Morgan also has sharp words for the underground surgeons who were beginning to offer sex-change surgery on demand. “A dozen years ago, when I had my operation, it was a rare thing. Now sex-change surgery has become as common as blue jeans, and many people are getting it who shouldn’t,” she charges. “For this I blame the doctors. Once I thought highly of doctors who did sex-change surgery. I regarded them as saviors of souls. Now I realize that they’re rip-off artists just like everyone else. … Very few of them send their patients to psychiatric counseling to find out if they’ll be able to function as women.” Bluntly, she lists the challenges that confronted transwomen after reassignment in that era. “The girl who had sex-change surgery gets rejected by her family. She isn’t able to hold a job. Most don’t have experience or education. Some have legal problems, because their papers still list them as men. Others get fired when their bosses find out. She can’t live the life of a normal woman. A man might fall for her, but when he finds out what she is, he says goodbye.”
Patricia Morgan’s assessment is couched in the tough talk of the streets, not the formal language of academia, but she reaches a conclusion similar to that of Jon Meyer’s infamous study. Far from solving their problems, sex reassignment created a whole new set of problems for some troubled individuals, challenges that overwhelmed their fragile coping mechanisms. “Three of the sex-changes I’ve known are now dead—either from suicide or from overdoses of drugs,” says Morgan. “And I’ve heard stories of about twenty others who’ve wound up the same way. … I might have wound up the same way myself, but as I said, I’ve been lucky.” By the end of the book, Morgan has left prostitution and is living on an income generated by her purchase of real estate, funded by an older gentleman who loves and supports her.
The difficulty of distinguishing those individuals who might benefit from sex-reassignment surgery from those who would be crushed under the weight of postsurgical adjustment problems was a major preoccupation of the university researchers. They sought to define characteristics in prospective clients that might predict success in post-surgical life. For this reason, the university clinics have been lambasted by members of the trans community for creating a myth of the “classic” male-to-female transsexual. A classic transsexual was essentially a traditional woman who happened to have been born in a male body. She was attractive, with feminine mannerisms and a feminine outlook, and had felt like a girl all of her life. She was, above all, heterosexual and desired marriage and, when possible, children by adoption or step-parenting. “Back in those days, they used to say that you had to be hyper-feminine to transition, and I’d say, ‘This isn’t me. So maybe I’m not transsexual,’” says Dr. Dana Beyer, who transitioned in 2003 at the age of fifty-one. “If the only true transsexuals are Jayne Mansfield types, how the hell am I ever going to meet the criteria?”
Members of the trans community, with their sophisticated pre-Internet communications network, quickly sussed out the conservative criteria that the clinics were using to choose candidates for surgery. In a self-fulfilling prophecy that would be comic if it weren’t so tragic, candidates for sex-reassignment thus began presenting themselves to researchers as demure heterosexuals who wanted nothing more than a good man and a stable home, with lots of delightful children running around. In fact, many MTFs were attracted to women both before and after sex reassignment, but were careful to keep this fact hidden, knowing that it would destroy their chances of being accepted for surgery.
The university researchers began to sense the deception and to probe deeper, eventually discovering that many of their patients weren’t exactly the transsexual June Cleavers of their intake interviews. “They all claim that they are the same, but I don’t believe that they are,” Paul McHugh says today. “Most of them, the beginning ones, the ones that we were seeing here at Hopkins, were all men wanting to be women. And it was obvious that they weren’t women. They were caricatures of women. They had ideas in their mind about what it meant to be a woman, and you brought a woman into the room to talk to them and the woman quickly got the idea, ‘That’s no woman!’ Secondly, many of them would say, I am a woman in a man’s body, but I’m a lesbian.’ That’s crazy,” McHugh exclaims with some heat. “That’s a long way around for a guy to get a girl. That’s just nuts,” he says.
Echoing the conservative view of gender roles and sexual orientation that guided the decisions of the Johns Hopkins Gender Identity Clinic, and eventually led to its closure, McHugh says, “Look, in this situation, the issue for the person who is making the claim is to prove to you that they really are a woman. When they start saying that they are lesbians, that should increase your level of doubt. Then they have no maternal feelings—none, zip! I think that maternal feelings are a common quality of women. Do you think that the only thing it takes to be a woman is genitalia? No. There is a psychology to womanhood. We’ve just touched on two elements of that psychology which many of these guys coming to be women don’t have.”
Admitting that some genetic women, socialized as women throughout their lives, also lack maternal feeling and also desire other women, McHugh nonetheless maintains that the population of transsexual women ought to reflect statistically the same prevalence of maternal feeling and heterosexuality as natal women. “It’s our job as doctors to look at this issue closely when somebody says, ‘I’m a woman in a man’s body’ And when you look closely, these are the things that pop out immediately. These are not the subtle things about womanhood that women can pick out, but these are the things that anybody, common sense, would say ‘This person says that he’s a woman, but he’s a lesbian.’ Gee, you know, guys like women more than women like women. Secondly—geez, you know, where’s the feeling for children, maternal feelings? It’s zero here.”
Operating with this set of assumptions, McHugh and the researchers who shared them began to view the transsexual people who presented themselves at the Johns Hopkins Gender Identity Clinic with distaste. Clearly, using their criteria, these individuals were not women. Many of them were, in Paul McHugh’s view, “aging transvestites—the kind of people who had been going to Victoria’s Secret since they were twelve years old. And Johns Hopkins is not a branch of Victoria’s Secret!” McHugh characterizes Money’s early advocacy of transsexuals as an ideology. “It’s still an ideology,” he says. “ I believe in transsexuals, and I believe this is what they should be able to do.’ It was an ideology. It was not psychiatry and it was not medicine and it was not science.”
However, the research that might have made the study of gender variance something more substantial than an “ideology” came to an abrupt end when the Johns Hopkins clinic closed in 1979 and most of the other university clinics followed suit. “One of the things that I think was so tragic about SRS being forced off of medical school campuses is that it meant that almost all good research came to an abrupt end. That to me is a tragedy because there’s just so much research crying out to be done,” says Ben Barres of Stanford. At Johns Hopkins, research on gender variance took a conservative turn after the closing of the Gender Identity Clinic, one that denies the medical legitimacy of the condition that Harry Benjamin and John Money sought to define. “Our clinic is still looking at these patients; we still try to help them,” Paul McHugh says. “We tell them that we’re not going to do this surgery on them, because it’s not right. We don’t tell them to stop going to Victoria’s Secret. It’s up to them. But we tell them that they are not correct and that science doesn’t bear them out and their psychology doesn’t bear them out.”