Bernard Norman Barwin (1939 - ) doctor serving trans persons

Barwin was raised in South Africa by parents of Russian and Lithuanian descent. He and his wife left in 1962 after the Sharpeville massacre:

“We were just so much opposed to the whole concept of apartheid. In fact the thing that made us finally leave was when Sharpeville happened. I was in university, and I saw literally hundreds of people lining up to fight against the blacks. I felt, ‘Gee: this is not a country I want to bring my children up in. Maybe I can make a better contribution from outside.” (quoted in Kennedy, 1993)

He completed his medical education at Queen’s University Belfast, where he also did a PhD in women’s medicine. He worked there in the Department of Physiology. The Barwins had four children, became involved with the Alliance Party which sought to unite Ulster’s Protestants and Catholics, and sheltered women from the Republic of Ireland who – those days – were not able to get fertility treatment at home. In 1969 he took over the fledgling fertility clinic. He initiated freezing of human sperm after working with veterinarians who had been doing it for cattle for some time.

However after a bomb went off near their children’s school, the Barwins decided to leave.

In 1973 the Barwins and their children emigrated to Canada, and he was hired by the Ottawa General Hospital to manage the High Risk Pregnancy Clinic and to co-direct its fertility clinic. He set up the hospital’s sperm bank (with donations by medical students), and the first sexual health clinics in Ottawa’s high schools. He was noted as a pro-choice advocate, and supportive to same-sex couples wanting children. Many heterosexual couples specifically thanked Dr Barwin in birth announcements in the Ottawa Citizen.

He was known for his experience in reconstructive surgery on children with incomplete genitals. In 1976 he was called to the hospital’s emergency ward to help with a desperate trans woman who had cut off her male genitals. After a long talk with her that persuaded him that she really was transsexual, he proceeded to construct a vagina for her using skin from the inner thigh. He did another five transgender operations over the next six years. He quickly became a go-to doctor noted for providing counselling, hormone therapy and gender surgery for trans persons. 

He was Associate Professor of Obstetrics and Gynaecology at the University of Ottawa. He was also one of the founding members of Fertility Self-Help Group, which later became the Infertility Awareness Association of Canada. He also founded Canadians for Choice and was President from 2004. He was on the board of the International Society for the Advancement of Contraception and the Bereaved Families of Ontario. He was a gynecology consultant at Ottawa’s Royal hospital and the Childrens’ Hospital of Eastern Ontario. He was the President of the Canadian Fertility Society, the Planned Parenthood  Federation of Canada and Planned Parenthood Ottawa.  In addition he was active in the Canada-Israel Cultural Foundation.

The hiring had come with an understanding that, as is standard for immigrant physicians, he would, within three years, take and pass the gynecology certification exam administered by the Royal College of Physicians and Surgeons of Canada. 

He presented a paper, “Vaginoplasty – A simple approach to vaginal agenesis” at the Proceedings of Symposium on the Human Vagina and Health Disease, Wayne State University, Oct 28-30, 1976.

Four years later he contributed a chapter, “The Surgical Treatment of Transexuality”, to Erwin Koranyi’s 1980 book Transsexuality in the Male.

Also that year, one of the trans women whom he operated on was in the news re being cut off welfare, but being a known transsexual was not able to find work either. In 1979 a letter from Dr Barwin had fixed the situation, but in 1980, the letter was rejected.

He did take the required Canadian exam, but failed – perhaps because he was too busy to prepare. This despite being voted the best clinical professor at the University of Ottawa medical school in 1976 and 1977. He was also FRCOG (Fellow of the Royal College of Obstetricians and Gynaecologists) and FACOG (Fellow of the American College of Obstetricians and Gynecologists). Lacking the required qualification, Barwin left Ottawa General Hospital in 1984 to set up his own clinic, but he no longer had gynecological privileges at area hospitals – not only was he no longer able to do vaginoplasties, he was not allowed to deliver babies either.

In 1995 a female couple sued Barwin in that their child had been born from the wrong sperm. They settled out of court.

In 1997 Barwin was named to the Order of Canada for having a "profound impact on both the biological and psycho-social aspects of women's reproductive health”.

A fitness enthusiast, Barwin ran in the Boston Marathon in 2000 – however there was no record of his passing through the multiple checkpoints, and he was officially disqualified. Again a year later in the National Capital Marathon in Ottawa he did not complete the second lap, but rejoined the race one kilometre before the finish. The full-page account of this in the Ottawa Citizen brought in letters supporting the doctor. “We should laud, not lash, Dr, Barwin”.

The GLBTQ Centre for Sexual and Gender Diversity at Carleton University was the organizer for 2008’s Trans Day of Remembrance (TDOR), and Dr Barwin was one of the speakers. The trans support group Gender Mosaic celebrated its 20^th anniversary and gave out three plaques – one of which was to Dr Barwin for continued work with and support for the trans community. Carleton University, Ottawa, awarded Barwin a honorary degree of Doctor of Laws in 2009.

In 2010 two trans women filed suit against Ontario re non-funding of laser hair removal, voice therapy and breast augmentation. Dr Barwin provided an expert report letter supporting the plaintiffs, and attached a copy of his 1980 chapter in Erwin Koranyi’s book, Transsexuality in the Male. 

In 2013 Barwin admitted to professional misconduct re three clients inseminated with the wrong sperm. He agreed to permanently end his fertility practice – he was now 73. He also formally resigned his appointment to the Order of Canada. 

He closed his transgender practice in August 2014, and retired.

Two years later a paternity test confirmed that Barwin is the biological father of one of the children of one of his patients. The child’s DNA was used to link Barwin to 10 other cases. In 2016 a class action lawsuit was started that involved 150 of his former patients. Barwin’s medical licence was revoked in 2019. The class action resulted in 2021 with a settlement of $13.375 million.

Publications by Norman Barwin

• B N Barwin. “Cervical Mucus Glucose Content in the Assessment of Ovulation”. Irish Journal of Medical Science, 140, 9, 1971. 
• B N Barwin, D M Brennan & T A McCalden. “The Effect of Oestradiol-17- β and Progesterone on the Contractile Behaviour of Ureteric Muscle”. In Dublin Journal of Medical Science, 142, 1, 1973.
• B N Barwin. “Intrauterine Insemination of Husband’s Semen”. Journal of Reproduction and Fertility, 36,1, 1974
• B N Barwin. “Vaginoplasty – A simple approach to vaginal agenesis”. In Proceedings of Symposium on the Human Vagina and Health Disease, Wayne State University, Oct 28-30, 1976.
• B Norman Barwin, Anthony Dempsey & Gilles D Hurteau. “Graphic Monitoring of Labour”. Obstetric and Gynecolic Survey, 32,7,1977.
• B Norman Barwin, Sheena Tuttle & Elaine Jolly. “The Intrauterine Contraceptive Device”. Obstretrical & Gynecological Survey, 33,8, 1978.
• Roberto Narbaitz, George Tolnai, Elaine Jolly, Norman Barwin, David McKay. “Ultrastructural Studies on Testicular Biopsies from Eighteen Cases of Hypospermatogenesis”. Fertility and Sterility, 30,6, 1978.
• B Norman Barwin. “Psychological Factors: Counseling and Motivation of the Contraceptive Patient”. International Journal of Gynecology and Obstretrics, 16,6, 1979.
• Norman B Barwin. “The Surgical Treatment of Transexuality”. In Erwin Koranyi. Transsexuality in the Male. Charles C Thomas Publisher, 1980.
• B N Barwin & S Belisle (eds). Adolescent Gynecology and Sexuality. Masson, 1982. Papers presented a meeting of the Canadian Fertility Society.
• B Norman Barwin. “Transmission of Ureaplasma urealyticum by artificial insemination by donor”. Fertility and Sterility, 41,2,1984.
• M C Devlin & B N Barwin. “Barrier contraception”. Advances in Contraception, 5, 1989.
• S L Douma, C Husband, M E O’Donnell, B N Barwin & A K Woodend. “Estrogen-related Mood Disorders: Reproductive Life Cycle Factors”. Advances in Nursing Science, 28, 4, 2005.

Other publications

• Pauline O’Connor. “Welfare won’t buy sex change ‘excuses’ “. The Ottawa Journal, Jul 15, 1980.
• Cathy Nobelman. “PMS: Local doctor helps women waging war with their bodies”. The Ottawa Citizen, August 16, 1991.
• Janice Kennedy. “Doctor in Demand”. The Ottawa Citizen, Jan 25, 1993. Online.
• Shelley Page. “Dr. B and the Women”. The Ottawa Citizen, April 1, 2001.
• Glan McGregor. “Prominent MD caught cheating in marathons”. The Ottawa Citizen, Nov 16, 2002.
• “We should laud, not lash, Dr. Barwin”. The Ottawa Citizen, Nov 20, 2002.
• Rosie Dimanno. “Wrong-sperm doctor Barwin took shortcuts in career and races, too: DiManno”. Toronto Star, February 4, 2013. Online.
• Bradley Turcotte. “Trans community supports Dr Barwin: Doctor who mixed up sperm an invaluable resource, trans Ottawans say”. Xtra, February 7, 2013. Online.
• Brodeur v. Ontario (Minister of Health and Long-Term Care). 2010. Online.
• Alison Motluk. “Fertility doctor used own DNA, suit claims”. The Globe and Mail, Nov 2, 2016.
• Elizabeth Payne. “Timeline: A look at the story of Dr.Norman Barwin”. Ottawa Citizen, May 03, 2018. Online.
• “$13.375 Million Settlement in Norman Barwin Class Action”. Nelligan Law, December 6^th, 2021. Online.
• Juanne Nancarrow Clarke. “Dr. Norman Barwin: The Story of Mixed-Up Sperm”. In When Medicine Goes Awry: Case Studies in Medically Caused Suffering and Death. University of Toronto Press 2022.

EN.Wikipedia

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The Wikipedia article says not a single word about Barwin’s work with and for trans persons, and does not list his publications.

Shelley Page in her April 2001 article for the Ottawa Citizen says that she asked for Barwin’s CV. “When the 26 pages were printed, it included 30 chapters in books and 79 journal articles he had written, 181 lectures he’d delivered”. Such a list I was unable to find. Above I do list the ones that I found.

Petra De Sutter (1963 - ) gynaecologist, academic, senator

De Sutter was raised in Oudenaarde, in East Flanders. De Sutter gained an MD, 1987, and two PhDs, 1991, 1994, from Ghent University, and also studied at the Reproductive Genetics Institute in Chicago, and became a professor and head of the Reproductive Medicine Department at Ghent University.

She completed transition in 2004.

She and her team researched on embryonic stem cells, the oocyte activation mechanism and fertility. De Sutter is on the executive of the European Society of Human Reproduction and Embryology (ESHRE), a member of the Royal Belgian Academy of Medicine, and of the French Agence de la Biomedecine. She has published more than 200 journal articles.

In 2014 Petra was placed second on the Green Party list for the European elections, but they gained only one seat. In July 2014 it was announced that De Sutter was appointed to the Senate as a Green Party nomination, where she will focus on health care and environmental issues.

• Petra De Sutter. "Reproduction and Fertility Issues for Transpeople". In Randi Ettner, Stan Monstrey & Evan Eyler (eds) Principles of transgender medicine and surgery. Routledge, 2007.
  
• "Petra De Sutter is eerste transgender op kieslijst". Nieuwsblad, 01 maart 2014. www.nieuwsblad.be/article/detail.aspx?articleid=DMF20140228_01004504.
  
• Marij Vanherie. "Groen stuurt Petra De Sutter als gecoöpteerd senator naar het rode pluche. De arts-gynaecologe van het UZ Gent greep naast een zitje in het Europees Parlement, maar wordt -na het afhaken van Freya Piryns- door de partij opgevist.". De Redactie, 21/06/2014. http://deredactie.be/cm/vrtnieuws/VK14-formatie/140621-desutter-groen.
  
• "Belgium: First transgender parliamentarian appointed to Senate". Pink News, 14/07/2014. http://www.pinknews.co.uk/2014/07/14/belgium-first-transgender-parliamentarian-appointed-to-senate.
  

NL.WIKIPEDIA   LinkedIn   UniversiteitGent   WorldCat   Blog

Shan Ratnam (1928 – 2001) gynaecologist, sex change doctor

Shan Ratnam was of Ceylonese Tamil descent, and was born in Jaffna where his mother came from, although his father's family had lived in Malaysia for three generations. From the age of six months he lived in Kuala Lumpur.

Ratnam's father was ordered to be beheaded by the occupying Japanese in 1942, but was saved by a Japanese woman married to an Indian man. His mother died at age 38 during the Occupation from rectum cancer, as did his youngest sibling from tuberculosis meningitis. This inspired him to become a doctor.

He trained at the Singapore General Hospital from 1959, and began teaching at the University of Singapore in 1963. He studied at the Royal Postgraduate Medical School in London where he earned MRCOG and FRCS in 1964. He then became Professor and Head of the Department of Obstetrics and Gynaecology at the University of Singapore in the new Singapore independent of the UK and then in secession from Malaysia.

In 1969 Ratnam was pestered by Shonna who was desirous to have sex change surgery. He became intrigued by the possibility, read the literature and finally practised the operation on two cadavers in the mortuary. He had Shonna evaluated by a team of psychiatrists who confirmed that she was indeed transsexual. Legal clearance was sought from the ministry of health and granted. Surgery was performed 30 July 1971 at the Kandang Kerbau Hospital 竹脚妇幼医院. This was the first such operation in east Asia.

A Gender Identity Clinic was set up headed by Prof Ratnam, who ran it until his retirement in 1995, when it was passed to his nephew, Dr. Anandakumar. In 30 years more than 300 sex change operations were performed.

In 1972 Ratnam's gynaecology department was recognized by the World Health Organization as one of 13 outstanding research centres in human reproduction.

In 1974 Dr Ratnam, his assistant Dr Lim and several of his then patients were featured in the documentary Shocking Asia.

In 1983 Ratnam did the first Asian In-vitro fertilization. In 1987 the first Asian live birth from a frozen embryo. In 1989 the world's first live birth after microinjection, and in 1991 the world's first infant born via human ampullary coculture. He published 596 research papers in internationally refereed journals, 396 in local and regional refereed journals, 138 chapters in books and 795 presentations at conferences. In 1996, Ratnam was appointed as Emeritus Professor. In 2000, the Shan S. Ratnam Professorship endowment was set up to award internationally recognised O& G specialists annually.

He developed heart complications and died of pneumonia at the age of 73.

After his death the Gender identity Clinic was quietly closed on the excuse that the gynaecologist in charge had left for private practice. The Ministry of Health had been pushing for closure for some years. However petitions from the trans community supported by local media resulted in the Clinic re-opening in 2003.

Other patients include: Wu Mingen(Li Jiang)

• S. S. Ratnam, Victor H. H. Goh & Wing Foo Tsoi. Cries from Within: Transsexualism, Gender Confusion and Sex Change. Singapore: Longman, 1991.
  

EN.WIKIPEDIA    EN.WIKIPEDIA(Transgender people in Singapore)  SgWiki     SingaporeInfopedia

This is from 1974's Shocking Asia.

Kurt Warnekros (1882 – 1949) gynecologist.

The son of a medical professor at Berlin University, Kurt Warnekros studied in Wuerzburg and Berlin. From 1909 he worked at the Women’s Hospital at the University of Berlin, and in 1924 he became the director. In 1925 he became director of the women’s clinic in Dresden.

In addition to being a gynecologist and obstetrician, he was also a pioneer in the use of X-rays.

He had high-society patients: the Romanian princess Ileana Hohenzollern-Sigmaringen, Ivy Lowe, the English Jewish wife of the Soviet Foreign Minister Maxim Litvinov, and members of the Rothschild family.

In 1930 following a trip to Paris, Warnekros took on Einar Wegener as a patient, and arranged a series of operation that transformed Wegener into Lili Elvenes (Elbe).  This was separate from the similar operations performed at Magnus Hirschfeld's Institut für Sexualwissenschaft.  This resulted in newspaper headlines.

++In February 1931, Warnekros was interviewed by Copenhagen's Dr Rank for the Ekstar Baldet newspaper.  He boasted that he had performed an unprecedented operation that the top French doctors were incapable of. There is no mention of the earlier trans women who had been operated on under the aegis of Magnus Hirschfeld.

However Lili died during a follow-up operation later that year (this is in contrast to Hirshfeld's transsexual patients who survived).

In 1933 Warnekros joined the Nazi party. In 1936 he was accused of being a Jew-lover because of his work with the Rothschilds. However he was able to keep treating Jewish patients until 1944, partly because he also treated the wife of Nazi Party leader in Saxony. In addition he also did involuntary sterilizations.  In 1944, he helped Eva Olbricht, whose husband had been involved in the Stauffenberg plot against Hitler, to escape from Dresden.

The clinic was destroyed in the February 1945 air raids and subsequent firestorm of Dresden.

Warnekros remained head of the clinic until 1948, when Baroness von Goldschmidt-Rothschild invited him to live in Paris.

++He died at the age of 67.

• Dr. Rank: "Manden, der blev Kvinde. Professor von Warnekros fortæller: Lili Elbe blev til ved et i Lægevidenskabens Annaler enestaaende Indgreb“"(The man, who was female. Professor von Warnekros says: Lili Elbe results from an intervention unique in the annals of medical science). Ekstra Bladet. 28.02.1931, 1, 9. 
• Susanne Kailitz. "Das Experiment: 1930 führte der Dresdner Gynäkologe Kurt Warnekros eine der weltweit ersten Geschlechtsumwandlungen durch". Zeit Online, 13. Januar 2012. www.zeit.de/2012/03/S-Geschlechtsumwandlung,

 DE.Wikipedia 

Eric Derk Crichton (1919 - ) gynecologist.

Derk's father, Eric Cuthbert Crichton was Professor of Obstetrics & Gynaecology at Cape Town University. Derk graduated from Cape Town University with an MD and a B.Ch in 1944. He was registered as a member of the Royal College of Obstetricians and Gynaecologists (M.R.C.O.G.) in 1952 and graduated from Oxford University with a D.Phil in 1953 and became a Fellow of the Royal College of Surgeons of Edinburgh the same year. He was then appointed professor of Obstetrics & Gynaecology at Natal University (now the University of KwaZulu-Natal), and Head of the Division of Gynaecology and Obstetrics, King Edward VIII and McCord's Hospitals, Durban, South Africa. 

In 1972 Dr Crichton was found guilty of providing safe abortions for unmarried white women in the Durban area. The trial was heavily covered in the South African press, and as a result the Apartheid government passed new laws in 1975 to restrict abortion for white women. 

Crichton wrote a much cited paper on the value of Cephalo-Pelvimetry.

In 1993, when he wrote a paper on gender surgery for the South African Medical Journal, he had done 58 such surgeries over the previous 24 years. His most famous patient in this regard was Lauren Foster.

• Derk Crichton. "Gender reassigment surgery for male primary transsexuals". South African Medical Journal. 83, May 1993: 347-9. http://archive.samj.org.za/1993%20VOL%2083%20Jan-Dec/Articles/05%20MAY/1.15%20GENDER%20REASSIGNMENT%20SURGERY%20FOR%20MALE%20PRIMARY%20TRANSSEXUALS,%20D.Crichton.pdf.
  
• "Person Page – 37545". The Peerage. http://thepeerage.com/p37545.htm#i375447.
  
• Susanne Klausen. "Nationalism, Racism and the Struggle over Abortion in Apartheid South Africa". History at Carleton. Fall 2008. www2.carleton.ca/history/ccms/wp-content/ccms-files/Fall-Newsletter-2008.pdf.
  

Franciszek Neugebauer (1856 – 1914) gynecologist

In the 1850s when gynecology was just emerging as a medical speciality, Ludwik Neugebauer was a Polish pioneer in the field. His son Franciszek decided to qualify as a gynecologist. He studied first in Warsaw and then in Dorpat (now Tartu, Finland) where he gained his medical doctorate. He further studied in Leipzig, Dresden, Berlin, Paris, London and Vienna before returning to Poland in 1887. In addition to Polish, he was also fluent in English, French and German. In 1897 he became chief of the Gynecological Department at the Evangelical Hospital in Warsaw, a position that he would hold until he died. 

He developed a reputation for his work with hermaphroditism and with inborn deformities of the spine. Patients with malformations were sent to him from all over Poland and beyond. Neugebauer himself travelled all over Europe and North America to investigate reports of such cases. He carefully documented what he found in writing, photographs and casts. He readily shared his collection with other doctors. He regularly attended meetings of medical associations in these countries and was elected to memberships of the British Gynaecological Society, the Warsaw Medical Association, the Warsaw Science Association, the New York Obstetrical Society, the Paris Academy of Medicine, the Association of Pathologists in Brussels and Belgian Royal Academy of Science. 

His writings consist mainly of observations with very little theory. He published in medical journals in Poland, Germany, France and Britain. Like most doctors of his generation he was very concerned to establish a person's 'true sex' for otherwise “disastrous consequences may follow an erroneous declaration of sex, and that not merely for the individuals immediately concerned, their families and connections, but for others besides". Consequences would include unhappiness, marriage to the same sex, divorce and even suicide. The 'true sex' of course was established by finding hidden testicles or ovaries, not by asking the person which sex they felt that they were. He was a major voice in the then emerging consensus that it is the gonads above all that determine a person's true sex. Other doctors needed to be educated to recognize the condition. In 1903 he published in the journal of the British Gynaecological Society "Hermaphroditism in the Daily Practice of Medicine: Being Information upon Hermaphroditism Indispensible to the Practitioner". He maintained that in addition to grave consequences resulting from erroneous determinations of sex, the frequency of such was that the ordinary practitioner could expect to encounter them. He advised his colleagues to go beyond prodding and poking, and search for evidence of ejaculation or amenorrhea in an apparent girl, and of menstruation in an apparent boy. He many times insisted: "pseudo-Hermaphroditism in its essence is a paradoxical incongruity between the genital glands on the one hand and the genital ducts and external genitals on the other". 

His major work is Hermaphroditismus beim Menschen, 1908, which summarizes 2000 cases of hermaphroditism across history and around the world. He had observed forty or so of the cases first hand. 

He authored 391 professional works, and was a member of 33 professional societies. He died at age 58.

• Franz Ludwig von Neugebauer. Hermaphroditismus beim Menschen. Leipzig: Klinkhardt, 1908.
  
• Krzysztof Boczkowski. "Franciszek Neugebauer (1856-1914)--Pioneer in the Study of Hermaphroditism". Polish Medical Science and History Bulletin. 9, no. 4: 155-7, 1966.
  
• Alice Domurat Dreger. Hermaphrodites and the Medical Invention of Sex. Cambridge, Ma, Harvard University Press. 2000: 49, 61-3, 75, 76, 79-80, 83, 85, 90, 96, 97-8, 117-8, 146, 223n103.
  

PL.WIKIPEDIA.

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It took 81 years before Hirschfeld’s Die Transvestiten was translated into English.  Neugebauer’s Hermaphroditismus beim Menschen is still untranslated.  While the social construction of sex has moved on and we no longer regard the gonads as the ultimate arbiter of which sex we are, his book is presumable a work of scholarship according to standards of the early 20th century and if so would be well worth reading alongside Hirschfeld and Havelock Ellis.

I have attached the category ‘sex-change doctor’ to Neugebauer in that based on a person’s gonads he told several who had been raised female, were happily so and even married as such that they were men and must switch, and vice versa.

I use the term ‘hermaphroditism’ here as that was the term used during Neugebauer’s lifetime.