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A Selective Bibliography of Transsexualism

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Dallas Denny MA
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A Selective Bibliography
of Transsexualism
Dallas Denny, MA
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ABSTRACT. Transsexualism, codified in DSM-IV-TR as Gender Iden-

tity Disorder, first appeared in DSM-III in 1980 with the name Gender
Dysphoria, but its history in the psychiatric profession dates back more
than 100 years. During the first half of the twentieth century, little was
published on gender identity variability, but the high-profile sex reas-
signment of Christine Jorgensen resulted in immediate negative reaction
from elements of the psychiatric community. Inquiry began into the na-
ture of the newly discovered and not-yet-named syndrome of people
who wanted to change their sex, and accelerated after the publication in
1966 of Harry Benjamins magnum opus, The Transsexual Phenome-
non. The entry of the prestigious Johns Hopkins University into the arena
of transsexualism led to the formation of other university-affiliated gen-
der clinics, of which there were soon more than 40 in the U.S. The late
1960s and the 1970s saw the publication of hundreds of journal articles,
varying from reports of surgical technique, outcome studies, descrip-
tions of clinical populations, and tips for treatment.
In 1979, Meyer and Reter published a study that purported to show
no objective improvement in male-to-female transsexuals who had un-
dergone sex reassignment surgery. The effect of this publication was im-
mediate and far-reaching. The Hopkins gender clinic closed in the furor
which followed, and other clinics folded in its wake. Of the more than 40
university-affiliated gender programs in the U.S., only three survived.
The closing of the U.S. gender clinics created a treatment vacuum which
resulted in the slow development of a market economy for the treatment
of transsexualism.
Long kept out of communication with one another by privacy require-
ments of gender clinics and by the insistence of the clinics that to be
proper transsexuals, they must blend into society and disappear, trans-
sexuals began communicating with one another, seeking and providing
Dallas Denny is a member of the board of Gender Education & Advocacy, Inc.
Journal of Gay & Lesbian Psychotherapy, Vol. 6(2) 2002
2002 by The Haworth Press, Inc. All rights reserved. 35
36 JOURNAL OF GAY & LESBIAN PSYCHOTHERAPY
information and comparing notes. By 1985, there were a number of sup-

port groups and regional conferences which welcomed both crossdressers
and transsexuals. Around 1990, transsexuals, who had been conspicu-
ously absent from the literature, began to publish, adding their voices to
those of feminist scholars. In 1991, Boswell suggested that many trans-
gendered people are neither transvestite nor transsexual, but have an es-
sential transgender nature. Transgendered individuals need not take
hormones or have genital surgery in order to express their gendered
selves; sex reassignment was not necessarily a requirement, but an op-
tion.
The collision of the psychomedical and postmodern models of trans-
sexualism provided fertile ground for a paradigm shift. An alternative

model had been proposed which changed the locus of pathology: trans-
sexuals were not mentally ill men and women whose misery could be
alleviated only by sex reassignment, but rather emotionally healthy indi-
viduals whose expression of gender was not constrained by societal ex-
pectations. Research on transsexualism proceeds apace, with advances
being made in surgical and hormonal treatments, and new treatment
models are being developed. Transgendered people have become politi-
cally active and have been successful in gaining some legal protections.
This century promises a continued and growing understanding of gender
identity variability, one in which transgendered people will themselves
contribute significantly. Toward that end, this annotated bibliography is
provided by a transgendered author, mental health professional, and
activitist. [Article copies available for a fee from The Haworth Document De-
livery Service: 1-800-HAWORTH. E-mail address: <getinfo@haworthpressinc.
com> Website: <http://www.HaworthPress.com> 2002 by The Haworth Press,
Inc. All rights reserved.]
KEYWORDS. Gender clinics, gender dyshporia, gender identity, post-

modernism, sex reassignment, transgender, transsexualism, transvesti-
tism
Transsexualism, codified in DSM-IV-TR as Gender Identity Disor-

der, first appeared in DSM-III in 1980 with the name Gender Dysphoria,
but its history in the psychiatric profession dates back more than 100
years. Early sexologists like Richard von Krafft-Ebing (1894), Karl
Ulrichs (1994), and especially Magnus Hirschfeld (1910, 1991) and
Havelock Ellis (1906), studied what was then known as sexual inver-
sion, a diagnostic category that encompassed homosexuality, transves-
tism, and transsexualism. Their observations differentiated homosexuality
from transsexualism and transvestism.
Dallas Denny 37
DEFINING THE SYNDROME
During the first half of the twentieth century, little was published on
gender identity variability, but the high-profile sex reassignment of
Christine Jorgensen and the 1953 publication in The Journal of the
American Medical Association of Jorgensens treatment protocol by
Hamburger et al. resulted in immediate negative reaction from elements
of the psychiatric community (c.f. Ostow, 1953; Wiedeman, 1953).
Hamburger also published a report noting the many requests he and
Jorgensen received from self-identified transsexuals desperate for the
same treatment (Hamburger, 1953).

Inquiry began into the nature of the newly discovered and not-
yet-named syndrome of people who wanted to change their sex, and ac-
celerated after the publication in 1966 of Harry Benjamins magnum
opus, The Transsexual Phenomenon. The sixties also saw the opening
of the United States first gender identity clinic at Johns Hopkins Uni-
versity (1966; see Hastings, 1969), the publication of a multidisci-
plinary text edited by Richard Green and John Money (1969), and the
first conference for professionals who worked with the people who
were now called transsexuals (1969).
Recent research by Holly Devor (1997a) has brought to light evi-
dence that female-to-male transsexual and philanthropist Reed Erickson
was a driving force behind this 1960s transsexual renaissance. He sup-
plied funds for the gender clinic at Johns Hopkins, the publication of
Green and Moneys text, and several multidisciplinary conferences, all
under the auspices of his Erickson Educational Association, which also
provided information and referrals to transsexuals.
The entry of the prestigious Johns Hopkins University into the arena
of transsexualism resulted in the formation of other university-affiliated
gender clinics, of which there were soon more than 40 in the U.S.
(Denny, 1992). The Hopkins clinic followed the multidisplinary model
introduced in Green and Money (1969). Surgeons, endocrinologists, psy-
chiatrists, psychologists, neurologists, social workers, nurses, electrol-
ogists, cosmetologists, aestheticians, speech therapists, attorneys, and
clergy comprised a team which addressed all aspects of the individuals
life during the period of sex reassignment.
Hopkins rationale for treating transsexuals came about because of
an imprinting theory developed in Moneys lab after extensive work
with intersexed individuals, perhaps best elucidated in a paper by
Money, Hampson, and Hampson (1957). The theory held that gender
identity is formed by about three years of age and is thereafter resistant
to change. Since transsexuals have a firm and fixed gender identity as a

member of the non-natal sex, and since this identity was resistant to
change by psychotherapy or other means (c.f. Bak and Stewart, 1974),
sex reassignment was justified; if the mind could not be changed to fit
the body, the body would be changed to fit the mind. Sex reassignment
was, then, considered not a cure, but a palliative treatment for the
widely-acknowledged suffering of transsexuals. Moneys theory was
also used for more than 40 years as a rationale for early surgical inter-
vention with intersexed children, a practice which came under attack in
the 1990s.
Psychiatrist and psychoanalyst Robert Stoller published widely on

transsexualism during the 1960s and 1970s. He believed only the most
feminine of males to be transsexual (Stoller, 1964); those not fortunate
enough to be convincing as members of the non-natal sex he considered
to be transvestites. Unfortunately, his primary test case, presented in
1964, later admitted to having achieved this natural feminization
through the surreptitious use of female hormones. Stoller dutifully re-
ported this in a later paper (1968).
Stollers theory of transsexualism (1967) held mothers responsible
for the condition, although this view was not supported by subsequent
data. In a 1982 paper, he bitterly summarized both the 30-year-old treat-
ment of transsexualism and male-to-female transsexuals themselves as
near misses; the paper is nevertheless among his best work, for it bril-
liantly lays out the ethical considerations of sex reassignment and the
medical treatment of transsexualism.
The late 1960s and the 1970s saw the publication of hundreds of jour-
nal articles, varying from reports of surgical technique (Edgerton,
1973) to outcome studies (Pauly, 1965) to descriptions of clinical popu-
lations (Stone, 1977), to tips for treatment (Ihlenfeld, 1973). Case studies
ranged from the informative (Symmers, 1968) to the bizarre (Milliken,
1982; Socarides, 1970).
The seventies saw the differentiation of male-to-female transsexuals
into two distinct clinical categories. Several clinicians had noticed that
male-to-female applicants for sex reassignment tended to fall into two
more-or-less distinct groups. The first consisted of younger, more femi-
nine, and usually homosexual or asexual males who reported cross-gen-
der identification from an early age; the second group was comprised of
men in their thirties, forties, and above, who reported a later onset of
cross-gender identification, and who often had histories of fetishistic
crossdressing. In a series of papers, Person and Ovesey (1974a, b) de-
scribed these groups, calling them, respectively, primary and secondary
Dallas Denny 39
transsexuals. Secondary transsexuals were themselves divided into two

types, depending upon whether their sexual attraction was to men or
women (Person and Ovesey, 1974b).
MEYER AND RETER
Jon Meyer, the director of the Johns Hopkins Gender Identity Clinic,
had long had doubts about the appropriateness of sex reassignment
(Meyer, 1973). In 1979, he dropped a political bombshell with a paper
co-authored by his secretary, Donna Reter, and published in The Ar-

chives of General Psychiatry. This follow-up study purported to show
no objective improvement in male-to-female transsexuals who had
undergone sex reassignment surgery. The effect of this publication was
immediate and far-reaching; Meyer publicized his findings with press
conferences, which resulted in extensive coverage in newspapers and
popular magazines. The announcement had been deliberately sched-
uled while John Money, Hopkins major proponent of sex-reassign-
ment, was out of the country (Ogas, 1994).
Criticism of the Meyer and Reter study was immediate and forceful
(c.f. Fleming et al., 1980; Oppenheim, 1979), but the damage was done.
The Hopkins gender clinic closed in the furor which followed, and the
other clinics folded in its wake. Of the more than 40 university-affili-
ated gender programs in the U.S., only three survivedtwo of which be-
came private surgical centers, while the program at the University of
Minnesota was taken over by another department and administered as a
non-surgical program (Denny, 1992; Ogas, 1994).
For more than a decade it was accepted without question by the gen-
eral public and by most professionalsincluding many in the fieldthat
sex reassignment had been definitively shown to be ineffective. This
was despite the fact that other outcome studies showed a preponderance
of good outcomes (c.f. Pauly, 1965) and continue to do so (c.f. Kuiper
and Cohen-Kettenis, 1988).
Meyer and Reter (1979) was methodologically unsound (see Blanchard
and Sheridan, 1990, for a more recent critique)so unsound, in fact, that
it was rumored to have been retrospectively engineered. Reporter Ogi
Ogas (1994), who interviewed most of the principals in the clinic,
makes a case for scientific fraud in this matter. For example, in a 1992
paper in The American Scholar, psychiatrist Paul McHugh reported that
his intention when he came to Johns Hopkins in the 1970s was to termi-
nate that institutions participation in sex reassignment.
Also in 1979 was the publication of Janice Raymonds The Transsex-

ual Empire, which postulated the existence of a secret male-dominated
network which sought to surgically turn males into females, making
real females obsolete. Raymond, harshly criticized male-to-con-
structed females for perpetuating the binary gender system by seeking
to move from one sex to the other. Like Meyer, Raymond worked hard
to publicize her book, which was for some time influential in feminist
circles.
A third important event in 1979 was the publication of Standards of
Care by the Harry Benjamin International Gender Dysphoria Associa-
tion; these were minimal consensual guidelines for the medical treat-
ment of transsexuals, and required ongoing involvement of mental
health professionals as gatekeepers for access to hormonal therapy and
sex reassignment surgery. The Standards continued a practice of the
Johns Hopkins clinic (Clemmensen, 1990; Money and Ambinder, 1978):
a one-year real-life test which required applicants for sex reassign-
ment surgery to live and work 24 hours a day, seven days a week in the
new gender.
The Standards of Care have been periodically revised, most recently
in 1996, and are once again under revision (see <www.symposion.com>
for the latest version). The real-life test is now called the real-life expe-
rience.
PARADIGM SHIFT
The closing of the U.S. gender clinics created a treatment vacuum

which resulted in the slow development of a market economy for the
treatment of transsexualism. Free from the restrictive policies of the
gender programs, transsexuals began to orchestrate their own sex reas-
signments, choosing services and service providers in an a la carte fash-
ion. Long kept out of communication with one another by privacy
requirements of gender clinics and by the insistence of the clinics that to
be proper transsexuals they must blend into society and disappear,
transsexuals began communicating with one another, seeking and pro-
viding information and comparing notes (Denny, 1992). By 1985, there
were a number of support groups and regional conferences which wel-
comed both crossdressers and transsexuals. Around 1990, transsexuals,
who had been conspicuously absent from the literature, began to pub-
lish, adding their voices to those of feminist scholars like Kessler and
McKenna (1978) and Bolin (1988). Perhaps the earliest and most influ-
Dallas Denny 41
ential was A. R. (Sandy) Stone (1991), who noted the existence of a

grapevine in which transsexuals carefully coached one another on what
to say to doctors so they would avoid being diagnosed as nontranssex-
ual and refused sex reassignment. Among other things, this grapevine
taught transsexuals to present themselves as sexual stereotypes in order
to fulfill the expectations of caregivers:
One clinician said that he was more convinced of the femaleness

of the male-to-female transsexual if she was particularly beautiful
and was capable of evoking in him those feelings that beautiful
women generally do. Another clinician told us that he uses his own
sexual interest as a criterion for deciding whether a transsexual is
really the gender she/he claims. (Kessler and McKenna, 1978,
p. 118)
Kessler and McKenna had interviewed male-to-female transsexuals

in developing their theory of gender, and were the first to comment on
the limitations and biases of the medical model of transsexualism. An-
thropologist Anne Bolin, who studied male-to-female transsexuals in a
transgender support group in the mid 1980s, critiqued the dynamics of
the patient-caregiver relationship:
The preoperative individual recognizes the importance of fulfill-

ing caretaker expectations in order to receive a favorable recom-
mendation for surgery, and this may be the single most important
factor responsible for the prevalent mental-health medical concep-
tions of transsexualism. Transsexuals feel that they cannot reveal
information at odds with caretaker expectations without suffering
adverse consequences. They freely admitted to lying to their care-
takers about sexual orientation and other issues.
Although caretakers are often aware that transsexuals will pres-
ent information carefully manipulated to ensure surgery . . . they
have only to scrutinize several of their most prominent diagnostic
markers available in the literature to realize the reason for the de-
ceit. If caretakers would divorce themselves from these widely
held beliefs, they would probably receive more honest informa-
tion. (Bolin, 1988, p. 63, emphasis added)
Bolin noted that the behavior, mode of dress, and gendered presenta-
tion of the transsexuals she studied was as varied as that of any other
group of women. This is a critical observation, for many of the polemical
attacks against transsexualism and against transsexuals themselvesfor

example, Raymond (1979)could be reinterpreted as misdirected at-
tacks on the medical model of transsexualism. When transsexuals are
accused of being exaggerated stereotypes of men and women, or as be-
ing defenders of the two-gender system, or for encroaching on the terri-
tory of nontransgendered men and women by pretending to be really
members of the non-natal sex (c.f. Billings and Urban, 1982; Lothstein,
1979; Mackenzie, 1994; Raymond, 1979; Socarides, 1977), the attack
is directed at a straw (wo)man, the transsexual as constructed and ideal-
ized by the psychomedical community.
An influential article by Holly Boswell was published in 1991 (see

also Boswell, 1997). There s/he suggested that many transgendered
people are neither transvestite nor transsexual, but have an essential
transgender nature. They feel more comfortable in the ground between
the two commonly accepted genders than in their natal gender or as a
sex-reassigned member of the non-natal gender. Transgendered indi-
viduals need not take hormones or have genital surgery in order to ex-
press their gendered selves. Any gendered presentation is appropriate.
Suddenly sex reassignment was not a requirement, but an option.
Boswell publicly articulated a discussion which had been taking
place in transgender community newsletters and magazines; indeed, the
very term transgender had been proposed some 20 years earlier by Vir-
ginia Prince, who used it to describe someone like herself, who cross-
lived full-time, but who had no desire for genital surgery (Prince, 1969).
Prince, who is nearing her tenth decade, continues to live as a woman,
yet identifies as male.
Boswell provided an alternative to the psychomedical literatures
essentialist position on gender, which held that there are only two sexes,
and that the best treatment for someone who is an exceedingly poor fit
in their natal sex is to help them become as much as possible like a
member of the other sex. Boswells views, like those of Kessler and
McKenna, Bolin, and Stone, fell within the emerging postmodern,
deconstructive framework which had emerged after the publication of
Foucaults History of Sexuality (1979). Postmodern theory holds that
gender is not a natural phenomenon, but is socially constructed. Unfor-
tunately, many clinicians and researchers seem unfamiliar with, indif-
ferent to, or even hostile to postmodern theories of gender.
The collision of the psychomedical and postmodern ways of thinking
about transsexualism provided fertile ground for a paradigm shift in the
classic Kuhnian sense (Denny, 1995; Kuhn, 1972). The change of per-
spective made it suddenly possible to critique the psychomedical litera-
Dallas Denny 43
ture analogous to Stephen Jay Goulds (1981) examination of the early

literature of mental measurement. More importantly, an alternative
model had been proposed which changed the locus of pathology. Under
the new transgender model, transsexuals were not mentally ill men and
women whose misery could be alleviated only by sex reassignment, but
rather emotionally healthy individuals whose expression of gender was
not constrained by societal expectations. Instead, the pathology was
shifted from the gender-nonconformist to a society which cannot toler-
ate difference (see Rothblatt, 1994).1
Not only the profoundly transgendered (Boswell, 2001) face dis-
crimination for violating gender norms; at some time in their lives, most
nontransgendered men and women run afoul of gender norms, whether
by their choice of job, sexual partner, mode of dress, or simply because
they are unwilling to adhere to what some have called the rambo/
bimbo extremes of gender expression.
THE NEW PARADIGM
As late as the mid-1980s, identity options for transgendered people

were limited. For example, the Midwestern support group studied by
Bolin (1988) in the mid-1980s required its new members to declare
whether they were crossdressers or transsexuals, and expected them to
behave accordingly. As Bolin discovered when she revisited the male-
to-female transgender community in the early 1990s, the emerging
transgender model allowed a wide range of self-identities as it removed
role expectations that encouraged transgendered people who identified
as anything other than crossdresser to vigorously pursue sex reassign-
ment (Bolin, 1994). A mid-1990s survey (Denny and Roberts, 1997)
revealed a range of more than 40 self-identities among its 339 gender-
variant respondents. Many who might once have identified as transsexual
and pursued sex reassignment are expressing their gender in a variety of
ways, including crossliving without surgery or hormones or deliber-
ately blending male and female characteristics in their gendered presen-
tations.
Some transgender theorists have echoed critics of sex reassignment
like Janice Raymond (1979), arguing that those who truly understand
the socially constructed nature of gender will have neither need nor de-
sire to change their sex (Mackenzie, 1994) or that transsexualism is a re-
sult of emerging medical technologies and would not exist without
them (Hausman, 1995). However, transsexuals still exist, and not be-
cause they lack some essential critical capacity which renders them in-
capable of understanding or appreciating the arbitrary and amorphous
nature of gender. Transsexuals are quite simply unhappy with their bod-
ies and social roles. As a rule they are not interested in pioneering new
manifestations of gender; they merely seek a level of personal comfort
and happiness in the world in which they must live. Many transsexuals,
however, have reinterpreted their experience in the light of the trans-
gender model and are less likely to disappear into society after sex reas-
signment than was the case under the medical model, which encouraged
such woodworking.
As books like Leslie Feinbergs Stone Butch Blues (1993) and Trans-
gender Warriors (1996), Kate Bornsteins Gender Outlaw (1994), and
Riki Wilchins Read My Lips (1997) have taken transgender sensibility
to a wide audience, the transgender model has begun to have an effect
on the larger culture. The impact in gay, lesbian, and bisexual circles
has been particularly significant. The issue of transgender inclusion,
long a topic in gay, lesbian, and feminist circles (c.f. Raymond, 1979),
took a new direction in 1993 (c.f. Wilchins, 1994). The major gay/les-
bian/bisexual organizations have since changed either their names or
their mission statements, or both. Transgender theory is now being
taught in universities. Positive portrayals of transgendered people in
films and popular print media, once rare, have become common and
even award-winning. These include Hillary Swanks Best Actress Os-
car at the 2000 Academy Awards and Best Documentary Award for
Southern Comfort at the 2001 Sundance Film Festival. The trend con-
tinues and seems to be accelerating.
Some clinicians remain attached to the medical model, but many
have been influenced by the transgender model. The gender clinics at
the University of Minnesota and the University of Michigan have bro-
ken from the tradition of the earlier programs, which were focused on
surgery as the inevitable and desirable outcome for transsexuals. The
Michigan and Minnesota programs encourage a wide range of self-ex-
pression in their clients, with genital surgery being but one of several
possible outcomes (Bockting and Coleman, 1992).
In the 1990s, intersexed adults began to compare their experiences
and question the treatment they had received as children. Many had un-
dergone genital surgery to bring their bodies into conformity with the
sex to which they had been assigned. The rationale for this treatment
was Money et al.s (1957) imprinting theory. Money (1975) had re-
ported the sex reassignment of an infant whose penis had been acciden-
tal amputated during circumcision, and had followed the case through
Dallas Denny 45
the years, reporting a successful adaptation to the female role. While

intersex activists, most notably Cheryl Chase, were among the first to
question the wisdom of early genital surgery, it was not until Diamond
and Sigmundson (1997) revealed the actual outcome of John Moneys
most famous test case that pediatric surgeons began to take heed (see
also Colapinto, 2000).
This article has made little mention of female-to-male transsexuals.
This is because male-to-females were the primary focus of most clini-
cians and researchers. The literature includes case studies and reports
about female-to-males, and one unfortunate book was authored on the
subject (Lothstein, 1983). However, it was not until the 1990s that
female-to-male transsexualism came under scrutiny. The most compre-
hensive work to date is that of Holly Devor (1997b), but female-to-
males themselves have begun to publish their own accounts (Cameron,
1996; Cromwell, 1999; Green, 1998). As with male-to-female transsex-
uals, female-to-males have proven as a group to be quite unlike their
portrayals in the psychomedical literature.
Research on transsexualism proceeds apace, with the influence of the
paradigm shift becoming ever more prevalent. Advances are being
made in surgical (c.f. Hage, 1992; Karim, 1996) and hormonal (Basson
and Prior, 1998; Cohen-Kettenis, 1992; Prior and Elliott, 1998) treat-
ments, and new treatment models are being developed (Warren et al.,
1985). Transgendered people, who for many years played no role in the
Harry Benjamin International Gender Dysphoria Association, are now
prominent in its ranks and on its various committees. Many prominent
academics are revealing themselves as transgendered (c.f. Wilson,
1998). Transgendered people have become politically active and have
been successful in gaining some legal protections (see Currah, Minter,
and Green, 2000). This century promises a continued and growing un-
derstanding of gender identity variability, in which transgendered peo-
ple will themselves contribute significantly.
TEXT REFERENCES
The bibliography which follows includes the above-referenced books

and articles, which were chosen for either their importance or illustra-
tive value, or both. A second section includes significant works which
are not mentioned in the text. My apologies to those whose work was
not mentioned due to the need for brevity. Some of the annotations be-
low are taken from my work Gender Dysphoria: A Guide to Research.2
Bak, R. C. & Stewart, W. A. (1974), Fetishism, transvestism, and voy-

eurism: A psychoanalytic approach. In American Handbook of Psychi-
atry, (2nd ed.), Vol. 2, eds., S. Arieti & E. Brady. New York: Basic
Books, pp. 352-363.
This article is notable for its report of the rescue, via psycho-
analysis, from pathological feminine identification, of Richard
Raskin. Raskin was not in fact, cured, for he later became Rene
Richards and had sex reassignment surgery.
Basson, R. & Prior, J. C. (1998), Hormonal therapy of gender dysphoria:

The male-to-female transsexual. In Current Concepts in Transgender

Identity, ed. D. Denny. New York: Garland Publishing, pp. 277-296.
Benjamin, H. (1966), The Transsexual Phenomenon: A Scientific Re-

port on Transsexualism and Sex Conversion in the Human Male and
Female. New York: Julian Press.
Benjamins sympathetic and insightful look at transsexualism was
the first major American treatment of the subject.
Billings, D. B. & Urban, T. (1982), The socio-medical construction of

transsexualism: An interpretation and critique. Social Problems, 29 (3):
266-282.
Billings and Urbans article blames transsexuals; however their
argument is really with the medical model of gender. They argue that
transsexualism is a socially constructed reality which only exists in
and through medical practice, and that transsexual people are com-
modified by sex reassignment surgery. They also echo Raymonds
(1979) criticism that by treating transsexuals medically, the medical
profession has indirectly tamed and transformed a potential wildcat
strike at the gender factory.
Like Raymond (1979), Billings and Urban miss the point that by
simply living their lives, transsexuals blur those gender boundaries.
Billings and Urbans critique, while valid enough when applied to
the outdated ethic of the gender clinics of the 1970s, is mired in their
anti-capitalistic bias and weakened by their outsiders perspective on
transsexualism. For instance, they speak several times about the de-
mands of some transsexual people for multiple surgeries. Such sur-
geries (for example, rhinoplasty) are often necessary to prevent
social stigmatization due to a non-passing appearance, and can lead
Dallas Denny 47
to a much less stressful life. There is no indication Billings and Urban

are aware of this.
Blanchard, R. & Sheridan, P. M. (1990), Gender reorientation and

psychosocial adjustment. In Clinical Management of Gender Identity
Disorders in Children and Adults, eds. R. Blanchard & B. W. Steiner.
Washington, DC: American Psychiatric Press, pp. 159-189.
Bockting, W. O. & Coleman, E. (1992), A comprehensive approach to

the treatment of gender dysphoria. In Gender Dysphoria: Interdisci-
plinary Approaches to Clinical Management, eds. W. O. Bockting & E.

Coleman. New York: Haworth Press, pp. 131-155.
The authors discuss the treatment model at the University of Min-
nesota Program in Human Sexuality. The comprehensive model
views the treatment of gender identity variability as part of the over-
all treatment of the individuals mental health. The client is encour-
aged to explore his or her sexuality and alternatives to sex reassign-
ment in group and individual counseling. Bockting and Coleman
were among the first clinicians to uncouple the desire for genital sur-
gery from the desire for hormonal therapy and cross-gender living;
some gender clinics continue to reject applicants unless they clearly
state a surgical objective.
Bolin, A. (1988), In Search of Eve: Transsexual Rites of Passage. South

Hadley, MA: Bergin & Garvey Publishers, Inc.
Bolins book has unfortunately been underappreciated by clini-
cians. Her doctoral thesis, which grew into the book, was a study of a
group of male-to-female transsexuals in the Midwest, whom she ob-
served in a non-clinical setting. Her findings reveal serious problems
with a treatment paradigm that obliged transsexual persons to mold
themselves to the sexist notions of clinicians in order to obtain treat-
ment.
Bolin, A. E. (1994). Transcending and transgendering: Male-to-female

transsexuals, dichotomy, and diversity. In Third Sex, Third Gender: Es-
says from Anthropology and Social History, ed. G. Hert. New York:
Zone Publishing, pp. 447-485.
Bornstein, K. (1994), Gender Outlaw: On Men, Women, and the Rest of

Us. New York: Routledge.
Bornsteins non-linear yet eminently readable treatise on gender

broke new ground by thoroughly divorcing itself from the medical
model.
Boswell, H. (1991), The transgender alternative. Chrysalis Quart., 1 (2):

29-31.
Boswell, H. (1997), The transgender paradigm shift toward free expres-

sion. In Gender Blending, eds. B. Bullough, V. Bullough & J. Elias.
Amherst, NY: Prometheus Press, pp. 53-57.
This book chapter is a reworking of Boswells 1991 paper.
Boswell, H. (2001), The transgender revolution. Transgender Tapestry,

1(95): 19-24, Fall.
Cameron, L. (1996) Body Alchemy: Transsexual Portraits. Pittsburgh,

PA: Cleis Press.
Camerons provocative photographs deliberately juxtapose the
male-and-female physical characteristics of female-to-male trans-
sexuals.
Clemmensen, L. H. (1990), The real-life test for surgical candidates.

In Clinical Management of Gender Identity Disorders in Children and
Adults, eds. R. Blanchard & B. W. Steiner. Washington, DC: American
Psychiatric Press, pp. 119-135.
Cohen-Kettenis, P. T. (1992), A Gender Clinic for Children and Ado-

lescents: The Dutch Model. Presented at International Conference on
Gender Identity and Development in Childhood and Adolescence,
March, 1992, St. Georges Hospital, London, England.
Colapinto, J. (2000), As Nature Made Him: The Boy Who Was Raised
as a Girl. New York: Harpercollins.
Follows up John Moneys ablatio penis case, in which a twin
boy was reassigned as a girl after a circumcision accident. Although
Money reported a successful adaptation to the female role, the sex re-
assignment was a disaster; the subject was profoundly unhappy as a
female and eventually made an adult adaption as a male.
Dallas Denny 49
Cromwell, J. (1999), Transmen and FTMs: Identities, Bodies, Genders,

and Sexualities. Urbana: University of Illinois Press.
Currah, P., Minter, S. & Green, J. (2000), Transgender Equality: A

Handbook for Activists and Policymakers. Washington, DC: National
Gay and Lesbian Task Force.
Provides a history of civil rights protections on the basis of gender
identity, and strategies for getting such legislation enacted. Available
free for download at <www.ngltf.org>.
Denny, D. (1992), The politics of diagnosis and a diagnosis of politics:

The university-affiliated gender clinics, and how they failed to meet the
needs of transsexual people. Chrysalis Quart., 1 (3): 9-20.
Denny, D. (1995), The paradigm shift is here! AEGIS News, 1 (4): 1,

4-5.
Denny, D. & Roberts, J. (1997), Results of a survey of consumer atti-

tudes about the HBIGDA Standards of Care. In Gender Blending, eds.
B. Bullough, V. Bullough & J. Elias. Amherst, NY: Prometheus Books,
pp. 320-336.
Devor, H. (1997a), Reed Erickson: His Influence on the Early Years of

Transexualism. Paper presented at the Second International Congress
on Sex and Gender Issues, King of Prussia, PA, 19-22 June, 1997.
Devor, H. (1997b), FTM: Female-to-Male Transsexuals in Society.

Bloomington: Indiana University Press.
In the early years, female-to-male transsexuals were considered to
be all of a type. Devors book explores FTMs in all their complex-
ity.
Diamond, M. & Sigmundson, H. K. (1997), Sex reassignment at birth:

A case report with long-term follow-up and clinical implications. Arch.
Ped. & Adol. Med., 151: 298-304.
The ultimate follow-up of Moneys (1975) ablatio penis case.
The individual is a twin whose penis was lost while being circum-
cised. He was reassigned as a girl, but ultimately transitioned to the
male role and had phalloplasty, as chronicled in John Colapintos As
Nature Made Him. The case, and the efforts of the Intersex Society of
North America, have caused pediatric surgeons to rethink the ethics
and efficacy of surgery on intersex infants.
Edgerton, M. T. (1973), A new male-to-female surgical technique. In

Proceedings of the Second Interdisciplinary Symposium on Gender
Dysphoria Syndrome, eds. D. Laub & P. Gandy. Palo Alto, CA: Stan-
ford University Medical Center, pp. 139-151.
Technical description of Edgerton and Bulls two-stage vagino-
plasty procedure, well-illustrated with photographs and drawings.
Edgerton notes that pressure on the neovagina from packing is the

prime cause of necrosis; he also describes his attempts to construct a
clitoris from scrotal skin.
Ellis, H. H. (1906), Studies in the Psychology of Sex: Erotic Symbolism,

Mechanism of Detumescence, the Psychic State in Pregnancy. Philadel-
phia: F.A. Davis Co.
Feinberg, L. (1993), Stone Butch Blues. New York: Firebrand Books.

This novel, which is based on Feinbergs history as a masculine
human being with a female sex designation, has been quite influen-
tial in lesbian and feminist circles. Feinbergs protagonist embraces
an essential transgender identity, rejecting conventional models of
maleness and femaleness.
Feinberg, L. (1996), Transgender Warriors: Making History from Joan

of Arc to Ru Paul. Boston: Beacon Press.
Feinbergs history interweaves transgender history and Marxism.
Fleming, M., Steinman, C. & Bocknek, G. (1980), Methodological

problems in assessing sex-reassignment: A reply to Meyer and Reter.
Arch. Sexual Behav., 9 (5): 451-456.
Foucault, M. (1979), The History of Sexuality. London: Allen Lane.
Gould, S. J. (1981), The Mismeasure of Man. New York: W.W.

Norton & Co.
Gould takes a retrospective look at the mental measurement move-
ment. Mismeasure is the perfect companion for Thomas Kuhns The
Dallas Denny 51
Structure of Scientific Revolutions. It shows in a most graphic man-

ner the ways science and scientists are constrained by the paradigms
under which they operate.
Green, J. (1998), FTM: An emerging voice. In Current Concepts in

Transgender Identity, ed. D. Denny. New York: Garland Publishing,
pp. 145-161.
Green, R. & Money, J. eds. (1969), Transsexualism and Sex Reassign-

ment. Baltimore: The Johns Hopkins University Press.
This multidisplinary text, which consisted largely of articles pre-

viously printed in professional journals, represented the state of the
art in the treatment and theory of transsexualism of its time.
Hage, J. J. (1992), From Peniplastica Totalis to Reassignment Surgery

of the External Genitalia in Female-to-Male Transsexuals. Amster-
dam: Vrieji Universiteit Press.
Hamburger, C. (1953), The desire for change of sex as shown by per-

sonal letters from 465 men and women. Acta Endocrinologica, 14:
361-375.
Hamburger, C., Strup, G. K. & Dahl-Iversen, E. (1953), Transvestism:

Hormonal, psychiatric, and surgical treatment. J. Amer. Med. Assn., 12
(6): 391-396.
This was the report of the sex reassignment of Christine Jorgensen.
Hastings, D. W. (1969), Inauguration of a research project on trans-

sexualism in a university medical center. In Transsexualism and Sex
Reassignment, eds. R. Green & J. Money. Baltimore: The Johns Hopkins
University Press, pp. 243-251.
Hausman, B. L. (1995), Changing Sex: Transsexualism, Technology,

and the Idea of Gender. Durham: Duke University Press.
Hirschfeld, M. (1910), Die Transvestiten: Eine Untersuchung uber den

Erotischen Verkleidungstrieh. Berlin: Medicinisher Verlag Alfred Pulver-
macher & Co.
Hirschfeld, M. (1991), Transvestites: The Erotic Drive to Cross Dress.

(Michael A. Lombardi-Nash, translator). Buffalo, NY: Prometheus
Books.
This is the first translation of Hirschfelds Die Transvestiten. Vern
Bullough notes in his introduction that the later study of gender-vari-
ant people would have been very different had the work been trans-
lated at the time when it was written.
Ihlenfeld, C. (1973), Thoughts on the treatment of transsexuals. J.

Contemp. Psychother., 6: 64-69.
Karim, R. B. (1996), Vaginoplasty in Transsexuals. Amsterdam: VU

University Press.
Kessler, S. J. & McKenna, W. (1978), Gender: An Ethnomethod-

ological Approach. New York: John Wiley & Sons. Reprinted in 1985
by The University of Chicago Press.
The authors argue that gender is not a reflection of biological re-
ality, but rather a social construct that varies across cultures (Quote
by Stanford M. Lyman). The authors rely heavily on transsexualism
in developing their theory. A lengthy appendix includes correspon-
dence from and discussion of Rachel, a male-to-female transsexual
person with whom, parenthetically, I happen to have gone to gradu-
ate school.
Krafft-Ebing, R. von, (1894), Psychopathia Sexualis, trans. C. G. Chad-

dock. Philadelphia: F.A. Davis.
Several of Krafft-Ebings case studies can be clearly read as trans-
sexual. Others are less clearly so, and seem indicative of modern-day
transgenderism.
Kuhn, T. S. (1962), The Structure of Scientific Revolutions. Chicago:

The University of Chicago.
Kuiper, A. & Cohen-Kettenis, P. (1988), Sex reassignment surgery: A

study of 141 Dutch transsexuals. Arch. Sexual Behav., 17 (5): 439-457.
Lothstein, L. M. (1979), Psychodynamics and sociodynamics of gen-

der-dysphoric states. Amer. J. Psychother., 33 (2): 214-238.
Dallas Denny 53
Basing this paper on his clinical experience with over 125 patients
at the Case Western Reserve University Gender Identity Clinic, the
author reports an amazing range and degree of psychopathology in
both male-to-female and female-to-male transsexual persons. What
makes this extended name-calling notable is Lothsteins reliance on
personal impressions rather than data.
Lothstein, L. (1983), Female-to-Male Transsexualism: Historical, Clini-

cal and Theoretical Issues. Boston: Routledge & Kegan Paul.
Insensitive and hostile account of female-to-male transsexualism

by a psychoanalyst.
MacKenzie, G. O. (1994), Transgender Nation. Bowling Green, OH:

Bowling Green University Popular Press.
Echoes of Janice Raymond! MacKenzie, who made a foray into
transgender culture in the Southwest before writing this book, ac-
cuses transsexuals of reinforcing binary gender norms, while Texan
transgenderists who choose not to have surgery ride like heroes
across the landscape.
McHugh, P. R. (1992), Psychiatric misadventures. American Scholar,

61 (4): 497-510.
McHugh discusses deinstitutionalization (the precipitate dismissal
of persons with severe, chronic mental disorders [e.g., schizophre-
nia]), Multiple Personality Disorder, which he considers a cultural
fashion, and transsexualism. He considers the surgical treatment of
transsexualism an abandonment of the physicians duty to protect pa-
tients from their symptoms and to be working on behalf of a cultural
force. He notes that his intention when he first came to Johns
Hopkins was to terminate that institutions participation in sex reas-
signment. This, unfortunately, was not done from a position of
knowledge about transsexualism. For example, the National Trans-
gender Library and Archive contains a 1994 letter written by McHugh
in which he expresses incredulity that a postoperative male-to-fe-
male person could be sexually interested in females. Anyone with
even passing knowledge of transsexuals would know this happens
frequently.
Meyer, J. K. (1973), Some thoughts on nosology and motivation among

transsexuals. In Proceedings of the Second Interdisciplinary Sympo-
sium on Gender Dysphoria Syndrome, eds. D. Laub & P. Gandy. Stan-
ford, CA: Stanford University Medical Center, pp. 31-33.
Meyer discusses how his early belief in Stollers smothering
mother theory of transsexualism was not borne out by his (Meyers)
experience in the gender identity program at Johns Hopkins. He
notes that transsexualism (he puts the term in quotes) has come to
stand for a multitude of sins, and worries that some applicants will
regret surgical sex reassignment. If diverse patients are lumped to-

gether under the term transsexual, there will be no going back later
to make potentially useful prognostic distinctions.
Meyer is embedded, if not mired in the medical model. Presented
with evidence that there is not a discrete syndrome of transsexualism,
he suggests that clinicians look harder. He never seems to consider
that the desire for sex reassignment need not be due to psychopath-
ology of any sort. Eventually, he burned out, published a seriously
flawed study (Meyer and Reter, 1979) and issued press releases con-
demning the surgical treatment of transsexualism which resulted in
the closing of the gender identity program at Johns Hopkins.
Meyer, J. K. & Reter, D. (1979), Sex reassignment: Follow-up. Arch.

Gen. Psychiat., 36 (9): 1010-1015.
This controversial and methodologically flawed study of the out-
come of male-to-female transsexual surgery, and the publicity atten-
dant upon its release, resulted in the closing of the Gender Identity
Clinic at The Johns Hopkins University. It also led to a resulting
domino-like effect, in which dozens of other university-affiliated
gender clinics closed their doors. The authors attempted to measure
success by looking at factors like change of residence, job and educa-
tional levels, and marital status. Not only is the study seriously
flawed, the authors conclusion that there is no objective advan-
tage to sex reassignment surgery is but one of a number of possible
conclusions.
Milliken, A. D. (1982), Homicidal transsexuals: Three cases. Can. J.

Psychiat., 27 (1): 43-46.
The author admits he has gone out of his way to dig up three
instances of transsexuals who had committed, or in one case, had at-
Dallas Denny 55
tempted to commit, homicide. This paper is indicative of a sensation-

alistic bias in medical literature; one need only transpose the subject
population to, say, homicidal ministers or murderous children with
heart problems to see how unfortunate it was that this paper was ac-
cepted for publication. It is more likely that the subjects histories of
childhood abuse, life on the street as prostitutes, substance abuse,
self-mutilation, rapes, and in one instance, obvious schizophrenia
were much more significant as causative factors for the assaults than
their gender dysphoria.
Money, J. (1975), Ablatio penis: Normal male infant sex-reassigned as

a girl. Arch. Sexual Behav., 4: 65-71.
Money, J. & Ambinder, R. (1978), Two-year, real-life diagnostic test:

Rehabilitation versus cure. In Controversy in Psychiatry, eds. H. Brady &
J. Brody. Philadelphia, PA: Saunders.
Money, J., Hampson, J. G. & Hampson, J. L. (1957), Imprinting and the

establishment of gender roles. A.M.A. Arch. Neurol. & Psychiat., 77:
333-336.
The authors note that in their study of 105 hermaphroditic persons,
gender identity is almost always congruent with assigned sex, no
matter what the various components of sex (which are listed) may be.
There is much wisdom in this paper; for instance, the authors note
that gender identity is caused by an interaction of environmental and
biological factors, and that once formed, environmental and social
cues are deciphered in relation to that gender identity. This is a re-
markable point of view for 1957. Unfortunately, the article concludes
with a likening of the development of gender identity to the imprint-
ing phenomenon discovered by Konrad Lorenz. The authors have
been taken to task for this repeatedly over the years.
Ogas, O. (1994), Spare parts: New information reignites a controversy

surrounding the Hopkins gender identity clinic. City Paper (Baltimore),
18 (10), March 9, pp. cover, 10-15.
Discusses the circumstances surrounding the closing of the Johns
Hopkins Gender Identity Clinic in 1979, following Meyer and Reters
paper, and the arrival of Paul McHugh. The author interviews John
Money, Marty Malin, and others who were active at Hopkins at the
time.
Oppenheim, G. (1979), Meyers survey draws fire from leading author-

ities. Transition, 11.
Includes reactions of Richard Green, Paul A. Walker, Stanley
Biber, and Harry Benjamin to Meyer and Reter (1979).
Ostow, M. (1953), Transvestism. Letter to the editor. J. Amer. Med.

Assn., 152 (16): 1553.
The author likens sex reassignment surgery to complicity with a
patients wish to die. Characterizing the desire for sex reassignment
as a neurosis, he states his belief that Hamburger et al.s patient
sought help in order to allay the guilt associated with dressing up. He
predicts that sooner or later, the patient will regret what she did
(Christine Jorgensen lived for nearly 40 years postsurgically with no
publicly stated regrets).
Pauly, I. B. (1965), Male psychosexual inversion: Transsexualism. A

review of 100 cases. Arch. Gen. Psychiat., 13: 72-181.
Person E. & Ovesey, L. (1974a), The transsexual syndrome in males: I.

Primary transsexualism. Amer. J. Psychother., 28: 4-20.
The authors divide male-to-female transsexuals into two types:
primary and secondary, with primary transsexual people progress-
ing toward a transsexual resolution without significant deviation ei-
ther heterosexually or homosexually.
Person, E. & Ovesey, L. (1974b), The transsexual syndrome in males:

II. Secondary transsexualism. Amer. J. Psychother., 28: 174-193.
The authors describe two types of secondary (homosexual and
transvestic) male-to-female transsexualism, using case illustrations.
The paper concludes with a discussion of treatment, in which they as-
cribe some blame to psychiatrists for their frequent dismissals of
transsexual persons as psychotic and/or delusional.
Prince, C. V. (1969), Men who choose to be women: A leading trans-

vestite explains why some men feel the need to dress or live as women.
Sexology, February.
Prior, J. C. & Elliott, S. (1998), Hormonal therapy of gender dysphoria:

The female-to-male transsexual. In Current Concepts in Transgender
Identity, ed. D. Denny. New York: Garland Publishing, pp. 297-313.
Dallas Denny 57
Raymond, J. (1979), The Transsexual Empire: The Making of the

She-Male. Boston: Beacon Press. Reissued in 1994 with a new intro-
duction by Teachers College Press, New York.
Raymonds bias is apparent by the second page. Her thesis is that
male-to-constructed females, as she calls them, are tools of a patri-
archal medical system, designed to make women obsolete. Rhetoric
disguising itself as science is not deserving of serious consideration,
although Raymonds polemic has received just that. It is worth read-
ing only as an example of how hostile some people feel towards
transsexual persons.
Rothblatt, M. (1994), The Apartheid of Sex: A Manifesto on the Free-

dom of Gender. NY: Crown Publishers.
Rothblatt likens sex-typing to the Apartheid of South Africa.
Socarides, C. W. (1970), A psychoanalytic study of the desire for sexual

transformation (transsexualism): The plaster-of-Paris man. Int. J.
Psycho-Anal., 51 (3): 341-349.
Absolutely bizarre case study of a person with many problems, of
which the desire for sex reassignment is only one.
Socarides, C. W. (1977), Beyond Sexual Freedom. New York: Quad-

rangle Books/New York Times Book Company.
Socarides attacks transsexualism and other forms of human diver-
sity in this narrow-minded and hostile little book. Socarides was one
of the opponents of removing homosexuality from the DSM III, and
his dislike of transsexualism (and transsexuals) is apparent in his
journal articles as well as in this book.
Stoller, R. J. (1964), A contribution to the study of gender identity. Int.

J. Psycho-Anal., 45: 220-226.
Stoller, R. J. (1967), Etiological factors in male transsexualism. Trans-

actions of the New York Academy of Sciences, 29 (4): 431-433.
The author discusses his mother-blame theory of transsexualism
with descriptions of mother-child interactions at a gender clinic.
Longitudinal studies have showed that the extremely feminine young
boys studied by Stoller were more at risk for homosexuality than

transsexualism.
Stoller, R. J. (1968), A further contribution to the study of gender iden-

tity. Int. J. Psycho-Anal., 49: 364-369.
The author reports that the individual described in his 1964 paper,
who he had eventually believed to have spontaneously feminized and
who he had used in a discussion of a biological force in the forma-
tion of gender identity, had admitted to him that she had been taking
estrogens since puberty. He reaffirms his theory that male-to-female

transsexualism is caused by a too-close relationship between a bisex-
ual mother and the child and a (psychologically and physically) ab-
sent father, while noting that he still feels there is a biological force
involved in gender identity formation.
Stoller, R. J. (1982), Near miss: Sex change treatment and its evalua-
tion. In Eating, Sleeping, and Sexuality, ed. M. R. Zales. New York:
Brunner/Mazel, pp. 258-283.
Cynical but nevertheless excellent summarization of the ethical
questions and controversies involved in sex reassignment surgery.
The author concludes that After 30 years . . . both the treatments and
the patients (of both sexes) have been, at most, near misses.
Stone, C. B. (1977), Psychiatric screening for transsexual surgery.

Psychosomatics, 18 (1); 25-27.
Discusses the characteristics of patients the author accepted for
male-to-female sex reassignment surgery. His selection criteria fa-
vored those who had taken drug overdoses and been psychiatrically
hospitalized, had long histories of prostitution and nonviolent crimes,
and were in general troublesome and demanding but who had man-
aged to feminize themselves (some, and perhaps the majority, no
doubt without medical help). Those who had managed to adapt to the
male role (i.e., those who did not seem to the author to be feminine)
were denied surgery, despite their often shrill insistence. Those ac-
cepted for surgery had lived cross-gender for at least 5 years. Out-
comes were good, with no reported regrets in the 13 operated patients.
Unfortunately, the non-operated patients were not followed up.
Dallas Denny 59
Stone, A. R. (As Sandy Stone) (1991), The empire strikes back: A

posttranssexual manifesto. In Body Guards: The Cultural Politics of
Gender Ambiguity, eds. J. Epstein & K. Straub. New York: Routledge,
pp. 280-304.
The author, a post-operative transsexual woman and a sociologist,
cuts through misconceptions perpetuated by the medical community
(e.g., all transsexual persons are confused and bizarre), as well as
those perpetuated by transsexuals themselves (e.g., the Im a woman/
man trapped in a mans/womans body argument). Stone suggests
that transsexuals, rather than assimilating, take responsibility for all
their history, to begin to rearticulate their lives not as a series of era-

sures . . . but as a political action begun by reappropriating difference
and reclaiming the power of the refigured and reinscribed body.
Symmers, W. St. C. (1968), Carcinoma of breast in transsexual individ-
uals after surgical and hormonal interference with the primary and sec-
ondary sex characteristics. British Med. Journal, 2 (597): 83-85.
Case studies of two male-to-female transsexuals who died of
breast cancer after hormonal and surgical interventions. The author
feels unable to attribute the cancer to either hormonal therapy or
augmentative mammoplasty.
Ulrichs, K. H. (1994). The Riddle of Man-manly Love: The Pio-
neering Work on Male Homosexuality. (Michael A. Lombardi-Nash,
translator). Vols. 1 and 2. Buffalo, NY: Prometheus Press.
Ulrichs work of a century ago, finally translated into English.
Ulrich believed homosexuality in men was due to a strong feminine
element. His diagnostic category urning encompassed both homo-
sexuality and cross-gender identity.
Warren, B., Blumenstein, R. & Walker, L. (1998), Appendix: The em-
powerment of a community. In Current Concepts in Transgender Iden-
tity, ed. D. Denny. New York: Garland Publishing, pp. 427-430.
Wiedeman, G. H. (1953), Letter to the editor. J. Amer. Med. Assn., 152
(12): 1167.
Responding to Hamburger et al. (1953), Wiedeman laments the
fact that more psychiatric data were not reported, and apparently
were not collected. He calls the patients wish for surgical conversion
masochistic. The difficulty of getting the patient into psychiatric
treatment should not lead us to compliance with the patients de-

mands, which are based on his sexual perversion.
Wilchins, R. A. (1994), The Menace in Michigan. Village Voice, Sep-
tember 6, pp. 41-42, 44.
Wilchins, R. A. (1997), Read My Lips: Sexual Subversion and the End
of Gender. Ithaca, NY: Firebrand Books.
Wilson, R. (1998), Transgendered scholars defy convention, seeking to
be heard and seen in academe: A growing movement demands protec-
tion in anti-bias policies and attention for their ideas. The Chronicle of
Higher Education, February 6, 44 (22): A10-A12.
OTHER RECOMMENDED READINGS

Allen, M. P. (1989), Transformations: Crossdressers and Those Who
Love Them. New York: Dutton.
Bayer, R. (1987), Homosexuality and American Psychiatry: The Poli-
tics of Diagnosis. Princeton, NJ: Princeton University Press.
Excellent analysis of the events leading of the removal from ho-
mosexuality as a diagnostic category in the DSM.
Bem, S. L. (1993), The Lenses of Gender: Transforming the Debate on
Sexual Inequality. New Haven, CT: Yale University Press.
Blanchard, R. (1989), The concept of autogynephilia and the typology
of male gender dysphoria. J. Nerv. & Ment. Dis., 177 (10): 616-623.
Reports findings of a study in which 212 male-to-female transsex-
ual persons were divided into homosexual, heterosexual, bisexual,
and analloerotic (unattracted to male or female partners). A self-rat-
ing scale indicated that the three nonhomosexual groups were more
likely to be autogynephilic (sexually aroused by the thought or fan-
tasy of themselves as women).
Blanchard, R. (1993), Varieties of autogynephilia and their relationship
to gender dysphoria. Arch. Sexual Behav., 22 (3): 242-251.
Blanchard examined the relationship between gender dysphoria
and the phenomenon he calls autogynephilia (the sexually stimulating
Dallas Denny 61
thought of the male individual who fantasizes about himself as a

woman). More than two hundred nonhomosexual outpatients of the
Clarke Institute of Psychiatry Gender Identity Clinic were given
questionnaires to determine gender dysphoria and patterns of sexual
attraction. He found that men who were most attracted to the thought
of themselves as nude women scored more highly on measures of
gender dysphoria than men who preferred to envision themselves as
clothed women. Both groups scored higher in gender dysphoria than
a group of men who were most aroused at the thought of themselves
as women in underwear. In other words, those most aroused by the
thought of being women were the most inclined to wish to change

their own bodies. Blanchard takes his results as a confirmation that
the desire for sex reassignment is part of a progression which begins
with sexual fantasies of wearing womens clothing.
Blanchard, R. & Steiner, B. eds. (1990), Clinical Management of Gen-

der Identity Disorders in Children and Adults. Washington, DC: Amer-
ican Psychiatric Press.
This edited text contains an excellent critique of Meyer and Reter
(1979) and other interesting and informative chapters. However, the
program used at the Clarke Institute of Psychiatry is the medical
model and therefore more conservative than the emerging, contem-
porary standards of treatment; the majority of chapters reflect the
conservative perspective. See also Steiner, 1985.
Bockting, W. & Coleman, E. eds. (1992), Gender Dysphoria: Interdis-

ciplinary Approaches in Clinical Management. New York: The Haworth
Press, Inc.
Brown, G. R. (1988a), Bioethical issues in the management of gender

dysphoria. Jefferson J. Psychiat., 6: 23-24.
Excellent treatment of the ethical dilemma transsexualism causes
physicians. Useful table of characteristics considered desirable and
undesirable in those requesting sex reassignment surgery.
Brown, G. R. (1988b), Transsexuals in the military: Flight into hyper-

masculinity. Arch. Sexual Behav., 17 (6): 527-537.
Brown, G. R. (1990a), A review of clinical approaches to gender

dysphoria. J. Clin. Psychiat., 51 (2): 57-64.
Discussion of differential diagnosis, with handy table of desirable

and undesirable characteristics for sex reassignment surgery (a more
extensive table can be found in Brown, 1988a). Good reference list.
Brown, G. R. (1990b), The transvestite husband. Medical Aspects of
Human Sexuality, 24 (6): 35-42.
This article actually discusses wives of crossdressers and the im-
pact upon them of their husbands crossdressing.
Brown, M. & Rounsley, C. A. (1996), True Selves: Understanding
Transsexualism for Family, Friends, Coworkers, and Helping Profes-

sionals. San Francisco: Jossey-Bass Publishers.
Bullough, B., Bullough, V. L. & Elias, J. eds. (1997), Gender Blending.
Amherst, NY: Prometheus Press.
Contains chapters derived from papers presented at the First Inter-
national Congress on Cross Dressing, Sex, and Gender Issues; an ex-
cellent book.
Bullough, V. L. & Bullough, B. (1993), Cross-Dressing, Sex, and Gen-
der. Philadelphia: University of Pennsylvania Press.
This is a well-researched and footnoted work, the most complete
on crossdressing since Hirschfelds 1910 Die Transvestiten. In the
first half, the authors take a historical approach, examining both
crossdressing and notions of gender through the ages. In the second
half, they look at nineteenth and twentieth-century crossdressing
phenomena, including transsexualism (but the major focus is on
crossdressing). Several chapters explore the personality of hetero-
sexual crossdressers, and one chapter examines the research on fe-
male partners of crossdressers. A thorough and insightful work.
Burke, P. (1996), Gender Shock: Exploding the Myths of Male and Fe-
male. New York: Doubleday.
Butler, J. (1990), Gender Trouble: Feminism and the Subversion of
Identity. New York: Routledge.
Butler, J. (1993), Bodies That Matter: On the Discursive Limits of
Sex. New York: Routledge.
Dallas Denny 63
Califia, P. (1997), Sex Changes: The Politics of Transgenderism. San

Francisco: Cleis Press.
Cole, S. S., Denny, D., Eyler, A. E. & Samons, S. (2000), Diversity in
gender identity: Issues of transgender. In The Psychological Science of
Sexuality, eds. L. Szuchman & F. Muscarella. New York: John Wiley &
Sons, Inc, pp. 149-195.
Denny, D. (1994), Gender Dysphoria: A Guide to Research. New York:
Garland Publishing.
Detailed bibliography with more than 700 pages of listings.

Denny, D. ed. (1998), Current Concepts in Transgender Identity. New
York: Garland Publishers.
Denny, D. (1999), Transgender in the United States: A brief discussion.
SIECUS Report, 28(1):8-13, October-November.
Desmond, P. & Hymers, R. L. (1976), Perry: A Transformed Tran-
sexual. Hutchinson, MN: Standard Printing.
The transformation in the title is post-op Perry Desmonds con-
version via Christianity and reversion to male form as a eunuch for
the Lord.
Devor, H. (1989), Gender Blending: Confronting the Limits of Duality.
Bloomington: Indiana University Press.
A psychological and sociological treatise on women who are or
who have at some time in the past been frequently mistaken for men.
Although several of the women had flirted with the notion of sex re-
assignment, none were seriously interested in actually becoming
men. The book includes photographs, end notes, and a 10-page bibli-
ography.
Docter, R. F. (1988), Transvestites and Transsexuals: Toward a Theory
of Cross-Gender Behavior. London: Plenum Press.
Dealing exclusively with biological males, Docter draws heavily
on sexual script theory to explain transvestism and secondary trans-
sexualism. Includes a review of the literature, a chapter on the wives
of crossdressers, and a chapter which gives results of a large survey
given by the author.
Ekins, R. & King, D. eds. (1995), Blending Genders: The Social Con-
text of Cross-Dressing and Sex-Changing. New York: Routledge.
Ekins, R. (1997), Male Femaling: A Study in Grounded Theory. Lon-

don: Routledge.
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der-Variant Clients. New York: W.W. Norton.
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Women and Men. New York: Basic Books.
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Construction of Sexuality. New York: Basic Books.
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tity. Englewood Cliffs, NJ: Prentice-Hall.
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Homosexuality. New Haven, CT: Yale University Press.
The results of Greens longitudinal study of extremely feminine
boys, originally selected because they were thought to be pre-trans-
sexual, are presented here. The majority of the boys had homosexual
orientations as adults. Only one was considering sex reassignment,
and he was apparently ambivalent about it.
Herdt, G. ed. (1994), Third Sex, Third Gender: Essays from Anthropol-
ogy and Social History. New York: Zone Books.
Edited text with chapters from a variety of cultures.
Israel, G. & Tarver, D. (1998), Transgender Care: Recommended

Guidelines, Practical Information, and Personal Accounts. Philadel-
phia, PA: Temple University Press.
The most comprehensive treatment manual to date.
Jorgensen, C. (1967), Christine Jorgensen: A Personal Autobiography.

New York: Paul S. Ericksson, Inc. Reprinted in 1968 by Bantam Books.
The report of Christine Jorgensens surgical and hormonal sex re-
assignment hit the headlines in late 1952, ushering in the modern age
Dallas Denny 65
of transsexualism. Jorgensen tells her story, some fifteen years after

her surgery and twenty years before her death from cancer.
Kessler, S. (1998), Lessons from the Intersexed. Brunswick, NJ: Rutgers

University Press.
Lawrence, A. (1998), Men trapped in mens bodies: An introduction

to the concept of autogynephilia. Transgender Tapestry, 1 (85): 65-68,
Winter.
Autogynephilia (literally, love for oneself as a woman) is a term

coined by Ray Blanchard (1989, 1993). Lawrence argues that most
males have sex reassignment not because of gender dysphoria, but to
fulfill their sexual fantasies of themselves as women.
Mallon, G. P. ed. (1999), Social Services with Transgendered Youth.

Binghamton, NY: The Haworth Press, Inc.
Also published as Journal of Gay and Lesbian Social Services, 10
(3-4), 1999.
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Chicago Press.
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(Available in US from Inco, Inc., Chicago).
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ters, America sleeps. American Family Association World Wide Web
Page, <http://www.gocin.com/afa/home.htm>. Reprinted from The Wash-
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Management. New York: Plenum Press.
An edited text from those working at the Clarke Institute of Psy-
chiatry in Toronto. See also Blanchard and Steiner, 1990.
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Sexual Culture. New York: Bantam Books.
Excellent treatment of transgender throughout. Fascinating read.
Walters, W. A. W. & Ross, M. W. eds. (1986), Transsexualism and Sex

Reassignment. New York: Oxford University Press.
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Los Angeles: The Center for Gender Sanity.
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Gender Identities. London: Garnet Publishing, Ltd.
NOTES
1. Editors Note: A similar strategy was employed by George Weinberg in Society
and the Healthy Homosexual (1972, Anchor Books) where he coined the term homo-
phobia and then defined that as a pathological problem, rather than homosexuality.
2. Annotations are copyright 1994 from Gender Dysphoria: A Guide to Research
by Dallas Denny and Garland Publishers. They are reproduced by permission of
Routledge, Inc., part of The Taylor & Francis Group.
RECEIVED: February 2001

REVISED: March 2001
ACCEPTED: April 2001

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This article was downloaded by: [Selcuk Universitesi]

On: 04 January 2015, At: 13:14

Journal of Gay & Lesbian Psychotherapy

A Selective Bibliography of Transsexualism

To link to this article: http://dx.doi.org/10.1300/J236v06n02_04

PLEASE SCROLL DOWN FOR ARTICLE

ABSTRACT. Transsexualism, codified in DSM-IV-TR as Gender Iden-

information and comparing notes. By 1985, there were a number of sup-

sexualism provided fertile ground for a paradigm shift. An alternative

KEYWORDS. Gender clinics, gender dyshporia, gender identity, post-

Transsexualism, codified in DSM-IV-TR as Gender Identity Disor-

DEFINING THE SYNDROME

same treatment (Hamburger, 1953).

to change. Since transsexuals have a firm and fixed gender identity as a

Psychiatrist and psychoanalyst Robert Stoller published widely on

transsexuals. Secondary transsexuals were themselves divided into two

MEYER AND RETER

co-authored by his secretary, Donna Reter, and published in The Ar-

Also in 1979 was the publication of Janice Raymonds The Transsex-

The closing of the U.S. gender clinics created a treatment vacuum

ential was A. R. (Sandy) Stone (1991), who noted the existence of a

One clinician said that he was more convinced of the femaleness

Kessler and McKenna had interviewed male-to-female transsexuals

The preoperative individual recognizes the importance of fulfill-

attacks against transsexualism and against transsexuals themselvesfor

An influential article by Holly Boswell was published in 1991 (see

ture analogous to Stephen Jay Goulds (1981) examination of the early

THE NEW PARADIGM

As late as the mid-1980s, identity options for transgendered people

the years, reporting a successful adaptation to the female role. While

The bibliography which follows includes the above-referenced books

Bak, R. C. & Stewart, W. A. (1974), Fetishism, transvestism, and voy-

Basson, R. & Prior, J. C. (1998), Hormonal therapy of gender dysphoria:

The male-to-female transsexual. In Current Concepts in Transgender

Benjamin, H. (1966), The Transsexual Phenomenon: A Scientific Re-

Billings, D. B. & Urban, T. (1982), The socio-medical construction of

to a much less stressful life. There is no indication Billings and Urban

Blanchard, R. & Sheridan, P. M. (1990), Gender reorientation and

Bockting, W. O. & Coleman, E. (1992), A comprehensive approach to

plinary Approaches to Clinical Management, eds. W. O. Bockting & E.

Bolin, A. (1988), In Search of Eve: Transsexual Rites of Passage. South

Bolin, A. E. (1994). Transcending and transgendering: Male-to-female

Bornstein, K. (1994), Gender Outlaw: On Men, Women, and the Rest of

Bornsteins non-linear yet eminently readable treatise on gender

Boswell, H. (1991), The transgender alternative. Chrysalis Quart., 1 (2):

Boswell, H. (1997), The transgender paradigm shift toward free expres-

This book chapter is a reworking of Boswells 1991 paper.

Boswell, H. (2001), The transgender revolution. Transgender Tapestry,

Cameron, L. (1996) Body Alchemy: Transsexual Portraits. Pittsburgh,

Clemmensen, L. H. (1990), The real-life test for surgical candidates.

Cohen-Kettenis, P. T. (1992), A Gender Clinic for Children and Ado-

Cromwell, J. (1999), Transmen and FTMs: Identities, Bodies, Genders,

Currah, P., Minter, S. & Green, J. (2000), Transgender Equality: A

Denny, D. (1992), The politics of diagnosis and a diagnosis of politics:

Denny, D. (1995), The paradigm shift is here! AEGIS News, 1 (4): 1,

Denny, D. & Roberts, J. (1997), Results of a survey of consumer atti-

Devor, H. (1997a), Reed Erickson: His Influence on the Early Years of

Devor, H. (1997b), FTM: Female-to-Male Transsexuals in Society.

Diamond, M. & Sigmundson, H. K. (1997), Sex reassignment at birth:

Edgerton, M. T. (1973), A new male-to-female surgical technique. In

Edgerton notes that pressure on the neovagina from packing is the

Ellis, H. H. (1906), Studies in the Psychology of Sex: Erotic Symbolism,

Feinberg, L. (1993), Stone Butch Blues. New York: Firebrand Books.

Feinberg, L. (1996), Transgender Warriors: Making History from Joan