‘They tour around, they swap around’: Trans mobility and medical citizenship in postwar Britain
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As demand for gender-affirming healthcare began to grow in the mid-1950s—and as the handful of British endocrinologists and surgeons who served trans clients scrambled to set up formal gatekeeping systems—people pursuing medical transition quickly learned that access to treatment often relied upon geographic mobility and participation in cross-regional knowledge networks. ‘They tour around, they swap around,’ one Manchester-based psychiatrist complained of his patients, “and of course they’re an in-group…They swap stories.’ For some trans people of this postwar generation, this ‘touring around’ in search of competent and sympathetic care was very literal.
Women with the means to travel to continental Europe or North Africa during the 1950s and 1960s were able to choose from a wider range of surgical specialists, some of whom worked on an informed-consent model. Conversely, some of the first clients of National Health Service (NHS) gender clinics were citizens of Singapore, South Africa, or other Commonwealth states with right of abode. And many more trans Britons followed chains of referrals down more local, less linear paths, navigating a complex array of state, private, and voluntary services with the aid of peers who had successfully navigated the same process.
Yet the link between access and mobility meant that trans people who lacked the ability to travel faced systemic barriers. For instance, while hundreds of men and women undertook hormone therapy on the NHS between 1948 and c.1975, they first had to find one of the small number of specialists who conceded that such treatment—as long as it reduced a patient’s visible gender-nonconformity—constituted a social good. Informed-consent care was restricted to those who could afford time off and tickets to London, people diagnosed with mental illness could be institutionalised for seeking transition and over the course of the 1960s, a series of Commonwealth Immigrants Acts all but excluded non-white migrants from the rights of medical citizenship.
Thus, while ‘touring around’ offered some trans people in postwar Britain a means of achieving their personal transition goals, the variable and piecemeal provision of gender-affirming medical services testifies to the fact that universal healthcare was—and remains—far from universal in practice.
Adrian Kane-Galbraith is a doctoral candidate in history at the University of Washington. Their current research examines the bureaucratic and medical practices involved in gender transition between c.1945 and 1975, and considers how the international circulation of people, narratives, and ideas about trans people shaped midcentury British debates about the nature of ‘biological sex’.
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