In 1956 Star traveled to New York to see a female endocrinologist, who performed physical and hormone tests that led the physician to conclude that despite her male genitalia, Hedy Jo Star was female— and to recommend sex-change surgery. The physician, whose name Star does not reveal in her autobiography, brought in a number of other specialists (also unnamed) to examine her unhappy patient. “My face was covered during the examination with a sheet. Then my doctor and her colleagues examined me. Later my doctor explained to me that what she was planning to do was illegal under New York law, which is the reason the other specialists she consulted wished to remain anonymous. It was all right, she said, for a doctor to straighten a cripple’s twisted limbs, but not all right to straighten a sexual cripple.”
Star’s endocrinologist explained that “there wasn’t a single hospital in New York who would take the case.” Her disappointment was somewhat assuaged by the intermediate steps the doctor suggested— administration of estrogen and breast-enhancement surgery. “I was disappointed that I couldn’t have the operation immediately but at least I knew I was heading in the right direction. I knew that eventually I would have the change and that was all that really mattered.” But more disappointments were to follow for Star. Despite the feminizing effects of the hormones, and the testimony of twelve physicians in favor of sex-change surgery for her, the New York State Medical Society refused to grant permission for the surgery a year later. The decision of the society was based not on medical or scientific criteria, but on a fear of legal action. In New York State, as in almost every other civic jurisdiction in the United States, it was illegal to surgically remove a man’s testicles.
These “mayhem” statutes, imported from English common law dating from the sixteenth century, forbade the amputation of any body part (fingers, toes, hands, or feet) that might prevent a male-bodied individual from being able to serve as a soldier. Although castration might not, strictly speaking, fall under the jurisdiction of the law, few American surgeons were willing to risk prosecution by becoming test cases. Christine Jorgensen circumvented the law by traveling to Denmark, where she had family and friends and knew the language. Hedy Jo Star had neither the money nor the connections to make such a trip possible. In the fifties and early sixties, mayhem statutes were the single greatest obstacle faced by every transsexual person in America unable to travel overseas for surgery or locate one of the few surgeons willing to flout the law by performing surgery in the United States.
On the advice of her endocrinologist, Star tried another route. In November 1958, she took a train to Baltimore and presented herself to the researchers at the Johns Hopkins Hospital who were becoming famous in medical circles for their work with intersexual children. Star was hopeful that they would be able to help her, too. “The hormone shots had done wonders. My testicles had all but disappeared. My penis had shrunk considerably. My physique was completely female. How could they refuse me?”
Star’s efforts to convince the Hopkins researchers that she was intersexual, and thus a suitable candidate for corrective surgery, failed. After five days of examinations at the hospital, she was sent home to await a letter. The letter arrived, dated February 24, 1959. Its author (possibly Money, though the name is obscured in Star’s autobiography) says that after he discussed Star’s case with “Dr. Eugene Mayer, Dr. William Scott, Dr. Hampson, and Dr. Shaffer,” the group’s unanimous decision was to advise her “not to go ahead with the conversion type of surgery that you seek.” The decision of the committee was based on both medical and legal considerations. “The studies that we have made would all indicate that your basic structure is anatomically male and that we would not be likely to find any evidence internally of ovaries or any female structures.” The physicians feared that the narrowness of Star’s pelvis would make the creation of a vagina difficult, and the possibility of postsurgical urinary difficulties might handicap her ability to make a living as a dancer.
“We do realize that you are psychologically more comfortable in your role as a female and perhaps it would be wise for you to continue as you have in the past,” the letter continues sympathetically. “You deserve considerable credit for having been able to adjust as well as you have to some of the difficult situations that you have encountered in the past.” Nonetheless the committee had decided that “there are numerous reasons from both your standpoint and from the standpoint of the surgeons involved that would suggest that the performance of this type of surgery might in actuality constitute mayhem and you must consider that possibility quite seriously before embarking on such a program.”
Sympathetic or not, the letter was a heavy blow to Star, who objected to the physicians’ paternalistic approach and their assumption that they knew better than she where her best interests lay. “I didn’t feel any malice towards the doctors. After all, they were only doing what they considered best for me. But I was sure they were wrong. Not wrong as far as the possible medical consequences of the operation … rightly or wrongly, I felt their decision had been based more on ‘moral,’ psychological and legal reasons than medical reasons. Certainly there was a risk involved, but I felt that I should be the one to decide whether I wanted to take it or not. They were wrong to deny me this decision. But in denying it to me, they only increased my determination to do—somehow, somewhere—what I knew had to be done.”
Star doggedly pursued her goal for the next four years, as her dancing career flourished and her romantic relationships continued to be sabotaged by the discrepancy between her gender and her anatomy. Eventually, she found her way to Harry Benjamin, who referred her to a “California surgeon” (most likely Elmer Belt) who could perform the surgery for about four thousand dollars. Estimating the costs of the surgery, hospital fees, travel expenses, and associated expenses at approximately six thousand dollars, Star began saving. Then, early in 1962, a friend referred her to a doctor in Chicago, who “examined me and told me immediately that he knew the man who could do the operation. Within a few minutes he had placed a call to a hospital in Memphis, Tennessee, and the appointment was made.”
After this doctor and four of his colleagues examined her, the unnamed Memphis surgeon informed her that “the operation is extremely complex and, for that reason, dangerous…. If the operation is a success, it is possible that you might never dance again. It is also possible that you might never walk. Also, it is extremely doubtful that you will ever be able to have a sex life.” As if that weren’t enough, the surgeon added that Star might not survive the operation. Star’s reply was simple. “Anything is better than living the misery I have lived my whole life. I realize it is a gamble, but the pot’s too big not to take a crack at it.”
The surgery was performed the next day. The initial operation took five hours. Nine days later, one of Star’s doctors accidentally punctured her urinary tract during an examination, necessitating another two-hour operation to repair the damage. Forty-five days later she left the hospital, and entered her future as a woman. “Since the change and my adjustment to it, my life has flowered,” she writes on the final pages of her autobiography. “Each day I discover something about my new self. Each day I gain even more confidence in myself, more interest in myself, and above all, more self-resect. Life has taken on a new look. It has become something to be enjoyed and lived, rather than a burden to make the best of.”
Although Star was eventually able to locate a surgeon in the United States willing to perform sex-reassignment surgery despite the fear of mayhem laws, it is clear from her account of their meeting that her doctor was performing the surgery for the first time, and was far from confident about his ability to provide her with a functional vagina. Meanwhile, back in Baltimore, urologists and plastic surgeons at Johns Hopkins were perfecting their reconstructive techniques as they attempted to fulfill the evolving mandate to provide intersexual children and adults with “normal” genitals. John Money began to use his growing scientific reputation and the institutional power that it conferred to persuade his colleagues at Johns Hopkins that they ought to challenge the mayhem laws that prevented surgeons from “matching the body to the mind,” as Harry Benjamin once wrote, and begin performing sex-reassignment surgery on adults.