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Trans Medicine, 1919

German physician and sexologist Magnus Hirschfeld founded a revolutionary clinic where transgender people could receive gender-affirming care, but he left behind a complicated medical and scientific legacy.

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Natalia Mesa

Natalia Mesa was previously an intern at The Scientist and now freelances. She has a PhD in neuroscience from the University of Washington and a bachelor’s in biological sciences from Cornell University.

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    A black and white photo of roughly a dozen people in costume
In the 1920s, the Institute for Sexual Research in Berlin was a haven for queer people, many of whom came to the institute seeking to express their identities without fear of being imprisoned. This undated photo shows a costume party at the institute; its founder, Magnus Hirschfeld (second from right, in glasses), can be seen holding hands with his partner, Karl Giese (center).
Magnus Hirschfeld Society


Recorded trans history can be traced back at least 4,500 years, to ancient Sumerian texts documenting priests known as gala who may have been transgender. But according to Jules Gill-Peterson, a historian at Johns Hopkins University, the word transgender as we use it today, to refer to people whose gender identities do not align with the sex they were assigned at birth, “is a contemporary, Western concept” popularized in part by German physician Magnus Hirschfeld around the turn of the 20th century. 

In early-1900s Germany, homosexuality was illegal. After witnessing several of his gay patients commit suicide, Hirschfeld, a gay man, left his practice to advocate for gender and sexual minorities. In 1919, he founded the Institute for Sexual Research in Berlin to establish sexual science as its own discipline and to provide sexual health services to the community. 

At the institute, Hirschfeld conducted extensive research on gender and sexuality, amassing a library of more than 20,000 books and manuscripts. “The research . . . was basically hanging out in bars and getting to know the queer and trans community,” Gill-Peterson says. In recording these stories, Hirschfeld developed prescient hypotheses, including the existence of gender and sexuality spectra. 

Hirschfeld employed medical professionals to administer hormone replacement therapy and perform early iterations of gender-affirming surgeries, and many of his patients lived and worked at the institute. He was able to provide some with legal “transvestite passes,” which protected them against police violence and incarceration. Gill-Peterson says this is an early example of medicine decriminalizing trans identity “by saying it’s more appropriate for them to see a doctor or a psychiatrist instead of ending up in prison.” But, she adds, it “was a tricky bargain” that also created new power imbalances. 

Even as the facility provided a valuable public service, many of Hirschfeld’s personal views and those of his colleagues “reflected their middle-class values and presumptions,” she says, including the idea that science was the best way to understand gender. And although he was Jewish and thought of himself as antiracist, Gill-Peterson notes that Hirschfeld still held views that women were less intelligent than men and that Black people were inferior to whites. 

Despite these complexities, Hirschfeld had by the 1930s become a world-renowned sexologist. But backlash followed when, after months of threats, Nazis raided his institute in 1933. Hirschfeld was in France at the time and remained in exile until his death two years later. At least one doctor who performed operations at the institute went on to voluntarily serve as a chief medical adviser at the Dachau concentration camp. 

Now, as anti-trans legislation sweeps across the US, Gill-Peterson says that while she doesn’t think we’re repeating the past, perhaps we haven’t fully divested ourselves of it. Trans people continue to struggle with police harassment and poor treatment within the carceral system, as well as for access to gender-affirming procedures and other medical care. In addition, there’s rampant disinformation “saying that medical research on trans people is brand new,” she says, which isn’t the case. To refute this idea, Hirschfeld’s story “is important to come back to.”

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