Laurence Michael Dillon (1 May 1915 – 15 May 1962) was a British doctor and author, and the first transgender man to undergo phalloplasty.^[1]: vii Dillon was an early user of masculinising hormone replacement therapy and one of the first recorded recipients of a double mastectomy for the purpose of gender reassignment, and his 1946 book ‘Self: A Study in Ethics and Endocrinology’ is considered a pioneering work in the field of transgender medicine. As a surgeon, he performed an orchidectomy on Roberta Cowell, the first British trans woman to receive male-to-female sex reassignment surgery.

His transition became a subject of public attention when it affected his listing as the heir presumptive for the Dillon baronetcy of Lismullen in Ireland. He later moved to India and became devoted to Buddhism, changing his name to Lobzang Sramanera and then to Lobzang Jivaka. Between 1960–1962, he wrote four books on Buddhism, including ‘Imji Getsul: An English Buddhist in a Tibetan Monastery’. His autobiography ‘Out of the Ordinary: A Life of Gender and Spiritual Transitions’ was completed in 1962, and published in 2016.

Dillon was the second child of Robert Arthur Dillon (1865–1925), heir to the baronetcy of Lismullen in Ireland, and his Australian wife, Laura Maud McCliver, née Reese. Dillon's mother died of sepsis ten days after giving birth. Dillon was raised alongside older brother Bobby by their two aunts in Folkestone in Kent, England.^{[citation needed]} He grew up in the Church of England.^[2]

Dillon was educated at Brampton Down School,^{[citation needed]} then at St Anne's College, Oxford, a women's college. Dillon was president of the Oxford University Women's Boat Club and won a blue for rowing, competing in the Women's Boat Race in 1935 and 1936.^{[3]: 19–25} After graduating he took a job at a research laboratory in Gloucestershire.^[3]: 35

Dillon was more comfortable in men's clothing and was more self-assured living as a male.^{[citation needed]} In 1939, he sought treatment from George Foss, who had been experimenting with testosterone to treat excessive menstrual bleeding; at the time, the hormone's masculinizing effects were poorly understood. Foss provided Dillon with testosterone pills but insisted that Dillon consult a psychiatrist first, and the psychiatrist he consulted gossiped^[1]: 5–6 about Dillon's desire to express a male gender identity, resulting in the story becoming widely known. Dillon fled to Bristol^{[dubious – discuss]} and took a job at a garage. The hormones soon made it possible for him to pass as male, and eventually the garage manager insisted that other employees refer to Dillon as "he" in order to avoid confusing customers. Dillon was promoted to recovery-vehicle driver and doubled as a fire watcher during the Blitz.^{[3]: 26–51}

Dillon suffered from hypoglycemia, and twice injured his head in falls when he passed out from low blood sugar. While in the Bristol Royal Infirmary recovering from the second of these attacks, he came to the attention of one of the world's few practitioners of plastic surgery. The surgeon performed a double mastectomy, provided Dillon with a doctor's note that enabled him to change his birth certificate, and put him in contact with the pioneering plastic surgeon Harold Gillies.^{[3]: 52–68} He officially became Laurence Michael Dillon in 1944 when the birth certificate was amended; this meant that he was now heir presumptive to the baronetcy. Dillon was one of the few transgender people able legally to change his identity at this time; in 1970 the marriage of April Ashley, a trans woman, was declared null in the court case Corbett v Corbett, and thenceforth changes of sex would not be legally recognized in the United Kingdom until a 1999 amendment of the Sex Discrimination Act of 1975, and not in the absence of medical supervision until the Equality Act of 2010.^{[citation needed]}

Gillies had previously reconstructed penises for injured soldiers and performed surgery on intersex people with ambiguous genitalia. He was willing to perform a phalloplasty, but not immediately; the constant influx of wounded soldiers from World War II already kept him in the operating room around the clock. In 1945 Dillon enrolled in School of Medicine at Trinity College Dublin under his new legal name, Laurence Michael Dillon. A former tutor of Dillon's persuaded the Oxford registrar to alter records to show that he had graduated from all-male Brasenose rather than the women's college St Anne's, so that his academic transcript would not raise questions. Again he became a distinguished rower, this time for the men's boat club.^{[3]: 69–76}

Gillies performed at least thirteen surgeries on Dillon between 1946 and 1949. He officially diagnosed Dillon with acute hypospadias in order to conceal that he was performing sex-reassignment surgery. Dillon, still a medical student at Trinity, blamed war injuries when infections caused a temporary limp. In what little free time he had he enjoyed dancing, but he avoided forming close relationships with women, for fear of exposure and in the belief that "One must not lead a girl on if one could not give her children." He deliberately cultivated a misogynist reputation to prevent any such problematic attachments.^{[3]: 6–9, 71–72, 79–82}

In 1946 Dillon published Self: A Study in Ethics and Endocrinology, a book about what would now be called transsexuality, though that term would not be introduced into the English language until 1949, when David Oliver Cauldwell introduced the word directly based on Magnus Hirschfeld's coinage (in German) of the term Transsexualismus in 1923. Dillon described "masculine inverts" as being born with "the mental outlook and temperament of the other sex", using Stephen Gordon in the 1928 novel The Well of Loneliness as an example. Since this form of "inversion" was asserted to be innate, as a hidden physical condition similar to intersex, Dillon said it could not be affected by psychoanalysis and should instead be treated medically. "Where the mind cannot be made to fit the body," he wrote, "the body should be made to fit, approximately at any rate, to the mind."^[4]

Self brought him to the attention of Roberta Cowell, on whom he would perform an operation to help her become the first British trans woman to receive male-to-female sex reassignment surgery. Despite the operation being illegal under British law and his not being a qualified medical practitioner, Dillon operated on Cowell to perform an orchiectomy (removal of the testicles).^[5] Dillon had also developed a strong romantic interest in Cowell, but she rejected his advances after he performed the operation.^[5] Dillon also introduced Cowell to Gillies, who then performed a vaginoplasty for Cowell.^[5]

Dillon qualified as in medicine in 1951 and initially worked in a Dublin hospital. He then spent the six years at sea as a naval surgeon for P&O and the China Navigation Company.

Dillon had not revealed his own history in Self, but it came to light in 1958 as an indirect result of his aristocratic background. Debrett's Peerage, a genealogical guide, listed him as heir to his brother's baronetcy, while its competitor Burke's Peerage mentioned only a sister [sic]. The discrepancy was noticed while Dillon was serving on a freighting vessel, and when he was tracked down by the press in Philadelphia, he said he was a male born with a severe form of hypospadias and had undergone a series of operations to correct the condition. The editor of Debrett's told Time magazine that Dillon was unquestionably next in line for the baronetcy, saying: "I have always been of the opinion that a person has all rights and privileges of the sex that is, at a given moment, recognized."^[6]

The unwanted press attention led Dillon to flee to India, where he spent time with Sangharakshita (Dennis Lingwood) in Kalimpong, and with the Buddhist community in Sarnath. While at Sarnath, Dillon decided to pursue ordination and became Sramanera Jivaka (after the Buddha's physician). Because Sangharakshita refused to allow him full ordination, and due to other frustrations with Sangharakshita's management of his Triyana Vardhana Vihara community, Jivaka turned to the Tibetan branch of Buddhism. He went to the Rizong Monastery in Ladakh. He was reordained a novice monk of the Gelukpa order, taking the name Lobzang Jivaka, and spent his time studying Buddhism and writing. Despite the language barrier, he felt at home there, but was forced to leave in 1961 when his visa was not renewed after false accusations of spying, followed by the leaking of his transgender status, as he records in the final chapter of his autobiography.^[1]

Writing under both of his Buddhist names,^{[clarification needed]} Jivaka published Growing Up into Buddhism, a primer on Buddhist practice for British children and teens, and A Critical Study of the Vinaya, which looks at the Buddhist rules for ordination; both books were published in 1960. Two additional books by him were published in London in 1962: The Life of Milarepa, about an 11th-century Tibetan yogi, and Imji Getsul, an account of life in a Buddhist monastery.

At the age of 47, Jivaka eventually passed away in Dalhousie, India, on 15 May 1962 according to the timeline in the appendix to his autobiography.^[1]: 236

After Dillon's death, his brother said he wanted to burn Dillon's unpublished autobiography,^[1]: 2 but the manuscript was saved by Dillon's literary agent and published as Out of the Ordinary in 2017.^[7]

• Self: A Study in Endocrinology and Ethics (1946), as Michael Dillon
• Poems of truth (1957), as Michael Dillon
• Growing Up into Buddhism (1960) as Sramanera Jivaka Maha Bodhi Society of India, ASIN B0007JB4I6
• A Critical Study of the Vinaya (1960) as Sramanera Jivaka Maha Bodhi Society of India
• The Life of Milarepa (1962), as Lobzang Jivaka
• Imji Getsul: An English Buddhist in a Tibetan Monastery (1962), as Lobzang Jivaka
• Out of the Ordinary: A Life of Gender and Spiritual Transitions (1962; published 2016) as Michael Dillon / Lobzang Jivaka, Fordham University Press, ISBN 978-0823274802