Volume 2, Number 1, January - March 1998
Genital Reassignment on Two Male Transvestites
By F. Abraham, M.D.
Citation: Abraham F (1997) Genital Reassignment on Two Male Transvestites. IJT 2,1, http://www.symposion.com/ijt/ijtc0302.htm
-with three photographs-
The following two cases represent the reassignment of two homosexual transvestites who have enhanced their physical appearance to today's highest form, matching it with the specific emotional experience and inclination. Even though the development of these two humans represents mainly the generally desired development of a transvestite, each of these two cases contains enough singularities so that a short description seems necessary and interesting. 1)
Case 1: Rudolph (Dora) R., domestic employee, is today a 40-year-old "male". He was born in the Erzgebirge region and is the child of healthy parents who have more than one child, all healthy and without abnormalities. Today's inclination manifested itself early on in the child and expressed itself at age 6 in the attempt to tourniquet his penis with a cord. Because this organ seemed to be hindering him, he attempted by such means to make it fall off. The attempt was discovered in time and it was possible to keep the child from further difficult complications; his inclination to feminine attitudes and behaviors, though, was getting strong and stronger.
It (the inclination) manifested itself already in childhood by a dislike for boy's clothing and led to him being permitted to live as a girl. The urge to adapt to the female gender increased from that point on and in the year 1922 the first step to feminization was made by means of castration. After this there was a long pause, until the beginning of the year 1931, when the penis amputation was done and in June, the here described surgery. The castration had caused, although not extensively, the body to become rounder/fuller, the beard growth to decrease, breast initiation to be noticeable and the fatty tissue of the buttocks and in the rest of the body to take on a more feminine form.
Case 2: Arno (Toni) E., painter, a 52 year old patient, had first noticed his inclination at the beginning of the 1920s. Despite his homosexual inclination, he got married and from this marriage a boy was born. In the extremely unhappy marriage he had only occasionally the possibility to wear feminine clothing. As frequently happens, during the first years the urge was weaker - to increase later. His inclination essentially preempted him from performing his profession when he did not have the possibility to wear clothing conforming to him. After the death of his wife, he lived completely as a female. Noticeable during the observation was the contrary behavior in male and female clothing: While he was totally calm and reasonable in the latter, in male clothing he was distraught, nervous and utterly worthless. Additionally, he only owned a single male suit, while having a fairly large female wardrobe. The physical evolution corresponds to the first case, except that surgery was done in shorter intervals. Within two years, E. suffered through castration, amputation and vaginoplasty. 2) In how far this surgery, especially the surgical forming of a vagina, has had an effect on the overall health cannot be evaluated at present because not enough time has passed since the end of surgery. The leftovers of the scrotum are to be placed lower and used as labia later, but this surgery has not yet been performed. The described surgery was performed by Dr. Gohrbandt, Director of the Surgical Clinic of the Urban Hospital in Berlin. Both patients have had castration and amputation in previous surgery, so that only the forming of an artificial vagina was necessary.
|It is to be recommended, insofar as the necessary procedures have not yet been done,
not to perform this surgery at one time with the vaginoplasty, but to proceed at two
times. Needless to say, the most scrupulous hygiene is a prerequisite: The surgical area
is cleaned well, the hair removed, and the surgical area covered. Then a catheter is
inserted into the penis stump to avoid damages. After this a cut is made in a vertical
direction into the muscles of the perineal area and the vagina is worked deep until the
peritoneum is reached. As a rule, a depth of 11 to 12 cm. will be achieved, which is the
final depth of the vagina. Next two-piece speculum pliers are inserted and the new vagina
dilated. Meanwhile, a rubber sponge measuring 11 to 12 cm. is prepared (see photos). It
will be lined with Thiersch's grafts taken from the upper leg and in such a fashion that
the skin surface is on the side of the sponge and that the corium touches the vaginal
walls. By this, one achieves that the skin grafts grow on the vaginal wall and that
closing and sealing of the vaginal walls is made impossible. The sponge is introduced in
such a fashion that the porcelain speculum is inserted into the vagina and then, through
this speculum, the sponge is introduced. Then the speculum is carefully removed and the
sponge that remains in the vagina is fixed (best by stitches). The sponge remains two to
three weeks and serves during this time to absorb possible secretions. Before introducing
the sponge, it is useful to introduce a wooden rod into its middle, which is removed
before the sponge itself, by which a folding of the sponge is achieved and, by this, the
extraction of same is facilitated. If after three weeks the adhesion of the grafts to the
flesh is not completed, one can introduce a new sponge, but naturally this time without
skin grafts. After this, surgery is perfored and post-treatments with rinsing, ointments,
and so on, and later, dilation of the vaginal walls with a dilator.
We describe the
surgical procedure also by the photos included.
This cannot be excluded. It was not easy for us to decide on the described procedures, but the patients were not to be dismissed, but also were in a mental state that made it probable that self-mutilation, with life-endangering complications, could be possible. From other cases we have learned that transvestites indeed cause themselves very severe harm if the doctor does not fulfill their wishes.
To perform this surgery was in these cases (and probably it will be the same in many other cases) a kind of emergency surgery necessary to save patients from worse self-inflicted procedures.