Transsexual Research Project

The University of Minnesota performed sex-reassignment surgeries (as they were called at the time) on twenty-five trans women from 1966 to the mid 1970s as part of a program called the Transsexual Research Project. Helmed by psychiatrist Donald W. Hastings and surgeon Colin Markland, the project sought to alleviate the gender dysphoria of its patients through hormone treatment, psychotherapy, and surgery. At the same time, it tried to reform them into middle-class, heterosexual, conventionally respectable members of American society. Fueled by a complex mix of empathy, sensationalized concern, and pity, the project established Minnesota as the center of trans life it remains today.

See editor’s note on language below.

Trans medicine became a legitimate field of study in the United States in the 1950s through the work of sexologists (like John Money and Harry Benjamin) as well as trans people themselves, who demanded recognition across the country. Christine Jorgensen inspired a sensationalist media frenzy when she returned to the US after receiving sex-reassignment surgery in Denmark in 1953, and the attention made trans issues more visible. In this context, however, “trans” was transsexuality— a rigid condition of mind-body incongruence named by doctors. Trans people, the doctors believed, could be “cured” of sexual and behavioral pathologies deemed deviant or unacceptable through hormones, surgery, and social reconditioning.

In December of 1964, a thirty-eight-year-old trans woman was admitted to the University of Minnesota Hospitals’ psychiatric wing. Psychiatrist Donald W. Hastings was deeply affected by her distress and desire for surgery. In response, he and colleagues designed a multi-year research project “to determine whether such surgery is a worthwhile approach to an otherwise untreatable condition.” They planned to study Hastings’ initial patient and twenty-four others during surgery and additional treatments, and then track their life progress over the next ten years.

After getting approval from higher-ups, Hastings, Markland, and other medical faculty began to implement the project in 1966. A gender committee vetted and interviewed trans women before enrolling them in intensive psychotherapy. Eventually, the patients began a six-month regimen of hormone treatments and then surgery. While gender-affirming surgeries had been performed for years in Europe, Morocco, and Mexico, and in secret in some major American cities, the University of Minnesota (U of M) became only the second American health system to provide them openly, beaten by Johns Hopkins by less than two months. The project accepted Minnesota residents free of charge, but it rejected people who were married or assigned female at birth, as well as those with criminal records unrelated to cross-dressing.

As patients received their operations and were discharged, project staff followed up every six months, recording patient progress according to a graded scale. “A” patients married heterosexual men, became professionals or housewives, passed as cisgender women, and abandoned their gay or trans friends. “Fail” patients did sex work, relied on welfare, failed to marry, and became “well-known to [the] morals squad of local police.” Implicit in this scale was the project’s secondary goal: to make acceptable the unacceptable, to erase homosexuality and gender difference, and to “treat” transsexuality by rendering it invisible.

The final days of the project exemplify its complex legacy. By the mid-1970s, despite a lack of public pushback, the university began charging high fees for access to surgery “...so that transsexual surgery would not be at the expense of the Minnesota taxpayer.” At this point, local trans women found it increasingly difficult to access the services so readily offered just a few years prior. The change damaged the relationship between the U of M and the community for decades to come. Hastings died of a heart attack in 1977, marking the official end of the project.

Despite its shortcomings, the Transsexual Research Project was revolutionary in its delivery of essential, low-cost medical services to trans patients. Patients awoke with tears of relief streaming down their cheeks; as of 1978, project staff could not find a participant who regretted their surgery, and half the group reported, unprompted, that the procedure had saved their lives. Many people in the trans community viewed Hastings positively. Patient Dona Ewing (aka Big Mama, a coat-check lady at the Gay ‘90s,) reported, “He was like a father to us…very kind and very accepting, and he was all for us.” Though the project ended in relative disfavor, it cemented the Twin Cities’ place in trans American history.

Editor’s note: Doctors began using the word “transsexual” in the 1950s to refer to a person who sought out medicine and/or surgery to change their sex so that it aligned with their gender identity. Because of this clinical association, many trans people stopped using “transsexual” in the 1990s in favor of a word they chose for themselves: “transgender.” That word (and eventually its abbreviation, trans) included people who did not identify as transsexual or seek out medical treatment. It now includes gender-non-conforming people who identify as non-binary, agender, and genderqueer. This article uses “trans” in recognition of the shared history of these groups; it retains “transsexual” in some instances to reflect the historical use of that word. It similarly uses the historical term “sex-reassignment surgery” (more often called gender-affirmation or -confirmation surgery in the 2020s).