- Email: [email protected]
Herbert Bower
Obituary
Herbert Bower A psychiatrist whose long career included pioneering work in the treatment and study of gender dysphoria. Born on Dec 19, 1914, in Vienna, Austria, he died of heart failure on Aug 29, 2004, aged 89, in Melbourne, Australia. When Herbert Bower arrived in Australia in 1939, on the last ship to sail from London before World War II, the authorities would not recognise his medical qualifications. It was not the first hurdle he had overcome en route to medical practice, having begun his training in Vienna but subsequently leaving for Switzerland in 1938 when the Nazis took over Austria. He completed his training at the University of Basel. In Australia, he took work as an orderly at Launceston General Hospital, as his son Humphrey Bower described in The Age recently. He then spent a year with a schizophrenic private patient, and 2 years in the Northern Territory as a medical officer. When the war ended, he repeated medical training at Melbourne University, the city he eventually settled in. All this meant that Bower wasn’t a young man when he started psychiatry. But in a career that remained active for another 50 years, the late start seems not to have mattered. “Herbert Bower has always been a father figure to psychiatrists in Australia”, says long-term friend and colleague, Trudy Kennedy. “He was a man of tremendous personality and character.” Bower’s career and interests ranged widely, but he may be remembered most for his work in gender dysphoria. In 1975, he approached the Queen Victoria Hospital with the idea of starting a gender dysphoria clinic, and the first gender reassignment surgery performed through the service took place in 1976. The clinic later moved to Monash Medical Centre in Melbourne, where it is still in operation. Bower’s contribution was to “take it out of being an attitudinal thing or a life choice, to saying it’s just the way you were born”, Kennedy said. “The patients all thought he was 1398
wonderful. He put himself out to make them feel comfortable—they trusted him. He was also quite convinced that surgery was the best approach.” The field is not without controversy. Two people who underwent gender reassignment have taken legal action against the state government and the clinic at Monash for wrongly assessing them for operations, but Bower stood by the clinic’s record. “If our team erred twice in 29 years, and during that period we operated . . . on 600 patients, two errors in 600 . . . in any area of human endeavour, is acceptable”, he said in an interview for the Australian Broadcasting Corporation in May this year. Bower had long believed that the cause of gender dysphoria is biological. Recently he became interested in researching its genetic basis. “Herb was very excited by evidence of this in mice”, Kennedy said. He maintained a close interest in the work of the Monash clinic into his 90th year. ”I last talked to him 4 months ago when he wanted to meet with a team who was visiting our service”, said Saji Damodaran, clinical director of Southern Adult Mental Health Services, which operates the clinic. “I was not expecting Herbie to take the pain of travelling and meeting them but he did and then sent a note of thanks to me. He was always a scholar and gentleman.” Bower’s career spanned other fields. In 1955, he became superintendent at Kew Mental Hospital, and found miserable conditions, “like something from the century past”, Kennedy said. He set about improving the patients’ environment and care. “When Herbert had something in his mind, he always succeeded.” In 1965, he had a heart attack and resigned the superintendency, and began working as a consultant with the Mental Health Authority of Victoria. He also began teaching, and in 1970 was appointed director of postgraduate studies at Melbourne University. Edmond Chiu, now associate professor of psychiatry at the University of Melbourne, remembers studying with him. “My first impression of Herbert was of a very cultured, beautifully spoken person [wearing] tailored English tweed”, he told The Lancet. In Chiu’s view, “His major contribution included his advocacy for the most disadvantaged; the elderly with mental disorders, transgender people, and improving of environment and quality of life for those with chronic mental illness.” “He was never inhibited by age”, said Kennedy. In 1999, aged 85, Bower was appointed to the Mental Health Review Board of Victoria. He traversed the city to assess and intervene on behalf of patients in various institutions. On his retirement last year, Bower was granted a Recognition of Service Award, and the meritorious service award from the Victorian branch of the Royal College of Psychiatrists “for outstanding service to Victorian psychiatry over many years”. He is survived by his sons Humphrey and Stephen, three grandchildren, and his companion Diane.
Stephen Pincock [email protected]
www.thelancet.com Vol 364 October 16, 2004
Herbert Bower A psychiatrist whose long career included pioneering work in the treatment and study of gender dysphoria. Born on Dec 19, 1914, in Vienna, Austria, he died of heart failure on Aug 29, 2004, aged 89, in Melbourne, Australia. When Herbert Bower arrived in Australia in 1939, on the last ship to sail from London before World War II, the authorities would not recognise his medical qualifications. It was not the first hurdle he had overcome en route to medical practice, having begun his training in Vienna but subsequently leaving for Switzerland in 1938 when the Nazis took over Austria. He completed his training at the University of Basel. In Australia, he took work as an orderly at Launceston General Hospital, as his son Humphrey Bower described in The Age recently. He then spent a year with a schizophrenic private patient, and 2 years in the Northern Territory as a medical officer. When the war ended, he repeated medical training at Melbourne University, the city he eventually settled in. All this meant that Bower wasn’t a young man when he started psychiatry. But in a career that remained active for another 50 years, the late start seems not to have mattered. “Herbert Bower has always been a father figure to psychiatrists in Australia”, says long-term friend and colleague, Trudy Kennedy. “He was a man of tremendous personality and character.” Bower’s career and interests ranged widely, but he may be remembered most for his work in gender dysphoria. In 1975, he approached the Queen Victoria Hospital with the idea of starting a gender dysphoria clinic, and the first gender reassignment surgery performed through the service took place in 1976. The clinic later moved to Monash Medical Centre in Melbourne, where it is still in operation. Bower’s contribution was to “take it out of being an attitudinal thing or a life choice, to saying it’s just the way you were born”, Kennedy said. “The patients all thought he was 1398
wonderful. He put himself out to make them feel comfortable—they trusted him. He was also quite convinced that surgery was the best approach.” The field is not without controversy. Two people who underwent gender reassignment have taken legal action against the state government and the clinic at Monash for wrongly assessing them for operations, but Bower stood by the clinic’s record. “If our team erred twice in 29 years, and during that period we operated . . . on 600 patients, two errors in 600 . . . in any area of human endeavour, is acceptable”, he said in an interview for the Australian Broadcasting Corporation in May this year. Bower had long believed that the cause of gender dysphoria is biological. Recently he became interested in researching its genetic basis. “Herb was very excited by evidence of this in mice”, Kennedy said. He maintained a close interest in the work of the Monash clinic into his 90th year. ”I last talked to him 4 months ago when he wanted to meet with a team who was visiting our service”, said Saji Damodaran, clinical director of Southern Adult Mental Health Services, which operates the clinic. “I was not expecting Herbie to take the pain of travelling and meeting them but he did and then sent a note of thanks to me. He was always a scholar and gentleman.” Bower’s career spanned other fields. In 1955, he became superintendent at Kew Mental Hospital, and found miserable conditions, “like something from the century past”, Kennedy said. He set about improving the patients’ environment and care. “When Herbert had something in his mind, he always succeeded.” In 1965, he had a heart attack and resigned the superintendency, and began working as a consultant with the Mental Health Authority of Victoria. He also began teaching, and in 1970 was appointed director of postgraduate studies at Melbourne University. Edmond Chiu, now associate professor of psychiatry at the University of Melbourne, remembers studying with him. “My first impression of Herbert was of a very cultured, beautifully spoken person [wearing] tailored English tweed”, he told The Lancet. In Chiu’s view, “His major contribution included his advocacy for the most disadvantaged; the elderly with mental disorders, transgender people, and improving of environment and quality of life for those with chronic mental illness.” “He was never inhibited by age”, said Kennedy. In 1999, aged 85, Bower was appointed to the Mental Health Review Board of Victoria. He traversed the city to assess and intervene on behalf of patients in various institutions. On his retirement last year, Bower was granted a Recognition of Service Award, and the meritorious service award from the Victorian branch of the Royal College of Psychiatrists “for outstanding service to Victorian psychiatry over many years”. He is survived by his sons Humphrey and Stephen, three grandchildren, and his companion Diane.
Stephen Pincock [email protected]
www.thelancet.com Vol 364 October 16, 2004