Yesterday I posted this material as two separate comments to a blog entry made by Ragtime Rachel, who was considering doing a story set in Germany between the world wars. It was a modest effort on my part to share information I had already ferreted out when preparing to do my story ‘The Other Side of the Wire.’ that I thought might be use to her.

The techniques and results pioneered by these men was actually far more advanced than I had originally thought.

Google the name of the surgeons and poke about yourself. You'll see what Rachel wish to do and I am doing in my story was perfectly well within the realm of possible.

Nancy Cole

www.nancycole.org

Ludwig Levy-Lenz, M.D
(1889 - 1976)

Sexual physician, surgeon

He was head of the Institute's gynaecological department between 1925 and 1933 and became actively involved in sexual counselling. He drew up expert forensic reports, published on abortion techniques and worked as the editor of the Institute's popular journal: "Die Ehe" ("Marriage").

Levy-Lenz performed the first sex-change operations on tranvestites. Furthermore, he ran a private clinic for sexual disorders in Berlin. In 1939, he was deprived of his citizenship. He went to Cairo in exile.

After the war, he practiced alternately in Cairo and Baden-Baden (West-Germany) as a famous cosmetic surgeon.

The gynecologist Levy-Lenz worked at Magnus Hirschfeld’s Institute for Sexology. During this time, he was one of the first physicians to perform genital reassignment surgery. He also wrote educational materials for the general public, for example about the prevention of STDs. In 1933, he fled to Paris, where he acquired new skills as a cosmetic surgeon. He returned to Berlin in 1935, taking advantage of a sudden climate of tolerance before the Olympic games and opened a surgical practice on the fashionable Kurfürstendamm. He fled Nazi persecution again in late 1936, this time going to Egypt, where he had a very successful career (his first patient was the great singer Om Kalthoum). After WWII, while maintaining his residence in Cairo, he regularly returned to Germany, teaching cosmetic surgery at various hospitals and writing one of the first German textbook on the subject. His "Memoirs of a Sexologist" contain, among other things, descriptions of his work at Hirschfeld’s Institute for Sexology. He also wrote fiction. Several unpublished manuscripts can be studied at our Archive.

Felix Abraham, M.D

Rudolph, who even early on in childhood - displayed a "tendency to act and carry on in a feminine way", was castrated at his own request in 1922.
He worked as a domestic at the Institute, dressed as a woman and generally called Dora.

Hirschfeld affectionately called her Dorchen (little Dora) and published her transformation process as a transvestite in his work on gender studies "Geschlechtskunde". Institute physician Felix Abraham published Dorchen's gender transformation as case-study: "Her castration had the effect - albeit not very extensive - of making her body became fuller, restricting her beard growth, making visible the first signs of breast development, and giving the pelvic fat pad... a more feminine shape."

In 1931, when Dora, is about forty, her penis was amputated by the Institute physician Dr. Levy-Lenz, and then an artificial vagina was surgically grafted by the Berlin surgeon Prof. Dr. Gohrbandt. Dorchen was one of the first sex changes altogether.

The sexual physician Dr. Levy-Lenz, who joined the Institute in 1925, recalls the domestic personnel as follows:

"It was, moreover, very difficult for transvestites to find a job.(...) As we knew this and as only few places of work were willing to employ transvestites, we did everything we could to give such people a job at our Institute. For instance, we had five maids - all of them male transvestites, and I shall never forget the sight one day when I happened to go into the Institute's kitchen after work: there they sat close together, the five "girls", peacefully knitting and sewing and singing old folk-songs. These were, in any case, the best, most hardworking and conscientious domestic workers we ever had. Never ever did a stranger visiting us notice anything..."

THE SURGICAL SOLUTION

In the 1910s, Hirschfeld began to explore the idea of a surgical solution to some of these cases.

Hirschfeld began working with a Vienna physician, Eugen Steinach (who later penned the 1940 book, Sex and Life. Forty years of biological and medical experiments). Steinach had experimented with gonadal transplantation in attempts to cure a variety of sexual disorders (ranging from homosexuality to transvestism). His early papers (Arbitrary Transformation of Male Animals into Animals with Pronounced Female Sex Characteristics and Feminine Psyche, and Feminization of Males and Masculinization of Females) detailed his experiments with transplantation on guinea pigs. He was the first to theorize that the sex glands contained secretions that made men act like men, and women act like women. Later, in the 20s and 30s, the blooming field of endocrinology would discover androgens and estrogens.

In 1918, Hirschfeld reported in Sexuelle Zwischenstufen: Sexualpathologie that the first incomplete sex-reassignment surgeries in female-to-male patients were performed in Berlin in 1912. In 1916, Max Marcuse published an article on Geschlechtsumwandlungstrieb, the desire of some to have their sex changed. In 1926, R. Muehsam reported (in Chirurgische Eingriffe bei Anomalien des Sexuallebens: Therapie der Gegenwart 67: 451-455) that in 1920, Hirschfeld referred the first male-to-female patient to a surgeon, Dr. Felix Abraham.

In 1921, the first private surgeon, Gohrbandt, began to practice early forms of sexual reassignment in Berlin.

These initial attempts at SRS were incomplete, usually entailing simply the removal of the sexual organs of the patient. Further enhancements to the procedure were developed in the following years. Most notable were the first attempts at vaginoplasty. Initially vaginoplasty was performed using skin grafts from the legs and/or lower abdomens. Further enhancements would not come along for over twenty years.

The first complete male-to-female SRS was reported in 1931, and it was performed based on Hirschfeld´s recommendation by two of his co-workers in his institute, Dr. Levy-Lenz, and Dr. Felix Abraham. The patient, Rudolph Richter, later living with the female first name Dorchen, lived and worked in Hirschfeld´s institute for more than 10 years as a housemaid (R. Herrn (1995) Vom Geschlechtsumwandlungswahn zur Geschlechtsumwandlung. pro famila magazin 23(2): 14-18). In 1922, Richter underwent castration, followed in 1931 with a penectomy and the construction of an artificial vagina.

Also that year, Dr. Abraham reported the details of two men undergoing sex reassignment surgery in his 1931 article Genitalumwandlung an zwei maenlichen transvestiten. (Zeitschrift fur Sexualwissenschaft 18:223-226) A translation of his article can be read at http://www.symposion.com/ijt/ijtc0302.htm.

In the Spring of 1930, Lili Elbe (formerly the Dutch painter, Einar Wegener), referred by Hirschfeld, had SRS under Dr. Gohrbandt in Dresden. She died the following year of complications from the surgery, but not before being heralded as the world's first transsexual. Dutch newspapers began reporting the news at the end of 1930, and her posthumous autobiography, Man into Woman (under the pseudonym of Niels Hoyer), was published two years after her death.

Some early female-to-male transexuals include Claire Schreckengost and Henri Acces (formerly Alice Henriette Acces). In 1935, a Czechoslovakian runner by the name of Zdenka Koubkova became Zdenek Koubkov. British athlete Mary Edith Louise Weston became Mark Weston in the mid-1930s. In 1937, Belgian cycling champion Elvira de Brujin became Willy de Brujin.

TRANSSEXUALISM IN WWII

On May 6th, 1933, Magnus Hirschfeld's Institute for Sexual Science was raided and destroyed by Nazis. Hirschfeld, in exile, died two years later. Writings on sexology were burnt, and sexologists were persecuted. Soon, even Hirschfeld's World League of Sex Research was disbanded.

Due to the political events in Europe, SRS was placed on a back burner. Only a handful of sex reassignment operations would be performed until the next decade. Clinics in Denmark and Norway resume some of the work halted by Germany, performing theraputic penectomies and castration.

However, the early years of WWII were also a time of medical advancement which would help future transexuals. It was at this time that the first estrogens became available, with the introduction of Di-Ethyl Stilbesterol in 1938 (originally for use in chicken feed!), and Premarin in 1941.

In 1944-5, a British surgeon, Harold Gillies, performed some initial operations on Michael Dillon (formerly Laura). He used the wartime technique of flap surgery, which proved to be a crucial advancement for FTM surgery.

Nazi book burnings


The Bebelplatz in Berlin is known as the site of the infamous Nazi book burning ceremony held in the evening of May 10, 1933 by members of the SA ("brownshirts"), SS, Nazi students and Hitler Youth groups, on the instigation of Propaganda Minister Joseph Goebbels. The Nazis under the leadership of Adolf Hitler burned around 20,000 books, including works by Thomas Mann, Erich Maria Remarque, Heinrich Heine, Karl Marx and many other authors.

Some days earlier, on May 6, the students had also dragged the contents library of the Institut für Sexualwissenschaft into the square, burning them on May 10.
Today a memorial by Micha Ullman consisting of a glass plate set into the cobbles, giving a view of empty bookcases, commemorates the book burning. Furthermore, a line of Heinrich Heine is engraved, stating "Dort, wo man Bücher verbrennt, verbrennt man am Ende auch Menschen" (in English: "Where they burn books, they ultimately burn people"). Students at Humboldt University hold a book sale in the square every year to mark the anniversary.

Lili Elbe

Lili Elbe was "born" one day while filling in for Gerda's absentee model; Gerda asked Einar to wear stockings and heels so that she could substitute Einar's legs for those of her model. Einar felt surprisingly comfortable in the clothing. Over time, Gerda became famous for her paintings of beautiful women with haunting almond-shaped eyes dressed in chic fashions. In approximately 1913, the unsuspecting public was shocked to discover that the model who had inspired Gerda's depictions of petite femmes fatales was in fact Einar.

After that, in the 1920s and 1930s Wegener regularly presented as a woman, attending various festivities and entertained guests in her house as Lili Elbe. One of the things Lili liked to do was to disappear, wearing her modeling fashions into the streets of Paris in the throngs of revelers during the Carnival. She was apparently very well accepted as a woman and even received a request for marriage many years before her surgical transition. Only her closest friends knew that she was transsexual and to others, Elbe was introduced by Gerda as Einar's sister.

In 1930 Elbe went to Germany for surgery, which was only in an experimental state at the time. A series of five operations were carried out over a period of two years.

The first surgery, removal of the testicles (orchiectomy), was made under the supervision of sexologist Magnus Hirschfeld in Berlin.

The rest of Elbe's surgeries were carried out by Dr. Kurt Warnekros in the Dresden Municipal Women's Clinic. The second operation was to remove the penis, and transplant ovaries, which were taken from a 26-year-old woman. These were soon removed in a third then fourth operation, due to rejection and other serious complications. The fifth operation was to transplant a uterus and was intended to allow Elbe, then nearing the age of 50, to become a mother. She soon after died of transplant rejections.

The reader should note here that no matter how 'wonderful' or 'noble' the efforts or motivation of Dr. Warnekros were, what he did was medical experimentation on a human being. To start with, one might wonder where the uterus came from. And while the experiments carried out by other German doctors ten years later were against the will of the subjects, the precedent to try new, radical and untested medical techniques on human subjects was not something dreamed up by the Nazis. Even in the U.S., African-Americans were used to test various forms of treatment for syphilis. I am not trying to defend the Nazis here. They were nasty sods. I am merely using this opportunity to point out history is what history is, even if we wish it to be otherwise.

Nancy Cole