“Benjamin’s first inclination was to send the boy to a psychiatrist, but he soon discovered that this was not a good idea,” says Christine Wheeler. When asked whether or not castration and peotomy were indicated for the “very effeminate” boy, “the psychiatrists disagreed among themselves,” Benjamin says. “Some were for it, others were against it.” He started the boy on a course of hormones, which “had a calming effect,” but was unable to find a urologist in the United States willing to perform surgery. He advised the boy (and his mother) to travel to Germany for the operation.
When the Jorgensen story broke, in 1953, Harry Benjamin was sixty-seven years old and looking forward to retirement. He had enjoyed a long and a productive career, and as his geriatric patients died, he stopped acquiring new ones. He recruited Virginia Allen, a doctor’s wife whom he had met at a meeting a few years earlier, to help him slowly phase out his practice. “He invited me for drinks at the Sulgrave Hotel and told me he felt he had only a few years left and wanted to spend them quietly in a retirement practice,” Allen recalled at the memorial that was held following Benjamin’s death, in 1986. However, things didn’t work out quite the way that Benjamin had planned.
At the memorial, Virginia Allen recalled the day that she stumbled upon a cache of patient folders that she found particularly puzzling. “While arranging files one day, I asked, ‘What are these few records off by themselves? They seem so strange—the patients have male and female names.’ H.B. sighed, ‘They’re transsexuals and transvestites, some referred by Kinsey. Not much is known about them.’ ‘Why don’t we do something with them, since we have so much time,’ I asked. He nodded and said, ‘Yes, that may be very good. They are sad people and deserve help but they make everyone, even other doctors, so nervous and uncomfortable. Bring the records in here and we’ll go over them.’ And so it began.”
Benjamin began seeing patients referred by Kinsey and others, including a husband and wife who had been married to each other twice—the second time, in reversed-gender roles. His remaining geriatric patients were not happy about the new crop of patients, and his long-awaited retirement had nearly materialized when Christine Jor- gensen suddenly burst onto the scene, thoroughly upsetting his plans. In December 1952, Benjamin wrote to one of his transsexual patients, an artist named Doris, with whom he had carried on a long and animated correspondence: “The papers here are full of the Jorgensen case, the boy who went to Denmark to be operated on and is now coming back as a girl. I’ll probably see the party when she returns home.”
At the Benjamin memorial, in 1986, Christine Jorgensen described the circumstances under which the two pioneers had met. Returning home from Europe in 1953, she said, she “encountered a mountain of mail and I do mean a mountain—thousands and thousands of letters, many of which were from people who had problems that were similar to mine—in that mountain of mail was a letter from Harry Benjamin, whom I had never heard of before and he asked me—told me that he was guiding people and so forth in the direction of transsexuality. And would I contact him, which indeed I did.”
Describing Benjamin as a “godsend,” Jorgensen recalled that “I could recommend Harry to all these thousands of people who contacted me … because I didn’t know where to recommend people to go, there were no gender identity clinics, there was no place for them to go. So suddenly the deluge fell onto poor Harry’s shoulders.” And a deluge it was. When he met Christine Jorgensen, and began monitoring her hormones and later sending her to see Los Angeles urologist Elmer Belt for the final stage of her surgery, Benjamin had treated fewer than a dozen transsexual patients. By the time he finally closed his practice, twenty-five years later, in 1978, he had seen more than 1,500 patients. It sometimes seems that every transsexual person in America in the sixties and seventies somehow found their way to Benjamin’s office, even before the publication of
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Benjamin created a chart, the Sex Orientation Scale, based on the Kinsey rating scale for homosexuality. In the Kinsey Scale, a completely heterosexual person is ranked zero, and a fully homosexual person six. A person who is equally attracted by either sex would be a three. In the Benjamin scale of transvestism/transsexuality, there are six “types,” which together make up three “groups” of progressively gender-variant individuals. Group one includes the three types of transvestite (“pseudo,” “fetishistic,” and “true”), who cross-dress to varying degrees and for varying reasons. Only the final type, the “true” transvestite, expresses an interest in estrogen therapy or surgery, and this interest tends to be of an experimental nature.
Group two includes only one “type,” the “nonsurgical transsexual,” a person who “wavers between TV and TS,” cross-dressing “as often as possible with insufficient relief of his gender discomfort.” This non-surgical transsexual will be likely to request hormones for “comfort and emotional balance,” Benjamin writes, but while he finds the idea of sex-reassignment surgery attractive, he will not pursue it with the intensity of the latter two types (group three), “true transsexuals” of moderate or high intensity. These individuals tend to feel “trapped in the wrong body,” according to Benjamin, and will hope for and work for sex reassignment surgery. The major difference between these final two types is that the “true transsexual, high intensity” doesn’t just dislike his genitals; he despises them and may attempt to mutilate his sex organs or commit suicide if unable to achieve his goals.
Like Hirschfeld, Benjamin focuses mainly on male-bodied persons in his book, even though he knew and treated female-bodied persons as well. He does include a final chapter on “the female transsexual,” but as with Hirschfeld, his interest in these persons appears somewhat secondary. He notes that in his practice, the proportion of male-to-female transsexuals to female-to-male transsexuals is eight to one— though he defers to the three-to- one estimate of Christine Jorgensen’s physician, Christian Hamburger, based on the letters from around the world that Hamburger received after the Jorgensen case was publicized. Hamburger received 465 letters from individuals desiring sex-change surgery in the months following the Jorgensen media blitz, with three times as many men as women requesting help. Benjamin notes the paradoxical fact that though Gallup polls report that “in our culture about twelve times more women would have liked to have been born as men than vice-versa,” many fewer female- bodied persons requested sex-reassignment surgery.
Like male-bodied transsexuals, female-bodied transsexuals “resent” their sexual morphology—“especially the bulging breasts,” says Benjamin, noting that his female patients “frequently bind them with adhesive tape until a plastic surgeon can be found who would reduce the breasts to a masculine proportion.” Most of his female-to-male patients also requested a total hysterectomy, including removal of the ovaries, and treatment with androgens. The latter request was relatively easy to fulfill, though the former was more difficult, because of the unwillingness of most surgeons to remove healthy organs. Of the twenty female-to-male patients Benjamin reports on in his book, only nine underwent hysterectomy (at an average age of thirty-five). Five of those patients also underwent mastectomy. Another five patients underwent only mastectomy without hysterectomy. Sixteen of the patients were taking testosterone, which eventually produces “a physical state resembling pseudohermaphroditism (enlarged clitoris, body hair, etc.),” Benjamin reports.
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