First Gender Identity Clinic Opens and Provides Gender Reassignment Surgery

The Johns Hopkins University School of Medicine established the first medical clinic to address gender identity and the medical concerns of transsexuals and those seeking gender reassignment. In the year before the clinic opened, the medical school performed the first gender reassignment surgery in the United States.

Date November 21, 1966

Locale Baltimore, Maryland

Key Figures

• Harry Benjamin (1885-1986), endocrinologist, expert on transsexuality, and author of The Transsexual Phenomenon
• Milton T. Edgerton (b. 1921), plastic surgeon and professor at Johns Hopkins
• John E. Hoopes (b. 1931), assistant professor of plastic surgery and chair of the Johns Hopkins Gender Identity Clinic
• John Money (b. 1921), associate professor of medical psychology and pediatrics at Johns Hopkins

Summary of Event

On November 21, 1966, a ten-member team of physicians, psychiatrists, and psychologists at the Johns Hopkins University School of Medicine announced that they had formed the university’s Gender Identity Clinic “to deal with the problems of the transsexual, physically normal people who are psychologically the opposite sex.” Chaired by John E. Hoopes, the group also included Milton Edgerton, who had previously performed surgery on transsexual patients, and John Money, a psychologist known for his work on hermaphroditism, psychoendocrinology, and childhood sexual development. With funding from the Erickson Educational Foundation, the group had been meeting since late 1965, and it already had begun taking patients by the time the public was notified of the clinic’s opening.

The first patient to receive full gender reassignment surgery at Johns Hopkins was a male-to-female transsexual in her twenties who was referred by Harry Benjamin, a New York physician widely recognized as the first endocrinologist to specialize in the medical treatment of transsexuals. The patient had surgery in February, 1965, and one year later made news when she was mentioned in a gossip column in the New York Daily News on October 4, 1966. A second gender reassignment surgery was performed on a male-to-female transsexual, also in her twenties, in the fall of 1966.

Although Johns Hopkins was the first hospital in the United States to initiate surgical treatment of transsexuals, by 1966 it was reported that approximately two thousand male-to-female surgeries had already been performed abroad, in Casablanca, Europe, Japan, and Mexico. Of those, some five hundred Americans were thought to have had the surgery. Female-to-male procedures for genital surgery were less common, primarily because techniques for the successful construction of a penis had not been developed. Money noted, in the book Transsexualism and Sex Reassignment (1969), that by 1966, his colleague Edgerton “had already attended to the surgical needs of two female-to-male transsexuals,” but it is not clear whether those were attempts at genital surgery or the more “routine” procedures of mastectomy and hysterectomy.

There had been four known sites in the United States in the mid-1960’s where transsexuals could seek medical treatment: the Harry Benjamin Foundation in New York, Johns Hopkins Hospital in Baltimore, the University of Minnesota Medical Center in Minneapolis, and the University of California, Los Angeles, Medical Center. However, of these, only Johns Hopkins and the University of Minnesota were performing gender reassignment surgery. At Minnesota, doctors formed a committee on gender in October, 1966, consisting of two surgeons, an obstetrician-gynecologist, a psychologist, a senior nurse, a hospital administrator, and a psychiatrist. Two months later, in December, 1966, the university hospital saw its first gender reassignment surgery.

At issue for medical professionals was the question of liability and the possibility of prosecution. At Johns Hopkins, a previous case involving the criminal prosecution of a seventeen-year-old boy (G. L.) for stealing a purse, women’s clothing, and “eight-hundred dollars worth of wigs” established a connection between the legal system and medical experts treating the boy for psychosexual problems. The juvenile requested gender reassignment surgery after his May, 1964, arrest, and the court later issued an order for medical intervention, but the surgery was never performed. The doctors at Johns Hopkins felt that the G. L. case had established “a liaison between medicine and the law in the event that elective surgical conversion should be challenged in the future.”

At the University of Minnesota, doctors interested in developing a gender program consulted with legal experts and university administrators before offering gender reassignment surgery to twenty male-to-female transsexual “candidates.” Central to the decision to offer the surgery was the removal of a “mayhem” statute in 1963 from the Minnesota criminal code. Mayhem statutes, derived from English common law, define as a criminal offense the specific malicious intent to maim or disfigure the body. Originally, these statutes were designed to prevent men from avoiding military service by damaging or otherwise injuring a body part, usually fingers or toes. Doctors feared that with such a law on the books, they would be at risk of criminal prosecution for performing gender reassignment surgeries.

Significance

The establishment of the Gender Identity Clinic at Johns Hopkins University and a committee on gender at the University of Minnesota gave a limited number of transsexuals (predominantly male-to-female) access to gender reassignment surgery in the United States in the mid-1960’s. The ensuing press coverage resulted in hundreds of letters from transsexuals all over the world who wrote to inquire about having the surgery. Prior to 1965, a person seeking genital reconstructive surgery had to travel outside the United States for the procedure.

Bibliography

Buckley, Thomas. “A Changing of Sex by Surgery Begun at Johns Hopkins.” The New York Times, November 21, 1966, 1, 32.

“Change of Gender.” Newsweek, December 5, 1966, 73.

Denny, Dallas, ed. Current Concepts in Transgender Identity. New York: Garland, 1998.

Green, Richard, and John Money, eds. Transsexualism and Sex Reassignment. 1969. New printing. Baltimore: Johns Hopkins University Press, 1975.

Meyerowitz, Joanne. How Sex Changed: A History of Transsexuality in the United States. Cambridge, Mass.: Harvard University Press, 2002.

Money, John, and Florence Schwartz. “Public Opinion and Social Issues in Transsexualism: A Case Study in Medical Sociology.” In Transsexualism and Sex Reassignment, edited by Richard Green and John Money. Baltimore: Johns Hopkins University Press, 1975.

“Sex-Change Operations at a U.S. Hospital.” U.S. News and World Report, December 5, 1966.

“Surgery: A Body to Match the Mind.” Time, December 2, 1966, 52-53.