Richard Mühsam (1872 – 1938) surgeon - and probably the first surgical sex changes

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Mühsam was a physician-surgeon who qualified at the Friedrich-Wilhelms-Universität Berlin in 1893. He married in 1896, and they had two sons and a daughter.

Between 1912 and the mid 1920s Mühsam was involved in several pioneering surgeries that he wrote up for the Therapie der Gegenwart journal in 1926. None of the patients are given names. 

In 1912 he did a double mastectomy and a hysterectomy on a painter aged 25, born female, who had always considered himself to be a "man in disguise". 

In 1920, at the request of Magnus Hirschfeld, Mühsam castrated a 23-year-old who had been dismissed from military school for not being brave enough, although he did serve in the Great War as an officer, which tested his manhood. By 1920 he could no longer function. "He gave up his medical studies ... spent the day in bed and slept most of the day". He normally wore a corset and stockings when he went out. He masturbated 3-8 times a day imagining himself as female. He implored Mühsam, who considered him to be a severe sexual neurotic, that he be castrated. This was done on 21 June 1920, and two days later he had stopped masturbating and resumed his studies. Mühsam wrote (seven times in three pages) that the purpose of the castration was to enable the patient to work. However now felt an enhanced desire to become a

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