The Riddle of Gender

Douglas—for example, was a radical group that, like the Gay Liberation Front, stood shoulder to shoulder with other revolutionaries working to change American society and that viewed the system, and not the (transsexual or transgendered) individual, as the problem. “I have a newspaper article in my files by Angela Douglas from ‘70 or ‘71 that calls for ‘transgender liberation now’ and provides a whole political critique of the gender system,” says Susan Stryker. “She was fairly self-aware in saying ‘the things that are fucked up about me are the result of oppression, and I have a critique of the conditions that have produced me as I am.’”

Douglas was not the only transsexual or transgendered person connecting her own oppression to a broader social critique, says Stryker. “There are some interesting connections between the antiwar movement and the transgender movement,” she says. “I think it’s not coincidental that these were the height of the war years, and that there is a relationship, particularly in what male-to-female transsexual people were able to accomplish, and a larger cultural imperative to fuck with masculinity, at least from the standpoint of the left. The way that you kept from being put in a green uniform and shipped home in a body bag was you became non-normatively masculine and therefore unfit for military service. The long hair, the love beads, the paisley shirt, the bell-bottoms—there was a way that the critique of gender became part of that larger critique, and it created a space for people who were coming from a more self-identified transgender place to work within the broader cultural synergy.”

This new breed of transsexual activist rejected the attempts of doctors and researchers to define transsexuality as a form of control— well before Janice Raymond burst onto the scene. “By the mid-sixties, I think that transsexuals were using the scientific discourse as received for their own ends,” says Stryker. “They were saying, ‘Because I am a transsexual, I should be allowed to change my legal identification paperwork. Because I am a transsexual, I am going to work with the neighborhood legal defense fund, and we’re going to wage this case and change employment law. Because I am a transsexual, I should have my medical needs met; therefore the city clinic should give me hormones.’ So the classic transsexual medical discourse was being deployed for purposes of gaining civil and human rights. That started in ‘65 to ‘66 here in San Francisco.”

Rather than applying to one of the university gender clinics, with their stringent criteria for acceptance, many transsexuals began to seek out private surgeons who were willing to perform surgery on demand. The most infamous of these, John Ronald Brown, “presented himself as the champion of transsexuals,” says Joanne Meyerowitz in How Sex Changed, “but he also won a well-earned reputation as the back-alley butcher of transsexual surgery.” But more reputable doctors and surgeons also began working with transsexual clients, and it became somewhat easier for people to access the services they required—if they had the money. Others traveled overseas for surgery, effectively subverting the medical model by contracting for services with health care providers who did not share American physicians’ views of the need for an extended period of “real-life” experimentation prior to surgery. A number of transsexual memoirists have written of their surgeries with “Dr. B” in Casablanca, Morocco. Dr. Georges Borou was for many years the surgeon of choice for affluent transsexual people, such as British journalist Jan (nee James) Morris. “He was exceedingly handsome,” Morris writes in Conundrum. “He was small, dark, rather intense of feature, and was dressed as if for some kind of beach activity. He wore a dark blue open-necked shirt, sports trousers, and game shoes, and he was very bronzed. He welcomed me with a bemused smile, as though his mind were in Saint-Tropez.”

Meanwhile, John Money’s erstwhile benefactor, Reed Erickson, continued to fund research and public education on transsexualism through the Erickson Educational Foundation throughout the seventies. “What Erickson did on a small scale in Harry Benjamin’s office in the sixties they did on a much larger scale later,” says Aaron Devor. “The first three international conferences on transsexuality were all funded by the EEF.” The first symposium was held in London, in 1969; the second in Denmark, in 1971; and the third in Yugoslavia, in 1973. A fourth conference, named the Harry Benjamin Fourth International Conference on Gender Identity, in honor of Benjamin’s ninetieth birthday, was held in 1975. The EEF, says Devor, “chose the locations, invited the people, did the advertising. That synergy created a whole new field of research. He [Erickson] created a whole new discipline, as well as a support network for transsexuals themselves who would call the EEF to find out where they could find a doctor or a therapist.”

The Erickson Educational Foundation also produced numerous publications for transsexual people and their families, brochures and pamphlets that explained in everyday language what transsexualism was and offered effective strategies for treatment. “In their day, these were the only educational material that transsexual people and their families could get their hands on. They were quality publications, and have been subsequently republished and are still in circulation,” says Devor. “The EEF really created public awareness, public sympathy, even empathy for transsexuals. I give Erickson a tremendous amount of credit for bringing this issue to the attention of researchers and the public.”

The EEF financed a steady stream of lectures at medical schools, at schools of social work and law, and to police officers in training.

“They sought out people in positions of power and influence over the lives of transsexuals and tried to educate them while they were being trained,” says Devor. “The EEF made movies and then sent them around to medical schools. In collaboration with John Money, they produced definitions of transsexuality and transvestism, which they sent out to 105 dictionaries and encyclopaedias, so that when you looked for a definition [of those terms] you found the ones they had created. It was almost as though they asked themselves what they could do to make people aware of this issue on every front.” The advice columnists Abigail van Buren and Ann Landers even referred people to the EEF in their columns. When the imminent closure of the EEF was announced at the Fifth International Gender Dysphoria Symposium, held in Norfolk, Virginia, in February 1977, the assembled group of researchers, under the direction of Paul Walker, M.D., discussed the creation of a new organization to carry on its work. The proposed organization, named for Harry Benjamin, was formally approved at the Sixth International Gender Dysphoria Symposium, held in San Diego, California, in February 1979.

In March 2003, I spoke to Jude Patton, a transman who was the first “consumer advocate” on the new Harry Benjamin International Gender Dysphoria Association (HBIGDA) Board of Trustees. Patton, a psychotherapist, was a graduate student when he became involved with HBIGDA through his doctor/patient relationship with Donald Laub, M.D., a surgeon at Stanford University’s Gender Clinic and one of the first members of the board. “When the first HBIGDA conference was going to be held, I asked Don Laub, who was my surgeon, if I could attend, and I came as his guest. At that time I had also met Zelda Suplee [of the EEF] and Paul Walker through some of the early support groups that I had started,” says Patton. At the meeting in San Diego in 1979, “there was a band of outspoken heterosexual TVs, consumer voices, who were very strident, saying, ‘Why don’t you include us?’ and other things of that nature,” says Patton. “So when they actually formed HBIGDA, Doctor Laub suggested that they include a consumer advocate, and he nominated me. The vote was fifteen to fifteen.” Patton says that the votes against were not against him personally—as “nobody really knew me”—but against the idea of having a consumer voice on the board at all. “I remember that someone stood up and said, I will not serve on any committee that has a consumer on it,’” he recalls.

Laub cast the deciding vote in favor of Patton’s membership, however, and Patton was elected. Patton served on the HBIGDA board from 1979 to 1981, and found the experience somewhat overwhelming. “I was very intimidated,” he says. “I was still a grad student, and these people were big names in the field.” Still, he says, “they were polite and they listened to me.” But after his two-year term expired, the board did not appoint another consumer advocate until 1997, when Patton was once again asked to serve, together with Sheila Kirk, M.D., an MTF surgeon. “It was my understanding that the position [of consumer advocate] would always be there,” he says. “But it didn’t happen again until 1997, when Sheila Kirk and I were contacted by the board. They knew our work and trusted us. I give Richard Green, who was president at the time, credit. He said, ‘It’s time.’” Patton believes that he was recruited to serve on the board again because of “the personal relationships I had developed over the years” with board members, and also because he is “an educator. I’m not a rabble-rouser,” he says.

The first order of business for the new Harry Benjamin International Gender Dysphoria Association was the development of a treatment protocol, or “Standards of Care,” for transsexual people, one that would both protect them from unscrupulous practitioners and also continue to exert some measure of medical control over the process of sex reassignment. “HBIGDA recognized the rise of private practitioners and tried to guide their professional behavior,” writes Joanne Meyerowitz in How Sex Changed. “Under its original Standards of Care, private endocrinologists and surgeons could not offer treatment on demand. Psychologists and psychiatrists … were to recommend medical treatment, and they were to have seen their clients for several months before making such recommendations. MTFs were to live as women and FTMs were to live as men for at least a year before they could undergo surgery. If they adhered to these guidelines, private practitioners could protect their