How Sex Changed: A History of Transsexuality in the United States, by Joanne Meyerowitz. Harvard University Press, ISBN 0-674-00925-8 (hardback).

First published in Triple Echo v. 4 no. 2, 2003

How Sex Changed: A History of Transsexuality in the United States brings together all the plots, subplots, themes, and characters that have shaped the current position on sex changing. This historical record would be valuable for just the stories and personalities involved, but by placing events in more or less chronological order, we can see the evolution of ideas regarding sex and gender, and the manner in which these varying ideas affected those most involved.

When I say those most involved, we naturally think of trans people, but part of the pleasure of this book is that it provides some perspective on the doctors and psychologists involved. Yes, as you might suspect, there were quite a number of ogres who made life very difficult for transsexuals, but there were also many otherwise decent doctors who were caught in a professional dilemma. Due to the controversial nature of sex reassignment surgery (SRS), and the almost unanimous opposition of psychotherapists to the procedure, many doctors risked losing their professional reputations by performing the surgery. Furthermore, as there were no standards for care, and the surgery was still relatively new, doctors feared being sued by transsexuals upset with the outcome. Indeed, Joanne Meyerowitz writes that more “than a decade after the Christine Jorgensen media madness, no major medical centers in the United States had endorsed transsexual surgery.”

This does not mean that it wasn’t being. performed; only that it was difficult to get and done very quietly when it was. The circumstances more or less guaranteed that the doctors involved would be the types of people who marched to the beat of their own drummer. Meyerowitz lists some of their eccentricities: “…Harry Benjamin was a hair fetishist who found long hair on women sexually arousing. Charles Ihlenfeld later came out as gay. Ruth Rae Doorbar, who was white, had an African-American boyfriend in an era when interracial marriage was still illegal in some states. Wardell Pomeroy had a ‘prodigious sexual appetite.'”

Those were the good guys. You might say the bad guys were also in a league of their own. You don’t read this book without coming to the conclusion that virtually all the psychotherapists in the 1950s and early 60s were in it solely to protect their turf. Their “cure” for transsexuality was a heavy dose of conventional gender role reinforcement (which by the revolutionary 60s was already obsolete for most of the general population), lots of talk, and shock therapy. Outstanding of this lot were Frederic G. Worden, a psychoanalyst at the University of California at Los Angeles, and James T. Marsh, a clinical psychologist. Worden and Marsh described transsexuals in language that was suggestive of abnormality and, according to Meyerowitz, “depicted their subjects as attention-seeking exhibitionists, overly eager for approval. They even held the patients’ cooperation with their research against them; to Worden and Marsh, the “offers to be scientific exhibits” fell under the heading of “need for recognition.” In the face of such opposition, the determination and obstinacy of transsexuals was remarkable. As Meyerowitz notes, doctors were accustomed to playing the role of medical pioneers, but in this instance the transsexuals were the ones driving the research. Even before the information age, they very often knew more about gender and hormones and medical procedures than the doctors who were treating them, and often complained that the doctors knew nothing. (This, of course, is a scenario that is not yet completely extinct.)

In order to get the treatment they required, many transgendered people devoted their efforts toward educating the doctors. There was Louise Lawrence who, from the time she started living as a woman in the mid 1940s, supplied a number of researchers and doctors with extensive clippings, books, photos and letters, and who corresponded with Harry Benjamin to discuss items in the popular press and medical literature. Sex researcher Alfred Kinsey eventually started paying her for her efforts and Benjamin admitted that he used her as a “sounding board” for his ideas.

Louise Lawrence was an exceptional individual. Although she lived her life as a woman, she never had surgery. She called herself a “permanent transvestite.” Meeting her through the pages of this book was a real pleasure.

Reed Erickson was another remarkable individual who used his own and his inherited fortune to establish the Erickson Educational Foundation (EEF) in 1964. Erickson was born a girl, but lived a mostly conventional masculine life until 1965 when he underwent a hysterectomy and mastectomy. The EEF promoted research and education on transsexuality, and it is difficult to underestimate its influence on the eventual acceptance of SRS. A list of the publications partially or wholly funded by the EEF and the institutions and doctors it supported during this crucial period in trans history makes me think that the trans community hasn’t honoured the memory of Reed Erickson nearly enough. This list includes Harry Benjamin, Vern Bullough, Richard Green, John Money and many others. Sadly, in the 1970s Reed Erickson fell victim to drug addiction and gradually deteriorated into paranoia and delusion. He died in 1992.

Of course, this review only covers a small portion of the drama that unfolded during the last half-century of transsexuality. Meyerowitz analyzes the evolving debate over what constitutes a man and a woman. She also covers popular culture during this period and the public’s appetite for sensational sex change stories. She writes about the changing images of trans people’s sexuality, from the demure and lady-like Christine Jorgensen to the racy French TS Coccinelle to the trans street workers who paid for their surgery through sex. She chronicles the turbulent 70s when feminists, lesbians and gays turned against transsexuals and the dismal, conservative 80s, which were indeed as bad as I remember them.

If you’re reasonably well read about transsexual history, there will be much here you already know, but chances are you haven’t ever had it all put into context like this. And there is much here that is fresh also. In short, this is an excellent book, especially recommended for trans activists.