Yesterday I went up to London to read a book by Michael Dillon. If you’ve not heard of him, Dillon is the first recorded instance of medically-assisted female-to-male gender transition. Dillon, an Irishman, began his treatment in 1939 while living in Bristol. Later he trained as a doctor and is believed to have assisted with the gender surgery for Roberta Cowell, a British trans woman. The American, Christine Jorgensen, who is generally lauded as the world’s first transsexual, did not have her surgery until a year after Cowell.

Dillon’s influence, however, goes far beyond these pioneering surgeries. During his transition, he wrote a book, Self: A Study in Ethics and Endocrinology. This is the book that I needed to go to the library of the Wellcome Trust to read. I have to admit that Dillon’s prose is pretty turgid, though he was trying to write a medical treatise so perhaps that can be excused. However, there is no doubting the passion with which he argues on behalf of himself and people like him. In the light of the #TransDocFail controversy, I’d like to share a few quotes with you.

Dillon’s argument is that trans people are probably a result of some sort of malfunction of the endocrine glads. He has no direct evidence for this, but has a wealth of examples of other known effects of these glands and the chemicals they produce on the sexual characteristics of the body. He suggests that with trans people the problem may arise during the development of the foetus, a view that modern science is only just coming around to. Given the situation of a male mind in a female body (or vice versa), Dillon suggests:

Surely, where the mind cannot be made to fit the body, the body should be made to fit, approximately, at any rate to the mind…

And that is pretty much how trans people are treated to this day, using the same techniques of hormone treatment and plastic surgery that Dillon pioneered.

The book was published in 1946, when Britain was still recovering from WWII and the British people were full of enthusiasm for the Welfare State. Dillon saw no reason why trans people should be excluded from this:

Hormone treatment, whether for disease of the gonads, or for this purpose, is expensive. Surely in our post-war world we should see that all medicinal products are for international use and should be free to all sufferers.

These days estrogen is so cheap that doctors make a profit on prescribing it, and yet many trans women, including myself, have been denied access to the drug on the NHS.

Dillon had little respect for mental health professionals, and with good reason. The GP he first approached was George Foss, an early pioneer of the use of hormones in medicine. Foss was initially very supportive, but he decided that he’d better make sure that his patient was of sound mind. The psychologist to whom Foss referred Dillon not only insisted that Foss stop the treatment, he also gossiped to staff at Dillon’s workplace, resulting in Dillon having to leave a well-paid scientific job commensurate with his Oxford education and take up work as a mechanic in a local garage. Dillon notes angrily:

Why, then, must smug , self-complaisant people and psychologists whose knowledge is limited because they have not, themselves, entered into the experience of those persons about whom they presume so glibly to write, dictate to such what course they should or should not take. Is it not for the individual to judge whether he be ‘mutilated’, experimented on or left alone?

Given that Dillon pretty much invented the process of gender transition (long before Harry Benjamin codified it), I was expecting him to be an advocate of the medical route. However, Dillon seems to have been well aware that the trans community existed on a very broad spectrum of experience, and that surgery would not be appropriate for all. Given his distrust of psychologists, he advocated a patient-centered approach.

If, on the other hand, there is an incompatibility between the mind and the body, either the body must be made to fit the mind, as we have said, or the mind must be made to fit the body; and that is for the patient himself to judge if he be of age.

Which is pretty much where the trans community wishes we were today, instead of being stuck in a process whereby “doctor knows best” and the patient is treated as too mentally unstable to be able to know her own mind. Dillon, of course, has 1940s views on the ability of children to know their own minds, and he also demonstrates some pretty typical 1940s views on the nature of women, but there is no doubting the modernity of his views on the medical treatment of trans people. If he had been listened to, trans people would be far better off today.

There is a lot more where that came from. I’ll be giving a lecture on Dillon at the M-Shed in Bristol on February 16th as part of the ongoing LGBT History Month events, in particular the exhibition of LGBT life in Bristol being staged at the M-Shed by Out Stories Bristol (of which I am co-chair).

And hey, they have an exhibition on chocolate running at the same time. What more incentive do you need to visit?