The first man to undergo phalloplasty pioneered a new medical ethics

Health · Published 20 October 2026 Swipe more like this →

In short: Before gender-affirming surgery was a standard medical practice, Michael Dillon lived as a medical pioneer. A doctor who navigated the boundaries of law, religion, and biology, he became the first known transgender man to undergo phalloplasty, fundamentally challenging the era's definitions of bodily autonomy and medical necessity.

Born in 1915 and assigned female at birth, Michael Dillon began living as a man shortly after graduating from Oxford in 1938. His journey was marked by significant medical firsts: he was the first recorded person to take testosterone exclusively for gender affirmation, a treatment he obtained from Dr. George Foss. While enduring public ridicule—such as being jeered at a fuel station throughout the second world war—Dillon leveraged his medical schooling to champion gender reassignment for himself and others, notably conducting an unlawful orchiectomy for Roberta Cowell, who became the initial UK trans woman undergoing vaginoplasty.

In 1946, Dillon sought out the renowned plastic surgeon Sir Harold Gillies. At the time, the medical establishment viewed such procedures as 'mutilation' of a healthy body. However, Gillies and Dillon shared a radical belief: that patients should have the agency to choose surgeries that alleviate psychological distress. To bypass the scrutiny of a medical community that viewed gender-affirming surgery as controversial, Gillies falsified Dillon's condition, diagnosing him with acute hypospadias to justify the phalloplasty. These surgeries, which involved using skin flaps from Dillon's legs and stomach, were often accompanied by infections and mobility issues.

Dillon’s life was a study in dual transitions. Beyond his physical and social identity, he sought spiritual transformation, eventually moving to India to become a Buddhist monk. In 1960, he became the first Westerner ordained in the Rizong Monastery in Ladakh, taking the name Lobzang Jivaka. He spent his final years writing about both his spiritual path and his gender journey, culminating in his autobiography, Out of the Ordinary. His legacy remains a foundational chapter in transgender medicine, bridging the gap between personal identity and clinical practice.

Dillon’s influence extended to hospital care; as a physician in Dublin starting in 1951, he implemented holistic treatments like occupational therapy and patient libraries. He also advocated for patient-informed treatment in his 1946 book, Self: A Study in Ethics and Endocrinology. His life highlights a persistent tension in medicine: the balance between a doctor's duty to preserve the body and a patient's right to redefine it.

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