Every year on March 31, Transgender Day of Visibility (TDOV) is celebrated worldwide. The event was created in 2009 by Michigan-based trans activist Rachel Crandall Crocker, who envisioned a day that centred trans life in the present tense, recognising a community that is alive, thriving and unapologetically visible. TDOV was also conceived as a counterpoint to the more sombre Transgender Day of Remembrance, held annually on November 20. Where remembrance honours loss, visibility insists on resilience and joy. In 2021, Joe Biden became the first U.S. president to issue a TDOV proclamation. In a statement from the White House, he acknowledged the “generations of struggle, activism and courage that have moved the United States, and the world, closer to full equality for transgender and non-binary people.”
It may come as a surprise that trans-affirming healthcare began in Berlin almost 100 years ago. Several procedures now widely used, including vaginoplasty, orchidectomy, penectomy and vulvoplasty, trace their origins to the city. At the centre was sexologist Magnus Hirschfeld and his Institute for Sexual Science, where he worked alongside gynecologists and surgeons including Dr Ludwig Levy-Lenz, Dr Kurt Warnekros, and Dr Erwin Gohrbandt. Together, they are credited with pioneering the first gender-affirming surgeries during the Weimar era.
Opening in 1919 on the edge of Tiergarten, on the site of what is now the Haus der Kulturen der Welt, the institute became a hub for transsexuals, transvestites and homosexuals, and the first centre dedicated to the study and support of gender identity and broader LGBTQ+ life. Its work was groundbreaking, and Hirschfeld has since been recognised with ‘Magnus Hirschfeld Day’ on May 14, his birthday. He worked tirelessly to support those who came to the institute seeking care. It is difficult to compare these early surgeries to those performed today, not only because medical techniques have advanced dramatically, but also because much of the institute’s work was lost. In May 1933, it was raided by the Nazi Party, and its research, patient records and archives were destroyed during the book burnings that followed. The loss was profound, both for Hirschfeld and for trans history.
The German trans woman Dora Richter is widely recognised as the first person to undergo a series of gender-affirming surgeries. In 1922, she received an orchidectomy at the Charité hospital by Dr Gohrbandt. In 1931, she underwent a penectomy performed by Dr Levy-Lenz, followed later that year by a vaginoplasty, again by Gohrbandt. These procedures were highly experimental, and little is known about their outcomes.
Richter had been a patient at the Institute, where she also worked as a maid while receiving psychiatric care from Hirschfeld before and after her surgeries. Reports suggest the procedures allowed her to live a more fulfilled life; by the end of 1931, she was working as a chef at Restaurant Kempinski (now Hotel Bristol) on Kurfürstendamm. After fleeing Berlin under the Nazi regime, she later settled in Allersberg, Bavaria, where she lived until her death in 1966 at the age of 74.
Alongside Richter, other trans women at the institute also underwent surgeries, including the painter Toni Ebel and her partner Charlotte Charlaque, a German-American actress and receptionist at the institute. All three appeared in the 1933 Austrian film Mysterium des Geschlechts (Mystery of Sex), directed by Lothar Golte. As news spread across Europe that medical transition was possible, more trans women travelled to Berlin seeking care from Hirschfeld’s team.
The most widely documented among them is Lili Elbe, a Danish painter who began her transition in 1930. Much is known of her life following the film The Danish Girl released in 2015 that starred Eddie Redmayne. Over two years, she underwent four surgeries, including a vaginoplasty and an experimental uterus transplant performed by Dr Warnekros at Dresden Women’s Clinic, the first procedure of its kind. The transplant led to a fatal infection, and without antibiotics, her body could not recover. Elbe died on 13 September 1931, just shy of her 50th birthday.
In 2024, aged 42, I underwent these surgeries myself. With hindsight, I can’t imagine how difficult it must have been for those women at the time. Without modern pain relief, antibiotics or advanced surgical techniques, they were risking their lives. I’m beyond grateful for their determination and visibility, and for the blueprint they created for future generations. Their courage and persistence laid the foundations for what exists today.
