Two New York plastic surgeons in the 1970s

http://zagria.blogspot.com/2016/09/two-new-york-plastic-surgeons-in-1970s.html

Facial Feminization Surgery is sometimes said to have been developed by surgeon Douglas Ousterhout in 1982.   Of course transsexuals had surgery to change their appearance before that date, although perhaps not in so systematic an approach.   It was then referred to by the more general term "plastic surgery" but also as "facial contouring".    Rhinoplasty (nose jobs) were the most common such operation.  The same plastic surgeons often also did breast enhancements.  Here are two New York surgeons who worked in this field. 

Felix Shiffman (1925 - 2005)

Felix Shiffman was born in New York City, served in the US Army, earned a dental degree at New York University and a medical degree from Hadassah University in Tel Aviv. He practiced cosmetic surgery for over forty years from 1954 in New York City, and also owned an art gallery. He advertised his services to transsexual patients, particularly in New York Magazine, and was known for his rhinoplasties.





In 1974 Luis Suria, then aged 45, was in transition to female.  She was an unlicensed school teacher, who had not worked steadily since 1961, but held sporadic employment as a commercial artist.  She visited Drs Shiffman and Rish, mainly the former, in June/July 1974 and again in December 1974 and underwent injections of free silicone to acquire female breasts. By March 1975 Suria’s breasts were sore and she returned for treatment from Dr Shiffman, who referred her to Dr Dhaliwal who performed a bilateral subcutaneous mastectomy.  Suria, shocked by the severity of the resulting wounds, checked out of the hospital against medical advice, and later developed a wound site infection which required another operation.

Meanwhile, in 1980 Dr Shiffman was advertising: “Specializing in Cosmetic Surgery and Facial Contouring for Transsexuals”. New York Magazine reported that his receptionist was giving quotes for silicone shots at $120 to $240 a unit, but when the magazine spoke to Shiffman, he denied doing silicone shots.

Luis Suria, having abandoned transition, became a born-again Christian, and, with psychiatric help, returned to being “a regular man”.  He sued for malpractice and the case Luis Suria v. Felix Shiffman et al came to court in 1983. The plaintiff argued that Shiffman committed malpractice when he injected silicone into Suria's breasts in July and December 1974, that Dhaliwal committed malpractice in the performance of the mastectomy, and that Dhaliwal had improperly failed to obtain informed consent for the procedure. Suria maintained that consent was given for "incision and drainage” but not for a mastectomy. In contention Shiffman claimed that he did not treat the patient until December 1976, and that “symptoms were caused by injections of mineral oil administered by a transsexual friend”.

In November 1983, the jury found that in July and December 1974 Shiffman did commit malpractice which was a proximate cause of the plaintiff's injuries, that Dhaliwal did not commit malpractice but did fail to obtain plaintiff's informed consent, which failure was a cause of the plaintiff's injuries, that the plaintiff was guilty of negligence that was a cause of his injuries, that Shiffman was 60% at fault, Dhaliwal 15% and the plaintiff 25%, and that the plaintiff's total damages were $2,000,000. The trial court dismissed the claim against Shiffman on the ground that plaintiff's contributory negligence barred recovery and, reducing the amount of the verdict by 25%, the proportionate share of plaintiff's fault, entered judgment in the principal amount of $1,500,000 against Dhaliwal alone.

Both Dhaliwal and Suria appealed, objecting to the direction of a verdict in favor of Shiffman. Dhaliwal argued that he was a "successive tort-feasor" (a person who commits a second tort against the same previously injured party) and should not be held responsible for the entire damage award. The verdict against Shiffman was reinstated.

Suria talked of writing a book to help “those who are confused about their sexual orientation” (sic).   His final award was $600,000.



In later years Dr Shiffman specialized in liposculpture, and as late as 1999, Shiffman was still doing breast augmentations.

In March 2000 Shiffman pleaded no contest to “practicing fraudulently; filing a false report; practicing with negligence and incompetence on more than one occasion and failing to maintain accurate records”, and surrended his medical license.

In 2001 Shiffman retired to Ormand Beach, Florida. In September 2003 he was involved in a car accident where a man pushing a motorcycle was killed. He died at age 79 shortly afterwards.
  • Sharon Churcher. "The Anguish of the Transsexuals". New York Magazine, 13, 25, June 16, 1980: 49.
  • “Suria v. Shiffman”. Appellate Division of the Supreme Court of the State of New York, First Department, March 19, 1985. Leagle. Find a Case
  • “Former transsexual wins malpractice suit”. The Auburn Citizen, February 20, 1986. PDF
  • Jack Lechner. Can’t Take My Eyes Off of You. Crown Publishers, 2000: 95.
  • Felix Shiffman. Surrender of License. PDF
  • “Man On Road Hit, Killed By Car”. Orlando Sentinel, September 21, 2003. http://articles.orlandosentinel.com/2003-09-21/news/0309210026_1_ormond-nova-beach-police.
Obituary

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

I couldn't find a statement that Suria actually got the $600,000 (almost $1,450,000 today).

Apparently Luis Suria v. Felix Shiffman et al has become case law with regard to successive tort-feasors.
________________________________________

Peter Fries (? – 1981)

Peter Freis was a plastic surgeon on Park Avenue, New York in the 1970s. He advertised in New York Magazine, and did facial work and breast implants for mtf transsexuals.

He is said to have practiced 'closed capsulotomy' to break the capsular contracture, a reaction to breast and other implants. This was just brute force, squeezing the breasts till the scar tissue split.

His last nurse was Robyn Arnold, the girlfriend who was charged with, but not convicted of, the murder of Diane Delia. Fries died, by happenstance, a few days after Delia was killed.
  • Linda Wolfe. “The Transsexual, the Bartender and the Jewish American Princess”.  New York, 17 Jan 1983: 30, 33. Online Uses the ‘Freiss’ spelling.
--------

While Wolfe mentioned “Freiss” in the magazine version of the Diane Delia story, he is not mentioned under either spelling in the reprint in her book The Professor and the Prostitute, and Other True Tales of Murder and Madness, 1987.

Charing Cross GIC – addendum

http://zagria.blogspot.com/2016/09/charing-cross-gic-addendum.html

There has been an article “Fifty years on: The Charing Cross Gender Identity Clinic and the funding of a category without parallel” published at Youth Trans Critical Professionals and again at Gender Trender.

The author is given as “Susan Matthews, UK Academic”, but does not list any academic qualifications.

The article gets off to a very bad start with one error after another.

“It [CXGIC] was founded in 1966”
I have already discussed this. Treating intersex patients, the clinic dates from the 1930s, treating transvestites and transsexuals, from the 1950s.
“at Johns Hopkins Gender Identity Clinic, the world’s first GIC  founded the previous year” [1965]
Actually the UCLA GIC was founded by Stoller in 1964.
“The founding clinician at Charing Cross, Richard Green, came with an impressive academic pedigree, having worked with Money, collaborating on research on boys who demonstrated cross-gender behaviour.”
Richard Green was reported to be in London in 1966 and 1969. He very likely visited the existing Charing Cross clinic, but he certainly had no position there. He is not even mentioned in John Randell’s book. Also the Feminine Boy Project was still in the future: it was done in the 1970s.
“Up until the second half of the twentieth century, the word ‘gender’ referred to grammatical gender, a feature of language not human identity.”
Not this canard again! Obviously Matthews does not read 17-19th century novels. Some examples:
Henry Fitzgeffrey 1620: “Now Mars defend us! seest thou who comes yonder? Monstrous! a Woman of the Masculine Gender.”
Susanna Centlivre, early 18th century playwright reported that theatre managers 'treated her ... in the Masculine Gender'.
George Byron, Don Juan, 1824, having got his protagonist into female dress justifies using female pronouns: 'I say her because,/The gender still was epicene'.
Matthews then writes about John Money, lobotomy, John Money again, Bruce Reimer of course. She does not at all mention the Charing Cross doctors who worked with trans patients in the 1960s, ie. John Randell, Lennox Broster, Peter Philip. Come to that, there is also no mention of a certain Harry Benjamin. For Matthews, it seems, Money alone invented transsexualism!

Matthews writes: “For the Reimer case is open to many different readings. Zoe Playdon attributes the failings of UK gender identity clinics to this history”. This is a remarkable statement in that the details of the Reimer case would not be known for another 20 or 30 years. Certainly there is no mention of it in Randell’s 1973 book.

Matthews seems to think that Money was such an overwhelming influence that Charing Cross followed his lead: “The science of gender emerged from a tiny group centred on John Money and its findings were ethically compromised”. If this were so why cannot it be demonstrated from Randell’s writings?

Here is the bibliography from Randell’s book.

 The only mention of Green or Money is the 1969 anthology, which would be included as Randell contributed a paper to it. However none of Money’s or Green’s writings are listed, nor are they in the index, nor are they mentioned in the text.

In the 1960s the UK was less dependent on US fashions. To take two contemporary examples, that is 1965-7, compare the anti-psychiatry of RD Laing to the Scientology fellow-traveller Thomas Szasz, or the radical difference between the psychedelic music of Pink Floyd and Soft Machine from that which came from San Francisco. John Randell, whatever else we may think of his attitude, was his own man, and no-one has argued that he was a disciple of Money.

Having ignored the history of the CXGIC, Matthews jumps quickly to the 21st century, and as proof of Money’s influence she writes: “Echoes of the founding beliefs are still apparent in a 2011 paper by James Barrett, currently lead clinician at Charing Cross GIC. ‘Disorders of gender identity have probably always existed, inside and outside Europe’, Barrett writes, citing a 1975 study (Heiman).” Heiman is not in her bibliography. Comments about trans people being everywhere are found in every popular survey. May I suggest Oscar Gilbert’s Men in Women's Guise: Some Historical Instances of Female Impersonation, 1926 or many News of the World articles over the decades. To claim this as part of Money’s influence is to show that Matthews does not begin to understand what he had to say.

She spends most of the paper attacking Barrett and the fact that he has said different things at different times. He is wrong when he and other clinicians decide what to do ignoring the patients’ wishes, and he is wrong when he listens to the trans persons who come to the clinic and he accepts their self-diagnosis. “This claim is important, for if trans were a disorder (as in 1966), the work of the clinic would belong in a worrying tradition, one that harks back at the worst to lobotomy and calls up disturbing memories of the treatment of David Reimer. If trans has any links to body dysmorphia, to anorexia, or to self-harm, then it could not be appropriate to medicate or to offer surgery, however acceptable to the patient, however fiercely demanded.”

Having attacked Money for not listening to David Reimer’s self-diagnosis that he was not a woman, Matthews is still not willing to accept the equivalent self-diagnosis of trans persons. She connects trans and trauma: “Perhaps the most important voices are those of transitioners and detransitioners who are now beginning to explore what they see as a relationship between trans and trauma, challenging the constricting logic which demands that the complexity of human experience must fit the constructs of the gender narrative.”

Let us suppose that there is merit in Matthew’s linking of trans and trauma. She undermines her own case by distorting the history of the CXGIC and especially her (how shall we put if) Money-fication of its history and by paying no attention at all to the clinic’s pioneers.

Charing Cross Hospital GIC: Part II: 1983-Now

http://zagria.blogspot.com/2016/09/charing-cross-hospital-gic-part-ii-1983.html


1983 Stephanie Anne Lloyd, marketing manager, was referred by a Manchester doctor to Russell Reid at Charing Cross GIC. Afterwards she would create Transformation retail shops for trans persons in Manchester and later London.

Ashley Robin, who had stepped in as the head of the GIC appointed Donald Montgomery as clinical physician in 1984, and retired in 1985.

1985 Christine Goodwin, bus driver, became a patient. She would later win recognition as legally female at the ECHR in 2002.

Two studies were carried out at the GIC by Charles Mate-Kole, Maurizio Freschi & A. Robin.
a) “We presented the results of a retrospective study of 150 patients and a second, randomised controlled study of 40 patients. We studied 150 male transsexuals at different stages of treatment: assessment stage (n= 50); waiting list stage (n= 50); and postoperative stage (n=50). The results indicated a significant reduction in neurotic symptoms and improved social state in transsexuals postoperatively compared with patients at the waiting list stage, who fulfilled the criteria for surgery but were awaiting operation, and assignment to an assessment group.”
b) We “compared two groups of male transsexuals who had been assessed and carefully selected for surgery. They were randomly assigned to one of two groups; the experimental group had their waiting time for surgery brought forward so that they were operated on within three months of fulfilling the criteria, and the control group had to wait for the routine two years before undergoing surgery. All the patients were equally matched for age, social class, number of years of clinic attendance, and several other variables that might affect outcome. The results suggested that after two years of follow up there were significant differences between the two groups on a number of psychiatric and social, variables, showing a significant advantage for the experimental group over the controls.”
11-12 December 1986. International Conference on Gender Identity was held in London. This was really a British conference, but the Clarke Institute, Toronto was represented, and thus the name. It was organised by Charles Mate-Kole, research psychologist at the GIC. “Addresses covered a broad range of themes from the literary style of transsexual autobiographies to the hepatotoxic effect of methyltestosterone, and from the work of the speech therapist in the team to the latest surgical development in phalloplasty which uses a radial artery flap to create the urethra. The present legal disabilities of transsexuals were discussed and an interesting paper on classification clarified the distinction between transsexualism and homosexuality yet noted the curious variants in the relationship of gender identity to sexual orientation.” The Mate-Kole-Freschi-Robin studies were presented.

In 1987 J Bryan Tully completed his PhD thesis, Accounting for transsexualism, based on 204 trans patients, most of whom were seen at Charing Cross GIC, and concluded that “here is a fundamental weakness in the imposition of psychiatric 'syndromes' on gender dysphoric phenomena. Rather, 'gender dysphoric careers' are proposed as fluctuating enterprises in the construction of meanings, some meanings being more fateful and workable than others”.

Grant Williams, consultant urologist at Charing Cross Hospital, wrote to the British Medical Journal in November 1987. “One gender reassignment operation takes the whole of one afternoon in the operating theatre. During that time, I could perform 10 cystoscopies or resect four prostates or do three vasovasostomies. Most people would feel that to pursue gender reassignment surgery in the current climate must be bottom of the list of medical importance. The hospital continues with this, although it is totally against the wishes of the division of surgery." Charing Cross GIC doctors Charles Mate-Kole, Donald Montgomery, James Dalrymple & Steven Hirsch wrote to the BMJ in reply: “He is unaware of studies done in our department, the results of which were presented at a conference in December 1986 at this hospital”. RP Snaith from St James University Hospital, Leeds, pointed out that while surgeons at Charing Cross oppose gender operations, “and this is understandable since this one hospital has undertaken the major proportion of this work for the whole of Britain. This unfair burden should be corrected, as I pointed out, by the establishment of regional services.” Williams resigned from Charing Cross the next year.

1988, James Barrett, joined the GIC

1989 Luiza Moreira/Roberta Close, the Brazilian model, had gender surgery at Charing Cross Hospital.

1990. 20-year old Jackie McAuliffe had a first appointment.

1993 psychiatrist Alfred Hohburger died.

1994 Richard Green, ex-colleague of Harry Benjamin, became Director of Clinical Research, and saw trans persons two days a week.

Donald Montgomery gave a presentation at the Gendys ’94 Conference in Manchester discussing the GIC from the doctors’ point of view. At that time the clinic was getting over 300 referrals a year, 80% mtf, of whom 20% had “some form of gender reassignment surgery within five years”. He presented a typology: “primary core transsexualism, secondary transsexualism, the heterosexual transvestite, the asexual cross-dresser, the female transsexual, the small - the very small - number of patients with a biological component”. He discussed other GICs: “We are by far the biggest in the UK if not Europe, if not the world, I think, in terms of patient referrals. There is a small clinic just for the Leeds/Yorkshire catchment area. Professors Goldberg and Linton used to have a clinic here in Manchester but I think all the Manchester patients are probably being referred to us at the moment. There are occasional psychiatrists scattered around the UK that have an interest in gender identity disorders, without professional back up on the whole. Dr. Christie Brown still has his clinic at Maudsley Hospital but I think it's probably running down rather than increasing. Dr. Dunleavy in Newcastle and his colleagues have a small clinic there. There is also the child and adolescent clinic at St. George's”

Jackie McAuliffe had surgery in 1995. Later she would work as a prostitute in Paddington Green and be featured in a docu-drama based in the area.

2000 The GIC approached James Bellringer to replace Mike Royal as the GIC’s surgeon. Royal provided on-the-job training,

Kelly Denise Richards, serving time at HMP Parkhurst for assault and robbery, was a patient. While still incarcerated, she had surgery and was transferred to a women’s prison.

In December that year it was announced that the number of NHS sex-change operations was set to triple, and that Charing Cross GIC would increase such operations from one to three a week at an extra £1 million per annum. Liam Fox, the Conservative shadow health secretary denounced the Labour Government of pandering to lobby groups.

2001 James Barrett became head of the GIC.












In 2003 the GIC moved into its new premises at 179-183 Fulham Palace Road. It was now part of the West London Mental Health NHS Trust.



2004 Charles Kane, businessman, in detransition, was, unlike his transition, a client of the GIC.

2004 In 2004 as the Gender Recognition Bill was proceeding through parliament, psychiatrist Russell Reid faced a complaint to the General Medical Council that he too easily accepted patients for hormone therapy and surgery. The complaint was brought by four of his colleagues at the Charing Cross Hospital Gender Identity Clinic, psychiatrists James Barrett, Richard Green, Donald Montgomery and senior registrar Stuart Lorimer on behalf of four of his former patients. Reid retired his NHS post the next year. In 2007 Reid was found guilty of Serious Professional Misconduct, mostly for failing to communicate fully with patients’ family doctor (a rule that many doctors are unaware of) and not documenting his reasons for departing from the HBIGDA Standards of Care guidelines sufficiently.

The same year David Batty of The Guardian interviewed the GIC surgeon James Bellringer and was told “The number who express immense gratitude is overwhelming”. However Persia West who researched a report on the needs of trans persons in Brighton and Hove (many of whom had been referred to the Charing Cross GIC) and found “The level of dissatisfaction with the Charing Cross GIC was very high, in essence concerning the time the treatment took and the manner in which it was given.”

2006 The GIC saw 498 referrals.

2011 A proposed conference, Transgender: Time to Change sponsored by the Royal College of Psychiatrists and led by Az Hakeem of the Portman Clinic, and featuring Julie Bindel, but with no input from any trans persons, was cancelled after the Charing Cross team criticized the emphasis of the meeting: “It now appears that the conference comes at trans issues from a very specific agenda, namely, to explore the validity or otherwise of gender diagnoses as medical and psychiatric phenomena. So long as this is the case, we feel we can’t support it.”

US physician Ted Eyton visited the GIC in 2013, and reported that it gets 1500 referrals per year from GPs. This rate has been doubling every five years. Charing Cross GIC gets about 50% of referrals in the UK. This was the same year as the Conservative-Liberal coalition proposed to demolish the main Charing Cross building, and to sell off 60% of the site to private developers.

2014 James Bellringer, who had been doing the majority of vaginoplasty work for Charing Cross Hospital resigned.

2016 The GIC saw 1892 referrals in 12 months.

The West London Mental Health Trust (WLMHT) announced: 
“However, as WLMHT moves forward it is necessary to refocus the services that we provide. The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.
“As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.”
Doctors include:

1933-1965 Lennox Broster, surgeon
193?-194? Clifford Allen, psychiatrist
1950-1982 John Randell, Physician for Psychological Medicine
196? – 198? Peter Philip, surgeon
1982-1985 Ashley Robin, head of GIC
1982-1993 Alfred Hohburger, psychiatrist
1982-2005 Russell Reid, psychiatrist
198?-200? James Dalrymple, Surgeon
1984- ? Donald Montgomery, clinical physician
1985-1990 Charles Mate-Kole, research psychologist
1994- ? Richard Green, Director of Clinical Research
? -2000 Mike Royal, surgeon
2000-2014 James Bellringer, surgeon
1988- now James Barrett, head of GIC from 2001.
EN.Wikipedia   TransActivist    WLMHTGIC
___________

Deborah Blaustein’s University of London thesis sounds quite interesting. Unfortunately I was not able to find a copy.

Re the two Mate-Kole-Freschi-Robin studies: obviously transsexuals who have been granted what they need are less neurotic than those who are frustrated by being kept waiting year after year for no good reason.

For several of the doctors, eg. Richard Green, I was not able to find out when they came and left.
The Wikipedia page on the West London Mental Health NHS Trust does not even mention the Gender Identity Clinic, nor does the Wikipedia page on the Hospital mention recent attempts to close it and sell off the land.

Obviously the attitude of the staff is much better than it was in the 1960s under John Randell who insisted on using birth pronouns and telling trans women that they would always be men. However Persia West’s report shows that there is further to go. The proposal that Charing Cross GIC be discontinued and replaced by local GICs is possibly a good thing, if it is done right. However the track record of the Conservative government since 2010 does not bode well.