Stanford University Gender Dysphoria Program collection, 1968-2011, bulk 1968-1979

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Summary

Abstract:
This collection reflects the birth and evolution of Stanford University's Gender Dysphoria Program, its rise to prominence in the field of gender-affirming care, and the career of its director, Dr. Donald R. Laub. It covers the period from just before the program's creation in 1968 through the 1970s. The bulk of the material is newspaper articles, however, press releases, reports, correspondence, photographs, and journal articles are also represented.
Extent:
8.09 Linear Feet 5 record cartons, 2 oversize flat boxes, 2 short archives box, and 1 half-size short archives box
Language:
English .

Background

Scope and content:

This collection reflects the birth and evolution of Stanford University's Gender Dysphoria Program, its rise to prominence in the field of gender-affirming care, and the career of its director, Dr. Donald R. Laub. It covers the period from just before the program's creation in 1968 through the 1970s. The bulk of the material is newspaper articles, however, press releases, reports, correspondence, photographs, and journal articles are also represented.

Items of potential interest include newspaper articles detailing the lives and treatment of transgender patients of the program, papers written by Dr. Laub and Dr. Fisk on transgender studies, and copies of some of the informational and legal forms supplied to patients. Material in "Articles about the program in general" (Box 1 folder 14) could also be used to chart the trends seen across the United States in attitudes towards transgender healthcare and people between the 1960s and 1980s.

Biographical / historical:

Gender-affirming care is a relatively new addition to the world of mainstream medicine, but it has existed for generations. In the 1930s, German surgeons at Dr. Magnus Hirschfeld's Institut für Sexualwissenschaft (Institute for the Science of Sexuality) treated "transvestites"—a term created to distinguish cross-gender identification from homosexuality—with surgery, reshaping female genitalia into male, and vice versa.[1] In the 1940s and 1950s, Dr. Harry Benjamin, himself a German-born physician and friend of Dr. Hirschfeld, provided hormone therapy to transgender people in the United States.[2] And throughout the twentieth century as a whole, increasing interest in sex and gender brought trans people and their search for care into the public eye.[3]

Although doctors provided the care, it was transgender people who pushed them to do so, and to whom much of the field's development is owed. Institut fĂĽr Sexualwissenschaft's first "complete genital transformation" took place between 1922 and 1931 at the behest of Dorchen Richter, a trans woman.[4] Richter may have been inspired by Alan Lucill Hart, a trans man who convinced a physician to give him a hysterectomy in 1917.[5] Hart may have been inspired in turn by Earl Lind, a trans woman who persuaded a doctor to castrate her in 1902.[6] With this in mind, it is hard to imagine that Dr. Laub's decision in 1968 to open a clinic at Stanford University for the study and treatment of trans people was not influenced by this longstanding, persistent demand by the trans community for gender-affirming care.[7]

Stanford's Gender Dysphoria Program (GPD) was modeled after the Gender Identity Clinic (GIC) at Johns Hopkins University, the United States' first center for transgender healthcare. In the words of Dr. Norman M. Fisk, co-director of the program, the GDP was meant to answer "only one principal question: is surgery worthwhile as a method to improve the quality of life in certain patients with Gender Dysphoria Syndrome?"[8] This question (and its reflection of the widely-held belief among medical professionals that gender non-conformity was a form of mental illness) shaped the GDP, creating something that was just as much a laboratory as it was a clinic. Trans people arrived in great numbers asking for care, but few of them actually received it—the majority were studied rather than treated.[9]

Much of this studying happened during the applicant screening process. People seeking admission to the program were asked to fill out what trans activist Lou Sullivan called a "15-page extravaganza," in which in-depth, personal, and often invasive questions had to be answered.[10] Once the clinic had the applicant's data, that person would often be turned away.[11] This happened in part because doctors at the time had a very heteronormative, cisgender-biased view of what it meant to be trans; homosexual trans men, for instance, were not considered "truly" trans, and were thus denied treatment.[12] However, general hostility towards gender-nonconforming individuals—still widespread despite the new interest in them—likely made Stanford doctors afraid of public outrage, and thus more reluctant to actually provide care. Regardless of its cause, this medical gatekeeping made some trans people desperate, pushing them towards unlicensed and overseas surgeons who would operate on anyone who paid. That surgeon John Brown continued to recieve patients for years after his medical liscence was revoked in 1977 for "gross incompetence" and unsanitary working conditions underscores how few options trans people had for care.[13]

Despite the strict entry requirements, trans people did receive gender-affirming care at Stanford. Twice a month, Dr. Laub used the operating room at Chope Memorial Hospital to surgically alter patients' bodies, helping them to appear more traditionally male or female in accordance with their gender identity.[14] These surgeries were uncommon, however; other forms of gender-affirming care, such as hormone therapy and counseling, were much more readily prescribed. For instance, speech therapist Maureen O'Connor offered classes to trans women, teaching them to meet contemporary expectations for how women spoke.[15] But although they performed it infrequently, Dr. Laub and Dr. Fisk eventually came to realize how effective surgery could be at relieving gender dysphoria. In 1974, Dr. Fisk performed "exhaustive five-year follow-ups" on postoperative patients, the results of which convinced him that gender affirmation surgery "affords certain selected patients an opportunity to live a more joyful and fulfilling life."[16] Many of the patients themselves corroborated this, both within and beyond Stanford--one patient of the GDP called his operation "a miracle," while a trans woman treated at a Colorado clinic said "I hadn't mutilated my body. I had released it."[17][18] It is difficult to know how much of the full picture these quotes provide--the doctors had much more control of the public's perception of the clinic, and of trans people in general, than the patients. However, available evidence suggests that those who made it through the program were largely satisfied with their results.

By 1979, following the closure of Johns Hopkins University's clinic, Stanford's GDP was the United States' leading transgender health center. It remained as such for at least another decade afterwards--correspondence from March of 1989 refers to it and attests to its continued existence.[19] But sometime between then and today, the GDP shut down. When and why are unclear from the documents in this collection.

[1] Joanne J. Meyerowitz, How Sex Changed: a History of Transsexuality In the United States (Cambridge, MA.: Harvard University Press, 2004), 15, https://hdl.handle.net/2027/heb30503.0001.001. PDF.

[2] Alison Li, "Harry Benjamin and the birth of transgender medicine," Canadian Medical Association Journal 195, no. 48 (December 10, 2023): E1666, https://pmc.ncbi.nlm.nih.gov/articles/PMC10718274/. PDF.

[3] Meyerowitz, How Sex Changed, 2.

[4] Meyerowitz, How Sex Changed, 19.

[5] Meyerowitz, How Sex Changed, 18.

[6] Meyerowitz, How Sex Changed, 17.

[7] Arthur Wiegand, "Barred from Transition: The Gatekeeping of Gender-Affirming Care During the Gender Clinic Era," Intersect 15, no. 1 (2021), 2, https://www.researchgate.net/publication/357255998_Barred_from_Transition_The_Gatekeeping_of_Gender-Affirming_Care_during_the_Gender_Clinic_Era. PDF.

[8] Donald R. Laub and Norman M. Fisk, "A Rehabilitation Program for Gender Dysphoria Syndrome by Surgical Sex Change," Plastic and Reconstructive Surgery 53 (April 1974), 391, http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006534-197404000-00003&D=ovft&PDF=y.

[9] Wiegand, "Barred from Transition," 3-5.

[10] Wiegand, "Barred from Transition," 4.

[11] Wiegand, "Barred from Transition," 4.

[12] Wiegand, "Barred from Transition," 2.

[13] Charles Petit, "Sex-Change Doctor Loses His License," San Francisco Chronicle, December 23, 1977, Box 1, folder 10, Stanford University Gender Dysphoria Program collection, Medical History Center, Stanford University Lane Medical Library.

[14] Rick Sullivan. "Sex Surgery at Chope: 160 Gender Alterations Since 1968." San Mateo Times, December 15, 1977, Box 1, folder 14, Stanford University Gender Dysphoria Program collection, Medical History Center, Stanford University Lane Medical Library.

[15] Blake Green, "Teaching a Man to Sound Female," San Francisco Chronicle, February 16, 1978, Box 1, folder 14, Stanford University Gender Dysphoria Program collection, Medical History Center, Stanford University Lane Medical Library.

[16] Norman M. Fisk, "Gender Dysphoria Syndrome—The conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen," Western Journal of Medicine 120 (May 1974), 390, https://pmc.ncbi.nlm.nih.gov/articles/PMC1130142/.

[17] "You Should Read: The Transsexuals," Emporia Gazette, November 19, 1976, Box 1, folder 14, Stanford University Gender Dysphoria Program collection, Medical History Center, Stanford University Lane Medical Library.

[18] Charles Petit, "Sex-Change Operations to Continue at Stanford," San Francisco Chronicle, August 15, 1979, Box 1, folder 14, Stanford University Gender Dysphoria Program collection, Medical History Center, Stanford University Lane Medical Library.

[19] Judy Van Maasdam, "Open Letter from Judy Van Maasdam (March 1989)," Digital Transgender Archive, https://www.digitaltransgenderarchive.net/files/6w924b840.

Processing information:

These materials were originally part of the UODJS, HSFLE, and OCPA Subject Files collections, which have since been merged to create the Collection on Race, Ethnicity, Indigeneity, and Gender in Activism and Policy at Stanford Medicine (MS117).

The Medical History Center would like to acknowledge and thank Isaac Fellman of the Digital Transgender Archive and Devin McGeehan Muchmore of the GLBT Historical Society for acting as consultants in the creation of this finding aid.

Arrangement:

The material is arranged into five series:

"The patients"

"The personnel"

"The program"

"Transgender healthcare beyond Stanford"

"Restricted"

"The patients" is comprised exclusively of newspaper articles about transgender people who received or hoped to receive gender-affirming surgery at Stanford. The amount of material devoted to some individual patients has earned them their own folders, while those who are only mentioned a few times (or who share articles with other patients) can be found in "Assorted patients who received or hoped to receive gender-affirming care" (Box 1 folder 1). Please note also that the article "Women Who Dare to Become Men" (also in this folder) includes information on the Gender Dysphoria Program in general.

"The personnel" is comprised of newspaper articles, journal articles, press releases, typed notes, project proposals, correspondence, reports, and photographs related to the life and career of Dr. Donald R. Laub. Subjects of note include his work as founder and head of the Gender Dysphoria Program, his leadership of International Plastic Surgeons (Interplast), his career as a plastic surgeon and faculty member at Stanford, and his fight against juvenile delinquency. Specifically related to his work with gender dysphoria are information on his service as a witness against John Brown (a surgeon who lost his medical license for "gross incompetence" and performed unsafe sugeries on trans people), and a copy of "A Rehabilitation Program for Gender Dysphoria Syndrome by Surgical Sex Change," an article Dr. Laub co-authored with Dr. Fisk. Also included in this series are a few articles describing the findings of Dr. Fisk on the effects that gender-affirming surgery has on income.

"The program" is comprised of newspaper articles, correspondence, and informational and legal documents produced by and about the Gender Dysphoria Program. Many of the articles feature quotes from Dr. Laub and Dr. Fisk, whose name is misspelled "Fiske" and "Fish." Others touch on the work of program coordinator Marti Norberg, counselor/program coordinator Judy van Maasdam, and speech therapist Maureen O'Connor. Also included is an article on Dr. Harry Benjamin, author of The Transsexual Phenomenon and one of the mid-twentieth century's leading authorities on transgender healthcare, as well as articles that mention the program while describing national events and trends in transgender healthcare.

"Transgender healthcare beyond Stanford" is comprised of newspaper articles and press releases that discuss studies and events relevant to transgender healthcare and its history in America.

"Restricted" is comprised of material that has sensitive information relating to patients. In compliance with the Health Insurance Portability and Accountability Act's privacy rules, these materials will remain restricted until 50 years after these patients' deaths.

Accruals:

A private donation in September, 2025, added a considerable amount of material to the series "Restricted," including patient records and photographs. The linear footage of the collection grew from 0.63 to 8.09.

Dimensions:
5W x 12 1/2L x 10 1/4"H (short archives box), 2 1/2W x 12 1/2L x 10 1/4"H (half-size short archives box)
Material specific details:

CONTENT WARNING: Please note that materials in this collection contain detailed discussions of child abuse, suicide, and sexual violence. Please also note that some materials contain photographs relating to operations performed on human genitalia.

Please note that the materials in Series 5, "Restricted," are still restricted in accordance with the 50-year privacy rule mandated by the Health Insurance Portability and Accountability Act (HIPAA).

Rules or conventions:
Describing Archives: A Content Standard

Access and use

Location of this collection:
Lane Medical Library & Knowledge Management Center
300 Pasteur Drive, Room L109
Stanford, CA 94305-5123, US
Contact:
(650) 725-8045
medhistory@lists.stanford.edu
Website