Before we explore this character, we'd like to pause to make sure we're all on the same page. As a rule, the respectful way to discuss transgender people is by using the name and pronoun they specifically identify with. Caitlyn Jenner should always be referred to as Caitlyn, no matter which era of her life is being talked about, and Laverne Cox should always be referred to with feminine pronouns, whether we're talking about her rise to fame or her early childhood. That said, since we're analyzing a text here, we're going to refer to Lili Elbe as both Lili and Einar as needed for the sake of clarity. If we were writing Lili's bio, though, it'd be all Lili, all the time.
Though chances are really good you've never heard of her before, Lili Elbe was the first person to undergo sex reassignment surgery in history. Without her, people we know today—like Laverne Cox from Orange is the New Black, Cher's son Chaz Bono, or Arquette sibling Alexis—would lead very different lives.
Lili started life as Einar Wegener, a landscape artist in Copenhagen in the early 20th century, a Danish Bob Ross who instead of painting happy trees paints not-so-happy gloomy landscapes of dank bogs. (For more on these bogs, swing by the "Symbols" section.) His landscapes are "white-capped and cruel" (1.1), though his life doesn't seem to be. He's married to Greta, a portrait artist, and life is good, or as the Danish would say, livet er godt (according to Google Translate).
And his livet would remain godt if not for the inciting incident in Chapter 1: Einar tries on women's shoes—and with that, his gender identity conflict goes from 0 to 60 in about three seconds. Einar starts with shoes then puts on a dress and stockings, and then his wife is calling him Lili.
No offense to Einar, but Einar is boring. Lili, however, is interesting—Einar himself even thinks that Lili is "his better half" (15.16). Perhaps because Lili is his better half, Einar decides to make Lili into his only half.
Not that transitioning genders is easy today, but consider this: In Einar's time period, it had never beendone. Ever. Any man who wanted to live as a woman was written off as having schizophrenia, being a danger to society, or otherwise disturbed. So Einar isn't just facing a difficult transition, he is basically facing the impossible. No wonder he thinks of his life a big murky bog.
Einar gives up those cruel landscapes of the bog and takes himself on as his own art project, putting on makeup and living as Lili. You might think this would be difficult in 1930, but no one seems to bat a (curled and mascara'd) eyelash. There are two reasons for Einar's relative ease. One is physical: He is mostly hairless, and even has small breasts, a minor case of gynecomastia, though this word isn't used in the book.
The main reason Einar starts living as Lili without much difficulty, though, is his wife, Greta. Greta is one hundred percent supportive of Einar's transformation into Lili. Her brother is supportive, too, as is Einar's childhood friend. Everyone is supportive—it's practically a utopia of support—and these people save Einar's life because he plans to kill himself if he can't become Lili. He just doesn't want to live a lie; he wants to live fully, which for him, means living as Lili.
To bust out a present-day comparison, a 2011 study found that forty-one percent of trans people attempted suicide, a staggering rate that is four times the national average (source). Being forced to live under an identity you don't identify with, then, is clearly a source of major pain.
On the surface, Einar seems to make decisions on a whim. Oh, I'll be a woman today. Oh, I'll commit suicide. But it only seems like that; beneath his aloof exterior, Einar is actually very conflicted. As we said, transitioning to become a woman is literally impossible at this time period, and Einar is still very serious about trying to do it. He might as well want to fly or be a dolphin, because all these things are equally achievable at this time. He is dead set on his goal, so there is no reason to think he won't follow through with his suicide threat, too, which is both very sad and adds a lot of dramatic tension to the plot.
Thankfully, Einar doesn't commit suicide because his friends form a support group around him. Why are they so supportive? Are people in the 1930s generally more open-minded than people today? We're not sure. Part of the reason, though, is that Einar is often described as "childlike" (2.11). Even before he becomes Lili, his wife views him less as a husband and more like "her most beloved toy" (2.64). So his transformation into Lili makes him even more like a doll. She's an Einar girl in a Lili world—or something like that—and Greta dresses her up, takes her out, and helps her live the life she wants to live.
And Lili is fine with this. Einar thinks of Lili as a "little girl" (22.139) who needs taking care of, and Greta often agrees with him. That's why she sticks with Lili after her surgery, caring for her more like a nurse than a wife. It's Lili who wants to be a wife now since Lili is heterosexual; she is interested in men, not Greta. Gender and sexuality are not necessarily linked, though it's worth noting that Einar's attraction to females was always quite mild.
We made it seem easy, but it's not: Einar's journey to living as Lili is long and painful. Because Einar actually has ovaries inside, he exhibits mysterious bleeding that no one can explain. He also gets nosebleeds when over-excited like an anime character. A few doctors treat him like a crazy person, and when Einar has surgery to enable him to more fully become Lili, it is excruciating. Remember: this is 1930, without modern anesthetics and pain relief.
But the surgery works. It's a modern miracle, as Einar completes the physical voyage from man into woman, emerging as Lili, the first person to have male-to-female sex reassignment surgery. If you think of gender as a binary, this is quite a reversal. But it's not the only role reversal. When Einar becomes Lili, she is no longer Greta's husband. And Greta, who was once so steadfast and loyal, decides not to stay with Lili. She also doesn't think Lili should have the final surgery to implant a uterus so she may have children. After standing by Lili for so long, Greta reaches her limit.
It's shocking how easily Einar seems to shrug off the marriage, like it's an old coat he's donating to charity. Lili never once seems to regret losing Greta—until Greta refuses to accompany her to Dresden. This reinforces our sense that their marriage was always a bit more about care taking than romance: Lili is only bothered by losing Greta when she turns to her for support and Greta declines, and neither woman seems to mourn the loss of their union much otherwise.
Lili doesn't want to just look like a woman and have a husband—she wants to be able to be a mother. This is a crucial part of her female identity for her. It's kind of surprising that she has this drive since Einar and Greta never once discuss having children. Considering Greta's personality, we have a feeling that if she wanted children, she'd have had them by now.
Even though Greta pushes for the initial surgery, now it's Lili pushing herself—and tragically, this final surgery causes an infection that kills her. With that, Lili perishes without fully realizing her dreams.