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02 January 2019

The Worden and Marsh project, UCLA 1954

In 1954 Frederick G Worden, psychoanalyst, and James T Marsh, clinical psychologist, both at the University of California, Los Angeles (UCLA) Medical Center, interviewed and tested five “physically normal men” (that is trans women): three of whom had already had transgender surgery, Annette Dolan, Caren Ecker and Janet Story; and two hoping for it, Carla Sawyer and Debbie Maine (all names pseudonyms).

Annette had prepared herself for surgery in 1954 by doing an auto-orchiectomy, and had sent an account to Harry Benjamin which was later published in Sexology magazine (albeit under another name). Carla provided Worden and Marsh with a 6-page letter, but they never bothered to read it. Caren had had surgery in San Francisco in 1953, where, while recovering, she gave out offprints of Harry Benjamin’s "Transsexualism and transvestism as psychosomatic and somatopsychic syndromes". She volunteered for the project to show “the true idea that I’m happy with my new life, and that for suitable subjects it is right to make these changes”. Debbie Mayne, hoping for surgery, spent a year working with Worden, waiting for surgical approval which never came – at the end Worden plain refused to approve her. She later wrote that Worden “has never recommended anything for anybody . . . he doesn’t know too much to begin with.”

At this same time, Elmer Belt, the urologist and surgeon ++and his nephew Willard Goodwin, who had been the first surgeons in the world to provide vaginoplasty for trans women as opposed to cis and intersex women, beyond a few experimental cases were persuaded to cease doing so --  Annette Dolan having been one of Belt's last patients. A committee of doctors at UCLA, including Frederick Worden, had decided against the practice.

Worden and Marsh published their paper in the Journal of the American Medical Association in April 1955. Their subjects, they wrote’ had “an extremely shallow, immature, and grossly distorted concept of what a woman is like socially, sexually, anatomically, and emotionally”. They depicted them as attention-seeking, and even held their co-operation with the study against them as a “need for recognition”. Worden and Marsh were irritated by the two subjects who wanted surgery, and criticized their refusal to acknowledge “the possibility that the wish for surgery might be symptomatic of a disorder within themselves”. They, of course, did not provide the desired recommendations for surgery.

Harry Benjamin immediately wrote to the journal to object. Worden and Marsh had “badly misunderstood or misinterpreted” his work. Four of the five interviewees wrote to Benjamin expressing outrage. Annette also wrote to the Journal and Elmer Belt as well as to Frederick Worden. “In general my words were twisted to suit their purpose.” She spoke of how she could sense the ridicule in their words.


Carla Sawyer had the misfortune to have a session with psychoanalyst Robert Stoller, then new to the field, who attempted to reverse her ‘sexual tendencies’ and antagonized her. Benjamin later helped her to obtain surgery in Mexico.

Caren Ecker later became a nurse.

Debbie Mayne (who was probably the same person as Dixie MacLane) later had surgery in Mexico with Dr Lopez Ferrer.
  • Frederick G Woden & James T Marsh. “Psychological Factors in Men Seeking Sex Transformation: A Preliminary Report”. Journal of the American Medical Association, 157, 15, April 9 1955: 1292-4, 1297-8.
  • Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Harvard University Press, 2002: 107-9, 143, 146, 155-7, 166.


A similar thing happened in 1970-2 when Harry Benjamin allowed Ethel Person and Lionel Ovesey to interview several of his trans patients.  Person and Ovesey applied a psycho-analytic interpretation.  They proposed a typology of trans persons assuming that a child's separation-individuation anxiety produced a fantasy of symbiotic fusion with the mother which the transsexual tries to resolve by surgically becoming her mother.  Papers to this effect were published 1973-85.  One trans woman who had been declared by Benjamin to be a type VI High Intensity, was rendered by Person and Ovesey as a secondary transsexual.  Again Benjamin was appalled by the printed study.  

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