Essays on trans, intersex, cis and other persons and topics from a trans perspective.......All human life is here.
This site is the most comprehensive on the web devoted to trans history and biography. Well over 1800 persons worthy of note, both famous and obscure, are discussed in detail, and many more are mentioned in passing.
There is a detailedIndexarranged by vocation, doctor, activist group etc. There is also a Place Index arranged by City etc. This is still evolving.
In addition to this most articles have one or more labels at the bottom. Click one to go to similar persons. There is a full list of labels at the bottom of the right-hand sidebar. There is also a search box at the top left. Enjoy exploring!
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 20th 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 6th, 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.
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.
It is said but not confirmed that the first transgender operation in China was performed in secret in 1983.
In 1992 Zhao Yede, from Zhejiang province, was working as a resident in a hospital in Beijing, where one of his duties was replying to letters from patients. When newspapers reported transgender surgery there, the hospital received many requests for similar surgery. Zhao researched the topic, and decided to move to Shanghai to learn from Dr He Qinglian, known for performing China's first female-to-male transgender surgery that year.
By 1999 Dr He had performed 11 male-to-female and 39 female-to-male operations – the most by a single doctor at that time. He had by then received over 4,000 letters requesting such surgery. He’s major innovation was to use skin from the patient's inner thigh to create the penis, which leaves minimal scarring (other surgeons doing phalloplasty used skin from the patient’s stomach or forearm).
Zhao practicing in Shanghai continued using He’s methods. He has operated on trans persons from all over China (although not from Xinjiang), and from all occupations. 90% of his patients are trans men desiring phalloplasty. By his method, it takes at least three surgeries for a trans man, and the price is correspondingly higher: ¥ 80,000-100,000 as opposed to ¥30,000-50,000.
Chinese regulations stipulate that candidates for transgender surgery must not have a criminal record, and must have a certificate from a psychiatrist and a letter of consent from family members. Since one of his patients returned after a few months demanding a reversal, Dr Zhao asks several probing questions. He accepts only 10% of those who apply to him.
He argues that whether we think of ourselves as a man or a woman is dependent on directives from the brain: Everything is dependent on these directives. And likewise for trans persons: “There’s a directive anomaly. It’s not something you can change.”
Graduation diplomas are the only official document in China that cannot be revised after being issued, and thus students, wanting to transition, want to have the operation before graduation.
Zhao has 40-50 consultations on a busy day, and he and his team do up to five operations a day.
Many patients are now coming from abroad, from Malaysia, Singapore and Japan.
In 2012, there was media attention to Zhao’s work when twins becoming men were his patients.
*not Zhao Yide, Party Secretary of Shaanxi.
*Not Dr Lee Zhao who is part of the transgender surgical team at NYU Langone in New York.
"China's Sex Change Master”. Shanghai Daily. 2 September 1999.
“China: Treatment of transsexuals who have undergone a sex change operation, particularly in Hong Kong (1997-2000)”. Canada: Immigration and Refugee Board of Canada, 4 April 2000. Online.
Xu Junqian. “Helping women find their inner man”. China Daily, 2017-03-24. Online.
Cao Xi. “Being true to yourself: LGBT in China”. CGTN. 01-Feb-2018. Online.
Piper Weiss. “Twins Undergo Sex Change in China. Go from Sisters to Brothers Together”. Yahoo, March 28, 2012. Online.
“Identical twins first to undergo gender surgery in China”. Out News, 28th March 2012. Online.
New Nation newspaper (Singapore) ran a ground-breaking survey of gay life in Singapore called “They are Different …”. This included “The close-knit community of local transvestites”, “Chance for a new life …” (a drag troope hoping for a tour of Iran) and “Case studies of men who have become women” which interviews four trans women who had recently had surgery at Kandang Kerbau Hospital: Miss X, a civil servant; Miss Y, who was a sex worker on Bugis Street and is attempting to become a model; a cabaret girl; a fourth who had already disappeared. All have new identity cards.
The introductory article, “People who lead very secretive lives”, was less positive:
"The transvestites who have become prostitutes frequent Bugis Street where they usually solicit after midnight and Johore Road, in foul-smelling, oppressive hovels, honeycombed with box-like cubicles big enough only for a double bed and standing space for one or two. At these places, they ply their trade at prices ranging from $3 to $20 or more for a quick time, often fleecing European tourists or resident expatriates. Their clients: Male homosexuals as well as men who also enjoy normal heterosexual relationships and do not regard themselves as homosexuals. The Bugis Street homosexuals often cater for Europeans or tourists, and the Johore Road group for the locals. Such male prostitutes find it extremely difficult to rent accommodation from decent, normal people."
1973
Singapore legalised trans operations, and permitted trans persons to wed. Soon afterwards a policy was put in place that if post-op, trans persons could have their sex corrected in identity cards and other documents - but not birth certificates. This was not specified in any law, but as a directive it functioned smoothly for over 20 years.
Saint Jack, a novel by Paul Theroux, about a US man setting up a bordello in Singapore, with only passing references to Bugis Street.
Russell Heng, speaking in 2005:
“Thirty years ago, the butch he-man type, many of whom were of working class background, could be found buying sex on Bugis Street and not in the gay bars. Let me recount a story about a friend whom I shall call Eugene that best illustrate a certain mindset that was not uncommon in those days. Eugene had a crush on a char kway teow hawker in his neighbourhood. Kway teow seller was also one of the local samseng with tattoo on his body, which drove Eugene wild with lust. Eugene was prepared to pay him for sex but to no avail. Then Eugene wised up to the fact that the only way to hook local butch men was to go in drag and seduce them on Bugis Street. Lo and behold, one night, Eugene in his wig and dress met kway teow seller on the street and tables were turned. He was prepared to pay Eugene for sex. In those years, many butch men could only bring themselves to have sex with another man if the latter turned himself into a surrogate woman by going drag. It probably lessened the guilt for them.”
1974
Dr Ratnam, his assistant Dr Lim and several of his then patients were featured in the exploitation documentary Shocking Asia, which included graphic footage of one of their genital operations, along with midget wrestling, Japanese S&M sex clubs, mass piercings in India and cremains being dumped into the Ganges.
First operation on a trans man, in several stages August 1974 to October 1977.
1975
James Eckardt, ex-Peace Corps, and afterwards married to a Thai woman and living in Thailand, had an affair with a Tamil trans woman Milly, until she left him for a Frenchman who promised to support her. Eckardt wrote an account of their affair in an attempt to win her back. 30 years later the Frenchman contacted him after Milly killed herself. Eckardt then, 2007, revised and published the manuscript as Singapore Girl.
1980
The film of Saint Jack had been shot entirely on location in Singapore, including on Bugis Street. They submitted a fake synopsis to the authorities. It was the first film with a gay Singaporean sub-plot complete including full frontal male nudity and the first to have a Singaporean trans woman nude scene. It includes a scene of a transwoman named Bridgit Ang, playing herself, chatting up a table of Western expatriates on Bugis Street.
It was banned in Singapore and Malaysia shortly after release.
“The police started to harass the transgenders, forcing them to migrate to Orchard Road or Geylang. I found this newsspaper report quoting a Delphine Tan about how hard a life it was operating away from Bugis St: ‘We were beaten and abused by some Singaporeans who despised us. And we were always being raided in Orchard Road. At least here, the foreigners are more broadminded and treat us well’. On returning to operate on Bugis Street, Delphine continued: ‘This is our home. It is where all our friends are. This is the only place we can go where we are accepted and appreciated.’ ” (Heng, 2005)
December: French photographer Alain Soldeville was on a two-year trip to Asia and Australia when he arrived in Singapore. After a few days sight-seeing, he headed out one evening to Bugis Street.
"Within an hour, strange androgynous creatures arrived by taxi. Dressed in sexy, tight-fitting dresses or satiny pants, wearing heavy stage makeup and high heels, they took over the territory. The street seemed to belong to them and their dramatic entrance was followed by scrutinizing eyes. It appeared that most visitors were there to watch the show that had just begun.
Photo by Alain Soldeville
I stroked up a conversation with Anita who was of Malaysian background. She was 23 years old, with a clearly outlined masculine face, tall, thin and muscular. She wanted to know where I came from, how long I was going to stay in Singapore. During the following weeks, I became close to Anita and she introduced me to her friends: Amina, Danita, Delphine, Rosa and Susanna. They liked having me photograph them and would strike natural poses.
After five or six weeks in Singapore, short of money, I had to leave for Australia. I would return in 1984 only to learn that Bugis Street was about to be torn down to make way for the subway."
1981
Wu Mingen 吳明恩 from Taiwan was sent to Singapore for surgery with Professor SS Ratnam, as the operation was then still illegal in Taiwan. This with her father's consent.
Amy Tashiana, not getting on with her father and step mother, ran away and was adopted by a group of older transsexuals who prepared her for her transition.
Abigail Chay, with the support of her parents had completion surgery.
1983
The Malaysian government had previously offered gender-affirming surgeries — the only country in Southeast Asia to provide such operations apart from Thailand and Singapore - and contributed funds towards the Mak Nyah Association (the local term for trans women). However in 1983 a fatwa was issued by the Conference of Rulers banning such surgeries and the hospital that undertook it was shut down, marking the beginning of a repressive, anti-LGBT chapter in Malaysia’s history. Teh Yik Koon: “This decline is tied directly to the revival of Islam, which has become increasingly politicized and institutionalized. The competition between rival political groups to be seen as more Islamic to gain support from the Muslim community has resulted in greater discrimination for the transsexual community.”
The film of Privates on Parade, was released. It was based on the 1977 stage play, set in Singapore and Malaya in 1948 during the “Emergency”, but filmed at Shepperton Studios in England, . Telling mainly of a British entertainment troope - with lots of drag - and their conflict with the authoritarian officers, along with scenes of the the corruption and violence of the civil war.
1985
October: the very end of the old Bugis Street as bulldozers demolished it. The street hawker stalls were cleared and relocated to other areas of Singapore.
Construction began on the Bugis Metro Station.
The trans women who solicited there were told to relocate to the other red light district, Lorong 6 in Geyland. Some kept returning and were arrested and charged.
Bianca who worked Bugis Street said it was not easy to make a living there towards the closing years. Another transgender who worked there called Bianca said where once they could make $300 a night, now "we are lucky to get $50". (Heng 2005)
1987
The Health Ministry asked hospitals to stop doing such operations [trans] on foreigners. It also discouraged them on Singaporeans. It said “the increased danger of Aids with such patients poses unnecessary risk to hospital staff”.
Psychiatrist Tsoi Wing Foo explained that the failure of psychotherapy alone in the treatment of trans women led to the development of modern sex reassignment surgery. He described our technique, its indications, complications and outcome.
1988
Psychiatrist Tsoi Wing Foo carried out a study on the prevalence of transsexualism in the country, and concluded that the prevalence rate for male-to-female (MTF) transsexuals was 1 in 2,900, and female-to-male (FTM) transsexuals, 1 in 8,300.
Tsoi’s dissertation, A psychiatric investigation of transsexualism in Singapore, was accepted at the National University of Singapore.
Amy Tashiana went to Bangkok for completion surgery. It was cheaper there (S$5,000) and no hassle about psychiatric assessment. She became one of the best known trans models in Singapore.
1989
W. F. Tsoi, E. H. Kua and L. P. Kok published Handbook of clinical psychiatry : a guide for medical students and family physicians.
1990
Dr Tsoi’s study of parental influence in a group of Chinese male and female transsexuals compared with a group of male and female heterosexual controls. The fathers of male transsexuals were found to be less caring, and mothers of female transsexuals were less overprotective than the fathers and mothers of the controls. Parental involvement of male transsexuals showed a weak father figure and an overinvolvement with the mother, and in female transsexuals, an unsatisfactory mother-daughter relationship.
Dr Tsoi’s study of 200 trans women and 100 trans men compared with 100 male and 80 female heterosexuals in Singapore. Transsexuals started their psychosexual development earlier than the controls. Transsexual feelings started in childhood. Trans women went through a homosexual phase followed by a transvestite phase, before they became transsexual. Trans men did not go through distinct phases. Cross-dressing was one of the early signs of transsexualism and started earlier in trans men. None of the transsexuals were married, in contrast to reports showing that up to 50% of Western transsexuals had been married
1991
Court case Lim Ying vs Hiok Kian Ming Eric. Lim discovered after marriage that Eric had been born female, and applied for an annulment. Three important points were decided. First, that marriages under the Women's Charter between parties of the same sex are not permitted; secondly, following the English case of Corbett v Corbett, that the determination of sex was to be by use of biological criteria (chromosomal, gonadal, and genital tests), ignoring any operative intervention; and thirdly, that breach of this requirement renders the marriage void ab initio even though it is not one of the grounds listed in the former section 99 of the Women's Charter. As Eric’s birth certificate still said ‘female’ the marriage was ruled null and void.
Did this invalidate all marriages of trans persons?
S. S. Ratnam, Victor H. H. Goh & Tsoi Wing Foo published Cries from Within: Transsexualism, Gender Confusion and Sex Change, the first Asian book on the topic.
The 15-year-old Leona Lo did not know how she was different until she found Cries from Within in the library.
1992
Tsoi Wing Foo published a comparison of 320 trans women and 130 trans men in Singapore. The subjects were given a semistructured psychiatric interview. The results showed that the trans women were slightly younger, had less education and held lower level jobs. Their occupational preferences were reversed. The trans women started petting, sexual intercourse and having partners about one to two years earlier, but they cross-dressed four to seven years later. Both trans women and trans men were homosexually orientated. Other studies showed that late maternal age was associated with homosexuality, but not with transsexualism. These studies also confirmed that transsexualism had its onset in early childhood, and that cross-dressing was an early feature. The Singapore transsexuals went through a "homosexual" and a "transvestite" phase before they became a transsexual. Western transsexuals exhibited both homosexual and heterosexual behaviour, and some were married to the opposite-sex-by-birth partners. Trans women prostitution was reported in many studies.
1993
The new rebuilt Bugis Street re-opened for business. Some of the former street hawkers and non-chain retailers were permitted back. Initially the sale of illegal and pirated goods sprouted, but they were repressed. The Singapore Tourist Promotion Board attempted to recreate the old atmosphere with contrived ‘Ah Kua’ shows on wooden platforms, but it was obviously artificial, the tourists did not go for it, and it was abandoned after a short while.
Boom Boom Room, Singapore’s only drag cabaret nightclub, was established by owner Alan Koh in 1993 at 4 New Bugis Street in Bugis Village. It later relocated on 2 April 2000 to the second floor of the old 2-storey Chui Eng Free School schoolhouse at 130-132 Amoy Street, Far East Square. The star attraction was risqué comedy routines by local drag superstar Kumar aided by his coterie of cross-dressing toyboys.
Leona Lo did her national service as a combat medic.
Dr Tsoi published a follow-up study of 45 trans women and 36 trans men. The subjects were interviewed before and 1 to 8 years following surgery. The trans women had less education and held lower level jobs, started their sexual life about 1-2 years earlier, but they cross-dressed 4-7 years later than the trans men. 35% were married and all of them had no problems adjusting to their new life. The overall results were 56% very good and 44% good. There are no pre-operative variables that can predict good adjustments for trans mens. For trans women, the earlier age of transsexual manifestation was related to good post-operative adjustments. The trans men were less satisfied with the surgery, but they adjusted as well as the trans women. The results were comparable with those from previous studies.
1995
Prof Ratnam retired. The Gender Identity Clinic was taken over by his nephew, Dr. Anandakumar. In 30 years more than 300 sex change operations had been performed, mainly at the Kandang Kerbau Hospital.
The Bugis Street film, directed by Hong Kong director Yonfan, about a cis teenager from Malacca (but played by a Vietnamese actress) who takes a job as a maid in the Sin Sin Hotel ($3 a night) on Bugis Street. She is initially disconcerted to discover that most of the residents are trans women, but comes to support them. While set in the old Bugis Street, it was filmed in the modern redeveloped version. It was given a restricted rating, which impacted sales. There is an associated book.
There is another book, with a different plot, which came out at the same time: Koh Buck Song’s Bugis Street: The novel, set in the last days of the old Bugis Street, which gives a full chapter to Rosie, a trans prostitute, but her life is secondary to a familial heteronormative melodrama, and she dies. The novel was developed into a theatre musical, cast mainly with cis gay men playing the trans women and only one real trans woman.
1996
A new law was passed amending the Women’s Charter:
“(a) the sex of any party to a marriage as stated at the time of the marriage in his or her identity card issued under the National Registration Act shall be prima facie evidence of the sex of the party; and
(b) a person who has undergone a sex re-assignment procedure shall be identified as being of the sex to which the person has been re-assigned. ”
Leona Lo was doing a degree in English literature at York University in England, and flew from there to Bangkok for completion surgery.
1998
A fire erased most of Johore Road where trans sex workers had previously been available.
Abigail Chay had become an actress in Singapore television and film.
2001
Dr Ratnam died age 73. After his death the Gender identity Clinic was quietly closed on the excuse that the gynaecologist in charge, Dr Anandakumar, had left for private practice. The Ministry of Health had been pushing for closure for some years.
2002
Newly declassified UK naval documents revealed that possibly 50% of its sailors in the 1960s gained “same-sex” experience often with the trans women on Bugis Street.
2003
Petitions from the trans community supported by local media resulted in the Clinic re-opening quietly. However by now clinics in Bangkok were taking most of the business, and were cheaper.
Leona Lo published My Sisters, their Stories, Singapore's first pictorial documentary on transsexuals in Singapore and Thailand.
Hidden Genders on Singapore National Geographic TV.
2005
The Boom Boom Room closed. Gold Dust opened six months later for a similar but more upmarket clientel.
“Sense of Being”. Channel U, April 2005. Singapore's first television programme to feature a local transwoman, 38-year-old Amy Tashiana, who talked about her life as a former model and performer at the defunct cabaret club Boom Boom Room.
Tina Lee, 60 year old, who was sexworker for two thirds of her life said that after she was too old and ugly to have any market value, she worked as a dish washer but lost the job when employer found out she was once a transvestite, fearing she had Aids. Remember Aids came on to the Singapore scene in 1984 with the first reported HIV positive case. She then lived in a rented room on her savings. She said: "no matter what they do, the government should realize there will always be places like Bugis Street. They should help us by giving us a place to stay and ICs so that they will know who we are and we are not criminals. We don't want sympathy nor do we want to be ignored. We just want understanding" (Heng, 2005)
At the First International Conference of Asian Queer Studies, 7 – 9 July 2005, held in Bangkok, one of the keynote speakers, Prof Vitit Muntarbhorn, Professor of Law at Chulalongkorn University, mentioned in his address that until now, no country in Asia has permitted the change of sex to be reflected in personal identity documents after sex-change surgery.
Muntarbhorn didn't seem to be aware that Singapore had recorded the change in status since 1973, and recognised marriages of sex-changed persons as well.
2007
Leona Lo published her autobiography.
2008
Marla Bendini’s first multimedia performance, in Pattaya, Thailand.
2009
The first annual Pink Dot Rally for the LGBTQ+ community
2010
The New Paper, 6 Dec 2010, ran an article on aging trans women who had previously lived by sex work on Bugis Street.
Sisters in Solidarity founded by Leana Lo and two others to oppose the anti-trans discrimination in clubs especially in the Clarke Quay area of Singapore.
The Ah kua show, based on Leana Lo's autobiography, Singapore and then the New York International Fringe Festival.
Fanny Ler, after marriage, a daughter and a divorce, transitioned at age 34.
2012
Tiffany’s Cabaret Show from Thailand, finally allowed to appear in Singapore. It had been refused twice in the 1980s because of ‘sensitive content’.
2013
December: the Bugis MRT (metro) station finally opened.
3 Feb-14 Mar: an exhibition eponymously entitled, "Bugis Street", open to the public, was held by French photographer, Alain Soldeville at the gallery of Objectifs - Centre for Photography and Filmmaking, 56A Arab Street.
21 September: Prof. Tsoi was interviewed in his clinic in the Tanglin Road Shopping Centre by four female team members of The Swan Project, a movement that aims to promote understanding and awareness of transgender individuals in Singapore by providing information, telling stories, providing support opportunities, and dismantling misconceptions about transgender people. Tsoi explained: “the incidence [of transsexualism] is quite high you know; I see about 1 or 2 a month. When they accumulate, combine cumulatively, they will end up in very large numbers. Roughly, I will have seen about 1000 each (male-to-female and female-to-male).” He explained that psychosexual and transsexual development occurs in linear phases, starting from the “homosexual” phase, then proceeding to the “transvestite” and cross-dressing phase, and finally, the transsexual phase. However, there has yet to be a cause identified within medical literature.
2015
Marla Bendini’s solo exhibition, "I’m Nervous", was included in the 10th edition of IndigNation, Singapore’s longest running LGBT festival.
2016
RFH, a 33-year-old Singapore national who lived as female in the UK for a decade, was to be deported home where she faced doing national service as a man, but on appeal was allowed to stay in UK.
2017
Lune Loh did her National Service , and after she said that she was trans, she was subjected to bullying and harrassment.
2019
Li Huanwu, nephew of current Prime Minister and grandson of Singapore’s first Prime minister, married his partner in Cape Town.
Singapore-born Gina Chua, an executive editor at Reuters transitioned on the job at age 60. more.
2021
Quen Wong produced and directed Some Women about herself from her days as a teenage boy coming out to her supportive family, to getting married at age 46. The film also includes Sanisa/Anita, a former sex worker from Bugis Street, and Lune Loh, a trans youth activist who is lesbian and has opted not to pursue medical interventions.
Ashlee, 18, the Millenia Institute school in Singapore, where teachers were initially supportive of her transition until she was about to begin hormone replacement therapy, was told that she would be expelled if she did not cut her hair and wear the boys’ uniform.
2022
The largely unenforced 1938 Section 377A of the penal code which made same-sex relations a crime, was repealed. At the same time the constitution was altered to reinforce rules against same-sex marriage.
The National Council of Churches of Singapore called on the government to guarantee the freedom of the clergy to preach against queer sex. The Singapore Buddhist Federation said traditional family values have to be preserved. "(But) we cannot force our values onto others or instil our own ideas, especially in the young. Let them have their own choices when they come to a mature age."
Lune Loh is a poet, and, after graduating from the National University of Singapore, is now doing an MA in creative writing at the University of London.
Andrea Razali is working as a para-counsellor, has a corporate job, and is undertaking a masters in psychology, and is the National Director of Miss Equality World, a new international beauty pageant.
2023
Harvey, an autistic Tamil trans woman who was raped in 2014 at the Singapore Institute of Mental Health while detained in a male ward, and no action was taken against the rapist. She attempted to sue the IMH in 2016. However she experienced a PTSD-induced flashback and destroyed a table in the courthouse. In 2023 she is facing criminal charges and may be sent back to to IMH.
Qatrisha Zairyah Bte Kamsi was the first winner of Miss Equality World Singapore, and also Miss International Queen Singapore. Her stepfather did not approve of her transition, so does not know of her marriage or her pageant successes.
The Bugis are a people from south Sulawesi (previously Celebes) that traditionally had five social genders: makkunrai and oroané (cis), calabai and calala (trans) and bissu (androgynous or intersex shamans).
In Malaysia the terms ‘pondan’ and ‘bapok’ have been used in the past for trans persons, but are mainly derogatory. Since the 1980s the terms ‘mak nyah’ for trans women and ‘pak nyah’ for trans men are the preferred terms.
Other terms for trans persons used in Singapore - mainly derogatory but some have have been reclaimed - are "ah kua" (Hokkien),"kidi" (Tamil) and "muffadet" (Singlish),
The Bugis were known in the 17th century and afterwards as they spread across south-east Asia as merchant-adventurers. It is not known how many calabai, calala and bissu were involved in this expansion. A Bugis sultanate was set up on the west coast of Malaya in the 18th century.
1819
The British governor Stamford Raffles arranged for the British East India Company to establish a trading post.
The Bugis were major traders in the British trading post.
The aboriginal Orang Kalland were relocated to the northern Singapore Straits at Sungai Pulau.
1820
After being pushed out of Sulawesi by the Dutch, several hundred Bugis settled in Singapore. With their trade networks, they were welcomed by the British rulers. They were alloted an area south of the Rochor River, which came to be known as Bugis Town.
1824
A further treaty with the Sultan led to the entire island becoming a British possession.
The aboriginal Orang Kalland were wiped out by a smallpox epidemic.
1867
The Straits Settlements were separated from British India, coming under the direct control of Britain.
1870s
By this time, with changes in the maritime trade, most of the Bugis had moved elsewhere, and immigrants from India and China were arriving. The British authorities authorised brothels in the Bugis Street area, and Chinese and Japanese women were brought in to work in them. The nearby Malay Street became the place where cis female street-walking prostitutes were found.
1915
The Singapore Mutiny by Muslimsepoys from British India, who were garrisoned in Singapore. After hearing rumours that they were to be sent to fight the Ottoman Empire, a Muslim state, the soldiers rebelled, killing their officers and several British civilians.
1921-38
The British built the large Singapore Naval Base as part of the defensive Singapore strategy. Originally announced in 1921, the construction of the base proceeded at a slow pace until the Japanese invasion of Manchuria in 1931. Costing £15 million and not fully completed in 1938, it was nonetheless the largest dry dock in the world, the third-largest floating dock, and had enough fuel tanks to support the entire British navy for six months. The base was defended by heavy 15-inch (380 mm) naval guns, as well as a Royal Air Force airfield at Tengah Air Base. Winston Churchill touted it as the "Gibraltar of the East".
The Bugis Street area further developed as the red light district, until the late 1930s when the authorities attempted to eliminate sexual soliciting.
1930
Noel Coward, on a round-the-world trip, visited Singapore and commented of Bugis Street:
“ubiquitous whores, none of whom were young or even remotely attractive”.
And thus it was in his 1964 book.
1938
Section 377a - an addition to the Singapore Penal Code introduced by the colonial government which criminalised sex between consenting adult males. It was not repealed until 2022, when it had been de facto unenforced for decades.
1941
7-8th December: Japanese forces attacked Thailand, Dutch East Indies, the UK colonies of Hong Kong, Singapore and Malaya, and the US colonies of the Philippines and Hawai’i.
1942
The 60,000 British empire forces in Singapore and Malaya finally surrendered to the Japanese 15 February 1942, what Churchill called "the worst disaster and largest capitulation in British history". Most UK and Australian troops, and later Dutch civilians, were imprisoned in the Selarang Barracks, near to Changi, an existing prison at the east end of Singapore. The Barracks also became referred to as Changi. 850 died in captivity, others were transported to work as forced labour in Japan or on the Thai-Burma railway (which included a bridge over the river Kwai).
Morale was inevitably bad, and the officers encouraged sports and theatricals. One of the first were The Mumming Bees concert parties, and it was at these that Bobbie Spong, who had already made somewhat of a name as a performer, first became well-known. Bobbie impersonated comedienne Beatrice Lillie, film star Marlene Dietrich and female impersonator Douglas Byng. From there Spong branched out into comedy sketches and revues, almost always in female parts. Even the Japanese and Korean guards came to watch. One night her appearance was greeted by a roar of applause that was heard across the island. Somehow Spong had managed to bring into the prison camp a full set of female clothing including corsets, and was allowed to grow his hair to a feminine length. Bobbie often stayed in role offstage. In particular she would tour the hospital wards and sing for those too sick to attend the performances. She was so convincing that when she sat on a patient’s bed they would blush and attempt to cover their nakedness.
1943
Late in 1943 when Private Spong returned to the Chungkai camp in Thailand from a work-camp up the line, and converted to Bobbie for a show, she was so convincing that the Japanese officers stopped the show and demanded proof of her manhood. Both Japanese and Korean guards often asked Bobbie to give a private performance in their quarters. This she did, graciously accepting fruit and cigarettes, and then would quickly flee back to her own quarters.
Christmas Day: Bobbie - in a light green and orange frock and hat - was in the hospital to give out cigarettes. Later that day she was at the mock horse races where everybody dressed up the best that they could. She kissed the winners of the races. The day ended with Bobbie under a large tree singing from the Douglas Byng repertoire.
1944
29 April: the Changi theatrical shows were cancelled because the Japanese had taken all the theatrical paraphernalia for the celebration of the Emperor’s birthday. Bobbie was part of a burlesque football match that was hastily arranged instead.
mid-May: Bobbie’s final appearance was in mid-May 1944 at Chungkai camp. Spong then shocked everyone by volunteering for a work detail in Japan because her best friend had been drafted for it. Departure was 8 June. By then Spong had had his hair cut, but managed to pack twenty frocks in his rucksack. 1300 POWs were crammed into an unmarked transport ship. The ship was spotted, torpedoed and sunk by a US submarine - very few survived.
1945
15 August: British military forces returned after the Japanese surrender.
1946
1 April: . British Military Administration ended on 1 April 1946, and Singapore became a separate Crown Colony
1948-1960
“The Mayalan Emergency”. The violent suppression of the Communist-led independence movement, using Agent Orange, concentration camps, forced relocations and slaughter of unarmed villagers.
Street hawkers selling cooked food and other sundries came to Bugis Street. Tables with white tableclothes were placed in the street. This became an entertainment area for British troops, and later - as the war in Vietnam developed - US forces also. There were some conflicts between the cis and the trans sex workers - the latter now starting to arrive. The trans women were almost all non-op in that it was far too expensive for Singaporeans to fly to Casablanca or Europe for the new gender operations.
Increasing numbers of Western tourists came for the booze, the food, the shopping and the "girls". Bugis Street became one of the most famous areas of Singapore for tourists. Western men persuaded themselves that they could tell the ‘real’ females in that they were not the gorgeous ones.
Writing in 2005, Russell Heng recollected what Bugis Street had been like:
If you want a mental picture of the old Bugis picture, imagined old shop houses before they were made pretty like they are today. In the evening, the street is closed to traffic and zhi cha stalls set up rows of table. Usually at around 9 pm, the first of the transgenders would arrive but you have to wait till at least 11 pm for the party to start warming up. The transgenders would move among the tables. If you strike up a conversation, they would sit down and chat. You can offer to buy drinks, which were not cheap with Coca Cola sold at $10 a bottle. Yes, t was a time when soft drinks were sold in bottles not cans. The exorbitant $10 was like a cover charge to see a show. However I cannot be certain if there was ever an arrangement for the drink stalls to pay a commission to the transgenders if they get tourists to buy the over-priced drinks. On a busy night, you can have as many as 40 transgenders. I also remember some interesting characters like the little girl who went round challenging tourists to play noughts and crosses for either 10 or 20 cents. She never lost a game.
1956
Singapore granted full internal self-government for all matters except defence and foreign affairs.
1959
Dr Shan Ratnam trained at Singapore General Hospital.
1962
The earliest published account of the trans women on Bugis Street and the tourists who came to gawp was Eastern Windows by F D Ommaney, an officer in the Research branch of the Colonial Service. He gave nine pages to Bugis Street, and in particular:
And now here comes Maisie, tall and graceful too, but perhaps a trifle over-slim and flat-chested. She wears a smart, black, sheath-like cheong-sam with little jet beads sewn in patterns. They shimmer as she walks . . . But there is something not quite right about her feet. They are a shade too large. I will tell you a secret about Maisie. No one is supposed to know it, but it is surprising how many do. She is not a girl at all. She is a boy. Sometimes clients have been known to make quite a scene when they discover their mistake, and Maisie has sometimes had to stay away from Bugis Street for a day or two nursing a black eye. But not for long. Nothing daunted, she will be back again in a day or two with a new cheong-sam and some new ear-rings. (p44)
James Clavell’s novel, King Rat, set in the Changi POW camp, features a character, Sean Jennison, who was selected to play female parts in camp theatricals, was at first reluctant, but then embraced the parts, and lived as female off stage. After the camp was liberated she could not cope and drowned herself in the sea.
1963
After a referendum on a proposed merger with Malaysia which included a choice of different terms for the merger and had no option for avoiding merger altogether, Singapore became part of Malaysia.
Shan Ratnam began teaching at the University of Singapore. He then did post-graduate medical studies in London.
Shonna, 16, worked as a sales girl, and frequented the trans scene on Bugis Street.
1964
Race riots in Singapore involved a series of communal race-based civil disturbances between the Malays and Chinese in Singapore.
Shan Ratnam became Professor and Head of the Department of Obstetrics and Gynaecology at the University of Singapore.
Shonna’s father died. She worked as a housemaid for a European man, and had an affair with him. Subsequently she worked in a bank and then in public relations for a hotel.
Noel Coward published Pretty Polly Barlow and other stories, about a young woman who arrives in Singapore with her strict aunt, who conveniently dies leaving Polly to explore her sexuality. Bugis Street is mentioned as a place to visit, but seems to be the Bugis Street that Coward had seen in the 1920s and 1930s, with no mention of trans women.
1965
The Singapore and central Malaysian governments disagreed on many issues. Talks soon broke down, and abusive speeches and writing became rife on both sides.
7 August: the Malaysian government, with the agreement of the Singapore government advised the Parliament of Malaysia that it should vote to expel Singapore.
9 August: Malaysian Parliament voted 126 to 0 to move a bill to amend the constitution, expelling Singapore from Malaysia, which left Singapore as a newly independent country.
King Rat - although set in the Changi POW camp - was filmed in California. The episodes of Sean Jennison acting and then living as female were in the script from the beginning, but at a late stage, Columbia Pictures executives finally realized that they were present, and Sean was completely removed from the film.
1966
Shonna came second in the Miss Singapore Beauty Contest, which led to modelling work.
1967
National service was implemented requiring all 18-year old males to train full-time for two or two-and-a-half years, depending on their educational attainment. Transgender was listed as a condition in a Singapore Armed Forces (SAF) 'Directory of Diseases' and recruits who outed themselves to the examining doctors had their 'deployability' denied in sensitive positions. They were assigned only clerical work at army bases.
The film A Matter of Innocence, based on Noel Coward’s Pretty Polly Barlow, was filmed in Singapore, about a young woman (Haley Mills) travelling with a stern aunt who becomes free to explore her sexuality after the aunt’s death. Includes some scenes in the actual Bugis Street of the late 1960s, unlike the straight version depicted in Coward’s story.
1968
Shonna started a cabaret act using the name Mama Chan. However she twice attempted suicide by taking sleeping pills.
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.
A secret report for the British Navy after an internal investigation concluded that of gay sailors and officers in the late 1960s "at least 50% of the fleet have sinned homosexually at some time in their naval service life”.
“Service chiefs agonised over the practice of sailors visiting the catamites of Bugis Street. The file says many sailors visited the area ‘for kicks’, got drunk and ‘end up sleeping with male prostitutes known as catamites’ who dressed up convincingly as females.”
This report was not declassified until 2002.
1971
Surgery on Shonna was finally performed by Dr Shan Ratnam 30 July 1971 at the Kandang Kerbau Hospital 竹脚妇幼医院. This was the first such operation in Asia.
Dr Ratnam
A Gender Identity Clinic was set up headed by Prof Ratnam, who ran it until his retirement in 1995. The psychological evaluations were done by Singapore's chief academic psychiatrist Prof Tsoi Wing Foo.
Jan Wålinder, the son of a civil engineer, was raised in Eskilstuna, 100 km west of Stockholm. He studied medicine at Uppsala University from 1952, and was licensed as a doctor in 1958. He spent a year at the Maudsley Hospital in London, 1961-2. In 1964, his boss, Hans Forssman, became a professor at the University of Gothenburg and chief physician at Sankt Jörgen Hospital in Gothenburg; Wålinder transferred with him.
From 1962–1974, 92 patients were referred to the University clinic, Sankt Jörgens hospital, for evaluation as transsexuals. Wålinder became the doctor leading the program. Fifty-two of these were considered transsexual and accepted for a sex reassignment program.
Wålinder published a first paper on occasional derivation of transvestism/transsexualism from cerebral dysfunction in 1965.
He wrote his dissertation in 1967, based on the patients in the program and a review of the then published literature.
He adhered to the then convention of using birth sex rather than gender identity – thus trans women are ‘male’ and ‘he’, and trans men are ‘female’ and ‘she’. Like many others, he incorrectly claimed that Hirschfeld had coined the term ‘transvestism’.
He analysed 207 cases that he found in the existing literature – 185 ‘males’ and 22 ‘females’. He found 70% had cross-gender behavior before the age of 10; that intelligence was distributed along the normal curve for the population; that 10 of the 207 had a family member who also cross-dressed; that 33% had adnormal EEG readings, and five of those also had epilepsy.
In February 1965 Wålinder sent a letter to every psychiatrist (child psychiatrists excluded) in Sweden asking about any trans patients that they had treated:
“Seventy-six per cent, or 361 out of the 474 psychiatrists answered the letter, and together reported 91 cases. Most of them gave detailed descriptions of their cases by letter or on the telephone. A few were unwilling to disclose any details about their patients, and these had to be excluded. Two of the patients were not known for sure to be alive on the census date, and these were also excluded. All patients under 15 were also excluded.
Sixty-seven of the remainder reported were transsexuals, judging by the safest criterion to use when one cannot interview the patient personally -- they wanted a surgical change in sex. It was checked that none were registered more than once. Including my own 43 cases, this gave 110 transsexuals in Sweden on December 31, 1965. Sweden having a population of ca. 5.96 million over 15 years of age, this meant a prevalence of ca. 1 per 54,000. Eighty-one of the 110 were men and 29 women, giving a male/female ratio of about 2.8:1, and a prevalence of ca. 1 per 37,000 for men and ca. 1 per 103,000 for women.
Transsexualism is naturally more common than indicated by these figures, which only stand for transsexuals under so much strain because of their anomaly that they had to consult a psychiatrist. Six of the 110 were foreigners, but only 3 of them appear to have come to Sweden expressly for a "change in sex". As I know of some Swedish transsexuals who have gone to other countries to have plastic surgery done, the admixture of these 3 persons to the series should not distort the figures for prevalence.”
Of the patients who came to the program at Sankt Jörgens hospital:
“Personal examination of the subjects, including: their personal accounts of their history, with the interviews conducted on informal lines in each case; physical and neurologic examination; body measurements; EEG-examinations; hormone analysis; examination of sex chromatin, occasionally supplemented with determination of the karyotype; analysis of personality by means of a questionnaire; psychologic tests of intellectual capacity and masculinity-femininity; examination for psychiatric disorders. In each case I first had an informal conversation with the patient, when he or she gave me a brief account of their troubles. The next time we met they were asked to describe their particular problems in detail. After these two interviews, the patients gave an account of their history along the lines of a questionnaire used routinely at our institute. Most of the patients stayed at the hospital for a week or so while the examinations were being made.”
Information was also gathered on the patients from their families and/or spouse, hospital records and social agencies.
Treatment:
“Ten men got no specific treatment, 11 only got estrogen treatment, 5 got estrogen treatment and afterwards a conversion operation. Eight got their name changed legally, all 8 after estrogen medication and 4 in combination with a conversion operation.
Two women got no specific treatment, 1 woman got only androgen treatment, 8 got their breasts amputated after androgen treatment, and 9 had their name changed legally, all after treatment with androgens and 7 in combination with a removal of their breasts.
In all except 3 cases of operation or change of name too little time has elapsed to be able to say anything definite about the results. The length of follow-up for the men who had an operation or their name changed now amounts to 20.7 months on the average (median 24.5 months) and for the women to 42.3 months (median 26.2 months). The patients themselves all said, however, that these measures had made it easier for them to adjust, made them more stable mentally, and improved their sex life. None regretted what had been done. None showed any signs of the treatment having an adverse mental effect.
On the whole, the women seemed to have profited more from their treatment than the men.
All patients were given supportive psychotherapy in order to help them cope with their problems, and various measures were taken to provide a better social adjustment.”
A notable difference between Wålinder’s study and that of Benjamin, published the year before, is the factor of organic causes which apply in some cases.
“Several authors have suggested that transsexualism is of organic origin, that it is due to genetic, hormonal or cerebrolesional mechanisms. Data pointing to an organic factor in my series were: (1) The large number of abnormal EEG's. Epilepsy was over-represented in the cases I collected from the literature, and 1 of the 43 transsexuals in my own series was epileptic and another got a grand mal attack during photostimulation. I have already reported (Wålinder, 1965) that cerebrolesional factors have been noted in cases of different kinds of sexual aberration. (2) In 1 of the present cases the transsexualism started some years after a severe head injury, no signs of deviation being observed before; in this case the transsexualism disappeared on anticonvulsant medication (given because of an abnormal EEG) and reappeared when the medication was stopped. (3) The familial occurrence in 4 cases of mental retardation, cerebrolesional signs and abnormal EEG's, pointing to the possibility of a hereditary disorder in cerebral functioning. (4) Definite evidence of an early cerebral lesion in 1 case (case 1) and the possibility of such in case 16. Adding together these cases gives 15, or about 35 per cent, with evidence of an organic disorder (cases 1, 4, 7, 12, 13, 15, 16, 19, 23, 25, 29, 31, 33, 38, 42).
It is unlikely that the same mechanism lies back of every case of transsexualism. On the other hand, disorders in cerebral functioning may cause a wide variety of mental disorders, the kind probably depending on the site of the injury, and the age at which it occurs. In view of NS, and the usually early onset of transsexualism, the injury must occur early in life if transsexualism is of organic origin. One can influence the sexual behavior of animals by giving hormones prenatally … My study of prenatal and perinatal factors, however, did not reveal any circumstances of note.
Of particular interest when discussing the possibility of an organic factor are the cases in which treatment of a hormonal disorder … or treatment of cerebrolesional disorders … eliminated or lessened the intensity of the transsexualism" transvestism. My case 15 is another example. In all these 3 cases the symptoms were reversible and, in my case at least, they began later than in most cases. In the majority of cases, however, the transsexualism begins early in life and does not respond to treatment. The consistency from case to case is compatible with some form of organic disposition.
My investigation has shown that it is hardly possible to attribute transsexualism to only psychologic or only organic causes. Circumstances pointing to organic origin were present in some cases, and circumstances pointing to environmental origin were present in others. It is reasonable to assume that the two kinds of factors interact, that environmental factors in the wide sense shape and determine how the transsexualism develops, and that some unfavorable external factors precipitate the transsexualism, or turn what was only a disposition to transsexualism into a permanent, fixed form of the anomaly. It is also possible that psychologic factors affect the fixity of the transsexualism, and help to make it irreversible after puberty.”
The dissertation, published 1967, led to his becoming an associate professor in psychiatry.
Harry Benjamin in New York read Wålinder’s study and tested the claim re an anti-convulsant drug and tried Dilantin with a few transvestites who wanted to be cured, and two transsexuals who were willing to experiment. This apparently worked for some of the transvestites who desisted [for a while at least] but it had no effect on the transsexuals. Leo Wollman, in a lapse of ethics, prescribed Dilantin instead of estrogen to Lyn Raskin - and it had no effect at all on her yearning to be a woman.
In 1968 Wålinder published a summary in Acta Psychiatrica Scandinavica. He repeated his definition:
“The line between transvestism and transsexualism drawn by many authors has been and still is all too obscure. As long as no definite criteria are employed to differentiate these two groups, progress in understanding of the conditions will be limited,
In an investigation of 48 cases of transsexualism primarily segregated according to Benjamin’s (1966) criteria, the following variables were noted in 100% of the subjects:
A sense of belonging to the opposite sex, of having been born into the wrong sex, of being one of nature’s extant errors.
A sense of estrangement with one’s own body; all indications of sex differentiation are considered as afflictions and repugnant.
A strong desire to resemble physically the opposite sex via therapy including surgery.
A desire to be accepted by the community as belonging to the opposite sex.
The fundamental, primary disturbance appears to be a feeling of contrary sex-orientation, i.e. inverted core gender identity in Stolleu’s (1964, a, b, c ) meaning. All of the other symptoms seem to cluster around this erroneous sex identity.”
In 1969 he contributed two papers to the Richard Green & John Money anthology, Transsexualism and Sex Reassignment: one on parental age and birth order of transsexuals, and one on the situation in Sweden.
He gave a paper at the Reed Erickson sponsored September 1971, Second International Symposium on Gender Identity in Elsinore, Denmark re legal changes for trans persons in Sweden.
In 1974 he became the chief physician at Sankt Jörgen Hospital
In 1996 Wålinder responded to a paper ‘Men as women’ by Stig-Eric Olsson, Inge Jansson, and Anders Möller in the Nordic Journal of Psychiatry:
“The authors of the previous article state that ‘the phenomenon of transsexualism is still controversial from a medical standpoint’. On the contrary, transsexualism is a well-recognized disorder and identified in DSM IV under the heading ‘Gender identity disorder’. The authors’ statement that ‘reports in the medical literature on psychologic adjustment after sex change treatment are rare’ indicates that they are unfamiliar with current research in the field.
It goes without saying that, given the irreversibility of sex reassignment surgery, the need for investigation of prognostic factors is compelling. Such factors have already been identified. In a Swedish sample of more than 200 sex-reassigned persons 3.8% have in some way regretted measures taken. Any one of these cases tells a sad story and is indeed a tragedy. If we consider the years from the early 1950s until now, the figures for repentance cases have steadily decreased, and of those who have been sex-reassigned after 1982 only one person has regretted what was once done. Thus, outcome has improved over the years owing to improved assessment and, consequently, more restricted inclusion criteria, improved surgical techniques, and more attention paid to psychosocial guidance and careful posttreatment follow-up procedures.
At-random-presented cases do not invalidate a worldwide pool of data that speak in favour of a successful outcome in cases that have been carefully selected for sex reassignment. These outcome data comprise in a strict sense both medical and psychologic factors.”
Wålinder was due to retire in 1997, but stayed an extra couple of years to secure the future of research projects. He returned to Gothenburg where his children lived. There he became involved with adult psychiatric reception at a clinic in Mölnlycke just outside Gothenburg.
Jan Wålinder died age 83.
----------------
Wålinder on trans topics:
“Transvestism, definition and evidence in favor of occasional derivation from cerebral dysfunction”. International Journal of Neuropsychiatry, 1, 1965.
Transsexualism: a study of forty-three cases. Goteborg Akademiforlaget, 1967.
“Transsexualism: Definition, Prevalence and Sex Distribution”. Acta Psychiatrica Scandinavica, 43, 1968.
“Transsexuals: Physical Characteristics, Parental Age, and Birth Order” and “Medicolegal Aspects of Transsexualism in Sweden” in Richard Green & John Money (eds). Transsexualism and Sex Reassignment. The Johns Hopkins Press, 1969.
with Hans Olof Åkesson. “Transsexualism. Effect on Rate and Density-Pattern of Change of Residence”. The British Journal of Psychiatry, 115, 522, 1969.
“Incidence and Sex Ratio of Transsexualism in Sweden”. British Journal of Psychiatry, 119, 1971.
“A Proposal for a New Law Concerning Sex Assignment of Transsexuals in Sweden”. Second International Symposium on Gender Identity, Elsinore, 12-14 September 1971.
with Inga Thuwe. “A law concerning sex reassignment of transsexuals in Sweden”. Archives of Sexual Behavior, 5, 3, 1976.
with Inga Thuwe. “A Study of Consanguinity Between the Parents of Transsexuals”. The British Journal of Psychiatry, 131, 1, 1977.
with M W Ross, B Lundströ & Inga Thuwe. “Cross-cultural approaches to transsexualism”. Acta Psychiatrica Scandinavica, 63,1. 1981.
with Bengt Lundström. “Evaluation of candidates for sex reassignment”. Nordisk Psykiatrisk Tidsskrift, 39, 3, 1985.
“Comments on the paper ‘Men as women’ by Stig-Eric Olsson, Inge Jansson, and Anders Möller. Nordic Journal of Psychiatry, 50, 5, 1996.
Mikael Landén, Jan Wålinder, and Bengt Lundström. “Prevalence, Incidence, and Sex Ratio of Transsexualism”. Acta Psychiatrica Scandinavica, 93, 1996.
Jan Wålinder otherwise specialised in affective diseases: depression, bipolar disorder, schizophrenia. Writings on these and other topicsmore.
Other:
Stoller, R. J . (1964 a ) : “A contribution to the study of gender identity”. Int. J . PsychoAnal., 45, 220.
Stoller, R. 1. (1964 b ) : The hermaphroditic identity of hermaphrodites. J . new. ment., 139, 453.
Stoller, R. 1, (1964 c): Gender-role change in intersexed patients. J A M A , 188, 684.
Harry Benjamin. “Newer Aspects of the Transsexual Phenomenon”. The Journal of Sex Research, 5,2, May 1969.
Erika Alm. “What constitutes an in/significant organ? The vicissitudes of juridical and medical decision-making regarding genital surgery for intersex and trans people in Sweden”. In Gabriele Griffin & Malin Jordal (eds). Body, Migration, Re/Constructive Surgeries. Routledge, 2019: 225-240.
Lyn Raskin. Diary of a Transsexual. The Olympia Press, 1971: 38.
Joanne Proctor writing as P J Schrödinger. “DSM-5: Gender Identity – Creating the Trans epidemic” Trans-friedfluff, December 27, Online.
Miki Agerberg, “»Jag lär mig något nytt varje dag«”. se, 2013-10-15. Online.
