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The Weimar Republic and the First Transgender Clinic

A costume party that was held at the Institute for Sexual Research in Berlin, though the date and photographer remain unknown. Magnus Hirschfeld, identifiable by his glasses, is holding hands with his partner, Karl Giese, who is in the center.

At the turn of the 20th century, a young doctor named Magnus Hirschfeld encountered a distressed soldier seeking refuge at his practice in Germany. The soldier, visibly troubled, had arrived to disclose his sexual orientation as an "Urning," a term used to describe homosexual men at the time. The secrecy of the late hour underscored the societal taboo surrounding such matters, as discussing homosexuality was considered perilous. The presence of the notorious "Paragraph 175" in the German legal system criminalised homosexuality, exposing individuals to the risk of losing their social standing and facing imprisonment.

Dr. Hirschfeld empathised with the soldier's difficult situation, being a homosexual and Jewish himself, and endeavoured to provide solace to his patient. Despite his efforts, the soldier had already resolved to take his own life. It was on the eve of his wedding, an occasion he found himself unable to confront. Shortly thereafter, he tragically ended his life.

In a poignant gesture, the soldier entrusted his personal writings to Hirschfeld, along with a letter expressing hope for a future where their identities would be regarded more fairly by the German nation. "The thought that you could contribute to [a future] when the German fatherland will think of us in more just terms," he penned, "sweetens the hour of death." This profound loss weighed heavily on Hirschfeld, as the soldier, feeling marginalised by societal norms and laws that favoured heterosexuality, deemed himself unworthy to live. These poignant narratives, chronicled by Hirschfeld in The Sexual History of the World War, shed light on the immense tragedy faced by individuals in Germany; what sense of homeland did they possess, and for what ideals did they fight?

In the wake of this sorrowful event, Hirschfeld abandoned his medical practice to embark on a quest for justice that would significantly impact the trajectory of LGBTQ+ history.

Attendees of the First International Congress for Sexual Reform on the Basis of Sexology, which was held in Berlin in 1921.

Hirschfeld dedicated his efforts to specialising in sexual health, an increasingly intriguing field of study. While many of his predecessors and peers viewed homosexuality as a pathological condition, drawing on emerging psychological theories to suggest a link to mental illness, Hirschfeld held a different perspective. He contended that individuals could be inherently born with traits that did not conform to traditional heterosexual or binary norms, advocating for the recognition of a natural existence of a "third sex" (or Geschlecht). Introducing the term "sexual intermediaries" for those who did not fit societal norms, Hirschfeld encompassed what he categorised as "situational" and "constitutional" homosexuals, acknowledging the spectrum of bisexual behaviours, along with individuals he labeled as "transvestites."

This group included individuals who desired to dress in attire typically associated with the opposite gender and those who, based on their character, should be regarded as the opposite gender. One military personnel, whom Hirschfeld collaborated with, expressed that wearing women's clothing provided an opportunity "to be a human being, at least for a moment." Furthermore, Hirschfeld recognised that these individuals could identify as either homosexual or heterosexual, a fact often misconstrued in contemporary understanding of transgender individuals.

Of particular note was Hirschfeld's inclusion of individuals with fluid or nonbinary gender identities, a concept reminiscent of contemporary understanding. Among those he recognised was the French novelist George Sand. Hirschfeld emphasised that these individuals were embracing their true nature rather than going against it.

Magnus Hirschfeld, director of the Institute for Sexual Research, in an undated portrait.

Such progressive thinking during that era was indeed remarkable. It could be argued that it surpassed even our current mindset, a century later. Present-day opposition to transgender rights often hinges on the misconception that transgenderism is a recent and unnatural phenomenon. Following a 2020 U.K. court ruling that restricted trans rights, an editorial in the Economist advocated for other nations to adopt similar measures. Meanwhile, an editorial in the Observer commended the court for resisting a concerning trend of minors receiving gender-affirming healthcare as part of their transition.

Historical evidence attests to the diversity of gender and sexuality. Hirschfeld regarded figures like Socrates, Michelangelo, and Shakespeare as sexual intermediaries, viewing himself and his partner Karl Giese in a similar light. Preceding Hirschfeld in the field of sexology, Richard von Krafft-Ebing asserted in the 19th century that homosexuality represented a natural sexual variation inherent from birth.

Hirschfeld's exploration of sexual intermediaries was not a passing trend but rather an acknowledgment that individuals could be inherently different from their assigned gender at birth.

And in cases where the desire to live as the opposite sex was strong, he thought science ought to provide a means of transition. He purchased a Berlin villa in early 1919 and opened the Institut für Sexualwissenschaft (the Institute for Sexual Research) on July 6. By 1930 it would perform the first modern gender-affirmation surgeries in the world.

Patrons at the Eldorado, a popular LGBTQ cabaret in Berlin during the Weimar years.

The institute, designed as a corner building with wings extending on either side, exemplified architectural excellence by seamlessly blending professional and intimate living spaces. A journalist noted that its opulent furnishings and vibrant atmosphere rendered it distinct from a typical scientific institution, describing it as "full of life everywhere." The institute's primary objective was to serve as a hub for research, education, healing, and sanctuary, aiming to alleviate physical ailments, psychological distress, and social marginalisation.

Dr. Hirschfeld's vision for the institute encompassed comprehensive sex education, health clinics, contraception counselling, and interdisciplinary research on gender and sexuality. His relentless efforts to challenge Paragraph 175, though unsuccessful, led to the issuance of "transvestite" identity cards for patients to safeguard them from legal repercussions for expressing their gender identity openly. The institute also accommodated feminist activists' offices and housed a publishing facility for sex reform journals aimed at dispelling misconceptions about sexuality.

Dr. Hirschfeld's institute boasted an extensive library on sexuality, featuring rare publications, diagrams, and protocols for male-to-female surgical transitions. Collaborating with specialists like gynecologist Ludwig Levy-Lenz and surgeon Erwin Gohrbandt, the institute pioneered male-to-female surgeries known as "Genitalumwandlung," involving castration, penectomy, and vaginoplasty. Notably, the institute exclusively catered to trans women during this period, with female-to-male phalloplasty not becoming a standard practice until the late 1940s. Patients also underwent hormone therapy to develop natural breasts and acquire softer facial features.

Their pioneering research, extensively documented, garnered global recognition. Nevertheless, legal rights and acknowledgment were not promptly forthcoming. Following their surgeries, certain transgender women encountered challenges in securing employment for their sustenance, leading to five of them finding work within the institute. Through this initiative, Hirschfeld aimed to offer a secure environment for individuals whose modified physical attributes deviated from their assigned gender at birth—providing, on occasion, protection from legal repercussions.

1926 portrait of Lili Elbe, one of Hirschfeld's patients. Elbe's story inspired the 2015 film The Danish Girl.

The establishment of an institute as early as 1919, which acknowledged the diversity of gender identity and provided support, may come as a surprise to many. This institute should have laid the foundation for a more progressive future. However, as the institute marked its first decade, the Nazi party was gaining strength. By 1932, it had become the largest political party in Germany, fueled by nationalism that targeted immigrants, the disabled, and those deemed "genetically unfit." Amid economic turmoil and lacking a majority, the Weimar Republic eventually collapsed.

Adolf Hitler assumed the role of chancellor on January 30, 1933, and implemented policies aimed at eliminating "Lebensunwertes Leben," or "lives unworthy of living," from Germany. What initially began as a sterilisation initiative ultimately led to the mass extermination of millions of individuals, including Jews, Roma, Soviet and Polish citizens, as well as homosexuals and transgender people.

When the Nazis seized the institute on May 6, 1933, Hirschfeld was abroad, and Giese managed to escape with minimal belongings. Troops swarmed the premises, confiscating a bronze bust of Hirschfeld and his valuable books, which were later set ablaze in a towering bonfire along with over 20,000 other books, some of which were rare editions that had contributed to the historical narrative of nonconforming individuals.

The devastation was captured in German newsreels, marking one of the earliest and largest Nazi book burnings. Nazi youth, students, and soldiers actively participated in the destruction, while accompanying commentary proclaimed the state's elimination of "intellectual garbage from the past" through the flames. The loss of the collection was irreparable.

Levy-Lenz, who shared Hirschfeld's Jewish heritage, fled Germany, while his colleague Gohrbandt, with whom he had collaborated on supportive medical procedures, joined the Luftwaffe as chief medical advisor and later engaged in grim experiments at the Dachau concentration camp. Hirschfeld's image was portrayed in Nazi propaganda as the epitome of the most egregious offender (being both Jewish and homosexual) against the ideal Aryan race.

One of the first and largest Nazi book burnings destroyed the library at the Institute for Sexual Research.

Following the Nazi raid, Giese reunited with Hirschfeld and their protege Li Shiu Tong, a medical student, in Paris. The trio lived together as partners and colleagues, aspiring to revive the institute until the looming threat of Nazi occupation in Paris forced them to seek refuge in Nice. Hirschfeld tragically passed away from a sudden stroke in 1935 while on the run, and Giese took his own life in 1938. Tong abandoned his plans to establish an institute in Hong Kong, opting for a life of anonymity abroad.

Their stories have gradually resurfaced in popular culture. In 2015, the institute played a significant role in the second season of the television series "Transparent," and one of Hirschfeld's patients, Lili Elbe, was the central figure in the film "The Danish Girl." Interestingly, the doctor's name is omitted from the novel that inspired the movie, and despite a few exceptions, the history of Hirschfeld's clinic has been largely erased. The iconic image of the burning library, even though widely reproduced, has been detached from its context, becoming a nameless tragedy.

The Nazi regime was founded on the premise of white, cisgender, and heterosexual masculinity posing as genetic superiority. Those who deviated from this norm were perceived as degenerate, immoral, and marked for complete eradication. What initially started as an initiative to "protect" German youth and promote healthy families transformed, under Hitler's rule, into a tool for genocide.



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