   
Dr. Eli Coleman Narrator   Andrea Jenkins Interviewer 
    
The Transgender Oral History Project Tretter Collection in GLBT Studies University of Minnesota 
February 29, 2016 
 
 
   

 
  
The Transgender Oral History Project of the Upper Midwest will empower individuals to tell their story, while providing students, historians, and the public with a more rich foundation of primary source material about the transgender community.  The project is part of the Tretter Collection at the University of Minnesota.  The archive provides a record of GLBT thought, knowledge and culture for current and future generations and is available to students, researchers and members of the public. 
The Transgender Oral History Project will collect up to 400 hours of oral histories involving 200 to 300 individuals over the next three years.  Major efforts will be the recruitment of individuals of all ages and experiences, and documenting the work of The Program in Human Sexuality.  This project will be led by Andrea Jenkins, poet, writer, and trans-activist.  Andrea brings years of experience working in government, non-profits and LGBT organizations.  If you are interested in being involved in this exciting project, please contact Andrea. 
Andrea Jenkins jenki120@umn.edu (612) 625-4379 
   
 
Andrea Jenkins -AJ 1 
Dr. Eli Coleman  -EC 2 
 3 
 4 
AJ: My name is Andrea Jenkins and I am the oral historian for the Transgender Oral History Project 5 at the University of Minnesota.  Today is February 29th  its a leap year, 2016.  And I am here 6 today at the University of Minnesotas Center for Sexual Health, Program in Human Sexuality, 7 talking with the esteemed Dr. Eli Coleman.  Dr. Coleman, Im going to ask you to introduce 8 yourself, state your gender identity, what are your preferred pronouns, and just because every 9 other participant in this project has had to say this, tell me what was your gender assigned at 10 birth. 11 
EC: So Im Eli Coleman and I am a professor and director of the Program in Human Sexuality at the 12 University of Minnesota Medical School.  The Center for Sexual Health is our clinical enterprise 13 under the umbrella of the Program in Human Sexuality.  Im also the first endowed chair in 14 sexual health here at the University. 15 
AJ: Wow. 16 
EC: I was assigned male at birth and my gender identity is male and preferred pronouns are he and 17 him.  18 
AJ: Wow, thank you.  You mentioned in your introduction youre the first endowed chair in sexual 19 health at the University of Minnesota.  What does that mean, just in historical terms at the 20 University of Minnesota?  And also, are there many other endowed chairs in sexual health 21 around the country or around the world that youre familiar with? 22 
EC: At present we have the only two endowed chairs in sexual health, both here at the Program in 23 Human Sexuality.  So the first chair was really established to support the director and provide 24 infrastructure support for the program and to ensure the continuity of the program in 25 perpetuity.  And, so that chair was established in 2007 and then we embarked on endowing a 26 second chair in sexual health education and that was named after the former US Surgeon 27 General, Jocelyn Elders, and that chair was established in . . . well it was finished in 2012 and 28 then we started the recruitment for that holder and in 2015, we had the inauguration of that 29 chair and Michael Ross was the appointed chair holder. 30 
AJ: So you hold the first chair and its named the Eli . . .  31 
EC: No, its not named.  Mostly chairs are named after people, right?  Usually after the benefactor 32 but the first chair was really supported by 300 different donors from all over the place and so 33 we just call it an academic chair in sexual health and it has no name.   34 
AJ: Youre going to have to change that one of these days.  I think it should be called the Eli 35 Coleman Chair in Sexual Health.  Well have to get to work on that.  How long have you been a 36 part of the program here at the University of Minnesota? 37 
EC: I started in an internship while I was working on my doctorate here at the University of 1 Minnesota and I did an internship here in 1977.  I did my dissertation here and then they hired 2 me immediately and so I came on faculty in 1978.  So Ive been here since 1978.   3 
AJ: Wow, thats quite some time.  Thats close to 38 years or so. 4 
EC: Its been a while.   5 
AJ: I think I know this to be true is that the Program in Human Sexuality was one of the first 6 programs to deal with transgender health and gender identity issues and concerns in the 7 country.  How do you think that came about?  Or do you have any knowledge of how that 8 particular focus came about for the Center for Sexual Health here at the University?   9 
EC: Well first of all it didnt start with the Program in Human Sexuality.  It did start at the University 10 of Minnesota but it started out of the Department of Psychiatry.  Don Hastings was the impetus 11 for establishing that program and I dont know the complete history of the early history.  But he 12 began his early work in the 1960s and so he led that effort through the 1970s and then he died 13 and really left a vacuum of leadership for that program in the Department of Psychiatry.  This 14 was just about the same time that I really kind of came onboard to the Program in Human 15 Sexuality so I remember being a part of some of the discussions of what the Department of 16 Psychiatry was going to do with that program.  We were invited to consult with them and it was 17 also at a pivotal time because Johns Hopkins was also . . . that was really the first center to do 18 sex reassignment surgery and the impetus there was John Money.  And then in 1979, a man 19 named John Meyer wrote a follow-up study that was published in a prestigious psychiatry 20 journal and sort of declared the experiment as a failed one.  This sent shock waves throughout 21 the country in terms of . . . because there were other programs at that time, like the University 22 of Galveston . . . or the University of Texas at Galveston.  There was a program in Virginia . . . 23 there were a number of . . . and at Stanford.  There were a number of programs around the 24 country . . . academic health centers doing sex reassignment.  It really gave pause to was this 25 something that was really helping people.  So, that gave the Department of Psychiatry some 26 pause too.  Fortunately, Dr. Sharon Satterfield had just been hired as director in 1979 here.  She 27 came from the University of Maryland but had worked with John Money at Hopkins and had a 28 fair amount of experience working with trans individuals.  And, there was no question on her 29 part that sex reassignment was a valid approach and essentially what happened is that the 30 Department of Psychiatry, without a real leader and people who felt rather ambiguous about 31 the program, Sharon offered to take the program over from Psychiatry and bring it over to the 32 Program in Human Sexuality.  So the program was transferred over here and has remained at 33 the Program in Human Sexuality ever since.   34 
AJ: Wow.  What has been, in your mind  over time, the support for this kind of work within the 35 university system and the medical school? 36 
EC: It was always very supported. 37 
AJ: Very much supported. 38 
EC: I dont remember . . . any controversy was really more internal in that department.  I dont know 39 that there was really much until that John Meyer report came out.  But as I say that, when we 40 took it over . . . and again, I dont remember really controversy, but there was certainly people 1 that still wondered is this the right thing to do.  Certainly we didnt have a lot of research 2 evidence to really support it and it was really still considered experimental, although it was not 3 under any kind of research protocol.  And I certainly remember educating the medical students 4 and them just sort of horrified that we would be doing sex reassignment surgery and really 5 viewing . . . really not understanding at all gender dysphoria or transgender people at all.  So, we 6 were kind of viewed with some suspicion or doubt, but I dont remember . . . Im reacting to the 7 word controversy.   8 
AJ: Yeah.  Thats wonderful to hear.  I think partly what prompts the question is that transgender 9 people and identities have been certainly marginalized within the broader society and so just 10 thinking what was the academic and the medical industry sort of feelings around that topic, 11 particularly in its earlier stages.  And so, you mentioned that there was some skepticism about 12 the approach, how has that changed over time in your perception or as youve seen it sort of 13 change over time? 14 
EC: Ive seen it dramatically change.  First of all I can think of what was the year that there was the 15 court ruling to have medical assistance pay for sex reassignment.  That had to have been in the 16 1980s. 17 
AJ: Yes. 18 
EC: The exact year . . . Im blocking on it right now. 19 
AJ: I just had a conversation with one of your other colleagues, Dr. Katie Spencer, and she . . . I think 20 she said 1988. 21 
EC: That sounds about right, and certainly Dr. Satterfield was really key to getting that really 22 approved.  It was a court ruling and so that was a big shift  that there was a recognition that 23 this was a health care benefit.  And then we really started challenging a lot of the other health 24 plans to really start covering reassignment as part of the health plan. 25 
AJ: As a medical necessity? 26 
EC: Yes.  And I think that we were . . . we were really very successful and then we were the first 27 state to have an antidiscrimination law around transgender which was . . . that was huge.  I think 28 that that was a result of this whole climate here where this was a recognized center for sex 29 reassignment.  People came here from all over the place, not only for the services but there was 30 a community that was being built here and so trans people could really come and live in the 31 Twin Cities and really feel safe.   32 
AJ: And supported. 33 
EC: I have to tell you one story, because when I was an undergrad in Milwaukee, at Marquette 34 University, I worked at the state mental hospital my senior year.  So this is 1969 and I knew 35 nothing about the University of Minnesota, I knew nothing about the program here  anything.  36 I was just an aide there, more of a job to help me pay through college.  There was this one 37 patient who identified as transsexual.  I was really struck by meeting this individual because 38 most people on the ward were completely psychotic and didnt know where they were.   39 
AJ: Non-communicative. 1 
EC: Well they were communicative but didnt know where they were or what was going on.  This 2 person was very sane and I sort of remember saying, Well, why are you here?  And him saying 3 . . . I say him because he was appearing as a male, and he said, All I need to do is get to the 4 University of Minnesota to get a sex change operation, that is my problem.  That was my first 5 exposure to anything like that or hearing about the University and its program.  And years later, 6 ironically I end up here.  But that was a very poignant moment of meeting that individual.   7 
AJ: Do you have any sense that that person ever made it here? 8 
EC: I dont know. 9 
AJ: Wow.  That is an interesting story.  What all happens here at the Program in Human Sexuality?  10 Weve talked a little bit about the transgender services, but what other types of . . .? 11 
EC: Before you go on to that, I want to finish . . . this change in attitude.  12 
AJ: Yes, thank you. 13 
EC: I think one critical thing that the program did was, we have a required course for all medical 14 students in human sexuality, and we were one of the first programs  first medical schools in the 15 country to have such a course.  And, from the very beginning we were teaching around 16 transgender issues  from the beginning. 17 
AJ: From the very beginning.   18 
EC: So this was a part of everyones education.  So, the medical profession . . . I told you about some 19 of the skepticism, but through the course we were changing attitudes and perceptions by giving 20 them solid knowledge about this.  And so, over time, I think that that helped change the climate 21 in the medical profession.  And, over time, I saw the students evolving and becoming more open 22 and understanding and accepting.  One of the main methods that we used were panel 23 discussions and so they were able to really meet trans people and talk to them directly rather 24 than just talking about studies or just giving them a lecture.  That was profoundly influential in 25 terms of their attitudes.  And over time, the questions that they would ask would evolve and the 26 whole attitude of the class sort of would evolve to the point where they were kind of upset to 27 hear that people were denied health care coverage or the kind of discrimination that they would 28 receive in medical settings.  And their questions became more about how can we be better at 29 doing this and so thats been a real kind of shift.  And now the medical students, they all want to 30 learn as much as they can about trans medicine and trans health care.  Its just an amazing 31 transformation that Ive seen over the years. 32 
AJ: So full disclosure, I have to say that Im proud to have been a part of some of those panel 33 discussions and hopefully . . . well, as you said, they have shifted ideas over time.  Thats been a 34 really high point for me as an out transgender person, but also as someone who considers 35 myself an advocate and an educator as well.  Im glad to hear that sort of acknowledgement and 36 the shift in attitudes over time given, in large part, to the education that you guys have been 37 providing to medical school students and positions over time.   38 
EC: Well your involvement, and other peoples involvement, was really transformative  really 1 transformative.  It just . . . all their myths were demystified and they had to really . . . yeah, it 2 was a real eye-opening experience for them and they couldnt think about it in the same way 3 after they would hear your personal story. 4 
AJ: So what else does happen here at the Program in Human Sexuality in terms of the services that 5 are offered, the type of research that happens here at the Center? 6 
EC: So the program, it provides education and thats how it was founded  to educate medical 7 students and residents.  It expanded to all health care professionals.  In 1973 we started to . . . 8 that was in 1970 the program started.  In 1973, we started offering sexual health care services 9 to, from the very beginning, a wide range of services to people with any kind of sexual, not just 10 sexual dysfunction or people that were victims of sexual assault or perpetrators of sexual assault 11 or people worrying about sexually transmitted infections or sexual orientation conflict or gender 12 identity concerns.  We dealt with all of those things since 1973.  And then the research began 13 too, and so the program is involved in a lot of research over the years, different topic areas 14 depending upon different faculty members interest.  And I think meeting community health 15 needs was a way that topics were decided upon.  And then, really from the very beginning 16 faculty were always involved in public policy advocacy so they would really try to bring the 17 science to policy makers to really help them make better decisions.  So those are the four arms 18 of the program.  I think in terms of the clinical services, again that started and that has really 19 grown and we still address all sorts of sexual issues and gender issues, how we define sexuality 20 encompasses gender  some people dont see it that way, they see it as separate issues and 21 certainly there is a difference between sex and gender.  But if you use a broad definition of 22 sexuality or gender or gender identity or gender expression or sex roles are all encompassed 23 under ones sexuality.   24 
AJ: Wow.  Say more about that.  You just exploded this whole narrative that gender identity is over 25 here and sexual identity is over here and everybody has got to understand that, and youre 26 saying that its a little more nuanced than that, that its a little more conflated than that.   27 
EC: Yeah.  Weve always used a very broad definition of sexuality and if you go back to the first 28 definition of sexual health that was defined by the World Health Organization in 1975, its very, 29 very broad.  And then it wasnt until 1987 that there was a WHO definition of sexuality and it 30 further articulated how broad it really . . . I remember, again, the Program would always say that 31 sex is only a part of sexuality.   32 
AJ: Meaning the act of sex. 33 
EC: The act of sex.  Even if you look at ones physical identity, ones sex is just a part of sexuality and 34 then a part of our sexuality is our desires for warmth, tenderness, contact for warmth.  It 35 includes our eroticism, it includes, again, our sexual identity which can be our natal sex, what 36 were born as, our gender identity, our gender expression, our sex role identity, and our sexual 37 orientation.  And those are all different components of sexual identity and you see, gender is 38 subsumed under sexual identity.  Yeah, its interesting how this division between sexual identity 39 and gender identity has sort of evolved and gender, the whole notion of gender, wasnt 40 invented until the mid-1950s  a term that was coined by John Money, again one of the 41 pioneers in this whole field, and had to invent that term to understand.  It started with his study 1 of intersex conditions and seeing gender as a separate component of ones sexual identity.  So, I 2 still see gender as a part of sexuality but some people want to see it as something completely 3 different.   4 
AJ: How do you define intersex?  You kind of threw that term in there and . . . you know, because a 5 wide variety of people may be viewing this at some point in time, just so we know what you 6 mean by the term intersex.   7 
EC: Well, intersex are individuals that are either born with or . . . well, first they may be born with 8 ambiguous genitalia because of chromosomal abnormalities or hormonal abnormalities, or 9 people feel variations that were not all male and female, but in some cases that there is sort of . 10 . . if something does not go as nature would plan it.  And so people are born in ambiguous 11 fashion, or later in development things dont turn on at the time that they should, like at 12 puberty, and so some people . . . we dont even discover that they may be intersexed until they 13 are at puberty or they try to conceive a child and something is not right.  14 
AJ: So, I think probably the majority of people think that intersex identity, or intersex people, are 15 born with sort of both sexual characteristics of this term we call gender.  So female and male 16 genitals.   17 
EC: All it really means is that they have male or female . . . the body parts are mixed or different. 18 
AJ: Ambiguous. 19 
EC: It says nothing about their gender, it is their sex  in the technical sense.  And then as everybody 20 develops a gender identity, some of them may develop confusion about their gender identity 21 because of what they see their body as and what may be in their mind.  Again, gender identity is 22 something that happens in the brain. 23 
AJ: Does the Program work with individuals who identify or have been identified as intersex?  24 
EC: Yes.  And we get involved with the kids that are born with these conditions and their decisions 25 that need to be made about how to manage and deal with their sex and their emerging gender. 26 
AJ: I know you said earlier that Dr. Satterfield started seeing and treating transgender identified 27 persons in 1973.   28 
EC: No, she didnt come until 1979. 29 
AJ: In 1979, Im sorry. 30 
EC: So there were other people who were working with trans people before that. 31 
AJ: OK, but she came in 1979. 32 
EC: Most of the gender . . . were over in psychiatry, they were being seen in psychiatry.  They were 33 coming here too, but if they were wanting sex reassignment, they were over in the Department 34 of Psychiatry. 35 
AJ: OK.  Do you have a sense of how many people may have been able to access sexual 1 reassignment surgery over the time that that surgery was being offered here at the University? 2 
EC: Surgery was offered up until . . . I dont know the last date, whether it was in 1977 or 1978.  We 3 lost our surgeon so he moved away, as best as I know.  So the University had someone who was 4 doing most of the surgeries and left.  It wasnt because we didnt want to do them or whatever, 5 it was just . . . 6 
AJ: The capacity, the person, was gone. 7 
EC: But obviously people continued to be evaluated and they were given hormones if that was 8 indicated and then they were referred to surgeons around the country. 9 
AJ: Any sense of the numbers?  I feel like Ive heard 40 people or . . . I dont know the exact 10 numbers though. 11 
EC: It seems that it was more than that.  It seems that there were . . . I mean, there were not 12 hundreds of people but I would say that there was . . . maybe there was somewhere between 50 13 and 100 that were done by 1979.   14 
AJ: Wow.  Any idea of how many transgender or gender . . . people presenting with what was called 15 gender dysphoria have come through the Program here at the University? 16 
EC: Since . . .? 17 
AJ: Since its inception? 18 
EC: I have no idea.  Boy, Id have to . . . I really dont know.  For a long while, of the whole clinic 19 population it seems that about 15% of our patients have been in our transgender program.  We 20 see . . . of course its grown over the years from 1979 until now, but now we see about 1200 21 patient visits a month and we probably see about 700-800 new patients a year.  So were talking 22 about at least 100 new patients a year.   23 
AJ: Wow.  Of trans-identified . . . 24 
EC: Yes. 25 
AJ: Wow.  That number seems . . . and I know this Program is no longer the only resource for . . .  26 
EC: No, theres a lot of other resources so there are a lot more . . .  27 
AJ: What do you attribute to that?  Is it because society has changed and people feel more 28 comfortable either expressing their gender identity or at least accessing information about it?  29 Or are there just more transgender people than there ever has been in time?   30 
EC: I think its only a matter of people really coming out of the closet and accessing services that are 31 available with the . . . every kind of media attention, it just increases the awareness and just 32 since Caitlyn Jenner came out, we see the impact of that  more and more people willing to 33 start dealing with it openly and seek help.   34 
AJ: And it also, you know, seems like people are becoming aware and accessing services at a much 1 earlier age as well. 2 
EC: Yes. 3 
AJ: Is the Center developing an approach or protocol around working with younger transgender-4 identified or gender-confused young people?   5 
EC: And thats probably our most recent develop is developing our child and adolescent services.  6 We mostly always dealt with adults and then finally had some faculty that were interested in 7 working with kids and really supported that.  We were only dealing with people that, after years 8 of damage and suffering that were kind of . . .  9 
AJ: Trauma. 10 
EC: And to be able to work with people at a younger age that we may help them deal with it then 11 was a very attractive idea.  So we opened those services and we quickly became overwhelmed 12 with the amount of people that were trying to come in.  We couldnt accommodate everyone 13 and so we started to . . . we decided to narrow the kind of children and adolescents that we 14 would take in and we quickly narrowed to gender  kids with gender issues rather than other 15 kind of sexual kinds of problems.  And the problem is that we cant even keep up with that 16 demand.  Its very disturbing that we cant because there are kids and parents that are just . . . 17 they just dont know what to do and we just dont have enough people to really, with the 18 expertise of being able to work with kids and with the gender issues, its just not something that 19 any therapist can do.   20 
AJ: What is your thoughts around the debate of medically treating younger people to either 21 postpone or delay puberty and help that transition along?  Or waiting until after puberty and 22 then pursuing medical treatment if they are still interested in that?  Do you have thoughts 23 around that? 24 
EC: Well certainly its one of the most . . . its one of the more significant recent developments of 25 really having some research and experience of really treating kids before puberty  using 26 puberty-blocking hormones.  And this has really been a tremendous help to these kids who are 27 very uncomfortable with their bodies and having a different gender identity.  And with the use 28 of puberty-blocking hormones is not a final treatment, but it buys time for these kids to sort out 29 their gender identity, that its not irreversible.  It saves them from developing all the secondary 30 sex characteristics in the case that they do want to go through sex reassignment, which would 31 then have to reverse all of those changes that have already taken place.  So, from a physical 32 standpoint of the effectiveness of hormonal and surgical reassignment, it makes it much easier 33 for them but it also gives them tremendous psychological relief at an earlier age.  And so, the 34 only thing that we are concerned about is that we dont completely know about the long-term 35 effects of those puberty-blocking hormones  that they are impacting peoples physical 36 development.  And this could have some long-range negative possibilities, but its like probably 37 any medical procedure, there is a cost benefit analysis that has to be made.  But it is not 38 necessarily a benign treatment and those kids need to be carefully evaluated before they go on 39  and they are.   40 
AJ: Sure. 1 
EC: But it has been, I think, rather life saving for many of them to get help earlier.  We dont have a 2 lot of follow-up study yet too to see in the long run has this really kind of helped.  Certainly 3 anecdotally or case report is that its been very good.  4 
AJ: Yeah, I mean you talk about the balancing  its the emotional health versus what the impacts 5 are to your physical health.  And you know both can affect each other.  One of the things that 6 fascinates me about the Center for Sexual Health and the Program in Human Sexuality and the 7 transgender services that are provided here is that prior to Dr. Spencer coming here, yourself 8 and Dr. Walter Bockting had really sort of solidified yourselves as world thought leaders around 9 transgender health, sexual health, and HIV prevention, which in turn put the Center in 10 leadership roles in some of the international organizations that promote transgender health.  11 Im referring specifically to the Harry Benjamin Association and now what is known as WPATH.  12 Tell me about the role that yourself and the program here in human sexuality played in the 13 development of these bodies that sort of shape the international thought process around 14 transgender health. 15 
EC: Well, I think we had a tremendous impact.  First we need to start and give credit to Dr. 16 Satterfield, who was a very active member of the Harry Benjamin Association and so she was . . . 17 she kept us very involved with the international scene from the very beginning.  Again, when I 18 came on board and in the first couple of years, I wasnt . . . Sharon was doing her thing and I was 19 focusing on . . . my interest area was sexual orientation.  And the transgender issue was 20 something I really didnt know anything about really.  So, I didnt really get involved right away 21 with that part of the clinical services or the program.  I started to become involved later on but . 22 . . 23 
AJ: You had a responsibility for running the entire Center, right? 24 
EC: I was the coordinator of the clinical services and then I became associate director under Dr. 25 Satterfield.  But that was still her thing and I was focusing on some other issues.  But whats 26 really very critical is that we were able to recruit Walter Bockting from the Netherlands as a 27 post-doctoral fellow in 1988.  That was at a time that Dr. Satterfield had resigned as director.  28 She was still in the department but moving into a different area.  She was still doing work with 29 trans but not with the program.  And with her departure that was an enormous void of 30 leadership and actually Michael Metz stepped in to manage the gender program on an interim 31 basis, although, again, that was not his passion but he took it over.  And then when Walter 32 came, he really jumped in because that was his passion.   33 
AJ: Sure. 34 
EC: That really saved . . . I think that really . . . without someone like him to really continue the 35 program, Im not sure if it would have survived.  But he really took it over and started to build on 36 Dr. Satterfields work but also take the whole program in some different directions.  He became 37 immediately involved with the Harry Benjamin Association and then Im getting pulled into that 38 organization at that time.  Again, I am really kind of learning from those people.  I really . . . this 39 is all new to me really and I always felt that they were more expert at this than I was.  But I was 40 going to the Benjamin Association meetings and I was learning a lot from others and then I was 1 starting to see patients and so that was good.  Walter and I both saw that the organization was 2 really stuck in a very old paradigm and a very gender-binary paradigm, a very . . . you know, 3 trying to diagnose the true transsexual and it was all about transsexuals and nothing about the 4 whole diversity beyond binary.  And really it was Walter that really started to really talk about 5 management of gender dysphoria across the spectrum and really helping people identity what 6 was helpful to them rather than following some sort of script of going from one box to another.  7 So, I learned about that and I became . . . I was more senior than Walter at that time and so I 8 was able to influence the organization in a way that I dont think Walter was able to do at that 9 point.  We really started kind of shifting it and then I became president of the Harry Benjamin 10 Association and had more impact that way.  I was very involved in the revision of the standards 11 of care and thats where we really started changing the paradigm for the field.  But I would say 12 that it was so many of Walters . . . he was the expert, I really was the messenger.  We did some 13 fascinating . . . I got more interested in trans issues from the angle of sexual orientation and 14 looking at how people could identify as trans and then how they would identify in terms of their 15 sexual orientation and if that would change with transition or not.  An old paradigm was that a 16 true transsexual should really become normal in the heterosexual sense.  I was fascinated with 17 all of these trans people who came out as trans and then came out as lesbian or bisexual or gay 18 and essentially had to go through two coming out processes.  That was my interest area and also 19 at that time the idea of a female to male transsexual identifying as gay or being attracted to 20 men . . . people didnt even believe that that existed and we were able to document some of the 21 very early cases of people like that. We were concerned too because people were being denied 22 sex reassignment because if they felt that they were going to be lesbian or gay after 23 reassignment . . .  24 
AJ: Then youre not a true . . . 25  26 
EC: You werent a true transsexual, you were probably gay or something like . . . so we were really 27 trying to debunk a lot of that misunderstanding and helping people understand that sexual 28 orientation and gender identity are two separate issues.  Anyway so we really did have a . . . and 29 then so were trans . . . I think were having a big impact on how people are treated clinically but 30 also we were starting to do more research and particularly at that time, the transgender 31 population was deeply affected by the HIV epidemic and there were much higher rates of HIV 32 infection and we were trying to understand what was that about and what we could do in terms 33 of prevention and Walter developed . . . again got one of the very first grants.  I think he really 34 got the first grant on HIV and trans and that little grant from the amfAR Foundation ended up 35 with support from the Minnesota Department of Health and developing prevention programs.  36 And then ultimately with funding from the National Institute of Health . . . so that research has 37 been very, very helpful in looking at not just at HIV factors but the understanding of the role of 38 stigma and discrimination and how that impacts mental health as well as sexual health and high 39 risk sexual behavior. 40 
AJ: And resiliency and how people can overcome some of those challenges.   41 
EC: Yes. 42 
AJ: Is the Program still engaged in those organizations and in the leadership? 1 
EC: I dont know if I can remember the whole sequence of events but . . . yeah, probably the first 2 thing is that the organization was in trouble just organizationally and so we were willing to take 3 on the executive offices.  So we brought the organization here and sort of provide the 4 secretariat for the organization. 5 
AJ: The recordkeeping, the . . .  6 
EC: Yeah, the membership, the running of the symposiums.  So we really took that over and Bean 7 Robinson, who is on faculty, became the executive director.  We had . . . she just really 8 transformed the whole . . . stabilized the organization and then we really grew it.  But it was also 9 not that we were great organizers but we were also . . . the field was growing so we went from, 10 when we took it over there were probably only about 200 members of the organization and now 11 there are over 1200.  So its amazing.  And it was very helpful having the office here during my 12 presidency.  So it was sort of seamless, that was helpful.  And then Walter Bockting became 13 president after I did  not immediately after and that was helpful to him.  We stayed on the 14 board, we were still very involved.  And we have stayed very much involved in the organization.  15 Bean has just stepped down as executive director and weve kind of . . . again, its grown beyond 16 us so now . . . and we were a part of the whole change, part of the paradigm change.  We said 17 we need to change the name of the organization so we changed it from the Harry Benjamin 18 International Gender Dysphoria Association to the World Professional Association for 19 Transgender Health.  So that really reflected, I think, movement from more of a disease focus to 20 a health focus and broader than just sex reassignment for transsexuals.   21 
AJ: Right, to treating a wide variety of gender identity disorders. 22 
EC: Right.  And then, as I said, we were very involved in standards of care and I still remain as the 23 chair of the standards of care revision committee and the recent revision in 2013, version 7, was 24 really revolutionary and now were working on version 8.  But version 7 really reflected, I think, 25 the culmination of this whole paradigm shift and has been extremely well received and has had 26 a tremendous impact on care and rights for trans people. 27 
AJ: Wow.  Am I mistaken in the fact that now the first transgender person . . . theres a transgender 28 person that is president of WPATH? 29 
EC: The first president was right after . . . was it right after me?  I remember bringing on Stephen 30 Whittle as chair of a new committee on legal issues and then Stephen went on to become the 31 first president, trans identified, and a legal scholar. 32 
AJ: Oh wow. 33 
EC: Which was interesting.  And then now there is a . . . the current president is also a legal scholar 34 and is an identified trans man. 35 
AJ: So Jamison Green, the person I was thinking of, is the actual second transgender-identified 36 person to lead that organization  which, in its inception, I dont think people would have ever 37 thought that a transgender person would be at the helm of the organization. 38 
EC: Well, from the beginning of the organization, it was founded in 1979, and there were trans-1 identified people on the board of directors from the beginning. 2 
AJ: From the beginning  all right. 3 
EC: So its always been an organization that has been trans inclusive.   4 
AJ: Sure, OK. 5 
EC: And I remember that was impressive about the meetings is that . . . well in the beginning it was 6 more trans individuals that were . . . they were allowed to attend meetings, the professional 7 meetings.  That was kind of unusual, but thats how inclusive, I think, the organization was from 8 the beginning. 9 
AJ: OK. 10 
EC: And then, obviously, some of them were professionals in the field or became professionals in 11 the field, but at the beginning there werent a lot of trans-identified surgeons, psychologists, 12 psychiatrists, that were out and open and so as that developed then the board of directors 13 became more and more diverse in terms of gender identity and certainly culminating with 14 people becoming . . . taking the role of president.   15 
AJ: Ive just got to say this history is fascinating.  There are no trans-identified people that I have 16 access to that could share this level of history of the movement.  And so you asked me when we 17 first walked in here, Why me and why now?  Im just pointing out thats why  because this 18 history is invaluable and theres not a lot of places to really capture this.  So Im just saying thank 19 you for the opportunity. 20 
EC: Youre welcome.  Its been an amazing . . . to watch it over this amount of time is fascinating and 21 to see this incredible shift, just even in the last five years of just the recognition of transgender 22 rights and health care as a fundamental right and to the highest levels of public policy to 23 recognize the importance of delivering the most optimal health care to trans individuals is really, 24 really remarkable. 25 
AJ: It is. 26 
EC: We still have a lot of battles to fight and were continuing to fight them.  And then also when 27 Walter Bockting, just when Walter Bockting left . . . I remember saying to him many times, I 28 fear that if you leave I dont know, without a champion, I dont know if . . .  The areas of focus 29 of the program always have depended upon people who are passionate about that particular 30 area.  And so if Walter left, I told him, I dont know that we would really continue . . . And I 31 wouldnt want to continue offering sub-standard care or that were not doing cutting edge stuff.  32 Thats not what were here to do at the university.  So we either . . . Youve got to stay or weve 33 got to find somebody to carry on.  We were fortunate to attract Katie Spencer as a post-34 doctoral fellow and she became very passionate about this work and has now taken over that, 35 but we also have other faculty  Jamie Feldman and Dianne Berg who are deeply passionate 36 about this issue, but its Katies leadership of the overall program.  But Dianne Berg in leading 37 the child and adolescent program that really makes it very, very continuing to be a strong 38 element here at the Program and at the University.  But it really . . . it can only keep going with 1 people that have that degree of passion.   2 
AJ: And continuing to do cutting edge research that is sort of changing and shifting the feel. 3 
EC: Yes. 4 
AJ: Where do you see the future of the transgender program within the Center of Sexual Health? 5 
EC: Well, a couple of things.  One is that were really . . . and some of it is just that the other thing 6 that has changed in the landscape is that . . . and I remember telling Walter when he first 7 started, saying, Youve got to think about this in terms of your career.  If you want to go into . . . 8 there is no funding for transgender research and you are never going to get promoted without 9 federal funding and . . . whatever.  He just persisted and broke the glass ceiling and was able to 10 get some of that early grant funding, but now its really shifting where there is much more 11 funding that is available.  So, before also, the only funding was HIV-related but now that has 12 really kind of shifted and so that creates an opportunity for us to really do more.  And so were 13 going to have to . . . now we can really look at more treatment protocols that are not so much 14 HIV-related because there is still not enough research to really back-up a lot of what were doing 15 and to lead us into ways of better doing this.  So, were really articulating our research agenda 16 more based upon our patient population and the needs of our population and so I think that we 17 will be developing research protocols that can examine different treatment methods.  Were 18 moving to, I think, just even more ways of helping people outside the gender binary, were going 19 to be working more with the kids and parents and families. Were working on dealing with the 20 sexual part of trans people and their sexual lives in the sex act part. 21 
AJ: You smile when you say that. 22 
EC: Again it just goes back to this misunderstanding of what sexual is.  But were going to focus 23 more on that.  So, its going to be . . . yeah, stay tuned. 24 
AJ: Stay tuned.  I cannot tell you how grateful I am for this opportunity to sit down with you, Dr. 25 Coleman, and really understand more about the Center and the work that has been going on 26 here for over 40 years now.  But also the work that has been happening around transgender 27 identity and transgender health and how the Center has had an international impact in really 28 shaping how the medical community, the political realm, because you guys have been engaged 29 in deep advocacy, and the leadership that the Center has shown around these issues.  So thrilled 30 to be able to capture this as a part of this transgender oral history project.  I think it would not 31 be a true oral history without that context of what has been shaping up here at the University of 32 Minnesota.  So Im just grateful for the opportunity.  Thank you so much. 33 
EC: Well thank you, it was great.   34 
AJ: Absolutely.  Until we meet again. 35 
EC: Yes. 36 

