Benjamin, 1964a
Private Practice, New York, NY, USA

The author worked as a gerontologist, endocrinologist and sexologist in private practice and remarked that he could not realize any systematic scientific studies there. At the end of the 1940s Alfred Kinsey transferred some patients with transsexual symptoms to him. Following the highly publicized surgery of Christine Jorgensen in 1952 in Copenhagen, his practice turned into "the" address for people with transsexual wishes from the USA and from abroad (comp. Memorial for Harry Benjamin [1988], especially the articles by Schaefer and by Jorgensen). This follow-up study and other publications (comp. Benjamin, 1964b, 1967), his close collaboration with doctors and psychologists of the renowned Johns Hopkins University Hospital in Baltimore, MD, USA and his monograph dated 1966 (Benjamin, 1966) most strongly influenced treatment concepts for transsexual symptoms, furthered hormonal and surgical procedures in particular and contributed greatly in that universities then dedicated their attention to the transsexual phenomena.

• Sample
• Study Methods
• Evaluation Fields and Criteria
• Results
• Case Studies
• Follow-up Studies Mentioned
• Authors' Conclusion
• Indication Recommendations
• Remarks

*The author says that the total group was 186 transvestites whom he had seen during the previous 12 years and "examined and partly followed for a shorter or longer period of time" (p. 108). Among these 186, 106 were transsexuals. It remains unclear if the follow-up studies include all or only part of those operated.

*"In most of the remaining ones" (p. 108, exact figures are lacking) the testicles were transferred retro-peritoneally by the method of Dr. Elmer Belt of Los Angeles.

Study Methods
The evaluation of the results by the author was done based upon clinical interviews and physical examinations, as well as correspondence or reports of friends and relatives.

Evaluation Fields and Criteria
Relatively vague global conclusions were made, in which the physical health, mental condition and social integration of the "new woman" (p. 109) were considered. If the follow-up study period for a corresponding evaluation was not too short, then the appearance and function of genitalia and sexual activity were regarded. For a more detailed description of the criteria, see Benjamin (1964b)

Results
The conclusion is evaluated as excellent for 16 females and for 11 as satisfactory. Four cases are deemed as doubtful by the author, but none as unsatisfactory. Six former patients married as females and 17 had permanent relationships.

Case Studies
To demonstrate the reasons that could lead to the wish of a sex reassignment the publication contains a short case study.

Follow-up Studies Mentioned
Hamburger et al., 1953

Authors' Conclusion
For the author "there can be no doubt in my mind that transsexuals are entitled to treatment other than psychotherapy which so often has proven futile and costly" (p. 111). In carefully selected cases hormonal and surgical treatment is indicated.

Indication Recommendations
"Most important to me for the indication is the belief that a successful >woman< can result from this operation, and that there is no other way to help the patient toward an emotionally healthier and happier future. Under >successful woman< I have in mind appearance, a reasonably stable personality, the consent of the family, and the assurance that the >new woman< can make a living as such" (p. 108).

Remarks
Benjamin's publication can be considered as a case presentation for the hormonal and surgical treatment. For the surgery he uses the term "conversion operation" (p. 110), probably as translated from his German mother-tongue term "Umwandlungsoperation," which was later replaced by the term "sex reassignment surgery."