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

英国目前的性别确认医疗保健系统通常被认为起源于1966年的查林十字性别认同诊所，精神病学家约翰·兰德尔开始用“变性之父”美国性学家哈里·本杰明规定的内分泌和外科手术“性别重置”来治疗“变性人”。自本世纪中叶以来，变性医学一直主导着我们对跨性别生活和医学转型的看法;将“变性”历史化是为了追溯其在二十世纪医学科学中不可避免的出现。沿着美国历史学家吉尔-彼得森（Gill-Peterson）、相浦（Aizura）和阿明（Amin）所开辟的道路，我开始撰写一部20世纪英国科学和医学的“前变性”历史。我问：在“变性”或“性别”进入临床之前，英国的变性是通过什么样的理论、技术和实践来阐述自己的？这项调查是分为三个相互关联的研究问题，这分别是智力，技术和社会的natural. Intellectual，我跟踪波动和竞争的概念化的“性”在医学科学思想从20世纪20年代末到60年代初。借鉴成熟的英国史学的性学，精神病学，心理学和科普，我检查专家和病人的话语，考虑如何跨生活是不同的理解和表达内的“转变诊断矩阵”的“雌雄同体，”同性恋，和“中间性”，占主导地位之前变性。从技术上讲，我感兴趣的是研究、技术和临床实践的变化如何允许身体增强的形式被归类为“医学过渡”。“我首先研究了生物化学和生物医学研究以及临床内分泌学如何促进20世纪20年代后期的激素治疗。谈到泌尿生殖外科，我研究了20世纪30年代重建和泌尿外科整形手术中可能存在的“男性化”或“女性化”形式。在社会方面，我研究演员如何发展和从事理论和技术在诊所和超越。患者和医生之间的互动如何塑造过渡的形式和可及性？后来，我研究了国家如何在后NHS时期从事医疗转型，询问什么，如果有的话，前变性患者公民身份存在于公共medicine.Practice的对象和启发式团结这三种模式的调查。虽然我借鉴了方法论，并从事英国知识，技术，社会，文化和主观历史的史学，我的研究主要是实践的倾向。在Mol和Mak之后，我认为医学科学的“实践”是代理人，对象，网络和程序的集合。因此，实践包含、创造了整个世界。这些世界被牵连到历史谱系中，它们的各种元素通过这些历史谱系得以实现。实践使我们能够通过开放实验室和诊所中汇聚的知识，技术，学科和社会历史来追求不同的调查路线。我的研究努力广泛地思考医学转型和相关的医学科学实践，以充分历史化英国变性和20世纪后期由此发展起来的医学法律架构。在这样做的过程中，我追踪“未采取的道路”，就像现在的道路一样。

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.