This is a history of transsexuality in Western culture in the last half of the 20th century, and how it came to be seen as a legitimate disorder that requires treatment. The author uses Christine Jorgensen, the "GI to blonde beauty" who made headlines in 1952 when she publicly announced her sex reassignment surgery, as a framing device for the changes. It's interesting, but fairly dry and reads like a text book. That's okay.

In the early 20th century, a few doctors in Europe experimented with hormones, ovary transplants, and other surgical methods to treat patients who came to them desperate for treatment because they believed themselves to be a member of the other sex. American doctors understood that there were people who were convinced they were in the wrong body, but either assumed they were simply gay crossdressers or interpreted this as an extreme type of homosexuality: these people hated being identified as homosexual so much that they felt they must really be the other sex. American doctors performed a few sex reassignment surgeries but only on people who were intersexed. It was felt that it was impossible for someone to change from one sex to the other for no reason other than the need to do so, but someone with ambiguous genitals or whose "real" gender appeared at puberty needed surgery to correct the defect.

In 1952 Christine Jorgensen was big news because she announced that she had had surgery to become the woman she had always felt herself to be. She had been a physically normal male but had always known she was female. She was not homosexual and not a crossdresser. She had found sympathetic doctors in Denmark. Back in America she supported herself with a tasteful nightclub act in which she talked about her transition, sang some songs, but didn't show her body. She framed her story in terms of someone struggling to be themself, which resonated with many people. By the end of the 50s, the term "transsexual" was accepted. The medical community was starting to redefine the ideas of sex, gender, and sexuality.

The 60s saw more sex reassignment surgery being performed in the United States on transsexuals, and distinctions became clear between cross dressing, homosexuality, and transsexuality. Johns Hopkins opened its gender clinic although the number of patients they accepted for surgery was very small. To quality, patients had to undergo a battery of psychological tests and needed to aspire to conventional gender roles. By the 70s, the terms "gender dypsphoria syndrome" and "gender identity disorder" were being used. Sex reassignment surgery was no longer a big news story. The public was becoming more open minded. At the same time, transsexuals in the gay community were coming into conflict with feminists. MTFs were excluded from the Michigan Womyn's Music Festival. Feminists and gay liberationists challenged doctors, too, for their acceptance of traditional sex roles. Gender studies from a feminist viewpoint increased. By the 90s, there was a strong transsexual movement in which transsexuals asserted the right to define their sexuality.

Christine Jorgensen died in 1989, age 62. She had been willing to advocate for herself and for others like her, and her life led to redefinition of sex, gender, and sexuality. ( )