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The History of Gender Dysphoria

Sir Harold Gilles was one of the pioneers of sex change surgery. In 1946 he performed surgery on the UKs first male-female transsexual Roberta Cowell.

For many years his home was at 71 Frognal, in the heart of London's Hampstead village. A blue plaque on the front of that house now commemorates his life and work.

Pioneering sex reassignment surgery

Michael Dillon

In 1946, he and a colleague carried out one of the first sex reassignment surgery from female to male on a young aristocrat, Michael Dillon. Michael Dillon is also believed to be the first woman to have taken the male hormone testosterone in order to look like a man. Within months of starting testosterone, he had grown a beard and was living as a man. It was the dramatic transition in his appearance that finally persuaded Gillies to operate.

Five years after the first sex reassignment surgery on Michael Dillon, Gillies and colleagues performed one of first modern sex reassignment surgery from male to female using a flap technique on Roberta Cowell, which became the standard for 40 years.

Roberta Cowell

On May 15th, 1951 Robert Cowell became Roberta Cowell the United Kingdom's first full surgically altered transsexual.

Roberta Cowell

Robert was examined by two gynaecologists, two GPs, a professor of anatomy and an endocrinologist. Their conclusion - they were amazed not that Robert was so feminine, but that such a female person could seem outwardly so masculine! They discovered an abnormal flow of female hormones in his body.

Robert had two options, the doctors suggested. To carry on unsatisfactorily as he was or to live the rest of his life as a woman if he cared to chose to do so. So Robert accepted that nature had originally intended him to be female. It explained his mental and physical contradictions, and allowed him to believe his depression had a physical reason; he was thus able to rationalise his situation to a greater degree.

Although none of the doctors had personal knowledge of gender change from male to female, they had often come across the female to male gender changes before, and had assisted such changes! They suggested that the use of female hormones, breast enhancement surgery, a face-lift and a genital operation could remove any sexual ambiguity.

Robert would have to fund his own operations, as the necessary specialists were not in the then fledgling NHS. The hormones alone were extremely expensive. So Robert started out on his great adventure - to become Roberta.

Robert became Roberta legally on May 15th, 1951 at the age of 30 years
Despite the fact he was still living mostly as a male! This caused her quite a few day to day problems, but finally the surgeons agreed to complete the gender change operations later that year. It was the early 1950's, when it was possible to take immediate legal steps to re-register birth gender. Affidavits were sworn, and a revised birth certificate was quickly issued.


Roberta Cowell’s story will have echoes for those who have any form of gender dysphoria, and especially for all transsexuals. Many will be envious of the ease with which her birth certificate change was allowed at the time, a state of comparative legal bliss which continued until the notorious Rowallen/Ashley case stopped such amendments.

TS Loss of Rights

UK law altered dramatically in 1970 as a result of the divorce case between the transsexual model, April Ashley and the late Lord Rowallen. Prior to this case, transsexual people were able to have their birth certificates corrected following surgery and had full legal rights. However, the only way that the judge could grant Lord Rowallen a divorce and to avoid handing over any inheritance to his ex-wife was to declare his wife to be legally still a man. Consequently, every other transsexual person lost their legal rights.

The current legal situation is that the 2004 Gender Recognition Act gives the TG community full legal rights.