The History of Estrogen Therapy

Ever wondered where estrogen therapy started? Or how transgenderism was carried out medically back in the early days? In this article, learn about a few of the most important points in transgender medical history.

Lili Elbe’s Story

Lili Elbe was a Danish painter. She was one of the earliest transgender women to have undergone sex reassignment surgery in 1930, which she had in Germany. Around this time, estrogen therapy was not developed yet, but the availability of this surgery at the time paved the way for medical advancements in transgenderism.

At the time, sex reassignment surgery was highly experimental. Lili Elbe underwent a total of four operations over a period of two years. The first was to remove her testicles, the second was an ovary implantation, the third was to remove her penis and scrotum, and the last was a uterus transplant and vaginal canal construction. 

Lili Elbe was popular in the Danish and German newspapers, as she not only underwent sex reassignment surgery but had also had her sex and name changed legally. She died three months after her last surgery. Her immune system rejected the new uterus, causing infection and a cardiac arrest. 

Christine Jorgensen’s Story

Hormonal medications such as estrogens, androgens, and progestogens were first developed in the 1920s and 1930s. Later, in the early 1950s, the endocrinologist and rehabilitative hormonal therapy specialist Christian Hamburger treated Christine Jorgensen, the first person in the United States who was widely known to have undergone sexual reassignment surgery.

Christine first took estrogen in the form of ethinylestradiol, then later received an orchiectomy (removal of the testicles), a penectomy (removal of the penis) and vaginoplasty (construction of female sex organs.)
Her first two operations were performed in Denmark, where the only doctors who performed such operations at the time were located. She had her vaginoplasty performed in the US when the procedure became available in the country
Christine’s journey was thoroughly documented in an autobiography. It was also widely publicized via the New York Daily News, which opened up a path for her to advocate for transwomen. She died at 62, due to bladder and lung cancer.
Harry Benjamin, also one of Christine’s doctors, had also treated several hundred transgender patients around the late 1950s with hormone therapy, and this allowed Benjamin to further develop his studies on hormone therapy. His studies became integral in the development of hormone therapy.
Development of the practice
In the mid-1960s, one of the first transgender health clinics opened up at Johns Hopkins school od medicine. (As the practice of treating transgender women grew through the years, in the 1980s, there were 40 active transgender health clinics across the country.)
By the late 1960s, the literature on transgender therapy was also growing deeper, with the first medical textbook on transgenderism (Transsexualism and Sex Reassignment by Richard Green and John Money) was published. Christian Hamburger and Harry Benjamin contributed a chapter to this textbook

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