The First Man-Made Man by Pagan Kennedy is the tale of two early sex changes in England – that of Laura Dillon, who becomes Michael, and of Robert Cowell, who becomes Roberta. Both are compelled to change their lives completely, no matter what it takes, which, at the time, was plenty. It was not easy to find surgeons willing or able to do such operations, especially those willing to construct and attach a new penis. Laura/Michael undergoes 13 surgeries between 1946 and 1949 to construct a penis. At least his surgery is legal: “While an arcane law protected male genitals from ‘mutilation,’ no such bans applied to female genitals and reproductive organs.” Roberta (who was previously married to a woman) is the “first vaginal construction that had ever been attempted in Britain.”

The two even meet, and Michael wishes to woo and wed Roberta, but that is not to be. However, their relationship takes some weird, unpredicted turns. Michael becomes an M.D. and a writer, and later a practicing Buddhist. Pretty Roberta becomes popular with many guys.

For a book with such an exciting premise, The First Man-Made Man is somewhat disappointing. The subject matter holds this reader’s interest, but the writing does not. The book doesn’t have enough life in its pages; the narrative is quite flat. That said, of course, the subject matter is first-rate, and the author has done extensive research. And, of course, writing about people one has never met presents a challenge.

We come to know the facts of Michael’s and Roberta’s (the latter, to a lesser extent) lives, their family problems and their struggles to become themselves and to fit into an unwelcoming society, but we do not come to know them as complex individuals. I wanted to care more about them.

The story is most appealing when it centers on early ideas about transsexualism, and the very earliest instances of and reasons for plastic surgery. Magnus Hirschfeld, a doctor and gay activist, created the world’s first sexual research institute, the Institute for Sexual Science in Berlin, Germany. He was the first to define “transsexual” in a medical paper as, according to Kennedy, “ a class of men and women who were gripped by the conviction that they had been born into the wrong body.” Dr. Harold Gillies worked with Michael and also worked with returning war veterans, those with blown off faces, missing ears and other physical catastrophes. In the early 1920s, he was the first plastic surgeon to create a private practice in Britain.

Michael and Roberta had their sexes changed before the famous American, Christine Jorgensen, who became an international tabloid “star” in the early ‘50s.

The latter part of the book, in which Michael becomes spiritual and lives with monks in remote Tibet is less gripping than the earlier histories, yet it is important to follow the duration of Michael’s celibate life. Sadly, the monks have almost no food, and for the last years of his life, Michael is on a downward swing, emaciated and hungry most of the time. However, by the end of his life, he has published books and has managed to feel comfortable in at least one community during his lifetime.

The book’s importance lies in its history of sex changes and of plastic surgery. These are, of course, not uncommon these days, but The First Man-Made Man serves to remind us of a time when anything considered remotely “unnatural” or not heterosexual was something that was hated, something to be ashamed of, something that put the men and women with these needs and desires far outside polite, average society.

Pagan Kennedy has published seven other books – both fiction and biography – and is a long-time reporter for prestigious magazines and newspapers. She won the Barnes & Noble Discover Award for her novel, Spinsters (1995).