The True Transsexuals

A Medical and Linguistic History of Sexual Deviance

“True North,” Juan Jinojosa.

Dora Richter’s first attempt at trans surgery came by her own hand. Born in 1891 in the German and Czech-speaking city of Carlsbad on the western border of the Austro-Hungarian Empire, Richter showed a “tendency to act and carry on in a feminine way” from a young age, a fact that her parents begrudgingly accepted. Still, Richter’s discomfort with her inherited body grew, and eventually led her to try to use a tourniquet to remove her penis at age six.This attempt prefigured a life of sexual self-determination that few could have imagined in a dying empire at the turn of the 20th century.

      As Richter aged, the social and emotional difficulties of living as a trans woman persisted. She held down work presenting as a man during Berlin’s busy summer season, permitting herself to wear women’s clothing at other times of the year. After a string of arrests sent her to male prisons, one kindlier judge eventually connected her with Magnus Hirschfeld, a German sexologist who had opened the Institut fur Sexualwissenschaft (Institute for Seuxal Research) in 1919. Arriving in 1920, Richter settled into work as a domestic servant, and through Hirschfeld’s advocacy was granted a special permit that allowed her to pass through the streets of Berlin without arrest for female impersonation.

      Richter’s early attempts at bottom surgery could not have been far from her mind as she arrived at the Institute and acclimated to her new environs, and by 1922, she had successfully received an orchiectomy, the removal of her testicles. Institute psychiatrist Felix Abraham would continue to observe Richter and fellow trans domestic servant Toni Ebel over the course of the decade, writing about the effects that the surgery had on Richter’s appearance: “The castration had caused, although not extensively, the body to become rounder/fuller, the beard growth to decrease, breast initiation to be noticeable and the fatty tissue of the buttocks and in the rest of the body to take on a more feminine form.”

      As a medical practice, castration was nothing new, but castration as a form of gender affirmation was. In 1931, Richter received two further operations: a penectomy, or the removal of her penis, early in the year, followed by a vaginoplasty that June. Taken together, these operations made Richter the world’s first documented person to undergo such a medically assisted transformation, setting the table for generations of further advances in trans surgical innovation.

      Much more is known about other figures who populated the Institute. Of course, Hirschfeld himself remains a focal point in the clinic’s history, his sexological writing and worldwide speaking tours bringing as much notoriety to his person as to the center which housed his research for many years. Well-known male figures like Walter Benjamin and Christopher Isherwood, temporary inhabitants in the building’s upper-level apartments, stand out for their wider cultural impact. Other trans women like Lili Elbe, born to a wealthy Danish family, and Charlotte Charlaque, whose English fluency gave her caché as Hirschfeld’s translator, leveraged their inherited wealth and developed reputations as well-traveled and educated socialites upon their deaths. Yet among the history of trans “firsts” (always a complicated and perhaps unnecessary attempt to pin the magnitude of social advancement onto one person), it seems that history chose Richter, the humble daughter of impoverished Bohemian farmers, to play the vital role as first patient to receive gender reassignment surgery as we understand it today.

      We know next to nothing about Richter’s daily life or inner thoughts, reliant as we are upon case histories written by sex researchers who consistently describe Richter and her peers as “male transvestites.” (This reference to the patient’s birth sex, rather than their adopted identity forged later in life, is a persistent quality in sexological literature well into the 20th century, even as today such language would be seen as disrespectful.) Most significantly, the vagaries of documentary evidence and the rise of Nazism in Germany mean that Richter’s fate is likely forever lost. It is possible Richter ended her life in a concentration camp, stamped with a small, black triangular patch (signifying “Asocial”) given to countless trans people and sex workers by the Nazi regime.

      Though it lasts just a few moments, we also have recorded footage of Richter, Charlaque, and Elbe standing together, arm in arm, beaming into the camera. These images, which recently appeared in the documentary Eldorado: Everything the Nazis Hate, capture a beautiful, if fleeting truth: “Queer and trans people can live in the light, in public, and it happens right here, in Berlin,” as trans historian Morgan M. Page says in the film. These images testify to the beauties of trans joy, capturing the lives of those who found themselves at the forefront of a gender and sexual revolution more than a century ago.

      Charlaque maintained that Richter escaped and “used cooking skills honed throughout her time at the Institute to open a restaurant in her rural hometown.” This is, as writer Leah Tigers suggests, a “comforting idyll,” one that cannot paper over the grim fate which befell both the Institute and countless individuals associated with it. Regardless of her final outcome, the thirteen years that Richter spent with the Institute showed that transsexual life, enhanced by medical intervention, was indeed possible, despite later Nazi attempts to turn back the clock on Weimar Berlin’s more permissive (if deeply tenuous) liberal atmosphere.

      Hirschfeld served as the primary voice for extensive research on the lives of his trans patients, referring to those he served as “sexual intermediaries,” many of whom were displayed in an array of images at the Institute. This exhibit taxonomized the fine distinctions in his patient’s feelings on gender, their sexed bodily characteristics, and their sexual attractions. As a leader in this field Hirschfeld was often at the forefront of debates on the language used to describe the community of gender-variant people who made their lives in the heady milieu of Weimar Berlin. Thus, we can look to Hirschfeld’s use of the term “transsexualismus” in 1923 as a certain originating point for the century of trans discourse that followed it. Itself indebted to Hirschfeld’s earlier coining of the term “transvestite” in 1910, the “transsexual” reflected a critical shift in this period, spurred in large part by the pioneering research carried out at the clinic. No longer reliant solely upon changing one’s outward gendered trappings like clothing, hair, and makeup, Hirschfeld’s transsexual was a creature of medical machinery, with advances in hormone replacement therapy (HRT) and genital reconstructive surgeries marking a new stage in the long human history of gender variance.

      Taking a century-long glance backward to this origin point, as well as the way the notion of transsexuality then traveled through the world, offers context for our own trans political moment. While transsexual is a term that has lost cachet in recent decades, largely supplanted in popular discourse and official language by the word “transgender” and “trans,” it nonetheless holds the key to many facets of this new century of trans politics. A product of the medical apparatus which spawned it, the transsexual as we know them today gradually broke free from the doctors who lorded over them, speaking back to a system that offered surgical solutions at the cost of rampant dehumanization and a rigid conceptualization of gender identity. Today, as battles around the proper language to describe our community generate debate on social media, the lineage of these terms is neglected, and our common ground is obscured when we need it most, as right-wing politicians and armed groups target any hint of gender or sexual deviance, from banning gender-affirming care to launching physical assaults on library drag storytimes. With trans people in a politically precarious position, being attacked by individuals and their governments alike, we are forced to ask ourselves: what can language offer us if we’re already at death’s door?

While the rich, multilayered history of an expansive experience of gender has been steadily eroded by Western colonialism—punishing two-spirit people among Native American tribes and the third-gender hijras in India, among others—a pervasive sense of gender frustration nonetheless continued to push back, and rose in popularity again, this time in 19th century Berlin. While restrictions on gender variance in colonial contexts originated back in the colonizer’s homelands, gender-nonconforming people living in Western cities like Berlin also struggled against a state that suppressed sexual deviance.

      Before there were transsexuals, there were transvestites. The term was coined by Hirschfeld in his 1910 study Die Transvestiten. Derived from Latin (trans-, “across, over” and vestitus, “dressed”), Hirschfeld’s early research into the lives of the gender-variant patients that visited him at the Institute for Sexual Research led to the foundation of the first library of sexological research in the world. In the years before cross-sex hormones and surgical intervention made the act of changing one’s sex conceivable, Hirschfeld’s efforts to offer patients a modicum of social acceptance in the form of transvestitenschein, or passes granted by German police that allowed trans people to dress in gender-affirming clothing without arrest, were a vital first step in the social mobility of trans people. While Hirschfeld coined the term, he still felt that “transvestite” was inadequate to describe the deeply felt disconnect his patients felt, recognizing the ways in which their gender expansiveness went far beyond the shifting of outward signifiers. In time the term would become associated with cross-dressing, a fetishized and socially demonized activity that would paint trans people as hopeless sexual deviants.

      Drawn in part from Hirschfeld’s work on transvestites, the birth of the idea of transsexuality also cannot be divorced from intersexuality. Intersexuality is a term to describe biological sexual variation, which may arise when disruptions to XX or XY chromosomal patterns emerge. Indeed, Hirschfeld’s first use of the term transsexual emerges in “Intersexual Constitution,” published in Jahrbuch für sexuelle Zwischenstufen (Yearbook for Intermediate Sexual Types), an annual publication by the Institute, in 1923. As the journal’s title suggests, Hirschfeld’s emphasis on minute categorization aimed to expand the public’s grasp on the fine distinctions of various sexed experiences, embedded in the motto offered at the start of the paper: “Man is not man or woman, but man and woman.”

      Yet this acute fixation on classification reveals the researcher’s less favorable ties to German colonialism, eugenics, and other realms of human difference-making—in this article, Hirschfeld describes transvestites “whose chunky noses and bulging mouths seem almost negroid”—which scholar Heike Bauer describes as “provid[ing] the broader framework for Hirschfeld’s work.” In the work, the first (and only) reference to “mental transsexualism” comes in a sentence about “follow[ing] intersexuality from homosexuality,” Within his argument, leaden with hyperspecific sexological terminology, Hirschfeld essentially claimed that intersexuality, homosexuality, and some form of “mental transsexualism” existed on a continuum of human sexological characteristics, with the evidence of intersexuality helping to explain the wider gradients of Hirschfeld’s “sexual intermediaries.” In effect, Hirschfeld argued that our binaristic notions of biological sex overlooked the much finer mixtures of true human physiology and behavior, which is a complex matrix of biological, chemical, gonadal, physiological, and hormonal characteristics, sexual attraction, and sexed or gendered thinking, all of which was set to explode the rigidly dogmatic, two-sex, heterosexually-oriented world of man and woman, happily reproducing the nuclear family and German herrenvolk, or master race.

      Thus, in a heady alchemy of research on sexual intermediaries, a burgeoning queer and trans social sphere in a colonial capital that challenged the German state’s legal restrictions on homosexuality, the transsexual was born. (It wasn’t until 1949 that psychiatrist Dr. David O. Cauldwell began to use the term transsexual with the meaning we have today, and as such is frequently credited for coining the term itself.) A few decades later in 1927, estrogen was synthetically isolated, as was testosterone the following decade. Now patients could also wield these new advances in medical science towards their own transition ends, making significant bodily transformations that were not reliant upon surgical intervention.

      While Hirschfeld’s clinical research inaugurated many of the medical advances in the early days of transsexuality, the Institute’s fiery demise, as a victim of the first book burning carried out under the newly-installed Chancellor Adolf Hitler in May 1933, meant that significant research was lost to time, gone up in smoke. Hirschfeld’s acolytes, including Harry Benjamin, had to take up the mantle of transsexual research in the late 40s and onwards, stitching together a historic continuity that the Nazi regime sought to irrevocably sever.

Benjamin was born in 1885 in Berlin, and finished a medical degree at the University of Tübingen in 1912. Though he did not formally study sexology in medical school, an early friendship with Hirschfeld helped to kindle this fascination for Benjamin, who would relocate to New York City in 1913. Initially interested in the role of sex hormones on the aging process, he was an early proponent of the Steinach vasoligation, a partial vasectomy paired with the implantation of simian testicles to restore male vitality and youthfulness.

      Though his endocrinological knowledge was originally centered on maintaining the liveliness and quality of life of cissexual (i.e. non transsexual) patients, Alfred Kinsey’s 1948 referral of a trans woman to Benjamin’s care prodded the sexologist to shift his focus towards gender variance. In 1947 a group of doctors deeply indebted to the earlier work of Hirschfeld and his collaborators founded the Society for the Scientific Study of Sexuality (SSSS), which brought a redoubled attention to transsexuality in the medical sphere, just five years after Christine Jorgensen’s high-profile sexual reassignment surgery drew global attention to the real possibilities of trans medical intervention. Then, with the 1966 publication of The Transsexual Phenomenon, Benjamin created another benchmark for the medical treatment of the trans community, a text whose radical impact at its origin has been tempered by years of ostensibly practical implementation in the healthcare field.

      The Transsexual Phenomenon is a rich, contradictory text, in some moments remarkably supportive, in other moments frighteningly dismissive, shifts that often occur in rapid succession. Discussing the commonplace use of psychotherapy to “cure” transsexualism—standard practice among many healthcare professionals at the time—Benjamin argues it is a “useless undertaking with present available methods.” The next sentence, “The mind of the transsexual cannot be changed in its false gender orientation,” reflects less the limitations of contemporary medical interventions than the doctor’s own deeply felt biases.

      One of the primary contradictions at play within the text is that between transvestites and transsexuals, and the persistent belief that only “true” transsexuals merit the surgical interventions necessary to make a passing go at life on the other side of the gender binary. Using Kinsey’s six-point scale which measured a person’s relative homosexuality or heterosexuality as a model, Benjamin created a similar TV/TS scale, with a firm insistence that living in the “wrong” body is the condition for a genuine case meriting surgical intervention. Transvestism was treated as a persistent sexual fetish felt at varying degrees of intensity, and thus collapsed a range of experiences into the same broad category: an occasional cross-dresser, and someone who might want to pursue HRT but forgo surgical intervention were considered similarly sexually deviant. These demarcations bear a resemblance to the wall of “sexual intermediaries” staked out in Berlin decades earlier; nonetheless, their presence reinforced unhelpful distinctions within the trans population, resulting in worse medical outcomes for many who sought trans care in the years that followed, and treating many aspects of the trans experience as mere sexual fetishes that have, over time, been widely criticized for perpetuating harmful stereotypes around trans desires.

      In the twenty-first century academic paper “The Transsexual Phenomenon: A Counter-History,” historian Barry Reay returns us to the late 60s and early 70s, an era when Benjamin and other sexologists made swift strides in solidifying transsexuality as a clinical diagnosis. As Reay’s research shows, this was a period of intense struggle within the medical profession and for trans patients themselves, as a rigid approach to diagnosing “true” transsexuality resulted in mismatched outcomes for patients who learned to approach their doctors with a script in hand. It was a period of rapid transformation in the medical world, “from one of no significant institutional support in 1965 to a situation in 1975 where about twenty major medical centers were offering treatment and some thousand transsexuals had been provided with surgery,” according to Reay. Yet that swift adoption of a certain level of medical acceptance, couched in deep-seated paternalism and ignorance to the many nuances of patients’ lives, resulted in uneven outcomes, legacies that remain salient in the social, legal, and medical lives of trans people today.

      The medical profession’s begrudging turnaround on trans surgeries would have been unlikely without the financial support of Reed Erickson, an eccentric trans man whose significant familial inheritance led him to found the Erickson Educational Foundation (EEF) in 1964. Erickson was a contradictory figure, compelled by esoteric interests like dream research, acupuncture, and interspecies communication. Nonetheless, his financial support for traditional medical research through organizations like the Harry Benjamin Foundation prodded the field forward, and was instrumental in Johns Hopkins University becoming the first university to publicly offer trans surgeries beginning in 1966.

      While the rapid quasi-acceptance of trans surgeries by leading institutions spoke in part to a good-faith effort to meet the real needs of the community, trans people themselves knew best the delicate dance required to achieve their desired outcomes. In her 1974 biography Being Different, Jane Fry wrote that “You’ve got to keep him happy,” sounding in many regards like a frustrated cishet suburban housewife, stuck in an unhappy marriage, but speaking about doctors: “One thing that I did learn in meeting all the doctors is that you have to give a little—pretend a little. Any one of them can kill you physically or emotionally.” Fry’s experience is one shared by countless other patients, many of whom, if they could not conform to doctors’ expectations for one reason or another, never made it far enough to receive the care they sought. In many cases, this meant the layering of racist stereotypes onto clinicians’ already-hostile attitudes: as one doctor stated as a reason for denying care, “We’re not taking Puerto Ricans any more; they don’t look like transsexuals. They look like fags.”

      These acts of dehumanization, even in the midst of offering medical care, set the stage upon which trans people were forced to act. They also reflected the many shortcomings that emerged from the rapid adoption of a highly rigid clinical definition of transsexuality. Psychoanalyst Lawrence S. Kubie raised concerns about the medical treatment of trans patients in 1968. After learning about how trans people had trained one another to approach their doctors, using descriptions that were often contradictory to their true lived experiences, he wrote:

            Such men often slant their descriptions because they soon become aware that in most medical centers, in the United States at least, they must present themselves as textbook examples of “transsexuals,” if they are to persuade any team of physicians to change them.

            Even with the limited information currently available it is clear that not all patients who have undergone surgical changes were unalterably convinced of their membership in the opposite sex. Moreover, abundant clinical and some empirical data show that retrospective self-justification can play a role in distorting the developmental histories given by individuals who petition for sex reassignment.

These concerns, while sometimes serving as the basis for denying trans care altogether, nonetheless express the limitations of treating each individual case with the same rigid touch. Even among those who might pursue surgical intervention, the diversity of possible procedures extends well beyond genital surgery. In the 1983 Spanish film Dressed in Blue, a group of six trans women living in post-Franco compare notes from their lives, at one point discussing the many procedures they’ve considered or pursued. The range in their desires is a testament to the nuanced realities which bind and divide members of the community, a reality flattened in the post-Benjamin world that unduly magnified a small sliver of the trans population. Some dialogue from the scene reads:

            Lorenzo Arana: They criticized me a lot about my breasts! Everyone criticized me a lot! But everyone wants the size of [Sophia] Loren’s breasts.

            José Antonio Sanchez Sanchez: I will remove my Adam’s apple. I’ll have my breasts operated to increase the volume. And maybe some other tweaks.

            José Ruiz Orejón: I want to have my breasts operated, my cheeks, and some tweaks, but I won’t have my penis operated.

            Francisco Perez de los Cobos Avila: I’ve never thought about it but I don’t think I’ll do it.

            René Amor Fernandez: That’s what I want to feel fulfilled.

            Orejón: People who had an operation went crazy. Think about it. They cut your… then what?

Growing recognition that the existing paradigm held deep flaws amongst doctors serving the trans population resulted in key shifts in the 1970s, changes which continue to influence trans health care today. Jon K. Meyer, a psychoanalyst at Johns Hopkins University, coined “gender dysphoria syndrome” as a larger framework for feelings of gender dissonance, attempting to preserve transsexual for “those who had actually undergone surgical reconstruction.” Perhaps even more importantly, Meyer created more space for his patients to have complex feelings about their identities, noting that his research “indicate[s] more ambivalence and ambiguity of gender than fixed reversal,” bringing into question whether medical transition meant “a true reversal of core gender identity.”

      Building upon Meyer’s critiques, as well as a 1973 symposium on gender dysphoria in which which Stanford psychologist Norman Fisk acknowledged that “far too many patients presented a pat, almost rehearsed history, and seemingly were well-versed in precisely what they should or should not say or reveal,” many doctors shifted their approach. Putting less pressure on identifying “true” transsexuality amongst those presenting various stripes of gender confusion, clinicians found that patients began offering stories more “honest, open, and candid” than they had previously.

      These shifts were piecemeal, uneven. Even as gender dysphoria gained acceptance as a term to better articulate a larger set of embodied discomforts, though still couched in a pathologizing gaze, countless other clinicians sought ways to “cure” their trans patients, especially so-called “pre-transsexual” children. This kind of “care,” aimed not at treating the real concerns of those seeking help, but at pursuing preventative measures meant to halt transness from arising in the first place, demonstrated the many contradictions at play within the medical establishment. With the addition of “transsexualism” to the Diagnostic and Statistical Manual of Mental Illness (DSM III) in 1980, just seven years after homosexuality itself had been removed from the clinical bible, doctors revealed the persistent gulf between themselves and the trans world, their assistance still laced with an icy paternalism.

      As trans patients continued to struggle to access basic care, let alone surgical interventions, intersex patients were receiving “treatments” against their will, with “gender corrective” procedures often conducted on infants incapable of consenting to such interventions. In the late 1960s, doctors cited legal concerns around removing “healthy sexual tissue” to deny trans surgeries, even as, “without apparent qualms, doctors routinely removed the healthy tissue, including genitals and reproductive organs, of intersexed children,” according to Joanne Meyerowitz’s How Sex Changed. These disparities persist: according to PBS, in 2023 alone, more than two-thirds of the bills introduced in the US that outlaw gender-affirming care for trans youth make exemptions for intersex patients, suggesting that shoring up the crumbling foundations of a two-sex system is more important to many doctors than competent care for trans and intersex patients.

      While doctors fumbled their way towards improved medical standards, trans people themselves continued to organize, fight back, and, perhaps most importantly, take care of one another throughout the sixties and seventies. Fed up with the mistreatment they experienced, trans communities built their own do-it-yourself care networks, in some cases helping one another receive medical interventions that they failed to access through formal channels. In “Doctors Who?,” an essay published earlier last year in The Baffler, trans historian Jules Gill-Petersondocuments how trans people, especially those further marginalized along class and racial lines, organized their own care, including smuggling estrogen injectables from Tijuana, Mexico to the Tenderloin district of San Francisco.

      “What’s not obvious from today’s perspective on trans health care is that smuggling and reselling hormones was once quite normal, verging on unremarkable,” Gill-Peterson writes, arguing that “DIY treats legitimacy as arising from the people whose lives are most affected by resources and care, not from the abstract power of the state or medical gatekeepers.” In countless cases where legitimate medical access was entirely inaccessible, a reality that’s returning in force with the rise in anti-trans care legislation, trans people subverted medical authorities in order to tend to one another, typically with greater sensitivity and knowledge than supposed medical authorities.

      At the same time that trans people began breaking ties with dehumanizing clinical settings, transsexuals in the burgeoning, defiant Gay Liberation 1970s began to question the frameworks that defined their lives. One trans person well positioned to address the consequences of public transsexuality was Sandy Stone, an audio engineer whose work with lesbian recording company Olivia Records led to death threats from radical feminists in the 1970s. In 1987, as a student in the Department of Consciousness at UC-Santa Cruz, she wrote “The Empire Strikes Back: A Posttransexualist Manifesto,” deeply indebted to the work of feminist thinker and author of the “Cyborg Manifesto,” Donna Haraway, under whom she studied. Much like the cyborg that Haraway envisioned defecting from the military-industrial complex that birthed her, a foundational image for feminist theory in a postmodern age, Stone’s posttransexual moves beyond the limitations placed upon them by their doctors, rejecting many of the assumptions that straight doctors had of their patients.

      Stone’s critique rests in part on the pat transition narratives of those like British travel writer Jan Morris, whose 1974 memoir Conundrum was one of the first major markers of trans self-narration. Stone argued that authors of many transition narratives “also reinforce a binary, oppositional mode of gender identification,” and that “they go from being unambiguous men, albeit unhappy men, to unambiguous women,” leaving “no territory between” in this smooth, surgical border crossing. (Morris also counted herself among the “true transsexuals,”contrasting her experience with “the poor castaways of intersex, the misguided homosexuals, the transvestites, the psychotic exhibitionists,” reinforcing the medical gatekeeping that kept countless others from receiving vital care.) Accounts like Morris’s obscure “any intervening space in the continuum of sexuality,” according to Stone, in effect ignoring the gender expansiveness at play within Hirschfeld’s intermediaries framework. Yet, as Stone argued, the medical apparatus spurned this ambiguity as well, and patients’ “behavioral profiles matched Benjamin’s so well [because] the candidates, too, had read Benjamin’s book.” While these kinds of typologies likely had a meaningful impact on trans people’s self-perception, Stone’s essay nonetheless showed that medical authorities often missed the inner workings of their patients, and that they knew they were playing a calculated cat-and-mouse game with authorities to receive the care they desired.

      What solutions did Stone present? She rejected the act of passing, or giving the appearance of successfully hiding one’s transness and appearing “normally” in their chosen gender, which she described as “the denial of mixture.” Instead, she argued that “the genre of visible transsexuals must grow by recruiting members from the class of invisible ones, from those who have disappeared into their ‘plausible histories,’” those fabricated accounts of a life spent in conformity with one’s birth sex, rather than a truer account of the changes necessary to create their own pathway. Much like Haraway’s cyborg, a robot created for the military-industrial complex, ultimately spurns its masters and rejects its “function,” Stone’s posttranssexual resists being made invisible by the doctors who demand they start new lives elsewhere, a frequent expectation placed upon midcentury trans patients in order to receive treatment. This demand in particular crystallized years of frustration with doctors among those seeking medical transition. Perhaps even more critically, the “post” in Stone’s “posttranssexual” suggested a trans world beyond the transsexual, a conception of gender that did not involve a “here” and “there” to transition from and to within a neat, tidy trajectory comprehensible to the medical establishment. This gesture toward new ways of thinking about gender marked the beginning of a shift that would reach a head with the publication of Leslie Feinberg’s influential 1992 pamphlet Transgender Liberation: A Movement Whose Time Has Come.

Transgender Liberation is not a text primarily focused on the language debates that swirled about in the closing years of the 20th century, although Feinberg does acknowledge that “[t]he language used in this pamphlet may quickly become outdated as the gender community coalesces and organizes—a wonderful problem.” With the early assertion, “Gender: self-expression, not anatomy,” Feinberg placed their focus on the wider spectrum of gender-deviant behavior that has constituted the human experience for thousands of years, offering a historic account of how colonialist and capitalist violence upheld the strict gendered bifurcation that now seems obvious to many. The text looked beyond the shortcomings of the medical system and spoke to the gender-outlaw longings of countless people for whom medical transition was hardly a possibility. Trans historian Susan Stryker argues in an upcoming work that “the early 90s version of transgender conveyed a militant, punk, queer, and utopian sensibility—a desire to seize upon the collapse of a world order as a moment of possibility for enacting something better.”

      Feinberg’s work helped broaden public consciousness around this longer history, and with it came a wider shift in terminology that’s reflected in linguistic shifts throughout the following years. A Google N-Gram analysis reveals that transsexual and transvestite were used at nearly equivalent rates until 1992, when transsexual gained a small but persistent edge in usage that still endures. Yet the term transgender, which was used at a significantly lower rate than either term into the 1990s, finally eclipsed transsexual in 2002, and as of 2018 appeared at nearly ten times the rate that transsexual appeared. With the burgeoning of the early internet and the rise of personal homepages and forums, the use of transgender went viral in a way that the older terms couldn’t match; its popularity would crystallize with Time Magazine’s widely-discussed 2014 “Transgender Tipping Point,” an article that spoke to the burgeoning cultural consciousness of (and growing backlash against) trans lives.

      Still, the adoption of transgender as an umbrella term did not come without controversy, particularly within subsets of the trans community. Evidence of the mixed feelings towards the term are abundant in the archives of TransSisters: The Journal of Transsexual Feminism, which spanned nine issues published in 1994 and 1995. One of the primary proponents of the continued use of transsexual was journal publisher and editor Davina Anne Gabriel, whose opinion piece “The Incredible Shrinking Transsexual Identity!!!”in issue eight of the journal railed against the widespread use of transgender (or “transgendered,” as was more common at the time). In the piece, Gabriel notes that debates on language play out for clear reasons: a field of shared understanding allows populations to speak among themselves, while simultaneously representing their lives and interests to the wider world. “I also recognize that the meanings of words are derived from a shared consensual reality and that; therefore, any process of redefinition of words is not accomplished by fiat, but through a process of negotiation; and that that process inevitably places limitations on the plasticity of words,” she wrote, sensing the ways in which her own journal, which published extensive letters to the editor, was itself a key forum for divergent opinions on these issues.

      While Gabriel does not dispute the existence of transgender people as a larger category of gender deviance, she argued that using the term broadly, like using mankind to describe all of humanity or gay to describe all homosexuals, would “[render] the entire phenomenon of transsexuality and everything that is distinct about it to nothing more than just another variety of cross-dressing.” She argued that transsexuals are more invested in creating a “state of congruity” between anatomical and psychological sex, while transgender people simply experience a dissonance between the two but don’t need medical intervention to bridge the gap.

      Most critically, Gabriel set her sights on Virginia Prince, who had popularized use of the term transgender within the pages of Transvestia, a journal she founded in 1960. Prince sought to name the distinction between transsexuals who seek surgical interventions, and “transgenderists,” another twist on the term she popularized, who don’t. (By the 1990s, transvestite had increasingly fallen out of fashion in this definition, overloaded with negative connotations related to sexual deviancy). Gabriel argued that Prince looked down on transsexual people and believed that “having a sex-change operation is not qualitatively different from crossdressing” as an expression of transgender practice, even as such surgical interventions took significantly more effort for those who sought such changes. Gabriel was particularly frustrated at Prince’s “Testosterone and You,” an essay published in Cross-Talk, a monthly informational newsletter circulated between 1988 and 1996. The essay opined glowingly of the benefits of testosterone, and argued that post-operative trans women “are sort of marooned on a desert island [hormonally],” unable to produce testosterone in any capacity, with estrogen being a far inferior hormone. In effect, Prince argued that crossdressing trans women, maintaining access to testosterone as their key sex hormone, were superior in many ways to those who sought surgical intervention, even going as far to say that post-op trans women stopped making an effort keeping up their feminine appearance. Gabriel’s frustration with Prince is palpable, and her argument that “it is the ultimate irony that a term that was originally intended to create a distinction from transsexuality should ultimately end up subsuming it” spoke to a simmering frustration amongst some in the community in how the language of their identities had shifted beneath their feet.

      The transsexual vs. transgender debate will likely rage on, accelerated by a social media climate that feasts on sharp contrasts of opinion and heightened emotions. Tracing the language of trans history backward reveals the many pathways of these competing terms as they bounced from within and beyond the community itself, each new inflection informed by personal experiences which then rippled into the wider trans public and beyond. A deep history of the term transsexual, particularly its origins in Hirschfeld’s research on sexual intermediaries and intersex conditions, speaks to one major reason why a newer generation of trans writers such as Leah Tigers and Aster Olsen, is self-consciously returning to transsexuality as a useful framework; as writer cosima bee concordia recently argued on Twitter, “Transsexual is a far from a perfect term, but I feel like transgender becoming the dominant nomenclature had the consequence of making most people think that transness complies with the rad[ical] fem[inist] idea that sex is binary and immutable.”

      Understanding the history of transsexuality helps to challenge the notion that biological sex is fixed and immutable, as people tinker with sex characteristics via HRT and surgical intervention to modify physical attributes that are already less binary than we’ve been led to believe. In its refashioned form, the archaic term transsexual pushes against the notion latent in transgender that only gender, and not biological sex, can be altered. (For example, in her column “Testosterone and You,” Prince argues that gender is what’s in “one’s own mind and in the perceptions that others have of you and not in what is or isn’t between your legs,” describing trans womanhood as “a psychosocial thing” and once more minimizing the significance of changing one’s sex.) Fully explaining the theoretical and historic distinctions between sex and gender is its own long-winded tale; nonetheless, the deeper history of transsexuality troubles any idea that gender, as a series of socially-constructed expectations for human behavior, is all that can be changed. Biological sex has a material force that inevitably shapes people’s lived experience–and yet, its many nuances, captured in Hirschfeld’s work on “sexual intermediaries,” forces us to look beyond social factors like gender roles and sexual orientations and instead trust that our very biology creates curious admixtures, that “Man is not man or woman, but man and woman,” always a combination of all of the above.

      As legal restrictions on trans-affirming healthcare push the US backward, making it legally and socially impossible for an increasing number of trans people to access hormonal treatments and other social services, a refusal to accept the biological division of the sexes into two neat, tidy boxes is a vital step to build greater connections between trans and intersex people fighting against dehumanizing medical systems. Restrictions on access to gender-affirming care that carve out exceptions for operating on intersex infants are a chilling reminder that our struggles are inextricably linked, and that bodily autonomy is a vital prerequisite for all people, most especially those whose bodies have challenged societal expectations and medical practices for generations.

      While the debates on terminology speak to substantive differences of opinion within our community, these debates can also all too easily distract us from our real enemies: the fascists keen to bury gender deviance once more, liberal media outlets like The New York Times and ostensibly progressive politicians whose hand-wringing around these issues encourages further restrictions on our lives. We will likely never know what words people like Dora Richter and the other trans people of Weimar Berlin used to understand themselves, their experiences lost in the downfall of a tenuous social and economic order that fueled the rise of Nazi Germany. In our own time, we are responsible for knowing and articulating ourselves to others, but, even more importantly, we are responsible for assembling the necessary political counterweight to prevent another genocide.

      “While we stand around bickering about what to call ourselves… Jesse Helms wants to lock us all up in AIDS concentration camps,” wrote Christine Tayleur in a letter to the editor to TransSisters in 1995. “[Conservatives] don’t distinguish fundamentally between cross-dressing, transsexuals, transgenderists or drag queens. We’re all too queer to live to them. If we don’t wake up and organize, we’re headed for the 1950s, lily-white, suburban brave new world that they envision. In that vision for Amerika, there is no place for transies, gays, lesbians, Jews, blacks or anyone else who isn’t white, Anglo-Saxon, male, Kristian and above all else, heterosexual.” Our differences are important and real, but always secondary to our fight to keep one another alive.

Annie Howard