Lili Elbe

Lili Elbe (* 18 December 1882 in Vejle, Denmark; † 12 September 1931 in Dresden), born Einar Wegener [Andreas Sparre], Danish painter, one of the first people who underwent gender-affirming operations in the Institute of Magnus Hirschfeld and the Dresden Women’s Clinic.

At the time, Lili Elbe was one of the most spectacular cases in all of Europe of Kurt Warnekros [Werner Kreutz], gynaecologist and Head of the Women’s Clinic in Dresden, and Magnus Hirschfeld [Professor Hardenfeld] at his Institute for Sexual Science [Institut für Seelenkunde] in Berlin.

After several operations that resulted in gender reassignment, an attempt was made to transplant a complete uterus. However, whether this really involved a transplant or rather vaginoplasty remains disputed today. She died on 12 September 1931 in the Women’s Clinic and was buried there on 15 September 1931. Not much information on the cause of death was preserved. A newspaper article in “Die Geburtenregelung” of 1933 mentions cancer as the cause of death on page 33. Reference was also made to her dying from cardiac paralysis and that this could be regarded as having resulted from the final operation. However, more detailed information remains unclear since the records of the Women’s Clinic were lost in the war and the death certificate did not include any notes.

It was the summer of 1929 when Lili Elbe, following the advice of a girlfriend, met Kurt Warnekros in a Paris hotel. At this time, she complained regularly of severe abdominal pains and had already attended several renowned physicians in vain. A brief medical history review was followed by a palpatory examination. This confirmed a diagnosis for Kurt Warnekros but he kept this to himself and advised Lili Elbe to set off straight for Berlin to meet Magnus Hirschfeld and then travel to Dresden.

Lili Elbe followed Kurt Warnekros’ instructions in February 1930 and travelled to Berlin. On the first day in the Institute for Sexual Research, Felix Abraham [Professor Arns], probably carried out an initial appraisal for Kurt Warnekros and carried out a haemogram, since he worked in the Institute as forensic specialist. On the second day in the Institute, Lili Elbe then met Magnus Hirschfeld, who to begin with gave her a questionnaire. In the discussion, he then revealed that a transfer to the Women’s Clinic in Dresden could only occur if an initial operation had already occurred in Berlin. He emphasised the “women” in Women’s Clinic in this connection and indicated thereby the then external appearance. One can safely assume that this meant castration (orchiectomy). However, the performance of a penis amputation (penectomy) is open since details of the operation were not precisely addressed. Another discussion occurred on the third day in the Institute and a renewed blood sample, since the results of the first haemogram had turned out clearly female. However, it is unclear with whom the treatment occurred on the third day.

The first operation of which Magnus Hirschfeld spoke took place in a practice in Berlin and he was also present himself. Lili Elbe arrived there on 4 March 1930. This was probably Ludwig Levy-Lenz [Professor Gebhard], who had a practice on Rosenthaler Platz and was specialised in gynaecology and cosmetic medicine. Levy-Lenz also published several reports on similar operations ^[1] and an article of 1933 also referred to his work at the Institute. The operation took place on 5 March in the presence of an assistant of Kurt Warnekros to ensure that the former could report to him directly.

The physicians were also surprised by the initial changes after the operation. For example, Lili Elbe’s voice was much higher and resembled a soprano. Her features were more feminine and she was perceived by the staff as a woman.

On 14 March 1930, Lili Elbe prepared to leave for Dresden and had to submit to the taking of a final blood sample. The assistant doctor, who performed this in the practice of Levy-Lenz, did not recognise her.

In the Dresden Women’s Clinic it was necessary to wait for some time since the healing after the first operation was not yet complete. Kurt Warnekros then carried out the gender reassignment surgery on 26 May 1930. There is no doubt that he transplanted female gonads (ovaries). Further details of the operation were not stated and can no longer be reconstructed either.

In July 1930, Lili Elbe was discharged in a healthy condition from the Dresden Women’s Clinic and travelled with her wife Gerda [Grete] to Copenhagen. There she spent her time with friends and acquaintances from her period in the art scene of Copenhagen before returning to the Women’s Clinic for a final operation on 14 June 1931.

Initially, Kurt Warnekros was by no means convinced of the idea of a further operation but then agreed to this after a further examination. Lili Elbe had expressed the desire to be able to become a proper mother, which makes the assumption of a uterine transplant highly probable ^[2]. Lili Elbe underwent the operation on 17 June 1931. After the operation, there are unbroken reports of severe pain and a feeling of weakness, even the desire to die. After four months, Lili Elbe died on 12 September amidst her family.

At the beginning of September, she wrote a final letter:

Not much is known about Lili Elbe’s family background. She was born as the youngest of four children, three sons and one daughter, of a merchant in Vejle, Denmark. On the father’s side, the family came from Mallorca and only the grandparents moved to Jutland. Early on, Lili was often taken for a girl due to her long blond hair and very fair complexion. At the age of five, the kindergarten awarded her a prize in handwork for good performance in embroidery and knitting. Her brothers often teased her because of her girl’s voice. Lili attracted very little attention during her school years. She often attended the library and as a “proper boy” was involved in fighting. However, she felt uncomfortable during swimming lessons due to her boyish figure. The boys were usually physically more developed than her, as she reported.

After completing upper secondary school, she went to the Royal Danish Art Academy in Copenhagen to study at the age of 19. During her first year there, she met Gerda and both fell in love with each other at first sight. One year later, they married and several years later they were in great demand in the European art scene. They travelled a great deal and spent their time in Germany, France, Italy, the Netherlands and had a close connection to Copenhagen as long as they lived. There are already images and presentations of Lili Elbe in early pictures of Gerda and she had already adopted this first name a few years before the first operation. The surname Elbe was only added in the Dresden Women’s Clinic and was intended to remind her of the place that gave her a new life. It was there that she also decided to write a book about her life, which was published a year later by Niels Hoyer and appeared in German. On 5 June 1931, Lili Elbe decided that in the event of her not surviving the final operation, she would let her book end with the words of Hans Jäger.

I am happy to meet this wish here in closing:

[*] pseudonyms used in the biography

[1] This first complete surgical “genital transformation” was carried out like the second case of Arno (Toni) E by Ludwig Levy-Lenz at the Institute. Both cases were published by Abraham in 1931 in the Zeitschrift für Sexualwissenschaft.

[2] “I so much want to be a mother!” this impels me once again to write to you, friend and confessor, in great detail. – page 241

Author: Niki Trauthwein/Bundesstiftung Magnus Hirschfeld