The US FDA’s proposed rule on laboratory-developed tests: Impacts on clinical laboratory testing

Lili Elbe
Black-and-white photograph of Lili Elbe. She is a white woman with dark hair. She is wearing a sunflower dress and jewelry and holding a hand fan.
Elbe in 1926
Born(1882-12-28)28 December 1882
Vejle, Denmark
Died13 September 1931(1931-09-13) (aged 48)
Other namesLili Ilse Elvenes (legal name)
Spouse
(m. 1904; annul. 1930)

Lili Ilse Elvenes (28 December 1882 – 13 September 1931), better known as Lili Elbe, was a Danish painter, transgender woman, and one of the earliest recipients of gender-affirming surgery (then called sex reassignment surgery).[1][2]

She was a painter under her birth name Einar Wegener.[3] After transitioning in 1930, she changed her legal name to Lili Ilse Elvenes, stopped painting,[4] and later adopted the surname Elbe. She was the first known recipient of a uterus transplant in an attempt to achieve pregnancy, but died due to the subsequent complications.[5][6][7][8]

The UK and US versions of her semi-autobiographical narrative were published posthumously in 1933 under the title Man into Woman: An Authentic Record of a Change of Sex.[9][10] A film inspired by her life, The Danish Girl, was released in 2015. An opera based on her life, Lili Elbe, composed by Tobias Picker, premiered in 2023.[11][12][13]

Early life

It is generally believed that Elbe was born in 1882, in Vejle, Denmark, the child of Ane Marie Thomsen and spice merchant Mogens Wilhelm Wegener, according to the registry at St. Nicolai Church.[14][15] Her birth year is sometimes cited as 1886 by a book about her in which some facts have been changed to protect the identities of the persons involved. Facts about her wife Gerda Gottlieb's life suggest that the 1882 date is correct because they married while at college in 1904, when Elbe would have been just eighteen if the 1886 date were correct.[16][17]

It is speculated that Elbe was intersex,[18][19][20] although that has been disputed.[21] Some reports indicate that she already had rudimentary ovaries in her abdomen and may have had Klinefelter syndrome.[2][7]

Marriage and modelling

Black-and-white headshot of Gerda Gottlieb
Gerda Gottlieb, 1904
Illustration of Lili Elbe before transitioning.
Elbe c. 1920

Elbe met Gerda Gottlieb while they were students at the Royal Danish Academy of Fine Arts in Copenhagen,[22] and they married in 1904 when Gottlieb was nineteen and Elbe twenty-two.[23] Gerda came from a conservative family, as her father was a vicar in the Lutheran church.[24] They worked as illustrators, with Elbe specialising in landscape paintings while Gottlieb illustrated books and fashion magazines.

They travelled throughout Italy and France before settling in Paris in 1912, where Elbe could live more openly as a woman by posing as Gottlieb's sister-in-law.[25] Elbe received the Neuhausens prize [da] in 1907 and exhibited at Kunstnernes Efterårsudstilling (the Artists' Fall Exhibition) at the Vejle Art Museum in Denmark, where she remains represented, and in the Saloon and Salon d'Automne in Paris.[26]

Elbe started dressing in women's clothes after she found she enjoyed the stockings and heels she wore to fill in for Gottlieb's model, actress Anna Larssen [da], who, on one occasion, had been late for a sitting. Larssen suggested the name Lili, and, by the 1920s, Elbe regularly presented with that name as a woman, attending various festivities and entertaining guests in her house. Gottlieb became famous for her paintings of beautiful women with haunting, almond-shaped eyes, dressed in chic apparel. The model for these depictions of petites femmes fatales was Elbe.[27][28] Elbe stopped painting after her transition.[4][2]

Surgeries and dissolution of marriage

Full body photograph of Lili Elbe. She is looking at the camera while holding a letter
Elbe in 1930

In 1930, Elbe went to Germany for sex reassignment surgery, which was highly experimental at the time. She contemplated suicide before learning of these options.[29] While in Germany, Elbe stayed in the Hirschfeld Institute for Sexual Science.[30] Prior to commencing any surgical procedures, Elbe's psychological health was evaluated by German sexologist, Magnus Hirschfeld, through a series of tests.[30] A series of four operations were then carried out over a period of two years.[28] The first surgery, performed in Berlin, was the removal of the testicles, carried out by Erwin Gohrbandt.[31] The remainder of her surgeries were carried out by Kurt Warnekros, a doctor at the Dresden Municipal Women's Clinic.[30][32] All of Lili Elbe's medical documents were ruined as a consequence of the Allied bombing raids that destroyed the clinic and its archives.[30][33] The second operation was to implant an ovary onto her abdominal musculature and the third to remove the penis and the scrotum.[30][34] By this time, her case had become a sensation in Danish and German newspapers. A Danish court annulled the couple's marriage in October 1930,[35] and Elbe was able to have her sex and name legally changed, even receiving a passport as Lili Ilse Elvenes.[36] The name "Lili Elbe" was first used in print in a Danish newspaper article written by Copenhagen journalist Louise "Loulou" Lassen for Politiken in February 1931.[33][37] Elbe returned to Dresden and began a relationship with French art dealer Claude Lejeune, whom she wanted to marry and with whom she wished to have children.[8][38] Gerda went on to marry an Italian man after separating from Elbe, although the marriage ended in divorce shortly after.[39]

In 1931, Elbe returned for her fourth surgery, to transplant a uterus and construct a vaginal canal.[8][40][7] This made her one of the earliest transgender women to undergo a vaginoplasty surgery, a few weeks after Erwin Gohrbandt performed the experimental procedure on Dora Richter.[33]

Death

Following Elbe's fourth surgery, her immune system rejected the transplanted uterus, leading to organ rejection due to tissue incompatibility of the allografted uterus from the cisgender female donor, and ultimately a decrease in immunity. This ultimately caused an infection, which led to her death from cardiac arrest on 13 September 1931 in Dresden, Germany, three months after the surgery.[7][8][33][40][41]

Elbe was buried in Trinity Cemetery [de] in Dresden, Germany, but the grave was leveled in the 1960s. In April 2016, a new tombstone was inaugurated, financed by Focus Features, the production company that produced The Danish Girl.[42] The tombstone does not indicate the date of Elbe's birth, just her name and places of birth and death.[43]

Paintings

Apart from being one of the earliest recipients of gender-affirming surgery,[1][2] Elbe was also a painter, but quit once she transitioned.[4] The majority of Elbe's painting focused primarily on landscapes. She had many successful paintings, including Portrait de femme (1923), Parti Fra Capri (1921), View from the Garden of Versailles (1922), Costal View from France (1918), and Trianon (1920), to name a few.[44]

The LGBTQ+ film festival MIX Copenhagen gives out four Lili Awards each year, named after Elbe.[45]

In 2000, David Ebershoff wrote The Danish Girl, a fictionalized account of Elbe's life.[46] It was an international bestseller and translated into many languages. This novel provided one of the earliest fictional accounts of gender affirmation surgery, which shaped LGBTQ+ literature.[47] In 2015, it was made into a film of the same name, produced by Gail Mutrux and Neil LaBute, starring Eddie Redmayne as Elbe. The film was well received at the Venice Film Festival in September 2015,[48] though it has been criticised for casting a cisgender man to play a transgender woman.[49] Both the novel and film omitted several topics, including Gottlieb's sexuality, which is evidenced by the subjects in her erotic drawings,[50] and the disintegration of Gottlieb and Elbe's relationship after their annulment.[51]

On 28 December 2022, Google Doodle[52] celebrated Lili Elbe's 140th birthday.[53]

Tobias Picker's Lili Elbe, featuring Lucia Lucas, premiered at Theater St. Gallen, Switzerland.[54][55][56] Based on the life of Lili Elbe and the book Man into Woman: An Authentic Record of a Change of Sex,[57][58] the opera premiered on 22 October 2023,[59] and received "Best World Premiere" in the 2023 Oper! Awards.

Publications

In 1931, Lili Elbe was living in Denmark collaborating with her friend, Ernst Harthern, on a memoir of her life.[31] Fra Mand til Kvinde was published by her German friend and editor under the name of Neils Hoyer following Elbe's death.[60] The narrative provided details of her life as Danish painter and her gender confirmation surgery.[31] The possibility of Lili Elbe being intersex has been proposed due her reported possession of both male and female reproductive organs and the absence of medical records documenting her pre-surgical anatomy due to the Allied Bombing Raids. However, this theory has been disputed.[60] The narrative was published four times, in three different languages over the course of two years.[31] The UK and US versions, Man into Woman: An Authentic Record of a Change of Sex were both published in 1933.[9][10]

Man into Woman: An authentic Record of a Change of Sex brought attention to new medical interventions as the story of Lili Elbe was circulated through American publications.[61] American publications, such as "A Man Becomes a Woman” and “When Science Changed a Man into a Woman”, published in the popular magazine, Sexology, associated the story of Lili Elbe with cases of intersex sex changes.[61] These narratives promoted a binary view of gender, reinforcing gender stereotypes among Americans.[61]

Lili Elbe and her memoir became well known in European media, publicized by Paul Weber.[62] The story encouraged political action and brought awareness to the challenges faced by gender non-conforming people.[62]

References

  1. ^ a b Hirschfeld, Magnus (1926). "Chirurgische Eingriffe bei Anomalien des Sexuallebens". Therapie der Gegenwart (in German): 67, 451–455.
  2. ^ a b c d Koymasky, Matt & Andrej (17 May 2003). "Famous GLTB: Lili Elbe". HistoryVSHollywood.com. Archived from the original on 10 October 2007. Retrieved 2 February 2016. Based on Brown, Kay (1997); Aldrich R. & Wotherspoon G., Who's Who in Gay and Lesbian History, from Antiquity to WWII, Routledge, London, 2001. [better source needed]
  3. ^ Meyer 2015, pp. 15, 310–313.
  4. ^ a b c Meyer, Sabine (2015). »Wie Lili zu einem richtigen Mädchen wurde«: Lili Elbe: Zur Konstruktion von Geschlecht und Identität zwischen Medialisierung, Regulierung und Subjektivierung (in German). Verlag. pp. 311–314. ISBN 978-3-8394-3180-1.
  5. ^ Goldberg, A. E.; Beemyn, G. (2021). The Sage Encyclopedia of Trans Studies. Sage Publications. p. 261. ISBN 978-1-5443-9382-7. Archived from the original on 12 January 2023. Retrieved 12 January 2023.
  6. ^ Kroløkke, C.; Petersen, T. S.; Herrmann, J. R.; Bach, A.S.; Adrian, S. W.; Klingenberg, R.; Petersen, M. N. (2019). The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age. Emerald Studies in Reproduction, Culture and Society. Emerald Publishing Limited. p. 154. ISBN 978-1-83867-044-3. Archived from the original on 31 January 2023. Retrieved 31 January 2023.
  7. ^ a b c d "Lili Elbe Biography". Biography.com. A&E Television Networks. Archived from the original on 6 January 2019. Retrieved 11 December 2015.
  8. ^ a b c d "Lili Elbe: The Transgender Artist behind The Danish Girl". This Week Magazine. 18 September 2015. Archived from the original on 26 December 2018. Retrieved 1 February 2016.
  9. ^ a b Worthen, Meredith (n.d.). "Lili Elbe – Painter". Biography.com. Archived from the original on 6 January 2019. Retrieved 15 August 2016.
  10. ^ a b Elbe, Lili (2020). "Introduction". In Caughie, Pamela; Meyer, Sabine (eds.). Man Into Woman: A Comparative Scholarly Edition. Bloomsbury. ISBN 978-1-350-02149-5.
  11. ^ "Lili Elbe". tobiaspicker.com. Archived from the original on 18 October 2022. Retrieved 11 January 2022.
  12. ^ Charles Shafaieh. "Living Authentically". Opera News. Archived from the original on 18 October 2022. Retrieved 11 September 2022.
  13. ^ Cannon, Richard. "Lucia Lucas: The BBC Music Magazine Interview". BBC Music Magazine. Retrieved 11 September 2023.
  14. ^ Meyer 2015, p. 340.
  15. ^ "Kunstindeks Danmark & Weilbachs Kunstnerleksikon". kulturarv.dk (in Danish). Archived from the original on 30 April 2022. Retrieved 30 April 2022.
  16. ^ She and She: The Marriage of Gerda and Einar Wegener. The Copenhagen Post. 3 July 2000
  17. ^ "Ejner Mogens Wegener, 28-12-1882, Vejle Stillinger: Maler". Politietsregisterblade.dk. Archived from the original on 3 August 2015. Retrieved 30 December 2011.
  18. ^ Hoyer, Niels, ed. (2004). Man into Woman: The First Sex Change, a Portrait of Lili Elbe: The True and Remarkable Transformation of the Painter Einar Wegener. London: Blue Boat Books. pp. vii, 26–27, 172. ISBN 978-0-9547072-0-0.
  19. ^ "Lili Elbe's Autobiography, Man into Woman". OII Australia – Intersex Australia. OII Australia. 16 April 2009. Archived from the original on 28 March 2015. Retrieved 1 September 2015.
  20. ^ Vacco, Patrick (29 April 2014). "Les Miserables Actor Eddie Redmayne to Star as Queer Artist Lili Elbe". The Advocate. Archived from the original on 29 September 2015. Retrieved 1 September 2015.
  21. ^ Kaufmann, Jodi (January 2007). "Transfiguration: A Narrative Analysis of Male-to-female Transsexual". International Journal of Qualitative Studies in Education. 20 (1): 1–13. doi:10.1080/09518390600923768. S2CID 144939698.
  22. ^ "Conway's Vintage Treasures". Vintage-movie-poster.com. Archived from the original on 27 March 2019. Retrieved 8 April 2014.
  23. ^ "Biography of Gerda Wegener". Biography.com. Archived from the original on 16 May 2019. Retrieved 17 December 2019.
  24. ^ "Wegener, Gerda (1886–1940) – Danish". Archived from the original on 13 January 2022. Retrieved 13 January 2022.
  25. ^ "Gerda Wegener: The Truth Behind The Canvas". artefactmagazine.com. 7 March 2017. Archived from the original on 18 December 2019. Retrieved 17 December 2019.
  26. ^ The Arts and Transgender. renaissanceblackpool.org
  27. ^ Gerda Wegener. get2net.dk
  28. ^ a b "Lili Elbe (1886–1931)". LGBT History Month. Archived from the original on 3 August 2015. Retrieved 8 April 2014.
  29. ^ Vianello, Laura (2 December 2015). "Lili Elbe and Gerda Gottlieb: Defining Gender through Artistic Representation". Laura Vianello. Archived from the original on 6 April 2023. Retrieved 6 April 2023.
  30. ^ a b c d e Vicente, Marta V (23 September 2021). "The Medicalization of the Transsexual: Patient-Physician Narratives in the First Half of the Twentieth Century". Journal of the History of Medicine and Allied Sciences. 76 (4): 392–416. doi:10.1093/jhmas/jrab037. ISSN 0022-5045. PMID 34553224. Archived from the original on 2 July 2023. Retrieved 26 March 2023.
  31. ^ a b c d "Lili Elbe Digital Archive". www.lilielbe.org. Archived from the original on 18 December 2019. Retrieved 26 March 2023.
  32. ^ Brown, Kay (1997) Lili Elbe. Transhistory.net.
  33. ^ a b c d "A Trans Timeline – Trans Media Watch". Trans Media Watch. Archived from the original on 26 December 2018. Retrieved 3 February 2016.
  34. ^ Meyer 2015, pp. 271–281
  35. ^ Meyer 2015, pp. 308–311
  36. ^ "Man Into Woman". Archived from the original on 18 December 2019. Retrieved 17 December 2019.
  37. ^ Loulou Lassen (28 February 1931). "Lili Elbe Digital Archive – Contextual Material – Et Liv gennem to Tilværelser". Politiken. Archived from the original on 2 October 2021. Retrieved 2 October 2021.
  38. ^ "The Incredibly True Adventures of Gerda Wegener and Lily Elbe". Coilhouse.net. Archived from the original on 11 May 2019. Retrieved 17 December 2019.
  39. ^ "Gerda Wegener – Art, Death & Facts". Biography. 6 April 2021. Archived from the original on 1 April 2023. Retrieved 26 March 2023.
  40. ^ a b Harrod, Horatia (8 December 2015). "The Tragic True Story Behind The Danish Girl". The Telegraph. Archived from the original on 21 April 2016. Retrieved 11 December 2015.
  41. ^ "Lili Elbe (Einar Wegener) 1882–1931". Danmarkshistorien.dk (in Danish). 10 September 2013. Archived from the original on 5 April 2016. Retrieved 2 February 2016.
  42. ^ "Letzte Ehre fürs Danish Girl" [Last honor for the Danish Girl]. Queer.de (in German). 23 April 2016. Archived from the original on 21 June 2018. Retrieved 24 May 2017.
  43. ^ Haufe, Kay (22 April 2016). "Hollywood rettet Lili Elbes Grab" [Hollywood saves Lili Elbe's grave]. Sächsische Zeitung (in German). Archived from the original on 21 June 2018. Retrieved 26 April 2016.
  44. ^ Shennan, Rhona (28 December 2022). "Lili Elbe Paintings: Who was Transgender Artist, is The Danish Girl Film About Her, When was Her Death?". Archived from the original on 6 April 2023. Retrieved 6 April 2023.
  45. ^ "MIX Copenhagen LGBT Film Festival – LGBTQ – Copenhagen". ellgeeBE. Archived from the original on 9 December 2018. Retrieved 8 December 2018.
  46. ^ "Books of the Times; Radical Change and Enduring Love". The New York Times. 14 February 2000. Archived from the original on 25 December 2018. Retrieved 11 December 2015.
  47. ^ "International Journal Of Arts, Humanities & Social Science". ijahss.net. Archived from the original on 26 March 2023. Retrieved 26 March 2023.
  48. ^ "The Danish Girl Wows With 10-Minute Standing Ovation In Venice Premiere". Deadline. 5 September 2015. Archived from the original on 15 April 2019. Retrieved 6 September 2015.
  49. ^ Denham, Jess (12 August 2015). "The Danish Girl: Eddie Redmayne Defends Casting as Trans Artist Lili Elbe After Backlash". The Independent. Archived from the original on 12 May 2019. Retrieved 7 March 2016.
  50. ^ "The Incredibly True Adventures of Gerda Wegener and Lili Elbe". coilhouse.net. 3 August 2012. Archived from the original on 11 May 2019. Retrieved 26 January 2016.
  51. ^ "Reading Group Notes The Danish Girl". allenandunwin.com. Archived from the original on 24 May 2020. Retrieved 10 December 2015.
  52. ^ "Lili Elbe's 140th Birthday". www.google.com. Archived from the original on 28 December 2022. Retrieved 28 December 2022.
  53. ^ "28 December: Google Doodle Celebrates Lili Elbe's 140th Birthday". Observer Voice. 28 December 2022. Archived from the original on 28 December 2022. Retrieved 28 December 2022.
  54. ^ "Lili Elbe". tobiaspicker.com. Archived from the original on 18 October 2022. Retrieved 11 January 2022.
  55. ^ Charles Shafaieh. "Living Authentically". Opera News. Archived from the original on 18 October 2022. Retrieved 11 September 2022.
  56. ^ "Lili Elbe". tobiaspicker.com. Archived from the original on 18 October 2022. Retrieved 18 October 2022.
  57. ^ Worthen, Meredith (n.d.). "Lili Elbe – Painter". Biography.com. Archived from the original on 6 January 2019. Retrieved 15 August 2016.
  58. ^ Elbe, Lili (2020). Caughie, Pamela; Meyer, Sabine (eds.). Man Into Woman: A Comparative Scholarly Edition. Bloomsbury. Introduction. ISBN 978-1-350-02149-5.
  59. ^ "Lili Elbe: Oper von Tobias Picker und Aryeh Lev Stollman". konzertundtheater.ch. 10 July 2023.
  60. ^ a b Gailey, Nerissa (15 October 2017). "Strange Bedfellows: Anachronisms, Identity Politics, and the Queer Case of Trans*". Journal of Homosexuality. 64 (12): 1713–1730. doi:10.1080/00918369.2016.1265355. ISSN 0091-8369. PMID 27892825. S2CID 11678847. Archived from the original on 2 July 2023. Retrieved 26 March 2023.
  61. ^ a b c Meyerowitz, Joanne (1998). "Sex Change and the Popular Press: Historical Notes on Transsexuality in the United States, 1930–1955". GLQ: A Journal of Lesbian and Gay Studies. 4 (2): 159–187. doi:10.1215/10642684-4-2-159. ISSN 1064-2684.
  62. ^ a b Sutton, Katie (May 2012). "'We Too Deserve a Place in the Sun': The Politics of Transvestite Identity in Weimar Germany". German Studies Review. 35 (2): 335–354. doi:10.1353/gsr.2012.a478043. JSTOR 23269669. Archived from the original on 29 March 2023. Retrieved 26 March 2023.

Further reading

  • Man into woman: an authentic record of a change of sex / Lili Elbe; edited by Niels Hoyer [i.e. E. Harthern]; translated from the German by H.J. Stenning; introd. by Norman Haire. London: Jarrold Publishers, 1933 (Original Danish ed. published in 1931 under title: Fra mand til kvinde. Later edition: Man into woman: the first sex change, a portrait of Lili Elbe – the true and remarkable transformation of the painter Einar Wegener. London: Blue Boat Books, 2004.
  • Schnittmuster des Geschlechts. Transvestitismus und Transsexualität in der frühen Sexualwissenschaft by Dr. Rainer Herrn (2005), pp. 204–211. ISBN 3-89806-463-8. German study containing a detailed account of the operations of Lili Elbe, their preparations and the role of Magnus Hirschfeld.
  • "When a woman paints women" / Andrea Rygg Karberg and "The transwoman as model and co-creator: resistance and becoming in the back-turning Lili Elbe" / Tobias Raun in Gerda Wegener / edited by Andrea Rygg Karberg ... [et al.]. – Denmark, Arken Museum of Modern Art, 2015.