TG History: The Measure of a Man — Dr. Alan L. Hart

“You’re neither unnatural, nor abominable, nor mad. You’re as much a part of what people call nature as anybody else; only you’re unexplained as yet — you’ve not got your niche in creation” — Radclyffe Hall, The Well of Loneliness

Halls Summit, Kansas doesn’t exist anymore. But there were hundreds like it once — little frontier railroad towns that shot up overnight as America drove westward. It was in the spring of 1888 that Mr. Albert L. Hart and his pretty young wife Edna arrived in town. They’re remembered as very pleasant people who endeared themselves to the entire community. Albert did good business as a merchant and on Oct. 4, 1890 the happy couple welcomed a healthy girl child, Alberta Lucille, into the world. But frontier life could be cruel back then and any number of illnesses could decimate a community. Typhoid fever claimed Albert that summer of 1892, leaving his widow Edna no choice but to return to her native Oregon with Lucille. Edna would eventually remarry and move to Albany, Oregon to care for her invalid mother and give Lucille the benefit of a “town education.”

WHAT’S A FELLOW TO DO?

Young Lucille was different, even then. Boy’s clothes just felt natural. Lucille always regarded herself as a boy and begged her family to cut her hair and let her wear trousers. Lucille disliked dolls but enjoyed playing doctor. She hated traditional girl tasks, preferring farm work with the menfolk instead. The self reliance that became a lifelong trait was evident early: once when she accidentally chopped off her fingertip with an ax, Lucille dressed it herself, saying nothing about it to the family. Socially, Lucille just didn’t seem to fit in with either boys or girls. School was a different matter. A voracious reader, Lucille became an excellent student and in 1908 enrolled at Albany College (now Lewis & Clark College). Lucille continued excelling academically and starred on the women’s debate team. At college Lucille’s ongoing attraction to women blossomed and she fell passionately in love with a fellow student, Eva Cushman. Their affair became so apparent that the student newspaper teasingly noted “Eva Cushman and Lucille Hart hereby announce that it is all a joke about them being in love and about to get married.” In that age, love between women still tended to fly under society’s radar. But while their relationship tended to escape serious notice, the continuing change in Lucille’s appearance and behavior was becoming all too apparent. Lucille began wearing strictly tailored men’s clothing and hats while smoking, drinking, and generally acting like a man. Alarmed by the attention Lucille’s masculine demeanor was receiving, Eva broke off their affair and left Lucille, alone and in debt.

Persevering, Lucille managed to graduate and in 1913 enrolled at the University of Oregon Medical College (Portland). While there, Lucille fell in love again, this time with a beautiful woman named Maude Dabney. Unhappily married, Dabney filed for divorce, which was granted. But rather than opt for a relationship with a poor medical student, Dabney abruptly decided to run off with a wealthy older man instead. Dabney’s parting words were bitter, saying she “loved (Lucille) sincerely but did not have the nerve to face the criticism that would follow their union.” Lucille never forgot the pain of Dabney’s desertion.

By 1917 Hart’s personal conflict was becoming intolerable. Citing a childhood phobia with loud noises, Hart sought counseling with a respected teacher, Dr. J. Allen Gilbert. During that time Hart also underwent a legal change of name, with the school yearbook showing “Alan Lucill Hart.” Despite these issues Hart graduated top of the class in 1917, securing an M.D. from the University of Oregon.

AMERICA’S FIRST GENDER REASSIGNMENT SURGERY

Dr. Gilbert, an extremely progressive psychiatrist for his time, would later document the case in the Journal of Nervous and Mental Disease, October 1920, anonymously referring to Hart only as “H”. During his examination Gilbert noted Hart routinely used phrases like: “the other fellows and I” or “what could a fellow do?” Prolonged questioning also revealed Hart’s sexual fantasies involved visualization in the male role. Hart complained of breasts “undergoing atrophy” and that menstrual periods were “always painful and decreasing in duration.” A vaginal exam “produced disgust as well as pain and distress.” Dr. Gilbert found little evidence of physical abnormality but Hart’s statements would be regarded today as one of the indicators of transsexualism. Meanwhile Hart began an intense affair with a schoolteacher named Inez Stark. Gilbert also interviewed Stark about their relationship, noting that “(Hart’s) natural male instincts carried her into associations with the female sex and positive attractions were unavoidable.”

Hart then presented Dr. Gilbert with an extraordinary proposal. Hart loved women as a man would, had always been most comfortable dressing, working, and living as a man. So why not just be a man? “After long consideration, (Hart) came to the office with her mind made up to adopt male attire in conformity with her true nature and try to face life under conditions that might make life bearable…” Hart then asked Dr. Gilbert about performing an excision of the uterus to prevent menstrual flow while living as a male. Surprisingly, Dr. Gilbert agreed, writing, “Hysterectomy was performed, her hair was cut, a complete male outfit was secured and … she made her exit as a female and started as a male with a new hold on life and ambitions worthy of her high degree of intellectuality.” He adds, “Let him who finds in himself a tendency to criticize offer some constructive method of dealing with the problem on hand. He will not want for difficulties. The patient and I have done our best with it.”

It’s important to stop here and note what just happened at this point in history. This is the first documented case of an American doctor recommending removal or modification of otherwise healthy organs based entirely on an individual’s gender identification. In effect, Alan Hart’s 1918 operation is America’s first known case of gender reassignment surgery.

While he continues referring to Hart in feminine pronouns by past association, Dr. Gilbert made his professional opinion clear, writing: “In fact, from a sociological and psychological standpoint she is a man. If society will but let her alone, she will fill her niche in the world and leave it better for her bravery.” Gilbert’s words proved insightful since Hart had no intention of quietly disappearing into obscurity.

A ROUGH BEGINNING

Hart and Inez Stark were married as husband and wife at the First Congregational Church in Martinez, California on February 18, 1918. Still in transition, Hart used an alias “Robert Allen Bamford, Jr.” (after Hart’s beloved grandfather). Though liberal for its day, it’s generally felt the church knew nothing of Hart’s status. Hart’s surgery was believed performed at Berkeley, California sometime in August 1918. Barely a month after surgery, Dr. Alan L. Hart began his medical career that year in Gardiner, Oregon, intending to take over the medical practice of a departing physician. But through an unlucky coincidence, Hart was recognized by a former student and as Gilbert wrote: “the hounding process began which our modern social organization can carry on to such perfection and refinement…” Word came that Dr. Hart was stricken with the flu and he quietly slipped out of town. Dr. Hart eventually began private practice in remote Huntley, Montana: “I did operations in barns and houses…(until) the crash of the autumn of 1920 wiped out most of the Montana farmers and stockmen, and me along with them.” He then took whatever jobs were available before a recommendation from noted Dr. Harriet J. Lawrence (decorated by President Wilson for developing a flu vaccine) secured Hart employment as staff physician at Albuquerque Sanatorium, 1921-4.

However, the constant moving, secrecy, and financial problems all strained Hart’s marriage. Inez left Alan in September 1923 and ordered Hart to have no further contact with her. By 1925, after rejecting all attempts at reconciliation, Inez Stark formally divorced him.

WRITER AND HUSBAND

Hart dealt with his personal turmoil as others sometimes have — by writing about it. He produced four fictional books, Doctor Mallory, The Undaunted, In the Lives of Men, and Doctor Finlay Sees It Through. All were autobiographical in tone, dealing with crusading doctors or gay men against fighting social prejudice and championing reform in the medical profession.

Hart’s first novel, Doctor Mallory (1935), about an idealistic general practitioner in a small Oregon town, was likely based on Dr. Hart’s experiences at Gardiner. After Doctor Mallory made the best seller lists, Hart wrote that one of his ambitions was “to be an ‘unofficial observer’ of the medical profession during the remainder of my life” and “to write a novel about a research institute, another about hospitals, another about a family of doctors.” In The Undaunted, the hero is Sandy Farquhar, a persecuted homosexual doctor: “He had been driven from place to place, from job to job, for fifteen years because of something he could not alter any more than he could change the color of his eyes. Gossip, scandal, rumor always drove him on. It did no good to live alone, to make few acquaintances and no intimates; sooner or later someone always turned up to recognize him.” Like Hart, Farquhar has a phobia of loud noises. Doctor Mallory’s wife, Katherine (believed based on Inez Stark), constantly laments his lack of money and prestige: “I want my husband to be a famous man, not a kindly, overworked, obscure country doctor… Nobody ever pays him for his work until weeks after it’s done and some never pay at all…” Apparently his clients’ failure to pay their bills played a substantial part in the altruistic Hart’s frequent moves and the collapse of his marriage.

Hart’s novels received critical review in The New York Times, The New York Herald-Tribune, The Saturday Review of Literature, and other leading publications. Interestingly, one critic reviewing In the Lives of Men wrote that: “For a doctor, he seems to know surprisingly little of women. His portraits of them are little more than profile sketches.” In 1935, Hart wrote a reviewer this sadly timeless commentary: “The ugly things that have grown up in medicine are the result of the ugliness and falsity of society as a whole, of our American preoccupation with success and making money, of our concentration of effort on the production of things rather than their use for a fuller human life. These things are not the fault of the individual physician; and neither can they be remedied by him. So long as the American people are permeated with the spirit of ‘I’m going to get mine, no matter how,’ just so long will that attitude filter into all the professions; doctors are people first and are affected by the current ideals just as other people are.”

Happily, the void created by Inez Stark’s divorce would soon be filled by another partner, Edna Adele Ruddick, with whom Hart would spend the rest of his life. Edna Ruddick was like no other woman Hart had ever known. A teacher with a Masters Degree in Sociology from Columbia, Edna was intelligent, outgoing, and independent. Also, unlike Inez Stark, Edna shared Alan’s dedicated commitment to public health and social improvement. The two married on May 15, 1925. While we may never know the full nature of their relationship friends unanimously described them as a devoted couple.

A SAVER OF LIVES

Dr. Hart’s career accelerated drastically as he dedicated himself to the fight against tuberculosis. Granted a research fellowship, Dr. Hart earned a Masters Degree in Radiology from the University of Penn and in 1929 accepted a post as Director of Radiology at Tacoma General Hospital. His work involved a fairly new invention: the x-ray machine. Only recently discovered in 1895, the medical community soon began using x-rays to locate bone fractures and tumors. But it was their vastly untapped potential for detecting tuberculosis that most intrigued Dr. Hart. Tuberculosis remained the undisputed number one killer in America with thousands dying annually. Plaguing mankind since Biblical times, it’s been called many names: “consumption,” “the white plague,”or simply “TB. Tuberculosis usually attacks the victim’s lungs first then grows and spreads throughout the body, including the kidneys, spine, and brain, ultimately crashing the immune system. It wasn’t until the 19^th Century that science finally recognized that TB wasn’t a hereditary disease and could be prevented. But with no cure yet available the only hope was early detection and the introduction of chest x-rays finally made that possible. In its early stages TB sufferers are usually unaware they even have the disease. But in the hands of professionals such as Dr. Hart trained to spot abnormalities, even early x-ray machines could detect most of the disease. This allowed for early treatment, often saving the patient’s life. Tuberculosis is an airborne virus rapidly spread to others in close proximity through coughing and sneezing. But once identified, sufferers could then be separated from the uninfected population, greatly lessening the spread of the disease. Public fundraising drives like the recently created Christmas Seal campaign helped finance these efforts. By the time antibiotics were finally introduced in the 1940s, doctors using these tactics had managed to cut the tuberculosis death toll down to one fiftieth.

Nevertheless, getting work proved difficult during the Great Depression — staff cuts were frequent and few could afford medical care. In 1937, Hart was hired by the Idaho Tuberculosis Association and later became the state’s Tuberculosis Control Officer. Dr. Hart set up Idaho’s first TB screening clinics and spearheaded the state’s war against tuberculosis. He traveled extensively through rural Idaho, covering thousands of miles while lecturing, conducting mass TB screenings, and treating the effects of the epidemic. The sensitive Dr. Hart knew the very word “tuberculosis” carried a social stigma similar to venereal disease, so he insisted his clinics be referred to as “chest clinics,” himself as a “chest doctor” and treatment for his “chest patients” with discretion and compassion. From 1933 though 1945, Hart labored to contain the epidemic in both Idaho and Washington while Edna worked for the Welfare Department in Washington. During World War II, Dr. Hart also served as medical advisor at the Recruiting and Induction Headquarters in Seattle.

In 1945 the Harts moved to West Hartford, Connecticut where they lived out the rest of their lives. Edna became a professor at the University of Hartford while Alan’s medical achievements continued. After graduating in 1948 with a Masters in Public Health from Yale, Dr. Hart became a respected Director of Hospitalization and Rehabilitation for the Connecticut State Tuberculosis Commission. As in Idaho, Dr. Hart took charge of a massive statewide x-ray screening program for TB, emphasizing early detection and treatment. Dr. Hart held this position the rest of his life and is credited with helping contain the spread of tuberculosis in Connecticut just as he previously had in Idaho, Oregon, and Washington.

HIS LEGACY

Nationally, Dr. Hart was recognized as one of America’s foremost experts on tubercular roentgenology — the branch of radiology using x-rays for diagnosis and treatment of tuberculosis. He authored several published articles on the subject and wrote an authoritative book, These Mysterious Rays (1943), later translated into Spanish for overseas publication. Dr. Hart was a member of the American Thoracic Society, American Public Health Association, American Association for the Advancement of Science, and American Civil Liberties Union, among many others. Socially, both he and Edna were well liked, active community leaders with Alan serving eight years as vice president for his local Unitarian Church council. Personally, Alan Hart was remembered as “ a small man, short and thin… (He) had an unusual voice… with an almost British diction.” Another recalled: “He was quite a courtly, gentlemanly guy…a man of the old school.” One distant relative remembered: “We always called them ‘Uncle Doc’ and ‘Aunt Ruddy’.” Alan’s immediate family was aware of his gender change and seemed to have accepted it. When his beloved grandfather and grandmother died, their obituaries each referred to Alan as their grandson.

Doctor Alan L. Hart died of heart failure on July 1, 1962. The terms of his will directed his body be cremated and his ashes scattered over Puget Sound where he and Edna had spent so many happy summers together. The Journal of the American Medical Association (JAMA) noted his passing with regret. His lifetime achievements are recognized in the National Cyclopædia of American Biography, which documents the accomplishments of prominent Americans. Hart’s will also directed that no memorial be erected in his name and perhaps that’s just as well. Of Hart’s life this could be fairly said: Given his circumstances and the age he lived in, anyone would’ve understood if he’d led a repressed, secretive half-life. Instead Alan Hart chose to live fully, love freely, and devote himself resolutely to public service — and that probably says more about the man than any monument could.

He found his niche.

Edna Hart passed away on March 21, 1982, leaving most of their quarter million dollar estate to the Medical Research Foundation of Oregon. The Alan L. and Edna Ruddick Hart Fund was established “in loving memory of my late husband Alan L. Hart, MD, a graduate of the University of Oregon Medical School, whose mother died of leukemia, whose life was devoted to medicine and whose earnest wish was to someday give financial support to medical research in its efforts to conquer leukemia and other diseases.” Altogether a legacy befitting the courage and compassion of a most extraordinary man.

Bibliography:

LBGT History with Alan Virta. Idaho’s Transgender Pioneer: Dr. Alan Hart, Diversity News, June 2000

Thomas M. Lauderdale and Tom Cook, The Incredible Life and Loves of the Legendary Lucille Hart, Alternative Connection Vol. 2, Nos. 12 and 13 (September and October 1993).

J. Allen Gilbert, Homo-Sexuality and Its Treatment Journal of Nervous and Mental Disease Vol. 32, No. 4 (Oct. 1920), pgs. 297-322.

National Cyclopædia of American Biography

Brian Booth, Alberta Lucille Hart / Dr. Alan L. Hart, An Oregon Pioneer

Ken Morris and Kay Brown. The Alan Lucill Hart Story…

Katz, Jonathan Ned, Gay/Lesbian Almanac: A New Documentary, Harper & Row Publishers, Inc. (1983), Carrol & Graf Publishers, Inc. (1994).

Halls Summit News, Halls Summit, Coffey County, Kansas, June 10, 1921

Reminisence (sic) of Hall’s Summit

— I’m proud that this 1999 project helped identify the first American to undergo gender reassignment. My grateful thanks to Oregon historians Tom Cook (GLAPN) and Brian G. Booth, and Idaho historian Alan Virta (Boise State University), who so generously provided their time, research, and assistance with this article. Mr. Virta contributed numerous facts about Dr. Hart’s time in Idaho. Mr. Booth was kind enough to provide a timeline he created of Alan Hart’s life. Both generously provided source material for this article. Mr. Cook was invaluable in providing new information regarding of both Hart’s name change and surgery. Mr. Cook also furnished several clarifications about Dr. Hart’s life in Oregon and Connecticut.

Category: Transgender History