A Gender Variance Who's Who

++original September 2013, revised February 2019 to include extra detail from Gill-Peterson's book, and December 2023 to acknowledge Jeanne's passing.

Eugene Hoff  was born in in St Louis.  Hoff did an MD at Columbia University, College of Physicians And Surgeons 1963 followed by a doctorate in solid state chemistry at University College, London (where he also converted to Catholicism), followed by training and a residency as a psychiatrist at the Washington University School of Medicine in St. Louis, Missouri.

Hoffinitially thought of himself as homosexual, but in exploring homosexuality found out that he was not. He was introduced to the Harry Benjamin practice, possibly by Wardell Pomeroy of the Kinsey Institute.

Hoff was a guest on the NBC television program Not for Women Only where he (as she was still) explained transsexualism from a medical viewpoint referring to trans women as 'men' as was the then practice.

"You can say that you know that you are a woman, therefore you want to be one. But no woman I have ever asked has been able to tell me what that means, and I doubt that transsexuals will be the first to define it."

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:

1. A sense of belonging to the opposite sex, of having been born into the wrong sex, of being one of nature’s extant errors.
2. A sense of estrangement with one’s own body; all indications of sex differentiation are considered as afflictions and repugnant.
3. A strong desire to resemble physically the opposite sex via therapy including surgery.
4. 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

From 1992-1996 he was professor of psychiatry and chief physician at Linköping University and Linköping Regional Hospital, where he stayed for 18 years, 

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 topics   more.

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.

SV.Wikipedia

Part I: history of the APA 

Part I: history of the APA 

Part I: history of the APA 

See also  John Randell (1918 – 1982) Psychiatrist.


In Richard Green's new book

• Gay Rights, Trans Rights: A psychiatrist/lawyer's 50-year battle.  2018.

Part I: Life
Part II: theory

Unless otherwise noted, page references are to The Sexual Century.

Ethel Jane Spector was raised in Louisville, Kentucky. Her mother was a mathematician, and her father owned a bar. He died when she was twelve. She completed a first degree at the University of Chicago in 1956, and then a medical degree at the New York University College of Medicine four years later. She became Mrs Person when she wed an engineer. The marriage ended after ten years, although she kept his name for her professional life. She married her second husband, a psychiatrist, in 1968, and became Mrs Sherman.

Soon after joining the Columbia University Center for Psychoanalytic Training and Research, Person was invited to work with Lionel Ovesey (1915-1995), the author of The Mark of Oppression: A Psychosocial Study of the American Negro, 1951, and Homosexuality and pseudohomosexuality, 1969. His concept of ‘pseudohomosexuality’ concerned `homosexual anxieties' in heterosexual males who were concerned about dependency and lack of power. Ovesey was one of the psychiatrists strongly opposed to the delisting of homosexuality from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1973.

Ovesey’s proposal was that he and Person would write a textbook on sex and gender. They quickly realized that neither of them had any experience with transvestites or transsexuals. An acquaintance in the psychoanalytical world was Harold Greenwald, the founder of the Professional School for Humanistic Studies (where Anne Vitale qualified as a psychologist). Greenwald introduced Person to the then 88-year-old Harry Benjamin and his assistant Charles Ihlenfeld in 1972. She spent time in Benjamin’s office interviewing some of his patients.

“The work that I did with Lionel would have been well nigh impossible without the cooperation of Harry Benjamin, who was hospitable to me despite his major bias against psychoanalysts. In fact we became great friends.” (p xiii)

Indeed Benjamin asked her to write a biographical portrait of him to be published after his death. She formally interviewed him to this end a dozen times.

One person that Person met at Benjamin’s offices was Ed/Edna, 60, a retired tugboat captain who had become the superintendent of a rental building. He fell in love with Clair, one of his tenants, a completed transsexual. He detransitioned to become her lover, and was devastated when she left him for a truck driver. To cope with the resulting depression, Edna restarted hormones and dressing full-time. Again he rented to a completed trans woman, Janet. Again he reverted to male, and became her lover. After Ed’s original wife died, he married Janet, and lived happily with her until she also died ten years later. He was then 85. (By Force of Fantasy p 131-4)

Edna subscribed to Transvestia magazine, and through that discovered transvestite social groups. Edna introduced Person to these socials: “it was at these events that I gained some of my deeper insights into the subjective meaning to transvestites of their participation in that world”. Person and Ovesey also sought confirmation for their work by visiting pornography shops and reading trans publications.

Person and Ovesey proposed a typology of trans persons assuming that a child's separation-individuation anxiety produced a fantasy of symbiotic fusion with the mother which the transsexual tries to resolve by surgically becoming her mother.  Papers to this effect were published 1973-85. (See part II for details).

One of the transsexuals included in the Person-Ovesey study was Elizabeth – author of the Notes from the T Side blog. She writes:

Harry Benjamin “in 1970 -71 asked me to talk to a Dr. Ethel Person as part of a study and I agreed although I am inherently distrustful of shrinks but I found her pleasant and quite nice and we became friendly. When the study was published I was stunned to be honest. I was part of the study and I knew two others who were part of it and friends of mine. We never talked about anything mentioned in the study directly. We talked about our lives as children until the current time and at the time I was 24 and had close to enough money for surgery. In point of fact Harry might have been more upset by the study than anyone. I am posting this to refute what they found because as one of the participants in the study I walked into her office and asked her where I fit in late 1974 and she said Secondary because I liked boys so I was a homosexual transsexual where by Harry's definition I was a Type VI high intensity transsexual and according to Harry the study was bogus.”

Ethel Person’s second husband died in 1976. She married a lawyer in 1978 and became Mrs Diamond. 


Person was director of the Columbia University Center for Psychoanalytic Training and Research 1981-91. She did an “epidemiological study of sexual fantasy” which she contrasted to Alfred Kinsey’s study of sexual acts.

Her best known book is By Force of Fantasy: How We Make Our Lives, 1995, where she argues that we shape our lives by trying consciously or otherwise to live out our fantasies.

In 1987 Person had paired the film critic Molly Haskell with an appropriate analyst, and became a friend. In 2005 when Haskell’s sibling was starting transition, she spoke to Person about the situation. Apparently Person said nothing to her about primary or secondary or separation anxiety. Only: “Transsexuals are the best, the kindest people I know, maybe because they have to learn compassion the hard way” and “He longs for validation,” Ethel spoke of transsexualism as being “a passion of the soul”. Later in Haskell’s book, Person is quoted: “The worst thing about it is you discover you don’t know the person you thought you knew.”

In 1997 Person gave a presentation to the International Psychoanalytic Association Congress in Barcelona on her life of Harry Benjamin, and used it to illustrate the origin of shared cultural fantasy. In 1999 she collected her works on sex and gender, including her biography of Harry Benjamin, and published them as The Sexual Century.

Person’s third husband died in 2009. Ethel Jane Spector Person Sherman Diamond, her final name, incorporating the surnames of all three husbands, died at age 77 of complications from Alzheimer’s disease.

(All quotations from Anderson 2015, unless otherwise specified).

Ira’s father was a successful bookmaker who raised his three sons and a daughter in Beverly Hills, Los Angeles. Ira was the youngest, and the first in the family to go to university. He graduated from the University of California, Los Angeles in 1953. He was a noted rugby and US football player. In the latter, he was on the UCLA winning team of 1953, and Pauly was the B’nai B’rith 1953 Los Angeles Jewish Collegiate Athlete of the Year.

 “I applied to medical school. And even though my, I had a pretty good GPA, probably 3.4, 3.5. But the guys that were getting in had 3.8 and 4.0s. But you know, because by then I had become known as a football player, I was the first one to get accepted at UCLA, I was told. So that didn’t hurt. They were looking for people who were so-called well-rounded.“ (Interview with Maija Anderson p2)

He graduated from the UCLA School of Medicine in 1958. After doing a surgical internship at UCLA, he was accepted for a psychiatric residency at Cornell Medical Center in New York. He married in 1960, and he and his wife had four sons.

In 1961 he was doing a rotation in the consultation service when he was called to urology to counsel a trans man who was in for a hysterectomy. He attempted research in the hospital library but found material on transsexualism only in French and German. He had patients who were willing to do longhand translations for him.

He then discovered a paper by Cauldwell.

“And then there was a brief article by someone named Harry Benjamin. And in those days, it was in a somewhat obscure journal. I don’t quite remember which journal it was. But it had his address. And it was an address that was about five blocks away from the hospital that I was working at. So I looked up his name in the phone book and told him that I was a psychiatry resident, and I had a little experience with a transgender, transsexual patient. And was there any way I could come over and talk to him, because I had read—he was an endocrinologist. And a lot of these folks, the first step in the physical transition is taking the contrary hormone.” (Interview with Maija Anderson p6)

For much of that year, he attended Benjamin's Wednesday afternoon clinic.

 “So every Wednesday afternoon, through the generosity and mentorship of Harry Benjamin, I was able to see probably more transsexual patients than any psychiatrist in North America. … As I got to know the patients, they uniformly described being happier into the gender role that they felt they were in from the very beginning. And that the only thing that needed to be done as far as treatment was concerned was to get the body on board with the gender of their choice.“ (Interview with Maija Anderson p6)

Pauly set out to aggregate 100 cases from the literature and from among Benjamin’s patients.

He had been in the Reserve Officers’ Training Corps (ROTC) at UCLA and would normally have done military service at the end of his education, but he had developed glaucoma, and the army no longer wanted him. In 1962 he obtained a position at the University of Oregon Medical School.

He completed "Male Psychosexual Inversion: Transsexualism. A Review of 100 Cases" in 1963, but it was not published until 1965. He concluded that that gender surgery had positive results and that trans patients should be supported by medical professionals in their quest to live as the gender of their identity. He then received a thousand requests from doctors around the world for offprints of his article. It also resulted in a job interview at Johns Hopkins, but Oregon doubled his salary to keep him.

++His presentation at the American Psychiatric Association in 1964 led to a sensationalized article in the National Insider that while quoting him that the desire to change is found in childhood, it then blames alcoholic fathers who punished their children, and that "It apparently gave them a reason to escape from responsibility and from being a man".

However, Harry Benjamin, in his 1966 The Transsexual Phenomenon, quotes Pauly as saying:

“Because of his isolation, the transsexual has not developed interpersonal skills, and frequently presents the picture of a schizoid or inadequate personality.” (p71-2/33).

Speaking to the American Psychiatric Association in May 1964, Pauly said:

“The transsexual attempts to deny and reverse his biological sex and pass into and maintain the opposite gender role identification. Claims of organic or genetic etiology have not been substantiated. … Although psychosis is not frequent in the schizophrenic sense, in its most extreme form, transsexualism can be interpreted as an unusual paranoid state, characterized by a well-circumscribed delusional system in which the individual attempts to deny the physical reality of his body. The term Paranoia Transsexualis has been suggested as an appropriate descriptive term for this syndrome. Psychosexual inversion is seen as a spectrum of disorders, from mild effeminacy to homosexuality, transvestism, and finally transsexualism, each representing a more extreme form, and often including the previous manifestation.” (quoted in Benjamin, 162-3/76)

He proposed the term ‘pseudotranssexual’ for those who sought transition to justify their
homosexuality.

He was one of the first doctors to point out that transsexuals tell the doctor what he wants to hear. He called them “unreliable historians”. (Benjamin, 164/76)

Pauly also saw private patients.

“But these folks were, among other things, very grateful because they had great difficulty getting a physician to empathize with their situation, let alone treat them. And prescribe hormones and refer them to the surgeon for surgery. So the word got around. So I probably treated everybody in the Portland area on a one-to-one basis.” (p12)

Oregon had no surgeon performing transgender surgery, so at first patients were referred to San Francisco, and then to Dr Biber in Trinidad, Colorado. Pauly did his own endocrinology prescriptions. In that period he also attempted to treat gay persons wishing to become heterosexual.

“And there was the occasional transgender person that wanted to go back to accept himself in the gender role that was consistent with what his body said. And some of us tried to help out in that regard. But I personally tried to do that with a couple of patients. And the only thing I really accomplished was to kind of push them into a psychosis. So that, by trial and error, I learned that I certainly didn’t have the ability to help them with that problem.” (p19)

In 1969 he contributed two papers to Green & Money’s Transsexualism and Sex-Reassignment, one on trans women, one on trans men; each includes four case studies, and an overview.

Paul McHugh, who would close down the gender identity clinic at Johns Hopkins after 1975, was dean of the University of Oregon Medical School until 1975.

In 1975 Pauly’s student Thomas Lindgren, wanting something more objective than a patient’s self-history, developed a body-image scale where patient’s rated how they felt about different parts of their body. Not surprisingly pre-op transsexuals rated their genitals worse than their arms or legs. However it was also used for anorexia and other conditions, including those wanting homeogender surgery.

In 1978 Pauly became chair of the University of Nevada Medical School. He was a founding member of the Harry Benjamin International Gender Dysphoria Association, (now WPATH) in 1979, and served as president of the Harry Benjamin International Gender Dysphoria Association from 1985 to 1987.

In the late 1980s, Louis Sullivan was lobbying the American Psychiatric Association and the Harry Benjamin International Gender Dysphoria Association and the gender identity clinics to recognize the existence of gay trans men. Pauly was one of the few psychiatrists to respond, and made a three-hour video interview with him.

Pauly retired in 1995, did sabbatical work in New Zealand, and returned to work in the state hospital in Reno, Nevada and became medical director for the Northern Nevada Adult Mental Health Service.

In 2004, Pauly was inducted into the Southern California Jewish Sports Hall of Fame.

He retired again in 2010.

• Ira B Pauly. "Female Psychosexual Inversion: Transsexualism. Read before the American Psychiatric Ass., St. Louis, May 1963.
• Arnold Wells. “Exclusive! MD Reveals The Fourth Sex! Not Male, Not Female, And Not Homosexual”. The National Insider, 5, 3, July 19, 1964. Online.
• Ira B Pauly. "Male Psychosexual Inversion: Transsexualism. A Review of 100 Cases". Archives of General Psychology, 13, 1965:172-181.
  
• Ira B Pauly. “The current status of the change of sex operation”. Journal of Nervous and Mental Disease, Nov;147, 5, 1968:460-71.
  
• Ira B Pauly. “Female Transsexualism”. Archives of Sexual Behavior,3, 1974:487-526.
  
• Harry Benjamin. The Transsexual Phenomenon. Julian Press, 1966. Warner Books Edition 1977, with a bibliography and appendix by Richard Green.  PDF (with different pagination): 71-2/33, 162-3/76, 164/76, 179/84, 181/84.
  
• Ira B Pauly. “Adult Manifestations of Male Transsexualism” and “Adult Manifestations of Female Transsexualism”. In Richard Green & John Money (ed). Transsexualism and Sex-Reassignment. Baltimore: The Johns Hopkins Press, 1969: 37-87.
  
• Joanne Meyerowitz. How Sex Changed: A History of Transsexuality in the United States. Cambridge, Ma, London: Harvard University Press, 2002: 123, 124, 125, 174.
• Amy Bloom. Normal: Transsexual CEO's, Cross-Dressing Cops, Hermaphrodites with Attitude, and More. Vintage, 2014: 18-22.
  
• Maija Anderson. Interview with Ira B. Pauly, MD. Oregon Health & Science University, Oral History program, Februray 18, 2015. Online

TSRoadmap
______________________

For some reason Harry Benjamin calls Pauly “Ira S Pauly”. 

The EN.Wikipedia article is almost the same as the TSRoadmap article.

At the end of Maija Anderson’s interview, Pauly is asked what he thinks about Alan Hart, the famous trans doctor from Portland, Oregon, who transitioned in 1917. Despite having lived in Portland for 16 years where Hart is remembered, he replies: “No. I wish I had seen that. Where was it published again”, and then “And as far as I knew, the first published female to male, as we referred to it, was the patient I described in the New York Hospital”. Obviously he does not spend much time reading trans history.

Herbert Bower, the only child of Jewish parents, was training as a doctor in Vienna in 1938. After the Nazi takeover, he fled to Switzerland, and completed his studies at the University of Basel, after which he and his fiancée made their way to London where they were married. They were on the last ship from London to Australia, as war broke out in September 1939.

However the Australian authorities would not recognise his medical qualifications. He worked as an orderly at Launceston General Hospital, and then did two years in the Northern Territory as a medical officer ministering to Chinese tungsten miners. The Government appreciated this and accepted him as a Swiss neutral rather than as an enemy alien. His parents died in the Theresenstadt concentration camp.

After the war, he repeated his medical training at Melbourne University. He became a psychiatrist, and encountered his first trans patient.

In 1955 Bower became the superintendent of Kew Asylum, which had many elderly patients and was appalled at the conditions, which he immediately set about improving.

By then he had fallen in love with another woman. They both divorced their spouses, and married in 1956.

Bower introduced the concept of ‘successful aging’, and in 1963 gave two influential lectures at the University of Melbourne on the topic.

In 1965 he suffered a heart attack, and resigned the superintendency, but continued as a consultant with the Mental Health Authority of Victoria. He also began teaching, and in 1970 became director of post-graduate studies at Melbourne University. In 1972 he called, but without much support, for psychiatrists to have a role in assessing the fitness of politicians. He was influenced by Herbert Marcuse, and engaged with feminism and the anti-psychiatry movement.

In 1974 at age 60 Bower, with Trudy Kennedy, approached the Queen Victoria Hospital with the idea of a gender dysphoria clinic. A team was created that eventually included a second psychiatrist, an endocrinologist, a speech therapist, a gynaecologist and a plastic surgeon. The first transgender surgery was performed there the next year. The clinic was later moved to Monash Medical Centre.

From 1975 Bower was technically retired, but continued to teach, consulted as a psychogeriatrician and saw an increasing number of trans patients. His second wife died from cancer in 1980, and later that year he suffered anginal attacks and had triple bypass surgery. He recovered and took a third life partner.

His work led to a Unit for Old Age Psychiatry at the Melbourne Clinic. At the gender dysphoria clinic he began co-ordinating a research project to establish possible genetic origins.

In 2004 a Melbourne patient who started on a change to male, but then reverted and later had three children attempted to sue the Gender Dysphoria Clinic for malpractice. This resulted in an independent review ordered by the State Government. Bower observed “If our team erred twice in 29 years, and during that period we operated, not saw, because many more - but we operated on 600 patients, two errors in 600 is, I think, in any area of human endeavour, is acceptable”.

He died later that year at age 90.

Two other ex-patients including Alan Finch also took legal action. Dr Trudy Kennedy was obliged to resign, and the Clinic was closed until 2009.  Various fundamental Christian groups and Alan Finch’s Gender Identity Awareness Association lobbied against the Clinic’s reopening.

• Herbert M. Bower. ‘Old age in western society’, Lectures 1 and 2, Medical Journal of Australia, 2, 8, 1964: 285-291; 2,8,1964: 325-332.
  
• Herbert M. Bower. ‘Psychiatry and Political Thought’, Australian and New Zealand Journal of Psychiatry 6,3, 1972: 191–6.
  
• H. M. Bower. “Liberation and Psychiatry—Towards a reconciliation”. In N. McConaghy (ed.), Liberation Movements and Psychiatry, Ciba-Geigy Australia, 1974: 125–8.
  
• Herbert M. Bower. ‘Diagnosis and Differential Diagnosis’, in Walters, W. and Ross, M. (eds), Transsexualism and Sex Reassignment, Oxford University Press: 1986.
  
• Herbert Bower. "The Concentration Camp Syndrome". The Australian and New Zealand Journal of Psychiatry : Official Organ of the Australian and New Zealand College of Psychiatrists. 28, 3, 1994: 391-397.
  
• Herbert Bower. "Psychogenic Trauma and Transient Psychosis". European Psychiatry: Supplement 4. 11, 1996: 294s-294s.
  
• Herbert Bower. "The Gender Identity Disorder in the DSM-IV Classification: a Critical Evaluation". Australasian Psychiatry. 35, 1, 2001: 1-8.
  
• “Concerns raised over sex change clinic”. Australian Broadcasting Corporation, 06/05/2004. Transcript
  
• Stephen Pincock. “Herbert Bower”. The Lancet, 364, October 16, 2004. PDF
  
• “Dr Herbert Bower – Psychiatrist – 19/12/1914-29/8/2004”. Australasian Psychiatry, 12, 4, December 2004: 430-2. First Page
  
• Cecily Hunter. “The concept of successful ageing: A contribution to a history of old age in modern Australia”. History Australia, 5, 2,2008: 42.1 – 42.15. PDF.
  
• Jill Stark. “Sex-change clinic 'got it wrong'“. The Age, May 31, 2009. www.smh.com.au/national/sexchange-clinic-got-it-wrong-20090530-br3u.html.

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Both the Lancet and the Australasian Psychiatry obituaries say nothing at all about the controversy that flared up just before Dr Bower died.

Like Harry Benjamin, Bower became interested in trans patients in his 60s and was also interested in gerontology.

Bower's comment that 2 errors out of 600+ as 'acceptable'  may sound callous, but it is very good statistics compared to other branches of medicine.