Pioneering Plastic Surgeon in Transgender Care Dies at 96

Marcia Frellick

July 20, 2018

Colleagues of Milton Edgerton, MD, the pioneering surgeon who helped found the first academic center for sex affirmation surgeries in the United States, praised his unparalleled contributions to the field of plastic surgery after the announcement of his recent death.

Dr Milton Edgerton

W.P. Andrew Lee, MD, is the inaugural Milton T. Edgerton, MD, professor and chairman in the Department of Plastic and Reconstructive Surgery at Johns Hopkins in Baltimore, Maryland. The professorship was established by the Edgerton family in 2011.

"The most important aspect that I'd like to continue is the foundation for education that [Edgerton] laid out at Johns Hopkins when he was the chief. He educated many residents who went on to become leaders in plastic surgery around the country, and those leaders trained future leaders," Lee said.

Lee said he visited Edgerton 2 years ago and asked him why he started the transgender program. He said Edgerton told him people were coming to him after complications from surgeries in Africa and no matter how severe the complications, they were so grateful to be seen by him. That led to his conviction that the clinic was crucial, he said.

"He made seminal contributions in so many areas that have since been refined and enhanced in the last three quarters of a century," Lee said.

According to his obituary, Edgerton, who was born in Atlanta, Georgia, in 1921, died on May 17 in Charlottesville, Virginia, after a 3-year struggle with multiple myeloma and malignant melanoma. A celebration of his life was held on July 14, which would have been his 97th birthday.

Medical Career Began at Hopkins

Edgerton completed his groundbreaking career from 1970 to 1994 at the University of Virginia and lived out his life in Charlottesville. His years at U-Va followed 16 years of pioneering achievements at Johns Hopkins School of Medicine.

Edgerton earned his medical degree at Johns Hopkins in 1944, and after years in the US Army Medical Corps, he returned to the university to complete a surgical residency, according to biographical information from Johns Hopkins. 

Edgerton was the first official resident in plastic surgery there, and he established the Division of Plastic Surgery and also created the Johns Hopkins Plastic Surgery Training Program.

The Washington Post reported that he joined psychologist John Money and endocrinologist Claude Migeon in 1965 in founding the Johns Hopkins Gender Identity Clinic.

"Initially shrouded in secrecy, the clinic marked the first time an American hospital performed sex-reassignment surgeries," the Post reported.

Few Doing Sex-Reassignment Surgeries in '60s

Few surgeons were performing sex-reassignment surgeries when Edgerton entered the field in the 1960s. They were performed mostly in Europe, Mexico, and Morocco.

The Post reported that Edgerton told the Journal of Clinical Psychiatry, "This is really cosmetic surgery because these people are already living as members of the opposite sex. It is gender-confirmation surgery, not gender-change surgery."

But the work was highly controversial and critics said such surgeries were both unethical and ineffective.

The Gender Identity Clinic closed in the late 1970s, and Johns Hopkins began performing sexual affirmation surgeries again only last year, when it opened the Johns Hopkins Center for Transgender Health in July 2017.

Specialized in Craniofacial Deformities

Edgerton's research also focused on pediatric patients with craniofacial deformities, which led him to be the first plastic surgeon to correct orbital hypertelorism.

His best-known patient was Debbie Fox, a girl from the Chattanooga, Tennessee, area, born with dozens of craniofacial defects, including eyes on the side of her head. In a 14-hour surgery, Fox's 37th surgery, Edgerton was able to give her forward vision, which allowed her to go to school for the first time, according to a report in Good Housekeeping.

Fox went on to tell her story in the book A Face for Me.

Johns Hopkins reports Edgerton was the author of more than 500 peer-reviewed medical papers and four medical textbooks.

He also had served as a president of the American Society of Plastic Surgeons (ASPS). In reporting his death, the ASPS noted that he was one of the early leaders influencing the growth of plastic surgery training programs nationwide.

ASPS President Jeffrey Janis, MD, told Medscape Medical News in a statement, "Simply put, Dr Edgerton was a true giant in plastic surgery whose impact was felt far beyond the institutions where he worked. He pioneered surgical techniques and mentored countless leaders and surgeons in the field, and he was a trailblazer in establishing departmental status for the specialty. We all owe him an immeasurable debt of gratitude. The legacy of Dr Edgerton will continue to live on without question."

His volunteer service included work at a leprosy hospital in India in 1962 and serving as a consultant at Walter Reed Hospital, Miller Center Governing Council, and the Jefferson Area Board of Aging (near Charlottesville), the obituary stated.

Lifelong Work Ethic

A former trainee of Edgerton's at U-Va, James W. Fox, IV, MD,  said he attended the celebration of life for the surgeon last weekend, which is where he found out they shared not only a love of golf, which he knew, but skiing, swimming, and bridge as well.

He told Medscape Medical News that when he applied for the residency, Edgerton was taking notes on a handful of the index cards he always had handy. When Dr Fox saw Edgerton at a talk at a plastic surgery reunion at U-Va 4 decades later, when Edgerton was 90, Edgerton was still writing notes with his pen on index cards, he said, laughing.

He said, "I think that he would be happy [that] at age 74, I'm still a professor and chairman at an academic center." (Dr Fox has been chief of plastic surgery at Temple University in Philadelphia, Pennsylvania, for the past 4 years.)

"He said if you're educated and you didn't have the shakes and you still had a brain, you're supposed to be going to work," Dr Fox said.

"He operated everywhere," he continued. "He operated on the hand, in gender transformation, cosmetic surgery, reconstruction — he did everything. And he was a master surgeon and a master in all these areas."

The current chair and program director at U-Va's Department of Plastic Surgery, Thomas Gampper, MD, told Medscape Medical News he was Edgerton's last fellow before he retired.

"He was incredibly beloved by patients and trainees," he said.

Gampper said Edgerton founded the department when he came in 1970 and kept close ties to the university all his life. His legacy will continue with a professorship in his name, he said.

Edgerton's obituary reports he was preceded in death by his wife of 64 years, Patricia, who died in 2010; four children; 11 grandchildren; and nine great-grandchildren.

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