Aarati Asundi (00:12) Hi, everyone, and welcome back to the Smart Tea Podcast, where we talk about the lives of scientists and innovators who shape the world. I'm Aarati. Jyoti Asundi (00:21) And I'm her mom, Jyoti. Aarati Asundi (00:23) So mom, quick correction before we get into today's episode. I posted a couple of shorts from our episode on Carlos Finlay, the doctor who figured out that mosquitoes were a vector for yellow fever. And in that episode, was talking about how the USS Maine blew up... Jyoti Asundi (00:46) Oh yes, I remember that cute little ditty "Remember the Maine, down with Spain." I remember that. Yes, Aarati Asundi (00:52) Yeah, to hell with Spain. Jyoti Asundi (00:54) To hell with Spain, yes. Aarati Asundi (00:56) In that episode, I said that Spain took credit for the attack, but actually our lovely viewers pointed out that I was mistaken about that. It turned out that it was actually a fire that started on board the ship and reached some ammunition stores and then the ship exploded and the US pinned it on Spain. Jyoti Asundi (01:01) Oh it was a genuine accident. Oh! Aarati Asundi (01:18) Mm-hmmm. Or some people even...conspirators say that the US blew up their own ship, which I'm not sure about. I don't know enough about it, but regardless, wasn't Spain's fault. Spain did not take credit for it, but the US did use it to stir up tensions and they created this propaganda. Jyoti Asundi (01:39) I can see the whole situation stirring up the pot pretty badly. Aarati Asundi (01:43) Yes. And a hundred years later or something, I'm embarrassed to say even I fell for the propaganda. So I'm very sorry about that. Jyoti Asundi (01:52) No, I can see how it could be used to ferment discord. I can see that. Aarati Asundi (01:57) Yes. So thank you to our viewers for being my fact checkers. Jyoti Asundi (02:01) Thank you, because then we are learning. Aarati Asundi (02:04) Okay, so for today's story, it is Pride Month. And you know how much I love doing a scientist that's on theme with you know what's happening. And so was thinking about it and I was like, I don't think we've actually done any scientists from the LGBTQIA+ community. So today, are going to be doing the story of Alan Hart, who is a transgender man who became this pioneering doctor in tuberculosis. Jyoti Asundi (02:42) Oh nice. Okay, tuberculosis is so rampant all over the world. And people can go around for years and years without knowing that it's present and they can just be silent carriers of it and silent spreaders of it. It's a really horrendous one. Aarati Asundi (03:00) Yes, and that is exactly what we'll be talking about today. His work in asymptomatic TB and detecting it. But his life is very interesting as well, his personal life. It's a bit of a difficult one, but he really was truly amazing in the struggles that he faced. Alan was born on October 4th 1890 in Halls Summit, Kansas. Biologically, he was born a female. And so he was initially given the name Alberta Lucille Hart. Jyoti Asundi (03:39) Okay. Aarati Asundi (03:40) His father, Albert, died from typhoid fever before Alan was even two years old. And even at this very young age, Alan started saying to his mother that now that his father had died, he would take on the role of man of the house and take care of her. Jyoti Asundi (03:58) At two? Aarati Asundi (03:59) Yes. Jyoti Asundi (04:00) How can...? Oh that's quite shocking. I just wonder how two year old would have those kind of thoughts. Aarati Asundi (04:10) I'm sure it was very cute and very like, "Since we have no dad, now I'm the dad." Something like that he probably would have said. Jyoti Asundi (04:18) I am sorry but I feel somebody fed that idea to him. Somebody must have said, well you're the little man, now you're the man, you know, something like that. Aarati Asundi (04:27) I mean, but his mom was still treating him as a female at this point, as a little girl. So I don't know who would have fed him that idea at this point. Jyoti Asundi (04:38) You're right. Oh goodness I'm getting confused already. I'm so sorry. I'm so sorry about this. But Aarati, I think... Aarati Asundi (04:45) No, it's okay. This is good. No, because I think a lot of people do get confused. Jyoti Asundi (04:51) So wait a second. This is a little two-year-old girl at this point. Aarati Asundi (04:56) Biologically, yeah. Jyoti Asundi (04:57) What the world is seeing is a little two year old girl at this point who is going around saying that she's now the man of the house since her dad is no more. Aarati Asundi (05:09) Yes. Exactly. Jyoti Asundi (05:10) Oh so very early on this child is already identifying as male. Aarati Asundi (05:20) Already that masculine energy is coming out. Yes. And I want to be clear also that I am using male pronouns the entire time I'm telling this story. I'm using he and him the whole time. But there are accounts, that refer to him as she and her before they made the transition to him and he so... Jyoti Asundi (05:42) I got it. Okay. Aarati Asundi (05:42) But I'm doing it because he always identified as male. He always was a male and so even though at this young age the world was perceiving him as a girl and as a female I'm using the pronouns he and him because he himself identified as a male. Jyoti Asundi (06:00) And two years old is roughly around the time that they are able to speak and share their thoughts in a lucid way. So basically from the very beginning of thought process in this child, the child is identifying as male. Aarati Asundi (06:16) Yes, exactly. Jyoti Asundi (06:17) Okay. Got it. Got it. Now I'm with you. You know, in the Hindu scriptures, there are various books and works that lay out the values that we should follow in life. And there are some, you know, very high level books like the Bhagavad Gita, for example, that just teach you, here's the value, here's what you have to do kind of thing. But people get bored of just being preached upon basically. So the same values have been presented in the form of very dramatic stories. And one of the dramatic stories in the Hindu literature is the Mahabharata. And the Mahabharata covers gender fluidity, where there is very young girl who is born to a king. And from the very beginning, he dresses as a boy, talks like a boy, acts like a boy, goes out to learn all the things with other warriors. At some point, he even leaves home and then there is, I think even in those days, were almost like there were secret doctors who methods and the medicines to change gender. So this gender fluid boy comes back home as a man. This is a story that is set 5,000 years ago. And this is the first time I am getting to hear of a story where a two-year-old child is already identifying as the other gender Aarati Asundi (07:47) Yeah, I think that's important though, because you often hear people say, why are there so many transgender people all of a sudden? Why are there so many gay people all of a sudden? It wasn't like this before. And it's like, no, it was always like this. Even 5,000 years ago, it was like this. Jyoti Asundi (08:03) It was always there. Aarati Asundi (08:05) But because society, you know, they hid or they, you know, they... Jyoti Asundi (08:09) Repressed it. Aarati Asundi (08:10) They were not as open about it. so Jyoti Asundi (08:11) Yes, yes. Aarati Asundi (08:13) And so Alan's life was very hard. He fought against it but someone who wasn't as strong as him would probably have somehow repressed it, you know, so, Jyoti Asundi (08:23) Wow, this is just tying so many things together in my head with connecting these old 5,000 year old tales that I grew up with. But then, you know, when I grew up with it as a child, I just thought of it as a story. But now it's true our ancient sages actually had experienced all of life, and then he put it all down in a way that was very engaging and saying, look, that boy, you know, the gender fluid child changed himself into a man. He's the one who brings that greatest warrior down in the final war that happens in that book. Aarati Asundi (09:01) Yeah, so not only is it presented as normal, it's like he's the hero of the story. Jyoti Asundi (09:05) Yeah, he's the big hero. Aarati Asundi (09:01) Yeah so it's always been there. Jyoti Asundi (09:10) Yeah I didn't mean to derail the whole thing, but it was just... it just connected so strongly with me that, That's amazing to me. Aarati Asundi (09:17) So his mother Edna reverted back to her maiden name of Bamford. And she and Alan moved back to Lynn County, Oregon, where her parents lived. She got remarried to a man named Bill Barton and together they moved on to the Bamford's family farm to live with the mother's parents. As he grew Alan was much more comfortable presenting as a boy than he was a girl. At that young age, he thought that as long as he wore boys clothes and cut his hair short, then he could be a boy. And so that's what he did. He thought that was the only difference because he's a child. Jyoti Asundi (09:56) Yes, yes, that makes perfect sense. Aarati Asundi (09:59) His mother said his "desire to be a boy", quote unquote, was but surprisingly for this era, his grandparents were fine with it. And they even called him their grandson. Jyoti Asundi (10:12) Wow. Very open-minded people for that era. Aarati Asundi (10:15) He spent most of his time on the farm and he didn't go to school so anything he learned was from homeschooling or reading books on his own. He was fascinated by history, especially the Spanish American war and the civil war. His grandfather would read current events to him and made him wooden toy guns to play with. As he grew older, he liked to rough house with other boys, and he preferred to help with jobs that men did on the farm, like milking the cows and driving horses, rather than working with the women doing all the housekeeping chores. And even when he liked to play pretend, he always cast himself in the male role. So he was always the father of the pretend family or the hero that swoops in to rescue the damsel in distress. Jyoti Asundi (11:00) Yes. Aarati Asundi (11:01) He later described this time as the happiest years of his life because he was completely free to express his identity as he wanted to. Jyoti Asundi (11:10) Yes. Aarati Asundi (11:11) Also though, very early on, he started showing an interest in medicine. The only times he ever played with dolls was when he was playing doctor, and they were presumably his patients. Jyoti Asundi (11:23) Oh my god. This reminds me of your brother at the age of four. Aarati Asundi (11:27) Oh yes. Jyoti Asundi (11:28) He used to play with your dolls, but only to decapitate them because he was very keen to figure out how the heck did those eyes open and close. So he needed to go to the other side of that... Aarati Asundi (11:41) Yeah, he needed to go inside. Yeah. Jyoti Asundi (11:43) Go inside to check what's happening. And he was trying very hard to poke at the eyes from with his little fingers from inside. This is so hilarious. This is so hilarious. Aarati Asundi (11:54) And I just come into my room with the doll in pieces like "Mommy!" Jyoti Asundi (11:52) Yes, yes, yes. Scientific curiosity trumps everything. Aarati Asundi (12:03) Yeah. He also became very self-reliant. For example, one day he somehow managed to chop off the end of his fingertip with an axe. And instead of running and telling everyone about it like a normal child, he cleaned and dressed the wound himself and then just went back to doing whatever he was doing. Jyoti Asundi (12:23) Wow, wow! That is some very high level of self-reliance. Aarati Asundi (12:25) Yeah. It's crazy. I was just like, I can't imagine, you know? Jyoti Asundi (12:35) Yes, even if you've just chopped off an itty bitty piece of the finger, the pain would be unbearable. The amount of blood gushing around would make me think that I'm going to bleed to death, whether it's true or not. I would... that would be my response. I would want to be rushed into surgery for a whole bunch of stitches. Aarati Asundi (12:55) I would immediately go running to find some adult and be like, save me, save my life. Yeah. Jyoti Asundi (12:59) Yes, don't let me bleed out here. Aarati Asundi (13:02) Yeah. very self reliant, when he was a kid. However, when he was 12, the family moved to Albany, Oregon. And here Alan had to present as a girl in order to go to school because his birth certificate said he was a girl. Jyoti Asundi (13:18) That is hard for him now because he's been allowed the freedom to express his true nature for 12 years. And in fact, this is the age when he would be hitting puberty. And so that would be more traumatic. He's recognizing becoming a boy doesn't just mean wearing boys clothes and chopping off my hair. There's more to it. That's very hard. Aarati Asundi (13:44) Yes, it was very difficult for him. His teachers were calling him Lucille and were treating him like a girl. His classmates teased him for being thin and unattractive. And so all of this made him withdraw socially and focus instead all his efforts on his academic work. And he quickly became the best student in the class because of this. But he still found ways to express his masculinity wherever he could. So by the time he got to high school, he had started to write for local newspapers and also got involved in the school yearbook. And he also wrote a number of short stories and he wrote all of this under the name Robert Alan Bamford or using the gender neutral A.L. Hart because writing under a pen name was considered normal. Jyoti Asundi (14:35) So he was at least able to recapture some of his autonomy there. Aarati Asundi (14:40) Yes. Jyoti Asundi (14:41) And actually, you know, that's a pretty good way to go forward because there was a skit that I saw about this topic somewhere. There was a boy, young child who was confused about his gender and he was being teased all around, being pulled in every different direction. And his father gives him very sage advice he says this very young age where you are right now is the time for you to study. Studies is something that you do as a boy or as a girl it doesn't matter. Gender is irrelevant to what you're doing right now in life. Aarati Asundi (15:17) Yes. Jyoti Asundi (15:18) So focus on what is your primary purpose of life right now and that is to acquire an education. And when finally when gender becomes relevant you will be older and you can deal with it at that time. Aarati Asundi (15:31) Yeah, that theme will come back around again. So back to his writing, he often wrote about masculine topics or had his characters doing masculine things, even if they were women. And then during the holidays, he could go back to his grandparents' farm and go right back to presenting as a boy. Jyoti Asundi (15:49) A bit of a reprieve there on farm where it could feel safe and happy again. Aarati Asundi (15:55) Yes. And as you mentioned, now he's, you know, in high school, he's gone through puberty and he's starting to notice girls and he's starting to have, fantasies about girls that he's having crushes on where he's like the successful doctor and husband and the girl is his wife. And he noted that he never fantasized that way about the boys in his class, the way that other girls did. Jyoti Asundi (16:20) He's oriented completely towards the masculine. Aarati Asundi (16:23) Mm-hmm. In 1908, Alan went to the local Albany College, which is now known as Lewis and Clark College. Again, here he at first had to present as a woman. was still a very good student, and he took an interest in physics, economics, and philosophy. But he also, because he was presenting as a woman, got involved in up the very first women's debate team. So things like that, you know, empowering women. Jyoti Asundi (16:50) Yes, yes, yes. Aarati Asundi (16:53) He also started dating a classmate named Eva Cushman and slowly over the years he went back to his comfort zone of wearing shirts and ties and suits. Jyoti Asundi (17:03) But, Eva Cushman sounds like a girl's name. Aarati Asundi (17:07) It is, yes. Jyoti Asundi (17:03) So he was- so as- he's still biologically a girl. Um, did she know? Aarati Asundi (17:15) Yeah, yeah, she knew. She definitely knew. I'm not sure about Eva Cushman's sexual orientation or anything, but she definitely knew. In 1910, Alan had the opportunity to go to Stanford for a year to study. By this time, he had inherited his father's estate and all the money that came with it. And so he was spending money lavishly on his friends and on his girlfriend, Eva Cushman. And he paid not only for his own tuition to go to Stanford, but also for Eva to come with him as well. Jyoti Asundi (17:51) Okay. Aarati Asundi (17:52) Alan loved the progressive atmosphere of San Francisco and the Bay Area. He would go out, spend the night on the town, go to fancy dinners and operas and buy gifts for Eva. And he became so addicted to spending money that by the time he went back to Albany College and finished up his degree, he had burned through his entire inheritance and was actually in debt. Jyoti Asundi (18:17) That is sad actually. Somebody should have taught him money management. Why...? Okay. This is... don't get me started on this. Aarati Asundi (18:25) I think spending the money gave him positive attention. Jyoti Asundi (18:29) Yes, of course. Aarati Asundi (18:29) People would hang out with him and like, liked him because you know, and that was such a change from how he was treated in middle school and high school, being picked on and being like the ugly duckling, kind of thing. And so now he's like, hey, people love me if I give them gifts and I spend money and buy them dinner. And so he's kind of addicted to that positive feeling, you know. Jyoti Asundi (18:51) Yeah, it's not love if you have to buy it. Aarati Asundi (18:55) Yes. So although Alan wanted to pursue medical school, he couldn't afford it. He worked a number of odd jobs to pay off his debt. And then finally he managed to secure a loan to pay for his medical school. So in 1913, he was admitted to the University of Oregon Medical School. He continued to excel academically, but on a more personal level, he was very, very unsettled. He slowly grew apart from Eva, but he continued to have relationships with other women. As a medical student now, he tried to research his sexuality from a medical perspective. But at the time, everything related to homosexuality or transsexuality was medically labeled a perversion or a deviance. Jyoti Asundi (19:40) Yes "deviance." Yes yes. Aarati Asundi (19:42) Yes. And so this seriously affected him the point that he actually contemplated taking his own life. Jyoti Asundi (19:50) Oh how sad. Because the message he's getting from everywhere is "What you're feeling, your true feelings are not correct. Your true feelings are a perversion." Aarati Asundi (20:02) But luckily, though, he decided to seek help from a professor of psychiatry, Dr. Allen J. Gilbert. Dr. Gilbert started off by trying a number of mental treatments, including psychotherapy and hypnosis to try and quote unquote "cure Alan Hart". But it soon became very clear that it was not working. Alan himself was also very clear from the beginning that he did not want his masculine mindset to change. So he didn't want the therapy to make his mental state become female, quote unquote, if that makes sense. Jyoti Asundi (20:37) He was very clear. He is a man, that's not the fix. Aarati Asundi (20:42) Exactly. In the midst of this, Alan graduated from medical school, but was extremely unhappy when his degree was given under the name Lucille Hart, parentheses, aka Robert L. Hart. because he knew even though the name Robert Hart was there, he knew that if he presented himself as Dr. Robert Hart, if any potential employer looked at his credentials, they would either discover the name Lucille was tied to him or not discover any proper record at all. Jyoti Asundi (21:14) Correct. He is not able to shake that off. Aarati Asundi (21:16) Yeah. And so again, after graduating, he was forced to present as a female to get a job at the Red Cross in Philadelphia. Meanwhile, the psychotherapy isn't working. And so Alan proposes a radical idea to Dr. Gilbert. He says he wants to have a full hysterectomy. And actually the argument that he used was very clever. So obviously the reason he wanted to have it personally was to physically be more in line with being a male. Jyoti Asundi (21:45) Yes because now he has recognized just cutting off the hair is not enough. And changing clothes is not enough to become a male and now he's saying okay actually change the body. Aarati Asundi (21:54) Yes. But that argument was not going to be persuasive at the time. Jyoti Asundi (21:59) Absolutely not. Aarati Asundi (22:01) So instead, he brought forward a eugenics argument that it was medically agreed upon that people with this quote unquote "abnormality" should be sterilized. That was the belief at the time. And he used that even though he didn't believe it. Jyoti Asundi (22:17) Absolutely smart, very smart. Use your own bad ideas for my greater good. Aarati Asundi (22:23) Exactly. Jyoti Asundi (22:23) What a clever, remarkable young man. Aarati Asundi (22:27) Mm-hmm. Dr. Gilbert was reluctant at first, but he was forced to admit that in their sessions, Alan had only ever saw himself as male. He would refer to himself as male, saying phrases like, "the other fellows and I", or "what was a fellow to do?" when he's talking about himself. And he's already able to pass as a male very easily by pinning up his hair under a hat or a wig and wearing men's clothing. He would go around the world and people would think he was a man very easily. Jyoti Asundi (22:59) Very easily. Aarati Asundi (23:01) He also knew that Alan was highly intelligent. He's getting top grades at a medical school and showed no signs of being mentally impaired, which might otherwise give Dr. Gilbert grounds to deny the surgery. And so finally, Dr. Gilbert agreed to go ahead and give him the hysterectomy, making Alan Hart the first documented case of a transgender male transition through a sex reassignment surgery in America. Jyoti Asundi (23:29) Okay he broke a big barrier that way. Hmm. Aarati Asundi (23:32) Mm-hmm. Jyoti Asundi (23:33) But I am very impressed by how he twisted the existing prejudices to suit his own needs. Aarati Asundi (23:42) Yes, very clever. Jyoti Asundi (23:43) Yeah, it reminds me of the movie of Ruth Bader Ginsburg where she goes to law school and everybody is asked by the professor, why are you here? And she very cleverly says, "I'm here because my husband is a lawyer and by understanding what he's going through, I'm able to support him better." Aarati Asundi (24:04) Yeah. Very, very smart. You have to be so smart in these situations to get what you want. Jyoti Asundi (24:08) You have to be! Because it's not easy to fight the tide. You have to figure little crooks and crannies through which you can find your own opposite path and pretend that you're going with the flow while actually you are moving in the exact opposite. Aarati Asundi (24:24) And I bet Dr. Gilbert even knew what he was doing. Jyoti Asundi (24:28) Yes, but how is he going to refute it? Aarati Asundi (24:28) And was like, you see, he's so smart. Yeah, he's so smart. Like, again, goes back to the highly intelligent argument. He's very intelligent. After the surgery, he legally changed his name from Lucille to Alan Hart. He cut his hair short and he started living openly as a man. He even registered for the draft. So that's how committed he was. Jyoti Asundi (24:51) Committed to being male, yes. Aarati Asundi (24:53) He got married to a school teacher named Inez Stark and he set up his own practice in Oregon. Dr. Gilbert was always referring to Alan as "she and her" in his notes. So just note that. Dr. Gilbert said quote, "She made her exit as a female and started as a male with a new hold on life and ambitions worthy of her high degree of intellectuality." Jyoti Asundi (25:21) Hmm. High praise coming from somebody who... basically what you Gilbert trying to do hypnosis and this and that, that's conversion therapy of today, right? And even he had to basically wave the white flag of surrender and say "Yeah, he's in alignment with his true nature." Aarati Asundi (25:40) Yeah. Unfortunately though, his troubles were far from over. In 1918, one year after the surgery, he was spending some time interning at San Francisco Hospital when a former classmate, Dr. R.A. Jones, recognized him and outed him to various media outlets. The San Francisco Examiner ran with it and published an article titled, "Woman Doctor Parades as Man." Jyoti Asundi (26:07) Oh the horror! Aarati Asundi (26:09) Oh terrible! It was a big scandal and Alan was forced to give up his internship and return back to Oregon. Jyoti Asundi (26:16) What happened to live and let live? I don't understand. Aarati Asundi (26:18) I know these people poking their noses where it doesn't belong. Jyoti Asundi (26:21) I mean, I don't even understand what did the other person get out of it? Whoever outed him? They probably got their only 15 minutes of fame by doing that. A few media outlets would have paid him some money? Aarati Asundi (26:36) Her. I think it was a girl actually who added him. A woman. Jyoti Asundi (26:39) Okay. Very sad, very sad. Aarati Asundi (26:42) When interviewed for a local paper about it, he said, quote, "I had to do it. For years, I had been unhappy. With all the inclinations and desires of the boy, I had to restrain myself to the more conventional ways of the other sex. I've been happier since I made this change than I ever have in my life and will continue this way as long as I live." End quote. Jyoti Asundi (27:04) Good for him, stood his ground. Aarati Asundi (27:06) But for the next few years, his life was like a never ending circus. He moved from state to state, but every time he tried to settle down, he was recognized and hounded, forcing him to move again. Eventually, he decided to go back to his hometown in Oregon for the time being. His family was still there, and so he had some support. Jyoti Asundi (27:26) Yeah. Aarati Asundi (27:28) This time was deeply distressing to Alan though, and he reached back out to Dr. Gilbert again to help him through it. Dr. Gilbert provided him with a document asserting that in his professional opinion, Alan was a man, Alan was able to use this letter to quiet some of the media outlets. Jyoti Asundi (27:46) He was able to shut up some of them at least. Okay. Aarati Asundi (27:48) Yes. And even his mother came to sort of his defense And she said, shouldn't really matter whether Alan wore a skirt or pants. It's not like he was the first person ever born as a female to ever wear pants. And it didn't affect his work as a doctor. So what does it matter? Jyoti Asundi (28:07) What is the hoo-ha about? Aarati Asundi (28:09) Yes. Who cares? He's a doctor. Let him, let him do his work. Jyoti Asundi (28:12) Women all over pants for riding and for everything else. So what is the big deal? Aarati Asundi (28:20) Why are you so concerned? Yes. Jyoti Asundi (28:22) Why are you concerned with? Yeah. Aarati Asundi (28:22) So she is still thinking of him as a woman, you know, but at least she was like, this is not a big deal. Jyoti Asundi (28:29) Yes. Aarati Asundi (28:30) Finally, in 1921, Alan managed to get a recommendation from a colleague, Dr. Harriet Lawrence, helped him get a position as a staff physician at Albuquerque Sanatorium. But the constant moving around had placed a heavy financial burden on Alan, and it became too much for his wife, Inez. She ended up separating from him in 1923 and divorcing him in 1925. But that same year, Alan married Edna Ruddick, another teacher whom he had met while he and Inez were separated. Edna stayed with him and supported him for the rest of his life. And they were a really good match because she was very active in doing social work and working on public health campaigns. So it complimented his work very well. _______________________________________________________________________________________ Grow Everything Podcast Advertisement Aarati Asundi (29:53) Hi everyone, Aarati here. I hope you're enjoying the podcast. If so, and you wish someone would tell your science story, I founded a science communications company called Sykom, that's S-Y-K-O-M, that can help. Sykom blends creativity with scientific accuracy to create all types of science, communications, content, including explainer videos, slide presentations, science, writing, and more. We work with academic researchers, tech companies, nonprofits, or really any scientists. To help simplify your science, check us out at sykommer.com. That's S-Y-K-O-M-M-E-R.com. Back to the story. _______________________________________________________________________________________ Aarati Asundi (30:41) In 1926, Alan and Edna moved briefly to New York to Queens, where Edna was originally from, and they got married there. Alan spent some time working at the Trudeau School of Tuberculosis in New York and then he went to Illinois to the Rockford Tuberculosis Sanatorium. Edna also got involved doing social work around TB and organizing health campaigns. Tuberculosis or TB was a very hot topic in the medical field at this time. It's a bacterial disease that primarily attacks your lungs, causing the patient to develop a fever and cough. And then the disease is spread from person to person when the patient coughs or sneezes. Today we have antibiotics to treat TB, but back then there was no cure. And so the next best thing that doctors could do was try to catch it in the early stages and prevent it from spreading. Jyoti Asundi (31:39) That is why you have those sanitariums where people can be quarantined. Aarati Asundi (31:44) Mm-hmm. But in the very early stages of TB, many patients don't show any symptoms. And so the question was, how could you detect an infection that is sitting quietly in the person's lungs and not causing them to cough or sneeze, and they're moving about the world? Jyoti Asundi (32:04) Just waiting quietly. Aarati Asundi (32:06) Yeah, and so Alan, spending time in these tuberculosis hospitals and sanatoriums, he's getting more and more interested in the disease. And he's also learning about this new technology at the time called Rontgen rays, or as we know them better today, x-rays. Long time listeners will remember that We covered Dr. Wilhelm Röntgen in episode 21. Jyoti Asundi (32:32) Bringing physics and medicine together now. Yes. Aarati Asundi (32:35) Yes. x-rays had been discovered by Wilhelm Röntgen in 1895 when Alan was five years old. And the remarkable thing that medical people were all excited about was that these X-rays could pass through less dense materials like skin and tissue, but were blocked by more dense things like our bones. And so by the mid-1920s, when Alan is now studying TB, X-rays had already been well established for looking at bones to see fractures and even cancer tumors. And even though the technology was not as good as it is today, x-rays could also be used to see severe cases of TB in the lungs because fluid and scar tissue would build up, and so the lungs would appear kind of cloudy. Jyoti Asundi (33:25) Yeah. Aarati Asundi (33:26) So Alan was like, if we can see severe cases of TB, how far back can we push that? How early can we catch it on an x-ray? Jyoti Asundi (33:35) Look at it in a longitudinal fashion until you can go back towards when it started. Aarati Asundi (33:41) Yes, and can we actually see it on an x-ray even before the patient starts exhibiting coughing and sneezing symptoms? Jyoti Asundi (33:48) Got it. Aarati Asundi (33:49) And so in order to pursue this line of inquiry, Alan went back to school. And in 1928, he graduated from the University of Pennsylvania with a master's in radiology. Jyoti Asundi (34:01) Wait a second. So he graduated with a master's in radiology and hopefully this time his master's his correct name on it. Aarati Asundi (34:09) Has his real name on it. Yeah. Yes. He started advocating for people to routinely get chest x-rays, especially if they were at risk for developing TB. And by studying these x-rays, he was able to spot small abnormalities on the lungs of early stage TB patients. He could see small white patches on the x-rays where immune cells were starting to build up. Or sometimes he would see little lesions or nodules called tubercles, which I'm guessing is where the name tuberculosis comes from. Jyoti Asundi (34:44) Yes, probably, yes. Aarati Asundi (34:46) And then sometimes there were even small cavities in the lungs where the tissue had been destroyed. Jyoti Asundi (34:51) And he's able to see all this with an X-ray. Aarati Asundi (34:54) Mm-hmm. And so when a patient started to show these things on an x ray, they were immediately put on bed rest and given good nutritious food and fresh air in the hopes of giving the body's immune system the best possible chance to fight off the infection. And in many cases, patients did actually recover thanks to the fact that it had been caught early. So Alan starts to strongly advocate for early detection of TB through x-rays. He started establishing x-ray "chest clinics", quote unquote, all around the country, because TB was heavily stigmatized at the time. And so by calling them "chest clinics" and himself a "chest doctor", he made it more likely that people would come to get the screenings. Jyoti Asundi (35:41) Yes, there is no barrier or stigma to it anymore. Aarati Asundi (35:45) Yes. And I think it still is kind of stigmatized in some parts of the world. If there's even a chance that you might have TB, it's like, ⁓ stay away from me. Jyoti Asundi (35:53) Yes. It's like, yes, stay away from me because you are silently bringing it into my vicinity. Yes. Yes, absolutely. Aarati Asundi (35:59) Mm-hmm. Yes. And so I can totally see people wouldn't want to go and be like, I'm getting a TB screen. Like, you know, it's like.. yeah. Jyoti Asundi (36:06) Correct. It's like, then why are you talking to me? Aarati Asundi (36:10) Yes exactly. Jyoti Asundi (36:11) Yes, be quarantined until you get a negative result. Aarati Asundi (36:16) So again, very smart marketing, calling himself a chest doctor and saying, yeah, come to the chest clinic. Jyoti Asundi (36:21) Yeah. He knows how...he has that property of water. You know, if there's a big boulder, you don't try to go through it. You just find your way around it, work your way towards where you want to go. Aarati Asundi (36:34) He traveled around speaking at conferences, giving interviews to newspapers and talking at high schools and universities to students to explain the importance of preventative care. And in 1930, Alan moved to Washington became the director of the radiology lab at Tacoma General Hospital. He and Edna immediately got involved in the community there, taking part in fundraising drives and educational outreach efforts. But just two years later, he left Tacoma General Hospital. Alan said that times were tough and the hospital had to let him go because there wasn't enough funding. But there were some rumors that maybe he fainted at work and when he was being seen to, his gender situation was discovered. And so we're not sure which one it is, but for the next few years he did have a very tough time again, landing a full-time job. Jyoti Asundi (37:32) Okay. Aarati Asundi (37:33) So he's running once again into financial issues. And this was made even worse because now we're in the Great Depression. So to take his mind off of his troubles, he turned back to his old love of writing and turned that into a second source of income. He wrote numerous publications, of course, and science articles about tuberculosis prevention that were aimed to educate the general public. But he also wrote four fiction novels that were all semi autobiographical, drawing on his real life experiences. They usually featured an underdog doctor character working for social justice. Jyoti Asundi (38:16) Yes. Aarati Asundi (38:17) So in 1935, he published his debut novel, Dr. Mallory, which was about a doctor in a small logging town in Oregon who treats poor, needy patients. One year later, he published The Undaunted, which was about a gay doctor and followed his story as he pursued a career in radiology but had to keep changing jobs because he was being harassed about his sexuality. Jyoti Asundi (38:42) Yes. Aarati Asundi (38:43) In 1937, he published In the Lives of Men, which was about a doctor living in a town very similar to Tacoma, Washington, and treating patients during a flu epidemic, which apparently hearkened back to kind of his grad school days a bit. Jyoti Asundi (39:00) Okay. Aarati Asundi (39:01) Ironically, although this novel generally got good reviews, one critic at the Saturday Review of Literature Magazine was a bit more critical writing that quote, "As a doctor, Hart knows surprisingly little about women," end quote. Jyoti Asundi (39:16) That is so funny. But it could be true because he definitely thinks of himself as a man. That's fairly hilarious. Aarati Asundi (39:26) Yeah, yes, I thought so. Jyoti Asundi (39:26) That's fairly hilarious actually. Aarati Asundi (39:30) I thought that was pretty funny. Jyoti Asundi (39:33) And it's really in a way frustrating to him because on the one hand, getting into trouble constantly losing his jobs and everything because he's presenting as a man and being told, no, you're a woman. And it's like, you don't know anything about women. OK, that's wonderful. It's like neither here nor there. Aarati Asundi (39:53) I would hope that would be one of the highest compliments. Like, if I was in his shoes, I'd be so happy. I'd be like, yes, he they finally yes, I'm a man. Yeah. Jyoti Asundi (39:59) Yes, that's what I've been telling you all along. I have been saying this. This is the story of my life, guys. Yes. Aarati Asundi (40:07) Yes, yes. And then in 1942, he published his final novel, Dr. Finlay Sees It Through, which was about a wealthy doctor who moved back to his hometown in the Pacific Northwest to reestablish his practice during the Great Depression. Jyoti Asundi (40:25) Okay, so it's the complete arc basically where he's back home as a successful, wealthy man. Aarati Asundi (40:33) Yes. Jyoti Asundi (40:34) Nice. So these four novels that he wrote, were they commercial successes or well reviewed? Aarati Asundi (40:42) Yeah, they were fairly successful. They were enough to generate a kind of second income that helped him get through the Great Depression. Jyoti Asundi (40:50) Get through the hard times. Okay. Aarati Asundi (40:51) Yeah, so this did become a genuine second income stream for him that helped him. Yeah. Jyoti Asundi (40:56) That's what I'm trying to... because he already being marginalized due to his gender fluidity and for him to be so smart, find different ways to with his situation, it's remarkable. Aarati Asundi (41:11) Yeah, it made the story even more fascinating to me because I was like, not only is he fighting against, you know, societal norms, not only is he this brilliant doctor, but he's also like a bestselling novelist. So how many more like ways can you show that you're brilliant Jyoti Asundi (41:29) And a major asset to any society and instead he is being treated like a criminal for dressing up in men's clothes. Aarati Asundi (41:38) Yeah. OK, so in the middle of all this, middle of writing all of these novels, in 1937, Alan was hired by the Idaho Tuberculosis Association to set up TB prevention and awareness across the state. Idaho specifically was a challenge because it was made up of many rural communities. And so it wasn't easy to just go to a big city and set up a clinic and have thousands of people come. People are scattered all over the countryside. And so in order to help as many people as he could, he created a mobile TB screening clinic that he and Edna would travel around in. So basically like a big van with an x-ray machine in the back. And then patients could come into the van and they could close it all up and they could have their x-ray privately and safely. Jyoti Asundi (42:32) You know, this thought has been brewing in the back of my mind as we have been talking about early intervention and early screening for tuberculosis. Tuberculosis is not easy to detect for other reasons as well. So a commonly known bacteria is E. coli, for example, that you grow in labs and it's a gut bacteria. Most bacteria they double their doubling time is 20 minutes. So if you go to a lab and you try to grow bacteria you can put like a couple of bacteria in a bit of broth and the next day the whole thing will be very cloudy because it's log 2. So 1 becomes 2, 2 becomes 4, 4 becomes 8 and so on very rapidly and if that's happening every 20 minutes you can imagine how many bacteria are there at the end of 24 hours. The tuberculosis bacteria it's called mycobacterium tuberculosis and that- the doubling time of that is 24 hours or more. So one bacteria becomes two after 24 hours. So imagine if you have got sample like a deep throat sputum sample and you're trying to grow that in a lab to see it have bacteria in it. There are so many other bacteria in your spit and in your throat and everything they'll take over. One or two lone mycobacteria tuberculosis they don't double fast enough and can easily be hidden under the plethora of the normal flora of your mouth. You can't detect it by looking for the bacteria. Aarati Asundi (44:15) And I'm sure they tried that, which is it why makes it even more remarkable that he's able to see this on an X-ray. Jyoti Asundi (44:22) Exactly, exactly. Nowadays of course there are other ways are immune based assays. So the tuberculosis bacteria causes this particular reaction immune reaction- interferon gamma or some such thing comes up- and so you detect for that. It's called an IGRA test today. But in those days, you didn't have these methods. So what he's doing becomes even more important. And this ability where he goes to the patient in a van rather than having the patient come and why would the patients come to him? Because if you think about it, they have their own farms, they have busy lives. They cannot take the time to travel miles and miles, maybe spend two, three days away from all their chores that they are doing, all their livestock. They have to leave all of that. Aarati Asundi (45:12) And the way he's doing it also, they probably would have to come for multiple scans. You'd have to come back one day, and he would say, I think maybe I see something. Come back, you know.... Jyoti Asundi (45:24) Come back in a month and let us check. Aarati Asundi (45:26) Yeah, let's check again. Jyoti Asundi (45:26) Yes, come back in a month and let's see if there's a change. Makes a lot of sense. Aarati Asundi (45:31) That said, he repeatedly did lobby politicians for funds to set up a permanent tuberculosis hospital in Idaho, but for almost a decade, it kept getting delayed for some reason or another. At one meeting with the North Idaho Anti-Tuberculosis Association, Alan, in a fit of frustration, said, quote, "We lost the sanatorium in 1919 and again in 1938 because of political boondoggling while your friends and mine were dying," end quote. Jyoti Asundi (46:03) You can feel his frustration, yes. Aarati Asundi (46:07) Yes, I hadn't heard that word boondoggling before. Jyoti Asundi (46:11) No, I have to look it up. Aarati Asundi (46:12) I did, I looked it up and basically it's wasteful pointless work that is done in order to look busy, but lacks any real value. Jyoti Asundi (46:21) I call it donkey's work. Where the teacher gives you a whole bunch of pointless exercises... Aarati Asundi (46:26) Yeah, just to make you seem busy. Yes. Jyoti Asundi (46:27) ...just to keep you busy and out of her, out of the teacher's hair Aarati Asundi (46:33) So finally, the sanatorium did get established in 1946 using donated buildings from a local college and repurposing a Japanese internment camp. So he's just using resources wherever they are. Jyoti Asundi (46:48) He is very clever. He knows how to find a path forward. Aarati Asundi (46:52) In 1943, a PhD student at Rutgers University, Albert Schatz, discovered streptomycin, which became the first antibiotic that proved to be an effective cure for TB. Jyoti Asundi (47:04) The light at the end of a very dark tunnel. Aarati Asundi (47:07) Yeah. But by this time, thanks to Alan and Edna and over a decade of advocating for preventative screenings, running chest clinics and training doctors on early detection methods, the rate of deaths from TB decreased by 35 to 40 % from 1930 to 1940. Jyoti Asundi (47:27) Wow. That is a significant contribution. 40% lower death rate. Remarkable. Aarati Asundi (47:33) And his methods for early detection were still very crucial to making sure that patients got the proper treatment as soon as possible. Because of course, like as soon as you have any signs of having the disease, if you can hit it with antibiotic, that makes your life a lot easier and your outcome probably better. Jyoti Asundi (47:50) And the nutrition, quarantine so others are not affected. Aarati Asundi (47:56) In 1947, Alan and Edna moved to Hartford, Connecticut, where they spent the rest of their lives. Again, here they got deeply involved in their community and in social work. Alan went to Yale and in 1948, at the age of 58, he got another master's degree in public health. Jyoti Asundi (48:17) Okay. Aarati Asundi (48:18) He became director of the hospitalization and rehabilitation for the State Tuberculosis Commission, where he oversaw statewide TB screenings. Edna became a professor the University of Hartford, and Alan would also go there to visit and give lectures. They would both hold fundraisers to raise money for people who couldn't afford TB treatments. And they also got very into other social issues like destigmatizing mental illness and opposing racial discrimination in housing. Jyoti Asundi (48:52) True pillars of the community. Aarati Asundi (48:53) And just fighting against every form of injustice or inequity that they can find. Jyoti Asundi (48:59) Social justice warriors. Aarati Asundi (49:02) On a more personal level, Alan finally got access to synthetic testosterone which been approved for therapeutic use by the FDA in the late 1930s. Jyoti Asundi (49:13) It had been approved in use for what? Aarati Asundi (49:18) Hypogonadism, for male hypogonadism. Jyoti Asundi (49:21) Okay. So the FDA has approved testosterone for some other purpose and again Alan is able to repurpose that and use it for his own purposes. Aarati Asundi (49:34) And by this time, I'm sure like all his paperwork and everything would say he's a male, he's a male. And so he could make the argument that yeah, I'm a man, but I'm not. displaying some of the physical features, which means that I fall into the category of hypogonadism. And so I need testosterone. Yeah. Jyoti Asundi (49:51) Yes, he is able to make those arguments. Aarati Asundi (49:54) Taking testosterone finally allowed him to grow a beard, and he developed a deeper voice, which boosted his self-confidence a great deal, especially when giving lectures and things like that. Jyoti Asundi (50:05) Yeah, and also I'm thinking now nobody's going to question him about whether it's male or female or if some random lady from his past comes back and says, "I know this was a lady before," he has a beard waving at her. So... Aarati Asundi (50:22) Yes, yes, he's truly fully made the transition at this point. And he lived this his death in 1962 at the age of 71. He died from heart failure. Following Alan's wishes, after his death, Edna had his body cremated and scattered over the Puget Sound, where he and Edna had vacation during the summer. She left most of their estate to the Medical Research Foundation of Oregon and established the Alan L. and Edna Rudnick Heart to support leukemia research, which was how Alan's mother had died. Jyoti Asundi (50:59) Yes, nice. Aarati Asundi (51:01) Edna, also at Alan's request, destroyed all of his personal papers hoping to keep their private life strictly private. However, in 1976, so 14 years after Alan's death, an author, Jonathan Ned Katz, found Dr. Gilbert's notes where he was writing about treating a patient named H. And he pieced together from like birth dates and significant events that H was Alan Hart. Jyoti Asundi (51:32) I see. I see. Aarati Asundi (51:34) At the time, Jonathan Katz didn't believe in transgenderism. And he thought that Alan and Edna must have actually been lesbians. Jyoti Asundi (51:43) Okay. Aarati Asundi (51:44) So he reached out to Edna hoping to get more information about their private life. But Edna refused to be interviewed, one, because it was too painful to dredge up all of this gender identity controversy around Alan again. Jyoti Asundi (51:57) One more time. Yeah, they have they have suffered enough. Aarati Asundi (52:01) Yeah. And two, because she was offended that Katz was wrongly portraying Alan and therefore herself as a lesbian. Jyoti Asundi (52:09) Correct. Aarati Asundi (52:10) But throughout the 1980s and into the 90s, people referred to Alan again as Lucille Hart in biographies and events. Even the Oregon Gay and Lesbian Rights Political Action Committee, which was called Right to Privacy, started hosting a Lucille Hart dinner, calling Alan Hart "a famous lesbian from Portland" believing that Alan chose to masquerade as a man in order to avoid stigma from society. Jyoti Asundi (52:39) Oh insult upon injury. Okay Aarati Asundi (52:42) Yeah, so even after his death, we're still fighting about it. Yeah. Jyoti Asundi (52:44) After his death, even after his death it's not done. Okay. Aarati Asundi (52:48) But in the 90s, trans advocates started pushing back, saying that Alan never once showed any signs of thinking of himself as woman or as a female. Jyoti Asundi (52:58) Correct. In fact, you have the reviewer of one of his famous books saying, doesn't understand what it means to be a woman. Aarati Asundi (53:04) Yeah, yeah, he doesn't know anything about. Yeah. In 1995, a group of trans people formed the Ad Hoc Committee of Transsexuals to recognize Alan Hart. They approached the Portland chapter of a group called the Lesbian Avengers. I love that name. Jyoti Asundi (53:24) Good for them. Yeah you need to avenge this kind of insult absolutely. Aarati Asundi (53:30) And so ad hoc committee on behalf of Alan Hart presented their case to the Lesbian Avengers saying that Alan Hart was in fact a trans man and not a lesbian. And so with all the facts laid out, the Lesbian Avengers agreed. And so together, they teamed up and they tried to negotiate with the Right to Privacy PAC to stop having this Lucille Hart dinner and calling Alan, Lucille Hart. And when that didn't work, they went to the dinner and other events with banners and buttons that said "His name was Alan Hart" and they were protesting. Jyoti Asundi (54:09) Got it. Yes. Aarati Asundi (54:11) This worked, and the following year, the Right to Privacy PAC changed the name to the Right to Pride Dinner. And then in 1999, the Right to Pride Group dissolved, and most of the members joined the Basic Rights Oregon Group. And the next year, this group hosted the 17th Annual Hart Dinner. Jyoti Asundi (54:30) Just the "Hart dinner". Aarati Asundi (54:31) Which is fine. Yeah. Jyoti Asundi (54:32) Which is wonderful! Treat them as human beings first, right? Whoever it is. You, me, Alan Hart, it doesn't matter treat each person as a human being first. Aarati Asundi (54:44) Yeah. And importantly, Jonathan Katz, the one who kind of kicked off all of this by calling Alan a lesbian, also backtracked on this belief and said he would not categorize Alan that way today. Jyoti Asundi (54:57) Got it. Okay. Aarati Asundi (54:59) And today, most writers and biographers do refer to Alan as a trailblazing trans doctor whose work in TB saved countless lives. And so that's the story of Alan Hart. Jyoti Asundi (55:11) Amazing, amazing. Not only did he contribute both medically and socially during his lifetime, but also continued to contribute after death. It took some time, but we are at a better place today because of all the confusions that arose then got cleared up because of the way he lived his life and clearly showed everybody that he was in no way thinking as a woman ever. His true soul was male. Aarati Asundi (55:40) Yep. And I liked this story a lot because I know like you and I as gender normal people, we have sometimes a hard time putting ourselves in the shoes of, trans people or gay people. But this really laid it out so beautifully and so clearly... Jyoti Asundi (56:01) Absolutely. Yes. Aarati Asundi (56:01) ...and just really helped to develop my own understanding, you know, so I thought it was a really important story. Jyoti Asundi (56:07) I absolutely agree because it's confusing to me as well, especially as more and more divisions occur. It's is already a marginalized group, the LGBTQA, it's already marginalized. And then they have so many subdivisions within them that it's very confusing to me. And they have so much to fight against. So there's a lot of misconceptions that are presented as fact to people like me who don't know much to begin with. And now we are wading through all that information and misinformation to kind of try sort is true. And Alan's life is a very clear, to kind of understand more clearly where they're coming from and how valid their thought process is. And not only you agree or don't agree doesn't matter at all because they are contributing a lot more to society than you ever could. With all your judgmental preconceptions and notions of how life should be and how many genders are there all of that, all of that preconception, doesn't contribute as much to society as Alan did in one lifetime. Aarati Asundi (57:19) Yeah, it's like if you can't appreciate him for being male, like... Jyoti Asundi (57:23) Male, Female, whatever. Aarati Asundi (57:23) ...appreciate his contribution. Like, yeah, appreciate. Yeah, forget that. Jyoti Asundi (57:28) Yeah, forget all that. Aarati Asundi (57:28) Appreciate the fact that he saved so many people's lives. Jyoti Asundi (57:32) Correct. Just look at him as a human being and go from there. Why can't we just do that to everybody? Look at everybody as a human being and allow each human being to achieve their full potential so that they can contribute to the greater good of mankind and of society. Alan had to fight so much to align with his true self. What if he was allowed full reign to be like call yourself whatever you want. Be whatever you want. whatever you want. what God put you on earth to do. How much more could he have achieved? Aarati Asundi (58:09) Yeah, already I was just astounded by the fact that it's like he got a medical degree. He got two master's degrees. He wrote four, you know, bestselling novels. Like- oh yeah, he also fought against social injustice for himself and for others. It's like, my goodness. Amazing guy. Yeah. Jyoti Asundi (58:25) Amazing, amazing, amazing guy. Aarati Asundi (58:29) Thanks for listening. If you have a suggestion for a story we should cover or thoughts you want to share about an episode, reach out to us at smartteapodcast.com. You can follow us on Instagram, TikTok, and Blue Sky @smartteapodcasts and listen to us on Spotify, Apple podcasts, YouTube, or wherever you get your podcasts. And leave us a rating or comment. It helps us grow. New episodes are released every other Wednesday. See you next time.