Transgender Surgery Addendum – July 2018

The full tale is still not told.   These items will be added to the full timeline, and are published here so that they will be noticed.

Netherlands, Arnheim Municipal Hospital 1959 – 

plastic surgeon S.T. Woudstra did a phalloplasty for a trans man. This was published in the Dutch Journal of Medicine resulting in letters of protest and questions in Parliament. Woudstra never did a second such surgery.

Japan. Nippon Medical School Hospital 1950-1. 

Akiko Nagai had an orchiectomy, a penectomy and breast augmentation.

Japan Tokyo - 1964. 

Gynecologist Taro Kono performed sex change operations on three trans women at a Tokyo clinic — and was arrested the following year and charged with violations of the Eugenics and Motherhood Protection Act of 1948, as  well as an  unrelated  violation of the Controlled  Substances  Act.  In 1969 he was found guilty of all charges , sentenced to two years and fined Ɏ400,000. The case attached a stigma to transsexualism and made it taboo for medical professionals for many years to provide adequate care or even information. This lasted until the late 1990s.

Billings & Urban

A history of transgender surgery that I did not consult for my transgender surgery timeline was,

• Dwight B. Billings and Thomas Urban. “The Socio-Medical Construction of Transsexualism: An Interpretation and Critique”. Social Problems, 29, 3, Feb., 1982: 266-282.

This was reprinted in In Richard Ekins & Dave King (eds), Blending Genders: Social Aspects of Cross-Dressing and Sex-Changing, Routledge 1996: 99-117, and various other places. It is much cited.

Here is the abstract:

“This article examines transexualism and its treatment by sex-reassignment surgery. Physicians have drawn upon their previous experience with hermaphrodites and the psychological benefits of elective surgery to legitimate sex-change surgery for what they view as a distinct patient population, transexuals. We demonstrate that transexualism is a socially constructed reality which only exists in and through medical practice. Furthermore, we contend that sex-change surgery reflects and extends late-capitalist logics of reification and commodification, while simultaneously reaffirming traditional male and female gender roles.”

The paper closes with:

“But rather than support contemporary movements aimed at reorganising gender and parenting roles and repudiating the either/or logic of gender development, sex-change proponents support sex-reassignment surgery. By substituting medical terminology for political discourse, the medical profession has indirectly tamed and transformed a potential wildcat strike at the gender factory”.

This was published only three years after Raymond’s The Transsexual Empire, and agrees with it that transsexuals would not exist without pushy profit-oriented doctors.  !!

Billings & Urban are not incorrect in what they write, although they twist the interpretation as indicated. They are extremely US-centric and have no interest at all in the work done by Gillies, Fogh-Andersen, Burou, Randel, Steiner or Ratnam. What facts they do have that are not in my timeline are those relating to the opposition by psychiatrists. That is another tale. I am first concentrating on the surgeons who made transgender surgery what it is.

However there are two items in their footnotes which are not mentioned anywhere else.

1) “Thomas Urban was a participant observer for three years (1978–80) in a sex-change clinic”.

But they do not say which one or otherwise elaborate. Did he leave, as did Grant Williams from the Charing Cross Clinic, because he disagreed with the program? This is an unknown.

2) Footnote 8 reads:

“Other university hospitals, such as the University of Minnesota’s, began surgical treatment at roughly the same time but avoided public disclosure. In addition, a few operations were secretly performed in the 1950s at the University of California at San Francisco. We have learned that Cook County Hospital in Chicago was performing sex-change operations as early as 1947, predating Jorgensen’s famous European surgery by five years.”

We know that Elmer Belt and his nephew Willard Goodwin (not mentioned at all in Billings & Urban) was doing such operations, the latter at the University of California at Los Angeles in the 1950s. Do they have the wrong city, or is this something lost to history?  Louise Lawrence worked with Alfred Kinsey and Harry Benjamin in San Francisco in the 1950s.   If these surgeries happened there is strange that neither Lawrence nor Benjamin knew about them.  The Langley Porter Clinic, while admitting that psychotherapy did not work, generally would not recommend surgery, although it is said that they did arrange surgery in a couple of cases.  Dr Frank Hinman, urologist, author of  “Advisability of Surgical Reversal of Sex in Female Pseudohermaphroditism”, 1951, was brought in in 1953 to save Caren Ecker after an auto-orchiectomy, which was felt to require a penectomy.


I cannot find any account of transgender surgery at Cook County Hospital in 1947. Orion Stuteville who did transgender surgery at Cook County and Northwestern University Medical School twenty years later was already a surgeon there, but in the dental school. Was it he who did the transgender surgery, or someone else?   Harry Benjamin had requested Max Thorek, a renowned surgeon in Chicago to do an operation, but, after consulting his lawyer, he declined. Again what Billings and Urban are referring to seems to be lost to history.