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Jeanne Hoff, Pioneering Transgender Psychiatrist, Dies at 85

In December 1977, Dr. Jeanne Hoff, a 39-year-old psychiatrist, invited a television crew into her Manhattan home. The next day, they would accompany her to the operating room for her gender-affirming surgery.

“Becoming Jeanne: A Search for Sexual Identity,” the resulting documentary about Dr. Hoff’s experience, was shown the next spring on NBC, with Lynn Redgrave and Frank Field as the hosts.

“It’s a very lonely moment indeed,” Dr. Hoff, a slight figure with shoulder-length brown hair, said that evening. She added, “The things we do to our bodies and our lives are very disturbing to the people around us, and I can see that fear and that confusion written on their face even when they’ve known me a long time.”

Her choice to undergo surgery was years in the making. Her choice to go public, however, which could have come at great cost to her livelihood and well-being, was easier.

She wanted to make known her own difficulty in finding care, her interactions with doctors who didn’t have enough knowledge of transgender people. She hoped that her experience would inform the medical profession.

In those years, the transgender figures in the public eye were few but notable. In the early 1950s, the glamorous Christine Jorgensen’s transition was fizzy tabloid news, though she was denied a marriage license a few years later because her birth certificate identified her as male. In 1974, the travel writer Jan Morris published “Conundrum,” a memoir of her own transition, to some acclaim. And in 1977, Renée Richards, the ophthalmologist and tennis player, won a court order to play in the women’s division at the U.S. Open.

But Dr. Hoff’s television debut was mostly done as an example for her patients. Since many were themselves transgender or gay, it didn’t seem possible, as she put it, for her to encourage them to live openly, confidently and free of shame without doing so herself.

Dr. Hoff, perhaps the first openly transgender psychiatrist, died on Oct. 26 at her home in San Francisco. She was 85. The cause was Parkinson’s disease, said Carol Lucas, a friend. Her death, which was not reported at the time, was announced this month by Gay City News.

Dr. Hoff had a private practice in Manhattan and, at the time of her transition, had also taken over the practice of Dr. Harry Benjamin, a German-born endocrinologist who has often been described as the father of transgender care in the United States. Yet in the history of that care, Dr. Hoff is not well known, if she is known at all.

Jules Gill-Peterson, an associate professor at Johns Hopkins University who studies sexuality, and transgender history in particular, recalled being surprised when she came across Dr. Hoff’s archives, which she had donated to the Kinsey Institute, when she was working on her 2018 book, “Histories of the Transgender Child.”

“The idea that in the 1970s a trans woman would be openly practicing as a psychiatrist is revolutionary by itself, when the profession was still struggling to depathologize homosexuality,” Dr. Gill-Peterson said by phone. “But knowing that your psychiatrist understood what it was like to be in your shoes was a tidal shift.”

In her research, Dr. Gill-Peterson learned that Dr. Hoff had argued successfully for the release of a Black transgender woman who had been institutionalized from age 15 to 30 because doctors had diagnosed her assertion of her gender identity as “mental retardation,” “delusion” and “sexual perversion.”

“Through all the florid language of the reports there is an unmistakable moralistic disapproval of her effeminacy and homosexuality,” Dr. Hoff wrote in her analysis of the woman’s care, “but not the slightest hint that the diagnosis of transsexualism was suspected, even though it was quite evident from the details provided.”

In “Becoming Jeanne,” Dr. Hoff talked about the reflexive, though less destructive, sexism of her own doctors, like the surgeon who thought her breast implants should be bigger; he was amazed, she said, that she didn’t want look like a showgirl.

At one point in the documentary, Ms. Redgrave asked Dr. Hoff her thoughts about getting married. Dr. Hoff said that she was in a relationship with a man, but that she didn’t think the relationship would survive the transition. (As it happened, it didn’t.)

“The marriage market for middle-aged spinsters is not a bull market,” she said. “I’m not going to die of grief if it doesn’t happen to me. I have an interesting occupation. I have a full life with friends who are affectionate and caring.” And that, she added, was “very much better than life was before.”

Dr. Hoff was born on Oct. 16, 1938, in St. Louis, the only child of James and Mary (Salih) Hoff. Her father was a laborer and, by the 1950s, was working as a bottler in a brewery. Dr. Hoff didn’t speak very much about her upbringing, though she hinted that it was marked by privation and disapproval, said Ms. Lucas, a friend since the 1980s. Her father, she told Ms. Lucas, was an alcoholic.

“I got the sense that she raised herself,” Ms. Lucas said. “She was so smart, they didn’t know what to do with her.”

Dr. Hoff earned a half scholarship to Washington University in St. Louis, from which she received a B.A. in 1960. She then earned a master’s in science from Yale, followed by an M.D. in surgery from the College of Physicians and Surgeons at Columbia in 1963. She returned to Washington University from 1971 through 1976, first as an instructor in pathology and then as a resident in psychiatry.

In the 1980s, Dr. Hoff sold her practice and moved to Hudson, in upstate New York. She worked for an outpatient clinic for the state in nearby Kingston, treating severely disabled, long-term psychiatric patients, including schizophrenics. After half a decade or so, she moved to a group practice in Pittsburgh and ended up working in Oakland, Calif., treating the formerly incarcerated through a program with the California Department of Corrections. Her last job was at San Quentin, where she treated prisoners on death row. She retired in 1999, after a prisoner attacked her.

“She did not recover well from that trauma,” Ms. Lucas said. “She said she couldn’t get mad, which would allow her to heal, because he was a patient. She would joke about it, ‘I thought it was going to happen today, but it only lasted a few seconds.’ She was enormously compassionate”

No immediate family members survive.

At the conclusion of “Becoming Jeanne,” Mr. Field asked Dr. Hoff how she would like to be treated. “What can we do, to accept you?”

She did not hesitate in her answer: “It may not be necessary for you to go to a lot of trouble to learn about accepting transsexuals if you have a general principle and that is, ‘Mind your own business,’ I suppose. It boils down to that.”

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