Harry Benjamin and the First American Gender Clinic

In 1966, The Transsexual Phenomenon by Harry Benjamin, a German-American endocrinologist with a practice in New York, was published. It was the first medical textbook on transsexuality. In November of that year, Johns Hopkins Hospital in Baltimore announced that it had opened a Gender Identity Clinic.

Benjamin’s Book

Benjamin described transsexuality as a distinct condition, separate from transvestism and homosexuality. In his view, psychotherapy did nothing to change these patients’ convictions. If the mind could not be adapted to the body, the body had to be adapted to the mind, with hormones and, if necessary, surgery.

The Clinic in Baltimore

Johns Hopkins was the first academic hospital in the United States to offer gender-affirming surgery. Psychologist John Money was one of the initiators, while plastic surgeon John Hoopes led the clinic. Many of the first patients had been referred by Benjamin. The news made the front page of The New York Times on November 21, 1966.

What Came Before

The treatment itself was not new. In 1952, American Christine Jorgensen made headlines around the world after undergoing surgery in Copenhagen. More about this early period can be found in the article on trans people in history. What was new was that a prestigious university hospital openly offered the treatment and linked it to research.

Who Was Harry Benjamin?

Harry Benjamin was born in Berlin in 1885 and settled in the United States in 1913. He had practices in New York and San Francisco and initially focused on hormones and aging. In Berlin, he met sexologist Magnus Hirschfeld, who was already helping people in the 1920s who wanted to live as the other sex. In 1948, researcher Alfred Kinsey referred a young patient to Benjamin who was convinced she was a girl. This marked the beginning of a practice in which he saw hundreds of patients over the years. Benjamin died in 1986 at the age of 101.

Benjamin’s Scale

In his book, Benjamin divided his patients into six types on a scale. At one end were men who occasionally dressed as women; at the other were people with such a strong aversion to their own bodies that they saw surgery as their only way out. According to Benjamin, only the latter group, whom he called the true transsexuals, qualified for surgery. This classification was used for many years to decide who would receive treatment. It was later criticized because patients learned what story they had to tell to be admitted.

How the Clinic Worked

The clinic in Baltimore was established as a research project. A committee of psychiatrists, psychologists, surgeons, and other specialists assessed every application. Of the many people who came forward after the reports in the press, only a small number were admitted. The clinic received financial support from the Erickson Educational Foundation, the fund of wealthy Reed Erickson, who had himself been a patient of Benjamin’s. The same fund also financed Benjamin’s research and distributed information to doctors.

Significance

Within a few years of Johns Hopkins, dozens of university-based gender clinics opened across the United States. Benjamin’s model—hormones first, followed by surgery—remained the standard for decades. How the term transsexual was gradually replaced by transgender and gender-diverse is described by transtijd.nl in the article on the meaning and history of transsexual and transgender. The organization that drew up the first Standards of Care in 1979 was named after him.