The Riddle of Gender - Deborah Rudacille [53]
Like Hirschfeld, Benjamin focuses mainly on male-bodied persons in his book, even though he knew and treated female-bodied persons as well. He does include a final chapter on “the female transsexual,” but as with Hirschfeld, his interest in these persons appears somewhat secondary. He notes that in his practice, the proportion of male-to-female transsexuals to female-to-male transsexuals is eight to one— though he defers to the three-to-one estimate of Christine Jorgensen’s physician, Christian Hamburger, based on the letters from around the world that Hamburger received after the Jorgensen case was publicized. Hamburger received 465 letters from individuals desiring sex-change surgery in the months following the Jorgensen media blitz, with three times as many men as women requesting help. Benjamin notes the paradoxical fact that though Gallup polls report that “in our culture about twelve times more women would have liked to have been born as men than vice-versa,” many fewer female-bodied persons requested sex-reassignment surgery.
Like male-bodied transsexuals, female-bodied transsexuals “resent” their sexual morphology—“especially the bulging breasts,” says Benjamin, noting that his female patients “frequently bind them with adhesive tape until a plastic surgeon can be found who would reduce the breasts to a masculine proportion.” Most of his female-to-male patients also requested a total hysterectomy, including removal of the ovaries, and treatment with androgens. The latter request was relatively easy to fulfill, though the former was more difficult, because of the unwillingness of most surgeons to remove healthy organs. Of the twenty female-to-male patients Benjamin reports on in his book, only nine underwent hysterectomy (at an average age of thirty-five). Five of those patients also underwent mastectomy. Another five patients underwent only mastectomy without hysterectomy. Sixteen of the patients were taking testosterone, which eventually produces “a physical state resembling pseudohermaphroditism (enlarged clitoris, body hair, etc.),” Benjamin reports.
In The Transsexual Phenomenon, Benjamin’s compassion for his patients comes through clearly, although the distancing language of science and traces of paternalism can work to disguise this. As a result of his age and personal history, Benjamin was able to offer not only a clinical perspective on the subject, but also historical parallels to the resistance that he and other clinicians had encountered in their attempts to help transsexual patients. Near the end of the book he recalls his youth in Berlin and the fate of another pioneer. “Fifty years ago, when I was a medical student in Germany, plastic surgery began to shape noses and perform face-lifting operations for cosmetic purposes. I remember a surgeon in Berlin who specialized in nose operations. His name was Joseph and he was referred to as the ‘Nasen Joseph’ [Nose Joseph]. He was bitterly criticized for what he did. Surgeons such as he were refused membership in medical societies and were branded as quacks by some of their particularly orthodox colleagues. And then, sex was not even involved.”
Though he doesn’t say so explicitly, Benjamin must have been aware that criticisms of “Nasen Joseph” stemmed from discomfort with the manner in which rhinoplasty was perceived as facilitating another kind of “passing”—from Jewish to German. As a “foreign” physician, Benjamin understood exclusion. Although he was invited by friends to deliver presentations at the New York University School of Medicine in 1963, at the Albert Einstein College of Medicine in 1964, and at Stanford University in 1967, his academic affiliations were limited, and throughout most of his career his practice remained “isolated and unconnected,” said Christine Wheeler. His insights and achievements seem all the more remarkable in light of these facts.
Benjamin “understood that you couldn’t separate the body from the mind,” Christine Wheeler says, and he looked forward to the day when an organic understanding of transsexualism