Laura Sellers

Alan Hart was an American radiologist and physician. He was the first person to use x-rays to detect early signs of tuberculosis (TB) and thus saved thousands of lives.

Born in Kanas in 1890 Hart graduated from Oregon Medical School in 1917 aged 26. Alan Hart was assigned female at birth. It is thought he identified as male very early on. After he graduated, he asked a former professor of his for sterilisation and surgery to stop menstruation. His request was initially rebuffed, and attempts were made to “treat” him with hypnotherapy and psychoanalysis. Nevertheless, Hart persisted and at his request a full hysterectomy was performed. This is believed to be the first medically assisted transition in the US. In 1918, after his medical transition, he said he was happier than ever and “ashamed of nothing”.

His grandparent’s obituaries in the 1920s both referred to him as their Grandson, he was accepted within the family and allowed to present as a boy outside of school. In 1918 he married his first wife and set up his own medical practice. Unfortunately, his medical peers and neighbours where often less accepting of his identity that his family and his identity was challenged, and he was “outed” on a number of occasions and consequently forced to relocate. The strain of moving and financial insecurity ended his first marriage, but he remarried in 1925, and his union with Edna Ruddick lasted until the end of his life.

Despite being forced to move and close his practice he had a successful career as a doctor. In 1928 he got a Master’s degree in radiology from the University of Pennsylvania, following studies of TB patients at the Trudeau School of Tuberculosis (New York) and the Rockford TB Sanitorium in Illinois. He was appointed the Director of Radiology at Tacoma General Hospital in 1929.

During the 1930s and 1940s Hart headed campaigns to get rid of TB. It was the biggest killer in America, doctors realised that a whole host of diseases/symptoms were actually TB. Hart was one of the first doctors to document how TB attacked the lungs and then spread throughout the body. If detected early TB could be treated but there were no cures for the advanced stages, consequently early detection was vital.

Hart realised that TB created shadows on the lungs of patients which could be seen using x-rays which meant patients could be diagnosed and treated earlier and the spread of the disease could be slowed. This was revolutionary was x-rays were almost exclusively used to detect breaks on bones and tumours. The early stages of TB often have no symptoms, so screening was invaluable for treatment and isolation which helped stop the spread of this air-born disease.

Hart set up mass screening across Idaho, including permanent centres and mobile clinics which screened, treated and educated people about the disease. He gave numerous public and academic lectures, upping the number after the second world war when synthetic testosterone became available in the USA which apparently helped give him more confidence in his public appearances.

He also published widely. He worked tirelessly to fundraise for research and for treatment of patients who couldn’t afford it. It is believed that Hart’s programmes had managed to cut TB deaths down to one fifth of what they had been previously. His work was greatly aided by the introduction on antibiotics in the 1940s.

Although his professional career focused on TB he also wrote fiction, including The undaunted (1936) one of the characters is a gay radiologist who is persecuted for his sexuality. It is interesting that major newspapers hailed this as an all-American book, as on the surface it seems that the characters fulfil the dominant gender binary and normality discourses of his day, but not far under the surface there is a queer narrative which doesn’t reinforce the norms of his time but rather to argues for a kinder world.