Although estrogen hadn’t received quite the same star treatment as testosterone in the press, research on female hormones had been proceeding in tandem with testosterone research throughout the first decades of the century. In 1923 and 1924, the zoologist Edgar Allen and the biochemist Edward Doisy published papers describing the induction of sexual maturity in young female animals through injections of “the ovarian follicular hormone.” They called the newly purified hormone “Theelin,” a name that was dropped in favor of “oestrin” in 1926. In 1929, various researchers—including Allen and Doisy; Thayer and Veler in the United States; and Adolf Butenandt in Germany—succeeded in isolating oestrin in crystalline form. This pure crystalline oestrin was called “estrone.” One year later, a researcher named Zondek discovered that the urine of pregnant mares was a rich source of the hormone. In 1932, at the International Conference on the Standardization of Sex Hormones, in London, the names “oestrone,” “oestriol,” and “oestradiol” were adopted, and in 1938, chemists working for the German pharmaceutical company Schering developed ethynyl estradiol, the first orally active estrogen. In 1939, diethylstilbestrol, a highly potent synthetic estrogen, was developed and marketed in Germany, and after review by the Food and Drug Administration, in the United States. By 1941, a pill made from conjugated estrogens collected from pregnant mares (Premarin) was being marketed in Canada, and a year later in the United States.
In tandem with these advances, scientists learned that women’s urine contained the “male” hormone, testosterone, and the urine of men contained the “female” hormone, estrogen. Though the proportions were different, both sexes produced both male and female hormones. One researcher commented on the baffling discovery by noting that “the present wonder is not that intersexual conditions occur, but that the balance of endocrine factors usually comes down on one side or the other to produce a recognizable male or female—perhaps in these days, I should say, a more or less recognizable male or female.”
Within two weeks of beginning daily doses of ethynyl estradiol in 1949, Jorgensen noticed physical effects (“sensitivity in my breast area and a noticeable development”) and emotional ones. “The great feeling of listlessness and fatigue, which often seemed to be with me even after a full night’s sleep, had disappeared. I was refreshed and alive and no longer felt the need to take little cat naps during the day.” Encouraged by these results, Jorgensen speculated that “if the female hormones that I was taking without guidance could have such a pronounced effect on me, would it not be possible for an expert to administer them in proper proportions, so that my body’s chemistry would be in complete and correct balance?”
Jorgensen craftily confessed her secret to a fellow student, Gene-vieve Angelo, whose husband was an M.D. The friend arranged an appointment with her husband, Dr. Joseph Angelo, and after weeks of discussion and research in medical journals, Dr. Angelo agreed to supervise the estrogen administration. “It was his plan to retreat and use strong doses of testosterone, thereby returning me to my original maleness, if the estrogen injections had proven unsatisfactory,” Jorgensen writes. Around the same time, she received a letter from a Connecticut physician whom she had consulted a few years earlier, who pointed out “the course of treatment that you requested” (sex-change surgery) had been carried out in Sweden. Soon after finishing the course at the medical technician’s school, in December 1949, Jorgensen decided to visit family and friends in Denmark, and to proceed from there to Stockholm, “where I hoped to find doctors who would be willing to handle my case.”
Arriving in Denmark in May 1950, Jorgensen discovered that there was no need to go to Sweden. Instead, in July, she visited the Statens Seruminstitut, in Copenhagen, searching for Dr. Christian Hamburger, a prominent endocrinologist who had published a number of hormone studies. Learning that he was on vacation in the country, the impatient young American sought him out at home and, after pouring out “the whole story of my perplexing life,” asked him point-blank “if he thought I was a homosexual.” Hamburger replied negatively, and when pressed for an explanation, told Jorgensen that “the trouble is very deep-rooted in the cells of your body. Outwardly, you have many of the sex characteristics of a man. You were declared a boy at birth and you have grown up, so very unhappily, in the guise of a man. But inwardly, it is quite possible that you are a woman. Your body chemistry and all of your body cells, including your brain cells, may be female.”
This theory, which had its roots in Steinach’s guinea pig experiments and subsequent animal experimentation, remained untested in humans—even though, by 1950, rudimentary “sex change” surgeries had already been carried out in more than one European country, on both male-bodied and female-bodied individuals. But European views on these matters were not generally accepted, or well-advertised, in the United States. Meanwhile, in Denmark, Dr. Hamburger was looking for a human guinea pig, and he found one in the young American who had traveled to Europe to seek the knowledge and understanding that he hadn’t been able to find at home. It was a fateful meeting. Jor-gensen recalls Hamburger’s proposal in her autobiography. “There are several questions about the interaction of the hormone which are not quite clear now and I am very much interested in having you help me clear up these complicated matters. They can only be accomplished by observing a person over long periods of time. Since they are based on urinalysis, it will be necessary to collect specimens carefully, for several months or even a year, each and every day. You must guarantee you will cooperate fully in this, and be very accurate.” Anxious for help, the young American agreed to become Hamburger’s research subject.
The first stage of the treatment involved discontinuing the oral doses of estradiol, and beginning a rigorous regimen of fluid collection. Hamburger’s young patient was instructed to save every drop of urine excreted. “Thus began a period in my life when I was never to be without a two-quart bottle, discreetly concealed in a black bag,” Jor-gensen writes. “I began to refer to it jokingly as my yor mor taske, which means ‘midwife’s bag’ in Danish.”
After Hamburger had established baseline levels of male and female hormones in Jorgensen’s body by running tests on the urine, he began injections of high-potency estrogen. “The first few injections brought my energy back up a startling rate,” Jorgensen reports. The injections were then replaced by the administration of much higher oral doses of estrogen. “By these methods of hormone administration, the male complement of my system was being suppressed into a slumbering state. I was undergoing what medical experts called a ‘chemical castration.’”
It was during this period that Jorgensen had her first plastic surgery—one that had nothing to do with sex but that corrected a condition that she had found a source of annoyance all of her life. She had her “prominent” ears, a source of lifelong teasing, pinned back.
Miraculously, the complex I’d had for years disappeared almost overnight. I regarded it as a small victory, as it was the first conquest of one of the things I disliked about myself.” At the same time, the high doses of estrogen were “imparting added weight in the hips and some bust development,” without any adverse effect on the pituitary—one of the doctor’s concerns. Most important of all to Jorgensen, “when the male chemistry was inert, I became alive and vigorous and felt fully capable of meeting my responsibilities and problems with competence.”