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14 September 2016

Charing Cross Hospital Gender Identity Clinic. Part I: 1818-1982

The hospital was originally founded in 1818 with royal patronage as the Royal West London Infirmary, located behind Haymarket Theatre. Patient numbers forced a move to a site near the Charing Cross. Doctors were being trained from 1822, and from 1829 this was recognised by the
newly founded University of London. The hospital was renamed to Charing Cross Hospital in 1827. After a major rebuild in 1877, the hospital had doubled in size, and it was further extended in 1902. In 1926 the Royal Westminster Ophthalmic Hospital was merged in.

Pioneering surgery on intersex persons, mainly those with adreno-genital syndrome (now known as Congenital adrenal hyperplasia) was being done by Lennox Broster as early as the 1930s. In 1936 the champion shot-putter and javelin thrower, Mark Weston underwent two operations. Broster said: “Mr. Mark Weston, who was always brought up as a female, is male, and should continue life as such". A similar operation was performed on Mark’s younger brother, Harry, a few years later. In 1938, Broster was co-author of a book on the adrenal cortex and intersexuality.

Because of the wartime bombing, the hospital was in effect moved to Boxmoor, Hertfordshire in 1940.

Broster's work on the Weston brothers was reported in The News of the World, in 1943 after Harry committed suicide. This report attracted patients who would now be regarded as transsexual. However there is no evidence that such persons were accepted, and Clifford Allen, the psychiatrist who worked with him, specifically rejected surgical treatment for ‘transvestites’ (the term then in use).

Charing Cross Hospital moved back to central London in 1947, but it was decided to relocate, although it would take many years before the new building was ready.

In 1950 John Randell was appointed Physician for Psychological Medicine at Charing Cross Hospital, where he worked with Broster. By then ‘transvestites’ were being accepted. Randell wrote up 50 cases of “transvestism and trans-sexualism” for The British Medical Journal in 1959, and his MD thesis for the University of Wales, 1960, discussed 61 mtf and 16 ftm cases. This was one of the first higher degree theses in English on transsexuality.

In 1957 it was proposed to join Charing Cross with the Fulham and West London Hospitals.

Through the 1960s Randell was seeing 50 ‘transvestite’ cases a year, which rose to nearly 200 in the 1970s. By his own figures, he saw 2438 patients (1768 mtf, 670 ftm). He also spent half his time with general psychiatric patients. However he was not in favour of surgery until his patients who had had surgery abroad returned with positive evaluations. Even in the 1960s less than 10% of his patients managed to achieve surgery and only a third of the mtfs of those had vaginoplasty. However most gender surgery performed in the UK was done at Charing Cross.

1965 Lennox Broster died, aged 77.

The future Alice Purnell, a co-founder of the Beaument Society, had been attending the Charing Cross Hospital Gender Clinic under the care of Dr Randell, and in 1966 was offered surgery.  However Purnell married a second wife instead.

Randell contributed a paper: "Preoperative and Postoperative Status of Male and Female Transsexuals" to Richard Green & John Money (eds), Transsexualism and Sex Reassignment, 1969.

The First International Symposium on Gender Identity was held at the Piccadilly Hotel, London, 25-7 July 1969. It was sponsored and organized by the Erikson Foundation and the Albany Trust. Arguments arose between the team from Chelsea Women's who regarded transsexuals as a form of intersex, and the team from Charing Cross Hospital who regarded them as having a psychological disorder. The Symposium did bring together the doctors working in the field. Randell’s name was mentioned several times in the press. The program for the symposium reported the situation in Britain as follows: “The treatment of transsexuals has also been undertaken by specialising teams of psychiatrists, physicians and surgeons but there is as yet no permanent gender identity unit”.

After reading about the symposium in The Times, Mark Rees, one of the future founders of Press for Change, contacted the Albany Trust, which passed him onto Dr Randell, at first at his Harley Street Rooms for a fee, and then at the GIC on the NHS.

One of Randell’s patients was the London school teacher, Della Aleksander, who had surgery with Dr Burou in Casablanca, 1970, and who would organise pioneering gender conferences in 1974 and 1975, and co-produce a BBC2 program on transsexuals in 1974.

1970 was notably the year of Corbett v. Corbett, the divorce trial litigated by Arthur Corbett, the heir apparent to the Rowallan Baroncy, against his estranged wife of seven years, the model, April Ashley. Dr Randell appeared for the litigant and testified that that he “considered that the respondent (ie April) is properly classified as a male homosexual transsexualist”. This opinion contributed to the verdict which redefined legal intersex as intersex, chromosomal, gonadal and genital sex at birth not being concordant, and that psychological aspects not otherwise to be considered. It was ruled that Lady Corbett was not a woman for the purpose of marriage, and the re-issue of revised birth certificates for transsexuals stopped immediately.

Randell published a paper, "Indications for Sex Reassignment Surgery" in. Archives of Sexual Behavior,1971.

The new Charing Cross Hospital, now located in the site of the former Fulham Hospital was formally opened in 1973. Initially it was called Charing Cross Hospital, Fulham, but eventually the ‘Fulham’ was dropped.

In the 1970s when numbers increased, still only 15% of patients achieved surgery. By then Randell was arguing that surgery could be appropriate and that psychotherapy did not work. Even then he restricted surgery to sane, intelligent, single and passable individuals. Passable implied conforming to Randell’s old-fashioned ideas of being ‘ladylike’, that many women had abandoned by the 1970s. Until the end he continued to refer to patients, including post-operatives, by the pronouns of their birth gender, and would tell a trans women, accepted for surgery, that ‘you’ll always be a man’.
By 1971 journalist/historian Jan Morris had been accepted in the program at Charing Cross, but withdrew as they insisted that Jan and her wife be divorced.

The future singer and actress, Adèle Anderson became a patient in 1973, the year that Randell’s one and only book, Sexual Variations, came out.

The model and Bond-girl, Caroline Cossey/Tula, was a patient of Randell, and was approved for surgery in 1974. Unlike other patients, Tula found him to be ‘absolutely charming’ (perhaps because she passed so well).

Rachael Padman arrived in England in 1977 as a Cambridge physics PhD student, and was quickly accepted at the Charing Cross GIC, and put on oestrogens.

Randell wrote an article, “Transsexualism and its management”, for the Nursing Mirror, also that year.

Rachael Webb, then a lorry driver, but who would become notorious in the press in 1983 when she used a £2,000 loan, available to all council employees, to pay for her operation (others used it as a deposit for a mortgage), became a patient at the GIC in 1978.

A 1979 episode of the BBC Inside Story documentary series was “George”, directed by David Pearson, about a pre-op transsexual. There was sufficient interest that this was expanded into a ground-breaking documentary, A Change of Sex, 1980, which followed the social and medical transition of Julia Grant (George) and also provided a snapshot of the Charing Cross Hospital Gender Identity Clinic. Randell is the unnamed doctor who shocked most reviewers by his attitude.



In 1980 the News of the World (12/10/80) claimed that Randell and his surgeon, Peter Phillip, had made London the ‘sex-change capital of the world’.

1981 Bülent Ersoy, Turkish singing star, had gender surgery at Charing Cross.

1982 John Randell died of a heart attack aged 64. Ashley Robin, who had retired after a heart attack, stepped in and became head of the GIC. Russell Reid became a consultant, and Alfred Hohburger joined, at first on a honorary basis.

Rachael Padman had GIC approved surgery in October, and her Cambridge PhD thesis was approved while she was in hospital.

  • L. R. Broster, Clifford Allen, H. W. C. Vines, Jocelyn Patterson, Alan W. Greenwood, G. F. Marrian, and G. C. Butler. The Adrenal Cortex and Intersexuality. London: Chapman & Hall Ltd., 1938.
  • “Two Sisters Turn into Brothers”. The Star, 25 August 1939.
  • “Were Once Sisters: Death Brings Strange Fact to Light”. News of the World, 2 Aug 1943. Reprinted in George Ives (ed Paul Sieveking). Man Bites Man: The Scrapbook of an Edwardian Eccentric. Penguin Books, 1981: 40.
  • John B. Randell. "Transvestitism And Trans-Sexualism: A Study Of 50 Cases". The British Medical Journal. 2, 5164, 1959: 1448-1452.
  • John B. Randell. Cross Dressing and the Desire to change Sex, MD Thesis, University of Wales, 1960.
  • R. J.Minney. The Two Pillars of Charing Cross: The Story of a Famous Hospital. London: Cassell, 1967.
  • John B. Randell. "Preoperative and Postoperative Status of Male and Female Transsexuals" in Richard Green & John Money (eds), Transsexualism and Sex Reassignment, Johns Hopkins University Press, 1969.
  • Program of the First International Symposium on Gender Identity: Aims, Functions and Clinical Problems of a Gender Identity Unit. 25, 26 and 27 July 1969. PDF
  • John B. Randell. "Indications for Sex Reassignment Surgery". Archives of Sexual Behavior, 1:2, 153-161, 1971.
  • John B. Randell. Sexual Variations. London: Priory Press. 1973.
  • John B. Randell. Transsexualism and its management, Nursing Mirror, 45-47, 1977.
  • David Pearson (dir). A Change of Sex. With Julia Grant. BBC TV. 1980.
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Charing Cross (51°30′26″N 00°07′39″W) denotes the junction of the Strand, Whitehall and Cockspur Street, just south of Trafalgar Square. It was the location of the most expensive of the Eleanor Crosses erected 1291-4. The cross was destroyed by order of Parliament in 1647, and after the Restoration, an equestrian statue of the first Charles Stuart was raised on the spot, and is still standing. A replacement cross was commissioned in 1865 by the South Eastern Railway Company and is still found in the forecourt of Charing Cross Railway Station. The site of the original cross is the official centre of London, and distances to/from London are to/from Charing Cross. The fact that Charing Cross Hospital later moved to Fulham complicates the issue.

The Wikipedia article on Boxmoor does not mention that it was the wartime location of Charing Cross Hospital.

The WLMHT GIC web site says: “The West London Gender Identity Clinic at Charing Cross Hospital (CX GIC) is the largest and oldest clinic of its type, dating back to 1966.” But what happened in 1966? Lennox Broster’s work with intersex persons dates back to the 1930s, and John Randell’s with transvestites and transsexuals dates to the 1950s. On the other hand the 1969 symposium reported “there is as yet no permanent gender identity unit”.

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