The TRANSSEXUAL PHENOMENON
Harry Benjamin, M.D
Preface and Acknowledgement
There is a challenge as well as a handicap in writing a book on a subject that is not yet covered in the medical literature. Transsexualism is such a subject.
The handicap lies in the absence of all previous observations to which to compare one’s own, and which would thus allow a more meaningful appraisal of the entire problem
The challenge lies in the novelty of these observations and in the attempt to describe clinical pictures and events without preconceived notions, with no axes to grind, and with no favorites to play. Conclusions, therefore, are “untainted,” growing out of direct observance.
As one who is neither surgeon nor psychiatrist – but rather as a student of sexological problems, and also as a long-time practitioner in sexology – I feel myself to be in a good position for the necessary objectivity.
There exists a relatively small group of people – men more often than women – who want to “change their sex.” This phenomenon has occasionally been described in its principal symptoms by psychiatrists and psychologists in the past; but a deeper awareness of the problem, and especially its general sexological as well as its therapeutic implications, was largely neglected, at least in the United States. It has been considered only during the last (roughly) thirteen years and then with much hesitation.
The case of Christine Jorgensen focused attention on the problem as never before. Without her courage and determination, undoubtedly springing from a force deep inside her, transsexualism might be still unknown – certainly unknown by this term – and might still be considered to be something barely on the fringe of medical science. To the detriment if not to the desperation of the respective patients, the medical profession would most likely still be ignorant of the subject and still be ignoring its manifestations. Even at present, any attempts to treat these patients with some permissiveness in the direction of their wishes – that is to say, “change of sex” – is often met with raised medical eyebrows, and sometimes even with arrogant rejection and/or condemnation.
And so, without Christine Jorgensen and the unsought publicity of her “conversion,” this book could hardly have been conceived.
If credit, therefore, goes to her (and to a few other pioneer patients who made their experiences known in the United States and in England), so it must also go to those courageous and compassionate Danish physicians who, for the first time, dared to violate the taboo of a supposedly inviolate sex and gender concept, and who published their findings in the Journal of the American Medical Association. Furthermore, being true physicians, they considered the patient’s interest before they thought of possible criticism by their colleagues.
This criticism was not long in coming. New and rather revolutionary medical and surgical procedures readily found their opponents, especially since sex was involved. Such a contretemps, however, is no novelty in the history of medicine.
Conservatism and caution are most commendable traits in governing the progress of science in general, and of medicine in particular. Only when conservatism becomes unchanging and rigid and when caution deteriorates into mere self-interest do they become negative forces, retarding, blocking, and preventing progress, neither to the benefit of science nor to that of the patient. More power, therefore, to those brave and true scientists, surgeons, and doctors who let the patient’s interest and their own conscience be their sole guides.
When I decided to write this book, with the principal objective of describing my own clinical observations of the past decade, I was well aware that I would meet opposition in various quarters and by no means only the medical. Breaking a taboo always stirs quick emotions, although attempts to rationalize may follow. How great this taboo is that aims to protect man’s sex or gender was for the first time well emphasized by Johann Burchard, psychiatrist at the University of Hamburg.
The forces of nature, however, know nothing of this taboo, and facts remain facts. Intersexes exist, in body as well as in mind. I have seen too many transsexual patients to let their picture and their suffering be obscured by uninformed albeit honest opposition. Furthermore, I felt that after fifty years in the practice of medicine, and in the evening of life, I need not be too concerned with a disapproval that touches much more on morals than on science.
Nevertheless, encouragement was needed. That came, directly or indirectly, from those doctors and friends, here and abroad, who themselves had observed the transsexual phenomenon in some patients and had formed an independent opinion. To these unnamed supporters go my heartfelt thanks; so also to my collaborators in this volume, science writer Dr. G. B. Lal, psychiatrist Dr. Richard Green, and sexologist-writer R. E. L. Masters. And not least to the publisher Mr. Arthur Ceppos, president of the Julian Press. Likewise to my associate Dr. Leo Wollman, surgeon-gynecologist, for his editorial advice in technical matters. Also to my friend Dr. Wardell Pomeroy for his frequent valuable assistance, as well as to Mr. Richard D. Levidow, New York attorney-at-law, for checking the accuracy of the chapter on legal aspects.
My sincere appreciation goes also to Dr. Robert W. Laidlaw and Dr. Johannes Burchard, psychiatrists, and to editor Mr. Brooking Tatum for their encouragement and interest in this book.
Indirect encouragement came unexpectedly when Mr. Reed Erickson, chairman of the Erickson Educational Foundation, offered me a grant for three years to conduct research in transvestism and transsexualism. This research has been in progress for only a short time and is, therefore, not included in the present book; however, it has given welcome moral support to its writing. My sincere thanks to Mr. Erickson for this support, and also to all my collaborators who are taking an active part in this research. Let us hope their names will soon appear in coming publications, publications that may well modify, change, supplement, or confirm statements in the chapters that are to follow.
Can an author ever appreciate sufficiently what a competent secretary can do in taking care of such matters as extracting essential scientific data from medical records, tabulating them, and arranging them so that they become useful? Hardly. Here I can only thank Mrs. Robert Allen, the understanding and much admired Virginia of my office staff, for her help in this aspect of the book’s preparation: for her devotion to the work and for her intelligent, efficient cooperation.
My thanks must also go to Mrs. Rhoda Sapiro in New York and to Miss Maureen Maloney in San Francisco for their ever-ready and valuable assistance in many ways.