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The New Woman of the fin de siecle was often coupled in print with a similarly transgressive male figure—the dandy, or aesthete, epitomized by Oscar Wilde and other decadent artists and writers. Languorous men devoted to the “poetry of appearance,” with an intense interest in fashion and interior decoration, dandies were not a new phenomenon, but in the context of late-nineteenth-century industrialization, they were newly disturbing. Wilde was gay, but many other dandies were heterosexual men, the forefathers of today’s “metrosex-ual.” With their attention to style and their embrace of elegance, extravagance, and artificiality, they expressed values coded “feminine” in the nineteenth century. In rejecting a focused professional life for an aesthetic dilettantism, the dandy expressed values once labeled aristocratic—but in the muscular new world of capitalist commerce, such languour appeared unacceptably feminine. The foppish masculinity of the dandies and decadents and their refusal to be “men,” as that term was commonly understood, were just as much a threat to the established order as the steely femininity of the New Woman. This challenge to conventional sex roles went deeper than mere fashion, as conservatives understood very well. Fin de siecle sexual anarchy was the first modern Western assault on patriarchy, and its scouts were New Women, dandies, and “an avant-garde of male artists, sexual radicals and intellectuals who challenged its class structures and roles, its system of inheritance and primogeniture, its compulsory heterosexu-ality and marriage and its cultural authority,” says Showalter.

Hirschfeld himself seems to inhabit a kind of borderline between traditional and modern views of masculinity and femininity. Asserting that “absolute” men or women who adhered perfectly in all respects to the traditional attributes of their sex as commonly defined were only “abstractions, invented extremes,” Hirschfeld nonetheless appears to have shared the traditional view that women were by nature less suited to intellectual work than men, for example. Although he formed political alliances with feminists, he was far from being a feminist himself, as we would define the term today. Masculinity and femininity appear in Hirschfeld’s theory of intermediaries as something akin to Platonic ideals, rather than social roles; the masculine and feminine ideals and their varying expression are, in his view, firmly anchored in biology. “In each person there is a different mixture of manly and womanly substances, and as we cannot find two leaves alike on a tree, then it is highly unlikely that we will find two humans whose manly and womanly characteristics exactly match in kind and number,” Hirschfeld writes.

This organic theory of gender variance led naturally for Hirschfeld to an acceptance of human sexual diversity, including a new tolerance for homosexuality, which was viewed then (as it still is in some quarters today) as the most extreme example of sexual “inversion.” “In a radical departure from earlier medical practices, Hirschfeld developed a psychotherapeutic procedure that emphasized the client’s ability to accept his own homosexuality, rather than to change it,” writes neuro-scientist and author Simon LeVay, who analyzed Hirschfeld’s research in his book Queer Science. Hirschfeld and his colleagues at the institute focused on helping their clients develop “strategies for surviving in a world that was still hostile to homosexuals,” writes LeVay. Hirschfeld’s approach to cross-dressers was equally progressive. He provided letters to the Berlin police, asking that his patients be allowed to dress in the clothes they felt most appropriate, for medical reasons. In many cases, the request was granted.

And in 1920, Hirschfeld began referring patients for sex-reassignment surgery. Though a few surgeons had already carried out some incomplete sex-reassignment surgeries in Berlin and in the United Kingdom—removing the sexual organs of their patients without attempting to create new genitalia—the first complete surgeries, encompassing not only the removal of the male sex organs but the creation of a vagina and labia, were carried out by Hirschfeld’s colleagues at the institute, Ludwig Levy-Lenz and Felix Abraham. Abraham published an article reporting the surgeries (with before-and-after photographs) in the journal Zeitschrift fur Sexualwissenschaft in 1931. One of the first to undergo the surgery was a longtime housekeeper at the institute, Dorchen (formerly Rudolf) Richter.

Even people who thought themselves sophisticated and open-minded sometimes found Hirschfeld’s approach to “sexual intermediaries” disturbingly liberal. Christopher Isherwood, for example, provides an amusing and instructive account of his first encounter with the patients and staff at the Institute for Sexual Science. The young writer, who saw himself as a gay sexual adventurer, liberated from middle-class standards and sensibilities, found himself definitively “out-queered” by the institute’s staff and guests. “I remember the shock with which Christopher first realized that one of the apparently female guests was a man. He had pictured transvestites as loud, screaming, willfully unnatural creatures. This one seemed as quietly natural as an animal and his disguise was accepted by everyone else as a matter of course. Christopher had been telling himself that he had rejected respectability and that he now regarded it with amused contempt. But the Hirschfeld kind of respectability disturbed his latent puritanism.”

Another visitor to the Institute for Sexual Science also was disturbed by the sexual intermediaries she found there, though grateful for the support and healing she found within its walls. In the fictionalized biography Man into Woman, the author, Niels Hoyer, describes the torment that drove his friend “Andreas” (in real life the Danish painter Einar Wegener) to seek out Hirschfeld in Berlin in the spring of 1930. Wegener had been cross-dressing for years, and Lili, the female self, was growing stronger and more insistent in her demands for fulfillment. “Andreas” had visited doctor after doctor, searching fruitlessly for medical assistance, until he met the Dresden gynecologist who sent him to Hirschfeld. “Some of the doctors to whom he went thought him neurotic, some thought him homosexual; but he himself denied the truth of both these diagnoses,” writes the British sexologist Norman Haire in the introduction to Man into Woman. The Dresden gynecologist “Kreutz,” on the other hand,agreed that Andreas [Einar] was probably an intermediate sexual type, furnished, by some sport of nature, with both male and female gonads. He explained that there were probably rudimentary ovaries in Andreas’ abdomen, but that these were unable to develop properly because of the inhibiting influence of the testicles which Andreas also possessed. He proposed that Andreas should go to Berlin, where certain investigations were to be undertaken. If these investigations confirmed his suppositions he promised to remove Andreas’ male organs and transplant into him ovaries from a young woman, which would, as the work of the Steinach school had shown, activate the rudimentary ovaries lying dormant in Andreas’ abdomen.