The Beginning...

Transsexuality has apparently been around long before it was diagnosed in the 19th century. However, modern diagnosis started back in the 1880s in Germany, where the fledgling field of sexology was being created. In 1886, a German doctor by the name of Richard von Krafft-Ebing began studying the prevalence of gender divergence among the homosexual population. He coined a term, "gynandry" to describe the phenomenon. Later, in 1902, he described something he called, "metamorphosis sexualis paranoia", wherein a homosexual truly believed him or herself to be one of the opposite sex. However, Krafft-Ebing believed this, in addition to homosexuality, was purely a delusion, and a mental illness.

Dr. Harry Benjamin was one of the first physicians to work with gender dysphoric persons. Benjamin was born in Berlin, but, as a young physician, left Germany in 1913 for a research project on tuberculosis in the USA. Trying to return one year later, his ocean liner was intercepted by the Royal Navy and diverted to a British port, because WWI had broken out. As a German "enemy alien", Benjamin was sent to an internment camp, but managed to obtain his release on the condition that he return not to Berlin, but to New York. There, in 1915, he began his private medical practice (starting in the forties, he also practiced in San Francisco during the summer months, thus, for many years, establishing a bi-coastal professional presence). His special interest was hormonal research, and thus he became a disciple of Eugen Steinach, whom he visited in Vienna every summer through the twenties and early thirties. On these occasions, he also took frequent side trips to Berlin, where he visited both Magnus Hirschfeld and Albert Moll and also participated in their congresses. He also knew Alfred Kinsey quite well and, through him, became acquainted with a young patient who was anatomically male, but insisted that he was really female. This led to Benjamin's interest in what he himself later described as "transsexualism". In his long and distinguished career, Benjamin came to know many famous American and European scientists, scholars, and artists. From his earliest youth, he was also an ardent opera lover (the legendary soprano Maria Jeritza was a patient and close friend). He always retained a great love for his native Berlin and hoped that it would, once again, become a center of sexology.

Though Krafft-Ebing's work was the first to touch upon transgendered topics, the first true pioneer in the field was Dr. Magnus Hirschfeld. As a gay physician, he devoted his studies to the fields of sex and gender. Hirschfeld was the first to coin two of the most popular terms to describe transgenderism: transvestism and transsexualism.

In the 1910s, Hirschfeld began to explore the idea of a surgical solution to some of these cases.
Hirschfeld began working with a Vienna physician, Eugen Steinach (who later penned the 1940 book, Sex and Life. Forty years of biological and medical experiments). Steinach had experimented with gonadal transplantation in attempts to cure a variety of sexual disorders (ranging from homosexuality to transvestism). His early papers (Arbitrary Transformation of Male Animals into Animals with Pronounced Female Sex Characteristics and Feminine Psyche, and Feminization of Males and Masculinization of Females) detailed his experiments with transplantation on guinea pigs. He was the first to theorize that the sex glands contained secretions that made men act like men, and women act like women. Later, in the 20s and 30s, the blooming field of endocrinology would discover androgens and estrogens.

In 1918, Hirschfeld reported in Sexuelle Zwischenstufen: Sexualpathologie that the first incomplete sex-reassignment surgeries in female-to-male patients were performed in Berlin in 1912. In 1916, Max Marcuse published an article on Geschlechtsumwandlungstrieb, the desire of some to have their sex changed. In 1926, R. Muehsam reported (in Chirurgische Eingriffe bei Anomalien des Sexuallebens: Therapie der Gegenwart 67: 451-455) that in 1920, Hirschfeld referred the first male-to-female patient to a surgeon, Dr. Felix Abraham.

In 1910, he wrote a two volume monograph entitled, Die Transvestiten: Eine Untersuchung ueber den erotischen Verkleidungstrieb mit umfangreichem casuistischem und historischem Material. In it, he detailed the biographies of several gender variant individuals, who would likely be classified as transsexuals today.

In 1923, Hirschfeld first labeled the phenomenon as what he called "psychic transsexuality" in Die intersexuelle Konstitution.

In 1919, Hirshfeld founded The Institute for Sexual Science in Berlin, the world's first sexological institute. Nine years later, in Copenhagen, he and Norman Haire founded The World League of Sex Research.

In 1930, addressing the Association for the Advancement of Psychotherapy, Hirschfeld delivered the first scientific lecture on transsexualism.