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18 January 2020

Alexander Polycleitos Cawadias - part II

Continued from Part I.

A.P. Cawadias expanded his 1941 lecture into a book, Hermaphoditus: The Human Intersex, first published in 1943 despite the wartime rationing of paper. A second edition was published in 1946.

He re-iterated that everyone is at least mildly intersex, hermaphrodites being severely so. For those assigned male he recognised four intermediate types:

A) Dilettante – talkers, emotionalists using supposed female social forms 
B) Transvestist “a higher degree of male psychological intersexualism”.
C) Homosexual – again “a higher degree of male psychological intersexualism (1946 p40)” but there are other non-intersexual homosexuals such as those of ancient Greece, and those due to “excessive virility”. “Oscar Wilde was wrong to defend his practices by referring to ancient Hellas, because his homosexuality was of definitely intersexual nature, as shown by the general emotional make-up of the poet. It was thus a source of social mischief and had no link with the homosexuality of ancient Greece (p41)”.
D) Masochistic – “a very high degree of psychological intersexualization (p41)”.

For those assigned female, he concentrates on adrenal virilism (the major form that was treated at Charing Cross Hospital under Lennox Broster at that time). The intermediate forms that he recognises are:

A) Amazonian – “These are women excelling in sports and other male activities, and exhibiting qualities of leadership (p63)”.
B) “Psychological forms corresponding to those described for male feminism are frequent. Female homosexuality and female transvestism are outstanding. Striking examples of the latter form are George Sand and Christina of Sweden. Joan of Arc does not enter into this category. (p64)”

For those severely intersexual he of course recommends medical support, but with an important caveat.
“The Pragmatic Sex is that indicated by the will of the patient. It is the sex that will make him happier and confer better adaptation. … The pragmatic sex is to be accepted in cases of severe intersexualisation, in which the genetic sex is very doubtful and cannot be discovered. These individuals must have their place in the sun, and can have it only by virtue of their will to a particular sex. Otherwise they would be abandoned as a class apart of ‘undetermined sex.’ Many will object that the sex they will may not be their true, i.e., genetic sex, but in such cases the sex that brings most happiness and the best adaptation is surely the true sex.(p32)”
He accepts and admires the female intermediaries. However:
“Even if male homosexuals or male transvestists live unhappily and commit suicide when thwarted, overwhelming social considerations oblige the physician to ignore their will and thus their pragmatic sex. A male homosexual, for example, is a source of moral depravity in a group of other persons, particularly at schools. Besides being a generally depraving influence he is a source of contagion of intersexuality. He must therefore be thwarted in his activities, although more by treatment than by punishment. (p33)”
Michael Dillon, in his Self: A Study in Ethics and Endocrinology, 1946, describes Cawadias’ book as “vigorous and original” but fails to take the point for he continues to talk of true and pseudo-  hermaphroditism.

Mary Cawadias had survived, stayed in Greece and was a correspondent for Time and Life magazines during the 1944-9 Civil War. She later married a British diplomat.

Christian Hamburger, Georg K Stürup & E Dahl-Iversen, of the team that operated on Christine Jorgensen, read a paper at a meeting of Danish medical societies 13 February 1953, and then published it in the Journal of the American Medical Association later that year. They specifically quote Cawadias re the physician must “ignore their will and thus their pragmatic sex”. Hamburger et al reply:
 “It is understood in medical ethics that if a disease cannot be cured an attempt should be made to improve the stress and inconvenience of the patient in order to make his life as tolerable as possible, having, naturally, due regard to the interests of society. We are unable to agree with Cawadias”.
In 1954 Cawadias wrote to the British Medical Journal: 
“What is the predominant sex in an intersexual ? As I pointed out in my Thomas Vicary lecture many years ago, ‘with our contemporary ideas the predominant sex is that manifested by the total personality and not that indicated by special features of nuclear genes, gonads, endocrines, or even by the balance of sexual characters. Total personality is shown by the behaviour and will of the individual. Thus, in principle, an intersexual individual has the right to demand of us to perfectionate his sex according to his choice.”  ... "The application of this principle of free choice for the other class of intersexes, the transvestites, is much more difficult. These are individuals whose genital organs and gonads are distinctly male or female but who feel they belong to the opposite sex and want to live, dress, and work like members of the opposite sex. … In my opinion, these transvestites are as much hermaphrodites as those designated with this term, and, in fact, we find definite endocrine, genital, and other physical stigmata pointing to a definite intersexuality. They are the most unfortunate beings, leading lives of misery often terminating in suicide. We have to help them-but how ?”
In 1955, Georgina Turtle, then in transition, was referred to Dr Cawadias “London’s leading sexologist”. He conducted a proper examination and declared Turtle to be a hermaphrodite, prescribed oestrogen and advised a change of sexual role. In 1960 he supplied an affidavit to aid her in obtaining a revised birth certificate.

In 1959 Cawadias wrote to The Lancet
“Are we to deny to transexualists (the most tragic of all intersexes) the benefit of a change of registration which would not do any harm to anyone and would prevent for these unfortunates a life of misery and even suicide, on the basis of their nuclear chromatin ? Our legislation regarding intersexual conditions is already very deficient, and the dogma of sexual chromatin will lead to even more erroneous legal decisions. For the clinician who will guide such legal decisions, the sexual chromatin is a part; and we cannot know the whole by considering only a part. Sex is a matter of total personality -including the most important, psychological personality --and not a matter of genes, gonads, genital organs, or endocrines.”
In 1962, at the age of 78, Cawadias returned to Athens where he continued to write and give lectures. He stayed after the 1967 coup d’état that led to rule by the Military Junta. He died at age 87.

Publications by Cawadias:

  • “Physical Methods of Endocrinotherapy”. The British Medical Journal, Aug 1, 1936.
  • “The History of Endocrinology”. Proceedings of the Royal Society of Medicine, XXXIV, 303, December 4, 1940.
  • “Hermaphroditism: A Historical Approach”. British Medical Journal, 818, Dec 6, 1941. First page.
  • Hermaphoditus: The Human Intersex. William Heinemann, 1943. Second edition 1946.
  • “Change of Sex”. Letter to the British Medical Journal, April 10, 1954: 876.
  • “Sex Reversal”. Letter to the Editor of The Lancet, 14 February 1959: 369.

By Others

  • Michael Dillon. Self: A Study in Ethics and Endocrinology. William Heineman, 1946: 58-9.
  • Christian Hamburger, Georg K Stürup & E Dahl-Iversen.  “Transvestism: Hormonal, Psychiatric, and Surgical Treatment”. Journal of the American Medical Association, 151, 5, May 30, 1953: 395.
  • Georgina Somerset. A Girl Called Georgina. The Book Guild, 1992: 34, 42.
  • Katrina Karkazis. Fixing Sex: Intersex, Medical Authority, and Lived Experience. Duke University Press, 2001: 44–45.
  • “Mary Henderson: Diplomatic consort with an unusual past”.  The independent, 15 April 2004. Online.

EN.Wikipedia                   Royal College of Physicians

Cawadias was one year older than Harry Benjamin, and his book came out 22 years before The Transsexual Phenomenon. From our 21st century viewpoint his legacy is mixed. His concept of the ‘predominant’ sex and the statement that the behaviour and will of the individual trump chromosomes, gonads and body shape is very modern. And yet it is a return to the 18th century when intersex persons where allowed to choose a gender, which would then be accepted. Cawadias’ position here is very similar to Benjamin’s “Seven Kinds of Sex” published in Sexology in 1961, and then revised as the first chapter of The Transsexual Phenomenon. It is noteworthy that Cawadias is not mentioned in Benjamin’s book. Not even in passing.

The intermediate types designated Dilettante and Amazon are now quaint and dated. The social construction of gender has changed since 1943 and the behaviours mentioned are now encouraged for both genders without implications of being intersex.

Cawadias’s book was advanced for its time. It is a shame that he succumbed to the homophobic mores of the time and demanded that male homosexuals and transvestists be thwarted in their attempts to be themselves.  However the letters that he wrote to medical journals in the 1950s indicate that he had changed his mind.

The claim that transvestites (which in the 1940s included what we now call transsexuals) are a type of intersex is of course contentious. But we cannot expect Cawadias to anticipate the next 80 years of debate after he wrote.

15 January 2020

Alexander Polycleitos Cawadias / Αλεξανδρος Πολυκλειτος Καββαδιας (1884 – 1971) endocrinologist - Part 1

Cawadias was the son of the noted Greek archeologist, Panagiotis Kavvadias/ Παναγιώτης Καββαδίας (1850 – 1928). Alexander was educated locally in Athens and then at Montpellier University and at the University of Paris where he earned a baccalaureate in 1901, and then studied in Bonn and Heidelberg. From 1906-10 he was a resident physician at a Paris teaching hospital, where he gained a MD. In 1912 he was elected Chef de Clinique in the Paris Faculty.

However the Balkan states having formed the Balkan League fought successfully to complete secession from the Ottoman Empire. This was the First Balkan War 1912-13. Immediately afterwards Bulgaria went to war against Greece and Serbia to settle boundaries. This was the Second Balkan War. Dr Cawadias returned to Greece to help his country, and in particular served during the cholera epidemic in Salonika. In 1914, he married the daughter of a banker, and, on the nomination of Queen Mother Olga, he was appointed Chief of the Medical Clinic in the Evangelismos Hospital in Athens, and he became physician to the new king, her son. During the Great War, Cawadias was the liaison officer to the British Sector, and in 1918 was appointed to the Order of the British Empire (OBE).

Greece attempted to expand into Asia Minor, but was defeated in the Greco-Turkish War 1919-1922. After this chaos and the need to absorb 1.5 million refugees, there was a referendum on the monarchy, and Greece became a republic in 1924. A fervent royalist, Cawadias followed his King Geórgios II (Olga’s grandson) into exile in London two years later. He qualified as a British MD at Durham University. He found a home in the prestigious Wimpole Street, and became a British subject. He quickly established a consulting practice mainly amongst wealthy Greek expatriates. He did not follow his king back to Greece in 1935 after the right-wing coup that restored the monarchy.

Cawadias specialized in endocrinology and established a reputation in the field. He was president of the History of Medicine Society of the Royal Society of Medicine from 1937 to 1939.

The reigning paradigm re intersex persons, or hermaphrodites as they were then called, was that of Theodor Klebs (1834-1913) who in his Handbuch der Pathologischen Anatomie, 1876 codified the already accepted notion that primacy in sex determination should be the gonads: thus a person with a typical female body but also testes would be designated male and a person with a typical male body but with ovarian tissue would be designated female. Klebs distinguished true hermaphroditism (both ovarian and testicular tissue) from what he called pseudo-hermaphroditism.

Cawadias was one of the first to speak out against this paradigm. In December 1941, when the worst of the Blitz was over, he gave the Thomas Vicary lecture at the Royal College of Surgeons: Hermaphroditism: A Historical Approach.
“In all cases of ‘complete’ hermaphroditism described even to-day the testis or the ovary was rudimentary and not functioning. Bisexualism could not be accepted on such slender evidence. Was there a normal woman who did not possess in her ovarian medulla testicular rudiments, or a normal woman who did not secrete testosterone? According to Klebs's criterion all normal women should be considered true hermaphrodites. (1941 p818)” …. “The ovary and testis were not the basis of sex, but merely manifestations or results of the initial genetic sexoformic impulse, which in human beings was either male or female and never bisexual. A female was not the appendage of her ovaries, to use Virchow's phrase, but had ovaries because she was female. A male was not male because he had testes; he had testes because he was male. There was neither absolute male nor absolute female. Every male had more or less latent female features, and vice versa. Intensification of this normal intersexualism characterised the disease hermaphroditism, and all degrees were encountered. (p819)”
Cawadias’ daughter Mary had been a Red Cross nurse during the Italian Invasion of Greece in 1940, and after the Germans also invaded in 1941 she was arrested by the SS and condemned to death for assisting the Allies.

Continued in Part II
52 Wimpole St


Cawadias was first at 52 Wimpole Street, and then at 50. Number 50 was the residence 1838-46 of poet Elizabeth Barrett, lover of poet Robert Browning. Their courtship was immortalised in the play  The Barretts of Wimpole Street, 1930. It was filmed twice, 1934 and 1957, in both cases directed by Sidney Franklin. It was also remade by the BBC in 1982.

The Royal College of Physicians biography of Cawadias (which does not mention intersex even once) says “In 1914, on the nomination of Queen Olga, he had been appointed Chief of the Medical Clinic in the Evangelismos Hospital”. However her husband Geórgios I had been assassinated in 1913 so she was no longer Queen. Their son Konstantínos ruled 1913-17 but was forced out for being pro-German. His second son, Aléxandros ruled 1920-3 until death from a monkey bite. Following a referendum, Konstantínos returned but abdicated in 1922 after Greece lost a war with Turkey. His first son Geórgios II then reigned 1922-4 until a republic was proclaimed. Geórgios then spent most of his time in Britain, and with his English mistress. He divorced his wife in 1935. After the right-wing coup that year and a rigged referendum, Geórgios returned and ruled during the Metaxas dictatorship, giving his consent to the suspension of the parliament, etc.

The Wikipedia page on Theodor Klebs does not mention his work on hermaphrodites. !!

07 January 2020

Donald Purcell (1914 - 1958) chauffeur, business man

In 1938 Purcell was living in Monton Green, Eccles, Manchester (map). He was accepted at Charing Cross Hospital in London and operated on by Dr Lennox Broster. An article in the Daily Mirror headlined “Doctor Changes Sex of 24: Patients Have Married”, concentrated on Purcell who was said to be taking the name Donald, although as his sister was quoted: “Doris was always a tomboy and my brothers called her Donald. … She knew all about motors and engineering, and was never happier than when tinkering with engines. …. Pretty frocks made no appeal to her. …. She never used paint or powder, and she smoked like a man”. The press discovered a special female friend, Charlotte, and wrote her up as Donald’s intended. This was not to be.

From his start as a chauffeur, Donald became a small business man. Donald took a wife, Lilian: they were married at Shrewsbury Register Office in May 1942. In 1946 they moved to Gorton, Manchester, close to where Donald’s mother had previously kept a small shop and off-licence. They adopted a son.

In January 1958, after two years of problems with his heart, Donald collapsed at home and was taken to hospital where he died – he was 44. His body was examined, and a policeman reported his death to Mrs Purcell, and also told her that her husband was a ‘woman’ – which came as a great surprise to her.
  • ‘Doctor Changes Sex of 24: Patients Have Married’, Daily Mirror, 5 May 1938: 2.
  • ‘Drama of Girls’ Surprise Meeting in Hospital Ward’, News of the World, 8 May 1938: 7.
  • ‘Police Tell Wife: Your Husband Was a Woman’, Daily Express, 27 January 1958, p. 1.
  • Alison Oram. Her Husband was a Woman!: Women's gender-crossing in modern British popular culture. Routledge, 2007: 115-6.
  • Alison Oram. “ ‘Farewell to Frocks’ – ‘Sex Change’ in Interwar Britain: Newspaper Stories, Medical Technology and Modernity” in Kate Fisher & Sarah Toulalan (eds). Bodies, Sex and Desire from the Renaissance to the Present. Palgrave Macmillan, 2011: 102, 109-10. 
  • Clare R Tebbutt. Popular and Medical Understandings of Sex Change in 1930s Britain. PhD Thesis, University of Manchester, 2014.:  88, 128-133, 139.

02 January 2020

Marsha Naquin-Delain (1953 - 2017) publisher, community activist

Marsha was raised as Marion Greeson in Baton Rouge, Louisiana.  His mother Betty Greeson was a cop, and Marion came out to her at age 15 – although they agreed not to mention the fact to his father, a high-school football coach.  His first boyfriend was his mother’s hairstylist. 

Marsha & Rip 1972
In 1973, on a weekend trip to New Orleans Marion met Rip Naquin (1954 – 2017) on Bourbon Street. They soon moved in with each other in Baton Rouge, and Marion became Marsha Naquin-Delain.  They started two gay publications that ultimately failed.  Their third attempt was Ambush Magazine.  Originally it covered Baton Rouge and north Louisiana, until 1985 when they moved to New Orleans.  

In 1986 they acquired the building at 828 Bourbon Street.  The ground floor was the office of Ambush Magazine and Naquin and Delain lived upstairs.  They have been active in Southern Decadence, PFLAG, LGBT+ Archives of Louisiana.  They founded the carnival Krewe of Queenateenas, and participated in the Gay Easter Parade.

When New Orleans introduced same-sex domestic partnerships in 1993, Naquin and Delain were the first to be registered.   In 2013 they were married in St Patrick’s Cathedral in New York on their 40th anniversary.   

Rip died age 63 in August 2017 of liver failure.  Marsha died four months later – some say of a broken heart.

·         Frank Perez & Jeffrey Palmquist. In Exile: The History and Lore Surrounding New Orleans Gay Culture and Its Oldest Gay Bar. LL-Publications, 2012: 131-2.
·         Cathy Hughes. “Rip Naquin, a leader in New Orleans' LGBT community, dies at 63”  The Times-Picayune, Aug 10, 2017. Online
·         Frank Perez.  “Obituary: Marsha Naquin-Delain”.  Ambush Magazine, February 27, 2018.  Online


Ambush Magazine is still going.   
I did not find any statement to the effect that Marsha considered herself transgender.  Certainly she did not change her legal gender to female so that she and RIP could marry before 2013.
In the two articles by Frank Perez the pronouns referring to Marsha drift from male to female.