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09 October 2012

Harry Benjamin. Part 3: transsexualism to 1966

Part 1: beginings
Part 2: rejuvenation
Part 3: transsexualism to 1966
Part 4: transsexualism since 1966
Part 5: rereading of The Transsexual Phenomenon.

Virginia Allen and her doctor husband first met Harry Benjamin at a lecture that he gave in Atlantic City in 1950. When she moved to New York two years later, she phoned him, and although he could not remember who she was, he went to lunch with her. Shortly afterwards she became his assistant, at first part time. He was in the process of moving to a smaller 'retirement' office on East 67th Street. She typed the many drafts of Prostitution and Morality. One day while rearranging his files, she asked about a small group by itself where each patient had both a male and a female name. He decided to pay more attention to them.

Benjamin, like everybody else, read about Christine Jorgensen in December 1952. He wrote to Louise Lawrence:
"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 gets home".
He wrote to Christine:
Dear Miss Jorgensen:
These lines are written to you in the interest of some of my patients and naturally also of those whose emotional problem nobody understands better than you do.
Frankly, I am worried over the effect your story and publicity may have in some instances. I had a few rather frantic phone calls and letters recently. Therefore, I would be grateful to you if you would tell me how you are handling the innumerable communications that undoubtedly came to you. Don't they all indicate hopefulness yet utter frustration ?
In my many years of practice of sexology and endocrinology, problems similar to yours have been brought to me frequently. I need not tell you how profoundly disturbed some of these people are. Naturally, they identify themselves with you. Can I tell them that you will answer their pleas with a personal note, a friendly non-committal form-letter perhaps, but—for psychological reasons—bearing your signature? That would help enormously. Or have you formulated another plan? Can I be of assistance? If so please feel free to call on me.
Most sincerely and earnestly yours,
Harry Benjamin, M.D. (Jorgensen: 190-1)
A meeting was set up at the home of Tiffany Thayer, the Fortean author. Benjamin became her endocrinologist and worked with her on the avalanche of mail that she had received from other transsexuals. Both she and Dr Christian Hamburger in Copenhagen referred patients to Benjamin. When in New York Christine would have dinner with Harry and Gretchen, and meet his other patients. In her honor he referred to transsexuals as cris-crosses (Person: 348).

Benjamin later summarized this period:
“While there was no way for me to help with any surgery or even a referral to a surgeon, some earnest professional attention to their complaints, psychological guidance, and cautious hormonal feminization went a long way toward making life a bit easier for them. In some cases, my efforts undoubtedly prevented attempts at suicide or self-mutilation - yet, by no means in all cases. These few instances of attempted self-castration by definitely non-psychotic individuals impressed me greatly. Their desperation as well as the entire clinical history with their vain search for help, often from childhood on, made me realize that the medical profession truly treated these patients as ‘stepchildren’. Educational and medical lectures and scientific publications were urgently needed. That became clear to me as I saw more and more the suffering of these tormented people. (Benjamin's Introduction to Green & Money: 3)”
In 1953 Benjamin, at the suggestion of Emil Gutheil, psychoanalyst and editor of the American Journal of Psychotherapy (AJP), arranged a symposium on transvestism and transsexualism. It was held at the New York Academy of Medicine: Benjamin read his paper, "Transsexualism and transvestism as psychosomatic and somatopsychic syndromes", and Gutheil and the others responded from their respective experiences and standpoints. This was the first time that Benjamin used the term ‘transsexual’. David Cauldwell had used the term, with one ‘s’, in a 1949 paper, and Louise Lawrence had introduced Benjamin to Cauldwell’s writings. “Whether I had ever read that article and the expression remained in my subconscious, frankly, I do not know”. The term had also been used earlier that same year in Ed Wood’s film, Glen or Glenda. In his paper, Benjamin argued that psychotherapy aimed at dissuading a transsexual is unproductive, and that the etiology is probably a combination of constitutional, psychological and hormonal influences. He identifies three types of transvestite: 1) the psychogenic transvestite 2) the intermediate type 3) the somatopsychic transsexualist. Gutheil reported that reprints of the paper were in unusually large demand, particularly by army doctors. By now Benjamin was getting as many new referrals through physicians as through other patients.

Tamara Rees like Jorgensen had surgery in Europe, arrived back in the US to media acclaim, and also became a Benjamin patient, and also received much mail which she answered by referring correspondents to Dr Benjamin.

In 1955 Frederic Worden & James Marsh published "Psychological Factors in Men Seeking Sex Transformation" in the Journal of the American Medical Association, wherein they described their five research subjects as having "an extremely shallow, immature and grossly distorted concept of what a woman is like socially, sexually, anatomically and emotionally", and dismissed their co-operation with the project as a "need for recognition", and concluded that the desire for surgery served as "an escape from ... sexual impulses". They also distorted what Benjamin had written. He replied both publicly and privately. In a letter to Kinsey he wrote: "Worden's sole interest is psychoanalytic research. He is not interested in helping any patients." Four of the five wrote to Benjamin expressing outrage at how they had been treated by Worden and Marsh.

By then Benjamin had met Virginia Prince, and helped her with “parental and marital problems”, put her on female hormones, and arranged for her to meet Christine Jorgensen. Prince came to consider him a personal friend. In 1957 C.V. Prince wrote a paper for The American Journal of Psychotherapy where she was introduced by Benjamin:  
"Dr Prince is known to me personally. I have met him in his male as well as his female role. I have had lengthy and stimulating discussions with him. He is highly educated with a fine cultural background."   
Prince presented three types of ‘males’ who may share ‘the desire to wear feminine attire’ (p82), that is homosexuals, transvestites and transsexuals. Much of that paper was recycled into Benjamin's 1966 book.

In 1960 Benjamin went to Chicago to give a legal deposition on behalf of a trans man, Tommie, who was attempting to change his birth certificate. Benjamin gave his usual explanation of the different sexes: genetic, anatomical, endocrine, psychological, social and assigned for rearing. The judge deferred to Benjamin's expertise. Benjamin wrote to Elmer Belt: "Isn't it encouraging, that occasionally we encounter an intelligent judge".

Hedy Jo Star, Patricia Morgan and Aleshia Brevard saw Benjamin in 1961, and were referred to Elmer Belt in Los Angeles for surgery, although Hedy then made other arrangements. In Aleshia's case, Benjamin even phoned her parents to explain. Ira Pauly was then at the New York Hospital, and having just seen his first transsexual patient, checked the scant literature that was then available and found Benjamin's name and address, and phoned to introduce himself. For much of that year, he attended Benjamin's Wednesday afternoon clinic.
"I never met anybody who seemed to care about his patients that way. It was almost as though they were all his family. How totally comfortable they were with him and thus with me, simply because I was somehow connected with Harry. During my previous 4 years with patients, I had always thought that it was important to achieve some professional distance from patients. Not to get too close was somehow the appropriate stance to seek vis-a-vis patients. Well, Harry showed me that was certainly not the case. He epitomized what I consider to be the ideal doctor-patient relationship. From that moment forward he was my model and I strived to achieve that level of comfort, intimacy, and caring that he so admirably demonstrated for me. (Memorial: 17)"
In 1963 Benjamin was invited by Dr Robert Hotchkiss, the urologist, to read a paper at New York's Bellevue Hospital. He also read a paper at the Society for the Scientific Study of Sex (of which he was a charter member). That year Reed Erickson became a Benjamin patient and started transition. The next year he donated money to the newly created Harry Benjamin Foundation. The money from Erickson enabled a move to a larger office at 86th and Park. Benjamin began to share his practice with gynecologist and hypnotist Leo Wollman. Benjamin also worked with sexologist Robert Masters, endocrinologist Herbert Kuppermann and psychologist Wardell Pomeroy, previously of the Kinsey Institute.

Benjamin met monthly with John Money and Richard Green in New York under the auspices of Reed Erickson’s EEF, where the idea was raised of applying the kind of surgery being done on intersex patients to transsexuals as well. Green described his first meeting:
"I was introduced to Harry Benjamin by John Money. ... From 1964 to 1966, I would see Harry’s patients in his New York office on Saturdays. For some, I wrote letters endorsing sex-change surgery in Europe. It was unavailable in the U.S. In retrospect, this may not have been a safe step at the beginning of my psychiatric career. Harry seduced me deeper into transsexualism. At our first clinical day, he introduced me to a beautiful post-operative patient. She had been operated on by George Burou in Casablanca. She allowed me to conduct a pelvic examination. I was astounded at the excellence of the surgery. The three of us went to an elegant Manhattan restaurant. I have never had a companion who caught the eye of so many admiring, lustful men. This was not because she appeared as a sex-change. She was a genuine woman stunner. I still receive her Christmas greetings. She is still beautiful. (Three Kings: 610)"
In 1964-5 meetings with the New York Health Department failed to clear the way for re-issued birth certificates, however John Money, who was agitating to open the first Gender Identity Clinic in the US at the Johns Hopkins Hospital in Baltimore, brought three postoperative patients of Benjamin to meet with his colleagues, Howard Jones and Milton Edgerton. Also in 1964  both Jan Morris and Renée Richards came for their first visits.

Morris, who would hesitate for 8 years before finally finding her own way to Dr Borou in Casblanca, describes the encounter with Benjamin in her autobiography, Conundrum, 1974:
"The first person I met who really seemed to understand something of the predicament was Dr Harry Benjamin of New York, to whose clinic in Park Avenue, wearied by the struggle, I eventually found my way. Dr Benjamin was then in his sixties, I suppose, and looked like a white gnome – white-haired, white-jacketed, white-faced. He seemed too small for his desk, and he talked with a scholarly Viennese accent, like a psychiatrist in a film. "Sit down, sit down – tell me all about yourself. You believe yourself to be a woman? Of course, I perfectly understand. Tell me something about it – take it easy, take it easy – now, tell me, tell me ..(p49-50)".
Richards, who was still in the US Navy, and also avoided surgery until 1974, later described the meeting:
"When I met Dr. Benjamin, I think that all of my nervousness and anxiety disappeared. ... I was confronted by a short man who was balding at that time, who wore very thick glasses and who wore a tong white coat and shook my hand warmly and escorted me to a chair opposite him at the same level, seeing eye to eye, to speak to me in consultation. And he was, to my view, a physician that I was looking at and he treated me with respect, as an equal, as a patient, as someone in need. And for the rest of my relationship with him, that's the way he treated me. He asked me the age-old question, "How long have you had this problem?" And I gave him the answer that all transsexual patients give, "As long as I can remember." And he folded his hands in front of him and he said, "Yes, that's right, that's what transsexual patients say. He was making his diagnosis of true transsexualism. (Memorial: 22)"
++Benjamin finally published his book Prostitution and Morality, co-written with REL Masters.  The book has a few passing references to trans prostitutes, and unlike his 1966 book, does acknowledge 'homosexual transvestites'.

++Also in 1964 Benjamin published Nature and Management of Transsexualism: With a Report on Thirty-One Operated Cases.  

By then Benjamin felt that he had enough clinical material to write a definitive book on transsexuals.

Other sexologists who started new activities in their sixties: Harold Gillies was 60 when he first operated on Michael Dillon, and 69 when he operated on Roberta Cowell; Howard Jones was 68 when he left Johns Hopkins and started a new career in in vitro fertilization at Eastern Virginia Medical School; Herbert Bower was 60 when he, with Trudy Kennedy, initiated the clinic that grew into the Monash Gender Identity Clinic. 

Both Benjamin and Prince refer to each other in their writings. It is therefore odd that Docter's biography of Prince mentions Benjamin not even once.

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