benjamin, 28 October 1953, Louise Lawrence
Collection, Box 1, Folder 2, Kinsey Institute, Bloomington, Indiana.

180
a fellow in Cincinnati, Ohio who goes by the name of Evelyn… He is the fellow I told you about
who has his nipples pierced and wears earrings in them. I have a couple more stories by different
fellows that I will be starting shortly. One is by a fellow in Niagara Falls, New York and the
other by the German fellow who lives here in San Francisco. I told you about him a short time
ago.” It’s unclear how much Lawrence was paid for her research, but in one letter, Kinsey
references the manuscript he received and includes a check for $10.
In 1951, with the encouragement of Benjamin, Lawrence wrote an essay titled
“Transvestism: An Empirical Study,” which was published under the pseudonym “Janet
Thompson” in the International Journal of Sexology. In the article, Lawrence draws from her
collection of case histories (over fifty), to make the argument that there is no common
denominator cause for transvestism. She says transvestites can be male or female, heterosexual
or homosexual, and of any economic, social, marital or family status. They can be fetishists,
sadists, masochists, and/or voyeurs. Lawrence reports that the practice of cross-dressing can
begin at any age and have varying intensities. “That transvestism exists, that it is worldwide and
that it has existed in one form or another in every culture known to recorded history, is a
demonstrated fact.”
55
In making such an argument, Lawrence is attempting to persuade clinicians
and researchers that there is in fact something natural and normal about cross-dressing. However,
she also states that, “Almost never do we find a case of simple or ‘true’ transvestism (dressing
only) because transvestism is, itself, only the outward and obvious manifestation or symptom of
other deeply rooted emotional problems.”
56
She argues that to “cure” transvestism, one would
have to address the underlying issue that leads to the condition, an argument that would seem to
undermine the idea that such behavior is normal or natural.

55
Thompson (Lawrence), 217.
56
Thompson (Lawrence), 219.

181
The article highlights the convergences between Kinsey and Lawrence’s thinking. Kinsey
was very much a behaviorist when it came to his opinions on transvestism. In the mid-century
there were two prevailing theories of gender deviance. The first, often referred to as innate
bisexuality, argued that no one was one hundred percent male or female, but that the two sexed
shared many elements of the other. The other theory, more based in psychology and
psychoanalytic theory, held that sex was the result of a psychodynamic process and that gender
deviance was the cause of disturbances in childhood (what would later become mother theory).
Kinsey did not accept innate bisexuality or sexual indeterminism and also thought that
psychology was too pathologizing of natural variation. He thought that conditioning was the
explanation of sexual variation, but that everyone’s unique experience meant that no two
transvestites were the same. Lawrence is expressing a similar opinion, stating that human
variation exists across time and place, but that these differences are manifestations of a certain
kind of conditioning. The so- called problem of gender deviance cannot be addressed without
addressing the conditions or behavior that creates it.
After the Christine Jorgensen story broke in December of 1952, Lawrence’s
correspondence with Benjamin becomes singularly focused on Jorgensen. On February 12, 1953
she writes: “In this morning’s paper I have just read that Christine is arriving in New York today
(Thursday, Feb. 12
th
), and remembering your statement in a recent letter that you MIGHT have
an opportunity to meet her, a thought occurred to me which is probably as obvious to you as it
was to me. SHOULD you have the chance of meeting and talking with her, I would be eternally
grateful if you could attempt to establish some sort of relationship whereby I might meet her.”
57

Lawrence would attempt to contact Jorgensen multiple times before finally getting a reply.

57
Louise Lawrence to Harry Benjamin, 12 February 1953, Louise Lawrence Collection, Box 1, Folder 2, Kinsey
Institute, Bloomington, Indiana.

182
With the public attention Jorgensen was getting, Lawrence saw it as an opportunity to
educate the general public and to develop a larger network of transvestites and transsexuals.
During her presentations at Langley Porter over the years, Lawrence had wanted to convince
doctors that cross-dressing was not a mental illness. With Jorgensen’s public platform, this
opportunity was only amplified. “I have always tried, in my small way, to further the
understanding of the problem of transvestism and I feel that there was a very good chance that
Christine could be of tremendous value in this regard,” she wrote to Benjamin.
58
Lawrence
doggedly pursued a friendship with Jorgensen.
As Jorgensen started writing her autobiography, Lawrence became preoccupied with how
Jorgensen would present her story to the general public. In 1955 she wrote:
Regarding your book. One night on Long Island you said something which has caused
me to do a lot of thinking so see what you think of this. You said that you didn’t feel that
you REALLY understood transvestism or homosexuality since you have never
experienced either; that you knew WHAT they were but that was as far as you could do
(fetichism was also mentioned). The reason this statement caused me so much thought
was not that there was any doubt in my mind regarding the truth of the statement but
rather the fact that the semantics, and therefore implications, involved could be
dangerous.
59

Privately, Lawrence was frustrated with Jorgensen’s decision to present her story to the public as
a case of intersexuality or, in the language of the time, hermaphroditism. From the moment the
story broke she was skeptical of Jorgensen’s narration of events. She wrote to Benjamin, “I feel
as you do, that if it is a case of hermaphrodism it could be handled in this country very easily.
Johns Hopkins has been doing such operations for years and now, from the papers, it seems that

58
Louise Lawrence to Harry Benjamin, 6 April 1953, Louise Lawrence Collection, Box 1, Folder 2, Kinsey
Institute, Bloomington, Indiana.
59
Louise Lawrence to Christine Jorgensen, 25 November 1955, Louise Lawrence Collection, Box 1, Folder 9,
Kinsey Institute, Bloomington, Indiana.

183
such cases are being handled all over the country.”
60
Lawrence doubted the veracity of
Jorgensen’s claims about her intersex condition, wanting her to more openly embrace a
transvestite or transsexual identity to help the movement for trans visibility/awareness/rights.
Over the years, Lawrence’s letters to Jorgensen include various theories of transsexual
and transvestite etiology. For example, in a letter sent on December 21, 1955, Lawrence tells
Jorgensen that there are quite a few theories about the causes of gender variance, some of which
contradict or offer very little in terms of conclusions. She says that she personally believes that
transvestism begins in childhood. “It is also my belief that this problem is not a sexual one until
it is made one. In itself it is a behavior problem pure and simple like sucking your thumb only in
this culture more extreme… in this culture we are reminded forcibly from earliest childhood that
a boy should be a boy ‘and not be a sissy’ and this is invariably accompanied by ridicule, shame
and often physical punishment if society’s conditions are not met.”
61
This stance echoes Dillon’s
ideas about society creating the conditions of transsexuality begin regarded as a problem.
Lawrence’s pressured Jorgensen to responsibly present the general public with scientific and
medical theories of transvestism and transsexuality. Her efforts were successful; in Jorgensen’s
1967 autobiography she included theories of trans etiology.
62
From her exchange with Jorgensen
we can see that Lawrence was a tireless advocate for trans people, but she also tried to gatekeep
the information the general public received about trans identities, obsessively controlling the
narrative.

60
Louise Lawrence to Harry Benjamin, 9 December 1952, Louise Lawrence Collection, Box 1, Folder 2, Kinsey
Institute, Bloomington, Indiana.
61
Louise Lawrence to Christine Jorgensen, 21 December 1955, Louise Lawrence Collection, Box 1, Folder 9,
Kinsey Institute, Bloomington, Indiana.
62
Christine Jorgensen, Christine Jorgensen: A Personal Autobiography (San Francisco: Cleis Press, 2000).

184
After the story of her sex reassignment surgery in Denmark broke, Jorgensen received
hundreds if not thousands of letters from individuals all around the country and world who
wanted to know how she had done it. Jorgensen, overwhelmed with the numbers of letters was
unable to keep up. On various occasions, Lawrence suggested to Jorgensen that she could reply
on behalf of Jorgensen and provide the individual with relevant information. She also wanted to
use the letters as an opportunity to grow the network of trans people she knew for both statistical
research and for the creation of national support groups. Lawrence would use the letters to
bolster her database of transsexuals and transvestites hoping to create correspondence clubs and
pen support groups. Ultimately, at Benjamin’s suggestion, Jorgensen did not give Lawrence the
letters.
63
However she did refer some of the letter writers to Lawrence.
64

Despite Lawrence providing Kinsey with the bulk of his materials on transvestite and
transsexual communities, Kinsey distanced himself and his research projects from Lawrence,
careful to never give the impression that she worked for him or the Kinsey Institute. For
example, in a letter to Kinsey, Lawrence writes: “In all my contacts I try to be very explicit that I
am not working FOR you, that I am merely collecting this information with the hope that you
will be able to make use of it for the good of society in general.”
65
After Kinsey death in 1956,
Lawrence applied for a passport under the name “Louise.” After initially receiving the passport,
the passport security office later revoked the document, saying it was issued under a false name.
Lawrence went to the passport office for an interview. During the interview, “I talked with them
for almost two hours giving them my story as honestly as I could and of course the name of Dr.

63
Louise Lawrence to Harry Benjamin, 27 March 1954, Louise Lawrence Collection, Box 1, Folder 2, Kinsey
Institute, Bloomington, Indiana.
64
Meyerowitz, 155.
65
Louise Lawrence to Alfred Kinsey, 8 April 1954, Louise Lawrence Collection, Box 1, Folder 1, Kinsey Institute,
Bloomington, Indiana.

185
Kinsey came into the discussion. Though one of the agents tried to imply that I ‘worked for’ Dr.
Kinsey I stated very firmly that I had no connection with either Dr. Kinsey or the Research other
than that I tried to contribute of my own free will whatever I could.”
66
Lawrence sent this
account to Paul Gebhard, Kinsey’s research colleague and the director of the Kinsey Institute
after his death. Gebhard responded to Lawrence saying: “We want to thank you for the forthright
and intelligent manner in which you explained your relationship with the Institute. A weaker
person might have attempted to use the Institute as an arguing point and emphasize their
relationship with the Institute. This could have led to some juicy newspaper accounts...”
67

Gebhard may have wanted to prevent the general public from knowing that a transvestite was a
central part of the research happening at the Kinsey Institute.
Lawrence’s contributions to trans medical research were erased or obscured by the fact
that many of her contributions happened anonymously, such as the talks she gave at UCSF, or
under a pseudonym, as was the case with her article in the International Journal of Sexology. She
was unable to publicly talk about her connections to the Kinsey Institute. Additionally, Lawrence
was not overly concerned with being publicly recognized. After Kinsey’s death, Lawrence sent a
letter to Gebhard about the possibility of her and her partner, Gay applying for a U.S. Public
Health Grant for her research on transsexual and transvestite communities. Gebhard responded
by saying:
In order to obtain money from foundations one must have a union card: a
doctorate, a professorship, or some such thing. Since you and Gay lack these, the realistic
procedure would be for you to join forces with someone (or some group) with the
requisite title and position…
In finding some person or organization interested in transvestism and affiliating
yourself with them, there is always the danger that you will find yourself doing the work

66
Louise Lawrence to Paul Gebhard, 6 November 1957, Louise Lawrence Collection, Box 1, Folder 1, Kinsey
Institute, Bloomington, Indiana.
67
Paul Gebhard to Louise Lawrence, 8 November 1957, Louise Lawrence Collection, Box 1, Folder 1, Kinsey
Institute, Bloomington, Indiana.

186
while they reap the credit. I do not know whether or not you are especially concerned
with such credit, but I thought a warning was appropriate. Even if this situation existed,
you would at least be doing research in your favorite field, obtaining some financial
recompense, and advancing scientific knowledge.
68

Lawrence responded by saying she was not interested in taking credit for the research.
69

Lawrence’s research was motivated by the desire to improve life conditions for trans people
rather than ego, as a consequence, her contributions to the study of trans communities and her
pivotal role in the development of trans therapeutics in the U.S. are often forgetten or under-
recognized.
As Joanne Meyerowitz notes, Lawrence’s work with Kinsey and the case histories she
provided him would set the stage for the university-based gender clinics. Both were influenced
by one another’s thinking—developing and circulating behaviorist theories of trans etiology.
“The notion that gendered behavior and identity were socially learned helped legitimate the
various ‘gender identity clinics’ established in university hospitals in the 1960s and 1970s, and
also served as a mainstay of the emerging feminist movement.”
70
Schaefer and Wheeler,
psychotherapists who worked with Benjamin and his patients describe Lawrence as Benjamin’s
“inner analytic inspiration,” who “taught him so much about the condition” and served as “a
sounding board for the development of many of his ideas.”
71
Lawrence was central to the
trajectory of trans medicine.

68
Paul Gebhard to Louise Lawrence, 16 April 1958, Louise Lawrence Collection, Box 1, Folder 1, Kinsey Institute,
Bloomington, Indiana.
69
Louise Lawrence to Paul Gebhard, 18 April 1958, Louise Lawrence Collection, Box 1, Folder 1, Kinsey Institute,
Bloomington, Indiana.
70
Meyerowitz, “Sex Research,” 90.
71
Schaefer and Wheeler, 81.

187
Reed Erickson
When it comes to the university gender clinics, their existences were quite literally made
possible from funding provided by transman philanthropist Reed Erickson and his organization,
the Erickson Education Foundation (EEF). Born in 1913 in El Paso, Erickson grew up primarily
in Philadelphia. Erickson worked for his father’s lead smelting business and opened his own
company making stadium bleachers. In 1940, Erickson’s father moved the family and his
business to Baton Rouge, Louisiana and after his death in 1962, Erickson and his sister inherited
the family business which they later sold for millions. Erickson’s business ventures along with
the oil revenue he earned from properties around Baton Rouge, Louisiana generated a net worth
in the millions.
Erickson began his transition sometime in the mid-to-late 1950s. While Erickson publicly
mentioned travelling to both Tijuana and Casablanca for gender affirming care, there’s no clear
evidence to support him receiving treatment in Morocco.
72
He had top surgery in Tijuana in 1957
or 1958. He may have originally accessed testosterone abroad but later became a patient of Harry
Benjamin in 1963. Erickson split his time between Baton Rouge, Southern California, and
Mazatlán, Mexico, with his businesses (including the EEF) headquartered in Baton Rouge. He
married four times and had two children. He was also known for his pet leopard Henry which
travelled everywhere with him.
The EEF was founded in 1964 and operated for two decades before officially closing in
1984. The foundation had various foci: it provided trans people with support—through
encouraging letters, support groups, and referrals to local physicians; it generated resources such
as a newsletters and educational pamphlets; it organized public speaking events and interfaced

72
Aaron Devor and Nicholas Matte, “Building a Better World for Transpeople: Reed Erickson and the Erickson
Educational Foundation,” International Journal of Transgenderism 10, no. 1 (2007), 65.

188
with mainstream media outlets; and it funded individual doctors and research clinics. The EEF
not only funded transgender related causes but also supported the homophile movement through
organizations like ONE Inc and new age spirituality projects such as the self-help book A Course
in Miracles, along with research into psychedelic drugs and dolphin communication. Erickson
said that the goal of the EEF was “to provide assistance and support in areas where human
potential seems limited by adverse physical, mental or social conditions, or where the scope of
research was too new, controversial or imaginative to receive traditionally oriented support.”
73

First and foremost, the EEF was a clearinghouse for trans people. They maintained and
constantly updated a list of trans-friendly medical providers across the country and around the
world. Any individual who contacted EEF by phone or letter could receive recommendations for
clinicians in their area who may be able to provide hormone replacement therapy or help a
patient access gender affirming surgery. Additionally, like Lawrence, Erickson and the EEF
attempted to build a safety net for trans people by fostering social support networks and pen pal
programs. For example, if a trans person contacted them expressing loneliness, social isolation,
or lack of community, they would help facilitate a connection to another trans person in a similar
situation.
The EEF also participated in many speaking engagements at universities and conferences.
They would put together panels of trans people to educate both the general public and specific
groups of individuals, such as law students, law enforcement personnel, and members of the
clergy on trans issues. As Aaron Devor and Nicholas Matte write, these panels were often
composed of the most respectable and passing trans people the EEF could find.
74
Similar to

73
Devor and Matte, 47.
74
Aaron Devor and Nicholas Matte have extensively researched the life and legacy of Reed Erickson, authoring
multiple publications about him. Both Devor and Matte are foundational in trans archives projects—Devor founded
and directs the Transgender Archives at the University of Victoria and Matte serves as the curator of the Sexual

189
Lawrence, Erickson wanted to control the messages the general public received about trans
people, focusing on scientific and medical “facts” and examples of “successful” transition.
The EEF also attempted to raise public awareness around trans issues by working directly
with the popular press. As Devor and Matte note, the EEF would work directly with reporters to
get stories in popular magazine. In 1970 they helped with an article in LOOK magazine titled,
“The Transsexuals: Male of Female?” and in 1973 they worked with Good Housekeeping on an
article titled “My Daughter Changed Sex.”
75
The articles often included contact information for
the EEF. They also helped produce TV segments which aired on news programs from
Washington D.C. to Los Angeles. The EEF had a series of documentaries that they showed at
speaking events and conferences. By raising visibility they wanted to increase acceptance of
trans issues and also get their name out there to trans people who may be looking for help or
support.

Fig. 5.2 Various Erickson Education Foundation pamphlets printed by in the 1970s

Representations Collection at the University of Toronto and a board member of the Digital Transgender Archive.
Devor and Matte, 55.
75
Devor and Matte, 57.

190
The EEF published a quarterly newsletter for seven years and printed pamphlets with
titles such as Legal Aspects of Transsexualism, Religious Aspects of Transsexualism, Information
on Transsexualism for Law Enforcement Officers, and Transsexualism: Information for the
Family. The EEF provided trans individuals on hormone replacement therapy with identification
cards signed by doctors in order to prevent police harassment. The cards stated: “The
undersigned is required to live in the gender of his/her choice for six months or more as a pre-
requisite for sex-reassignment surgery” (53). These various efforts were meant to help trans
people navigate the world and provide them with up-to-date research and resources.
In addition to all of the education and advocacy materials that the EEF produced, they
also directly funded individual doctors, institutional programs, research projects, and
international symposia. While Zelda Suplee, the EEF’ assistant director, managed most of the
day-to-day activities of the EEF, Erickson was entirely responsible for selecting which clinicians,
researchers, and clinics would receive funding. To be considered, the potential applicant would
first have to talk to Erickson about the proposed project. If he deemed it of interest, they would
be given an official grant application. Erickson made the final decision on which projects would
be funded. Recipients of such grants include: Harry Benjamin, John Money, Richard Green,
Donald Laub, Ira Pauly, and Anke Erhardt, all central players in mid-century trans therapeutics.
76

Perhaps the first grant to be distributed was to Benjamin in 1964. The EEF gave him
$18,000 each year for three years to “investigate the nature, causes, and treatment of
Transvestism and particularly Transsexualism.”
77
Erickson also provided funding for the
founding of the Johns Hopkins Gender Identity Clinic and provided funding to individual doctors

76
Devor and Matte, 59.
77
Devor and Matte, 60.

191
at other clinics such a Laub at Stanford and Richard Green at UCLA. Erickson’s financial
support was the catalyst behind the creation of the university-based gender clinics.
Perhaps motivated by the fact that he had needed to go abroad to receive top surgery and
hormones, something that was financially out-of-reach for most people, Erickson felt that the
gender clinics would allow for transsexuals in the U.S. to access care domestically. Indeed, it is
rumored that after Erickson funded the Hopkins clinic, he received care there. However,
Erickson was critiqued for financially supporting the university-based gender clinics because of
the fact that they treated and operated on very few patients.
78
Some critics of his philanthropy
felt the money would be better spent in funding public clinics which performed surgery on
demand. Erickson had the conviction that institutional research would be more fruitful in the
long-run, making in-roads with doctors and researchers who could work to advance and
legitimize trans medicine more broadly.
While Erickson was responsible for funding the gender clinics and getting physicians
across the country to join the EEF’s referral program, Erickson’s background as a businessman
impacted the structure of trans therapeutics. Erickson was savvy at making investments and
approached the problem of trans healthcare from a free market perspective. He would recruit
doctors who were open to treating trans people, provide them with educational information, and
then add them to his referral system, hence sending patients their way. Being approved for
treatment often required consulting with multiple medical professionals on the referral lists,
keeping the cash flowing. But because paying for multiple consultations was cheaper than
traveling abroad, Erickson was still making trans therapeutics cheaper to access. As Devor and
Matte note, “Thus, the referral system fulfilled to important sets of needs that the EEF always

78
Devor and Matte, 61.

192
saw as complimentary: those of trans people and those of the medical profession.”
79
While the
EEF undoubtedly expanded access to gender affirming care with their referral system and grants
to doctors/clinics, it’s also important to consider how Erickson’s capitalist, free market ethos
impacted the model of treatment. In other words, how might trans medicine be different if the
original funding structure had not been set up by a multi-millionaire businessman?
In 1974 the EEF ceased publishing their pamphlets and newsletters and announced they
would no longer be operating as a clearing house, providing guidance to individuals, or
information to organizations. They also ended their public speaking engagements. In 1977, the
EEF officially closed their office. Their programs and Zelda Suplee were transferred to the Janus
Information Facility, an organization run by Paul Walker at the Gender Clinic in Galveston,
Texas. Erickson continued to fund Suplee’s salary and also gave some operational money to
Walker. In 1983, the EEF published one last newsletter and offered some final transsexual
research grants before finally closing for good. Devor and Matte cite the reasons for the end of
the EEF as threefold: 1. Erickson’s interest pivoting towards other projects, mostly related to
new age spirituality, animal communication, and psychedelics; 2. Erickson’s funds were
dwindling; 3. Erickson’s intention was “to provide only the initial funding for new and creative
social projects.”
80
However, the closing of the EEF may have also had to do with Erickson’s
shifting ideas about transsexuality and transition.
In 1972, Erickson was indicted by the Drug Enforcement Administration (DEA) for
several drug-related charges.
81
Erickson who was, at the time, severely addicted to ketamine fled
to his mansion in Mazatlán, Mexico which he referred to as the Love Joy Palace Ashram.
82

79
Devor and Matte, 52.
80
Devor and Matte, 64.
81
Stryker, Transgender History, 79.
82
Devor and Matte, 49.

193
Around this time, Erickson began to write about transsexuality and the topic of embodiment as a
kind of spiritual journey:
A transsexual is, in fact, of the sex he desires to be. Only the error of his and
others’ gross physical senses deny him his harmonious being. He must, in turn, deny
these apparent manifestations and know ‘It is God’s good pleasure to give him the
kingdom’ which would include a harmonious sense of being. Sex or gender comes from
at least one plane out (or frequency higher). In reality, being spiritual, we are genderless;
but for physical experience we may assume gender…
The answer to the inharmony is not in a life ‘on hormones,’ this is a stop-gap at
best. The same goes for sex reassignment. Ultimately, a proper resolution must be made
to the problem (or adventure). Since we are not flesh and bones, disregard that body and
others’ comments regarding it. Perhaps it may be necessary to stop ‘work’ and apply all
diligence or concentration to the resurrection of that body. Don’t waste your time asking
God for ‘help’ to alter your body, etc. All you want is already yours, you have but to
accept it: ‘Father, thank you for my perfect, harmonious state of being.’ Do not try to
‘take’ anything, to ‘force’ or manipulate anything; to ‘free yourself from’ anything. Just
attain that consciousness wherein there is nothing from which to be freed. Realize that
your improper body is a false belief, an acceptance of the lies of the senses. Don’t allow
lies to deny you the kingdom (your manhood or womanhood).
83

In this document authored by Erickson, he argues that transition should be about personal and
spiritual resurrection rather than a medical transition. For Erickson, the problem does not reside
within the body but outside of it, in the perception of others. The transsexual’s job is to transcend
this plane, this world which resides on a lower level than that of divine gender embodiment.
Perhaps as Erickson’s beliefs about transition shifted from an interest in medical therapeutics to
spiritual transcendence, he was less interested in funding medical researchers and gender clinics.
Toward the end of Erickson’s life, he became increasingly unmoored from reality due to
his addiction to ketamine and cocaine. Erickson became convinced that everyone was out to get
him. After initially purchasing a large mansion, known as the “Milbank Estate,” for the
homophile organization, ONE, Inc., Erickson refused to hand the deed over to the organization.

83
Untitled and undated document, Reed L Erickson Papers, Box 2, Folder 3: Manuscripts, circa 1970-1979, ONE
National Gay and Lesbian Archives, Los Angeles, California.

194
A court battle ensued, but Erickson did not even trust the lawyers he hired, making handwritten
notes such as “false,” “not true,” and “incompetent” on the legal invoices he received.
84
Erickson
started donating his money to religious and pro-life organizations.
85

Erickson is a complicated figure with a complicated legacy, but without the financial
support he provided to doctors and clinics throughout the 1960s and 1970s, many of the
university-based gender clinics would have never come into existence. As Joanne Meyerowitz
notes, “In [the EEF’s] support for research, treatment, and advocacy, they helped transform
transsexuality into an acknowledged medical specialty and a serious social issue.”
86
The EEF
were also pivotal in connecting trans people across the country to doctors in their local
communities that would treat them. They worked to make trans therapeutics more accessible,
allowing individuals the freedom to pursue hormone replacement therapy and gender affirming
surgery.

Trans Sexologists
How do the lives of Dillon, Lawrence, and Reed and the concept of transsexual
knowledges require us to reconsider narratives of transsexuality in which the term/identity is
described as the creation of heterosexual cisgender doctors? Understanding Dillon, Lawrence,
and Reed’s direct involvement with the development of trans therapeutics—writing textbooks,
collecting case histories, and dispersing resources both informational and monetary—requires a
correction to how we talk about the creation of the so-called trans medical model and the history

84
Legal invoices, 1984-1985, Reed L Erickson Papers, Box 3, ONE National Gay and Lesbian Archives, Los
Angeles, California.
85
Miscellaneous correspondence and charitable receipts, Reed L Erickson Papers, Box 7, Folder 5: Donations 1980-
1983, ONE National Gay and Lesbian Archives, Los Angeles, California.
86
Meyerowitz, How Sex Changed, 212.

195
of sexology more broadly. Dillon, Lawrence, and Reed were sexologists in their own right. They
worked with and alongside clinicians to parse apart categories, develop nosological schema,
theorize etiology, and propose best practices. As Lawrence’s influence on Kinsey’s thinking
spotlights, the process of developing trans therapeutics was dialectical and dialogical. Medicine
was not an external force imposed on trans communities without their consent. What the stories
of Dillon, Lawrence, and Erickson make clear is that the knowledge project of transsexuality
evolved over time, emanating from a complex back-and-forth between clinicians, researchers,
and transsexuals.
I am not arguing that trans medicine, because it was partially created by trans people, is
perfect or not in need of reform. Rather, I am arguing that by describing transsexuality as a
knowledge project created by white colonial cis men in the service of bad projects (segregation,
racialization, disenfranchisement), a generation of transsexuals came to be seen as the dupes of
said project. The stories of transsexuals that reach us, either from a case history, an in-take
interview, or from an autobiography, are often regarded as false narratives, a performance for
medical professionals who set the terms of the conversation. What happens when we realize that
trans people, such as Dillon, who were writing in what would now be dubbed the “born in the
wrong body narrative” (“incompatibility between the mind and the body”), were maybe not just
saying that for surgical approval but because that description felt true for them? What if the
wrong body narrative is not a doctor-imposed metric for diagnosis but rather a way that many
mid-century transsexuals made sense of their own gender confusion?
In Jules Gill-Peterson’s Histories of the Transgender Child, she “read[s] trans people as
complex participants in the production of scientific knowledge, rather than its objects,” but also
declares transsexuality to “explicitly mark a medical discourse and biopolitical apparatus, a

196
colonial form of knowledge with racializing and disenfranchising effects” (emphasis hers).
87

Gill-Peterson is able to articulate the ways that trans people were active participants in the
production of medical knowledge, but still finds ways of distancing trans people from both the
categories it produced (transsexuality) and the violence of such categories (biopolitics and
coloniality). In this chapter I sit with this tension, but rather than dismiss transsexuality as a
product of “those people” (heterosexual, cisgender pathologizing men) and not “us” (trans
people), I am interested in considering what surfaces when we engage with both the categories
and their violences as the knowledge products of not just clinicians but also trans people.
Scholars such as George Chauncey and Henry Milton have made similar arguments about
homosexual involvement with the creation of the so-called medical model. In Departing from
Deviance: A History of Homosexual rights and Emancipatory Science in America, Milton states
that “homosexuals were not only passive victims of scientific and medical inquiry, but also
active agents in utilizing scientific research as a vehicle for homosexual rights.”
88
George
Chauncey asserts that sexual identities emerge through a complex dialectical process between
expert and vernacular knowledges, challenging the idea that medical discourses have an
unchecked power over the identification and naming of sexual practices and communities.
89

It can be true that trans medicine is the co-creation of medical professions—who were
invested in scultping gender diversity back into the gender binary—and simultaneously,
transsexuals—who were invested in sculpting their own bodies into something new or (to borrow
a phrase from Erickson) into perfect and harmonious states of being. These two paths crossed in

87
Jules Gill-Peterson, Histories of the Transgender Child (Minneapolis: University of Minnesota Press, 2018), 9-11.
88
Henry L. Minton, Departing from Deviance: A History of Homosexual Rights and Emancipatory Science in
America (Chicago: University of Chicago Press, 2002), ix-x.
89
George Chauncey, “From Sexual Inversion to Homosexuality: Medicine and the Changing Conceptualization of
Female Deviance,” Salamagundi 58/59 (1982-1983): 114–46.

197
a shared investment in the administering of hormones, sex reassignment surgery, and other forms
of trans therapeutics. Doctors saw themselves as doing one thing and transsexuals saw
themselves as doing another. These contradictions are what make the story of transsexuality and
trans medicine so compelling.

The Erasure of Transsexual Knowledges and Historical Grace
As I have thought about the erasure of trans people from history, and most specifically
the erasure of transsexual and transvestite contributions to mid-century research and writing, I
am struck by the ways that trans survival often depended on maintaining a certain degree of
anonymity, but how this anonymity is partially to blame for trans erasure. Just as doctors would
later demand that surgical patients remain stealth, the editor of the International Journal of
Sexology would demand that the identity of trans contributors remain secret. Was the editor truly
concerned with maintaining Lawrence’s privacy? More likely is that the editor was concerned
with the reputation of his publication and the tarnishing of their credentials by allowing a
transvestite to publish in their scholarly/professional journal. Just as Kinsey and Gebhard asked
Lawrence to not tell people she was working for them; Lawrence was forced to publish under a
pseudonym.
Yet, individuals like Dillon experienced quite the opposite. Dillon, who wished to live a
stealth and anonymous life was constantly outed by the press. Dillon’s life, in many ways, was
defined by the lengths he would go to disappear. This is indeed the double bind of trans
visibility—you are either made to disappear and be erased or, if you make yourself known, you
are an object of scrutiny and analysis. Dillon would eventually find his escape, although perhaps
not in the way he imagined. Because of his brother’s desire to make him disappear, his

198
autobiography would go unpublished, and his papers and materials would sit for decades in a
warehouse in England. Not until biographers came looking for his story would his materials be
re-discovered and printed. This is the kind of erudite knowledge that (de)subjugated knowlegdes
calls for: an unearthing of the past. How though, by publishing his autobiography were Jacob
Lau and Cameron Partridge engaging in an act of exposure just like the reporters from the
Baltimore Sun?
Dillon, Lawrence, and Erickson’s legacies are unruly. Dillon wrote of gender self-
determination in the same text in which he argued that there is a difference between the male and
female brain. Raised in a titled British family, Dillon’s fascination with India was seeped in
orientalist tropes about the simplicity of the racialized mind. He may have run away from
England, but he could not outrun the racism he was socialized with, reportedly struggling to bow
to the monks he studied under, unable to see them as experts with something to teach him.
Lawrence, THE community organizer and social hub of mid-century transvestite communities
was also obsessive about how people presented themselves. She was embarrassed for Jorgensen
to meet members of the Long Beach transvestite community who were working class and lived
in low-rent apartments. She would chastise friends for what she deemed to be sloppy cross-
dressing and looked down on those who engaged in sex work. Erickson, despite being seen at
times are a visionary philanthropist, began to give his money to pro-life and religious causes later
in life. Erickson undoubtedly made the world a better place for many trans people, but also
perpetuated ideas about the importance of passing and upholding trans respectability politics,
something that becomes quite complex when we think about the madness, paranoia, and
addiction that defined his later years. To understand their legacies is to sit with these
contradictions, to understand them as both visionaries and bullies, trailblazers and gatekeepers.

199
In this chapter, I have aimed to highlight how transsexuals participated in the creation,
communication, and reproduction of trans medicine, with all of its affirmations and exclusions.
For me, telling their stories is what Keeling refers to as, “looking after,” a process in which the
past is invoked in the present to imagine a different future.
90
The ways in which Lawrence,
Dillon, and Erickson structured their lives and work—building long term infrastructure for
change, cultivating connection and community now, and operating from a place of spirit—
provides a model for how we can continue their projects of building better world for trans
people.

90
Kara Keeling, “Looking for M—: Queer Temporality, Black Political Possibility, and Poetry from the Future,”
GLQ: A Journal of Lesbian and Gay Studies 15, no. 4 (2009): 565–82.

200
Without Conclusion: The Legacies of the University-Based Gender Clinics

How does one begin to measure the broad impact of the university-based gender clinics
for trans people both in the U.S. and globally? Like Michael Dillon, Louise Lawrence, and Reed
Erickson, the clinics’ legacies are layered and complex. The clinics made material differences in
the lives of many mid-century transsexuals who sought to change their bodies and place in
society. By bringing trans therapeutics—which had previously only existed in a few locales
outside of the U.S. (e.g. Casablanca and Tijuana)—into states like California, Maryland,
Michigan, and Minnesota, access to medical interventions were expanded to those unable to
travel internationally for care. As both Erickson and Lawrence predicted, anchoring the clinics in
the university setting also provided a certain amount of legitimacy to trans identities, moving
them from the spheres of morality/deviance to the medical/scientific and academic.
However, the treatment protocols and diagnostic criteria established by the university-
based gender clinics were rigid and discriminatory when it came to their ideas about who was
worthy of care and who was capable of being a “successful” and productive member of society.
The clinics’ criteria were racially coded and exclusionary by nature. Transsexuals like Christine
Jorgensen and Mario Martino, who wrote and published autobiographies, came to represent the
model of an ideal patient because of the ways their whiteness allowed the doctors to see them as
capable of assimilating into productive citizenship and practices of heterosexuality. Meanwhile,
nonwhite individuals like C.K. and Rosy Son of Rosa, who sought treatment at the University of
Oregon and UCLA, were deemed to be beyond assimilation and denied care. For example, Rosy
Son of Rosa’s letter to UCLA doctors mentions engaging in sex work with her mom—an
informal economy outside of wage labor that clinicians did not accept as a productive nor
legitimate job—which foreclosed the possibility of Rosy being seen as incorporable into

201
productive citizenship. Furthermore, many theories of transsexual etiology blamed the mother
for gender pathology, and developed an elaborate, multi-generational theory of how gender
deviance manifests. They applied this eugenicist logic to the patients they accepted or denied,
rejecting nonwhite patients like C.K. because deviance gender was regarded as endemic to
communities of color. Trans therapeutics are bound to the logics of racism, racial capitalism, and
the pathologization of the racialized family.
As the gender clinics were closing in 1979 and 1980, they codified their ideas about
gender and treatment with two documents: the Standards of Care and the Diagnostic and
Statistical Manual of Mental Disorders (DSM). The Standards of Care, originally titled “The
Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons”
was approved in February 1979 at the Sixth International Gender Dysphoria Symposium in San
Diego, California.
1
Written by six researchers and doctors, most of whom were affiliated with
the gender clinics, the document provides best practices and guidelines for treating transsexuals.
In 1980, the DSM-III was released which included a section on gender identity disorders in the
chapter “Psychosexual Disorders,” establishing a new diagnostic code for transsexualism
(302.5X) and “gender identity disorder of childhood” (302.60), codes which are often used by
trans individuals to have their treatment covered by health insurance.
2
Both of these documents,
although updated many times, remain in circulation and are the clearest example of how the
university-based gender clinics continue to shape trans health care in the present.

1
Jack C. Berger, Richard Green, Donald R. Laub, Charles L. Reynolds Jr., Paul A. Walker, and Leo Wollman,
“Standards of Care: The Hormonal and Surgical Sex Reassignment of Gender Dysphoric Persons [First Version]”
(Janus Information Facility, 1979).
2
Diagnostic and Statistical Manual of Mental Disorders, Third Edition (Washington D.C.: American Psychiatric
Association, 1980), 261-266.

202
After transsexualism was added to the DSM, the World Health Organization followed
suit, adding transsexualism to the International Statistical Classification of Diseases and Related
Health Problems (ICD-10), exporting the diagnostic criteria of the U.S. university-based gender
clinics to other parts of the globe.
3
In the DSM-IV (1994), transsexualism was replaced with
“gender identity disorder in adults and adolescence” and in the DSM-5 (2013), it was changed
again to “gender dysphoria.”
4
Transgender individuals and activists regarded this shift in
nomenclature as a victory, pleased that the pathologizing language of “disorder” was eliminated.
Interestingly, in the history of the university-based gender clinics, the use of “gender dysphoria”
as a diagnostic term predates “gender identity disorder” by over a decade, as evidenced by the
name of the Stanford Gender Dysphoria Program. The change to “gender dysphoria” was not so
much a new term as it was a call-back to the days of the university-based gender clinics, a
reminder that their legacies remain with us.
In regards to the Standards of Care, six new editions have been published since 1973,
with the newest version, the Standards of Care 8 (SOC8) set to be published in the summer of
2022. The document has ballooned in size over the years, growing from thirteen pages (SOC) to
one hundred and twenty (SOC7). As the document has changed in size and scope, it has also
become more pliable, incrementally making access to trans therapeutics easier. For example, in
the SOC5 (1998), the document stated that it was “intended to provide flexible directions for the
treatment of gender identity disorders,” allowing for clinicians and providers to raise or lower the

3
Gender Dysphoria Diagnosis,” American Psychiatric Association, November 2017,
https://www.psychiatry.org/psychiatrists/cultural-competency/education/transgender-and-gender-nonconforming-
patients/gender-dysphoria-diagnosis.
4
Diagnostic and Statistical Manual of Mental Disorders, Forth Edition (Washington D.C.: American Psychiatric
Association, 1994); Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (Washington D.C.:
American Psychiatric Association, 2013).

203
standards based on their own judgement and the circumstances of the patient.
5
In 2001, SOC 6
began to allow physical (non-psychiatric) interventions for trans adolescents.
6
In 2012, SOC7
was added the category of “gender nonconforming people,” expanding access gender-affirming
medicine do not identify as trans men or women.
7
Moreover, these protocols have been exported
outside of the U.S., becoming the global standard for trans care. SOC7 was translated into
eighteen different languages from Arabic to Hindi to Serbian, expanding the reach of the
epistemologies of the university-based gender clinics and practitioners who got their start at
these clinics.
8
In the summer of 2022, the trans medical community awaits the release of the
SOC8, due to be published any day now according to the WPATH website. The latest edition
will have a new chapter on treating non-binary individuals and a new chapter on ethics, which
focuses on the importance of trans bodily autonomy and informed consent.
9

I highlight these changes to make clear that trans medicine is not in the same place it was
in the 1960s and 1970s or when the original SOC was first published in 1979. The treatment
protocols have become more yielding and accepting of nonbinary, gender nonconforming, queer,
lesbian, gay, and young trans people. Incrementally, more and more trans people have been
included in the process of updating the SOC, serving as committee members and authors. While
the original document was written by six clinicians and researchers, the latest version (SOC8)

5
Stephen B. Levine, George Brown, Eli Coleman, Peggy Cohen-Kettenis, J. Joris Hage, Judy Van Maasdam,
Maxine Peterse, Friedemann Pfafflin and Leah C. Schaefer, “The Standards of Care for Gender Identity Disorders
[5th Version]” (Harry Benjamin International Gender Dysphoria Association, 1998).
6
“The Harry Benjamin International Gender Dysphoria Association’s Standards Of Care For Gender Identity
Disorders [6th Version]” (The Harry Benjamin International Gender Dysphoria Association, 2001).
7
“Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People [7th Version]”
(The World Professional Association for Transgender Health, 2012), https://www.wpath.org/publications/soc.
8
SOC7
9
The new chapters according to the WPATH website will be: Assessment, Support and Therapeutic Approaches for
Adolescents with Gender Variance/Dysphoria; Competency, Training, Education; Ethics; Applicability of the
Standards of Care to Eunuchs; Assessment, Support and Therapeutic Approaches for Non-Binary Individuals;
Sexual Health Across the Lifespan

204
was first released in draft form allowing trans community members and stakeholders to provide
feedback via online surveys.
10

Nevertheless, trans therapeutics are still rooted in the racially exclusionary model for
treatment that was established by the university-based gender clinics in which white patients
were more likely to receive gender-affirming care due to their ability to travel to clinics and be
deemed capable of “successful,” productive, heterosexual citizenship. Evidence of a new model
of racial exclusion can be found in report issued by the Williams Institute at the UCLA School of
Law. In June 2022, the Williams Institute released the report, “How Many Adults and Youth
Identify as Transgender in the United States?” which draws its data from two surveys conducted
by the Centers for Disease Control and Prevention (CDC).
11
The document states that 1.4% of
youth between the ages of 13-17 identify as transgender.
12
Twenty percent of the entire
transgender population in the U.S. are between the ages of 13-17 years old. The Williams
Institute states: “The racial/ethnic distribution of youth and adults who identify as transgender
appears generally similar to the U.S. population, though our estimates mirror prior research that
found transgender youth and adults are more likely to report being Latinx and less likely to
report being White compared to the U.S. population.”
13
This data mirrors the demographic shifts
taking place in young populations in the U.S. According to the Brookings Institution, less than
half of U.S. children under the age of fifteen are white, with the percentage of young Latinx

10
WPATH - World Professional Organization for Transgender Health, “DRAFT Version on the Standards of Care
Version 8,” December 2, 2021.
11
Jody L. Herman, Andrew R. Flores, and Kathryn K. O’Neill, “How Many Adults and Youth Identify as
Transgender in the United States?” (Los Angeles: Williams Institute, UCLA School of Law, June 2022),
https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/.
12
Azeen Ghorayshi, “Report Reveals Sharp Rise in Transgender Young People in the U.S.,” New York Times, June
10, 2022.
13
For example: The Williams Institute identifies 51.3% of 13-17 year olds in the U.S. as white, but only 46.3% of
the young transgender population is white. In contrast, 24.8% of young people in the U.S. are Latinx, but 31.0% of
the transgender youth population are Latinx. Many of these Latinx trans youth live in the U.S. southeast region in
states such as Texas and Florida.

205
Americans growing.
14
However, this fact contradicts information about what kinds of trans youth
are accessing care in 2022. According to the New York Times Magazine, “Most of the young
people today who come to clinics for treatment are affluent and white, live in progressive
metropolitan areas and have health insurance.”
15
The Williams Institute’s data shows that the
U.S. region with the most trans youth is southeast, including states such as Texas, Arkansas,
Mississippi, Alabama, Florida, and West Virginia.
16
This region also has a high concentration of
youth of color, low-income residents, and rural residents.
I am writing this conclusion in a moment in which the right to transition, to make
decisions about one’s own body, and to be capable of gender self-determination is under attack
in the U.S., particularly as it relates to trans kids and adolescents. 2022 has been marked by a
cascade of anti-trans legislation in states across the country from Florida to Alabama to Texas—
the same states that the Williams Institute identifies as having the largest population of trans
youth. In February, Texas Attorney General Ken Paxton released an official opinion stating that
gender-affirming medical care—including hormone blockers, hormone replacement therapy, and
surgery—constituted child abuse under Texas law.
17
Within days, Governor Greg Abbott was
calling on health care providers and concerned citizens to report the parents of transgender
children to the authorities for investigation. In March, Iowa Governor Kim Reynolds signed a
bill banning trans girls from participating in sports and Florida Governor Ron DeSanits signed

14
William H. Frey, “Less than Half of US Children under 15 Are White, Census Shows” (Brookings Institution,
June 24, 2019), https://www.brookings.edu/research/less-than-half-of-us-children-under-15-are-white-census-
shows/.
15
Emily Bazelon, “The Battle Over Gender Therapy,” The New York Times Magazine, June 15, 2022.
16
The data shows 102,200 trans youth in the U.S. southeast region, 81,700 trans youth in the western region, 61,700
trans youth in the northeast region, and 54,500 trans youth in the Midwest region.
17
“AG Paxton Declares So-Called Sex-Change Procedures on Children and Prescription of Puberty Blockers to Be
‘Child Abuse’ Under Texas Law,” Texas Attorney General (press release), February 21, 2022,
https://www.texasattorneygeneral.gov/news/releases/ag-paxton-declares-so-called-sex-change-procedures-children-
and-prescription-puberty-blockers-be.

206
the “Parental Rights in Education” bill which prevents schools from providing instruction which
mentions gender identity in grades K-3.
18
In April, Alabama lawmakers outlawed gender
affirming care for trans youth, making the medical treatment of trans kids a felony punishable
with up to ten years in prison.
19

These laws being passed in the U.S. southeast, which criminalize parents seeking gender-
affirming care for their children or clinicians providing life-saving therapeutics,
disproportionately target trans youth of color and continue the pattern (established by the gender
clinics) of trans therapeutics being held intentionally out-of-reach for nonwhite individuals. They
target youth of color because these states have some of the highest concentrations of Black youth
(e.g. Alabama) and Latinx youth (e.g. Texas). They target low-income families that cannot move
or travel to seek care elsewhere, re-entrenching the connection between trans therapeutics,
productive citizenship, and racial capitalism. Even as the youth population of the U.S. becomes
more racially diverse, the majority of young people being seen at adolescent gender clinics are
white.
In contrast to the expanding criteria of the SOC over the years, these laws mark a
contracting of access to trans therapeutics. As access to gender-affirming care wanes in some
regions, we must be attuned to who exactly is being excluded and how. Trans youth of color are
disproportionately harmed by these laws. And because of the financial burdens that come with
having to move house or travel in order to access care, trans therapeutics continue to be racially

18
Jaclyn Diaz, “Florida’s Governor Signs Controversial Law Opponents Dubbed ‘Don’t Say Gay,’” NPR, March 28,
2022, https://www.npr.org/2022/03/28/1089221657/dont-say-gay-florida-desantis; Stephen Gruber-Miller and Ian
Richardson, “Iowa Gov. Kim Reynolds Signs Law Banning Transgender Girls from Female Sports,” Des Moines
Register, March 3, 2022, https://www.desmoinesregister.com/story/news/politics/2022/03/03/trans-transgender-
girls-banned-womens-sports-kim-reynolds-lgbtq-iowa-signs-bill/9349887002/.
19
Noah Y. Kim, “Alabama Legislature Approves Extreme Anti-Trans Bill Criminalizing Gender-Affirming Care,”
Mother Jones, April 8, 2022, https://www.motherjones.com/politics/2022/04/alabama-legislature-transgender-youth-
passes-extreme-anti-trans-bill-criminalizing-gender-affirming-care/.

207
exclusive in a way that mimics the era of the university-based gender clinics. The new SOC will
decrease the age-minimums for treatment, but it will not address the fact that a large portion of
trans youth of color now reside in states where care is beyond reach. As we assemble to defend
trans youth and their right to bodily autonomy, this fact should remain at the center of our
organizing. The history of trans therapeutics has been racially exclusive; it is imperative that the
future we build will not be too.

208
Bibliography

PRIMARY SOURCES

MANUSCRIPT MATERIALS

California State University, Northridge, Special Collections

Prince, Virginia Papers 1930-1980

GLBT Historical Society, San Francisco, CA

FTM International Records
GLBT Historical Society Oral History Collection
Sullivan, Louis Graydon Papers

Kinsey Institute at Indiana University

Benjamin, Harry Collection
Harry Benjamin International Gender Dysphoria Association (HBIGDA) Collection
Lawrence, Louise Collection

New York City Trans Oral History Project, New York Public Library

Griffin-Gracy, Miss Major Interview

ONE National Gay and Lesbian Archives, University of Southern California

Erickson, Reed L. Papers 1916-1994, Collection 2010-001
Money, John Papers 1802-1993, Collection 2008-023

Stanford Medical History Center, Lane Medical Library

Laub, Donald Materials

Stanford University, Archive of Recorded Sound

Meyer Library Lecture Tapes 1958-1977

UCLA Library Special Collections, Charles E. Young Research Library

Stoller, Robert J. Papers 1942-1991, Collection 373

UCLA Library Special Collections, Medicine and Science

Belt, Elmer 1920-1980, Collection 66

209
ARTICLES, BOOKS, AND REPORTS

Benjamin, Harry. The Transsexual Phenomenon. New York: Julian Press, 1966.
Berger, Jack C., Richard Green, Donald R. Laub, Charles L. Reynolds Jr., Paul A. Walker, and
Leo Wollman. “Standards of Care: The Hormonal and Surgical Sex Reassignment of
Gender Dysphoric Persons [First Version].” Janus Information Facility, 1979.
Cauldwell, D.O. “Psychopathia Transexualis.” Sexology 16 (1949): 274–80.
Colapinto, John. As Nature Made Him: The Boy Who Was Raised as a Girl. New York:
HarperCollins Publishers, 2000.
Diagnostic and Statistical Manual of Mental Disorders. Third Edition. Washington D.C.:
American Psychiatric Association, 1980.
Diagnostic and Statistical Manual of Mental Disorders. Forth Edition. Washington D.C.:
American Psychiatric Association, 1994.
Diagnostic and Statistical Manual of Mental Disorders. Fifth Edition. Washington D.C.:
American Psychiatric Association, 2013.
Diamond, Milton. “A Critical Evaluation of the Ontogeny of Human Sexual Behavior.”
Quarterly Review of Biology 40, no. 2 (1965): 145–75.
Diamond, Milton and H. Keith Sigmundson. “Sex Reassignment at Birth: A Long Term Review
and Clinical Implications.” Archives of Pediatric and Adolescent Medicine 151, no. 3
(1997): 298–304.
Dillon, Michael. Self: A Study in Ethics and Endocrinology. London: Heinemann, 1946.
Dillon, Michael/Lobzang Jivaka. Out of the Ordinary: A Life of Gender and Spiritual
Transitions. New York: Fordham University Press, 2017.
Ehrhardt, Anke A. “The Etiology of Transsexualism.” In Proceedings of the Second
Interdisciplinary Symposium on Gender Dysphoria Syndrome, edited by Donald R. Laub
and Patrick Gandy, 44–48. Stanford, California: Division of Reconstructive and
Rehabilitation Surgery, 1973.
Fleming, Michael and Carol Steinman and Gene Bocknek. “Methodological Problems in
Assessing Sex-Reassignment Surgery: A Reply to Meyer and Reter.” Archives of Sexual
Behavior 9, no. 5 (1980): 451–56.
Frey, William H. “Less than Half of US Children under 15 Are White, Census Shows.”
Brookings Institution, June 24, 2019.
Fritz, Melanie, and Nat Mulkey. “The Rise and Fall of Gender Identity Clinics in the 1960s and
1970s.” Bulletin of the American College of Surgeons, April 1, 2021.
Herman, Jody L., Andrew R. Flores, and Kathryn K. O’Neill. “How Many Adults and Youth
Identify as Transgender in the United States?” Los Angeles: Williams Institute, UCLA
School of Law, June 2022.
Jones, Paul K., and Susan L. Jones, and Ann Keller. “Sociological Distinctions Among Gender
Dysphoria Patients: A Comparison by Race.” Journal of Psychiatric Treatmemt and
Evaluation 3 (1981): 445–50.
Jorgensen, Christine. Christine Jorgensen: A Personal Autobiography. San Francisco: Cleis
Press, 2000.
Krafft-Ebing, Richard von. Psychopathia Sexualis. Philadelphia and London: F.A. Davis Co,
1892.
Laub, D. “A Rehabilitation Program for Gender Dysphoria Syndrome By Surgical Sex Change.”
Department of Surgery, Stanford University School of Medicine, 1973.

210
Levine, Stephen B. and George Brown, Eli Coleman, Peggy Cohen-Kettenis, J. Joris Hage, Judy
Van Maasdam, Maxine Peterse, Friedemann Pfafflin and Leah C. Schaefer. “The
Standards of Care for Gender Identity Disorders [5th Version].” Harry Benjamin
International Gender Dysphoria Association, 1998.
Martino, Mario, and Harriett. Emergence: A Transsexual Autobiography. New York: Crown
Publishers, 1977.
McHugh, Paul R. “Psychiatric Misadventures.” The American Scholar 61, no. 4 (1992): 497–
510.
Meyer, Jon K., and Donna J. Reter. “Sex Reassignment: Follow-Up.” Archives of General
Psychiatry 36, no. 9 (1979): 1010–15.
Meyer, Jon K., and John E. Hoopes. “The Gender Dysphoria Syndromes: A Position Statement
on So-Called ‘Transsexualism.’” Plastic and Reconstructive Surgery 54, no. 4 (1974):
444–51.
Money, John. “Ablatio Penis: Normal Male Infant Sex-Reassigned as a Girl.” Archives of Sexual
Behavior 4, no. I (1975): 65–71.
Money, John, and Anke A. Ehrhardt. Man & Woman, Boy & Girl: Gender Identity from
Conception to Maturity. Northvale, NJ: Jason Aronson, 1973.
Money, John, and Geoffrey Hosta. “Negro Folklore of Male Pregnancy.” The Journal of Sex
Research 4, no. 1 (1968): 34–50.
Money, John and J.G. Hampson and J.L Hampson. “Hermaphroditism: Recommendations
Concerning Assignment of Sex, Change of Sex and Psychologic Management.” Bulletin
of the Johns Hopkins Hospital 97, no. 4 (1955): 284–300.
Money, John and Patricia Tucker. Sexual Signatures on Being a Man or a Woman. Boston:
Little, Brown, 1975.
Moynihan, Daniel Patrick. “The Negro Family: The Case For National Action.” Office of Policy
Planning and Research United States Department of Labor, March 1965.
Pauly, Ira B. “Adult Manifestations of Female Transsexualism.” In Transsexualism and Sex
Reassignment, edited by Richard Green and John Money, 59–87. Baltimore: Johns
Hopkins Univ. Press, 1969.
Schaefer, Leah Cahan, and Connie Christine Wheeler. “Harry Benjamin’s First Ten Cases (1938-
1953): A Clinical Historical Note.” Archives of Sexual Behavior 24, no. 1 (1995): 73–93.
Siotos, Charalampos and Paula M. Neira, Brandyn D. Lau, Jill P. Stone, James Page, Gedge D.
Rosson, and Devin Coon. “Origins of Gender Affirmation Surgery: The History of the
First Gender Identity Clinic in the United States at Johns Hopkins.” Annals of Plastic
Surgery 83, no. 2 (2019): 132–126.
“Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming
People [7th Version].” The World Professional Association for Transgender Health,
2012. https://www.wpath.org/publications/soc.
Stern, Alexandra Minna. “Obstetrics and Gynecology.” In University of Michigan: An
Encyclopedia Survey, 32–62. Ann Arbor, 2015.
http://hdl.handle.net/2027/spo.13950886.0003.071.
Stoller, Robert J. Sex and Gender: On the Development of Masculinity and Femininity. New
York: Science House, 1968.
———. Splitting: A Case of Female Masculinity. New Haven: Yale University Press, 1997.

211
Stoller, Robert J. and Harold Garfinkel, and Alexander C. Rosen. “Passing and the Maintenance
of Sexual Identification in an Intersexed Patient.” AMA Archives of General Psychiatry 2,
no. 4 (1960): 379–84.
“The Harry Benjamin International Gender Dysphoria Association’s Standards Of Care For
Gender Identity Disorders [6th Version].” The Harry Benjamin International Gender
Dysphoria Association, 2001.
Thompson, Janet. “Transvestism: An Empirical Study.” The International Journal of Sexology
IV, no. 4 (1951): 216–19.
WPATH - World Professional Organization for Transgender Health. “DRAFT Version on the
Standards of Care Version 8,” December 2, 2021.

NEWSPAPERS

Atlanta Constitution
Baltimore City Paper
Baltimore Sun
Daily Bruin
Daily News
Des Moines Register
Los Angeles Free Press
Los Angeles Times
National Insider
New York Times
San Diego Union-Tribune
San Jose Mercury
South China Morning Post
Washington City Paper
Washington Post

PERIODICALS

Mother Jones
sN+1
New York Times Magazine
Rolling Stone

SECONDARY SOURCES

Aizura, Aren Z. Mobile Subjects: Transnational Imaginaries of Gender Reassignment. Durham:
Duke University Press, 2018.
Anderson, Warwick. “The Case of the Archive.” Critical Inquiry 39, no. 3 (547 532): 2013.
Arondekar, Anjali. For the Record: On Sexuality and the Colonial Archive in India. Durham:
Duke University Press, 2009.
———. “Without a Trace: Sexuality and the Colonial Archive.” Journal of the History of
Sexuality 14, no. 1/2 (2005): 10–27.

212
Awkward-Rich, Cameron, and Hil Malatino, eds. “The T4t Issue.” TSQ: Transgender Studies
Quarterly 9, no. 1 (2022).
Baik, Crystal Mun-hye. “Sensing Through Slowness: Korean Americans and the Un/Making of
the Home Film Archive.” American Studies 56, no. 3/4 (2018): 5–30.
Beemyn, Genny. “Autobiography, Transsexual.” Glbtq.Com (blog), 2006.
Berlant, Lauren. “On the Case.” Critical Inquiry 33, no. 4 (2007): 663–72.
Bolin, Anne. In Search of Eve: Transsexual Rites of Passage. South Hadley, Mass: Bergin &
Garvey, 1988.
Boylan, Jennifer Finney. She’s Not There: A Life in Two Genders. New York: Broadway Books,
2003.
Brown, Phil. “Social Implications of Deinstitutionalization.” Journal of Community Psychology
8, no. 4 (1980): 314–22.
Chakrabarty, Dipesh. Provincializing Europe: Postcolonial Thought and Historical Difference.
Princeton: Princeton University Press, 2000.
Chauncey, George. “From Sexual Inversion to Homosexuality: Medicine and the Changing
Conceptualization of Female Deviance.” Salamagundi 58/59 (1983 1982): 114–46.
———. Gay New York: Gender, Urban Culture, and the Making of the Gay Male World, 1890 –
1940. New York, NY: Basic Books, 1994.
Childs, Greg L. “Secret and Spectral: Torture and Secrecy in the Archives of Slave
Conspiracies.” Social Text 33, no. 4 (2015): 35–57.
Chu, Andrea Long. “The Wrong Wrong Body: Notes on Trans Phenomenology.” Transgender
Studies Quarterly 4, no. 1 (2017): 141–52.
Chu, Andrea Long, and Emmett Harsin Drager. “After Trans Studies.” Transgender Studies
Quarterly 6, no. 1 (2019): 103–16.
Clare, Eli. Brilliant Imperfection: Grappling with Cure. Durham: Duke University Press, 2017.
Coviello, Peter. Tomorrow’s Parties: Sex and the Untimely in Nineteenth-Century America. New
York: New York University Press, 2013.
Dain, Norman. “Critics and Dissenters: Reflections on ‘Anti-Psychiatry’ in the United States.”
Journal of the History of the Behavioral Sciences 25 (1989): 3–25.
Delgado, Richard, and Jean Stefancic, eds. Critical White Studies: Looking behind the Mirror.
Philadelphia: Temple University Press, 1997.
Devor, Aaron, and Nicholas Matte. “Building a Better World for Transpeople: Reed Erickson
and the Erickson Educational Foundation.” International Journal of Transgenderism 10,
no. 1 (2007): 47–68.
Dinshaw, Carolyn. Getting Medieval: Sexualities and Communities, Pre- and Postmodern.
Durham: Duke University Press, 1999.
Driskill, Qwo-Li. Asegi Stories: Cherokee Queer and Two-Spirit Memory. Tucson: University of
Arizona Press, 2016.
Featherstone, Mike. “Archive.” Theory, Culture & Society 23, no. 2–3 (2006): 591–96.
Foucault, Michel. “17 March 1976.” In Society Must Be Defended’: Lectures at the Collége De
France 1975-1976, 239–64. New York: Picador, 2003.
———. History of Sexuality, Volume 1. New York: Vintage Books, 1978.
———, ed. I Pierre Riviére, Have Slaughtered My Mother, My Sister, and My Brother: A Case
of Parricide in the Nineteenth Century. Lincoln: University of Nebraska Press, 1982.
———. The Birth of the Clinic: An Archaeology of Medical Perception. New York: Vintage
Books, 1994.

213
Foucault, Michel, Mauro Bertani, Alessandro Fontana, François Ewald, and David Macey.
Society Must Be Defended: Lectures at the Collège de France, 1975-76. 1st Picador pbk.
ed. New York: Picador, 2003.
Freud, Sigmund. Leonardo Da Vinci: A Memory of His Childhood. London: Routledge, 1999.
———. Three Essays on the Theory of Sexuality. Translated by A.A. Brill. Seaside, Oregon:
Rough Draft Printing, 2014.
Gill-Peterson, Jules. “General Editor’s Introduction.” Transgender Studies Quarterly 8, no. 4
(2021): 413–16.
———. Histories of the Transgender Child. Minneapolis: University of Minnesota Press, 2018.
Gordon, Avery. Ghostly Matters: Haunting and the Sociological Imagination. Minneapolis:
University of Minnesota Press, 2008.
Halberstam, Jack. In a Queer Time and Place: Transgender Bodies, Subcultural Lives. New
York: New York University Press, 2005.
Harris, Verne. “The Archival Sliver: Power, Memory, and Archives in South Africa.” Archival
Science 2 (2002): 63–86.
Harsin Drager, Emmett, and Lucas Platero. “At the Margins of Time and Place: Transsexuals
and the Transvestites in Trans Studies.” TSQ: Transgender Studies Quarterly 8, no. 4
(2021): 417–25.
Hartman, Saidiya. Scenes of Subjection: Terror, Slavery, and Self-Making in Nineteenth-Century
America. New York: Oxford University Press, 1997.
———. “Venus in Two Acts.” Small Axe 12, no. 2 (2008): 1–14.
Hausman, Bernice. Changing Sex: Transsexualism, Technology, and the Idea of Gender.
Durham: Duke University Press, 1995.
Hayward, Eva. “Lessons from a Starfish.” In The Transgender Studies Reader 2, edited by Susan
Stryker and Aren Z. Aizura, 178–88. New York: Routledge, 2013.
Head, Emma. “The Ethics and Implications of Paying Participants in Qualitative Research.”
International Journal of Social Research Methodology 12, no. 4 (2009): 335–44.
Holmes, Kwame. “What’s the Tea: Gossip and the Production of Black Gay Social History.”
Radical History Review, no. 122 (2015): 55–69.
Iacovetta, Franca, and Wendy Mitchinson. On the Case: Explorations in Social History. Toronto:
University of Toronto Press, 1998.
Irving, Dan. “Normalized Transgressions: Legitimizing the Transsexual Body as Productive.” In
The Transgender Studies Reader 2, 15–29. New York, NY: Routledge, 2013.
Jay, Martin. Downcast Eyes: The Denigration of Vision in Twentieth-Century French Thought.
Berkeley, Calif.: Univ. of California Press, 1994.
Joynt, Chase, and Kristen Schilt. “Anxiety at the Archive.” Transgender Studies Quarterly 2, no.
4 (2015): 635–44.
Kahan, Benjamin. The Book of Minor Perverts: Sexology, Etiology, and the Emergences of
Sexuality. Chicago: The University of Chicago Press, 2019.
Karkazis, Katrina. Fixing Sex: Intersex, Medical Authority, and Lived Experience. Durham:
Duke University Press, 2008.
Keeling, Kara. “Looking for M—: Queer Temporality, Black Political Possibility, and Poetry
from the Future.” GLQ: A Journal of Lesbian and Gay Studies 15, no. 4 (2009): 565–82.
Kennedy, Pagan. The First Man-Made Man: The Story of Two Sex Changes, One Love Affair,
and a Twentieth-Century Medical Revolution. New York, NY: Bloomsbury, 2007.

214
Kunzel, Regina G. “Pulp Fictions and Problem Girls: Reading and Rewriting Single Pregnancy
in the Postwar United States.” American Historical Review 100, no. 5 (1995): 1465–87.
Lewis, Abram. “I Am 64 and Paul McCartney Doesn’t Care About Me: The Haunting of the
Transgender Archive and the Challenges of Queer History.” Radical History Review 120
(2014): 13–34.
———. “We Are Certain of Our Own Insanity: Antipsychiatry and the Gay Liberation
Movement, 1968-1980.” Journal of the History of Sexuality 25, no. 1 (2016): 83–113.
Lewis, Vek. “Thinking Figurations Otherwise: Reframing Dominant Knowledges of Sex and
Gender Variance in Latin America.” In The Transgender Studies Reader 2, edited by
Susan Styker and Aren Z. Aizura, 457–70. New York: Routledge, 2013.
Lowe, Lisa. “History Hesitant.” Social Text 33, no. 4 (2015): 85–107.
———. Immigrant Acts: On Asian American Cultural Politics. Durham: Duke University Press,
1996.
Malatino, Hil. Queer Embodiment: Monstrosity, Medical Violence, and Intersex Experience.
University of Nebraska Press, 2019.
———. Trans Care. Minneapolis: University of Minnesota Press, 2020.
Marshall, Daniel, and Zeb Tortorici. “Introduction.” In Turning Archival: The Life of the
Historical in Queer Studies. Durham: Duke University Press, 2022.
Martínez, María Elena. “Archives, Bodies, and Imagination: The Case of Juana Aguilar and
Queer Approaches to History, Sexuality, and Politics.” Radical History Review 2014, no.
120 (2014): 159–82.
McCloskey, Deirdre N. Crossing: A Transgender Memoir. Chicago: The University of Chicago
Press, 1999.
McKeganey, N. “To Pay or Not to Pay: Respondents’ Motivation for Participating in Research.”
Addiction 96, no. 9 (2001): 1237–38.
Meyerowitz, Joanne. How Sex Changed: A History of Transsexuality in the United States.
Cambridge: Harvard University Press, 2002.
———. “Sex Change and the Popular Press: Historical Notes on Transsexuality in the United
States, 1930–1955.” GLQ: A Journal of Lesbian and Gay Studies 4, no. 2 (January 1998):
159–87.
———. “Sex Research at the Borders of Gender: Transvestites, Transsexuals, and Alfred C.
Kinsey.” Bulletin of the History of Medicine 75, no. 1 (2001): 72–90.
Minton, Henry L. Departing from Deviance: A History of Homosexual Rights and Emancipatory
Science in America. Chicago: University of Chicago Press, 2002.
Mirandé, Alfredo. Behind the Mask: Gender Hybridity in a Zapotec Community. Tucson:
University of Arizona Press, 2019.
Mirzoeff, Nicholas. “The Right to Look.” Critical Inquiry 37, no. 3 (2011): 473–96.
Mock, Janet. Redefining Realness: My Path to Womanhood, Identity, Love & so Much More.
New York: Atria Books, 2014.
Moskop, John C., Catherine A. Marco, Gregory Luke Larkin, Joel M. Gelderman, and Arthur R.
Derse. “From Hippocrates to HIPAA: Privacy and Confidentiality in Emergency
Medicine--Part I: Conceptual, Moral, and Legal Foundations.” Annals of Emergency
Medicine 45, no. 1 (2005): 53–59.
Mount, Andre. “Grasp the Weapon of Culture! Radical Avant Gardes and the Los Angeles Free
Press.” The Journal of Musicology 32, no. 1 (2015): 115–52.

215
Murray, Heather. Not in This Family: Gays and the Meaning of Kinship in Postwar North
America. Philadelphia: University of Pennsylvania Press, 2010.
Najmabadi, Afsaneh. Professing Selves: Transsexuality and Same-Sex Desire in Contemporary
Iran. Durham: Duke University Press, 2014.
Plant, Rebecca. Mom - The Transformation of Motherhood in Modern America. Chicago:
University of Chicago Press, 2012.
Prosser, Jay. Second Skins: The Body Narratives of Transsexuality. New York: Columbia
University Press, 1998.
Ramírez, Catherine Sue. Assimilation: An Alternative History. Oakland, California: University of
California Press, 2020.
Rawson, K.J. “Introduction: An Inevitably Political Craft.” Transgender Studies Quarterly 2, no.
4 (2015): 544–52.
Raymond, Janice. The Transsexual Empire: The Making of the She-Male. Boston: Beacon Press,
1979.
Reddy, Gayatri. With Respect to Sex: Negotiating Hijra Identity in South India. Chicago:
University of Chicago Press, 2005.
Rondot, Sarah Ray. “‘Bear Witness’ and ‘Build Legacies’: Twentieth- and Twenty-First-Century
Trans* Autobiography.” Auto|Biography Studies 31, no. 3 (2016): 527–51.
Schuller, Kyla. The Biopolitics of Feeling: Race, Sex, and Science in the Nineteenth Century.
Durham, NC: Duke University Press, 2018.
Sears, Clare. Arresting Dress: Cross-Dressing, Law, and Fascination in Nineteenth-Century San
Francisco. Perverse Modernities. Durham: Duke University Press, 2015.
Sedgwick, Eve. Epistemology of the Closet. Berkeley: University of California Press, 1990.
———. Tendencies. Durham: Duke University Press, 1993.
Serlin, David. Replaceable You: Engineering the Body in Postwar America. Chicago: University
of Chicago Press, 2004.
shuster, stef m. Trans Medicine: The Emergence and Practice of Treating Gender. New York:
New York University Press, 2021.
Silva Santana, Dora. “Mais Vida! Reassembling Transness, Blackness, and Feminism.” TSQ:
Transgender Studies Quarterly 6, no. 2 (2019): 210–22.
Simonetto, Patricio, and Johana Kunin. “Mariela Muñoz: Citizenship, Motherhood, and
Transsexual Politics in Argentina (1943-2017).” TSQ: Transgender Studies Quarterly 8,
no. 4 (2021): 516–31.
Singer, Benjamin. “From the Medical Gaze to Sublime Mutations: The Ethics of (Re)Viewing
Non-Normative Body Images.” In The Transgender Studies Reader, 601–20. New York:
Routledge, 2006.
Skidmore, Emily. “Constructing the ‘Good Transsexual’: Christine Jorgensen, Whiteness, and
Heteronormativity in the Mid-Twentieth Century Press.” Feminist Studies 37, no. 2
(2011): 270–300.
Snorton, C. Riley. Black on Both Sides: A Racial History of Trans Identity. Minneapolis:
University of Minnesota Press, 2017.
Somerville, Siobhan B. Queering the Color Line: Race and the Invention of Homosexuality in
American Culture. Durham: Duke University Press, 2000.
Spade, Dean. “Mutilating Gender.” In The Transgender Studies Reader, edited by Susan Stryker
and Stephen Wittle, 315–32. New York: Routledge, 2006.

216
———. Normal Life: Administrative Violence, Critical Trans Politics, and the Limits of Law.
Brooklyn, NY: South End Press, 2011.
Stanley, Eric A. “Gender Self-Determination.” Transgender Studies Quarterly 1, no. 1–2 (2014):
89–91.
Stoler, Ann Laura. Along the Archival Grain: Epistemic Anxieties and Colonial Common Sense.
Princeton, NJ: Princeton University Press, 2009.
Stone, Sandy. “The ‘Empire’ Strikes Back: A Posttranssexual Manifesto.” Camera Obscura: A
Journal of Feminism, Culture, and Media Studies 29, no. 29 (1992): 151–76.
Stryker, Susan. “Christine Jorgensen’s Atom Bomb: Mapping Postmodernity Though the
Emergence of Transsexuality.” In Playing Dolly: Technocultural Formations, Fictions,
and Fantasies of Assisted Reproduction, edited by E. Ann Kaplan and Susan Squier, 157–
71. New Brunswick, NJ: Rutgers University Press, 1999.
———. “(De)Subjugated Knowledges: An Introduction to Transgender Studies.” In The
Transgender Studies Reader, edited by Susan Stryker and Stephen Wittle, 17–34. New
York: Routledge, 2006.
———. “Foreword.” In Out of the Ordinary: A Life of Gender and Spiritual Transitions. New
York: Fordham University Press, 2017.
———. Transgender History. Berkeley: Seal Press, 2008.
Stryker, Susan, and Paisley Currah. “General Editors’ Introduction.” Transgender Studies
Quarterly 2, no. 4 (2015): 539–43.
Stryker, Susan and Paisley Currah, and Lisa Jean Moore. “Introduction: Trans-, Trans, or
Transgender?” WSQ 36, no. 3–4 (n.d.): 11–22.
Sullivan, Nikki. “Transmogrification: (Un)Becoming Other(s).” In The Transgender Studies
Reader, edited by Susan Stryker and Stephen Wittle, 552–64. New York: Routledge,
2006.
Terry, Jennifer. An American Obsession: Science, Medicine, and Homosexuality in Modern
Society. Chicago: University of Chicago Press, 1990.
Timm, Annette F., and Michael Thomas Taylor. “Historicizing Transgender Terminology.” In
Others of My Kind: Transatlantic Transgender Histories, 251–65. Calgary: University of
Calgary Press, 2020.
Tomes, Nancy. “Patients or Health Care Consumers? Why the History of Contested Terms
Matters.” In History and Health Policy in the United States, 83–110. New Brunswick,
NJ: Rutgers University Press, 2006.
Valentine, David. Imagining Transgender: An Ethnography of a Category. Durham: Duke
University Press, 2007.
Velocci, Beans. “The Standards of Care: Uncertainty and Risk in Harry Benjamin’s Transsexual
Classification.” TSQ: Transgender Studies Quarterly 8, no. 4 (2021): 462–80.
Weinstein, Deborah. The Pathological Family: Postwar America and the Rise of Family
Therapy. Normal, Ill: Dalkey Archive Press, 1996.
Williams, Cristan. “Transgender.” Transgender Studies Quarterly 1, no. 1–2 (2014): 232–34.
Wylie, Philip. Generation of Vipers. Normal, Ill: Dalkey Archive Press, 1996.

Abstract (if available)

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Gut cultures: fat matter(s) in genealogies of health, nation, and empire

PDF

A contaminated transpacific: ecological afterlives of the Vietnam War

PDF

The racial interface: informatics and Asian/America

PDF

Towards a politics of perfect disorder: carceral geographies, queer criminality, and other ways to be

PDF

Worthy of care? Medical inclusion from the Watts riots to the building of King-Drew, prisons, and Skid row, 1965-1986

PDF

(Trans)itioning voices: gender expansive vocal pedagogy and inclusive methodologies for choral directors and teachers of singing

PDF

Reorienting Asian America: racial feeling in a multicultural era

PDF

Roguish femininity: gender and imperialism in the nineteenth‐century United States

PDF

Backward: queer rurality in American popular culture from 1920 to the present

PDF

The Chinovnik and the Rond-de-cuir: bureaucratic modernity in nineteenth-century Russian and French literature

PDF

Specters of miscegenation: blood, belonging, and the reproduction of blackness

PDF

Tentacular sex: Gender, race, and science in American speculative fiction

PDF

Cinematic activism: film festivals and the exhibition of Palestinian cultural politics in the United States

PDF

Fearing inflation, inflating fears: the end of full employment and the rise of the carceral state

PDF

A meta-analysis exploring the relationships between racial identity, ethnic identity, and Black students' positive self-perceptions in school

PDF

The motley tower: master plans, urban crises, and multiracial higher education in postwar Los Angeles

PDF

AIDS and its afterlives: race, gender, and the queer radical imagination

PDF

“A door, an exit, a way out”: trans*temporality in hybrid media

PDF

A peculiar paradise: tribal place, property and the peripatetic tradition in African American literature

PDF

Sick cinema: illness, disability and the moving image

Asset Metadata

Creator Harsin Drager, Emmett (author)

Core Title To be seen: transsexuals and the gender clinics

School College of Letters, Arts and Sciences

Degree Doctor of Philosophy

Degree Program American Studies and Ethnicity

Degree Conferral Date 2022-08

Publication Date 07/28/2022

Defense Date 05/09/2022

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag gender,gender affirming care,gender clinics,Gender Studies,Medicine,OAI-PMH Harvest,Sex,trans,transgender studies,transsexuality

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Shah, Nayan (committee chair), Gualtieri, Sarah (committee member), Halberstam, Jack (committee member), Khanna, Neetu (committee member)

Creator Email e.harsindrager@gmail.com,harsindr@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC111375307

Unique identifier UC111375307

Legacy Identifier etd-HarsinDrag-11026

Document Type Dissertation

Format application/pdf (imt)

Rights Harsin Drager, Emmett

Type texts

Source 20220728-usctheses-batch-962 (batch), University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright. The original signature page accompanying the original submission of the work to the USC Libraries is retained by the USC Libraries and a copy of it may be obtained by authorized requesters contacting the repository e-mail address given.

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA

Repository Email cisadmin@lib.usc.edu