Ralph Greenson (1911 – 1979) UCLA psychoanalyst

Romeo Greenschpoon was raised in Brooklyn, by parents who were immigrants from Russia. His physician father, a Shakespeare enthusiast, had named his twins Romeo and Juliet, which created some ribbing. The boy changed his first name to Ralph.

Ralph did pre-med at Columbia University. There being discrimination against Jews at US medical schools, he studied medicine at the University of Bern in Switzerland, and graduated in 1934. Ralph also married a Swiss woman, Hildi, and they moved to Los Angeles for Ralph to do an internship at the Cedars of Lebanon Hospital. They anglicised their surname to Greenson in 1937.

Ralph Greenson returned to Europe to become a psychoanalyst and was analysed in Vienna by Wilhelm Stekel (a maverick in the psychoanalysis movement, who coined the term ‘paraphilia’ which was later popularized by John Money, and who distinguished transvestism from fetishism). However 12 March 1938 saw the Anschluß Österreichs, the Nazi takeover of Austria. Steckel and his wife immediately fled via Switzerland to England. Greenson returned to Los Angeles, and resumed analysis with Otto Fenichel (an orthodox Freudian, who had written about transvestites needing a fantasy of girls with penises).

Greenson enrolled in the US Army in 1942, and initially worked in a veterans' hospital in New York state, until he cracked his skull while working in a military ambulance. This exempted him from overseas service and he served as chief of the neuropsychiatric unit at the Army Air Force Convalescent Hospital in Fort Logan, Colorado, where he became known for his work with soldiers suffering post-traumatic stress. He also observed gambling among US officers, and wrote a paper on it for the psychoanalytical journal American Imago.

Back in Los Angeles as a civilian, in 1946 Greenson bought a house at 902 Franklin Street in Santa Monica from Eunice and John Murray who could no longer afford it. The Murrays divorced, and Eunice was hired by Greenson as his housekeeper, assistant and sometimes companion for his clients.
 
He was a founding member of the Los Angeles Psychoanalytic Society and was appointed to the faculty of the University of California Los Angeles (UCLA) medical school. A gifted raconteur, he became one of the best-known psychoanalysts in Los Angeles, famous for his lectures and teaching. Greenson was also a violinist and he and some friends held a weekly salon where they played chamber music. He became friendly with screenwriter and novelist Leo Rosten (1911-1997), also Jewish and from New York who was the brother-in-law of Margaret Mead. Psychoanalysis was then in vogue and Rosten recommended Greenson as an analyst to his Hollywood friends – Frank Sinatra, Tony Curtis and Vivien Leigh came to Greenson’s private practice. Greenson suffered a heart attack in 1955, and afterwards he worked from home in the afternoons: many of his better-known clients who didn’t want to be spotted entering a medical facility, preferred to see him there.

In February 1960, during the filming of the movie Let’s Make Love, co-starring Yves Montand and with a script revised by her husband Arthur Miller, Marilyn Monroe (born 1926) had a breakdown, and her New York psychiatrist, Marianne Kris, recommend that Greenson be brought in on a temporary basis. He had fifteen sessions with her 11 February to 12 March, and was appalled by the drugs that she was taking. Greenson was considered daring in accepting Monroe because of her suicide attempts. Other psychiatrists had had their careers damaged after a patient’s suicide, and Monroe was so famous. In addition Greenson was overworked. He had already had a heart attack, and had cut down on the number of his patients, but he still taught classes at UCLA, supervised psychiatrists in training, and served on the board of directors of the American Civil Liberties Union (ACLU).

In late August Monroe returned to Los Angeles from Nevada where she was filming The Misfits, again from a script by Arthur Miller, and Greenson revised her drug prescription. After the film she returned to New York, and in between dates with the newly elected John F Kennedy and Frank Sinatra, she saw her psychiatrist, Marianne Kris, forty-seven times in two months.

In January 1961 Kris had Monroe committed to a mental asylum at the New York Presbyterian Hospital. Only the dramatic intervention of her previous husband, the baseball star Joe DiMaggio, got her out. She no longer wanted to continue therapy with Kris, and wrote a long letter to Ralph Greenson. By June Monroe was living in Los Angeles and seeing Greenson as often as five times a week. It was as if her needs were insatiable. He wrote to Marianne Kris how Monroe called him at all hours, threatened suicide, and then improved, only to break down again.

“I had become a prisoner now of a form of treatment which I thought was correct for her but almost impossible for me”.

Leo Rosten wrote a 1961 novel, Captain Newman M.D, based on Greenson’s wartime experiences in Fort Logan, Colorado.

In December 1961 Greenson placed his friend and housekeeper, Eunice Murray (1902 – 1994), to be nurse and companion to Monroe. Murray had never seen a Monroe movie. Monroe was delighted to find that Murray was an excellent seamstress, as several of her clothes needed to be taken in. Monroe – who was still exploring alternate spiritualities – was fascinated to discover that Murray was a Swedenborgian. In February 1962, Murray helped Monroe look for a house, and they found an ideal one at 12305 Fifth Helena Drive, Brentwood, only just over a mile from the Greenson residence. Greenson’s sister’s husband, Mickey Rudin, a well-known Hollywood lawyer became Monroe’s agent. Greenson held analysis sessions with Monroe at his own house at the end of each day, which led to his inviting her to stay for meals and musical evenings, and she met his wife Hildi, and his grown children Joan and Daniel.

A 5-minute drive from Monroe's House to Greenson's

Hildi suffered a mild stroke in February, and Greenson needed a rest from Monroe. They left on 10 May for six weeks in Europe and Israel. Monroe had been dumped by John F. Kennedy, and was having difficulties with director George Cukor on Something’s Got to Give, and, against precedent, the Fox Studio executives ignored her birthday on 1 June (they were in panic that the filming in Rome of Cleopatra with Elizabeth Taylor was going to bankrupt them). The next day she phoned Greenson’s house and his children went round. They called Milton Wexler, psychiatrist, Greenson’s designated locum. Monroe had Murray phone Greenson in Europe, and he returned 6 June. He met with the Fox Studio executives, but to no avail. They fired her on 9 June, but by the end of the month were negotiating to get her back. She was then interviewed by Life and Cosmopolitan, and did her first photo shoot for Vogue.

At UCLA there were discussions about a new clinic, discussions that used the newly formulated expression: 'gender identity'.

Eunice Murray sometimes stayed overnight, and was doing so on the night of 4/5 August 1962. Around 3 am she suspected something to be wrong and called Greenson, who came round and broke into Monroe’s locked bedroom via the window. He found her dead from a drug overdose – this was confirmed by her physician, and the police were summoned. She was the only patient who died in Greenson’s care.

Later that year Robert Stoller, Richard Green and several UCLA psychiatrists founded the Gender Identity Research Clinic. This was the first gender clinic so named, although those at Johns Hopkins and Charing Cross had been doing pioneering work in the field without such a name. The UCLA GIRC was explicitly oriented to research, not to providing support and surgery to trans persons. While Stoller was the Director, Greenson was Senior Psychoanalytic Consultant. His son Daniel was also on the team as a Research Associate. At this point Greenson’s experience with trans persons was minimal.

The film version of Captain Newman M.D., starring Gregory Peck as the Greenson character, was released in 1963. Greenson had had his name completely removed from the credits for fear that one of his patients would sue him for the portrayal.

In 1964 Greenson presented a paper “Drugs in the Psychotherapeutic Situation,” which is generally taken to be a thinly disguised account of Marilyn Monroe being promiscuous. Also that year he interviewed a trans woman who is assumed to have been Tamara Rees (who had completed transition in 1954). Greenson diagnosed her as in flight from homosexuality. He claimed that some persons had such a dread of their own homosexuality that it undermined their sense of gender identity: if I love a man then I must be a woman. However, Tamara Rees was then on her second marriage. She and her husband adopted children and remained together until his death decades later. This same stance re flight from homosexuality was adopted by the anti-gay psychiatrist Charles Socarides in New York a few years later.

Later that year Greenson took over from Richard Green the analysis of a five-year-old boy, whose mother had brought him in after neighbors and his teacher commented on his frequent cross-dressing. Greenson and the UCLA referred to the child as ‘Lance’. He treated Lance mainly at the swimming pool at his own home, where he even taught Lance to swim. Most of the sessions were comprised of games in the water. This helped Lance to overcome his fears about being alone with a male adult. He bought Lance a Barbie doll, but restricted its use. Apparently Lance stopped cross-dressing. As Greenson saw it, he replaced Lance playing with the doll by playing with an adult male. According to Greenson, Lance had had difficulty differentiating loving an object from wanting to be the object. Initially he had referred to the doll as ‘me’.

Stoller and Greenson refined the concept of ‘gender’ that was being used at UCLA, by using the term ‘gender identity’ to refer to “one’s sense of being a member of a particular sex”.

In his 1965 public lecture, “Masculinity and Femininity Reconsidered”, Greenson had this to say: “It is not true that girls and boys are identical in behavior until the phallic or oedipal phase. For example, girls do much more playing with dolls than do boys, and boys are more prone to be ‘blanket lovers.’ This is an indication of a greater tendency to fetishism in boys. Boys who play with dolls are more apt to become transvestites." and “Deep analysis of fetishism and transvestitism in men, as well as deep analysis of neurotics, indicates that there exists in men a deep wish to be a woman. This is not just a wish for castration or a defense against castration anxiety; it is an indication of a special problem in individuation. In early development it becomes necessary to differentiate oneself from the mother. In individuals who fail or who do this only imperfectly there is apt to remain a need to become a woman. Both boys and girls go through a normal phase of envying mother. The girl has a special problem in changing her love object from mother to father. The boy has a special problem in changing the object of his identification from mother to father. This has important implications for the development of masculine or feminine traits.” (Nemiroff et al, p166)

In 1967 he was able to complete his The Technique and Practice of Psychoanalysis,which has become a classic in the field. He advocated an orthodox approach to the therapy, not such variances as he had done with Marilyn and Lance.

In 1968 Greenson proposed a developmental theory for homosexuality: “The male child, in order to attain a healthy sense of maleness, must replace the primary object of his identification, the mother, and must identify instead with the father. I believe it is the difficulties inherent in this additional step of development, from which girls are exempt, which are responsible for certain special problems in the man's gender identity, his sense of belonging to the male sex. ... The male child's ability to dis-identify will determine the success or failure of his later identification with his father.”

In 1972 Greenson gave a lecture for West German television, and surprised them by doing so in German. The English translation was entitled “A MCP Freudian Psychoanalyst Confronts Women’s Lib”. “I was first made aware of the possibility that man's envy of women was more widespread than I had anticipated by some clinical experiences that I had at the Gender Identity Research Clinic at the UCLA Neuropsychiatric Institute. In that Clinic we see patients who desire a surgical change of gender. People come there who believe they are ‘really’ a man in a woman's body or a woman in a man's body, or who simply insist they cannot live in their assigned gender and want an anatomical, surgical readjustment. Incidentally, these patients are clinically not psychotic. My theoretical training had led me to expect that, on the basis of penis envy, most of the patients would be women hoping to achieve a male habitus. To my surprise, two-thirds of the patients were men desiring to be transformed into women. The wish in men to be a woman is far more widespread than the conscious attitudes of men and women indicate, and more than the psychoanalytic literature would lead one to expect. Incidentally, transvestism, masquerading in the clothes of the opposite sex, only occurs in men, not in women.’ (Nemiroff et al, p260)

Greenson died age 68 in 1987.

The Greenson papers on Monroe and other celebrity and rich clients have been filed with the Special Collections at UCLA and will not will available to the public until 2039.

• Ralph R Greenson. “On Gambling”. American Imago, 4,2, April 1947: 61-77.
• Leo Rosten. Captain Newman, M.D. Fawcett Publications, 1961. A novel based on the wartime experiences of Rosten’s friend Ralph Greenson, and issues with empathy and post-traumatic stress.
• David Miller (dir). Captain Newman, M.D. Scr: Richard L Breen, Phoebe Ephron, Henry Ephron, based on the novel by Leo Rosten, with Gregory Peck as Josiah J Newman. US 126 mins 1963.
• Ralph Greenson, “Drugs in the Psychotherapeutic Situation,” presented at a conference on “Psychotherapeutic Drugs: Indications and Complications,” January 12, 1964, USLC Center for the Health Sciences.
• Ralph R. Greenson, “On Homosexuality and Gender Identity,” International Journal of Psycho-Analysis, 45, 1964. Analysis of Tamara Rees.
• Ralph R. Greenson. “A transvestite boy and a hypothesis”. International Journal of Psycho-Analysis, 47, 1966: 396–403.
• Ralph R Greenson. The Technique and Practice of Psychoanalysis. International Universities Press, 1967.
• Robert Stoller. Sex and Gender: On the Development of Masculinity and Femininity, Science House,1968: 144, 152-3, 161, 254, 263, 266.
• Ralph R. Greenson, "Dis-Identifying From Mother: Its Special Importance for the Boy," International Journal of Psychoanalysis, 49, 1968: 370.
• Robert J Stoller. Sex and Gender Vol II: The Transsexual Experiment. Hogarth Press and the Institute of Psycho-analysis, 1975: 41, 53, 104-5, 124, 293.
• Ralph R Greenson. Explorations in Psychoanalysis. International Universities Press, 1978.
• Janet Malcolm. Psychoanalysis: The Impossible Profession. Rowman & Littlefield, 1980: 45, 74-5.
• Kenneth Lewes. The psychoanalytic Theory of Male Homosexuality. Simon and Shuster, 1988: 192, 197-8, 204, 206.
• Robert A. Nemiroff, Alan Sugarman & Alvin Robbins (eds). On Loving, Hating and Living Well: The Public Psychoanalytic Lectures of Ralph R. Greenson. Karnac, 1992.
• Luciano Mecacci. Il caso Marilyn M. e altri disastri della psicoanalis. Giuseppi Laterza & Figli, 2000. English translation by Allan Cameron. Freudian Slips: The Casualties of Psychoanalysis from the Wolf Man to Marilyn Monroe. Vagabond Voices, 2009: Chp 1.
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Harvard University Press, 2002: 115, 126, 173.
• Pierre-Henri Castel. La métamorphose impensable: essai sur le transsexualisme et l'identité personnelle. Gallimard, 2003: 88-9, 432n17.
• Daniel Greenson. “Greenson, Ralph (1911-1979)” in Alain de Mijolla. International Dictionary of Psychoanalysis. Macmillan Reference, 2005.
• Douglas Kirsner. “‘Do as I say, not as I do’: Ralph Greenson, Anna Freud, and superrich patients”. Psychoanalytic Psychology, 24, 3, 2007: 475-486.
• J Randy Taraborrelli. The Secret Life of Marilyn Monroe. Rose Books, 2009: 158, 164, 166, 168, 180-190, 199, 201, 203, 205, 215, 217, 224-6, 228-9, 240-2.
• Riccardo Galiani. “Un cas, deux écritures, une catégorie”. Topique, 3, 108, 2009: 143-156. Online.
• Christopher Turner. “Marilyn Monroe on the couch”. The Telegraph, 23 June 2010. Online.
• Richard Green. “Robert Stoller’s Sex and Gender: 40 Years on”. Archives of Sexual Behavior, 39, 2010: 1461.
• Lois W Banner. Marilyn: The Passion and the Paradox. Bloomsbury, 2012: 164, 166, 308, 329, 332-4, 341-2, 349-350, 352, 358-9, 363-372, 375-6, 380-8, 391-407, .
• Jat Margolis & Richard Buskin. The Murder of Marilyn Monroe: Case Closed. Skyhorse Publishing, 2014: Chps 3, 16, 17, 20, 21, 24, 25. Also p1-3, 5, 32, 34, 41-4, 47, 51-2, 55, 57-9, 61, 67, 74, 76, 83, 92-3, 98, 121, 125, 153-5.
• “Dr Ralph Greenson”. Marilyn Forever, May 10, 2014. Online.

EN.Wikipedia(Ralph Greenson)      EN.Wikipedia(Death of Marilyn Monroe)      Find a Grave
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The books on Ralph Green that discuss his involvement with Marilyn Monroe don’t mention his involvement with the GIRC; those that discuss his involvement with the GIRC don’t mention his involvement with Monroe. Janet Malcolm mentions neither, nor does the article on Greenson in the International Dictionary of Psychoanalysis written by his son Daniel.

There are an amazing number of personal interconnections in the Marilyn Monroe case.  See the diagram on p33 of Mecacci's book.  For example Greenson's patient Frank Sinatra was also a lover of his patient Monroe.   Eunice Murray's former husband John Murray was the analyst of Anton Kris who was the son of Marrianne Kris, Monroe's New York psychoanalyst. 

If you google Greenson and Marilyn Monroe, you will find him accused of everything from having an affair with her, to controlling her life, to being complicit in her murder. Caveat lector.

Elmer Belt (1893 - 1980 ) urologist, pioneer sex-change surgeon.

++Original version April 2009; revised March 2019, and again February 2021.
                                                                             
Originally from Chicago, Elmer Belt moved to Los Angeles with his family at age 9. He did a bachelors, 1916, and a masters, 1917 at University of California Berkeley.  He married his high-school girlfriend in 1918. He qualified as M.D. in 1920 at the University of California Medical School in San Francisco. As his first son had been in a serious motor accident, and as he was not satisfied with the orthopedic treatment at the UCLA, he  applied for a residency in General Surgery at Peter Bent Brigham Hospital in Boston, where his son could be treated by Dr Lovett. Afterwards they returned to and lived in Los Angeles for the rest of their lives. Belt opened a private practice. 

Belt had collected the works of novelist Upton Sinclair since he was a student. In 1934 he was part of Sinclair’s campaign to become governor of California. By then he had established the Elmer Belt Urologic Group, a group practice which moved to its own building on Wilshire Blvd. in 1936; the second floor of this structure housed his ever-expanding library.

From 1939 through 1954 Belt served as the President of the State Board of Public Health, having been first appointed by California Governor Culbert Olsen and then reappointed by Governor Earl Warren for each of Warren's three terms in office. While treating Warren, Belt was able to put the case for a medical school at UCLA, which opened in 1946. He was not only instrumental in the founding of the UCLA School of Medicine, he found its first dean, and continued to support it for his whole life. Dr. Belt had privileges as a staff, attending, or consulting urologist at many hospitals around Los Angeles County and taught as Clinical Professor of Surgery (Urology) in the UCLA School of Medicine. He was acknowledged as a specialist for prostate problems.

In 1950, when he was 57, Belt was contacted by Harry Benjamin who was starting to accept transsexual patients, and was looking for competent and willing surgeons.   At some point after that Belt became the first surgeon in the US to do sex change operations on a regular basis, many on patients referred by Harry Benjamin. While he was associated with the UCLA School of Medicine, he did not perform his operations there.  They were usually done at the Good Samaritan Hospital.   He predated the team led by Poul Fogh-Andersen in Copenhagen, and he was doing vaginoplasty using skin grafts from the thigh, buttocks or back while the Fogh-Andersen team was doing only orchiectomy and penectomy. While most surgeons would not do a castration because of the mayhem laws in effect in California and most other states, Belt got around this by preserving the testicles, pushing them into the abdomen, to preserve the hormones that they produced and to avoid charges of mayhem. He regarded this as good practice. As he explained to a colleague: “It is not necessary to disturb the patient’s endocrine balance to maintain his condition as a transsexual since the faulty tissues lay within the substance of the testis in the first place.” 

Belt's nephew, Willard Elmer Goodwin (1915-98) was in 1951 the founding chair of the Division of Urology in the Department of Surgery at the UCLA School of Medicine.  Belt had trained him in the techniques of sex-change surgery, and he did several such operations at UCLA.  Belt's second son, Bruce (1926-2012) also became a urologist and practiced with his father for 20 years or so. 

Belt was also interested in doing surgery for trans men. He corresponded with Harry Benjamin about how to do this. Benjamin mentioned the flap techniques that Harold Gillies had done for Michael Dillon, but was unsure that such a procedure was worth following. Belt did have a trans man client who had had breast reduction from another Los Angeles surgeon, and as he had a cystic ovary, hysterectomy was medically justified anyway. Phalloplasty was considered, but in the end was not done.

Willard E Goodwin asked Rollin Perkins, a professor of law, about the mayhem statutes in 1954. Perkins acknowledged that there was a “want of judicial decision on the point” and advised caution given the uncertainty and the prejudice.  A committee of doctors at UCLA, including Goodwin and psychiatrist Frederick Worden, decided against the practice, and Goodwin ceased doing so.  Belt also ceased although as he never did the operations at UCLA he was not affected by the decision.   Annette Dolan, who did her own auto-orchiectomy, was one of his last patients.  

In 1956, Dixie MacLane was arrested in Los Angeles by a vindictive policeman, and although she had had her surgery in Mexico, Dr Lyman Stewart from Belt’s practice provided supportive written testimony as did Harry Benjamin.

Both Belt and Goodwin had restarted quietly. As Belt wrote to Benjamin, he considered himself a softie who found it hard to turn away such desperate patients. In 1956, he did completion surgery on Barbara Wilcox, who was one of the first trans women to receive female-hormone injections and who in 1941 had successfully petitioned the Superior Court of California to change her name and to legally become a woman. 

In 1958 there was a fire in Belt's office and most of his records were lost. 

A notable patient was Agnes who approached UCLA psychiatrist Robert Stoller also in 1958. Stoller convinced himself that she was intersex rather than transsexual, and referred her to Belt for surgery. Also that year, Belt saw an 18-year-old trans woman “who is trans-sexual and earnestly desires an operative procedure for the change of his sex”, but as he explained to Benjamin, he turned her away for being under the age of medical consent. 

Patricia Morgan, from New York came in 1961, but it took four months before a bed could be found in a hospital for Belt’s type of surgery. Then she had to wait another two months for the second phase, the vaginoplasty. And then she developed urinary problems and Belt had to do a third operation.

Aleshia Brevard, who like Annette Dolan had done an auto-orchiectomy, came in 1962, one of Belt’s last trans patients.  Hedy Jo Star had also been referred to Belt and accepted.  She was saving up for this just before Belt discontinued doing genital surgery, however a friend referred her to a doctor in Chicago who arranged surgery elsewhere.

He discontinued finally in 1962 under family pressure after he heard about the growing practice of Georges Burou. He had continual problems finding hospitals where he could do the work; he feared that a dissatisfied patient would ruin his practice by suing; he had a number of patients who did not pay their bills. There were also complaints about the way that he treated some patients. He was by then 69 and ready for retirement.

He was not part of the UCLA Gender Identity Research Clinic (GIRC) that was founded the same year, led by Robert Stoller and Richard Green, although he had more experience of transsexual patients than the entire GIRC team together.

Elmer Belt was a collector of artefacts by or about Leonardo de Vinci for over 60 years. He gave the collection to the UCLA in 1966.

Willard Goodwin was a member of the GIRC and was the urological surgeon for the operation on Beverly-Barbara in 1968, the GIRC’s first transgender operation.

Bruce Belt left medicine in 1977 and became a high-school teacher.

Elmer Belt died in 1980 at age 87.

• Elmer Belt. Surgical teaching through motion pictures, A. R. Fleming co, 1937.
• Elmer Belt. Leonardo the anatomist. Logan Clendening lectures on the history and philosophy of medicine, Ser. 4, Univ. of Kansas Press, 1955.
• Patricia Morgan as told to Paul Hoffman. The Man-maid Doll. Lyle Stuart, Inc, 1973: 51-3, 56-64, 68-9.
• Willard E Goodwin, MD.  "A Chat with Elmer Belt".  Urology, 10, 4, 1977.  
• Akleshia Brevard. The Woman I Was Not Born to Be. Temple University Press, 2001: 81-7.
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States . Harvard University Press. 363 pp 2002: 142, 146, 147-8, 160, 162-3, 164,192, 242.
• Jules Gill-Peterson. Histories of the Transgender Child. University of Minnesota Press, 2018: 137, 171-2, 244n25n26n28, 251n27.
• Victoria Steele.  Emails to Zagria, February 2021. 

LA Conservancy   Elmer Belt Papers   Vidensbanken om konsidentiten     Google Scholar     EN.Wikipedia   

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When Belt was interviewed by Goodwin in 1976, he said that after the car accident that injured his son, "I wasn’t satisfied with the orthopedic care he was getting at the University of California" and so did a residency in Boston.  I think that was 1922.  Virginia Prince's father was Charles Lowman, an orthopedic physician trained in Boston with the same Dr Lovett that Belt was taking his son to see.  As I wrote "The owner of the building where Charles Lowman had his clinic made an offer that if Lowman could establish a functioning hospital within 15 years, he would donate clear title to the building and its gardens. This was done and further expansion of the Los Angeles Orthopedic Hospital was being discussed when the 15 years had passed in 1922".   So one does wonder why Belt did not take his son there.

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, Claire Elgin and Janet Story; and two hoping for it, Carla Sawyer and Debbie Maine (all names except Claire are 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. Claire 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.

Claire Elgin later became a photographer and business woman.

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.  

Two early pioneers in Los Angeles

Annette Dolan

Annette Dolan had been told by doctors that “there was no ‘help’ for me, and I accepted this [as] gospel”.  After the news about Christine Jorgensen in 1953, she consulted with Harry Benjamin who suggested that she go abroad for castration, after which a US surgeon would be willing to complete the operation.

 However she could not afford such a trip. She decided to perform the operation herself. She read medical texts and bought the appropriate equipment.  "I learned to ligate, suture and anesthetize. I studied the surgical procedure step by step and memorized its sequence”.

She presented her doctor with the successful result and in 1954 she went for completion surgery with Elmer Belt. However she was disconcerted to see her confidential records left open on the business manager’s desk.

Annette sent an account of her self-surgery to Harry Benjamin and it was later published in Sexology magazine, under a different pseudonym.

In 1955 she participated in the Worden and Marsh project, and like other participants was angered by the way that they used her words to cast transsexuals in a negative light. She wrote to the Journal of the American Medical Association, Elmer Belt and Harry Benjamin 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.

• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Harvard University Press, 2002: 145-6, 157, 162, 166.

Tom Michaels

At age 16, in the late 1940s, Michaels, then still living as a girl, discovered the lesbian scene, and was initially elated to find other similar people, but then realized that they were not so similar. Michaels lived as a man, but then went back to living as a woman for a while.

As a man, Tom had difficulties being accepted, and for some years lived in a criminal subculture, the one place where he was accepted on his own terms.

Eventually he moved elsewhere and did a bachelor’s degree in zoology. He again reverted to living as a woman, and did a year at a medical school. In the mid-1960s he contacted Robert Stoller at UCLA and was able to start taking testosterone.

• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Harvard University Press, 2002: 143, 144, 195.

Patricia Morgan (1939 - 1986) sex worker, business woman.

Henry Peter Glavocich was born in Jersey City, and raised in Hoboken, New Jersey. His mother left his father soon after his birth because he refused to feed them. At fifteen months Henry was put in an orphanage. When his mother remarried, she took him out of the orphanage, but he did not get on with his stepfather, and stayed with aunts and uncles.

At age eleven, after a mutual undressing with a girl downstairs, the juvenile authorities put him in a boys home. Each time he ran away they put him in the home’s jail, where he was raped.

After three years he was released to live with an aunt, where he was raped by her husband. Later, living with another aunt, he tried on his female cousin’s clothes.

At fourteen he started shining shoes, first in Hoboken, and then on 42^nd St in Manhattan. He became friends with Shelley, a male prostitute. He made good tips from gay men but refused their sexual offers. At fifteen he ran away and as Pat became a male prostitute.

Six months later he started dressing as female. With some friends he went shoplifting, and then with Shelley robbed a prospective trick. Pat was sentenced to three years at Elmira Reformatory, where he met the man he loved, William Hurst. William got out first, but was back inside by the time that Pat got out.

Pat returned to male sex work. He met a transsexual for the first time, and then Shelley and another of his friends went to California and returned as women.

Pat started taking female hormones, and began living full-time as female. She learned how to have sex with a man without his realizing that she had male organs. She was saving seriously for the $5,000 plus expenses for the operation. She was arrested as a female prostitute, got through the strip search without being read, and declared herself as a ‘boy’ only in court. She was released in that the prostitution law applied only to women.

She made arrangements through Harry Benjamin, and flew to Los Angeles in 1961 for surgery with Dr Elmer Belt. While waiting for a hospital bed, she was in a car crash with a drunken john. She sued the john, a movie producer, to cover her medical bills, and they settled out of court.

After four months in Los Angeles, Pat had a penectomy and her testicles implanted in her abdomen. Two months after that she had a vaginoplasty. Afterwards she was in pain, very weak and her money had run out.

She moved in with Shelley, but was gang raped by two of Shelley’s tricks. Later they were arrested and Pat was charged with living in a house of prostitution. She served 30 days in the prison hospital. She developed urinary problems and had to have a third operation with Dr Belt.

She hustled to raise the airfare to go home. Back in New York she took up prostitution again. She had breast implants to 42DD but then reduced to 38D. She also had her nose straightened. She was booked for prostitution when she accepted a ride in the rain. Her lawyer tried to get her off on the technicality that she was still a man, not having changed her name or birth certificate. The judge ruled that she was a female anyway, and gave her a suspended sentence.

She did change her name shortly afterwards to Patricia Anne Glavocich. Patricia Morgan was her professional name. She started a business of limousines with female chauffeurs, but it lasted only a year. She also did modeling.

Returning to prostitution she tricked with many celebrities, whom she diplomatically does not name. In 1971 William Hurst escaped from prison just before he was due to released. Pat thought that he was released, but he had changed so much that she did not love him any more. He was re-arrested for bank robbery and murder.

Pat developed a friendship with an older man who put up money for her to buy a candy store, and then the building that it was in, and the one next door. She became a landlady.

++In 1973 she published her autobiography as told to Paul Hoffman.

++Apparently she died in 1986, as there is a grave in the name of Patricia Glavocich in New Arlington, New Jersey.   She was then 46.

*Not the keynote speaker, nor the sociologist, nor the artist.

• Patricia Ann Morgan.  "How I Changed My Sex".  Female Mimics, 1,3, 1963. Online.
• Patricia Morgan as told to Paul Hoffman. The Man-maid Doll. Secaucus, NJ: Lyle Stuart, Inc 123 pp 1973.

Find a Grave   

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Arrangements were made in advance, but she still had to wait four months after arrival in Los Angeles before the operation. This would exhaust most people’s savings, and anyone in a more conventional line of work would lose their job!

According to this site, the US inflation factor from 1961 to 2007 is 7.1210. Therefore Belt’s operations cost over $35,600 in modern money.

On the second prostitution trial, the judge ruled that Pat was a woman. Another legal precedent that was never used elsewhere. See also Francis Carrick.

In my article on Elmer Belt, I mentioned that it was his standard procedure to push the testicles into the abdomen. Diane Kearney replied to this: “Pat Morgan was a friend of mine and she did have the final surgery but you make it seem she was simply a half woman for her entire life with testicles in her abdomen. Not true!”. If Diane is in Pat’s book under a pseudonym, she is well disguised. If she ever ever read Pat’s book, she must have forgotten it. On page 53 Pat summarizes what Dr Belt does with the testicles. I couldn’t find the reference when I first replied to Diane.

Now, which movie producers are known to have had a car crash in Los Angeles in 1961?

What happened to ... Agnes (1939 -).

Agnes (a pseudonym) grew up the youngest of four children in a Catholic working-class family. Her machinist father died when she was eight. The mother did semi-skilled work in an aircraft plant to raise the children.

From the age of twelve Agnes took her mother's post-hysterectomy estrogen pills and feminized her body. At 17 she was living as a woman. She was tested in Portland Oregon, and found to have XY chromosomes, and neither a uterus nor the hypothesized tumor that might produce estrogen.

In 1958 she was working as a typist for an insurance company, and had a boyfriend. His insistence on intercourse and marriage led to a series of quarrels, and she disclosed her details to him. The affair continued.

She was referred to Dr Robert Stoller at the University of California at Los Angeles Medical Center, and interviewed by him, Dr Alexander Rosen, a psychologist, and Harold Garfinkel, a sociologist interested in the way sex (gender as it would later be called) works in society.

Agnes was taken to be an example of testicular feminization syndrome. She refused to meet or be classified with any other trans person or any homosexuals. She was vigorously conventional (heteronormative) in her opinions on sexual matters. Agnes refused to discuss certain topics, and as she refused to let the doctors interview her family, this led to some suspicions being raised. Stoller and his colleagues did discuss whether she had taken external estrogens, but they decided that she was conventionally feminine, as opposed to the “caricature” and “hostility” found in transvestites and transsexuals, and therefore must be genuine.

She was recommended for surgery as an intersex patient, at a time when such surgery was regularly denied to transsexuals. Surgery was done in 1959 by a team of doctors including Elmer Belt. Stoller presented his findings at the 1963 International Psychoanalytic Congress in Stockholm; Garfinkel included an extensive chapter on Agnes in his pioneering 1967 book on Ethnomethodology.

Post-operative infection of and partial closure of her vagina, weight loss that led to a reduction in breast size, and unpredictable mood changes led to problems with her boyfriend.++However she subsequently married, and was accepted as a popular and attractive young woman.

In 1966 Agnes confessed to Stoller that she had indeed taken external estrogens. This did cause Stoller to doubt his own theories. He retracted his earlier findings at the 1968 International Psychoanalytic Congress in Copenhagen.  ++As stated by Stoller: "she began stealing Stilbestrol from her mother, who was taking it on prescription following a panhysterectomy. The child then began filling the prescription on her own, telling the pharmacist that she was picking up the hormone for her mother and paying for it with money taken from her mother's purse. She did not know what the effects would be, only that this was a female substance; she had no idea how much to take, but more or less tried to follow the amounts her mother took." (Stoller 1968: 135-6)

++Then for the first time Stoller was permitted to speak with Agnes' mother.   He found that mother and child had slept encurled until the child was eight.  The father worked nights, and was rarely seen.  The mother had, as a child, worn boys' clothes and played sports with boys as an equal.   However at age 15 when her breasts developed, she put aside her male clothes and activities, and acted feminine.  She married her first serious date.   Stoller notes that this was similar to the mother of Lance, the 'boy transvestite' who had come to the Clinic a few years earlier.

• A.D Schwabe, David H. Solomon, Robert J. Stoller & John P. Burnham. “Pubertal Feminization in a Genetic Male with Testicular Atrophy and Normal Urinary Gonadotropin”. Journal of Clinical Endocrinology and Metabolism. 22, 8 Aug 1962: 839-845.
• Harold Garfinkel and Robert Stoller. “Passing and the managed achievement of sex status in an ‘intersexed’ person”. Studies in Ethnomethodology. Prentice Hall, Inc 1967: 117-185. Online at: www.intersexualite.org/passing-is.html
• Leia Kaitlyn Armitage. “Truth, Falsity, and Schemas of Presentation: A Textual Analysis of Harold Garfinkel's Story of Agnes”. The Electronic Journal of Human Sexuality. 4, April 29, 2001. www.ejhs.org/volume4/agnes.htm.
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Cambridge, Ma, London: Harvard University Press. 363 pp 2002: 159-161.

++

• Robert Stoller. "Etiological Factors in Adult Male Tarnssexualism". Sex and Gender: On the Development of Masculinity and Femininity, Science House, 1968: 133-9.
• Richard Green. “Robert Stoller’s Sex and Gender: 40 Years on”. Archives of Sexual Behavior, 39, 2010: 1461-2.

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This is a really great story. The self-appointed experts and gatekeepers are outwitted by a 19-year old girl.

"Agnes" managed to keep her real name - the female one as well as her birth name - out of the press. Once she had finished at the UCLA Medical Center she disappeared from history. She will now be 69 80.

It is sad that she did not want to meet any other transsexuals. Her journey must have been very lonely.
I was put off by the conventionality of Agnes' opinions as reported by Garfinkel, but I had to remind myself that a) it was 1959 b) she is a pioneer in telling the doctors what they want to hear, and does not know just what will work.

Stoller - unlike Money especially - had the honesty to return to his professional peers and admit that he had been wrong.

There is nothing on Agnes in Lillian Faderman & Stuart Timmons, Gay L.A.: A History of Sexual Outlaws, Power Politics, and Lipstick Lesbians, which there should have been, but then the book also has nothing on Edward Wood either.

Barbara (1913 - 1963 ) & Lauren Wilcox (1906 - ) transheterosexuality pioneers

When speaking of transgender persons the term 'heterosexual' is best used for persons who encouple with a person going in the other direction, that is an MTF with an FTM. Here is the first known such couple to attain surgery.

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Edward Richards attended Pomona College, Los Angeles in the 1930s where he shared a dorm with Arnold Lowman, the future Virginia Prince, and then worked as a salesman in Los Angeles.

In July 1941, as Barbara Ann Richards, she was featured in the press as she petitioned the Superior Court of California to change her name and to become legally a woman. Her story was that two years earlier changes to feminine had occurred spontaneously, that she was a hermaphrodite. An endocrinologist, Marcus Graham, presented her case at a medical conference, attributing the change to an hormonal imbalance resulting from a childhood illness. 

However at a hearing in October at which the judge granted the legal change, a medical report revealed that she had been taking female hormone injections.

Lorraine Richards played the role of a devoted wife, but in 1944, away from media attention, she also had a sex change and became Barbara’s husband.

They were both only-children , and married twice: first in their gender roles as assigned at birth, and again after both had transitioned. They had met Karl Bowman and Alfred Kinsey, and the latter referred them to Harry Benjamin who became their hormone prescriber.

They were friends of Louise Lawrence, the prolific networker who brought so many early transgender persons together. The newspaper accounts of Richards were inspirations to Virginia Prince. Barbara had her final surgery in 1956 from Elmer Belt.

Barbara died 1963 of a coronary

• “’Man’ Asks Legal Right to Assume Woman Status”. Los Angeles Examiner. July 3, 1941.
• Barbara Ann Richards, as told to Bart Lytton. “Nature Betrayed My Body”. Sensation. Nov 1941, 88.
• “Young Bride Won’t Leave Mate Who’s Victim of Sex Change”. Oakland Tribune. July 4, 1941
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Cambridge, Ma, London: Harvard University Press. 363 pp 2002: 39-41, 48.

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In Leah Cahan Schaefer & Connie Christine Wheeler. “Harry Benjamin's first ten cases (1938-1953): a clinical historical note”. Archives of Sexual Behavior 24:1 Feb 1995: 4-5 Barbara and Lauren are referred to as  Carol and Christian.