May 4, 2015 (ThePublicDiscourse.com) -- Bruce Jenner and Diane Sawyer could benefit from a history lesson. I know, because I suffered through “sex change” surgery and lived as a woman for eight years. The surgery fixed nothing—it only masked and exacerbated deeper psychological problems.
The beginnings of the transgender movement have gotten lost today in the push for transgender rights, acceptance, and tolerance. If more people were aware of the dark and troubled history of sex-reassignment surgery, perhaps we wouldn’t be so quick to push people toward it.
The setting for the first transgender surgeries (mostly male-to-female) was in university-based clinics, starting in the 1950s and progressing through the 1960s and the 1970s. When the researchers tallied the results and found no objective proof that it was successful—and, in fact, evidence that it was harmful—the universities stopped offering sex-reassignment surgery.
Since then, private surgeons have stepped in to take their place. Without any scrutiny or accountability for their results, their practices have grown, leaving shame, regret, and suicide in their wake.
The Founding Fathers of the Transgender Movement
The transgender movement began as the brainchild of three men who shared a common bond: all three were pedophilia activists.
The story starts with the infamous Dr. Alfred Kinsey, a biologist and sexologist whose legacy endures today. Kinsey believed that all sex acts were legitimate—including pedophilia, bestiality, sadomasochism, incest, adultery, prostitution, and group sex. He authorized despicable experiments on infants and toddlers to gather information to justify his view that children of any age enjoyed having sex. Kinsey advocated the normalization of pedophilia and lobbied against laws that would protect innocent children and punish sexual predators.
Transsexualism was added to Kinsey’s repertoire when he was presented with the case of an effeminate boy who wanted to become a girl. Kinsey consulted an acquaintance of his, an endocrinologist by the name of Dr. Harry Benjamin. Transvestites, men who dressed as women, were well-known. Kinsey and Benjamin saw this as an opportunity to change a transvestite physically, way beyond dress and make-up. Kinsey and Benjamin became professional collaborators in the first case of what Benjamin would later call “transsexualism.”
Benjamin asked several psychiatric doctors to evaluate the boy for possible surgical procedures to feminize his appearance. They couldn’t come to a consensus on the appropriateness of feminizing surgery. That didn’t stop Benjamin. On his own, he began offering female hormone therapy to the boy. The boy went to Germany for partial surgery, and Benjamin lost all contact with him, making any long-term follow-up impossible.
The Tragic Story of the Reimer Twins
The third co-founder of today’s transgender movement was psychologist Dr. John Money, a dedicated disciple of Kinsey and a member of a transsexual research team headed by Benjamin.
Money’s first transgender case came in 1967 when he was asked by a Canadian couple, the Reimers, to repair a botched circumcision on their two-year-old son, David. Without any medical justification, Money launched into an experiment to make a name for himself and advance his theories about gender, no matter what the consequences to the child. Money told the distraught parents that the best way to assure David’s happiness was to surgically change his genitalia from male to female and raise him as a girl. As many parents do, the Reimers followed their doctor’s orders, and David was replaced with Brenda. Money assured the parents that Brenda would adapt to being a girl and that she would never know the difference. He told them that they should keep it a secret, so they did—at least for a while.
Activist doctors like Dr. Money always look brilliant at first, especially if they control the information that the media report. Money played a skilled game of “catch me if you can,” reporting the success of the boy’s gender change to the medical and scientific community and building his reputation as a leading expert in the emerging field of gender change. It would be decades before the truth was revealed. In reality, David Reimer’s “adaptation” to being a girl was completely different from the glowing reports concocted by Money for journal articles. By age twelve, David was severely depressed and refused to return to see Money. In desperation, his parents broke their secrecy, and told him the truth of the gender reassignment. At age fourteen, David chose to undo the gender change and live as a boy.
In 2000, at the age of thirty-five, David and his twin brother finally exposed the sexual abuse Dr. Money had inflicted on them in the privacy of his office. The boys told how Dr. Money took naked photos of them when they were just seven years old. But pictures were not enough for Money. The pedophilic doctor also forced the boys to engage in incestuous sexual activities with each other.
The consequences of Money’s abuse were tragic for both boys. In 2003, only three years after going public about their tortured past, David’s twin brother, Brian, died from a self-inflicted overdose. A short while later, David also committed suicide. Money had finally been exposed as a fraud, but that didn’t help the grieving parents whose twin boys were now dead.
The exposure of Money’s fraudulent research results and tendencies came too late for people suffering from gender issues, too. Using surgery had become well-established by then, and no one cared that one of its founders was discredited.
Results from Johns Hopkins: Surgery Gives No Relief
Dr. Money became the co-founder of one of the first university-based gender clinics in the United States at Johns Hopkins University, where gender reassignment surgery was performed. After the clinic had been in operation for several years, Dr. Paul McHugh, the director of psychiatry and behavioral science at Hopkins, wanted more than Money’s assurances of success immediately following surgery. McHugh wanted more evidence. Long-term, were patients any better off after surgery?
McHugh assigned the task of evaluating outcomes to Dr. Jon Meyer, the chairman of the Hopkins gender clinic. Meyer selected fifty subjects from those treated at the Hopkins clinic, both those who had undergone gender reassignment surgery and those who had not had surgery. The results of this study completely refuted Money’s claims about the positive outcomes of sex-change surgery. The objective report showed no medical necessity for surgery.
On August 10, 1979, Dr. Meyer announced his results: “To say this type of surgery cures psychiatric disturbance is incorrect. We now have objective evidence that there is no real difference in the transsexual’s adjustments to life in terms of job, educational attainment, marital adjustment and social stability.” He later told The New York Times: “My personal feeling is that the surgery is not a proper treatment for a psychiatric disorder, and it’s clear to me these patients have severe psychological problems that don’t go away following surgery.”
Less than six months later, the Johns Hopkins gender clinic closed. Other university-affiliated gender clinics across the country followed suit, completely ceasing to perform gender reassignment surgery. No success was reported anywhere.
Results from Benjamin’s Colleague: Too Many Suicides
It was not just the Hopkins clinic reporting lack of outcomes from surgery. Around the same time, serious questions about the effectiveness of gender change came from Dr. Harry Benjamin’s partner, endocrinologist Charles Ihlenfeld.
Ihlenfeld worked with Benjamin for six years and administered sex hormones to 500 transsexuals. Ihlenfeld shocked Benjamin by publicly announcing that 80 percent of the people who want to change their gender shouldn’t do it. Ihlenfeld said: “There is too much unhappiness among people who have had the surgery…Too many end in suicide.” Ihlenfeld stopped administering hormones to patients experiencing gender dysphoria and switched specialties from endocrinology to psychiatry so he could offer such patients the kind of help he thought they really needed.
In the wake of the Hopkins study, the closure of the flagship Hopkins clinic, and the warning sounded by Ihlenfeld, advocates of sex change surgery needed a new strategy. Benjamin and Money looked to their friend, Paul Walker, PhD, a homosexual and transgender activist they knew shared their passion to provide hormones and surgery. A committee was formed to draft standards of care for transgenders that furthered their agenda, with Paul Walker at the helm. The committee included a psychiatrist, a pedophilia activist, two plastic surgeons, and a urologist, all of whom would financially benefit from keeping gender reassignment surgery available for anyone who wanted it. The “Harry Benjamin International Standards of Care” were published in 1979 and gave fresh life to gender surgery.
My Experience with Dr. Walker
I myself suffered greatly to come to terms with my gender. In 1981, I sought out Dr. Walker to ask him, the man who wrote the standards of care, for help. Walker said I was suffering from gender dysphoria. A mere two years after both the Hopkins study and the public statements of Ihlenfeld drew attention to the increased suicide risk associated with gender change, Walker, even though he was completely aware of both reports, signed my approval letter for hormones and surgery.
Under his guidance, I underwent gender reassignment surgery and lived for eight years as Laura Jensen, female. Eventually, I gathered the courage to admit that the surgery had fixed nothing—it only masked and exacerbated deeper psychological problems. The deception and lack of transparency I experienced in the 1980s still surround gender change surgery today. For the sake of others who struggle with gender dysphoria, I cannot remain silent.
It is intellectually dishonest to ignore the facts that surgery never has been a medically necessary procedure for treating gender dysphoria and that taking cross-gender hormones can be harmful. Modern transgender activists, the descendants of Kinsey, Benjamin, and John Money, keep alive the practice of medically unnecessary gender-change surgery by controlling the flow of published information and by squelching research and personal stories that tell of the regret, unhappiness, and suicide experienced by those who undergo such surgery. Negative outcomes are only acknowledged as a way to blame society for its transphobia.
Transgender clients who regret having taken this path are often full of shame and remorse. Those who regret their decision have few places to turn in a world of pro-transgender activism. For me, it took years to muster the courage to stand up and speak out about the regret.
I only wish Dr. Paul Walker had been required to tell me about both reports when I consulted him: the Hopkins study showing surgery did not alleviate severe psychological problems, and Ihlenfeld’s observation of the continuing transgender unhappiness and high incidence of suicide after hormones and surgery. This information might not have stopped me from making that disastrous decision—but at least I would have known the dangers and pain that lay ahead.
Walt Heyer is an author and public speaker with a passion to help others who regret gender change. Through his website, SexChangeRegret.com, and his blog, WaltHeyer.com, Heyer raises public awareness about the incidence of regret and the tragic consequences suffered as a result. Heyer’s story can be read in novel form in Kid Dakota and The Secret at Grandma’s House and in his autobiography, A Transgender’s Faith. Heyer’s other books include Paper Genders and Gender, Lies and Suicide. Reprinted with permission from The Witherspoon Institute.
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This special issue represents a comprehensive, multidisciplinary look on gender dysphoria. We invited investigators to contribute original research articles as well as review articles that will further encourage the continuing efforts to understand the role of gender dysphoria, sex reassignment surgery, modalities of surgical treatment, and the patient's evaluation of hormonal, psychosocial, and psychosexual outcomes. We were particularly interested in articles describing new operative procedures, the modifications of old ones, the modalities of postoperative follow-up, the role of hormonal support, and the recommendations for the future. As a result, we have assembled this special issue with eight excellent papers providing authoritative and concise information on gender dysphoria patients and covering almost all aspects of their treatment.
In “An overview of neovaginal reconstruction options in male to female transsexuals,” M. Bizic et al. reviewed numerous methods that have been described for vaginal reconstruction in the treatment of transgenders. The choice of surgical option for vaginoplasty depends on the surgeon's experience as well as on the patient's wishes and expectations. Sometimes a multidisciplinary approach is necessary in prevention of postoperative complications and poor psychosocial and psychosexual outcome. S. Vujović et al. investigated the importance of prenatal hormone exposure in the development of transsexualism by measurement of finger lengths in a sample of Serbian patients. In their paper entitled “Finger length ratios in Serbian transsexuals,” both FtM and MtF patients were included and compared to cisgendered females and males. The results obtained support the biological origins of transsexualism.
The authors of “Personality disorders in persons with gender identity disorder” assessed personalities and personality disorders (PD) by comparing gender dysphoric and cisgender persons using the art's most frequently applied instrument, Structured Clinical Interview (SCID-II). Duisin et al. obtained significant results, some of which were similar to previous studies, while others diverged. Evaluation of PD's comorbidity with gender dysphoria is important for the optimization of treatment during the pretransitory and transitory periods, but for some patients it is relevant in the postoperative period as well. A paper entitled “Assessment of self-perception of transsexual persons: pilot study of 15 patients” by J. Barišić et al. investigates the self-perception of transsexuals by using the Rorschach test, an important and useful tool in psychological examination of candidates for sex reassignment surgery. The value of this pilot study lies in its examination of adaptive capacities for transition, which is of great importance in prediction of the outcome.
The complex anatomy of the clitoris is a subject area with which reconstructive surgeons must remain completely abreast. In their paper “The role of clitoral anatomy in female to male sex reassignment surgery,” V. Vukadinovic et al. confirmed the significance of comprehensive understanding of the clitoral anatomy as a basis for a successful outcome after metoidioplasty. In addition, they pointed out the role of the clitoris in achieving a normal sexual life after transition from female to male, following either metoidioplasty or total phalloplasty. Preliminary results from an Italian group of researchers, described by S. Bogliolo et al. in “Robotic single-site surgery for female-to-male transsexuals: preliminary experience,” showed us the importance of minimally invasive principles for hysterectomy and bilateral oophorectomy in FTM patients. Following the experience of laparoscopic approaches in reconstructive surgery, authors take a step beyond with recommendations on robotic surgery.
The paper entitled “Psychosocial adjustment to sex reassignment surgery: a qualitative examination and personal experiences of six transsexual persons in Croatia” presents N. Jokić-Begić's personal clinical experience in the specific cultural and religious environment of the Balkans. Exchange of the clinical observations of insights from the personal lives of transgender persons worldwide is significant, as it creates a medical and scientific ambience for overcoming the difficulties and obstacles gender dysphoric patients face throughout the process of transition and psychosocial adjustment after SRS. The authors stress the importance of social and medical support which sometimes highly correlates with the prolongation of transition period.
Finally, the paper from P. Tiewtranon'sgroup entitled “The development of sex reassignment surgery in Thailand: a social perspective” retrospectively evaluated the development of surgical procedures in Thailand. It describes how rich experience teamed with a dedication to surgical excellence provides the ideal environment for successful surgical treatment of transsexuals. The experiences described prove that guidelines for sex reassignment surgery are both simple to understand and useful to apply.
This project was supported by Ministry of Science, Republic of Serbia, no. 175048.
Miroslav L. DjordjevicMiroslav L. Djordjevic
Christopher J. SalgadoChristopher J. Salgado
Marta BizicMarta Bizic
Franklin Emmanuel KuehhasFranklin Emmanuel Kuehhas