Transness and Transition in Twentieth-Century British Medical Science Before Transsexuality, 1920-1966

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The present system of British gender-affirming healthcare is generally thought to originate with Charing Cross' Gender Identity Clinic in 1966, where psychiatrist John Randell began treating 'transsexuals' with the endocrinological and surgical 'sex-reassignment' prescribed by the 'father of transsexualism,' U.S. sexologist Harry Benjamin. Since the mid-century, transsexual medicine has dominated how we think about trans life and medical transition; to historicise 'transsexuality' was to trace its inevitable emergence in twentieth-century medical science. Following the path broken by U.S. historians Gill-Peterson, Aizura, and Amin, I undertake a 'pre-transsexual' history of twentieth-century British science and medicine. I ask: through what theories, technologies, and practices did British transness articulate itself before 'transsexuality' or 'gender' entered the clinic?This investigation is divisible into three interrelated research questions, which are respectively intellectual, technical, and social in nature.Intellectually, I trace fluctuation and contest in the conceptualisation of 'sex' in medical-scientific thought from the late-1920s to the early-1960s. Drawing on the well-established British historiographies of sexology, psychiatry, psychology, and popular science, I examine expert and patient discourses to consider how trans life was differently apprehended and expressed within the 'shifting diagnostic matrix' of 'hermaphroditism,' homosexuality, and 'intersexuality' that dominated before transsexuality. Technically, I am interested in how changes in research, technology, and clinical practice permitted forms of bodily augmentation classifiable as 'medical transition.' I first examine how biochemical and biomedical research and clinical endocrinology facilitated hormonal therapies from the late-1920s. Turning to urogenital surgery, I examine the forms of 'masculinisation' or 'feminisation' possible within reconstructive and urological plastics from the 1930s. Socially, I study how actors developed and engaged theory and technology in the clinic and beyond. How did interactions between patients and practitioners shape the form and accessibility of transition? Latterly, I examine how the state engaged with medical transition in the post-NHS period, to query what, if any, pre-transsexual patient-citizenship existed within public medicine.Practice is the object and heuristic uniting these three modes of investigation. Though I draw on the methodologies and engage the historiographies of British intellectual, technical, social, cultural, and subjective history, the bent of my research is primarily praxiographic. After Mol and Mak, I consider medical-scientific 'practice' as an assemblage of agents, objects, networks and procedures. Practice thus encompasses, creates, whole worlds. These worlds become implicated in the historical genealogies that their various elements materialise through. Practice allows us to pursue varied lines of investigation by opening up the intellectual, technological, disciplinary, and social histories that converge in laboratories and clinics.My research endeavours to think expansively about medical transition and related medical-scientific practices in an effort to adequately historicise both British transsexuality and the medico-legal architecture that developed therefrom in the later twentieth-century. In so doing, I trace the 'roads not taken' as much as the path to the present.