DR. HARRY BENJAMIN: THE “FATHER OF TRANSSEXUALISM”
Endocrinologist Harry Benjamin is known as the “founding father of contemporary western transsexualism.”1 Born in Germany but living most of his professional life in New York, he treated some 1,500 trans patients over the span of his career from the time of World War I until the mid-1970s.2 One of his first trans patients was referred to him by Dr. Alfred Kinsey, the famous sexologist and professor at Indiana University.3
Dr. Magnus Hirschfeld, a German doctor who worked with Benjamin beginning early in his career, was among the first to talk about the difference between being a feminine gay man and a transwoman (though he did not use this terminology).4 Many people conflated the two terms, as they still do now. Benjamin went on to expand on Hirschfeld’s work.
Benjamin believed that transpeople suffered from a medical, rather than a psychological, condition. Because of this, he was at odds with most psychiatrists of the day, many of whom diagnosed transpeople (transwomen especially) with being delusional or having schizophrenia.5 Benjamin brought legitimacy to the feeling of being born or living in the wrong body.6 In 1966, his book The Transsexual Phenomenon, the first of its kind, was published. Many people who might have used the Internet to find help and resources, had it been available to them, instead wrote to Dr. Benjamin and a handful of other doctors. Benjamin was seen as an important advocate for transpeople, and not only in the medical sense.7 In response to one of the many heart-wrenching letters he received from young patients seeking his advice, Benjamin wrote words that opened up possibilities to the youngster with the following: “You have your whole life ahead of you. Something can and will be done for you. Just be patient and eventually you will lead a happier life than you do now.”8
The Harry Benjamin International Gender Dysphoria Association (now called the World Professional Association of Transgender Health, or WPATH) was named in Benjamin’s honor in 1978. WPATH oversees the International Journal of Transgenderism, a scholarly journal, and has written and maintained the Standards of Care for trans patients outlined in chapter 4. Dr. Benjamin died in 1986 at the age of 101 with his faculties still very much intact.9
CHRISTINE JORGENSEN AND AMERICA’S INTRODUCTION TO TRANSPEOPLE
George Jorgensen was labeled male at birth and served as a soldier in the U.S. Army during World War II. Upon returning to the States, Jorgensen transitioned from George to Christine, becoming America’s first well-publicized transperson. As one can imagine, the news of her transition was not met with immediate acceptance and respect. But once the public learned more about Jorgensen, they began to understand that real transpeople existed.
Shortly after returning home from war, Jorgensen began to read books at the library about the power of hormones over masculinity and femininity. In her autobiography, she said, “I didn’t know how my own case might be related to these ideas but at that moment it seemed possible to me that I was holding salvation in my hands: the science of body chemistry. Even then, I think I knew that Providence had intervened again and opened a door on a new and shining vista.”10
Jorgensen first met Dr. Harry Benjamin after she had already begun taking female hormones under the care of a different endocrinologist.11 Benjamin would later write the introduction to her 1967 autobiography, in which he said: “Her success as a woman is no longer in doubt.”12 Her genital surgery was performed in 1952 by transgender surgical pioneer Dr. Paul Fogh-Andersen of Denmark.13
Jorgensen’s autobiography was a way for her to quell the curiosity and near hysteria that the story of her transition created to America. Newspapers announced Jorgensen’s story with such headlines as “Ex GI Becomes Blonde Beauty14” and “Bronx ‘Boy’ Is Now a Girl.”15
Doctors who worked with trans patients after World War II in what can be called the “Jorgensen era” had lower status in their profession and little access to research money earmarked for disease. Those who advocated sex reassignment/gender affirming surgery could not expect support from other doctors, hospitals, the American Medical Association, or the public agencies and private foundations that provided money for research. In fact, both inside and outside the United States the controversy surrounding transsexuality could hurt their professional standing.16
Jorgensen’s coming out was pivotal on many fronts, but perhaps her most important contribution to the world was proving that transgenderism was a real issue separate from homosexuality and cross-dressing.17
THE REIMER CASE AND THE FIGHT OVER NATURE VERSUS NURTURE
We learned a great deal about nature versus nurture from the infamous story of Canadian David Reimer. He was born Bruce Reimer in 1965, a healthy male with an identical twin brother, Brian. In infancy he endured a botched circumcision that left him without a penis. His parents, Janet and Ron Reimer, were at a loss for what to do until they were referred to Dr. John Money, a psychologist at Johns Hopkins University in Baltimore. Together with Money, the Reimers decided it would be easiest to raise Bruce as a girl named Brenda and keep the child’s past a secret from her. At age fourteen, Brenda Reimer learned the truth and immediately reverted to living as a boy, which he had always felt he was. Reimer changed his name to David. He later married, was the father to three stepchildren, and ultimately separated from his wife.18 He committed suicide in 2004 at age thirty-eight by shooting himself in the head with a shotgun.19 In an interview in 2000, Reimer proclaimed: “You don’t wake up one morning deciding if you’re a boy or a girl. You just know.”20
David had a very troubled childhood as Brenda. Dr. Money and the Reimers agreed that Brenda and Brian would make annual visits to Baltimore to see Money. Under Money’s supervision, Brenda had plastic surgery to construct a vulva. Money remained adamant that the Reimers keep Brenda’s past a secret from everyone.
Money theorized that parents could raise a child to be whatever gender the parents wanted regardless of the child’s birth sex or core gender identity.21 When the Reimers came along, he saw a perfect opportunity to begin documenting an experiment that he thought would prove his case, and Brenda and Brian were the ideal subjects. Obviously, his theory was refuted by the tragic unfolding of events in the Reimer family. Still, Money defended his actions as well as his theory about nurture and gender until his death in 2006 at age eighty-four.
In John Colapinto’s book As Nature Made Him: The Boy Who Was Raised as a Girl, Janet Reimer recalls an incident after giving Brenda a dress that she had made: “She was ripping at it, trying to tear it off. I remember thinking, Oh my God, she knows she’s a boy and doesn’t want girls’ clothing. She doesn’t want to be a girl. But then I thought, Well, maybe I can teach her to want to be a girl.”22
During a session between Brenda and Dr. Money in 1978, Money brought in a transwoman who had gone through a full vaginoplasty to talk to Brenda about it. This was precisely the type of surgery Money was pushing Brenda to have at the time. After the session, Brenda told her parents that she would kill herself if she ever had to see Money again.23 In the 2000 interview, Reimer said, “I was scared to death. I figured, you know, I was perfectly fine…. What do I need surgery for? I thought deep down inside that if I went through this surgery, it would change me somehow.”24
In the early 1990s, Dr. Milton Diamond, an opponent of many of Money’s theories, decided that he wanted to revisit the Reimer case. He convinced David to meet with him. David saw him as genuine and caring and agreed to work with him. Diamond got in touch with the psychiatrist who oversaw David’s childhood psychiatric visits in Canada (when he was known as Brenda). In 1994, after hearing David’s story and spending some time with him, Diamond wrote an article concluding from the Reimer case that gender identity is inborn. He said that although nurture has an impact on the way a child acts, nature is what is responsible for forming a core sense of gender identity.25 Diamond is still actively researching gender and sexuality.
Some of Reimer’s last words in that 2000 interview reveal a tortured soul. “If you’re not going to take my word as gospel, because I’ve lived through it, who else are you going to listen to? … Is it going to take somebody to wind up killing themselves—shooting themselves in the head—for people to listen?”26
Prior to David’s eventual suicide in 2004, his twin brother Brian overdosed on antidepressants in 2002 and died. In following two years, David’s marriage began to fail, and he made a poor investment with a large sum of money, lost his job, and continued to deal with the terror that was his childhood. These events (though mainly his struggle with his childhood) all led up to his death.27 The Reimer case, sometimes called the John/Joan case, is still cited today in the nature-nurture debate.
OTHER TWENTIETH-CENTURY PIONEERS IN THE TRANS MOVEMENT
Many people share responsibility for helping the trans movement along. This is simply a sample of the great number of people, some famous and some nameless, who promoted the change that has occurred over the past century. Many of them did not set out to do this, but rather looked to help normalize transgenderism.
One of the first patients to undergo successful genital reassignment (gender-affirming) surgery was male-to-female transperson Dora Richter. The surgery was set up by Magnus Hirschfeld in Germany in 1931.28 FTM surgeries began to follow later on in that decade.
• • • • •
Reed Erickson was a transman born in 1917. He became a patient of Harry Benjamin in 1963 and, because Erickson had inherited a very large fortune from his father, he was able to fund Benjamin’s book The Transsexual Phenomenon.29 Erickson’s story is especially notable because even in the mid-1960s the American medical community appeared skeptical about the existence of transmen. Joanne Meyerowitz writes in How Sex Changed: “At the end of the 1960s doctors at UCLA’s Gender Identity Research Clinic debated privately whether FTMs even qualified as transsexuals.”30 After his transition, Erickson started several trans-positive foundations including the Erickson Education Foundation. He played a key role in putting transgenderism on the map.
• • • • •
On June 28, 1969, police raided the Stonewall Inn, a gay bar in Manhattan’s Greenwich Village neighborhood. The cops mostly went after transwomen and other gender-nonconforming people because they were the easiest targets. These types of raids on GLBT bars were commonplace, and not just in New York. This time the patrons of Stonewall fought back, and chaos ensued. Stonewall became the name of a movement that jump-started organized GLBT rights in America. Most people described the Stonewall Inn as a gay men’s bar and credit that evening in June 1969 with the birth of the organized gay rights movement, but transpeople of all types were very much a part of the Stonewall rebellion.
MILESTONES IN AMERICAN TRANSGENDERISM
1886: We’wha, a two-spirit Native American, visits President Cleveland at the White House.a
1914: Harry Benjamin opens his own endocrinology practice in New York.b
1929: One of the first well-known transwomen worldwide, Christine Jorgensen, is born in the Bronx.
1951: Jorgensen officially begins life as a woman.
1966: Johns Hopkins University opens its Gender Identity Clinic in Baltimore.c The same year, baby Bruce Reimer endures a botched circumcision. Soon after, his parents enlist the help of John Money at the Hopkins Clinic and they begin to raise Reimer as a girl.d
1969: Riots erupt after gay and transgender people are arrested at New York’s Stonewall Inn bar.
1975: Minneapolis becomes the first American city to pass a law protecting gender identity (though it was in a clause titled “Affectional Preference” and thus may have been unclear at the time).e
1978: The Harry Benjamin International Gender Dysphoria Association, now known as WPATH, is formed.
1989: Seventy-five-year-old jazz musician Billy Tipton dies and it is revealed that though he lived as a man for fifty-five years, he was actually born female.
1992: Leslie Feinberg publishes a pamphlet titled Transgender Liberation. Feinberg uses the word “transgender” to describe all types of gender-variant people.
1993: Transman Brandon Teena is raped and murdered in Nebraska. The 1999 film Boys Don’t Cry is based on his story.
1999: The first Transgender Day of Remembrance is held in San Francisco as a vigil to those transpeople who have been killed because of their identity.
2002: Transwoman Gwen Araujo is murdered in California, causing outrage in the GLBT community.
2004: The International Olympic Committee officially decides to allow transsexual athletes to compete if they have had genital reassignment surgery and at least two years of hormone therapy.f The same year, David Reimer commits suicide at age thirty-eight.
2007: Transwoman Susan Stanton is fired from her job as city manager of Largo, Florida, after announcing her impending transition.
2008: The first openly transgender mayor of a U.S. city, Stu Rasmussen, is elected in Silverton, Oregon.
2009: Thomas Beatie, a transman from Oregon, gives birth to his second child. Chaz (formerly Chastity) Bono, the only child of Cher and the late Sonny Bono, comes out as a transgender man. Bono is perhaps the first famous person to reveal that he is FTM.
2010: Amanda Simpson is appointed senior technical adviser to the U.S. Commerce Department by President Barack Obama, becoming the first openly transgender person to be appointed to a post in the federal government.
aLillian Faderman, Horacio Roque Ramirez, Yolanda Retter, Stuart Timmons, and Eric C. Wat, eds., Great Events from History: Gay, Lesbian, Bisexual, Transgender Events, Vol. I, 1848–1983; Vol. II, 1984–2006 (Pasadena, CA: Salem, 2007), 21–22.
cFaderman et al., Great Events from History, 108–166.
dSanjida O’Connell, producer, Dr. Money and the Boy with No Penis (BBC Horizon, 2004).
fFaderman et al., Great Events from History, 320–328.
Among those involved in the 1969 tumult at the Stonewall Inn was transwoman Sylvia Rivera.31 Rivera went on to become an activist, helping transpeople of all backgrounds who had been thrown out of their homes. Sylvia’s Place, an “emergency night shelter” in New York City for GLBT youth,32 was named in her honor, as was the Sylvia Rivera Law Project, an organization that advocates for low-income transpeople. Rivera passed away in 2002 at age fifty from cancer.33
• • • • •
Lou Sullivan, a transman living in San Francisco, began the first known support group for FTMs and later added a newsletter. Sullivan was also active in the gay rights movement and identified as a gay man. His organization became what is now FTM International.34 It presently has chapters in eighteen countries, all of which hold support groups for transmen.35 Sullivan died of complications from AIDS in 1991 at age thirty-nine.36
SCIENCE, EVOLUTION, AND GENDER
Although presently there is not a lot of research on the subject, some important scientific discoveries can begin to shed light on transgenderism. Dr. Joan Roughgarden, professor of biology at Stanford University, tackled the subjects of sex and gender and their connection to the natural world in her book Evolution’s Rainbow. Roughgarden writes: “[P]eople turn to science, trying to use the biological criteria for male to define a man and the biological criteria for female to define a woman. However, the definition of social rests with society, not science, and social can’t be made to coincide with biological categories.”37
Roughgarden goes on to explain that nature proves some important points. She debunks the myth that all natural organisms retain their birth sex for life. The truth is that many plants and animals can be both male and female, biologically speaking, at the same time or at different points throughout their lives. In some species, males actually give birth or females have the exact same chromosomes as the males.38 Roughgarden writes about some species that have more than two genders and some whose biological structure challenges what we believe is normally male or normally female: “[I]n the spotted hyena, females have a penislike structure externally identical to that of males, and in the fruit bat of Malaysia and Borneo, the males have milk-producing mammary glands.”39
Clownfish are among those who change sex when the need arises. Female clownfish are normally the ones in charge. When a dominant female passes away, one of the males in the school becomes female and, in the process, becomes capable of breeding. At the same time, a clownfish who was previously unable to breed changes sex to become a male that then is able to breed.40
These examples are just the beginning of what nature can tell us about sex and gender diversity in many plants and animals. In a comparison of thirty-four postmortem human brains, scientists found that the part of the brain comprised of a small group of nerve cells thought to pertain to gender and sexuality were similar in transwomen and non-trans women. Although the study only had one transman’s brain, it found that group of nerve cells to be similar to that of a non-trans man.41
Figure 5.1
Source: © 2010 Jennifer Levo. Text of cartoons by Nicholas M. Teich
One can conclude that it might be normal to have variation in sex and gender of people just as it is normal to have variation in sex and gender of animals. Perhaps Dr. Milton Diamond put it best when he said: “Biology loves variation. Biology loves differences. Society hates it.”42
TRANSGENDERISM AROUND THE WORLD
Transgenderism didn’t just pop up in the twentieth century. It has likely been around since the dawn of human expression, long before the written record or biblical times. We are beginning to learn more about how gender may have broken out of the binary throughout history and throughout the world. I will give just a few examples of many that illustrate the existence, and sometimes even reverence, of gender bending. It is important to remember that there are many, many more examples out there.
It has been noted that some Southeast Asian communities in the fifteenth and sixteenth centuries revered males who dressed in women’s clothing during certain special ceremonies. At that time the gods that people worshipped were either male or female; it does not seem that there was room for anything else. Nonetheless, these cross-dressing people “served as sacred mediators between males and females and between the spheres of humans and the domains of spirits and nature.”43
In Thailand, different variations of transwomen include phuying praphet song (“second type of woman”), kathoey (historically any gender-variant, male-bodied person, but now usually used to describe transwomen), and ladyboys44 (sometimes used as an English synonym for kathoey). During the Silla Dynasty in seventh-century Korea, “the Hwarang warrior elite included many boys who dressed as women, wearing long gowns and make-up when they were not practicing archery or preparing for battle.”45
India’s hijras have always been known as a third gender. Hijras are essentially transwomen (though the identities may not translate 100 percent) who do not, on the whole, have many political rights. They are often not widely respected in India, though times may be changing as they are here in the United States. Many hijras point to Shiva, the god of destruction in Hindu mythology, to legitimize their existence and power as a community. Shiva was a strong god known as being “half man and half woman.”46
In Africa, there is record of belief in gods who transcended gender boundaries in at least twenty-eight different tribes. Male-to-female Zulu spiritual leaders worked alongside women and may still be practicing in parts of South Africa.47
In the eighteenth century in Ireland, England, and Wales, transpeople and crossdressers existed in the ruling classes, in agrarian culture, and likely everywhere in between.48
TWO-SPIRIT PEOPLE
Many native tribes in cultures indigenous to North America have incorporated transpeople into daily life in different ways. In some cases these people, called two-spirit people, were revered because of their gender differentness. Two-spirit people do not usually directly translate to the Western notion of male-to-female or female-to-male (transitioning from one sex to the other). Oftentimes two-spirit people were and are a blend of gender identities, roles, and expressions. Here is one example from Alaska: “The Chugach Eskimo believed that aranu’tiq were two persons united in one, that they were more gifted than ordinary people, and that they were very lucky, like twins.”49
Two-spirit is a term that was coined in 1990 at gathering of queer aboriginal people in Winnipeg, Manitoba.50 Some people use it to mean GLBT identities of native or aboriginal people on a broad spectrum, while some use it as encompassing only those on the transgender or gender-nonconforming spectrum. This is in large part because of the fact that Western culture is so different from most aboriginal cultures that it is not always effective, or even possible, to make a direct comparison between the two. The NorthEast Two-Spirit Society, based in New York City, describes two-spirit people in the following way:
In many American Indian communities, men and women[’s] styles of speech were distinct; sometimes even different dialects were spoken. The Two Spirit people knew how to speak both in the men and women’s ways. They were the only ones allowed to go between the men’s and the women’s camps. They brokered marriages, divorces, settled arguments, and fostered open lines of communication between the sexes. Their proficiency in mediation often included their work as communicators between the seen (physical) and unseen (spiritual) worlds.51
Although this may be true for some aboriginal people, some tribes and nations did not recognize two-spirit people as having these duties or powers.
Prior to the use of the term two spirit, many Western people, mostly anthropologists, used the term berdache to describe (usually) male-born, gender-variant people. Berdache is thought of as a derogatory term that originally meant a male sex slave, male prostitute, or a gay man taking on a passive sexual role. Since this is not what two-spirit people are, the term has fallen out of favor.
Let us look at traditional Navajo society as one example of many. In that society, “feminine male” and “masculine female” are two genders distinct from male and female. Feminine males are often associated with typically female gender roles and vice versa for masculine females. A relationship between a feminine male and a masculine male and a relationship between a masculine female and a feminine female are both seen as heterosexual. However, this is not true of contemporary Navajo society, and much of the reason for that is because Western society deems the aforementioned relationships to be homosexual.52 Traditional Navajo society’s view of these relationships shows the blurring of lines between gender and sexuality. Although its structure may allow for more flexibility in gender and sexuality, the juxtaposition of the masculine female with the feminine female and the masculine male with the feminine male comes from heterosexual norms. A relationship between two masculine males or two feminine females, for instance, is not even considered as a possibility in traditional Navajo society.53
Many kids in traditional Navajo society did not have to fight the fight that faces our contemporary transgender or gender-nonconforming kids. “Historically, children who showed a keen interest in work tools and activities associated with the gender opposite their sex often were encouraged to develop skills in the occupational domains of their interest.”54 Imagine if our kids were encouraged to be who they wanted to be and do what they wanted to do regardless of gender. Perhaps sometime in the future we will be able to re-create what the Navajos began doing long ago.
Carrie H. House, who is of Navajo and Oneida descent, describes some of the other ways that gender variance was accepted in traditional Navajo society:
Our oral traditions acknowledge that the he-shes and she-hes (those who hold in balance the male and female, female and male aspects of themselves and the universe) were among the greatest contributors to the well-being and advancement of their communities. They were (and we are) the greatest probers into the ways of the future, and they quickly assimilated the lessons of changing times and people. Recent studies into the lives of contemporary she-hes and he-shes have recovered models or near models of this rich, inventive, reverential, and highly productive approach to keeping balance within a society viewed as an extension of nature.55
It is important to note that although House uses the terms “he-she” and “she-he” in a positive light in her description of the Navajo, these are not acceptable terms in contemporary American society; they are thought of as insulting toward transpeople and gender-nonconforming people.
GENDER EXPRESSION IN AMERICA’S EARLY DAYS
Men’s and women’s clothing did not always look like it does today. In fact, it could not have been more different in some cases.
In colonial times, men wore scarves or neckbands tied in bows, ruffled shirts complete with ruffled sleeves, knee stockings, tight pants, and extravagant long-haired wigs in tight curls tied neatly with a ribbon in the back. Manly? Well, not by today’s standards, but at one time, it was.
Women’s fashion has changed a fair amount as well. While it was once nearly unheard-of for women to wear pants, it is now the norm. Not too long ago, it was expected that women wear long dresses with corsets underneath. Now, walking down the street in any large city or town, it’s likely that only a minority of women are wearing long dresses, and few, if any, with corsets underneath.
Even for babies things used to be different. Pink and blue were “assigned” to girls and boys, respectively, in the twentieth century. But in the nineteenth century most every American baby wore a white dress, which, as Leslie Feinberg writes in Transgender Warriors, “didn’t seem to skew the gender expressions of these generations of children.”56 What would it be like if the choice of colors were reversed? What if babies in pink, complete with bows, screamed masculinity? We may never know the answer, but one sure bet is that fashion trends will continue to change over the years. Maybe when the United States celebrates its four hundredth anniversary, formal wear for men and women will include tank tops, and who knows what for the rest of America’s genders.
As America grew as a country, the North and South developed an extreme ideological split. In 1861, when the Civil War began, all soldiers were male-born and male-identified—or so it seemed. The truth is that women fought in wars throughout the world before they were legally allowed to do so. The Civil War, in both the Union and Confederate Armies, was no exception. Some of these women were discharged for “sexual incompatibility,” meaning that someone found out their natal sex by doing a full physical examination (usually upon injury or illness). There were no complete physical examinations prior to enlistment.57 Perhaps it is true that anatomically these soldiers looked female, but what of their gender identity? This was hardly something that one could bring up in the mid-nineteenth century. Most of these disguised soldiers may have been women who wanted to show their true patriotism; some fought beside their husbands so they would not have to be apart. However, there is at least one famous case (and probably more undocumented ones) of someone who was likely a transman.
Albert D. J. Cashier was born in Ireland and immigrated to the United States. He was labeled female at birth and given the name Jenny Hodgers, though when he enlisted in the Union army, he did so under the name Albert Cashier. Cashier fought for over three years in approximately forty battles including the infamous siege of Vicksburg.58 After his service was over, Cashier continued to live as a man. In 1913 a doctor discovered that Cashier had female anatomy, and a barrage of newspaper stories about his “deception” began. In 1914 he was committed to an insane asylum; interestingly, this was because he suffered from dementia, not because he was still living as a man.
“In the end, Albert/Jenny did receive veteran status, but sadly, was shipped to a mental institution and forced to wear female clothing, greatly affecting [his] mental state even more with ‘tragic consequences.’ At 67 years old, frail and unfamiliar with the finesse of walking in women’s clothing, [he] tripped and broke [his] hip. Unfortunately, [he] never recovered from the injury and spent the rest of [his] life confined in bed.”59
Although this is a sad ending to a life fully lived, Cashier’s headstone was engraved with the words “Albert D. Cashier, Co 95 Ill. Inf.” and he is honored at Vicksburg National Military Park under this name.60
A NOTE ON RESEARCH
Although small-scale studies have been done on trans issues, research continues to be scant. One of the most notable studies to date is the one (mentioned in this chapter) of thirty-four postmortem brains of transpeople outlined in Joan Roughgarden’s Evolution’s Rainbow. Other small studies published in scholarly journals in the last few decades, while helpful, give us only glimpses into the world of transpeople. There are no large-scale, complete long-term studies of lifelong cross-sex hormone use in transpeople in the United States, and there are few if any long-term studies regarding most trans-related issues. This is partly because the topic is so new to the masses, partly because a large number of out transpeople willing to participate in a study may be difficult to find, and partly because the topic is still so controversial. It is difficult to get such research funded for these and other reasons.
A lot of the existing research has been done on the GLBT community. While this is helpful in some respects, the differences between gay, lesbian, bisexual, and trans are so great that it is difficult to lump them together for a study. There is no doubt that trans-related research is picking up and hopefully in the near future we may begin to understand more about the origins of transgenderism as well as health-related and social aspects of trans life.
