Medical studies regarding transgender healthcare and gender-affirming surgery have existed for over a century, yet its history is mostly unknown or overlooked. Though exploring the unique healthcare concerns of the queer community was both a danger and a risk, doctors and patients persisted in investigating information and formulating solutions. One important pioneer in queer healthcare history was a gay German physician, sexologist Magnus Hirschfeld, who:
Focused on embryology and endocrinology, leading to early advances in hormone replacement therapy (HRT);
Consulted with gender-affirming surgery for Karl M. Baer in 1906, who legally gained documented recognition of his gender identity in 1907;
Tirelessly fought for LGBTQIA+ civil rights.
Though seemingly “before his time”, Hirschfeld was only able to gather trial data and an immense library of medical study due to the bravery of the queer community who came forward to share their experiences and dreams. Targeted by Hitler, gender-affirming care was not able to advance at the rate that it could have due to much of Hirschfeld’s research being destroyed by a Nazi raid, one of many early tragic book-burnings in 1933. Today, similar tactics persist in the pursuit to ban queer healthcare and censor queer education in academia, willingly ignoring 100 years of medical research and leaning on misinformation to deny the validity of the trans experience.
Despite conservative dissent in World War I and II, hormone replacement therapy (HRT) and gender-affirming surgery made strides. Christine Jörgenson’s successful gender reassignment surgery in 1952 was a particular milestone in world news. With increased studies of sex hormone variations and intersex classifications, by the late 1950’s hundreds of genderqueer people pursued the expertise of Dr. Harry Benjamin. Benjamin recognized the suffering involved in genderqueer identity yet leaned heavily on a base transphobic view of gender itself and perpetuated the conflation of identity and orientation. His 1967 publication The Transsexual Phenomenon ran the gamut of compassion to fetishization, noting accurate cultural challenges yet still reverting to traditional gender socialization and binaries.
Sadly, the medical field lacked the queer perspective of earlier Hirschfeld. Psychological “experts” viewed the LGBTQIA+ community through a demeaning lens, relying heavily on “treating” mental illness rather than understanding the lived queer experience. The Diagnostic and Statistical Manual of Mental Disorders was a central resource that contained a myriad of discriminatory assumptions, referring to any identity other than cis as a “gender disorder”, which was not changed to “gender dysphoria” until 2013. The very doctors that trans individuals wanted to trust were more often than not viewing them through the lens of transphobia. Even though the trans population were technically a minority, this official and initial treatment of genderqueer people by “top experts” mirrored social prejudices over rigorously labored scientific research.
“Our experience of gender is no more or less pathological than that of ‘mainstream’ society… We have a right to live in a body that matches our self-image and deep desires without someone else being the gatekeeper to our experience.”
–Florence Ashley, bioethicist
Genderqueer identity was beyond medical, biological or psychiatric grasps alone; trans identity is also anthropological, social and cultural. It wasn’t until 2022 that the revised DSM-5 finally stated “gender non-conformity is not in itself a mental disorder”, a belief that Hirschfeld strongly felt in the early 1900’s. The extreme barriers against queer people entering healthcare fields was a further disadvantage to accurate research as their perspective may have prevented some of the extremely dehumanizing treatment and views of the LGBTQIA+ community. Two notable trans medical researchers and healthcare providers who challenged both misogyny and transphobia while doing important work in their fields were Ben Barres and Marci Bowers. The need for trans voices in healthcare is stronger than ever just as the need for queer-specific healthcare services persists.
In 1966, the Sex and Gender Clinic opened at John Hopkins Hospital. The clinic closed in 1979 due to terroristic threats against providers and patients by trans-exclusionary radical feminists in addition to the views of Hopkins’ own Dr. Paul McHugh who “argued the clinic was promoting mental illness by encouraging individuals to transition”. Reagan’s Department of Health and Human Services shut down funding for existing clinics in the 1980’s with the determination that gender-affirming care was “experimental”. It wasn’t until The Affordable Care Act of 2010 that protections were expanded to the community.
Despite the fact that the American Medical Association, the American Psychological Association, the American Psychiatric Association, the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, the Endocrine Society, the World Professional Association for Transgender Health (WPATH) and other many organizations have through and through opposed the bills to ban gender-affirming care, many right wing politicians are determined to criminalize access. Information is skewed to frame supposed dangers of trans healthcare during the bill propositions, despite the evidence that gender-affirming care is life-saving. Considering that the public is little-informed on the facts around trans healthcare, many of these bills have unfortunately gained traction.
Today, over 50% of trans adults have reported discriminatory experiences with a healthcare provider. In medical academia, trans health on average spans about 5 hours of study in total. Up to 30% of the LGBTQIA+ community have been refused when seeking healthcare services. After only 5 days into 2024, 125 anti-trans bills were filed in the United States, more than double in 2023. Telehealth is one option for people looking for a safer space to discuss their healthcare concerns and goals and Equal Health makes compassionate healthcare, tailored specifically for the queer community, its utmost priority.
Equal Health currently serves 20 States and DC, offering Mental Health Management, Gender Affirming Care, Sexual Health, HIV Prevention, HIV Treatment and Weight Management services through the privacy and convenience of telehealth. There are no hidden fees for Equal Health’s Memberships. Equal Health’s partnership with Grassroots Labs helps with discounts by 30-70% of the market price and partnered pharmacies greatly reduce the cost of medications, offering fast and discreet prescription delivery right to the patient's home.
Magnus Hirschfeld and transgender people, Transgender Map
The Forgotten History of the World's First Trans Clinic, Scientific American
Why Anti-Trans Laws Are Anti-Science, Scientific American
Stop Using Phony Science to Justify Transphobia, Scientific American
Sex Reassignment Surgery, ScienceDirect
Shifting syndromes: Sex chromosome variations and intersex classifications, National Library of Medicine
The Misuse of Gender Dysphoria: Toward Greater Conceptual Clarity in Transgender Health, Association for Psychological Science
To protect gender-affirming care, we must learn from trans history, Harvard Public Health
The bad science behind trans healthcare bans, The Verge
A First Step in Addressing Medical Education Curriculum Gaps in Lesbian-, Gay-, Bisexual-, and Transgender-Related Content, The University of Louisville Lesbian, Gay, Bisexual, and Transgender Health Certificate Program
Only 5 Days Into The Year, 125 Anti-Trans Bills Have Been Filed, Erin in the Morning