Vaginoplasty with Milton Edgerton, Jr. (retired)

Contact information:

In 2008, a University of Virginia spokesperson sent the following update: "Dr. Edgerton retired years ago, and we no longer offer gender reassignment surgery."

Address: University of Virginia Medical Center

Dr. Edgerton is a major figure in the history of surgical intervention for women seeking trans health services. As you will see in the selected bibliography I have compiled, his articles when read from earliest to latest read like an unfolding of the history of our community.

General pages:

Practiced with John Kenney.

Related pages:

Edgerton MT. Plastic surgery: its roots and rewards. Ann Plast Surg. 2003 Mar;50(3):240-3. PMID: 12800898

Edgerton MT. Early plastic surgery at the Johns Hopkins Hospital. Plast Reconstr Surg. 2002 Jul;110(1):229-33. PMID: 12087260

Edgerton MT. Plastic surgery: the rainbow profession. Ann Plast Surg. 1997 Mar;38(3):197-201. PMID: 9088453

Edgerton MT, Langman MW, Pruzinsky T. Plastic surgery and psychotherapy in the treatment of 100 psychologically disturbed patients. Plast Reconstr Surg. 1991 Oct;88(4):594-608. PMID: 1896531

This paper reviews the senior author's long-term experience with the surgical-psychiatric treatment of 100 aesthetic surgery patients with significant psychological disturbances. Patients with psychological disturbances of a magnitude generally considered an "absolute contraindication" for surgery were operated on and later assessed to determine the psychological impact of surgery. Patient follow-up averaged 6.2 years (maximum follow-up 25.7 years). Of the 87 patients who underwent operation (7 patients were refused surgery and 6 voluntarily deferred surgery), 82.8 percent had a positive psychological outcome, 13.8 percent experienced "minimal" improvement from surgery, and 3.4 percent were negatively affected by surgery. There were no lawsuits, suicides, or psychotic decompensations. Patients with severe psychological disturbances frequently benefited from combined surgical-psychiatric treatment designed to address the patient's profound sense of deformity. This study suggests that plastic surgeons are "passing up" a significant number of patients who may be helped by combined surgical-psychological intervention. Comment in: * Plast Reconstr Surg. 1992 Aug;90(2):333-5.* Plast Reconstr Surg. 1992 Jun;89(6):1173-5.

Edgerton MT Jr, Langman MW, Pruzinsky T. Patients seeking symmetrical recontouring for "perceived" deformities in the width of the face and skull. Aesthetic Plast Surg. 1990 Winter;14(1):59-73. PMID: 2330857

This article describes plastic surgery patients who sought symmetrical recontouring of the width of the face and skull. The basic demographic and personality characteristics of these facial width deformity (FWD) patients and the surgical procedures performed on them are discussed. Details of the surgical and psychological management of three representative cases are given. Speculative conclusions regarding the general characteristics of the FWD population are offered. Suggestions are proposed for a combined surgical-medical psychotherapeutic collaboration in managing these patients.Comment in: * Aesthetic Plast Surg. 1990 Fall;14(4):299-300.

Pauly IB, Edgerton MT. The gender identity movement: a growing surgical-psychiatric liaison. Arch Sex Behav. 1986 Aug;15(4):315-29. PMID: 3741090

The evaluation and treatment of individuals with gender identity problems has resulted in an interesting and productive collaboration between several specialties of medicine. In particular, the psychiatrist and surgeon have joined hands in the management of these fascinating patients who feel they are trapped in the wrong body and insist upon correcting this cruel mistake of nature by undergoing sex reassignment surgery. Over the last two decades, some 40 centers have emerged in which interdisciplinary teams cooperate in the evaluation and treatment of these gender dysphoric patients. The model for this collaboration began at The Johns Hopkins Hospital, where the Gender Identity Clinic began its operation in 1965 (Edgerton, 1983; Pauly, 1983). This "gender identity movement" has brought together such unlikely collaborators as surgeons, endocrinologists, psychologists, psychiatrists, gynecologists, and research specialists into a mutually rewarding arena. This paper deals with the background and modern era of research into gender identity disorders and their evaluation and treatment. Finally, some data are presented on the outcome of sex reassignment surgery. This interdisciplinary collaboration has resulted in the birth of a new medical subspecialty, which deals with the study of gender identification and its disorders.

Edgerton MT. The role of surgery in the treatment of transsexualism. Ann Plast Surg. 1984 Dec;13(6):473-81. PMID: 6524842

The increasing use of surgery for sex reassignment in the treatment of transsexualism is described. The author's early experience over a twenty-year period with the Gender Identity teams at The Johns Hopkins University and The University of Virginia is summarized. Many of the reasons for slow acceptance of this type of surgery by many members of the medical profession are analyzed. The satisfactory subjective results described by patients who have received sex reassignment continue to exceed the results obtained by other methods. The author concludes that further study of surgical treatment is justified, but that it should be limited to established multidisciplinary teams working in academic settings. Physicians are urged to withhold judgment on the role of surgery in gender disorders until they have had significant personal experience with these desperate and complex patients.

Edgerton MT Jr, Langman MW, Schmidt JS, Sheppe W Jr. Psychological considerations of gender reassignment surgery. Clin Plast Surg. 1982 Jul;9(3):355-66. PMID: 7172587

Edgerton MT, Sheppe WM Jr, Turner UG 3rd, Thorup OA. Transsexualism. An insight into the power of psychologic gender--a panel discussion. Pharos Alpha Omega Alpha Honor Med Soc. 1978 Oct;41(4):31-6. PMID: 724795

Turner UG 3rd, Edlich RF, Edgerton MT. Male transsexualism--a review of genital surgical reconstruction. Am J Obstet Gynecol. 1978 Sep 15;132(2):119-33. PMID: 356612

Transsexualism is a poorly understood, uncommon, and controversial entity of recent interest to the lay public and medical profession. Important features of the condition are discussed, surgical procedures for genital conversion in male transsexuals are compared, and our experience at the University of Virginia where 53 patients have been treated surgically is presented. All patients have made satisfactory postoperative psychosocial adjustment despite a surgical complication rate approaching 50 per cent. It is concluded that alternative (better) surgical procedures for male transsexuals should be explored.

Bralley RC, Bull GL, Gore CH, Edgerton MT. Evaluation of vocal pitch in male transsexuals. Commun Disord. 1978 Sep;11(5):443-9. PMID: 730836

A 49-year-old male-to-female transsexual was administered voice therapy following surgery. Tape recordings were made of her speech prior to and each week during therapy. Selected sentences from these reocrdings were analyzed. Results indicate that changes in both fundamental frequency and perceptual judgments of femininity were statistically significant and supportive to the client. The voice of the client was still discernible from that of a female speaker, although less so than before therapy. It is suggested that a composite treatment program combined with laryngeal modification through surgical intervention may be necessary.

Thomson JA Jr, Knorr NJ, Edgerton MT Jr. Cosmetic surgery: the psychiatric perspective. Psychosomatics. 1978 Jan;19(1):7-15. PMID: 622436

Edgerton MT. Liquid silicone injections to improve scars: is this a solution to the problem? Clin Plast Surg. 1977 Apr;4(2):311-9. PMID: 852228

Edgerton MT. The surgical treatment of male transsexuals. Clin Plast Surg. 1974 Apr;1(2):285-323. PMID: 4609668

Edgerton MT. Transsexualism--a surgical problem? Plast Reconstr Surg. 1973 Jul;52(1):74-6. PMID: 4713823

Edgerton MT, Bull J. Surgical construction of the vagina and labia in male transsexuals. Plast Reconstr Surg. 1970 Dec;46(6):529-39. PMID: 4923947

Edgerton MT, Knorr NJ, Callison JR. The surgical treatment of transsexual patients. Limitations and indications. Plast Reconstr Surg. 1970 Jan;45(1):38-46. PMID: 490284

Knorr NJ, Hoopes JE, Edgerton MT. Psychiatric-surgical approach to adolescent disturbance in self image. Plast Reconstr Surg. 1968 Mar;41(3):248-53. PMID: 5644617

Knorr NJ, Edgerton MT, Hoopes JE. The "insatiable" cosmetic surgery patient. Plast Reconstr Surg. 1967 Sep;40(3):285-9. PMID: 6037160

Consumer experiences (most recent first)

Turner, Edlich & Edgerton, 1978
Dept. of Obstetrics, Gynecology and Plastic Surgery, University of Virginia Medical Center, Charlottville, VA, USA
In structure and representation this publication is closely related to the one of Edgerton & Meyer (1973), that is, it is no follow-up study with reliable data. Related are mostly surgical techniques for MFTs and surgical complications. Under historical viewpoints it is an interesting statement that Edgerton was already in 1963 the director of the Johns Hopkins Gender Identity Clinic in Baltimore, MD, while everywhere else the founding of this institution is generally dated two years later. Also it is interesting that a psychologist is given a key role or a veto right to the indication to surgery. For the rest, the necessity for a successful one-year-long "Real-Life-Test" as it was already in Edgerton & Meyer (1973), the experimental surgical breast enlargement is recommended as a step if the patient and treatment provider are insecure regarding the stability of the female identity of the patient. In how far the statement: "The only justification for the ongoing evaluation of surgery as a definite treatment entity is that patients with this condition have proved resistant to psychotherapy and drug therapy" (p. 121) is a general postulate or if the corresponding possibility has been tested with those who underwent surgery is not to be discerned by the publication.
It is reported about 53 gender reassignment surgeries of MFTs that Edgerton made after changing from Baltimore to Virginia.
Forty seven females came to the follow-up study in the first year after surgery. Globally it is said that all were subjectively happy and self-secure and socially better adjusted. "Psychological testing has substantiated these subjective claims" (p. 128). Suicide attempts after surgery or desires to role re-reversal were not observed. Eighteen females had gotten married and six had adopted children.
In the series of the first 20 surgically treated, 14 females required corrective surgery; in the series of the second 20, only eight. The most frequent complication was the stenosis of the vagina. Injuries of the urethra or rectum with corresponding fistulae did not occur.