Lili Elbe (1882–1931) was a Danish artist who underwent one of the first documented sex reassignment surgeries. Her story became known through the book and film 'The Danish Girl'.

How was gender diversity treated in the Netherlands in the past?

This varied per period. In the twentieth century the Netherlands developed into a relatively progressive country in this area, partly thanks to medical pioneers and active emancipation movements. But in the Netherlands too, gender-nonconforming people were socially and legally pressured for a long time.

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Trans people in history

Q: Were there transgender people in antiquity?

There are historical sources describing people who did not fit the binary gender norms of their time. Whether they would recognize themselves as transgender in the modern sense is uncertain — we project contemporary concepts onto historical contexts.

In the contemporary gender debate it is regularly argued that "transgender people have always existed" and that modern categories such as "trans woman" or "non-binary" have centuries-old historical precursors. That representation is largely a retrospective construction. People who did not fit the gender norms of their time have indeed always existed — but the link between those historical persons and the modern transgender identity is much looser than is often suggested.

The problem of retroactive labels

The modern concept of "transgender" stems from the second half of the twentieth century and builds on specific medical, legal and psychological ideas that simply did not exist in earlier eras. When historians or activists retroactively label figures from antiquity, the Middle Ages or the early modern period as "transgender", they project a contemporary framework onto people who would never have understood themselves that way. That is a form of anachronism that is historically impure and that makes history serve a contemporary political agenda.

Women who lived as men: more than one explanation

Through the centuries countless cases have been documented of women who dressed as men and functioned that way — sometimes for decades. A large part of these had practical reasons: access to professions, military service, travel, or safety in a world in which women were legally and economically in a subordinate position. Women such as Joan of Arc, Catalina de Erauso or the English soldier Hannah Snell are sometimes claimed by modern activism as "trans men"; in reality their own self-understanding from their sources is much more reserved and pragmatic.

For some, something we would today call gender dysphoria may have played a role. But the majority is better understood as women who circumvented the limitations of their time, not as people with an inner cross-gender identity. It is good historiography to preserve that distinction.

Men who lived as women

Cases of men who permanently presented as women are historically rarer and often have a religious, ceremonial or theatrical context. The Roman emperor Elagabalus is sometimes claimed as "trans" on the basis of a few sentences in the non-contemporary Cassius Dio — an unreliable source written with the explicit intention of blackening the emperor. Deriving a modern identity from this is methodologically problematic in terms of sources.

Non-Western "third gender" categories

The hijra in South Asia, the two-spirit persons in indigenous North American traditions and the bissu among the Bugis in Indonesia are cited in the Western debate as historical evidence for "non-binary" identities. That is misleading for several reasons:

they are often specific, often ritual or marginalised social roles, not freely chosen identities;
in most cases they concern biological men taking on a role, not a spectrum that anyone steps into themselves;
the term "two-spirit" itself is a late-twentieth-century pan-Indian invention (1990), not a centuries-old concept;
the social reality of many of these groups — poverty, prostitution, marginalisation — is romantically left out of the Western debate.

See also Two-spirit and Gender in other cultures.

The twentieth century: rise of a medical model

Only in the twentieth century do the medical infrastructure and the conceptual categories arise from which the modern transgender concept grows. Lili Elbe (1930s) and Christine Jorgensen (1952) are early public cases. Here too caution is warranted: Lili Elbe died shortly after the experimental operations and her story has been strongly romanticised in later fictionalisation (including the film The Danish Girl). The early medical results were regularly dramatic.

In the Netherlands Amsterdam UMC played a central role from the 1970s onwards in the development of what later came to be called the Dutch Protocol — an approach that was internationally regarded as the standard for a long time, but is now being critically re-evaluated on its methodological and ethical shortcomings.

Recent history and revision

From the 1990s onwards the visibility of transgender people increased. At the same time, since 2010 an unprecedented rise has been visible in trans identifications among adolescents, particularly girls — a pattern that is historically unprecedented and that stands apart from the classical small population of adults with long-standing dysphoria. The current international reorientation (Cass Review, SBU, COHERE) is a correction to a period in which the affirmative model was applied more broadly than the evidence justified.

Source-critical historiography

History contains real stories of people who did not fit the gender norms of their time. Those stories deserve serious attention — but with respect for the sources and without retrospective over-interpretation. It is a misconception to equate every historical gender variant with the modern transgender identity. Good historiography distinguishes; activism levels. That distinction is in order here.

Were there transgender people in antiquity?

Is the concept of "two-spirit" centuries old?

Who was Lili Elbe?