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29 July 2010

Johns Hopkins – Part 2: 1966-1979.

Continued from Part 1.



++Psychiatrist Ira Pauly had published the first aggregation study of transsexual cases in 1965, 
"Male Psychosexual Inversion: Transsexualism. A Review of 100 Cases".  This resulted in a job offer from Johns Hopkins, but, after a pay rise, Pauly decided to stay at the University of Oregon Medical School.

It was to Johns Hopkins that underground film star Holly Woodlawn went for the operation in 1966, but she was denied it in that she had not been in the program for at least a year. She went on a shopping spree instead with the money that her boyfriend had provided for the operation.

One-year-old Bruce Reimer was brought to see Dr Money and surgically reassigned to female as Brenda in 1967, and continued annual visits for almost 10 years, until Brenda began to refuse, and started to change back to male as David.

++The same year Barbara Dayton moved to Baltimore with wife and children, and started living as female.  The Clinic declined her application based on age, appearance and numerous tattoos. Also Barbara could not afford the fee.

The most prominent patient in the Gender Identity Clinic was writer Dawn Langley Hall who had surgery in 1968, married an African-American the next year, and publically announced the birth of a daughter in 1971 (a claim that the Gender Identity Clinic said was “definitely impossible”).   ++This was also the year that Roberta White was admitted for surgery.

In 1968 the Gender Identity Clinic provided surgeon Stanley Biber with diagrams on how to do sex change surgery. Renée Richards met with John Money, but at the end was told that Johns Hopkins was not accepting any more transsexual patients at that time.

In 1969, transsexual pioneer Christine Jorgensen came to Johns Hopkins for corrective surgery.  Future showgirl Michelle Brinkle ran away to Baltimore intending to register at the Clinic, but never did, and ended up at Dr Burou’s Clinic in Casablanca instead. Psychiatrist Jon Meyer became chairman of the Gender Identity Clinic, and his predecessor, John Hoopes wrote: “The surgery, often considered outrageously excessive and meddlesome by the uninformed, must be undertaken regardless of the censure and taboos of present society”. Also in 1969, Richard Green and John Money co-edited Transsexualism and Sex Reassignment, with a preface by Reed Erickson, an introduction by Harry Benjamin, and published by Johns Hopkins University Press.

John Money conducted a follow-up study of ‘17 male and seven female patients’, and found that after surgery nine patients had improved their occupational status and none declined. “Seven male and three female patients married for the first time” and “All of the 17 are unequivocally sure they have done for themselves the right thing”.

In 1970, Dr Edgerton left for the University of Virginia, where he established a Gender Identity Clinic, and Dr Hoopes returned to Johns Hopkins to replace him as Chief of Plastic Surgery. Dr Meyer started his own study of the benefits of surgery.

In 1972 future doctor Dana Beyer, then a student, came to the Clinic but found the intake application so off-putting that she fled before seeing a doctor.

In 1974, 23-year-old future intersex-cum-HSTS activist Denise Tree (Kiira Triea) had surgery with Dr Howard Jones after years of therapy from Dr Money.

In a paper with John Hoopes, Meyer wrote: “Most of the patients continue to be emotionally and socially much the same as they were in the pre-operative phase”.

In 1975, Catholic psychiatrist Dr Paul McHugh became head of the Psychiatry department at Johns Hopkins. He later wrote that he intended from the start to put an end to sex change surgeries which he described as “the most radical therapy ever encouraged by 20th-century psychiatrists— with perhaps the exception of lobotomies”.

In 1976 Charles Annicello from the clinic testified in a New Jersey court on behalf of M.T., a trans woman who was suing for alimony. Louis Gooren, who would develop the Gender Clinic at the Vrije Universiteit in Amsterdam, studied at Johns Hopkins in 1976, as did Russell Reid who later became a consultant at Charing Cross Hospital.

The clinic was also featured as the location of a rather unusual at-knife-point FTM operation in John Walters’ film Desperate Living, 1977.

The Joneses retired from Johns Hopkins in 1978, and became professors of obstetrics and gynecology at Eastern Virginia Medical School, where they established the first in vitro fertilization program in the United States.

In 1979, (the same year that Janice Raymond published the transphobic The Transsexual Empire) psychiatrist Jon Meyers and co-author Donna Reter reporting to Paul McHugh, finished their evaluation of fifty post and pre-op patients they saw as still deeply disturbed. “To say that this type of surgery cures psychiatric disturbance is incorrect. We now have objective evidence that there is no real difference in the transsexual’s adjustment to life in terms of jobs, educational attainment, marital adjustment and social stability,” he said. He later told The New York Times, “My personal feeling is that surgery is not a proper treatment for a psychiatric disorder, and it’s clear to me that these patients have severe psychological problems that don’t go away following surgery.” He even referred directly to “one case”, probably Reed Erickson, “In which a woman required hospitalization for drug dependency and suicidal intentions after being changed to a man”.

John Hoopes also changed his mind: “Prior to the surgery, these patients were at least male or female, but after the surgery the males converted to females weren’t really females and the females converted to males weren’t really males. . . You’ve created a new breed. You’ve created something you don’t know what to do with. … I never saw a successful patient. For the most part they remained misfits”.

The Meyer study has not been supported by later studies. Its methodology has been strongly criticized, especially the vagueness of some of its scoring, and that it does not include any measure of personal satisfaction. None of the post-operatives regretted the operation (as Meyers and Reter acknowledged). However, citing the study, the hospital administration closed the program.

The Johns Hopkins program was never important in terms of numbers, in fourteen years they provided surgery to only thirty people (compare to Dr Biber who would do many more than that every year), but in that it was the first clinic it was felt as a loss when it closed.

Even so, Johns Hopkins' reputation was such that transsexuals continued to apply to the Hospital. They were seen in the Sexual Behaviors Consultation Unit at $150 a time, but no referrals for surgery were made after 1979.

John Money stayed at the PRU, even after 1986 when it was moved to smaller premises outside the Hospital.

As late as 2005, a group of Christian ministers went to Trinidad, Colorado and tried to use the Meyer study to force Marci Bowers to stop performing gender surgery.

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The Wikipedia article, "History of Intersex Surgery", should be called "Intersex Surgery at Johns Hopkins"; as it completely ignores work done elsewhere. The work  of Lennox Broster in particular is scandalously missing.

For those who like to perceive patterns in history, it is remarkable how the Johns Hopkins GIC falls between the publications of The Transsexual Phenomenon and The Transsexual Empire.

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