Reviewed by Suzi Steffen

From the first scene of Pagan Kennedy’s slim biography, readers know they’re in skillful hands. Kennedy carefully reconstructs a meeting between one of the world’s first medically supported transsexual women and the world’s first transsexual man. Her story covers the medical and societal advances — surgical techniques and a new understanding of hormones; a change in thinking in medical circles about gender and the possibilities of plastic surgery — which made this possible -- but Kennedy’s main focus remains on her titular character.  In an author’s note, Kennedy explains the terminology:  a transsexual woman is a person who was born male and transitions to life as a woman, and a transsexual man, born a woman, transitions to life as a man.

Although she talks about two sex changes, the second, when Robert Cowell became Roberta, takes up fewer pages. Instead, Kennedy focuses on Michael Dillon, born Laura Dillon, a daughter of minor Irish gentry. Born in 1915 and brought up to be a gentle servant to her mentally ill aunts, Dillon recreates himself - first as a mechanic, and then entirely as a man using hormones and surgery. He graduates from medical school and writes a book about transsexuals even as he completes his surgery — what is now known as "sex reassignment surgery." 

Mortally afraid of being discovered, Dillon hides from the British tabloids’ ridicule and flees to India and Tibet to follow spiritual paths as he attempts to leave behind the whole weary world of the body. Kennedy’s thoughtful recreation of Dillon’s feelings, gathered from journals, books and articles, smartly introduces readers to the world of those whose assigned birth sex or gender don’t fit them. And her historical research, perceptive analysis and clear understanding of the broader scope of Western notions of gender help inform her intelligent, moving book.