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Magnus Hirschfeld

Magnus Hirschfeld (1868–1935), a German physician and sexologist, opened the Institut für Sexualwissenschaft in Berlin in 1919 and coined "Transsexualismus" (1923). In the 1920s and 1930s, some of the first sex reassignment operations took place from his institute, using the experimental techniques of the time.

Institute for Sexual Science (1919–1933)

The Berlin institute was the global center of sexology until 1933. Hirschfeld developed a theory of "sexual intermediate stages"—a continuum on which transvestism, homosexuality, and transsexualism were placed as variations on a single scale. That ideological line—sexual identities as an infinite continuum—lives on in contemporary activism, despite the fact that biological sex is binary and chromosomes and gametes do not form a continuum. Hirschfeld's typology was clinical observation without validation—an early illustration of the problem that burdens the entire evidence base to this day.

The first operations: experiments with fatal outcomes

Dora Richter underwent an orchiectomy in 1922 and a penectomy and vaginoplasty in 1931; she is regarded as the first recorded trans woman to undergo vaginoplasty (source). It was long assumed that Richter died in 1933 when the institute was ransacked, but according to research published in 2023 and 2024 she survived the Nazi era and died in 1966 in Allersberg, Bavaria (source). The Danish painter Lili Elbe underwent a series of experimental operations in Germany from 1930; after the fourth, a uterus transplant in Dresden in 1931, her body rejected the organ and she died on 13 September 1931 (source).

In today's activism Hirschfeld is presented as a pioneer. The medical-affirmative model that was later anchored in the work of Harry Benjamin and in WPATH SOC has its roots here.

Political instrumentalization and end

Hirschfeld was a social democrat and Jewish. The institute was looted by Nazi students on May 6, 1933; the archives were burned four days later at Bebelplatz. Hirschfeld died in France in 1935. The symbolic status of the institute — "the first trans care, burned by the Nazis" — is a rhetorical shield used to dismiss contemporary criticism of affirmative care as hatred. But the substantive science behind it does not meet modern evidence standards, and the fate of Lili Elbe is no recommendation.

The direct line runs via Harry Benjamin, who met Hirschfeld early on in Berlin (source), to HBIGDA/WPATH and the later gender clinics. The Cass Review (2024) calls care for young people with gender dysphoria 'an area of remarkably weak evidence' (source), and SBU (2022) found the evidence for hormone treatment of young people insufficient (source).

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