Science In Transition Episode 1: Birth of The Clinic | from Cursed Media
This is the very first episode of the six-part podcast series network Science In Transition by Liv Agar and Spencer Barrows, from our new podcast series network Cursed Media.
Science in Transition is an investigation into the intellectual origins of the contemporary right wing backlash against transgender acceptance. Through six deeply-researched episodes, hosts Liv Agar and Spencer Barrows unearth a bizarre coalition of well-meaning clinicians, aristocratic sexologists, militant feminists, right-wing culture warriors, headline-chasing journalists, and conservative politicians.
Listen to the first two episodes of Science In Transition and the rest of the six episodes as they are released weekly by subscribing through this link.
www.cursedmedia.net/
Subscribers to Cursed Media get access to three new podcast series per year, plus every episode of QAA’s existing mini-series (properly organized!)
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Science In Transition Episode 1: Birth of the Clinic
As various fields in the medical sciences advance during the interwar period, doctors confront a problem: the treatment of adults who desire to change their sex. While many clinicians propose psychotherapy, a few dotted across the Western world have a different idea: use newly synthesized hormones and surgical procedures to treat them. Liv and Spencer dig into the early decades of the Western gender clinic, its treatment of gender-variant and intersex children, and the crusaders who sought to morally mandate the transsexual out of existence.
A full list of sources for the entire series will be available soon; for further reading, please consult:
Florence Ashley, ““Richard Green wasn’t an ally to trans communities: a controversial legacy” https://medium.com/@florence.ashley/richard-green-wasnt-an-ally-to-trans-communities-a-controversial-legacy-e6d9a485f66e
Jules Gill-Peterson, Histories of the Transgender Child
Julia Serano, Whipping Girl
Joanne Meyerowitz, How Sex Changed: A History Of Transsexuality In The United States
Karl Bryant, “Making Gender Identity Disorder of Childhood: Historical Lessons for
Contemporary Debates”
Lisa Downing, Iain Morland, and Nikki Sullivan, Fuckology: Critical Essays on John Money's Diagnostic Concepts
Melanie Fritz and Nat Mulkey, “The rise and fall of gender identity clinics in the 1960s and 1970s” https://archive.is/7cNQr
Samantha Riedel, “Gen(d)erations: How Sandy Stone “Struck Back” Against Transmisogyny” https://www.them.us/story/genderations-sandy-stone
Stacey D. Jackson-Roberts, “Pushed to the edge: the treatment of transsexuals through time:
a behavioral discourse analysis of the diagnostic and treatment protocols for transsexuals and the implications for contemporary social work practice” https://scholarworks.smith.edu/cgi/viewcontent.cgi?article=2037&context=theses
We have launched a new podcasting network called Cursed Media.
It's a new platform where we serve up exclusive podcasts on topics that you can't hear anywhere else.
For example, have you been listening to podcasts that don't have Liv Agar in them?
Well, we're here to help you fix that.
Our first series is Science in Transition, hosted and researched by Liv Agar and Spencer Barrows.
It's a six-episode investigation into the intellectual origins of the contemporary right-wing backlash against transgender acceptance.
You are about to hear the very first episode, Birth of the Clinic.
I, Liv Agar, and my co-host Spencer Barrows dig into the early decades of the Western Gender Clinic.
To hear the second episode right now, plus get access to each new episode as they're released once a week, visit cursedmedia.net and subscribe.
Cursed Media subscribers also get access to every episode of every QA miniseries, plus two more exclusive series we're going to release over the next year.
This is something we've been working on for a long time, and we're very excited to finally be able to share it with you.
And now, here is the first episode of the first Cursed Media miniseries, Science and Transition, Birth of the Clinic.
Before we begin, this podcast, all six episodes, will contain difficult and triggering content.
There'll be discussions of conversion therapy, sexual abuse, torture, pedophilia, racism, and transphobia.
While we believe it is important to account for this backlash and its history in exacting detail, we understand this series will no doubt be a difficult sit for many listeners.
Discretion is advised.
This podcast will also use a variety of language regarding trans people that is now considered anachronistic or offensive.
For clarity's sake, we will generally use the typologies and terminologies used by scientists we're discussing.
We would like to thank Julia Serrano for fact-checking and consulting for this entire project.
And now we present to you Science in Transition.
Science in Transition
In 2016, John Oliver released a viral segment on his show Last Week Tonight called Transgender Rights.
The segment, released as a response to a barrage of bathroom bills hitting the states, essentially restated a classic liberal cliché.
Oppose transgender rights and you'll be on the wrong side of history.
If you are not willing to support transgender people for their sake, at least do it for your own.
Because we've been through this before.
We know how this thing ends.
If you take the anti-civil rights side and deny people access to something they're entitled to, history is not going to be kind to you.
There is no biopic where Liam Neaton kicks the shit out of a suffragist.
This is not a stamp featuring George Wallace at the schoolhouse door.
And you are not going to get the monument that says at the base of it, he told people where to shit.
At the time, it felt hard to disagree.
Transgender rights were winning, and progress can be so intoxicating that it becomes impossible to ever imagine that one day you might start to lose.
Kamala even supports letting biological men compete against our girls in their sports.
Kamala is for they, them.
President Trump is for you.
I'm Donald J. Trump, and I approve this message.
Hi, I'm Luva Gar from the QA podcast.
And I'm Liv's research assistant, Spencer Barrows.
I worked on Chapo's Seeking a Friend for the End of the World series.
And this is Science in Transition.
This is a show about the backlash to transgender rights.
You might have seen in headlines stories about restrictions and discriminations against trans people by the Trump administration.
You may have also seen headlines about the controversy surrounding transgender rights.
If you don't know anything about trans people and trans rights, you might not know how to react to this topic.
You might even hold some private confusions, even concerns about this issue.
What this series is aiming to do is to teach you about the history of the transsexual, not the history of trans, gender-variant, and third sex people, who have existed heterogeneously across cultures for a very long time, but rather the transsexual as a medical and clinical entity, a sexual deviant to be treated by doctors, whether affirmatively by hormones or adversely through therapy.
We will show how after decades of scientific research and clinical treatment, transgender civil rights exploded into the public eye rather recently.
It is a story about a group of vulnerable and marginalized people who fought tooth and nail for their own bodily autonomy and self-determination, and how just as it achieved a minor victory, it could all be taken away.
Ten years after Oliver's segment, the movement for transgender rights has suffered countless brutal setbacks in an all-out assault, organized and enacted at a shocking speed.
Given the relative size of the trans population, the scale of this attack has been difficult to comprehend.
It has developed into a well-oiled machine, systematically targeting the legal, political, and social recognition of transgender people in a dozen or more countries, learning from its past mistakes and refining its most effective methods in order to eliminate trans people's ability to participate in society.
When the 2015 North Carolina Transgender Bathroom Bill failed catastrophically, it was impossible for most to imagine how horrifyingly effective the movement that birthed it would become.
It seems like the inevitable forward march of history itself was enough to be smugly confident that it had nowhere to go but up.
So how did we get here?
In her 1991 book Backlash, the author and journalist Susan Faluti charted a history and theory of backlash politics.
Faluti had watched as the women's rights movement ground to a halt and its hard-fought victories were snatched away one by one.
It wasn't just the Reagan Revolution's 12-year dominance.
It was that every aspect of American culture had seemingly turned against the concept of women's rights overnight.
Pop culture began portraying career women through anti-feminist stereotypes created by right-wing agitators, and legitimate journalistic institutions started uncritically repeating bunk scientific studies about how much unhappier women were when they entered the workforce or waited to have children.
Women's role in the workplace shrunk, and the so-called rights of the fetus grew at an inversely proportional rate to The rights of the person carrying it.
Despite the remarkable success of the backlash against women's rights, it plays a rather insignificant role in our general understanding of how women's position in society has developed over time.
It's as if there was no backlash at all, and our current, rather sorry position is merely a product of where the victories for women's rights have left us.
This is, of course, with the exception of elements of the backlash within recent memory, which seem too hard to ignore.
It's as if we have been on a slow but steady upward swing throughout the 20th and 21st centuries, only to see some significant downturn when this loss is recent enough that it is impossible to ignore.
We are so entranced by the image of progress, we are so invested in it, that it is hard to realize the degree to which this anti-feminist backlash continues to structure how we talk and think about both the patriarchy and women.
We are so blindsided by the feeling that our victories will last forever that we don't even realize when our world has become structured primarily by our defeats.
So where did this backlash even come from?
I think the answer to this question clashes pretty strongly with how we generally view progress.
While yes, most people will concede that fascism could happen here.
The actual content of backlash politics and the nature of the movements that birth it can be far more subtle than Mussolini's march on Rome.
Backlash politics can find profound success in a liberal democracy, where a majority of the population views themselves as in favor of civil rights and social progress.
Progress, as it is generally talked about, is simply an act of convincing the majority of society that a downtrodden group deserves to be treated better.
And as soon as this is done, assuming one lives in a liberal democracy, the laws of the land will reflect this belief.
On this view, laws generally reflect the sentiments of the majority.
Elected politicians accurately represent their constituents, and the degree to which a marginalized group receives legal and social recognition is inextricably linked to that group's favorability and opinion polls.
If you think that this is a straw man, that's because it is.
It's how progress makes us feel, and any successful form of backlash politics is able to take advantage of this false sense of security.
Crucially, backlash is neither a top-down conspiracy nor a grassroots swelling.
It is a multifaceted blob of conflicting interests and motives, enjoying both elite support and exploiting and feeding upon the fears, bigotries, and confusions of the public.
As Valuti writes, The Backlash is at once sophisticated and banal, deceptively progressive and proudly backward.
It deploys both the new findings of scientific research and the dime-store moralism of yesteryear.
It turns into media soundbites both the glib pronouncements of pops like trend watchers and the frenzied rhetoric of new right preachers.
Backlash politics is broadly a chameleon.
It defines itself in whatever ways it must in order to adapt to a new political environment marked by a move away from the old conservative status quo.
It can appear progressive to liberal journalist elites, scientifically rigorous to judges and politicians, and a controversial hot topic to newsroom pundits.
The demands of the backlash are defined by a group who is in cahoots purely as a result of their collective opposition to a particular form of progress.
This is the essence of what makes backlash politics so effective.
It isn't merely the old and now defeated status quo, nor is its success contingent upon the overthrow of the liberal democratic order.
It can advance its goals in a liberal society occupied by a progressively minded populace and shape its arguments to fit within our popular image of societal progress.
Yet while the backlash to feminism successfully curtailed the freedom of half of the population, how might this differ from a movement intending on further marginalizing a group approximately 50 times smaller?
The backlash to transgender rights is simultaneously far more totalizing in its vision for society and much more modest.
While the segment of society this movement is attempting to disempower is far smaller than the anti-feminist backlash, the severity of this disempowerment is openly spoken about in far more absolute terms.
And especially for the good of the poor people who have fallen prey to this confusion, transgenderism must be eradicated from public life entirely.
The whole preposterous ideology at every level.
While the anti-trans backlash has gained considerable purchase in America, it still must be understood that it, just like the anti-feminist backlash before, is not a coordinated conspiracy, taking orders top-down from a shadowy cabal.
It is a rickety coalition of well-meaning clinicians, pedophilic sexologists, militant feminists, right-wing culture warriors, headline-chasing journalists, and conservative politicians.
Groups that, even as they sometimes work together, nonetheless carry completely antithetical images of their ideal society and trans people's place within it.
While the fruits of the anti-trans backlash have only begun to properly ripen in the past decade, its seeds were planted more than half a century ago, embedded in the early encounters between cisgender male doctors and a new clinical entity some of them had begun attempting to treat, the transsexual.
The birth of the Western Gender Clinic, an indisputable moment of progress for the trans community, a moment when transgender healthcare became standardized and legally attainable, also provided the blueprints for the transphobic empire to come.
Mr. Backlash, Mr. Backlash, just who do you think I am?
You raise my taxes, freeze my wages, and send my son to Vietnam.
You give me second-class houses...
In the late 1940s, Christine Jorgensen, a former American GI then living under her old male identity, discovered a book titled The Male Hormone at her local library.
This fictional detective novel fantastically explored some of the newfound possibilities for the modification of sexual characteristics opened up by the burgeoning field of endocrinology.
To put it simply, doctors had discovered doping, and after testosterone was synthesized in 1935, they'd begun to develop experimental therapies that promised increased vitality and extended youth.
Yet this was not the only significant breakthrough being made.
It was certainly not the component of the male hormone that Jorgensen was most interested in.
Scientists had also begun conducting experimental sex changes on animals, confirming the suspicion of many biologists from the 18th century, including the likes of Charles Darwin, that sexual characteristics could be modified through chemical alteration.
To quote from the book Christine was reading, Testosterone, when you gave enough of it, could actually transform hens toward roosters.
They stopped laying eggs.
Their hinder parts narrowed toward the anatomical build of that of their lords and masters.
They started to strut.
They began to crow.
They conducted themselves in every particular like kings of the barnyard, though they might not become actual fathers.
Yet these experiments were not only being done on animals.
Even going back to the early 1920s, German sexologists had been providing medical intervention as a means of treating patients who wished to live as the opposite sex.
The paradigm-defining figure in this form of treatment was a man named Magnus Hirschfeld, who opened his Institute for Sexual Research in Berlin in 1919.
Hirschfeld would coin the term transvestite in 1910 as a medical diagnosis not only for those who desired to cross-dress and achieved arousal at doing so, but also those who wished to live as a different sex than the one they were assigned at birth.
In 1950, Drugensen would travel to Denmark to meet endocrinologist Christian Hamburger, who over the next three years provided her with hormone replacement therapy, lowering the testosterone in her body and raising the estrogen to better resemble the levels of a cisgender female.
He also performed two sex change procedures on her.
These procedures were banned at the time in the United States, so Christine had used her Danish heritage as an excuse for her frequent trips to Denmark in order to continue her transition in secret.
She intended to continue living in New York in a life of relative anonymity as Christine, a name she chose to honor the doctor who treated her.
Yet in late 1952, the letter she wrote to her parents coming out was leaked to the press, and the story of her medical transition covered the first page of the New York Daily News.
The title for this story reading, XGI Becomes Blonde Beauty, Operations Transformed Bronx's Youth.
Juergenson was far from the first individual to receive hormone replacement therapy or undergo sexual reassignment surgeries.
The history of early endocrinology and its use on gender non-conforming individuals who wish to change their sex is at the very least decades older than Christine's transition.
Yet her story captivated the American public, introducing them to the idea that science and medicine was capable of changing an individual's sexual characteristics.
Christine was almost immediately rendered into a spectacle, being written about in hundreds of newspapers in America and abroad.
Audiences read the story through their own wonderments and anxieties about the scientific possibilities opened up by the atomic age.
Jorgensen, for her part, took being publicly outed in what might be the most high-profile case of medical transition in history in stride.
She arrived in New York a few months after the initial media firestorm in a scene akin to the Beatles' first trip to America.
Journalists and reporters analyzing her every move to see if they're sufficiently feminine and asking horrifically invasive questions about her life.
She would soon launch her own successful nightclub act, and appeared on various radio and television shows to maintain a career in the public eye.
I met her in a club down in North Soho, where you drink champagne and it tastes like Coca-Cola.
C-O-L-A, Cola.
She walked up to me and she asked me to dance, uh-uh.
Much of the fascination with Christine and the media came with benevolent intention.
News stories of her often used she-her pronouns to refer to her in the present, for instance.
Yet Juergensen was nevertheless still primarily rendered a spectacle.
The publicization of her story laid bare the most intimate details of her body and mind, and it gave every pop culture consumer the social permission to speculate about and examine her mind and body with the intimacy of a psychologist or medical doctor.
It was as if she was a scientific test case for the possibilities of medically induced sex change.
Jugenson navigated a particularly rigid and unforgiving image of white femininity present in the popular culture of the period, doing so with an especially scrupulous audience who was looking for any potential reason to delegitimize her position as a woman.
One such rumor related to the idea that she was secretly intersex, having been born with female internal reproductive organs.
For the public then, as well as now, sex had been understood as an immutable characteristic.
Females are born female, males are born male, and your position on the binary cannot be changed at all.
This is how gender and sex broadly appears to a majority of people in their daily lives.
It can be believed by both the conservative Christian and the radical feminist, despite their images for society being entirely antithetical.
This viewpoint is the easiest way of thinking through gender norms and provides a relative stability for understanding how men and women relate to each other.
But Jorgensen's story had introduced an idea into the minds of the public that biologists had already begun to understand a century earlier.
Someone's biological sexual characteristics can be changed.
While many were uncomfortable with this fact, for some, it opened up new avenues of possibility.
The story of Christine Jorgensen served as a flashpoint for transgender health care in the United States, not because she was the first to receive medical care related to changing her sexual characteristics, but because she was the first major figure to demonstrate to the American public that such a form of care was possible.
Christian Hamburger, for instance, reported that after Christine's story went public, hundreds of people, both wishing to become male and female, wrote letters to him requesting sexual reassignment surgery from all across the world.
The cat was out of the bag, and clinicians now more than ever before felt a need to formulate a response to these requests for care.
Holly came from Miami, FLA.
Hitchhiked her way across USA Plucked her eyebrows on the way, shaved her legs, and then he was a she.
She says, hey, babe, take a walk on the wild side.
When we think of healthcare and medicine and its relationship to a patient in need, the most common association that comes to mind is that of care.
Things like the Hippocratic Oath.
First, do no harm.
Uplift the sick.
Help those in need of their assistance.
And it's not a surprise why most of us, at least, have this association.
You go to the doctor with a really bad cough and chest pain.
They prescribe you something, and it helps alleviate your symptoms.
But what happens when doctors refuse to provide you care?
Even when you are in need?
What happens when a doctor thinks they know better than you?
Even when it turns out the solution they have in mind is actually far worse than the one you might be suggesting?
Doctors have power over their patients, and medicine, especially as it's implemented practically, is far from perfect.
Most, if not all, the significant medical professionals responding to the upswing in requests for sex change procedures were white, cisgender, and heterosexual.
The internal life of one of their trans patients, who is in significant distress due to a desire to change their sex, was entirely foreign to them.
In the United States, the scientific interest in trans people was mainly taken up by psychiatrists, most of whom had little to no interest in Hirschfeld's paradigm-defining work on the subject.
His major work on, quote, the transvestite had not even been translated into English.
Instead of following Hirschfeld's suggestions related to easing patients' discomfort through medical transition, most American medical professionals opted for a purely mental approach, with psychotherapy as a means of dissuading the individual from permanently altering their physiology.
Yet not all American doctors were unfamiliar with Hirschfeld.
One essential figure in the development of a standardized medical diagnosis for those wishing to change their sex was a German-American endocrinologist and sexologist named Harry Benjamin.
He would originally be introduced to Hirschfeld through a family friend in 1907, and the two would occasionally visit some transvestite bars in Berlin.
Receiving a German medical degree in 1912, Benjamin would visit America in 1914 looking for treatment for tuberculosis.
Yet on his return trip to Germany, his boat was prevented from passing as a result of a British Navy blockade on the country.
Setting up an endocrinology practice in New York, Benjamin would help import the sexological and endocrinological work happening in Germany into the American context, frequently visiting Germany in the 20s and 30s and working with Hirschfeld as well as endocrinologists experimenting with the modification of sex.
Benjamin had even been Christine Jugensen's physician after she returned to the United States.
In the 1920s, Benjamin met with what he considers his first transvestite patient, Spangler.
Benjamin suggested medical intervention, meaning Spangler in 1928 was one of the first cases of a trans patient receiving exogenous hormones, aka hormones originated outside of the body.
At the time, Benjamin was still working through the conceptual heuristic of transvestite provided by Hirschfeld, which made no meaningful distinction between what we would now consider a cross-dresser or a man who receives sexual arousal by putting on women's clothing and a transgender person.
It is important to remember that even those doctors providing groundbreaking medical intervention towards trans patients continue to navigate their relationship with these patients through the beliefs and assumptions about sexuality and gender of their day.
In a letter related to Spangler's transition, where someone had asked Harry Benjamin whether she was a quote, a man, a woman, or a lunatic, he replied this.
Believe it or not, this person is a man, a woman, and somewhat of a lunatic.
So you guessed 100% right.
To be serious, he is a married man, father of several children, but is a transvestite.
That is, his passion is to go in women's clothes.
The internal world of these patients was, in a certain sense, entirely foreign to the doctors treating them.
Benjamin, the man of science he was, had nevertheless recognized the remarkably positive effect that medical transition induced in his trans patients.
While Benjamin did not coin the phrase transsexual, he popularized it first in a lecture he gave on the subject in 1953.
He was on the cutting edge of American medical treatment of trans people and would be one of the first in the United States to open up a practice for this aim during the 60s.
At the end of that decade, Benjamin would publish what was then the definitive rubric on transsexuality in his book titled The Transsexual Phenomenon.
The book contained a seven-point scale, ranging from the pseudo-transvestite all the way up to the true transsexual high-intensity.
The transvestite, on the one hand, simply gained sexual desire from cross-dressing, and the transsexual, on the other, had an intense, long-standing desire to live as a woman, a belief that has been prevalent in them since childhood.
It should be added here that much of the clinical discourse surrounding transsexuals revolved around transsexual women assigned male at birth.
Benjamin's scale did not focus on transsexual men.
While there are many coercive treatments that have been used in the past and present on gender-variant girls and transsexual men, we will primarily focus, at least in this episode, on the clinical discussion surrounding transsexual women, as it was the primary object of fascination among clinicians of this period.
One crucial component of Benjamin's rubric related to the Kinsey scale of sexuality.
Alfred Kinsey was a colleague and friend of Benjamin, introducing Benjamin to one of his first trans patients in the late 1940s.
Benjamin's true transsexual is mainly attracted to men, desiring them specifically as a woman, even if they may have previously been married with kids before transitioning.
The transvestite, on the other hand, is primarily sexually attracted to women.
Today, of course, we understand that trans people's sexualities vary in a manner similar to cis people's, although Benjamin and the like did not see it the same way.
Benjamin's observation borrows from a 19th and early 20th century concept called sexual inversion, where homosexual behavior was believed to be connected with behavior correlated with the opposite sex.
Very little room was provided for transsexual women, exclusively or primarily attracted to women.
Benjamin's categorization is first and foremost medical in nature.
It was created to solve a problem related to the gender clinics popping up in the United States during the 60s, concerning which patients asking for gender-related medical care would benefit from treatments.
These Western clinics needed to be sure that those who were requesting care actually needed it, and would not later, in large numbers, regret the non-reversible components of their treatment.
Such a reaction would not only damage their ability to perform futural transsexual procedures, but very well could have rendered these clinics liable to malpractice suits.
It should not be a surprise, therefore, that these very early criteria for transsexuality focused on isolating the most outwardly severe and persistent cases demanding some form of treatment.
Benjamin's true transsexual of high intensity had such persistent negative feelings about their sex and gender that both hormone intervention and vaginoplasty, the surgical creation of a vagina, were urgently needed to alleviate their suffering.
We now understand that there are many different trans experiences not conceptualized through Benjamin's rubric, where medical transition is greatly beneficial.
Many countries, such as the United States and Canada, now work on an informed consent model to very positive effect, where the primary function of doctors is not to gatekeep medical transition, but to make patients aware of the effects of transition and let them decide for themselves.
Benjamin's rubric for diagnosing transsexuality was certainly problematic, and it was born from a rather small sample size of patients he had encountered in his practice.
It blurred the line between transvestism as a sexual paraphilia and transsexuality, oftentimes leading many people who are certainly in the latter category and would have greatly benefited from medical intervention being relegated to the former.
By the 1960s, gender clinics began to pop up around the United States.
While they were more than a decade late to the increased demand produced by the virality of Jorgensen's story, there was nevertheless some process for trans people to receive medical care within the country.
These programs were very limited in scope.
Doctors required some sort of rubric to understand who is most suited to receive care, broadly following Benjamin's assessment.
For the first few years, doctors were quite content with this rubric, noticing how similar Benjamin's explanations of the true transsexual were to most of the prospective patients.
These patients would say they have always felt like a girl, dressing up in women's clothing as a child and playing with girls' toys, that even if they were previously married to a woman with kids, that they were only sexually attracted to men, that they don't receive much pleasure from penile genital stimulation, that they view themselves as a woman trapped in a man's body,
components of Benjamin's understanding of the true transsexual.
It wasn't until the late 1960s that doctors at these early clinics realized that many patients had been lying to them and pretending that their personal life stories aligned sufficiently with Benjamin's rubric in order to receive medical care.
These patients were also able to read Benjamin's textbook and get the care they desperately wanted at these clinics that had very few spaces open for them.
While doctors initially assumed this was because the patients were pathological liars or psychotic, it is fairly clear that their life stories did not match with Benjamin's account, and yet they still desperately needed the medical care being provided in these programs.
Doctors would also consider a multitude of very unscientific factors with relation to who received care.
Most of the patients in these clinics were white, conventionally attractive, and naturally feminine enough that doctors had faith that they would be the most likely to pass, aka, blend in as cisgender women.
The first gender clinic to open in the United States was at Johns Hopkins University in 1966 by a medical psychologist by the name of John Money.
Of the approximately 2,000 patients who applied in the first two years there, only 24 received surgical intervention.
It's difficult to properly place John Money in both transgender history and its backlash.
On the one hand, he opened the first gender clinic in the United States and helped coin and popularize several important concepts in our understanding of transgender identity, such as gender roles and sexual orientation.
Though contrary to popular belief, gender identity was first coined by UCLA psychologist Robert Stoller.
On the other hand, Money also had a deep distrust for trans people.
He once said that transsexuals were, quote, devious, demanding, and manipulative, unquote, and possibly incapable of love.
Money had first become interested in the subject of trans people through his work with intersex children beginning in the 1940s.
He had encountered a child whose parents had been instructed by doctors to raise as a boy as a result of the child having external testes.
Yet this child had grown increasingly feminine since adolescence and now passed as a girl.
Conventional wisdom at the time among doctors concerning the sex of a patient posited that the genitalia of a child determined whether or not they were a man or a woman.
And so in this case, where a child who appeared to be a girl had genitalia that marked them as male, picked Money's interest.
He became fascinated both with better understanding these intersex conditions, as well as developing a scientifically rigorous method of creating a sex assignment for these patients.
That is to say that for Money, it was clear that all of these patients should either be raised as boys or girls.
Intersex conditions merely provided a challenge to the male-female binary that he believed medical science could fix.
Money would eventually choose the term gender as a means to better explain the inner psychological affiliation towards men or women that he believed intersex patients still had.
Money's conceptualization of gender was quite different to how we might understand it today.
For Money, our gender identity, or whether we come to understand ourselves as either a man or a woman, essentially develops out of the sexual characteristics we have during our childhood and adolescence.
Everyone is initially completely plastic, molded by the sexual characteristics that we have as we develop into adolescence.
We go through various stages, or gates, as he calls them, related to the gendered nature of our behaviors and our sense of self.
As we age, these gates, the most fundamental of which are the earliest, close, and we are locked into some component of the gender connected to our sex.
So while we're not born with a gender, our sexual traits inadvertently determine our gender as we age.
This conceptualization of gender allowed Money to advocate for non-consensual surgical correction of intersex children's genitals, altering them to appear more similar to a non-intersex child.
He believed that this would produce intersex children who had a stable identification with being either a man or a woman.
One high-profile case related to Money's surgical intervention into children was the John Joan case, aka David Reimer, whose genitals were badly damaged after a botched circumcision.
At 22 months, Money counseled his parents to give David sex reassignment surgery and raise him as a girl, believing that the child's gender identity would develop into being female because of his altered sexual characteristics.
Money subsequently counseled both David and his twin and reportedly sexually abused them, posing them in sexual positions and photographing them.
In his early teen years, a psychiatrist treating David wrote to John Money about how David was deeply psychologically disturbed, yet Money would keep this information quiet.
When David Reimer turned 13, he learned of the circumstances of his birth and reverted to living as a man.
The medical community was, at the time, entirely unaware both of David's psychological status as well as his decision to revert to living as a boy.
They assumed that the experiment was a success and proof of gender's plasticity.
Both twins, however, committed suicide in their 40s.
Money would take his attitudes towards intersex and gender non-conforming children with him when he found the first trans medical clinic in the United States at Johns Hopkins University.
This was an academic clinic, so its primary purpose was developing a better understanding of transsexuality as a medical entity.
The trans people who volunteered, desperate for some form of gender-affirming care, were half-patients being treated and half-guinea pigs pushing the bounds of science.
Initially, Money and the others running the clinic did not even want its existence to go public, only working through private recommendations from Benjamin.
When news of the clinic's existence broke into the public sphere, the committee that ran it publicly stated that its purpose was, quote, to deal with the problems of the transsexual, physically normal people who are psychologically the opposite sex, end quote.
This statement betrays the attitude that Money had towards what was beginning to Be understood as transsexuality.
First, that it was a problem to be dealt with, and secondly, that it was distinct from intersex conditions.
The idea that an individual could be, quote, psychologically the opposite sex, end quote, seems to almost directly contradict Money's views of gender as they apply to his study of intersex people.
As an example of Money's earlier attitudes concerning transsexuality, he wrote this in a letter to a transgender woman requesting medical intervention in the 50s.
It is impossible for a person to change all the habits of a lifetime as a male.
Habits of thought, of feeling and action, simply because he gets hormones and undergoes surgery.
You may wear women's clothes, but in spite of your conviction of yourself, you will never think and feel as a woman, through and through.
This statement follows fairly directly from Money's earlier image of gender.
While it's quite malleable during very early stages of development, having male sexual characteristics and being placed within a male schema for social development throughout someone's life would surely prevent them from meaningfully identifying at the level of their gender with being a female.
Money viewed the transsexuals he was studying as having what he called gender cross-coding.
Many of the observations that led to this conclusion were bound up in the sexuality of transpatients he was studying.
For Money, so-called male-bodied individuals are primarily sexually driven by visual stimuli and genital stimulation, whereas so-called female-bodied individuals cared more for physical touch and emotional intimacy.
Money noted that the male and female transsexuals aligned far more with their identified gender and not their natal sex.
This is another instance where Money's conception of gender works to solidify biological determinism, where he codifies stereotypes related to how men and women think about sex as being based upon their biology, and transsexuals merely have a gender that is the opposite of the rest of their sexual characteristics.
Money maintained that this was likely the result of some biologically driven phenomenon, pointing potentially to prenatal sex hormone exposure as having an effect on neural pathways, as well as a failure to identify with one's assigned sex because of restrictive gender norms.
For Money, gender could be completely malleable, entirely determined by biology, or contingent upon healthy psychosexual development depending on the context he was writing about.
It was a term that was meant to ensure a biologically determined image of sexual identity in a scientific context where the belief that man and woman were merely determined by what genitalia a person has was becoming refutable.
Money explicitly resisted the use of the term gender being taken up by more constructivist thinkers, such as second-wave feminists, for this very reason.
For money, gender was a tool to enforce rigidity, even if under this rigid image money did allow for the most supposedly presentable and potentially passing transsexuals to gain access to medical transition.
Down to Cypress Avenue With a childlike vision sleeping into view Clicking, clacking of a high-heeled shoe This view of transsexualism was shared by Money's student Richard Green, who had begun to study so-called feminine boys with money in the 1950s.
Money and Green argued that while many medical professionals viewed gender-variant activity within boys as primarily just a phase, it represented an increased risk of an individual developing into a transsexual as an adult, an outcome that the two believed to be suboptimal.
Money and Green therefore viewed the scientific study of these gender-variant boys and the rendering of their behaviors into a psychological condition as useful for preventing the supposedly suboptimal outcomes in the future.
Their work would be foundational in later studies of gender-non-conforming boys, which broadly took with it their assumption that this gender variance was not desirable.
Although Green's earliest work suggests a view of homosexuality as suboptimal, he eventually came to the conclusion that it was instead biological and lobbied to remove homosexuality from the DSM.
The classification was removed in the early 1970s, although it should be noted he still believed parents had the quote legal right unquote to try and counsel homosexual behaviors out of their children.
Green conducted research on transsexualism as well and helped create the blueprint for the diagnosis of gender identity disorder of childhood or GIDC.
Even if one reads the creation of this diagnosis as ultimately progressive in recognizing transness, treatments require a DSM diagnosis to be covered by insurance after all, the logic underlying most of his work is the assumption that transness was an outcome to be avoided.
Green's later work in the 1970s would shift to finding a potential link between gender-variant boys and adult transsexuality, an outcome that Richard Green was much more willing to explicitly contextualize as undesirable than his teacher John Money.
This is possibly due to the theories of another of his teachers, Robert Stoller, who drew on psychoanalysis to conclude that the behavior of effeminate boys came from their repressed tomboy mothers, who saw their sons as, quote, their treasured, feminized phallus, end quote.
In 1970, Green, under the auspices of UCLA, would conduct one of the largest studies of gender-variant boys in American history.
He called it the Feminine Boy Project, which later became the basis for his 1987 book, The Sissy Boy Syndrome.
Green procured boys for his study from local psychiatrists, psychologists, as well as on TV.
He asked for pre-pubescent boys that dressed, acted, or expressed a desire to become a girl.
All told, he and his colleagues studied several dozen so-called feminine boys, expecting them to either be pre-homosexual or transsexual.
To his surprise, he found that only one of them became a transsexual, and that 75% ended up as gay men.
Observing this, Green concluded that transsexuality was very rare, and that most children would desist in gender-variant behaviors when entering adolescence.
This large desistance is likely due to a few factors.
Aside from the larger social stigma and medical barriers surrounding transition that existed in the 1970s, a gender-variant child was, and still is, a much broader category than what we now think of as a transgender child.
Not every child who cross-dresses or expresses interest in the opposite gender stereotypical interests or walks with a supposedly feminine gait will wind up asking to transition.
This is important to consider as, nonetheless, children with no gender dysphoria and no desire to transition, but a gender expression outside of rigid, binaristic norms, can nonetheless be labeled as gender variant and were often sent to treatment.
A child included in Green's study under the pseudonym Craig was sent because he had experimented with cross-dressing and disliked being a boy because, quote, boys had to Go to the army and be killed.
The child had expressed no discomfort with his anatomy, nor even wearing boys' clothes.
This is in line with how the diagnosis of GIDC would develop.
GIDC held different standards for boys and girls.
In 1980, the diagnosis would require a girl to state a desire to be a boy, whereas boys simply had to strongly express that desire.
By the 90s, GIDC, or later GID, aka gender identity disorder, could be used to diagnose children even if they expressed no stated desire to change their sex or gender.
There was also the fact that, as will be discussed next episode, Green and Coe's observations were more coercive than the study might have implied.
What little progress Money and Benjamin had made by the start of the 1970s would not survive for the rest of the decade.
Ten years after the opening of the Johns Hopkins University Clinic, or JHU, a man by the name of Paul McHugh was hired and immediately set to work closing it down.
McHugh, a staunch Catholic, opposed sex reassignment surgery out of religious conviction and believed psychotherapy to be more appropriate for transsexuals for reasons that did not seem to be based in evidence but religious ideology.
As the American College of Surgery Tal said, Under McHugh's leadership, Johns Hopkins University psychiatrist John Mayer, MD, published a study of 50 surgical patients from the JHU clinic, which concluded that GAS offered, quote, no objective benefit for transgender people.
Although this claim directly contradicted a growing body of evidence that found significant benefit for transgender patients, the publication sparked the rapid closure of the JHU clinic in 1979.
More specifically, Meyer stated in that report that sex change operations were, quote, subjectively satisfying, unquote, but did nothing for quote social rehabilitation.
McHugh reached a similar conclusion, saying, quote, I conclude that Hopkins was fundamentally cooperating with a mental illness, unquote.
The New York Times reported on it as such, quote, benefits of transsexual surgery disputed as leading hospitals halt the procedure.
More gender clinics shuttered in the 1970s as well.
While some quietly closed due to a lack of enrollment, others were forcibly closed by an often religiously motivated medical establishment.
The gender clinic at the Religious Baptist Medical Center in Oklahoma was shuttered by a 54-2 vote by the board of directors.
Pushback from medical gatekeepers, compounded by the difficulty transgender individuals had in paying for the surgeries, as well as some of the few surgeons who knew how to perform the procedure retiring, meant that the practice had taken a significant blow by the end of the 70s.
The same year the JHU clinic closed, however, the Harry Benjamin International Gender Dysphoria Association, now known as the World Professional Association for Transgender Health, or WPATH, was formed by a group of individuals including Benjamin and Green, quote, for the study and care of transsexualism and gender dysphoria.
Richard Green, meanwhile, started the journal known as the Archives of Sexual Behavior in 1971.
Even with the JHU clinic and many others closed, the quest against medical care for transsexuals continued.
But the paternalistic medical professionals and Catholic reactionaries were not the only ones on this crusade.
They were joined by an unusual ally, members of the radical feminist movement.
*Music*
Janice Raymond was not the first member of the feminist movement to advocate against transsexualism, but she was crucial in popularizing the rhetoric of anti-trans radical feminism.
One of the first targets of her wrath was a trans woman working at the women's music label Olivia Records by the name of Sandy Stone.
While Stone worked as an engineer, the label received a manuscript for Raymond attacking Stone's presence at the label, beginning an onslaught of harassment against Stone from, by her accounts, a group of queer women who wrote similar sounding letters.
Stone remarked that, quote, it was as if people were out there passing around a form letter, unquote.
As for the manuscript, it would later be turned into a book called The Transsexual Empire, The Making of the She-Male.
In it, Raymond wrote that transsexuals, quote, rape women's bodies by reducing the real female form to an artifact, unquote, and then suggests, quote, the problem of transsexualism would best be served by morally mandating it out of existence, unquote.
Raymond's beliefs were, even among second wave feminists, controversial.
The year prior to the Empire's release, two feminists wrote the book Gender, an ethno-methodological approach, which approached transsexualism with considerably more curiosity.
The second wave movement's own backlash has had the effect of rewriting the movement as being man-hating radicalism when it fought for many practical economic opportunities for all women.
Raymond's beliefs, while certainly not universal among the movement, weren't an outlier either.
Her book built upon the attitudes that many members of the radical feminist movement held.
In 1980, the National Center for Healthcare Technology commissioned Raymond, among others, to research the efficacy of transsexual medical care.
Raymond unsurprisingly found such practices to be quote-unquote controversial.
And quote, because of the lack of well-controlled, long-term studies of the safety and effectiveness of the surgical procedures and attendant therapies for transsexualism, the treatment is considered experimental.
In 1981, centers for Medicare and Medicaid services agreed.
Transsexual surgery was removed from Medicaid and Medicare.
As the Reagan Revolution and the AIDS epidemic swept across the states, the 1980s would turn out to be an unimaginably dark time for the queer community, cis and trans alike.
Playwright Larry Kramer wrote a letter begging NIAID head Anthony Fauci to take the pandemic seriously.
But as the United States weathered countrywide backlash to the rights of women, people of color, and queer people, the development of transgender medicine and treatment continued up north, where a few figures developed new practices and typologies to further treat the condition of transsexualism.
On nights like this, when the world's a bit amiss and the lights go down across the trail park I get down,
I feel a hat I feel a verge of going mad And then it's time to punch the clock I put on some make-up Time will take deck And put the wake back on my head
Suddenly I am miss Midwest Midnight check out queen until I head home and I put myself to bed That was the first episode of Science in Transition.
The history only gets stranger from there.
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