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XV HBIGDA Symposium: Vancouver Highlights (1997)

XV HBIGDA Symposium: Vancouver Highlights (1997)

©1997, 2013 by Dallas Denny

Source: Dallas Denny. (1997, October). XV HBIGDA conference highlights. AEGIS News, (1)12, pp. 1-2. Reprinted in The Crystal Chronicle, September, 1997, V. 9, No. 9, pp. 6-7 and Renaissance News & Views, V. 11, No. 10, October, 1997, pp. 16-17.



HBIGDA is now The World Professional Association for Transgender Health. The Vancouver conference marked a sea change in the organization. This is my report of the conference.


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The Crystal Chronicle, Sept. 1997 (Link)

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XV HBIGDA Symposium: Vancouver Highlights

By Dallas Denny


The 15th meeting of the Harry Benjamin International Gender Dysphoria Association was held 10-13 September, 1997 in Vancouver, British Columbia; the host organization was the Gender Identity Program at Vancouver General Hospital.

HBIGDA is a worldwide organization for professionals who work with transsexuals. Named after the pioneering endocrinologist Harry Benjamin, M.D., it was founded in the late 1970s. HBIGDA is perhaps best known for its Standards of Care, a document which establishes minimal guidelines for the provision of hormones and surgery to transsexual people.

The conference, which was held at the rather expensive Sutton Place Hotel ($269 per night Canadian), had more than 200 registrants, quite a few of whom were not only professionals, but transsexual as well. The local population of transsexuals and transgendered people was represented. Some registered for the conference, and some staged a protest during the Thursday morning plenary, complaining of the high cost of the conference and demanding access to the seminars. HBIGDA decided to allow protesters to attend sessions without charge, and several did so.

At the 1993 HBIGDA conference inNew York City, trans members of HBIGDA were very low key, wearing their “We’re All Professionals Here” hats. The unspoken presumption was that transsexuals are marginal individuals; this atmosphere was also reportedly present at the 1995 conference in Bavaria, which I did not attend. 1997 was different: transsexual and transgendered folk were out and proud and very much a part of the proceedings. Valerie Harvey, Dr. Becky Allison, Dr. Sheila Kirk and I had the opportunity to address the entire assembly at a plenary on Saturday. Many transpeople, including Jamison Green, Marsha Botzer, Dr. Tarryn Whitten, Christine Burnham, Stephanie Castle, Dr. Rebecca Auge, Jude Patton, Rosalyne Blumenstein, Tracie O’Keefe, and Dr. Anne Lawrence presented papers or posters. There was a roster of surgeons, including Drs. Eugene Schrang; Donald Laub, Sr.; J. Joris Hage; Toby Meltzer; Stan Monstrey; and Refaat B. Karim; other physicians, including Drs. Rosemary Basson, Stacy Elliott, Louis Gooren, and Bengt Lundstrom; attorneys Louis Schwartz and Richard Green, who is also a psychiatrist; and a variety of social scientists, including Drs. George Brown, Sandra Cole, Walter Bockting, Eli Coleman, Lee Emory, Collier Cole, George Mayer, Randi Ettner, Leah Schaefer, Milton Diamond, and Bonnie Saks. We’re stopping right here; we realize we left out about 90% of the presenters, but if we continue with the listing, there will be no article!

The conference was kicked off by a talk on sexual differentiation of the brain by Dr. Roger Gorski. Following was a plenary. Dr. Marilyn Wilchesky of the gender program in Ottawa led with a paper about transsexualism (the same old stuff—separation and invidiuation, weak fathers, narcissistic mothers). Dr. Wilchesky was followed by Dr. Holly Devor, who set the tone for the conference by presenting a multi-factorial model of female-to-male gender variance and pointing out that gender variability is not prima facie evidence for psychopathology, but can be a healthy adjustment to restrictive gender roles. Dr. Devor brought many attendees to their feet when she called for HBIGDA to acknowledge and serve the many kinds of gender-variant people rather than dividing the world into transsexuals and nontranssexuals.

Dr. Devor was followed by Dr. Walter Williams, who spoke about models of psychopathology and how they vary with the cultural zeitgeist. He gave an example of a Native American culture in which twins and the mother who bore them were exiled to a “Twin Town,” and an example from Western culture, pointing out that at one time women who pursued an education were considered deviant. He reiterated Dr. Devor’s point that it is time for us to stop looking at gender variance as an illness and celebrate it as a natural form of human difference.

After this plenary, the talk was all about continuity and variability; the transgender revolution had finally come home to roost at HBIGDA. There were a few dour faces, which was only to be expected: HBIGDA’s world had just turned upside down. One member suggested that if there is nothing wrong with transsexuals, the organization simply disband.

In my talk on Saturday, I noted that the change of viewpoint means that the organization is needed more than ever before; if it concerns itself with the use of medical technology to transform human bodies rather than the perhaps artificial notion of transsexualism, it will reach people, like heterosexual crossdressers, some of whom do the same things to their bodies as transsexuals, but have heretofor escaped the safety web cast by HBIGDA because they are not “transsexual. This new way of thinking was apparent at a plenary on intersexuality on Friday; it was clear the HBIGDA membership has concerns about the surgical reassignment of infants with unusual genitalia. Previously, there is little doubt that most members would have endorsed the prevailing practice of operating on infants to make their genitals “normal.”

A logical consequence of the ideological rollover was a realization that data are needed, especially to justify the Standards of Care. Valerie Harvey and Dr. Becky Allison made this explicit at a Saturday plenary in which they noted that those who access medical technology will not tolerate gatekeeping from the medical community unless data exist to justify that gatekeeping. As part of the same plenary, Dr. Sheila Kirk spoke about how she had come to realize that hormonal therapy can be appropriate for those who are not inclined toward genital surgery. Dallas Denny followed Dr. Kirk, stated baldly that the classical model of transsexualism propels people to a surgery they may neither want nor need; the transgender community has come to realize that while surgery is necessary for many, it is not for all, there are all degrees of gender variance, and a one-size-fits-all approach is not only unhelpful, but can be damaging.

In contrast to all this talk of variability, Saturday afternoon saw Dr. Stephen Levine presenting the proposed Standards of Care to the assembled members. The proposed Standards do away with the numbered Standards and Principles in favor of a much more understandable descriptive prose style. Unfortunately, they also call for a period of either psychotherapy or real-life test before initiation of hormonal therapy; this is in addition to the 90-day evaluation period now in effect.

Discussion of the proposed Standards was heated. While it was obvious the Standards Committee had put a lot of work into the document, members took exception to various provisions and to the deletion of material from previous versions.

The Standards of Care will now go back to committee, and, after one more revision, will then be taken to the membership for vote.

The conference ended with a speech by incoming President Dr. Richard Green, and the announcement of the results of the recent election. Alice Webb, who was forced to resign from her Executive Director job last year by then-president Friedemann Pfafflin, was installed as President-Elect, and new Board members were announced; this included two out transfolk, Sheila Kirk and Jude Patton.

The next HBIGDA meeting will be held in two years in London.