Painting by Tony Robert Fleury titled "Pinel, médecin en chef de la Salpêtrière en 1795." French psychiatrist Philippe Pinel (1745-1826) releasing lunatics from their chains at the Salpêtrière asylum in Paris in 1795

An original OutHistory publication: March 28, 2020

Translations assisted by Laur Bereznai
A note on the title.[1]

Often, misgendering people—speaking of them using gendered terms which do not fit their gender identity—is put down as New Age “political correctness." But it has been shown to directly impact transgender and gender non-conforming persons’ health.[2]

From pseudonyms to secret languages, LGBTQIA+ history (and especially transgender history) can be hidden from view, obscured by sudden shifts in terminology and relegated, at best, to second- or third-hand accounts in medical textbooks.

One of the first academic explorations into transgender history was in Ira Pauly’s 1965 “Male Psychosexual Inversion: Transsexualism”, published in the Archives of General Psychiatry (now JAMA Psychiatry).[3]

It is important to note that male psychosexual inversion referred to persons who we would likely consider as transgender women today. But even the terms transsexual and transsexualism had not been popularized for long. Harry Benjamin’s The Transsexual Phenomenon would not be published until 1966. This is an era in which even Christine Jorgensen was still being referred to as a “transvestite”.[4]

Pauly first begins his review of 100 cases of “transsexualism” with a historical review, noting that the "concept of psychosexual inversion [being transgender]… have been known since antiquity”. He continues:

The first mention of this problem in the medical literature was in 1830 by the German author Friedreich, who discussed the fixed delusion of being a woman, and mentioned that this “is not a very rare mental disorder and has been observed almost everywhere.”

This provides us with a substantial lead, over 100 years previous to Pauly’s article and almost 200 years before the “Transgender Tipping Point” (Time magazine's headline reporting on the transgender civil rights movement, May 29, 2014).

Skipping down to Pauly’s references, note 43, we see: 

Friedreich, J.: Versuch Einer Literargeschichte der Pathologie und Therapie der psychischen Krankheiten, Würzburg, 1830.

Roughly translated from the German, we have the title Attempt at a Literary History of the Pathology and Therapy of Mental Diseases.[5] The author is Johannes Baptista Friedreich, a physician and professor, born April 19, 1796, in Würzburg. Luckily, his work has been scanned and is available via Google Books.

It is here we see the original quote:

Der fixe Wahn, Weib zu seyn, ist keine so selt vorkommende psychische Krankheit, und ist schon fast überall beobachtet worden.

Another English translation of the quote (included for the sake of completeness) is found in a 1916 article Notes on the History of Psychology in The Alienist and Neurologist:

The fixed delusion of being a woman is not an uncommon psychical disease, and is observed everywhere.

It being 1830, it is important to ask: what evidence does Friedreich provide concerning such a condition’s ubiquity? As it turns out, quite a bit for the time. He cites a number of contemporary reports on from Siberia[6] and North America[7], as well as historical literature concerning Scythians (Krankheit der Scythen; the disease of the Scythians; a topic for its own article).

Schaeffer’s Report
But there is one report which stands out in Friedreich’s writing due to its sheer precedency. A case written about by Gottlieb Christoff Schaeffer in 1790. Thankfully, the Internet Archive and Google Books just happen to have this original piece, in volume 1, issue 1 of Archiv für die Geschichte der Arzneykunde in ihrem ganzen Umfang[8] (Archives of the History of Medicine in Its Entirety).[9]

On page 217, in Schaeffer’s “Vierter Brief” (“Fourth Letter”) dated to 18 March 1788, we get the shortest of discussions regarding an individual in a teaching hospital in Paris, the Pitié-Salpêtrière Hospital. The individual is not named or specifically identified other than as one of the 200 “lunatics” (Wahnsinnigen) considered residents of the institution. There is little pomp or circumstance in connection to the person’s situation. It is treated as so normal as to lead one to believe that this is not even the first case like this that Schaeffer has seen.

Schaeffer refers to the patient as “he” (er), even though the patient clearly identifies as a woman. Translated, Schaeffer’s brief report reads (emphasis retained from the original):

I saw another [“lunatic,” i.e. another patient in this area of the teaching hospital] in female clothes, with a long beard, sitting quietly in his [sic] room: he [sic] has lived here for some twenty years, and believes he [sic] is a woman; if one addresses him [sic] as ‘Madame’, he [sic] answers modestly and is well-behaved—but if he [sic] is called ‘Monsieur’, he becomes angry and falls silent.[10]

And that’s all we get. The first known case of distress based on being misgendered. If this individual’s story is to be believed, they were in this Paris hospital as early as 1768, nearly a decade before the American Revolution.

-------
NOTES

[1] Title chosen to mirror Vern L. Bullough’s 1987 article “A nineteenth-century transsexual” (https://doi.org/10.1007/BF01541843). Bullough’s article set the groundwork for posthumous application of transgender-related terminology and constructing of contemporary transgender histories; this conceptualization would be continued by individuals such as Joanne Meyerowitz, Leslie Feinberg, Susan Stryker, and Emily Skidmore.

[2] Dolan IJ, Strauss P, Winter S, Lin A. Misgendering and experiences of stigma in health care settings for transgender people. Med J Aust. 2020 Mar; 212(4):150.

Russell ST, Pollitt AM, Li G, Grossman AH. Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. J Adolesc Health. 2018 Oct; 63(4):503–5.

[3] Note that Friedreich records this journal as Wittwer’s Archiv für die Geschichte der Arzneikunde, illustrating the small changes in the German language from the 18^th to the 19^th century.

[4] Hamburger C. TRANSVESTISM: HORMONAL, PSYCHIATRIC, AND SURGICAL TREATMENT. J Am Med Assoc. 1953 May 30;152 (5):391.

Hertz J, Tillinger K-G, Westman A. TRANSVESTITISM.: Report on five hormonally and surgically treated cases. Acta Psychiatr Scand. 1961 Dec; 37(4):283–94.

[5] Friedreich JB. Versuch Einer Literargeschichte der Pathologie und Therapie der psychischen Krankheiten. Würzburg, Prince-Bishopric of Würzburg: Carl Strecken; 1830.

[6] Gmelin JG. Reise durch Sibirien. Verlegts A. Vandenhoecks seel. Wittwe; 1751.

[7] De Pauw C. Recherches philosophiques sur les Américains. Vol. 2. Chez J. G. Baerstecher; 1774. 

[8] Note that Friedreich records this journal as Wittwer’s Archiv für die Geschichte der Arzneikunde, illustrating the small changes in the German language from the 18^th to the 19^th century.

[9] Schaeffer GC. V. Schaeffers Briefe (Vierter Brief). Arch Für Gesch Arzneykunde Ihrem Ganzen Umfang. 1788 Mar 18; 1(1):199–218. 

[10] Original German: “Einen andern sah ich in weiblichen Kleidern mit einem langen Bart still in seinem Zimmer sitzen: er wohnt seit einigen zwanzig Jahren hier, und glaubt, — ein Weib zu sein; redet man ihn Madame an, so giebt er bescheiden Antwort, und ist artig, — nennt man ihn aber Monsieur, so wird er ärgerlich, und verstummt.”  

Schaeffer's Citations
To inspire further future research here are Schaeffer's additional citations to sources referencing what we call transgender history:

• Page 31
  • (a) Schon abgedruckt im “Magazin für die philosoph. medic. und gerichtliche Seelenkund, herausgeg. Von J. B. Friedreich. I. Heft. S. 71. Würzb. 1829.
  • (b) Lib. I. Cap. 105. Lib. IV. C. 67.
  • (c) Von der Luft, den Wassern und Klimaten. Sprengel, Apologie des Hippocrates, II. Thl. S. 609.
  • (d) Var. lect. Lib. III. Cap. 7.
  • (e) Diss. sur l’histoire d’Herodote, Cap. 20.
• Page 32
  • (a) Sprengel’s Apologie S. 613. 614.
  • (b) Patinus, Comment. in vetus monumentum Ulpiae Marcellinae, p. 413.
  • (c) Gruner, Aphrodisiacus, sive de lue venerea, Jen. 1898. Hensler, Geschichte der Lustseuche, Hamb. 1789. I. Bd. S. 211.
• Page 33
  • (a) Die beinahe wahnsinnigen Schamanen und Jongleurs der heutigen Tungusen und anderer Mongolen sind gewöhnlich dieselben Unmänner, wie die Scythen.
• Page 34
  • (a) Unter den vielen Fällen, die für die Möglichkeit einer wirklichen psychischen Ansteckung sprechen, mag unter andern folgender als Beweis dienen. Barbier, Marc, Bricheteau, Esquirol, Serres und Villerme erzählen mehrere Fälle von krankhafter Mordlust, die sich gleich nach dem Prozesse der Französinn Cornier zugetragen hatten. Daher ist Mare der ganz richtigen Meinung, dass das öffentliche Bekanntwerden solcher Fälle andere zu ähnlichen Handlungen psychisch disponire, M. s. Revue medicale francaise et etrangère. Paris 1826. Vol. IV.
  • (b) Kircher. China illustr. p. 70. Amstelod. 1767.
• Page 35
  • (a) Gmelin’s Reise durch Sibirieu, Götting. 1751. I. Thl. S. 320.
  • (b) Wittwer’s Archiv für die Geschichte der Arzneikunde, I. Bd. 1. St. S. 217.
  • (c) Es liegt auch dieses ganz in der Natur der Sache, in dem geistigen Entwicklungszustande der Völker. Die alte Welt fand in allem Ausserordentlichen, und nicht Erklärbarem…
• Page 36
  etwas Ueberirdisches, was sie mit ihrer Sprache als Wunder bezeichnete. Daher wird der Glaube an Wunder auch nur auf dem Boden von Völkern wurzeln, die sich in dem Kindesalter ihrer psychischen Evolution befinden. [Das Wunder ist des Glaubens liebstes Kind: Goethe’s Faust.] So mussten nun auch die Seelenkrankheiten, (als dem Volke etwas Unerklärbares) als überirdisch, von Oben commend betrachtet warden. Daher wurden Wahnsinnige, wie Begeisterte, als Inspirirte in den Tempeln geheilt: daher warden sie von den Muhamedanern noch immer als etwas Heliges geachtet. S. Carus, Psychologie der Hebräer. Leipz. 1809. S. 395.

• (a) Vita Constantin. Lib. IV. Cap. 25.
• (b) Meyer’s Darstellung aus Italien, S. 278.
• (c) Vergl. Auch: Recherches philosophiques sur les Americains. T. II. p. 19, 20.

• Page 37
  • N/A
• Page 38
  • N/A
• Page 39
  • (a) De Scytharum νοσῳ ϑηλεια ad illustr. Locum Herodoti. Lips. 1778. p. VII.
  • (b) Man vergl. auch Tollius, not. Ad Longinum πεϱι ὑψους. Sect. XXVII. not. 15. Clemens Alexandrinus cohort. ad gent. p. 14. Edit. Sylburg. So findet man auch bei Pollux, Lib. VI. Cap. 30 den Ausdrunk: Κιναιδος ανδϱογυνος ϑῆλυσ την ψυχην
  • (c) Geschichte der Lustseuche. S. 210. 211.
  • (d) Nämlich: eines Ausflusses aus den Geschlechtstheilen.

-------------------

References

1. Dolan IJ, Strauss P, Winter S, Lin A. Misgendering and experiences of stigma in health care settings for transgender people. Med J Aust. 2020 Mar;212(4):150.
2. Russell ST, Pollitt AM, Li G, Grossman AH. Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth. J Adolesc Health. 2018 Oct;63(4):503–5.
3. Pauly IB. Male Psychosexual Inversion: Transsexualism: A Review of 100 Cases. Arch Gen Psychiatry. 1965 Aug 1;13(2):172.
4. Hamburger C. TRANSVESTISM: HORMONAL, PSYCHIATRIC, AND SURGICAL TREATMENT. J Am Med Assoc. 1953 May 30;152(5):391.
5. Hertz J, Tillinger K-G, Westman A. TRANSVESTITISM.: Report on five hormonally and surgically treated cases. Acta Psychiatr Scand. 1961 Dec;37(4):283–94.
6. Friedreich JB. Versuch Einer Literargeschichte der Pathologie und Therapie der psychischen Krankheiten. Würzburg, Prince-Bishopric of Würzburg: Carl Strecken; 1830.
7. Gmelin JG. Reise durch Sibirien. Verlegts A. Vandenhoecks seel. Wittwe; 1751.
8. De Pauw C. Recherches philosophiques sur les Américains. Vol. 2. Chez J. G. Baerstecher; 1774.
9. Schaeffer GC. V. Schaeffers Briefe (Vierter Brief). Arch Für Gesch Arzneykunde Ihrem Ganzen Umfang. 1788 Mar 18;1(1):199–218.