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The Surprisingly Old Science of Living as Transgender

In the 20th century’s middle decades, the first recipient of phalloplasty surgery fought to be recognized as a man

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This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American


In early March of 1958, Michael Dillon, ship’s surgeon, made his way below deck. A member of the United Kingdom’s Merchant Navy, possessed of athletic bearing and a luxuriant beard, Dillon had hardly opened his sick bay when the steward delivered a cable. “Do you intend to claim the title since your change-over?” it read. “Kindly cable the Daily Express.” Dillon blanched and crushed the letter in his palms, then lit his pipe with shaking hands. He had kept a secret for over 15 years: Dillon had been born Laura Maud (sometimes written as “Maude”) Dillon.

Transgender individuals have been recently maligned as succumbing to a new “fad,” symptomatic of “leftist” modern culture. In fact, bigendered, nongendered or transgendered people have appeared throughout human history, and the practice of sexual reassignment surgery dates from the Second World War. Dillon would be one of the pioneers, making use of plastic surgery developed to treat the battle-scarred. In many ways, the technical, medical and legal hurdles were more easily surmounted then than now, but the fight for acceptance, and the right to exist in peace, was just as fraught.

Dillon’s father, the seventh Baronet of Lismullen, had been a Navy man. Dillon grew up playing soldiers and sailors with brother Bobby, rather than with dolls. At seven, he’d hoped an aunt would “take him to the blacksmith to made into a boy,” only to be reduced to tears when told this wasn’t possible. By the time Dillon became an undergraduate at all-women’s St Anne’s College, Oxford, he’d done all he could to express his gender on his own; athletic, bold and master of a two-stroke Coventry Eagle motorbike, he wore close-cropped hair, a cap and trousers in the style of male students. After graduating in 1938, he would begin his first course of hormone therapy.


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Today, finding a doctor to help with transition can be difficult; in Britain, long waits through NHS mean delaying treatment; in the United States, increasing pressure from conservatives has resulted in anti-trans legislation (most recently a rash of bills prohibiting therapy for teens). By contrast, Dillon received testosterone pills from the first expert he consulted. Hormone therapy had been in use at least since 1918; in Germany, Magnus Hirschfeld offered patients opportunities to use estrogen and testosterone to adjust gender presentation (prior to being shut down by Nazis in 1933). While Dillon acquired hormones with relative ease, he faced the prejudice of his peers. One of his physicians breached confidentiality and publicized his attempts to change genders. Dillon was mocked at his laboratory job and left to take work at a garage.

As a mechanic, Dillon’s co-workers came from lower class backgrounds. Most were uneducated, and the majority of the teasing Dillon received was for his collegiate way of speaking. Meanwhile, a fuzz of hair growth appeared on his chin and fat reserves began to redistribute. A young plastic surgeon agreed to remove remaining breast tissue, and even Dillon’s boss referred to him as mister, because using miss confused the customers.

Dillon wanted to pass unobtrusively as a man, and only one more bodily change remained. He sought the services of Sir Harold Gillies. Widely considered the father of modern plastic surgery, Gillies had performed genital reconstruction for injured soldiers. He took on Dillon’s case with enthusiasm, even agreeing to diagnose him with a condition (hypospadias, or misplacement of the urethral opening) to act as a cover for Dillon’s visits. In the end, it took 13 operations over four years to create a penis, and in 1949 Dillon became the first trans man to receive successful phalloplasty. “The world,” he wrote, “began to seem worth living in.”

The legal system served Dillon well. Laws prohibited genital “mutilation,” including removing a penis, but no laws governed adding one. Dillon’s surgery and use of hormones were sanctioned in part by omission; nothing prohibited him from living fully as a man—so long as his secret remained safe.

The very visibility of Dillon’s new gender meant the necessary invisibilityof his past life. On official application forms, he declared he’d been to Oxford, but named a men’s college. By the time Dillon joined the Merchant Navy, Laura Maud Dillon had been largely erased. Dapper, pipe-smoking, and genial, Dillon built a new life at the cost of secrecy and relative isolation. Meanwhile, trouble was brewing back in England.

In 1958, English papers broke a story about a “discrepancy” found in the peerage accounts by two leading authorities. Did Sir Robert, the current Baronet of Lismullen, have a sister (as Burke’s Peerage suggested) or a brother (as printed by Debrett’s)? The press descended upon Dillon’s brother, who refused to answer. Piqued, journalists married scraps of truth to fiction, publishing “The Strange Case of Dr. Dillon” in the Sunday Express, an homage to the title of Jekyll and Hyde and just as sensational.Once the headlines broke, the ship’s crew became sniggering and suspicious. Dillon’s naval career was over.

Dillon did received support from Gillies, his old friends at the garage and his superiors in the Navy. Even the editor of Debrett’s ruled Dillon was a legal heir, because his gender should be taken as presented: male. The damage, however, had been done. Dillon chose exile over spotlight, traveled to India, and became a Buddhist monk.

Today, we have come far in the fight for transgender media representation, but individuals are still hounded by the press and bullied; an estimated 30–50 percent of transgender teens attempt suicide. Meanwhile, though medical techniques have greatly improved, access to sex reassignment has not, and trans legal rights are constantly under threat. For Dillon, there weren’t two sexes; there were gradients—a spectrum onto which any individual might fall and be healthy, ethical, moral. “Where the mind cannot be made to fit the body,” he wrote in Self: A Study in Ethics and Endocrinology, then the body ought to be remade to fit the mind. Dillon demonstrated both the exuberance of successful transition and its fragility in the face of intolerance. More than 60 years on, we still have a long way to go.