Remembering Dr. Leah Schaefer, the Sweet Singer-Turned-Psychiatrist Who Healed a Generation of Trans Women

Dr. Leah Cahan Schaefer died this past week at 92. A giant in the fields of transsexualism and female sexuality, she represented the best of the medical profession. During her professional life, as the custodian of the voluminous professional files of Dr. Harry Benjamin, the dean of transsexual medicine in the United States, himself a student of the renowned German scientist Magnus Hirschfeld, she persisted in recognizing transsexualism as a normal human developmental variant, a vision that she lived long enough to see come to fruition in the latest edition of the American Psychiatric Association's diagnostic manual, the DSM-5, this past December.

I was fortunate to have had the opportunity to collaborate with her in the late '90s, when I was researching the link between fetal DES (diethylstilbestrol) exposure and transsexualism. The possibility intrigued her, and she supported my work on endocrine disruption before others in the profession were even willing to consider the possibility. She was professional and gracious, which fit with the description others had shared with me.

One of my earliest post-transition relationships was with a woman who knew Dr. Schaefer professionally, and it was clear from her stories that the trans community of New York felt blessed to have her as a counselor and general resource. At a time when most trans women had been excluded from society, receiving just a modicum of kindness would have seemed like a lucky thing. But Dr. Schaefer not only cared deeply for her patients; she offered them hope.

It's not easy today, even for those of us who lived through those decades, to remember the depth and brutality of the ostracism. For me it was even more intense because my professional colleagues were among the worst. I spent years combing the stacks of my university library and the libraries of the other Ivies whenever I got the chance, to learn about who I was. And everything I discovered in the psychiatric literature during the '70s and '80s was uniformly vile and hateful, until I happened across Drs. Harry Benjamin and Leah Schaefer.

It's hard to believe that physicians, including psychiatrists, could so totally lack compassion and understanding. In one respect, reading the work of Drs. Benjamin and Schaefer highlighted the contrast even more. How could these two be right and everyone else wrong? I won't comment on the humanity of the majority, but Dr. Schaefer certainly was a woman of compassion and loving kindness. She and her mentor were also scientists, however, and they refused to be overwhelmed by religious sensibilities and the pseudoscience known as Freudianism, which was the cultural consensus among psychiatrists during those years.

I had learned from the eminent Jewish writer and philosopher Elie Wiesel that all it took was a single human being to be witness to one's suffering to find sufficient hope to get through the worst that life can dish out. Certainly Professor Wiesel's experiences during the Shoah proved that point, and I discovered it to be true as well. Before I started medical school my witness was Rabbi Eliezer Waldenberg, the Tzitz Eliezer, Israel's leading bioethicist. He had ruled that trans women were to be welcomed into the Jewish community as women. This from a leading Orthodox rabbi, mind you, a fact that, to this day, drives some of the fundamentalist community insane with rage. However, it should be said that in traditional-Jewish-legal-reasoning mode he clarified his ruling to say that while he accepts women post-transition (b'dieved, in Talmud speak), he couldn't in good conscience encourage a pre-operative trans woman to undergo genital reconstruction (l'chatchilah, in Talmud speak). That would be such a waste of a perfectly good pair of testicles!

Once I got to medical school, however, all my behavioral science and psychiatry texts had nothing but the most demeaning and denigrating things to say about trans persons. All this while an affiliate hospital of the University of Pennsylvania system, Pennsylvania Hospital, was performing genital reconstruction on trans women. Fortunately we don't live in a totalitarian society, as Professor Wiesel did in the '30s in Central Europe, so opposing attitudes and behaviors could happily coexist. But I needed another witness to keep me moving forward, and that was Dr. Schaefer.

Dr. Schaefer went on to become a founding member of the Harry Benjamin International Gender Dysphoria Association (HBIGDA), now far larger and known as the World Professional Association of Transgender Health (WPATH). The first trans conference I ever attended was the HBIGDA meeting in New York in 1993, 10 years before I transitioned and joined the organization. Dr. Schaefer was president when I first met her at the conference, and she authored the first five versions of the Standards of Care, beginning in 1979. Today we use version 7, published in 2011.

In 1974 she published the very well-regarded tome Women and Sex, one of the first of its kind to document the full range of women's sexuality, an outgrowth of her Columbia University doctoral dissertation. And appropriately for a woman who has encouraged so many women to become themselves and fly, she was a professional singer and recording artist in her youth, heard on the radio as the lead of Leah and the Barries, and was in love with Johnny Mercer, known for "Moon River" and "That Old Black Magic." America certainly got talent with Leah Schaefer, who overcame the black magic of transphobia that was poisoning psychiatry and used her voice to liberate not only the trans community but her colleagues as well.

Listen to Dr. Leah Schaefer sing "Heather on the Hill":