Alexander Polycleitos Cawadias - part II

​

Continued from Part I.

A.P. Cawadias expanded his 1941 lecture into a book, Hermaphoditus: The Human Intersex, first published in 1943 despite the wartime rationing of paper. A second edition was published in 1946.

He re-iterated that everyone is at least mildly intersex, hermaphrodites being severely so. For those assigned male he recognised four intermediate types:

A) Dilettante – talkers, emotionalists using supposed female social forms 

B) Transvestist “a higher degree of male psychological intersexualism”.

C) Homosexual – again “a higher degree of male psychological intersexualism (1946 p40)” but there are other non-intersexual homosexuals such as those of ancient Greece, and those due to “excessive virility”. “Oscar Wilde was wrong to defend his practices by referring to ancient Hellas, because his homosexuality was of definitely intersexual nature, as shown by the general emotional make-up of the poet. It was thus a source of social mischief and had no link with the homosexuality of ancient Greece (p41)”.

D) Masochistic – “a very high degree of psychological intersexualization (p41)”.

For those assigned female, he concentrates on adrenal virilism (the major form that was treated at Charing Cross Hospital under Lennox Broster at that time). The intermediate forms that he recognises are:

A) Amazonian – “These are women excelling in sports and other male activities, and exhibiting qualities of leadership (p63)”.

B) “Psychological forms corresponding to those described for male feminism are frequent. Female homosexuality and female transvestism are outstanding. Striking examples of the latter form are George Sand and Christina of Sweden. Joan of Arc does not enter into this category. (p64)”

For those severely intersexual he of course recommends medical support, but with an important caveat.

“The Pragmatic Sex is that indicated by the will of the patient. It is the sex that will make him happier and confer better adaptation. … The pragmatic sex is to be accepted in cases of severe intersexualisation, in which the genetic sex is very doubtful and cannot be discovered. These individuals must have their place in the sun, and can have it only by virtue of their will to a particular sex. Otherwise they would be abandoned as a class apart of ‘undetermined sex.’ Many will object that the sex they will may not be their true, i.e., genetic sex, but in such cases the sex that brings most happiness and the best adaptation is surely the true sex.(p32)”

He accepts and admires the female intermediaries. However:

“Even if male homosexuals or male transvestists live unhappily and commit suicide when thwarted, overwhelming social considerations oblige the physician to ignore their will and thus their pragmatic sex. A male homosexual, for example, is a source of moral depravity in a group of other persons, particularly at schools. Besides being a generally depraving influence he is a source of contagion of intersexuality. He must therefore be thwarted in his activities, although more by treatment than by punishment. (p33)”

Michael Dillon, in his Self: A Study in Ethics and Endocrinology, 1946, describes Cawadias’ book as “vigorous and original” but fails to take the point for he continues to talk of true and pseudo-  hermaphroditism.

Mary Cawadias had survived, stayed in Greece and was a correspondent for Time and Life magazines during the 1944-9 Civil War. She later married a British diplomat.

Christian Hamburger, Georg K Stürup & E Dahl-Iversen, of the team that operated on Christine Jorgensen, read a paper at a meeting of Danish medical societies 13 February 1953, and then published it in the Journal of the American Medical Association later that year. They specifically quote Cawadias re the physician must “ignore their will and thus their pragmatic sex”. Hamburger et al reply:

 “It is understood in medical ethics that if a disease cannot be cured an attempt should be made to improve the stress and inconvenience of the patient in order to make his life as tolerable as possible, having, naturally, due regard to the interests of society. We are unable to agree with Cawadias”.

In 1954 Cawadias wrote to the British Medical Journal: 

“What is the predominant sex in an intersexual ? As I pointed out in my Thomas Vicary lecture many years ago, ‘with our contemporary ideas the predominant sex is that manifested by the total personality and not that indicated by special features of nuclear genes, gonads, endocrines, or even by the balance of sexual characters. Total personality is shown by the behaviour and will of the individual. Thus, in principle, an intersexual individual has the right to demand of us to perfectionate his sex according to his choice.”  ... "The application of this principle of free choice for the other class of intersexes, the transvestites, is much more difficult. These are individuals whose genital organs and gonads are distinctly male or female but who feel they belong to the opposite sex and want to live, dress, and work like members of the opposite sex. … In my opinion, these transvestites are as much hermaphrodites as those designated with this term, and, in fact, we find definite endocrine, genital, and other physical stigmata pointing to a definite intersexuality. They are the most unfortunate beings, leading lives of misery often terminating in suicide. We have to help them-but how ?”

In 1955, Georgina Turtle, then in transition, was referred to Dr Cawadias “London’s leading sexologist”. He conducted a proper examination and declared Turtle to be a hermaphrodite, prescribed oestrogen and advised a change of sexual role. In 1960 he supplied an affidavit to aid her in obtaining a revised birth certificate.

In 1959 Cawadias wrote to The Lancet: 

“Are we to deny to transexualists (the most tragic of all intersexes) the benefit of a change of registration which would not do any harm to anyone and would prevent for these unfortunates a life of misery and even suicide, on the basis of their nuclear chromatin ? Our legislation regarding intersexual conditions is already very deficient, and the dogma of sexual chromatin will lead to even more erroneous legal decisions. For the clinician who will guide such legal decisions, the sexual chromatin is a part; and we cannot know the whole by considering only a part. Sex is a matter of total personality -including the most important, psychological personality --and not a matter of genes, gonads, genital organs, or endocrines.”

In 1962, at the age of 78, Cawadias returned to Athens where he continued to write and give lectures. He stayed after the 1967 coup d’état that led to rule by the Military Junta. He died at age 87.

Publications by Cawadias:

• “Physical Methods of Endocrinotherapy”. The British Medical Journal, Aug 1, 1936.
• “The History of Endocrinology”. Proceedings of the Royal Society of Medicine, XXXIV, 303, December 4, 1940.
• “Hermaphroditism: A Historical Approach”. British Medical Journal, 818, Dec 6, 1941. First page.
• Hermaphoditus: The Human Intersex. William Heinemann, 1943. Second edition 1946.
• “Change of Sex”. Letter to the British Medical Journal, April 10, 1954: 876.
• “Sex Reversal”. Letter to the Editor of The Lancet, 14 February 1959: 369.

By Others

• Michael Dillon. Self: A Study in Ethics and Endocrinology. William Heineman, 1946: 58-9.
• Christian Hamburger, Georg K Stürup & E Dahl-Iversen.  “Transvestism: Hormonal, Psychiatric, and Surgical Treatment”. Journal of the American Medical Association, 151, 5, May 30, 1953: 395.
• Georgina Somerset. A Girl Called Georgina. The Book Guild, 1992: 34, 42.
• Katrina Karkazis. Fixing Sex: Intersex, Medical Authority, and Lived Experience. Duke University Press, 2001: 44–45.
• “Mary Henderson: Diplomatic consort with an unusual past”.  The independent, 15 April 2004. Online.

EN.Wikipedia                   Royal College of Physicians

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Cawadias was one year older than Harry Benjamin, and his book came out 22 years before The Transsexual Phenomenon. From our 21^st century viewpoint his legacy is mixed. His concept of the ‘predominant’ sex and the statement that the behaviour and will of the individual trump chromosomes, gonads and body shape is very modern. And yet it is a return to the 18^th century when intersex persons where allowed to choose a gender, which would then be accepted. Cawadias’ position here is very similar to Benjamin’s “Seven Kinds of Sex” published in Sexology in 1961, and then revised as the first chapter of The Transsexual Phenomenon. It is noteworthy that Cawadias is not mentioned in Benjamin’s book. Not even in passing.

The intermediate types designated Dilettante and Amazon are now quaint and dated. The social construction of gender has changed since 1943 and the behaviours mentioned are now encouraged for both genders without implications of being intersex.

Cawadias’s book was advanced for its time. It is a shame that he succumbed to the homophobic mores of the time and demanded that male homosexuals and transvestists be thwarted in their attempts to be themselves.  However the letters that he wrote to medical journals in the 1950s indicate that he had changed his mind.

The claim that transvestites (which in the 1940s included what we now call transsexuals) are a type of intersex is of course contentious. But we cannot expect Cawadias to anticipate the next 80 years of debate after he wrote.

Alexander Polycleitos Cawadias / Αλεξανδρος Πολυκλειτος Καββαδιας (1884 – 1971) endocrinologist - Part 1

Cawadias was the son of the noted Greek archeologist, Panagiotis Kavvadias/ Παναγιώτης Καββαδίας (1850 – 1928). Alexander was educated locally in Athens and then at Montpellier University and at the University of Paris where he earned a baccalaureate in 1901, and then studied in Bonn and Heidelberg. From 1906-10 he was a resident physician at a Paris teaching hospital, where he gained a MD. In 1912 he was elected Chef de Clinique in the Paris Faculty.

However the Balkan states having formed the Balkan League fought successfully to complete secession from the Ottoman Empire. This was the First Balkan War 1912-13. Immediately afterwards Bulgaria went to war against Greece and Serbia to settle boundaries. This was the Second Balkan War. Dr Cawadias returned to Greece to help his country, and in particular served during the cholera epidemic in Salonika. In 1914, he married the daughter of a banker, and, on the nomination of Queen Mother Olga, he was appointed Chief of the Medical Clinic in the Evangelismos Hospital in Athens, and he became physician to the new king, her son. During the Great War, Cawadias was the liaison officer to the British Sector, and in 1918 was appointed to the Order of the British Empire (OBE).

Greece attempted to expand into Asia Minor, but was defeated in the Greco-Turkish War 1919-1922. After this chaos and the need to absorb 1.5 million refugees, there was a referendum on the monarchy, and Greece became a republic in 1924. A fervent royalist, Cawadias followed his King Geórgios II (Olga’s grandson) into exile in London two years later. He qualified as a British MD at Durham University. He found a home in the prestigious Wimpole Street, and became a British subject. He quickly established a consulting practice mainly amongst wealthy Greek expatriates. He did not follow his king back to Greece in 1935 after the right-wing coup that restored the monarchy.

Cawadias specialized in endocrinology and established a reputation in the field. He was president of the History of Medicine Society of the Royal Society of Medicine from 1937 to 1939.

The reigning paradigm re intersex persons, or hermaphrodites as they were then called, was that of Theodor Klebs (1834-1913) who in his Handbuch der Pathologischen Anatomie, 1876 codified the already accepted notion that primacy in sex determination should be the gonads: thus a person with a typical female body but also testes would be designated male and a person with a typical male body but with ovarian tissue would be designated female. Klebs distinguished true hermaphroditism (both ovarian and testicular tissue) from what he called pseudo-hermaphroditism.

Cawadias was one of the first to speak out against this paradigm. In December 1941, when the worst of the Blitz was over, he gave the Thomas Vicary lecture at the Royal College of Surgeons: Hermaphroditism: A Historical Approach.

“In all cases of ‘complete’ hermaphroditism described even to-day the testis or the ovary was rudimentary and not functioning. Bisexualism could not be accepted on such slender evidence. Was there a normal woman who did not possess in her ovarian medulla testicular rudiments, or a normal woman who did not secrete testosterone? According to Klebs's criterion all normal women should be considered true hermaphrodites. (1941 p818)” …. “The ovary and testis were not the basis of sex, but merely manifestations or results of the initial genetic sexoformic impulse, which in human beings was either male or female and never bisexual. A female was not the appendage of her ovaries, to use Virchow's phrase, but had ovaries because she was female. A male was not male because he had testes; he had testes because he was male. There was neither absolute male nor absolute female. Every male had more or less latent female features, and vice versa. Intensification of this normal intersexualism characterised the disease hermaphroditism, and all degrees were encountered. (p819)”

Cawadias’ daughter Mary had been a Red Cross nurse during the Italian Invasion of Greece in 1940, and after the Germans also invaded in 1941 she was arrested by the SS and condemned to death for assisting the Allies.

Continued in Part II

52 Wimpole St

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Cawadias was first at 52 Wimpole Street, and then at 50. Number 50 was the residence 1838-46 of poet Elizabeth Barrett, lover of poet Robert Browning. Their courtship was immortalised in the play  The Barretts of Wimpole Street, 1930. It was filmed twice, 1934 and 1957, in both cases directed by Sidney Franklin. It was also remade by the BBC in 1982.

The Royal College of Physicians biography of Cawadias (which does not mention intersex even once) says “In 1914, on the nomination of Queen Olga, he had been appointed Chief of the Medical Clinic in the Evangelismos Hospital”. However her husband Geórgios I had been assassinated in 1913 so she was no longer Queen. Their son Konstantínos ruled 1913-17 but was forced out for being pro-German. His second son, Aléxandros ruled 1920-3 until death from a monkey bite. Following a referendum, Konstantínos returned but abdicated in 1922 after Greece lost a war with Turkey. His first son Geórgios II then reigned 1922-4 until a republic was proclaimed. Geórgios then spent most of his time in Britain, and with his English mistress. He divorced his wife in 1935. After the right-wing coup that year and a rigged referendum, Geórgios returned and ruled during the Metaxas dictatorship, giving his consent to the suspension of the parliament, etc.

The Wikipedia page on Theodor Klebs does not mention his work on hermaphrodites. !!

Harry Benjamin. Part 4: transsexualism since 1966

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

Harry Benjamin's The Transsexual Phenomenon, came out in 1966, with an appendix and bibliography by Richard Green. Much of the early two chapters on transvestites reflect the writings of Virginia Prince. Benjamin proposed a 6-point scale inspired by Kinsey's sexual-orientation scale, with the caveat that the types overlapped and blurred. He labeled the six types: Transvestite (Pseudo) Transvestite (Fetishistic), Transvestite (True), Transsexual (Nonsurgical), Transsexual (Moderate intensity),Transsexual (High intensity). In chapter 8, he summarized his work in the field:

"By the end of 1964, a total of 249 male transvestites were observed in my offices, either in New York or in San Francisco. Of these, 152 were diagnosed as transsexuals. This figure, however, may actually be higher as some transvestites do not reveal their true intentions during the first few interviews. In some others, an apparent transvestism may gradually seem to progress into transsexualism with or (more likely) without any treatment and patients originally diagnosed as transvestites (of the II or III type in the S.O.S.) are actually transsexuals (V or VI on the S.O.S.). A few of them are among the 51 cases operated upon.

These patients were, in the earlier years, mostly operated upon in Denmark, Holland, or Sweden, and a few in Mexico. Then, Dr. Elmer Belt in California performed a series of such operations. In approximately half of them I could observe the results. Dr. Belt discontinued this type of surgery a few years ago, largely for personal reasons. During the last three or four years, most conversion operations among patients I know were done in Casablanca, Morocco, by a French surgeon, Dr. Georges Burou. Reports have reached me of operations being done occasionally, rather secretly, in the United States, rather freely in Japan, occasionally in Mexico,and a few in Italy. (p146)"

Also in 1966, Benjamin referred Phyllis Wilson who was the subject of the first sex-change operation by Howard Jones at the Johns Hopkins Hospital in Baltimore. He also witnessed an operation by Jones. John Money said:

"Without the evidence of Harry Benjamin's pioneering success in the hormonal and the surgical sex reassignment of transsexuals, there would have been no program set up for the treatment and rehabilitation of transsexuals at Johns Hopkins ... The Johns Hopkins transsexual program was a source of immense satisfaction to Harry Benjamin, for it vindicated and authenticated his otherwise lonely advocacy of a group of patients generally despised and ridiculed by the medical establishment. Conversely, the public repudiation of this program by medical moralists who were not members of the gender-identity team was to him a source of immense sorrow. I knew about that sorrow from my periodic phone calls and occasional visits with Harry Benjamin. (Memorial: 16)"

In 1967 Benjamin gave brief talks at Stanford University, at Palo Alto Medical Clinic, and met with the new transsexual counseling group organized by the San Francisco Health Department, where his ex-patient Wendy Kohler was active. Later that year he spoke at the Cook County Hospital in Chicago, and witnessed another operation there, and wrote an introduction for Christine Jorgensen’s autobiography. The Harry Benjamin Foundation presented eight separate papers at its first meeting at the prestigious New York Academy of Sciences in 1967, mainly considering etiology based on pre and post examinations of Benjamin's patients.

In 1968 Benjamin and Reed Erickson were in disagreement, mainly over money and who was to decide what, and after that year there was no more funding, and Benjamin had to vacate the large office.

Wendy Carlos became the world's best-selling electronic musician and was also in transition with Benjamin, as was Lynn Conway, the informatics engineer. In 1969 Charles L.Ihlenfeld arranged to cover Benjamin's New York practice while he was in San Francisco for the summer, and stayed for 7 years.

In 1969 Benjamin wrote an introduction for Richard Green and John Money's Transsexualism and Sex Reassignment in which he summarized his work on transsexualism to that date. He also met Suzan Cooke and referred her to the Palo Alto Clinic.

In 1970 Rupert Raj started transition with a prescription from Charles Ihlenfeld. Diane Kearny was referred by Benjamin to Roberto Granato for surgery.

In the early 1970s, Benjamin befriended the psychoanalyst Ethel Person and gave her access to his patients. He asked her to write about him after his death. She interviewed him over several months. She also recruited a sample of his patients for two papers that she wrote with Lionel Ovesey that came to conventional psychoanalytic conclusions that transsexualism derived from separation anxiety.

Benjamin was a friend of the writer David/Gail Wilde and offered to talk to his girlfriend Joan Bennet about David's crossdressing.

Benjamin finally did retire on his 90^th birthday in 1975, and Ihlenfeld took over the practice for a short while. The New York Times commented that Benjamin: "must be one of the last New Yorkers who receives visitors to his home attired in a silk smoking jacket".

++The practice passed to Eugene/Jeanne Hoff, who fired the existing staff.  She was starting her own transtion.   Her most noted patient was the punk musician, Jane County.   By 1980 there were very few patients and the practice was discontinued. 

The fourth International Symposium on Gender Identity, which was held that year at Stanford University Medical Center, was the first to use Benjamin's name, and with his blessing. At the 5^th Symposium at Norfolk, Virginia, the demise of the Erickson Educational Foundation was announced and it was decided to create a new body named after Harry Benjamin. Two years later, in San Diego, the Harry Benjamin International Gender Dysphoria Association (HBIGDA) was formally inaugurated.

Connie wheeler and Leah Schaefer interviewed Benjamin in 1979 about the history of the SSSS, he took to them and trusted them with his files. They read all the 1500 or so files, and started meeting regularly with him to discuss what they found.

Harry turned 100 in 1985. He told people that the first thing he was going to do when he awoke on the morning of his 100th birthday was to look in the mirror: "Because I've never seen a 100-year-old man before!"

He died at 101, and was survived by Gretchen. They never had children. His younger brother, Walter, and sister, Edith, also lived into their nineties, and also had no children. Their mother Bertha had lived to 97. Altogether Benjamin had 1560 trans patients.

In 1994 Tom Reucher co-founded the Association du Syndrome de Benjamin, in homage.

In 2006, HBIGDA changed its name to World Professional Association for Transgender Health (WPATH).

From 2005, Charlotte Goiar and Diane Kearny created the Harry Benjamin Syndrome movement that attempted to change Benjamin's legacy into an ideology of separation and intolerance that is quite alien to Benjamin's approach. In 2010 Rose White vanity published a book, Harry Benjamin Syndrome Review, that purported to follow Benjamin's work, but instead was obsessed with supposed dangers of oral sex, and claims that the practical test for HBS is an enthusiasm for shopping.

In 2011, the Harry Benjamin Resource Centre Europe was announced with a mainly Norwegian direction. It would seem to be an alternate to WPATH that intends to be much like what HBIGDA was before.

*++There is a different Harry Benjamin who wrote Better Sight without Glasses, 1929 and other books.   Some sites (Gender Trender, TS Roadmap and NO.Wikipedia) have confused the works of the two Harry Benjamins. 
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So how high were Benjamin's fees? This never seems to be discussed. Leah Cahan Schaefer & Connie Christine Wheeler in their article on Benjamin's first 10 cases almost boast: "Socioeconomic levels were exclusively middle class, with 3 from upper-class backgrounds". When you read the biographies of less well-off New York area trans people, Benjamin is rarely mentioned. That is the Warhol trans women, the Stonewall participants, the Paris is Burning voguers. Tri-Ess members like David Wilde could afford to be a friend of Harry Benjamin, but not Candy Darling, Elizabeth Coffey, Rachel Harlow, Dorian Corey, Sylvia Rivera, Ajita Wilson, Anjie Xtravaganza etc. Some went to Leo Wollman instead, and others who couldn't afford Wollman's fees went to Jimmy Treetop for hormones. However Phyllis Wilson, Patricia Morgan and Suzan Cooke apparently had little money when they approached Benjamin. I assume that he sometimes waived or reduced his fees.

Virginia Prince, one of the many friends of Benjamin, lived to be 96. Did he the gerontotherapist aid her in this?

There are three biographies of Magus Hirschfeld (by Charlotte Wolff, Ralf Dose and Elena Mancini), an autobiography and three biographies of Havelock Ellis (by Phyllis Grosskurth, Chris Nottingham, Arthur Calder-Marshall, John Stewart). Why is there no book length biography of Harry Benjamin?

Given Benjamin's antipathy to psychoanalysis, it is noteworthy that he developed a friendship with Ethel Person, gave her access to his patients and asked her to write a short biography of himself. This is the same Person who with Lionel Ovesey wrote two papers in 1974 proposing the term Primary Transsexuals for non-sissy asexuals, and Secondary Transsexual for those with homosexual or transvestic experience. Person and Ovesey claim that "in male transsexualism, the child resorts to a reparative fantasy of symbiotic fusion with the mother to counter separation anxiety. In this way, mother and child become one and the anxiety is allayed, but the cost is an ambiguous core gender identity. (The Sexual Century:111).
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• Harry Benjamin & Albert Ellis. "Prostitution Re-assessed". International Journal of Sexology, 5, 1952: 41-42.
  
• Harry Benjamin. "Transsexualism and transvestism as psychosomatic and somatopsychic syndromes". American Journal of Psychotherapy 05/1954; 8(2):219-30.
• Frederic G. Worden & James T. Marsh. "Psychological Factors in Men Seeking Sex Transformation: a Preliminary Report". Journal of the American Medical Association, 157, 15, 1955: 1292-8. Abstract.
• C.V. Prince, with a preamble by Harry Benjamin. “Homosexuality, Transvestism and Transsexuality: Reflections on Their Etiology and Differentiations”. The American Journal of Psychotherapy, 11, 1957: 80-5. Reprinted in Richard Ekins & Dave King (eds) Virginia Prince: Pioneer of Transgendering. The Haworth Medical Press, 2005: 17-20 and the International Journal of Transgenderism, 8,4, 2005: 17-20. 
• Harry Benjamin. In Time--We Must Accept. Los Angeles: Mattachine Review, 1957.
• Harry Benjamin. "Nature and Management of Transexualism, with a Report on 31 Operated Cases", Western Journal of Surgery, Obstetrics and Gynecology, 72, 1964: 105-11.
• Harry Benjamin & Robert E. L. Masters. Prostitution and morality: a definitive report on the prostitute in contemporary society and an analysis of the causes and effects of the suppression of prostitution. Julian Press, 1964. 
• Harry Benjamin. Nature and Management of Transsexualism: With a Report on Thirty-One Operated Cases. Seattle, Wash.?: s.n, 1964.
• Harry Benjamin. The Transsexual Phenomenon. New York: Julian Press, 1966. New York: Warner Books Edition 1977, with a bibliography and appendix by Richard Green. Online at: www2.hu-berlin.de/sexology/ECR6/benjamin and at www.mut23.de/texte/Harry%20Benjamin%20-%20The%20Transsexual%20Phenomenon.pdf. Page references are to the 1977 Warner edition.
• Christine Jorgensen with Lois Kibbee. A Personal Autobiography. With an Introduction by Harry Benjamin. New York: Paul S. Eriksson, 1967, New York: Bantam Books (pb) 1968.
• Harry Benjamin. "Introduction". Richard Green & John Money (ed). Transsexualism and Sex-Reassignment. Baltimore: The Johns Hopkins Press,. 1969.
• Harry Benjamin. Reminiscences. 12th Annual Conference of the Society for the Scientific Study of Sex, November 1st, 1969. www2.hu-berlin.de/sexology/GESUND/ARCHIV/REMINI.HTM.
• Jan Morris. Conundrum. London: Faber, 1973: 49-50.
• Charles L. Ihlenfeld. "Dedication to Dr Harry Benjamin at the Fourth International Conference on Gender Identity". Archives of Sexual Behavior, 7,4,1978.
• Erwin J. Haeberle interviews Harry Benjamin. “The Transatlantic Commuter”. Sexualmedizin, 14, Jan 1985. Online at: www2.hu-berlin.de/sexology/GESUND/ARCHIV/TRANS_B5.HTM.
• “Harry Benjamin (1885-1986)”. Archive for Sexology. www2.hu-berlin.de/sexology/GESUND/ARCHIV/COLLBEN.HTM.
• Charlotte Wolff. Magnus Hirschfeld: A Portrait Of A Pioneer In Sexology Quartet Books. 1986: 126, 245, 259, 277, 279, 284, 365-8.
• Connie Christine Wheeler & Leah Cahan Schaefer. "Historical overview of Harry Benjamin's first 1500 cases." Harry Benjamin International Gender Dysphoria Association, Tenth International Symposium on Gender Dysphoria, Amsterdam, The Netherlands, 1987.
• “Memorial for Harry Benjamin”. Archives of Sexual Behavior, 17, 1, 1988.
• 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. Online at www.helen-hill.com/pdf/hbfirst10cases.pdf.
• Friedemann Pfaefflin. "Sex Reassignment, Harry Benjamin, and some European Roots ". The International Journal of Transgenderism, 1,2, Oct-Dec 1997. www.wpath.org/journal/www.iiav.nl/ezines/web/IJT/97-03/numbers/symposion/ijtc0202.htm.
• Ethel Spector Person. “Harry Benjamin and the Birth of a Shared Cultural Fantasy”. In The Sexual Century. Yale University Press, 1999: 347-366.
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Cambridge, Ma, London: Harvard University Press, 2002: 30, 45-8, 51, 70, 98, 102-4, 106, 107, 108-9, 112, 113, 117-8, 120, 121, 123, 124, 133-4, 153, 154-5, 156, 165, 175-6, 189, 211, 214-7, 219, 222, 223, 225, 241-2, 256, 279-280, 297n100.
• Richard Green. "The Three Kings: Harry Benjamin, John Money, Robert Stoller". Archives of Sexual Behavior, 38, 2008: 610-613. 

 GLBTQ    DE.WIKIPEDIA    

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 67^th 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 86^th 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.
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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.

Harry Benjamin: part 2: rejuvenation.

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

Harry Benjamin became intrigued by the burgeoning new field of endocrinology and joined the New York Neurological Institute. In 1920 there was enormous publicity about Sergei Voronoff of the Collège de France who rejuvenated old men by transplanting monkey glands. Benjamin thought to meet with Voronoff, and in 1921 had the opportunity of accompanying a female patient, all expenses paid, to Vienna. There he discussed the idea with Max Herz, the appropriately-named heart specialist in Vienna, who thought that Eugen Steinach of the Vienna Vivarium was the real pioneer in the field.

Steinach proposed that ligation of the vas deferens, while causing atrophy of spermatogenic tissue, would produce additional testosterone. This vasoligation, unlike the similar vasectomy, was done on one testicle only, and most patients reported increased vigour and sexual power. He also apparently did ‘sex changes’ on guinea pigs with castrations and gland transplants. Benjamin met with Steinach and was duly impressed. Also in 1921, Benjamin returned to Berlin for the International Conference for Sexual Reform on a Sexological Basis, and again met its organizer, Magnus Hirschfeld, and also his assistants and collaborators, one of whom, Arthur Kronfeld briefly psychoanalyzed him. Benjamin became Steinach’s US disciple.

Benjamin delivered a lecture on Steinach and his work at the New York Academy of Medicine in late 1921, and screened the Steinach film in 1923. In 1922 he  published two articles in medical journals. Benjamin performed over 500 Steinach operations in new York (unlike Steinach who never did the surgery himself), but many US doctors, especially Morris Fishbein at the Journal of the American Medical Association (JAMA) violently opposed the operation as quackery.

Benjamin had many rich, powerful and famous patients, and himself became rich and a celebrity. He had a twelve-room suite of offices at 728 Park Avenue at 71st Street, (Google street view) and he lived in a deluxe duplex apartment with a sweeping marble staircase. He had servants and a chauffeur.

Along with Steinach, Benjamin pioneered an equivalent operation for women, diathermy, applied to one ovary, supplemented by x-ray treatment of the area. The prolific and celebrated novelist, Gertrude Atherton, then in her sixties, credited Benjamin’s treatment in overcoming writer’s block. She wrote the experience into a new novel, Black Oxen, 1923,with a renowned scientist-doctor who was a composite of Steinach and Benjamin. The novel was filmed the same year.

Harry married in 1925.  Six months later Harry’s mother, Bertha, came from Germany to live with them after Harry's father died. (Person:359)

Atherton continued as a devoted patron, and introduced Benjamin to San Francisco society. This led to his summertime practice in San Francisco that he continued for 37 years. Until Atherton died in 1948, his first dinner in San Francisco was always with her. Benjamin also visited Europe nearly every summer during the inter-war period.

Steinach arranged for Benjamin to meet Sigmund Freud. They both had had the Steinach operation. Benjamin mentioned his analysis with Kronfeld, but Freud regarded him as a ‘very bad character’. Benjamin made the joke that disharmony of the emotions may well be caused by dishormony of the endocrines. He also revealed to Freud that he had impotence problems with his wife. Freud leapt to the conclusion that Benjamin was a latent homosexual. As he regarded himself as a ladies’ man this annoyed Benjamin, and was the start of his deploring psychoanalysis as unscientific.

Carla Van Crist, who was one of Hirschfeld's patients, later claimed that she had visited Benjamin in his New York office and been advised to go to Berlin, but Benjamin did not recall this.

Benjamin gave papers again at a Hirschfeld-arranged conference, and at two conferences, the first in 1926, arranged by Hirschfeld’s opponent, Albert Moll on geriatric and potency problems. One of the latter conferences was in London, and Benjamin established a friendship with Norman Haire.

In 1929 Benjamin had dinner at the Algonquin Hotel with Ben Lindsey, judge and author of The Companionate Marriage, the night before Lindsay attended service at the Cathedral of St John the Divine where he was denounced and calumnied, and arrested for disturbing a church service.

Benjamin, Hirschfeld, Thorek - Chicago 1930

In 1930 Harry and Gretchen were largely responsible for arranging Magnus Hirschfeld’s visit to the US. In New York he stayed at their home and gave 'private lectures' in Benjamin's office. Benjamin continued with him to Chicago where Max Thorek, also a Berlin emigrant, was the host. In 1933 Benjamin attempted, unsuccessfully, to organize a congress of the World League for Sexual Reform in Chicago.

Benjamin was one of the few doctors to speak up in favor of prostitutes in this period. He also used his good relationships with prostitutes to arrange therapy for inhibited young men who could not otherwise function. This was many years before Masters and Johnson contemplated doing the same thing.

Benjamin’s private practice with wealthy patients continued paying very well until the late 1930s. Benjamin was also the consulting endocrinologist at City College in New York. However new physicians were also offering the same services, and, ironically, Benjamin had arranged financing from his wealthy patients for Casimir Funk, the Polish biochemist, then in Paris, who first isolated androgen from human urine. Benjamin was one of the first to inject himself with the extract. From then androgen treatments would replace the Steinach operation. In addition psychoanalysis was becoming the fashionable alternate treatment.

In 1937 Benjamin visited Havelock Ellis at home in London, only two years before Ellis died.

One of Benjamin’s patients was Otto Spengler, who had been featured as an example of a transvestite in a 1913 paper by Bernard Talmey. However only in 1938, while treating him for arthritis, did Benjamin realize that he was a transvestite. At Spengler’s request he prescribed the new German drug Progynon and x-ray sterilization of the testicles.

Vienna, March 1938

Benjamin was in Vienna on 12 March 1938 when German troops arrived to enforce the Anschluss. Steinach and his wife happened to be in Switzerland at that date, and wisely chose not to return home.

The gynecologist and hiker Robert Dickinson knew Benjamin and in 1945 he introduced him to Alfred Kinsey . Three years later Kinsey and Benjamin were both staying at the Sir Francis Drake Hotel in San Francisco. Kinsey had encountered the person later referred to as Sally Barry, who had a strong desire to be a women, and asked Benjamin to examine her. The mother wished to help rather than punish her child. Benjamin realized that this was a different condition to ‘transvestism’ which was the only classification then in use. He prescribed the newly available estrogen, and helped arrange for Sally and her mother to go to Germany for surgery, but then lost contact.

The next year, 1949, Kinsey sent the married couple Barbara and Lauren Wilcox who were both advanced in their transitions. Benjamin became their hormone provider and later introduced them to Elmer Belt for surgery. Then Kinsey introduced transvestite organizer Louise Lawrence who had been working with Karl Bowman at the Langley Porter Clinic. She informed Benjamin about David Cauldwell’s earlier writings on the topic. She introduced him to other trans women, including Bambi and Coccinelle in Paris.

In 1951 a new patient, Frank, arrived. He thought that he was sick to have transvestic urges, and equivocated for 20 years. Benjamin at first counselled him himself, and then referred him to the psychotherapist Albert Ellis. Benjamin and Ellis also co-wrote an article on prostitution that year.

In 1952 Norman Haire visited New York and was honored in Benjamin’s office. Shortly afterwards he was taken ill with heart problems, and had to be hospitalized. Benjamin and Kinsey together visited him in hospital. He died a few months later back home in London.

Benjamin was now 67 years old and about to launch a new career.
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When did Benjamin become a US citizen? When he travelled in Germany and Austria in the 1930s, did he use a German or a US passport?

More on Voronoff. His second wife was Evelyn Bostwick, the mother of transman Joe Carstairs, the power boat racer. Voronoff would validate his claims to rejuvenation in 1934, at the age of 68, by marrying his third wife, the 20-year-old Gerti Schwartz, related to Romanian royalty.

Harry was 40 when he married Gretchen, two decades younger. From her name one would assume a probability that she was of German descent. Harry described himself to Ethel Person as a 'ladies' man', however the only previous actual girlfriend mentioned in the accounts that I have read was the one who introduced him to Kriminal-Kommissar Dr Kopp, and her name remains unknown. Ethel Person (p359) summarized what he told her: "But there was blight in his life, both romantic and sexual.  He describes his love life as always tragic, beginning from the time he was fifteen and fell in love with a thirty-year-old actress.  It was love at a distance since she was engaged to a German officer.  His second great love was a lesbian, a musical comedy star, and their relationship lasted ten years with never a kiss.  He describes  himself as having long relationships and staying in love with hopeless cases. He married Gretchen, a woman he never fell in love with but whom he felt responsible for."  There are other hints about Harry's private life: Ihlenfeld told Person that Gretchen had told him that after Harry's mother came to stay, "their bedroom door remained open" (again p359). Green told Meyerowitz that some patients and colleagues knew that Harry had a fetish for long hair on women (p217). Unlike Freud I will not draw any conclusions.  Unlike many marriages contracted upon love, the Benjamins remained married 61 years until Harry's death.

In both the First and the Second World War the US interned German citizens and German-Americans. Benjamin doesn't seem to have encountered this.

In Richard Docter's book on Christine Jorgensen, Sir Francis Drake Hotel in San Francisco has become the St Francis Hotel. !!

By tradition the hereditary part of Judaism is passed via the mother and thereby Benjamin was not Jewish. However to the Nazis he would have been, from his father's origins, certainly Jewish. Benjamin had two younger siblings, Walter and Edith, who lived till their nineties. Were they in Germany in the Nazi period? Did they follow him and their mother to New York? The accounts that I have read did not even ask this question. And what about other relatives on his father's side? Did they flee or die? We know about Erich Benjamin, mentioned in the notes to Part 1, who did flee to the US, although we don't know if he was related.

Neither de.Wikipedia nor en.Wikipedia on Eugen Steinach care to mention his US disciple.