The Institute of Sex Research was burned down in 1933. It wasn't a "different time", it was a time with the same political issues and the same Nazi rhetoric attacking trans people. Had something been done to prevent the rise of the Nazis and protect the Institute of Sex Research, trans healthcare would be 50 years ahead in technology and we wouldn't be facing the same issues today. But Genocide Joe (the Russian one) opted not to do anything about the Nazis until 8 years later when Hitler brought the war to Russia.
Genocide Joe was aware of the issues. He chose not to protect trans people, and he chose to persecute gay people. Marx said a worldwide revolution would be required, but Joe said fuck that, homosexuality is bourgeois, and stayed in Russia. He is in large part responsible for the current plight of LGBT people.