Dr. Alan L. Hart, a Kansas-born doctor who helped pioneer a lifesaving tuberculosis treatment, was also one of the first known transgender men in the U.S. to undergo gender-affirming surgery.
But he spent much of his distinguished medical career forced to switch jobs and relocate across state lines.
March 31 marks the annual International Transgender Day of Visibility, which was recognized by Democratic Kansas Gov. Laura Kelly in an official proclamation.
Meanwhile, Republican legislators in Hart’s home state have repeatedly targeted transgender rights and health care — banning gender-affirming care for minors, restricting the use of bathrooms by transgender people, and invalidating state IDs that do not align with residents’ sex assigned at birth.
“I really admire his resilience,” said Isaac Fellman, assistant director of the Digital Transgender Archive based in Boston. The collection contains a variety of materials from global transgender history, including those related to Hart.
“At the same time, I think about what more he could have done if he had spent his life in a position of safety and security,” Fellman added.
Born in Halls Summit, Kansas in October 1890, Hart had “always regarded” himself as a boy and preferred dressing in boys clothing, according to a medical biography by his psychiatrist. But Hart didn’t stay in Kansas for long. He and his mother moved to Albany, Oregon, after his father died of typhoid fever when Hart was two years old.
On the West Coast, Hart became a talented student, studying at Albany College (now Lewis & Clark) and Stanford University. At the University of Oregon Medical School (now Oregon Health & Science University), Hart graduated top of his class.
Soon after, Hart went to Dr. J. Allen Gilbert, a psychiatrist and his former medical school professor, for help. Initially, the professor’s therapeutic and hypnotic treatments focused on conforming Hart to contemporary expectations for a “conventional” woman. But Hart decided against that goal.
In 1917, Hart underwent a hysterectomy instead, and lived openly as a man afterward.
“It strikes me as a remarkably and shockingly early example of somebody doing a medical transition for strictly gender affirming reasons,” Fellman said.
Nearly 30 states across the country now have restrictions on gender-affirming health care, primarily banning treatments for minors, including Kansas and Missouri.
After transitioning, however, Hart struggled to find stable employment in the medical field. In 1918, while working at a San Francisco hospital, Hart was recognized by a former classmate and outed.
Newspapers across the region treated “the discovery” as a scandal. “Dr. Alan Hart Said To Be Oregon Girl,” read the headline in Salem, Oregon’s Capital Journal. “Attire Did Not Proclaim Man,” remarked the Oakland Tribune.
Hart resigned and moved back to Oregon.
“I had to do it… For years I had been unhappy,” Hart told his hometown paper, the Albany Daily Democrat, later that year. “I have been happier since I made this change than I ever have in my life, and I will continue this way as long as I live.”
Over the next decade, Hart treated Oregon loggers during the Spanish flu epidemic, poor Montana farmers, and countless others across Wyoming, New Mexico and Washington. But he was repeatedly forced to uproot himself after being outed.
Still, by the 1930s, Hart had earned a masters degree in radiology from the University of Pennsylvania and rose in his field. He became the director of radiology at Tacoma General Hospital, and took on the title of Idaho State TB officer.
TB is an infectious disease that in 1920 killed nearly 100,000 people in the U.S. alone. Two decades later, the annual number had dropped closer to 60,000, but the illness remained a leading cause of death in the country.
Because many tuberculosis cases can be asymptomatic, Hart developed and helped popularize the use of chest X-rays as an early screening tool. Medical professionals still use X–rays to screen for TB today.
Hart held roving X-ray screening clinics and preached the virtues of preventative health care, helping to reduce stigma and save lives.
Hart found the time to become a successful author too. He published four medical thrillers — “Doctor Mallory,” “The Undaunted,” “In the Lives of Men,” and “Dr. Finlay Sees It Through” — that were often heavily infused with lightly-masked autobiographical details.
These books are one of the few windows we have into Hart’s worldview, according to Fellman. (Upon his death, Hart ordered his personal papers and photographs destroyed.)
“What he has left behind is his imagination of the lives of others, rather than his understanding of his own,” Fellman said.
In 1947, Hart and his second wife moved to Hartford, Connecticut, where he finally found some stability. Hart received a masters degree in public health from Yale University in 1948. He worked as the X-ray director for the State Health Department Office of Tuberculosis Control, Hospital Care and Rehabilitation until his death in July 1962.
Fellman said Hart’s story resonates heavily with him, particularly these days. Legislation across the country has sought to restrict transgender people’s civil rights, access healthcare, participation in athletics, and more.
“It’s still really palpable what it must have been like to be just walking on thin ice all the time,” Fellman said. “You can fall in at any time and there’s no real recourse for you.”
But Fellman also wants to see Hart’s accomplishments celebrated, beyond a focus on his gender identity.
“Hart should be remembered for so many reasons other than being a cool trans guy,” Fellman explained — clarifying that he loves that fact, too. “The medical history he was part of and the literary history that he was part of both deserve so much more attention.”
