The Riddle of Gender

Surgeons such as he were refused membership in medical societies and were branded as quacks by some of their particularly orthodox colleagues. And then, sex was not even involved.”

Though he doesn’t say so explicitly, Benjamin must have been aware that criticisms of “Nasen Joseph” stemmed from discomfort with the manner in which rhinoplasty was perceived as facilitating another kind of “passing”—from Jewish to German. As a “foreign” physician, Benjamin understood exclusion. Although he was invited by friends to deliver presentations at the New York University School of Medicine in 1963, at the Albert Einstein College of Medicine in 1964, and at Stanford University in 1967, his academic affiliations were limited, and throughout most of his career his practice remained “isolated and unconnected,” said Christine Wheeler. His insights and achievements seem all the more remarkable in light of these facts.

Benjamin “understood that you couldn’t separate the body from the mind,” Christine Wheeler says, and he looked forward to the day when an organic understanding of transsexualism was possible. “He always held out hope that the biological key would be found,” she says, “but he also believed that we didn’t have the tools to understand it” at the time he was working. Benjamin was “a product of his age,” Wheeler says, and some of his views have been revised by later researchers and clinicians. His attitude about surgery is one of them. According to Benjamin, “you weren’t a true transsexual if you didn’t desire surgery,” Wheeler says, whereas Wheeler, who has been in practice for thirty-three years, has many clients who “move in and out of transition … according to what feels safe at the time.” She also sees about a dozen people who have lived in their birth sex their entire lives but who decided “in their sixties and seventies that they couldn’t go to their graves” without talking with someone about their lifelong gender dysphoria. “They’ve never cross-dressed, they’ve never taken hormones,” she says. Are they transsexuals? Not in Benjamin’s view, but a new generation of clinicians and activists might argue differently.

Wheeler, along with her colleague Leah Schaefer, is the guardian of Benjamin’s archives, the voluminous patient records, correspondence, and other products of a lifetime of writing and research on two continents. This archive will provide a rich trove of data for future historians and other scholars. Someday, a biography of Harry Benjamin—far more than the brief sketch of his work in this chapter—will illuminate the significance of his research not only for transgendered people seeking a solution to their personal difficulties, but toward a broader and more comprehensive scientific understanding of sex and gender in the twentieth century.

“Treating the gender dysphoric person was ultimately the sum total of all of Benjamin’s previous interests and knowledge. One might say his work in the field was an accident for which he was totally prepared,” Schaefer and Wheeler wrote in 1995. “The course and events of Benjamin’s professional life were destined to crown a career that would unlock the door to an area of study that would have the most profound implications for our understanding of human nature and would change the lives of countless people forevermore.” Transsexual people themselves often express a less adulatory, though still generally positive, view of Benjamin and his accomplishments. Susan Stryker calls him “a genial old paternalist, a really nice guy who cared about his clients and saw himself as doing what he could to help. Really going above and beyond the call of duty in trying to arrange surgery for people, really compassionate.” Still, Benjamin could also be “very sexist and elitist and condescending to people,” Stryker says. “He called [transwomen] his ‘girls’ and he would only work with, take under his wing, the ones he thought were really attractive.”

Nonetheless, like his predecessor, Hirschfeld, “Benjamin did a lot of good progressive political work,” Stryker says. His office was in San Francisco’s Union Square, and many of his patients lived and worked in the Tenderloin, the city’s notorious red-light district. She adds (though I have not been able to confirm this) that Benjamin also served as “clap doctor for some of the best whorehouses in town” and that he performed abortions for the city’s elite Pacific Heights crowd. “If you look at some of these early sexologists, the people who are involved in doing transsexual/transgender work also tend to be involved in abortion rights and in prostitution rights,” Stryker says. Benjamin and sexologist colleagues such as Kinsey were sexual pragmatists, Stryker says, whose attitudes can best be summarized as “people fuck, and they fuck in lots of ways—get over it. Some people dress in different ways—get over it.”

Like Hirschfeld, Benjamin refrained from judging his patients/ clients. He was aware that many dabbled in prostitution, for example, admitting in The Transsexual Phenomenon that “the unfortunate fact that a number of patients went into prostitutional activities right after their operations has turned some doctors against its acceptance as a legitimate therapy.” He quotes a urologist who told him, “I don’t want a respectable doctor’s clinic to be turned into a whorehouse.” Such a physician, Benjamin says, “may enjoy the feeling of being on the side of the angels but he scarcely has ethics or logic for support. Should a physician refuse to heal the injured right hand of a pickpocket because he may return to his profession and perhaps forge checks besides?” he asks. “Should a urologist—for argument’s sake—decline to treat sexual impotence because a cure may induce the patient to start an illicit love affair, or, if married, lead him to adultery?”

Benjamin concludes that the responsibility of the physician is to heal, not to judge the morals or behavior of his patients. “A doctor could hardly be held responsible, and should not hold himself responsible, for what a patient will do with his regained health. That is none of his business. Such an attitude could lead to endless absurdities as the above examples show.” This attitude was quite rare among physicians encountering transsexual and transgendered patients throughout the latter decades of the twentieth century, and remains rare today. Nearly every transgendered person I spoke with had experienced some painful interaction with a health care provider, most often a doctor, whose distaste for gender-variant people was hardly disguised. In Trans Liberation: Beyond Pink or Blue, the author and activist Leslie Feinberg describes a series of such encounters, one of which culminated in a physician shoving his hands down her pants and shouting, “You’re a freak!” Whatever Harry Benjamin’s flaws, he was at least cognizant of the fact that his Hippocratic oath applied to all his patients, not just the normatively gendered ones.

Benjamin died in August 1986, at the age of 101. His friend Christine Jorgensen, for whom he felt immense respect and gratitude, outlived him by only three years, dying of bladder cancer at the age of sixty-two. In the introduction to The Transsexual Phenomenon, Benjamin pays tribute to Jorgensen in words that echo the praise of his own friends and colleagues at his memorial service.Without her courage and determination, undoubtedly springing from a force deep inside her, transsexualism might still be largely 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.

In a 1953 letter to Benjamin, written soon after they met, Jorgensen explained why she had overcome her initial resistance and was beginning to speak to the media and accept offers to perform in nightclubs— in other words, to embrace her notoriety, rather than running from it. “As you know, I’ve been avoiding publicity, but this seems the wrong approach. Now I shall seek it so that ‘Christine’ will become such an average thing in the public mind that when the next ‘Christine’ comes along the sensationalism will be decreased. You know what I’m trying to do is not as great as the big medical discoverers in the past, but it will be a contribution. With God’s help and those who believe as you do, I know this will be a step into the future understanding of the human race. I wonder where there are more who join us in this struggle.”

CONVERSATION WITH ALESHIA BREVARD

Aleshia Brevard is an actress and writer. A graceful woman in her sixties, in 2001, Brevard published a memoir, The Woman I Was Not Born to Be, in which she describes her childhood in Tennessee, her pre-transition years in San Francisco, performing as Lee Shaw at the famous drag club Finocchio’s, and her post-transition life and career as an actress and a Playboy bunny in Hollywood. Brevard, who transitioned in 1962, is a member of the first generation of Americans who underwent sex-reassignment surgery, a group whose belief that one’s identity as a transsexual is left behind in the surgical suite has been increasingly challenged by a later generation.