In the WHO framework of social determinants, discriminat=
ion
is a subset of the social exclusion category. But the concept of discrimination =
has
both a micro and a macro level role in these stories. Discrimination itself is notable a=
s part
of social exclusion, this is the micro-level view of this phenomenon. At the macro-level, we must acknow=
ledge
that discrimination is often the causal root of the other adverse social
determinants as well. For exa=
mple,
discrimination and stigma significantly determine a participant’s
position on the social gradient in cases when employers are unwilling to em=
ploy
transgenders. When anti-transgender violence creates a backdrop as ever-pre=
sent
as the paint on the walls of a room, the adverse effects of this stress can
also be traced back to discrimination. When a participant has been =
kicked
out of their family for being transgender, this social exclusion is again
caused by discrimination.
When a participant is involved in sex work, or has =
mental
health or addiction problems, the critical reader can always make a strong =
case
that discrimination is the root of each of these issues. The experience of discrimination i=
s so
prevalent among the transgender people interviewed for this study that it w=
ould
arguably be difficult to propose alternative causal factors for the adverse
health issues affecting them.
The discrimination faced by transgender partici=
pants falls
directly into the conceptual model of stigma outlined by Link and Phelan27. In this
model they outline how stigma in many populations follows similar
processes: people are identif=
ied,
isolated from the non-stigmatized group, subjected to negative stereotyping,
then stripped of social status through discriminatory practices. This stigma profoundly affects the
distribution of life chances. Link
and Phelan caution that, due to its pervasive impact, the negative effects =
of
stigma are likely underestimated.
They also conceptualize stigma as a matter of degree, with some peop=
le
experiencing more or less depending upon their level of external identifica=
tion
as other. The findings that f=
ollow
are congruent with these claims, both showing the pervasive impacts of stig=
ma
in the lives of study participants, and demonstrating the extreme variation=
of
stigma based on external labeling as other. In this population, the labeling is
determined by a person’s ability to pass as gender normative. Those who are less able to pass as
gender normative experience the highest degree of stigmatization for their
gender variance.
The role of discrimination and stigma in the stories that
follow is not subtle, it could more accurately be described as overwhelming=
. Discrimination bounds the lives of
transgender people on every side.
For some, gender-based discrimination interacts with discrimination
based on other traits, such as race or ethnicity. There is not enough data to fully
explore how gender discrimination interacts with other types of discriminat=
ion,
but examples here show how these multiple burdens can destabilize an
individual. Early in the rese=
arch
for this project, I was struck by a comment from an African American MTF
transexual friend. She said t=
hat
among all the transgender people she knew, she was the only one who had nev=
er
done sex work. I was amazed a=
t the
time to hear this, but after the fieldwork I could understand the truth in =
that
statement easily. The gender
variance model explained in Chapter Two demonstrates that gender violence
exists on a continuum, with gender-based oppression experienced in proporti=
on
to an individual’s violation of normative gender roles and
appearances. The stories of
transgender people collected here show survival amidst the most extreme for=
m of
gender oppression. For those =
among
them who must negotiate multiple oppressions, the outcomes are even more
debilitating.
The persistent bounding of experience by discrimination
could and does result in lives that are irrefutably altered. Some people do not survive this
experience, and the high rates of suicide attempts within the transgender
population demonstrate the debilitating impact of this cumulative stress.
As discussed at the close of chapter three, all social
determinants of health affect the lives of transgender people. However, presenting a simple narra=
tive
explanation of these multiple impacts does nothing to critically analyze th=
e unique
interplay of social determinants for this population. After analyzing the data for this
project, three categories of social determinants emerged as dominant in the
equation of health impacts: social exclusion, stress, and social support.
Each of the three dominant categories actively interact =
with
each other. For example: social exclusion includes job discrimination, which
results in under or unemployment, which in turn affects stress. So, while data has been sorted into
thematic categories, these effects cannot be realistically isolated from ea=
ch
other. Understanding this rea=
lity,
the findings section is nevertheless organized around exploring these three
dominant themes. Information =
about how
the social determinants overlap, or how additional ones interplay with these
three will be woven into these dominant themes as appropriate.
A
note on pronoun usage:=
Throughout the analysis, I have
attempted to use the preferred gendered pronoun of all participants. Therefore, when I refer to the chi=
ldhood
of an MTF participant, I will use the female pronoun although at the time
recounted, that participant may have gone by “he.” I have made occasional exceptions =
to
this rule in order to follow the usage or respect the wishes of individual
participants.
From the data in this project, two themes emerg=
ed as
primary to the category of stress as a social determinant: the stress of pe=
rvasive
violence and the stress of internalized gender oppression. Violence deserves special no=
te
here since it stands out from all other social determinants. These narratives were notable both=
for
the extreme manifestations of violence and for the level to which violence
pervaded the stories. In shor=
t,
violence was the single most dramatic theme to emerge from this research.
Every story is affected by social context, and =
the
phenomenon of violence against transgender people was very much a part of t=
he
social context of life in
The death of Amanda Milan was said to galvanize=
the
transgender and larger LGB communities to speak out against this violence.<=
span
style=3D'mso-spacerun:yes'> It sparked a forum on transgender
violence and, later, a push for inclusion of gender identity in the
For me as an investigator, the most disturbing element of
conducting the interviews was the level of violence embedded in some of the
life stories. At first,=
I did
not understand why it was so unsettling since I had certainly girded myself
against the knowledge that violence would emerge. But in retrospect, the emergence of
violence in narratives demonstrated a gap between my perceptions as a resea=
rcher
and those of the participants. I
viewed violence as more of an outstanding phenomenon, as it had been in my
life. My personal stories of =
past
threats and violence are notable, something I would naturally include in a =
life
history I would give another. But
the difference in these stories was that violence was not necessarily prese=
nted
as outstanding by the participants.
I would find that particularly violent events were not actually incl=
uded
in the primary narrative, but instead emerged like landmines in probes about
different issues. As an
interviewer, this was unsettling, because I was often unprepared for the
violence to emerge. But the
implications for the participants were even more unsettling: what type of l=
ife
experience results in major violence no longer being central to your story?=
Several factors could all intertwi=
ne to
answer this question: people could be reluctant to recall distressing past
events, they could be suppressing traumatic memories to help them cope, they
could be hiding their vulnerability in front of a relatively unknown
interviewer. But while these
factors may contribute to the phenomena, a different answer began to emerge
from the stories. Simply put,
violence is no longer central to your story when it pervades the stories of=
you
and those around you so thoroughly.
One participant interview demonstrated this phenomenon
aptly. Nirvana Rose is a tran=
sexual
woman in her early thirties. =
She is
mixed race, both Asian/Pacific Islander and
I just felt so comfortable talking to her, an= d she just like made everything so real, she just made everything so different in= the way I was being taught, and in ways, she was showing me a different side to life. And it stuck in me, everything she used to tell me. And that’s = what urged and pushed me a little bit more to get out. And I wasn’t ready = to tell my moms and my dad, so I ran away.
At the age of twelve, she ended up in downtown
And she came up to me and asked me what was I=
doing
out on the street. What are you doing out on the street, little girl. And I=
was
like, little girl? What the hell are you talking about? And then when she f=
ound
out, when she really got into me, she was like oh my God. And I was like oh,
did I do something wrong, and I looked at her and I was a little scared,
that’s my tough image. And I started explaining the situation to her a
little, and she was like oh, no problem, come on, and I was so leery, but I=
was
so fascinated because this person was like so good. She was like let’=
s go
over to my house and you can sleep on the couch, and I’ve got to go o=
ut,
but I’ll leave you in the house, just don’t touch nothing and
behave. I said okay. I was in her house, she gave me a tuna fish sandwich a=
nd
some milk, because back then I was like a fiend for milk, and she left. She
just turned around and left. She said be good. She left. Wow. I was like ok=
ay.
She came in like 4 or
This “drag queen,” Mimi, befriended
Nirvana Rose, and immediately took on a mentoring role. Slowly Mimi showed the confused yo=
uth
how she had been born a man, and explained to Nirvana that she had to make =
her
own choice about what she wanted to be.&nb=
sp;
Then, Mimi dressed Nirvana up as a girl for the first time. She showed her how to make m=
oney
and how to hide that you were male.
Mimi went with Nirvana on her first “dates,” and after s=
he
liked it, “slowed her down” and “set her up with the
equipment she needed” for this life, namely hormone shots. At this point, Nirvana’s nar=
rative
starts to speed up, quickly following her rise in social status until in her
later adolescence she was a “goddess”, with a sugar daddy who g=
ave
her $10,000 a month, a jaguar, and a brownstone overlooking
I had the money, I had unlimited, so shopping= was like, I stayed in the stores. I had everything that Mae West or Marilyn Mon= roe could have had. I had diamonds, I had opals, I had everything. Sapphires, a= ll that.
Her story could have just moved on from here, b= ut I prompted with a question about Mimi, the woman who had been so instrumental= in her early years. Nirvana says= they were still the best of friends but then the story abruptly backs up, to an event several years back that had not otherwise gotten into the narrative:<= /p>
When I was 16 years old, Mimi was found kille= d. She was found in the hotel. Back then there was a big thing on gay bashing. And= she was found in the Fulton Hotel with her throat slit, and her penis in her mo= uth, cut off. I was devastated.
Was Nirvana just selectively remembering the mo=
re
glamorous side of the story? =
Or was
the murder of her mentor, in such an aggressively brutal fashion actually
something she had forgotten to note as a milestone? The murder changed her life, the f=
ear
that it could happen to her drove Nirvana to re-approach and ultimately
reconcile with her birth family.
But she also describes a hardening inside of her. She talks about how she beca=
me a
“cold bitch” who was “mercilessly cruel,” especiall=
y to
other trannies who were not of her caliber. While she had the highest level of
social standing among sex workers, exceeding even the “G-Girls”=
or
genetically female prostitutes, this social standing was limited to the tim=
es
she passed as female. T=
his
status could disappear in an instant, putting her in immediate danger. At this point in the narrative, we=
start
to hear more about her aggression, but it is mostly portrayed as resistance=
to
an outside threat. Sometimes =
dates
do not guess she is a transexual, “and if they find out, they’re
going to act maliciously.”
She does not work with a pimp for protection, she provides her own,
“I was already vicious verbally, but I became vicious manually. I lea=
rned
how to shoot a gun, I learned how to carry it.” Her world evolved into a dangerous=
mix
of prostitution, drug dealing, and using.&=
nbsp;
A stint in jail was easy, in part because of her well-known willingn=
ess
to cut anyone who offended her. She
learned to move to aggression quickly, and talks about how these skills were
used to reinforce her social status among the top tier of trannies, “I
was a really nasty person. I was really conniving, I was really malicious. I
threw drinks in people’s faces just for looking at me wrong.”
Now in her early 30s, Nirvana views herself as a “wise old owl” in the transgender communities. While this age would hardly confer= elder status in many communities, she understands her survival to this age is an oddity, or in her words “a blessing.” Almost all of her early showgirl f= riends are already dead. She has mov= ed through many of the perils that befall community members, from elitist isolation, to addictions, prostitution, jail, and HIV. Now, from her position of advanced wisdom, she fights to try to create more opportunities for the next generation. She is a strict “gay mother” to several young girls, and wants to open a nonpro= fit to help provide more jobs and housing for transgender people.
Towards the end of the interview, a question ab=
out
survival prompts another demonstration of the violence that again did not
emerge in the chronological narrative:&nbs=
p;
“I was stabbed in my neck, it was by a trick…. with a
switchblade, and it missed my jugular vein by one tenth of an inch.”<=
span
style=3D'mso-spacerun:yes'> Only this time, the unexpected vio=
lence
has been contextualized by a level of constant threat and resistance Nirvana
lived within. Violence was
normalized in her life, and her aggression was in part a survival skill.
The reason why I’m doing this interview= is because I want people to understand that you can make it if you want toR= 30;. Because I know how the old me was. I know how cruel and malicious and vindictive and chaotic I was. Today, I’m content. I can look in the mirror and be happy with the reflection that I see. I can smile. A lot of t= hese trannies, they think they’re really smiling at the way they look, a l= ot of them were crying out. They just don’t have no place to go to let it out. And that’s [why I want to start a social service agency for them= ].
Again and again, this level of high normalizati= on of violence was repeated by the interviewees.= For example, I conducted an interview with key informant Barbara Cas= sis, an African American MTF woman who now works as a case manager for a transge= nder support agency, Housing Works. When I asked her about community members’ adverse experiences with emergen= cy rooms, she described her clients’ experiences as “horrible̶= 1; in this area. She presented t= he common scenario of a sex worker being beaten up first by a john who “spooks” her as transgender, then being emotionally “beat= en up” by the medical professionals who are trying to treat the physical wounds. To demonstrate the pr= oblem she moved to personal experience, “I was raped, I was brutally raped,= by thirteen people, and kidnapped. But anyway… “ and she moved on = to the real point, her added brutalization at the hands of the medical professionals. In this instance the participant’s storytelling emphasizes the omnipresence of violence in some transgenders’ lives. An episode of remarkable personal violence is transformed in the telling from an event in itself to the conte= xt for an explication of more violence still.=
Like Nirvana Rose’s description of hersel= f as “cold inside,” others directly cited the exposure to violence a= nd assault as formative in their emotional makeup. The complexities of early trauma, emotional “hardening” and its impact on the personal relationsh= ips in ones life is revealed in another story that first skips over then backs = up to reveal a particularly dramatic incident. R. Francine Bailey describes what happened when she was an eleven year old boy, recovering from a surgery to = fix congenital arm problems:
I came out with this horrible cast, to the wa= ist. Horribly cast, they called me frankenstein everyday, pushed down in the snow and fucked by the same boys when I was 11. In the snow in my driveway. I’ll never forget it, twelve years old. Right in the driveway. All my mother had to do was look downstairs in the driveway, or my father drive up with the damn car.
Again, the incident alone stands as horrific, b= ut what are the contextual factors that surround it, and how did they all affe= ct emotional development?
At the time of the interview, Ronelle Francine =
Bailey
was 47 years old. Earlier kno=
wn as
Ronelle, she now goes by the name Francine. She is of mixed African American a=
nd
Native American descent and identifies herself as a person of transgender
experience. She embraces her =
unique
status as between two genders, and bridles at transexuals who think they are
“real women.” Fra=
ncine
grew up amongst working class African Americans in an admittedly tough small
town in
At age six, just days before he was to start sc= hool, Ronelle was publicly sexually molested by older boys. He was confused about what was occurring, but remembers the feeling of shame as the other kids laughed and pointed at him. Over the ensu= ing years, a boy left to babysit him continued this pattern of molestation. The trauma of this experience is vivid:
Every weekend. I used to always beg my mother crying, holding onto her screaming, I can see it now, mom, don’t leav= e me mommy, and she would leave me to go out drinking, she was a terminal alcoho= lic. She was going to follow the bottle. And my father was going to follow the d= ice and the cards. That left me with the baby sitter.
But in time and without other influences, this = small child starts to normalize this experience, eventually becoming an active participant in the previously forced sexual contact. Ronelle talks about his abuser:
I didn’t even know he done nothing wrong after all these years it seemed like the normal thing to do, after that, ca= use I went from him to his brother to the younger brother.
By age ten, Ronelle learned how to use Vaseline= to help avoid rectal bleeding. B= y age eleven Ronelle and one other boy would head over to a vacant house in town every day after school to “take” seven or eight of the neighbor boys. The sex was tinge= d with negative and positive elements: it brought both opprobrium and a type of status. The boys routinely denigrated Ronelle for his passive role in their sex. Conversely, Ronelle gained a type = of pride from claimed ownership over the boys in the house. He would tell his sister, “You’re getting my leftovers, don’t forget it.” By the time of the incident in the driveway, Ronelle had fallen in love with one of the boys.<= span style=3D'mso-spacerun:yes'> Perpetuating the contradiction of responding to their abuse he loved him particularly “because he punch= ed me in the chest and told me you shouldn’t be doing this.” It was this boy, his boyfriend at = the time, who initiated the incident in the driveway.
Now, as it is contextualized, the dramatic rape= of the young boy in that driveway starts to shed light on the contradictions in normalizing personal violence, and the formative impact it can have on relationship development. For= young Ronelle, he learned early to identify his value as a sexual object for othe= rs, and this was one of the few positive imprints in a life otherwise troubled = with neglect, ostracization, and harassment. But his value to others was = itself often the source of more brutality and harassment. This created an illogical situatio= n that was difficult for the youth to navigate, and ultimately he closed off his emotions in response: &nb= sp;
See that little boy right there, don’t = mess with the urchin, he’s a known urchin. I didn’t play with nobody. Did not play. Dodge ball, nobody hit me with a dodge ball, I’ll kill = you. There’s an evil in me all my life that’s horrible. And like I s= aid I didn’t do a whole lot of playing. For one thing, I’ve seen a = lot of people get hurt, and I feel no harm, I was born hurt. There’s no r= oom in my life to be hurt again. =
For the older Ronelle, now known as Francine, t=
his
emotional hardening and learned aggression served her well throughout her
life. She learned to be a fig=
hter
early, and her willingness to fight came through in many later
experiences. In
Like Nirvana, Francine understands that she is a long-term survivor. Most of t= he people in her stories have now died. Her own health is precarious, as neuropathy, asthma, and additional = HIV complications remind her that she is living on “borrowed time.” Like Nirvana, sh= e also wants to start a non-profit to help the younger generation get opportunities she never had. For Francine, = it is important to tell her story on the record, she asks that no pseudonyms be u= sed because she is proud of what she has survived.
But while acknowledging her incredible will in
staying a survivor in a litany of difficult situations, it is clear parts of
the story are a testimony to how close she came to not surviving. At=
age
19, torn by conflict with a boyfriend who rejected her for “girls,=
221;
Francine desperately tried to get “all that loving and affection and
attention” back by threatening to drink bleach and ammonia in front of
him. Echoing the continued th=
emes
of earlier transphobic partners, the boyfriend responded, “Oh, you dr=
ank
it you stupid fuck. Here take a whole fucking bottle and drink it all. I
don’t care. I still don’t want you. Stupid ass. Think that would
make me want you? Faggot.R=
21; And Francine did drink it, a half a
bottle of bleach and about a quart of ammonia. This was the first of two times she
would attempt suicide by drinking bleach with ammonia that year. In the second attempt, Francine ra=
n down
This and other stories of transgender survival = reveal exactly how precarious that survival is.&n= bsp; The fact that living to the age of thirty of forty is a relatively r= are survivorship within this community, obviously points to a high level of ear= ly death among that community. S= ome of the participants demonstrate amazing skills at survival. But their stories highlight how ma= ny did not survive to that point. Th= e high mortality rate also truncates the study sample. Among populations that face = less violence, one might expect to find a normal distribution of survival skills, some people would have more, some less. For a population such as transgenders, where fatal violence is all too common, the study sample is skewed because so many community members have died young. It is likely that study participan= ts, especially the eldest among them, represent transgender people with higher-than-average survival skills.
All of the violent incidents examined so far sh= are a common theme: the perpetrators are male and the victims are MTF transgenders involved with men in a sexual capacity.&nb= sp; This echoes the literature review, it is clear that sexual partners = are a great risk to MTF transgenders. For the natal male sexual partners of MTF transgenders, the contradictions inherent in desiring a socially-disdained person can cause a high level of internal conflict. These men too often externalize this conflict onto the transgender person in the form of emotional or physical violence. This violence is covertly sanction= ed by a society that holds the transgender person in disdain. This violence becomes even more problematic when it is recognized that a social role as sexual object for m= en is one of the rare places where MTF transgender people find acceptance and value, albeit in a compromised fashion.&nb= sp; Both Ronelle and Nirvana achieved status through this social role, as did Amanda Milan. When combin= ed with the socioeconomic forces that will be explored later, it becomes clear that many MTF transgender people are not realistically able to shield themselves from the high level of violence that accompanies this social position.
Yet not all of the stories of violence emerged = from the MTF transgender interviews; one of the most notably violent histories c= omes from an FTM person. This time= , the violence is more often of aggression, not victimization. Despite the differences, similar t= hemes persist: early conflict leads to survival aggression, social location gives rise to later violence, and the participant outlives their early peer group. In this instance, the = social location was as a male drug dealer.
Jenna is a Black lesbian in her fifties, she currently works as an educator, trying to help younger people make better choices than she did. She doe= s not identify as transgender or even dyke, neither word represents her understan= ding of herself. Her upbringing is= in a poverty-class African American inner-city community. Her early life had little stability. Her parents divorc= ed early and her mother caught tuberculosis after struggling with two jobs in = an effort to support the family. The family first moved into the sanitarium with the mother, then bounced between different relatives. Jenna remembers her first abuse at the sanitarium, where the mostly-white staff h= ad already isolated her from her siblings, and would punish her for misbehavio= r by locking her in a dark closet for hours on end. In the years following, her mother partially recovered, but continued to have babies and was less able to care= for the growing brood. One of the babies was abandoned at the hospital until the grandmother intervened, pick= ing him up and raising him herself. At age 12, her mother re-entered the sanatorium and the family moved in with an alcoholic aunt. The aunt phys= ically abused all the kids, but here Jenna got exceptional notice for her gender variance. This led to additio= nal beatings, but also gender-based psychological abuse. Jenna remembers with distress her aunts’ game of dressing her up in highly feminine clothing and forcing her out of the house, which would invariably lead the little tomboy to hour= s of tears.
Jenna describes herself at this point as reluctant to move= to physical violence, “I wasn’t one of them young tomboys that lik= ed to fight, I could fight, but you had to really, really push me to really pu= sh my buttons in order for me, I would defend myself, I wasn’t one of th= em bully type of ones.” Sh= e also talks about the effects of being a tomboy, and how in her opinion it caused people to avoid her. This soc= ial isolation echoes throughout her adolescence, when she found herself in cons= tant conflict with the gender role she was expected to play, and not supported by any group who would accept her male role.&= nbsp; Despite her reluctance to fight, Jenna found herself in an increasing number of situations where she had to defend herself or her younger siblings. Similar to Nirvana = Rose and Francine, she quickly learned to be aggressive, “I used to fight a lot… I would fight if I had to fight. If you hit me, we’d fight= and that’s all.” By mid-adolescence she was in jail for assaulting a teacher at school, and by later adolescence she had already been shot once.
As Jenna steps through the different phases of = her life, she talks with pride about one time.= In her early 20s, she used her skills at talking to help deal drugs, ultimately becoming known as “John” and gaining acceptance in a group of male drug-dealers. <= /p>
You know, I wanted to be like them. Because t= hey were fucking gangsters, and I loved it. I did, I loved it. I carried a .357 Magnum. That thing was so big that I used to have to keep it in a bag in my car, close to me. And I loved these gangsters, and I wanted to be one…= ; I used to wear a 3-piece suit and the whole shit. I didn’t have no men&= #8217;s underwear on, but I had a 3-piece suit on. It was for a guy. Shoes and everything. And they always used to say Who is that? And they’d say O= h, that’s my girl. That ain’t no girl. And you couldn’t conv= ince them that I was a girl at that time. Because I used to wear a hat all pulled down and shit. Oh man, I loved it.
At this point, Jenna recalls, she was the riche= st she had ever been. She had three = cars, a house, and a woman at home she “threw money at.” Like the other gangsters, she love= d to go out and trick with girls. = These girls accepted John easily despite the fact that she was female-bodied. But she frankly admits that despit= e her past immersion in a world where all her contacts were male, she cannot stand men. She cites two reasons for this, both of which hinge on her gender identity: men have always tried to = tell her a lesbian was not as good as a man, and men have claimed that they could make her straight. In her “gangster” days, Jenna would not tolerate competition from men. She warned her woman at = home that she would need to leave if she ever wanted to sleep with a man. Later, when the woman flouted this warning, Jenna resorted to the most dramatic example of the violence she has always used to defend her position.
So I hear her up in the room with this guy. They’re in the back room. Our bedroom’s here, my daughter’= ;s bedroom here, and we had a back room. But I had put chicken wire on the win= dow, and then nailed the window shut from the outside and the inside. Paranoid, that’s what I was. And so I know the only way out of that room that they’re in is through that door. And there’s a lock on it. There’s a latch going across. I went up there and latched it. I went = down to the corner. I bought some gasoline. I came back to the house, I set there just as nice. I listened to what they did until I heard them snore. I poured the gasoline, I went up to the door and lifted the latch, I put gasoline all around the door, I came down the steps, threw the can, light the match, and went back to my mom’s house to go to bed.
From the present vantage point, Jenna describes herself as “blessed”. She feels blessed in part because the fire department ended up rescu= ing the two people in the house she had set alight. She is later blessed because her e= fforts to shoot the offending man also failed.&nb= sp;
Jenna’s early life was rife with instabil= ity and violence, which could suggest that the later violence was simply be an outgrowth of this socialization. However, Jenna’s narrative suggests another source for the vio= lence. Throughout her story, she maintain= s a consistent theme: that she was constantly defending her gender-variant soci= al location, as a tomboy, as protector for her siblings, as a butch dyke, or a= s a male-passing gangster. She characterizes herself as always being a rebel and resistant to initiating violence, but explains how, over time, violence became a learned response to the persistent assaults on her relatively isolated positioning. Even the coldly deliberate a= ct of trying to burn down the house with her lover in it hinges on an act of gend= er defiance; the woman has slept with the one type of person who Jenna will not tolerate, a man.
Like the earlier examples, Jenna’s story = is also one of survival:
All my friends are dead, they either took a d= rug overdose, HIV got ‘em, or that fucking crack got ‘em now…= I was going home for funerals so much, I had to tell my daughter don’t = call me anymore. I was going home once a month. People was just dropping dead. A= lot of them, I couldn’t even make it down there for their funerals.
This is the final way in which she describes he= rself as being blessed, for surviving. Not long after the house-burning incident she became the target of an FBI sting operation. With painstaking effort, they collected enough evidence to confiscate all of her goods and send her to the penitentiary.&nb= sp; She describes this incarceration as providential, saying it motivated her to get clean, and ultimately saved her from the AIDS epidemic. Again, while Jenna’s story s= tarts from a very different position from that of Nirvana Rose or Francine, three themes echo through it: early survival aggression, social role giving rise = to later violence, and a survival beyond the peer group.
The three stories of Nirvana Rose, Francine, and
Jenna are remarkable for including the greatest level of violence among all=
the
life histories. Nirvana Rose,
Francine and Jenna shared commonalities in that all three are people of col=
or
who were encultured in a lower SES environment. People in low socio-economic class=
es
share a much greater exposure to violence.=
Both being low SES and living in a low SES neighborhood constitute r=
isk
factors for increased violence.
Research has shown this is a result of a complicated host of factors,
including: stress, addictions, community structural disorganization, and
violent modes of governing illicit industries (such as drug sales)205, 206. Being of a non-dominant race or
ethnicity also correlates with a higher level of exposure to violence. For many African Americans in
particular, historical structural isolation in higher crime communities is a
major exposure pathway to violence207, 208. Discrimination also engenders viol=
ence
on many levels, ranging from the extreme violence of the hate crime, to the
more quotidian aggressions of a racism that assumes people of color to be l=
ess
valuable than whites. However, the stories here demonstrate the level to wh=
ich
this violence is clearly correlated with people’s gender variance.
To explore these questions, I examined the role= of violence in several of the other narratives. Several trends emerged. First, violence remained thematic = in the lives of MTF participants. St= ories of abusive partners, routine street hostility, and extreme aggression abounded. Second, while viole= nce was often less present in the lives of FTM participants, it was not absent. Third, while exposure= to violence could be exacerbated by race, ethnicity or, class, it was primarily linked to public gender variance. A short analysis of several participants’ stories will be presented her= e to demonstrate these points.
Three of the MTF life history interviews were w= ith people of similar backgrounds: all were white, over 40, and from middle cla= ss or professional class families. The stories shared common themes. People relayed some form of extreme distress and personal destabilization leading up to the point of awareness and acceptance of the gender variant identity. Unif= ormly, this resulted in extreme isolation as well as poverty. In one case, the act of transition= ing dramatically sheared off all social and financial supports. In two others, longer history with addictions and social isolation had already served to move the participant = into the lowest SES category. The personal ability of each of these three participants to pass as gender normative is very different: Marnie is a crossdresser, so controls her gend= er variant presentation by choosing whether or not to dress in public; Anna is rather short for a natal male, and knows she has always been able to pass easily; Darlene is almost 6’2” tall and this height makes it a constant struggle to pass. Th= eir experiences with violence differ widely, ultimately correlating most highly with their ability to pass as gender normative.
Anna, the one of the three who is most able to =
pass,
has the least violence in her narrative.&n=
bsp;
She even describes being in and near the dangerous drug and sex work
scene without noting violent events.
She also does not bring up early school-based violence. However, she was not publicly gend=
er
variant in those early years but rather presented as a typical male jock.
Marnie also has little violence in her narrativ= e. She does mention some early family abuse, which may be linked to suspicions about her gender variance. Violence emerges as a persistent t= hreat only recently, where it haunts her every public act of crossdressing. For years she feared dressing in p= ublic, and only recently has her affiliation with a group of crossdressers allowed= her to challenge this long-held boundary. Interestingly, after doing it the first time, her predominant memory= is not one of relief, but of concern for her safety:
I could feel the threat. I wouldn’t let= it penetrate, but I could feel it. Because we were walking, and it was a matte= r of just going past one thing after another. So we realized that whatever people thought, however long they hold it, that’s not up to you. So once they’re past, that experience is gone and its irrelevant. But to have= to go through it during that long duration with that amount of intensity was something to deal with.
In contrast to these two stories, the narrative=
of
the 6’ 1-1/2” tall transexual is saturated with violence. Darlene’s experience with vi=
olence
diverged from those participants with a similar background, instead falling
closer to that of Nirvana Rose, Francine, or Jenna. Darlene remembers being “pre=
yed
upon” and beat up frequently as a child, specifically for appearing
effeminate. Unlike some other
participants, she does not describe becoming aggressive as a result. The violence then recedes during h=
er
most gender normative years, only to reappear strongly during transition.
Now, despite being able to pass more easily, she identifies her history of violence as a major life issue and talks about be= ing unable to control its impact on her mental health:
I think you accumulate a lot of scar tissue, = and a lot of those wounds are covering up unhealed wounds, and I feel like I̵= 7;m really covering a lot of wounds. Little things happen that aren’t so little. Like you get followed home, I got followed home by somebody the oth= er day. Its really scary… I am going through a period right now where I’m having a lot of nightmares, a lot of early sleeping problems wher= e I wake up hysterical after 15 or 20 minutes of sleep. That happens for a few hours. Even though I’m taking medication, its hard to get back. So I really am not in a good place right now. I just want to isolate, and not be around friends. So it’s probably not good. If I had a plan, I would feel bett= er. I wouldn’t feel quite so depressed.
Darlene’s race and early SES do impact her experience with violence. Unl= ike the low SES people of color, Darlene did not stay in the higher-risk sex industry or at poverty level after transitioning. While she is still burdened by deb= ts related to that process, she is very aware that her high level of education= and privilege of race helped her bounce back from the destabilization of transition.
I had a very large group of friends in the tr= ans community.. I was a popular girl. And I was probably one of the weird people because I was between two worlds. I was very into the strip community, but I was also someone that could talk about owning a professional business. So I= had these two things going on. Clearly I was very privileged. I was white.
These privileges provided her with many of the resources required to escape the dangerous, low-SES world of many of the ot= her participants. After transitio= n, she capitalized on opportunities that allowed her to leave sex work behind: a r= ich mentor was able to pay for many of her surgeries, she was offered a rewardi= ng job, and she now is pursing a second graduate degree. The opportunities of which Darlene= was able to take advantage are most likely related to her privileged position a= s a white person.
The narratives of MTF and FTM participants dive= rge around the issue of violence. Jenna’s experience stands out as much more violent than those = of the other FTMs interviewed. Violence does emerge in each interview, but in a role less central t= han in many of the other narratives. Individuals FTM narratives will be treated in more detail later, but here I will briefly review their various depictions of violence. Derek’s father would beat hi= m in an attempt to force a traditional gender identity on him. Later he chose to pass as male and= date females, always knowing that in his restrictive cultural environment discov= ery would equal death. Chris grew physically rebellious in school early as she flailed against a female social role, her later acceptance as one of a gang of disruptive boys then led her into a pattern of drunken physical fighting with others. Carrington grew up in a family wit= hout physical violence, but his extreme addiction problems exposed him to violen= ce from strangers and partners. = Craig was mentored into the Black butch community by elder dykes who spoke of long experience with violence, emphasizing the coping strategies they had learne= d. In perhaps the best encapsulation o= f how violence pervades these communities, Craig says he actually feels left out during discussions on the subject, because he sees it as odd that he has not experienced any transphobic violence. While the levels of exposure to violence are different between the F= TM and MTF respondents, the issue of vulnerability is always present, which it= self is a cause of stress. Violenc= e was discussed in each of the two focus groups.= In the MTF group, people easily relayed direct experiences of abuse,= one had even survived being thrown out of a fourth floor window. In the FTM group the stories were = not as dramatic, but the theme of vulnerability and fear was just as present. Stories of challenge and threat em= erge, but here they are tinged with a sense of physical vulnerability. This group has been socialized as female. As such, individuals = often believe that they are physically weaker than—and therefore at risk of attack from—predatory males. Most FTMs try to escape or defuse potentially violent situations rat= her than challenge agressors:
I’ve had people not know, and then chal= lenge me. That’s always interesting. Its’ like what am I going to do? Usually, my number one consideration is don’t oen your mouth. Whatever you do, do not respond, because I’m like one way or another, if they = are going to kick my ass because they think I’m a guy that’s like pissed off because they’re staring at me, then that might happen. But= if they’re going to kick my ass because they think I’m guy that’s sick of them staring at me who happens to actually be a woman, then I’m really fucked.
This physical vulnerability stemming from birth gender is a stressor. In other situations, the effect of being born female may offer a protective effect f= rom violence. “I feel too someone’s not going to really beat me up if they think I’m a wo= man, they’re not going to hit me, they’ll just throw words at you.” But in some participant’s minds, this protective effect is related to their would= -be attacker’s perception of females as occupying a low social location.<= span style=3D'mso-spacerun:yes'> For these FTMs, being = spared violence because of their natal gender merely reinforces the negative messa= ge that one cannot deviate from the gender strata. In general, transgenders on the MTF spectrum are targeted more often than those on the FTM spectrum. This is a complicated phenomenon, related to the social power of natal males, and perhaps due to outrage than anyone would reject that privileged role for the role of the less-valuable woman or the troubling between-gender person.
A theme of extreme aggression towards a gender variant person resonates throughout the literature review and in the stories here. Transgender murde= rs are marked by overkill: multiple stabbings, multiple gunshots. Exploring these stories in t= he context of past literature starts to crystallize another facet of violence = as it relates to transgender people: a phenomenon I have termed “hair-trigger violence.” Gender transgression evokes extreme emotional response in some peopl= e, so much so that the possibility of violence can be quickly introduced to an otherwise benign social situation. Importantly, the extreme nature of this response is not reliant on an adverse interaction or in fact any interaction at all, so there is no warni= ng that it is coming. This makes= the emergence of violence that much more unpredictable, and underscores the difficulties in shielding oneself from it.= In essence, gender variance is so distressing to some people that th= ere is not a standard trigger before violent response. Instead the infinitely more sensit= ive hair trigger is all that stands between socially acceptable behavior and aggression. This leaves trans= gender people permanently vulnerable to hair trigger violence whenever gender vari= ance is exposed.
Examples from Darlene’s story underscore = this phenomenon. She talks about h= er experiences walking down the streets: the man washing the car turns and hoses her down, the youths on the other side of the street start yelling at her, people inside apartments thr= ow things at her. For her, it is routine that people will go out of their way to become aggressive towards h= er. No precipitating interaction is ne= eded to catalyze this response. Her presence alone is enough to move them to act, almost as if they were trying= to fight so not much against her= , but against her existence. In ano= ther example, Darlene talks about how an otherwise non-aggressive person was mov= ed to violence simply by being confronted with the smallest of tokens of her gender variance, a “fleck” of mascara. Dressed as a male, Darlene s= howed up to her ex-wife’s house in an agreed-upon arrangement to see their children. As they spoke, the = wife spotted the offending fleck of mascara and in response she punched Darlene = in the face. This person h= ad never before been physically aggressive in all of Darlene’s history w= ith her.
Hair trigger violence emerges again and again in these interviews. Sometimes disaster seems only to be averted by fate, as in this story told by a participant of the MTF focus group:
I’m walking and this young man…sa= ys ‘come to my house.’ We didn’t have any sexual intercourse, we went to sleep and I took a sho= wer and my girlfriend called me and said you gotta get out of there. And I turned my back, and the man started choking me. He was trying to kill me. Then he tried to smother me w= ith a pillow… And while I w= as struggling, I couldn’t really struggle too hard, my girlfriend came up and knocked on the door and he got scared, and I got up and walked away lik= e it was nothing. And then the cops came and they said being who I am I had no business being in that house.
Sometimes the hair trigger of violent response = stops just short of physical assault, as in this story by an FTM focus group participant:
On my ride home on the train, this guy was sitting… and then he started in with this like homophobic shit about = me, like about how the Gay people are just awful and how they should get out of= the streets, and blah, blah, blah, looking straight me, and he hates fags, and these fucking fags have got to get out of the city. Nobody is speaking up, nobody is d= oing anything… finally he got up and he left… showing me his knife, which was clipped onto the belt of his pants. Like he made a point of it, l= ike of scratching his shirt, and then walked off the train, looking at me the w= hole time… I could have been just like Shut the fuck up, or something like that, and all of a sudden I could have had a knife on me. So it’s sca= ry, totally scary.
The constant risk of hair trigger violence clea= rly shows how violence is not an isolated traumatic event in the lives of transgender people. It is more aptly described as a specter, a type of mental haunting that creates prolon= ged stress.
The knowledge that visibility equals risk resul= ts in another dynamic within the transgender community: hiding gender variance to survive. This survival strate= gy is powerful, and is effective not only in shielding one from violence but from many other adverse social determinants related to gender identity as well.<= span style=3D'mso-spacerun:yes'> But while hiding gender variance is protective, it also takes a toll on stress. Some people hide as their birth ge= nder, either in reluctance to risk shearing off the supports in their lives by exposing their gender variance, or because physical constraints make it unlikely they could ever pass as the opposite sex. Katie Douglass, a trans-identified= mental health provider talks about the stress that results:
This being visible is to put yourself at risk= , you know. That is there’s an automatic incentive to be closeted, just not being who you are, which creates so many mental health issues. In some resp= ects it can be mentally tortuous to know you can have control over how you look = and then you would have some control as to how you would be treated, but then y= ou wouldn’t have any control over how you feel about yourself. All those mental gymnastics can drive somebody nuts.
On the other hand, some people can pass as the opposite of their birth gender, and use this ability to blend into a new ge= nder normative community. Katie se= es this happen a lot in the FTM community.&nb= sp; But she is concerned about it as a barrier to personal support as we= ll as community development:
What seems to be happening is … there&#= 8217;s a high attrition, so people in the FTM community will come to groups and get their needs met, and then they become invisible via the process of transiti= on, and then they have no role models, no masculine role models or ideas of representation of oneself in the future, and that’s such a barrier to having continuity of your community.
Going stealth not only creates isolation, it al= so creates stress as people attempt to navigate social situations that devalue their lives. Chris talks about these problems.
Passing as a man was uncomfortable for me in = a lot of ways. It was a novelty for a while, and especially became more and more uncomfortable for me as I started to see sides of men that I didn’t g= et to see when I was a girl. Yea= h. I heard jokes, and I saw the real attitudes that men have towards women, and I just didn’t want to be a part of that in a lot of ways.
For Chris, the stress of going stealth ultimate= ly led her to reconsider her transition to male. Ultimately, she made a decision to “re-present” or move back to a female identity.
I didn’t want to be hidden. My invisibi= lity was starting to really get to me. I had always been so invisible my entire life, and I thought of it as a cross to bear, and I wanted to get rid of it, but I did realize it was valuable in some ways, too. I mean I didn’t = want to get my ass kicked, but at this point, I’m not going to, because I = pass when I want to, which is convenient for me.
So, for Chris, the stress of violence and the s=
tress
of assuming a social role that had the effect of shielding her form this
violence were both distinct factors in her life. She ingeniously navigates into a
position of safety and support =
by
relying on her ability to pass as male in the streets, limiting her
identification as female to situations that are less potentially hostile.
For each of these groups, being read as gender variant constitutes the greatest risk for violence. Some people choose to mediate this= risk by hiding their gender variance, but this act results in its own family of stressors. Some people, espec= ially natal males, are less able to control whether they can pass as gender normative, leaving them exposed to violence for a greater percentage of the= ir lives. For some, issues relat= ed to social locations connected with gender variance also lead to violence; some= times this is through associations with unstable populations, sometimes it is in defense of ones own nontraditional gender role. For FTM populations, an exte= rnal perception of them as less-powerful females may help protect them from violence. For MTF populations= , an external perception of them as failed males may increase their exposure to = this violence. Social vulnerabilit= y from other factors, such as lower education or being a member of a minority raci= al or ethnic group can exacerbate exposure to violence. This social vulnerability can also reduce a persons’ ability to escape high violence cultures, such as s= ex work.
In summary, violence affects the stress level o= f the transgender communities through three pathways. A large subset of the population is affected through direct exposure to violence. The full population is affected by= two additional factors: community-level knowledge about frequent anti-trans violence; and the permanent sense of vulnerability resulting from the poten= tial for hair trigger violence. The cumulative effects of these phenomena create marked stress and increase the allostatic load of individual community-members. For all of these reasons, violence= is the hallmark of how social determinants affect transgender health.
As if to reinforce how very perilous survival u= nder these circumstances can be, on the third week of data collection, Paola Mat= os, a 31 year old transexual from Brooklyn, was found murdered in her bed.
I learned about Paola Matos in an interview with Christopher Leonard, a health educator working with transgender populations. This was not the= only sad news, but was paired with more evidence of the toll that social problems take on the transgender community. &n= bsp; A transgender friend of his had overdosed on drugs, and was currentl= y in a deep coma.
Addictions were a consistent theme in the life histories of the transgender people interviewed, almost every person I interviewed told of struggling with them.&= nbsp; Out of the twelve full live histories collected, only two people did= not echo this theme. Some addicti= on issues were clearly related to a hazardous social location, particularly association with the sex work industry.&nb= sp; The story of 21 year old Shashatika brutally demonstrates an example= of this phenomenon.
I try [to resist drugs]… at a time I wasn’t doing it. I was hanging out with a lot of people that did drug= s. And I wasn’t doing it, and people was telling me “Get away from= me, you’re hanging out with those crackheads, you’re going to wind = up doing it”. And I was with this trick one day, and he told me I’= ll give you $150 if you take a hit. And I did. Then he said for every hit you = take I’ll give you $50 more. So you know, I was just taking hits and hits = and hits and hits. And smoking. And I was doing it on the weekends. And then I started getting heavy on it. And I just started hitting really, really heav= y.
But upon deeper exploration, it became clear th= at the role of addictions in transgender health could better be examined by lookin= g at the causal factors that lured people to their promise of temporary escape.<= span style=3D'mso-spacerun:yes'> While addictions were common in the narratives, older people generally spoke about them as occurring in the pas= t. A group of the stories shared a co= mmon theme related to addictions, and interestingly, these stories spanned lines= of gender vector, age, and to a limited extent, race/ethnicity. Everyone in this group talked about beginning the use of alcohol or drugs near the time they were first identif= ying their gender variance. Many of these cases shared a second pattern; a dramatic escalation of drug and alco= hol use as a person approached their public transition into a gender variant person, followed by a tapering then ultimate stabilizing of the situation n= ear or after this transition. Kat= ie Douglass, the transgender mental health provider quoted earlier, is also concerned about this phenomenon: “I’m starting to notice a patt= ern of a lot of craziness goes on with a person as they come to terms with their gender identity. They go through a lot of wild swings, they go sometimes through very self-destructive behavior.” Barbara Cassis talks about how dru= g use fits into this equation, “I think people are trying to medicate themselves to sort of forget, or just for that moment to forget whoeverR= 17;s inside of you, you’re not who you are, you’re high so you’= ;re feeling good.” The participant stories echo both of these observations. Through this lens, addictions beco= me an indicator of a multi-faceted stress related problem; the escalating “pattern of craziness” Katie talks about as people come to terms with their gender identity.
As described in the last section, Anna is curre= ntly a passing MTF transexual in her early fifties. Anna’s early childhood= home life appeared stable from the outside, but was not a “safe space̶= 1; emotionally for any of the three siblings.= She knows threatening things happened to her, but cannot remember if= the details were correlated with her early awareness of gender variance. She remembers becoming a “world-class liar,” a skill which served her as she started to crossdress around age eight. = By age ten, she was in significant trouble in school, breaking into houses and set= ting fires, being discovered crossdressing by her parents, and being forced to s= ee a psychiatrist. As she says, “So whatever was going on within myself and my little world was very, very unsettling.” By ag= e 11 she had discovered the word “transvestite” and started to read every available book on the subject. As can be common for transgender people, the onset of puberty only served to reinforce the chasm between internal perception of one’s ge= nder and the external reality of one’s physical body. For Anna, puberty was “traumatic” to such a high degree that she spent the years of 1= 3-15 in a stress-induced fugue state. “I have very little memory of who my friends were, how I felt, how I viewed the world around me, that period is almost virtually blacked out.” After this she enjoys a time she describes as “happy” because her burgeoning drinking became an effective tool to help her “mesh better, fit in better” as a male. But in her words, “And as I = got older, I became far, far, far more troubled.” Her parents were ignori= ng and hostile to the open secret of her crossdressing. In college, her alcohol was supple= mented by drug use, and she described herself as “a really smart person who = did as little as humanly possible…no expectations, no horizons, no dreams= , no aspirations.” For her, =
Trying to pretend to be this man holds me bac= k, holds me down, I can never be self-actualized because there’s no there there, and to accomplish what I did, I’m pleased, you know. I am. I d= id the best I could. And it’s a miracle I survived it.
As her friends started to reduce their drug use=
and
stabilize into jobs and personal relationships after college, Anna’s =
drug
and alcohol use continued to rise.
She moved onto graduate school, but with her growing gender conflict=
she
dropped out after one semester. At
this time, she made a link to the community, and started to frequent a bar =
for
transexuals. But her self-ima=
ge as
“too masculine and ugly to be a woman” left her little
understanding of how to fit in, so she bought acceptance as a
“stealth” male providing cocaine to the women. The bar became part of a stressful
double life she led and the drug use continued to escalate. Within three years, “All my =
money
was gone. All my credit was gone. My ability to have a life was
gone.” In a desperate a=
ttempt
to stabilize, Anna signed onto a job working in
“My life had become very single minded,= it was all about the drugs, and everything else disappeared, and I was hooked = and I was trapped, drug use… And I couldn’t get sober…. I just didn’t care enough. I would see sobriety as a man and say, ‘You know what? I’d rather die.’ … I’d rather jump in fr= ont of the subway.”
As she was approached her fortieth birthday Ann= a hit bottom; she was deeply in debt, barely able to hold a job, losing teeth, and homeless.
Faced with few other options, Anna entered drug treatment, but she could not treat the drugs without addressing the gender identity issues underneath.
[In rehab] they said put everything on the sh= elf, and all that stuff on the shelf crashed and hit me on the head… when I went to rehab, I ran out of lies, you know… like I’ve been livi= ng this lie for all these years... The process of therapy made it clear to me [that I was a woman]. I was shocked, I was shocked that it would be so real= and powerful, it was always the deep dirty secret.
Anna’s story demonstrates the extreme
destabilization that can occur as a person struggles with recognizing and
integrating a gender variant identity that is so disrespected by society.
The act of transitioning brought Anna some elem= ents of further instability, as it commonly does with others. Despite being able to hold a job t= hrough the extreme drug use, she was fired as soon as she told co-workers about her transition. Soon she was tryi= ng to balance her newfound sobriety with the reality of having to supplement her income as a cocktail waitress and occasional sex worker in a transexual bar. The threat to her self-perception was profound, because her ability to work has been a mainst= ay of her life. But despite the combined challenges of the long history of drug use and present discrimination-based un/underemployment, her stress receded once Anna found= an acceptable social location as a passing transexual woman. Relieved of this internal conflict= , her story now starts to plot a steady trajectory towards more personal stabilit= y. At the time of the interview, she = now enjoys more stability than ever before in her life, she has a good job, owns her condo, and is involved in engaging community politics. In her words, “I honor mysel= f and my community.”
Carrington is on the FTM gender vector. He sees himself not as male or fem= ale, but as “other.” He adopts a new term to describe this, FTX, roughly translated to mean female-to-unknown variable x. His story also demonstrates the st= ress that results from internalizing the societal knowledge that gender variance= is unacceptable. Interestingly i= n this case, Carrington’s stress is caused both by traditional and non-tradi= tional gender paradigms. In particul= ar, his relationship to a feminist and/or lesbian interpretation of gender play= s an ongoing role in both his stress and social isolation around this issue.
Carrington was raised in a middle-class, white, highly educated family. He ea= rly on realized he was different, and remembers how he wanted his body to be male = at age four. But for him, his mother’s feminism complicated this knowledge, “There was a lot = of guilt associated with that desire to be male, because my mom has instilled = in me this idea that being a girl is great and you can do anything and that wo= men were wonderful and men were like not so great.” Struggling with the traumatic effe= cts of puberty and frequent family moves, he had no friends and retreated to ̶= 0;a made up life” in his head. “I didn’t feel like I was like anybody else… I wasn’t happy with my sexuality and my gender.” Near this time a cousin raped him,= a memory he would suppress for years. As well, school was “very traumatic,” as kids called him “lezzy” and hassled him for his gender variance. By age twelve, Carrington lost his ability to cope with these multiple stressors and became an alcoholic. By thirteen, he was drinking a cas= e of beer daily. Dropping in= to a fantasy role as an young college student, he would go to bars and ”hu= stle old letches” to buy him drinks. This itself was risky, leading to additional trauma as he tried to a= void the sexual advances of his benefactors.&nb= sp; At 15, he tried to escape the isolation with the “culturally appropriate” response of getting engaged to a man. But he kept this secret from every= one, which then left him more bereft when the man was unexpectedly killed. At this point his drinking quickly spirals upwards. He also make= s his first connection with the lesbian community. He describes this with great relie= f, thinking “thank god I’m not a mutant.” But from his current perspective, = his long association with the lesbian community also held a type of false promi= se.
“I came out in a very political rigid l= esbian environment… you cannot be too masculine, you cannot be too feminine,= you must be androgynous… So finally I find a community I think I can iden= tify with, and I feel comfortable with because I can wear men’s clothing a= nd its not a big deal… And it was yet another realization that I wasn’t going to be who I wanted to be.”
His drinking continued to define his life. By age 18 he was friendless, livin=
g in
an abusive relationship with a lesbian drug addict, and trying to curb his
hunger by sneaking food from his job at a fast food restaurant. “To be so young, and to just=
be so
fucking hopeless, that’s what life felt like at that point.”
So I’m like in the ambulance, and I rem= ember them saying we have no heart rate, no respiration. So basically I’m dead…. I have a clear memory of seeing and feeling and hearing myself being respirated with a bag, and feeling my chest going up and down, knowing that I’m not breathing, and feeling very peaceful at that point, like okay, this is good.
In an experience similar to Anna’s, Carri=
ngton
eventually entered rehab, transitioned to male, and ultimately stabilized h=
is life. But he continued to have stress re=
lated
to his gender presentation and the expectations of the dyke community around
him: “So there’s =
still
like that man-hate thing. So now I’m this traitor, I’ve become =
the
other, I’ve become the enemy.”=
This stress causes him to leave his hometown and move to
Like the examples used to explore violence, Ann= a and Carrington’s stories are particularly illustrative of stress-related destabilization resulting from gender oppression. This phenomena affects community members in various ways.
First, the phenomenon is not rare. As mentioned previously, all but t=
wo of
the full-life histories included addiction problems, and they were often
directly attributed to the stress from early life awareness of gender
variance. Self-destructive
behaviors were also commonly reported, such as genital mutilation or high r=
isk
sex. People also commonly tal=
ked
about depression or other mental health problems before transition. The first movement towards a great=
er
reconciliation or simply an understanding of one’s gender variance can
then provoke its own stress, as a person lets out years of frustrations.
Isolation is a common theme pre-transition, and=
may
have a large effect on the degree to which a person experiences stress rela=
ted
to their gender variance. Dif=
ferent
communities have varying levels of acceptance of gender variant behavior.
The guys hang out with them, they’re ju= st one of the guys…. I don’t know how they do it, but they just kind of fit in, they come in there, they’re rough and they’re tough, and they got the whole thing down, and they’ll beat your behind as well as any guy around the corner, you know, so it’s like no big deal.
Among study participants, the most reliable pre= dictor of ability to stabilize after transition was early life SES. But people rarely talked about rec= eiving support from their social or family networks during this process, they were much more likely to be struggling with active rejection from these groups.<= span style=3D'mso-spacerun:yes'> Instead, having a higher level of = early life education or work experience was a factor that helped many people reco= ver from the transition process. = Within this small sample, white people were more likely to have a higher SES than people of color. Accordingly,= white people were more likely to stabilize after transition and people of color w= ere more likely to struggle longer near the poverty line. The experiences of Marnie, Craig a= nd Derek suggest that this ability to stabilize is more closely related to SES than race. Marnie is a white = MTF, who was highly educated and raised middle-class. Yet she currently lives near the p= overty line and does not expect this to change.&n= bsp; This is probably related to the fact that she is still in the proces= s of reconciling her gender variance. Marnie presents with the flattened affect of a depressed person, and admits living in extreme isolation most of her life. Conversely, Craig and Derek are bo= th Black, and while their lives are not free from stress related to gender variance (such as underemployment), they are both present as stable and talk about a relatively easy transition into their new roles as transexual men.<= span style=3D'mso-spacerun:yes'> In part, this is likely due to the= ir being FTM, and the fact that they are able to pass easily. But they are both notable because = they have the highest levels of education of all the people of color in the study. Thus we see that, for = this small sample, stabilizing despite the stress of internal gender oppression = is most correlated with SES and not race.
All people in our society are socialized into a system of gender oppression. We are taught to be male or female, which creates internal stress for people who start to realize that this paradigm does not fit them. This stress can escalate sharply o= ver time, resulting in a “pattern of craziness” for the gender vari= ant person. For some people, the = lack of access to alternative paradigms creates an information void that fuels i= solation. For those who do encounter people outside the binary-gender paradigm, their experience is often tainted by the high level of public discrimination against gender variant people . For example, popular books often r= efer to gender variance as a mental illness, and talk shows feature gender varia= nt people in situations designed to portray them as freaks. This negative cast on gender varia= nce often enhances stress in transgender people. With or without a larger gender-variant community, a transgender individual is likely to feel extreme isolation and to struggle with mental health issues. Coping mechanisms such as anti-soc= ial behavior or addictions are common. This extreme stress can become debilitating and even life-threatening quickly. People who go throug= h a protracted period of time before reconciling their gender variance are more likely to suffer adverse health outcomes related to this stress. Even those communities that purpor= t to expand the traditionally gendered constraints of patriarchy can still be op= pressive for transgender people, as in the foregoing example related to feminists and lesbians. Sometimes seemingly traditional communities can be supportive, as in the example of the accepta= nce of FTMs in the urban Black community. Going through a process of transition into accepting ones gender variance dramatically relieves this stress, often putting an end to the “pattern of craziness”. This transition does not take the same form for all: some people cha= nge to the opposite sex, while some step out of the traditional paradigm, becom= ing something new like genderqueer or FTX. The time of transition usual= ly includes some public exposure of gender variance. This often results in additional challenges to stability, such as family rejection or loss of job. For this small sample, the ability= to recover from this dual threat of the debilitating internal stress and the external effects of discrimination was most highly correlated with higher early life SES. Gender vector, community acceptance, or ability to pass may also play a role in this recovery, but t= here is too little information here to draw conclusions on these points. The high correlation between SES a= nd race meant that over the sample, people of color were much more likely than white people to experience longer term destabilization as a result of being gender variant.
Many of the transgender people in the study had= been destabilized by the act of transitioning.&= nbsp; Some of those people also came from challenging low-SES environments where drug use, violence, and health problems were already common. Could it be argued that the bias t= owards lower SES people in this small sample results in less stability overall, ultimately confounding whether instability is related to gender variance or= low SES? The story of Darlene sta= nds in stark opposition to this hypothesis, demonstrating instead how social exclu= sion related to gender variance is a powerful independent destabilizing effect.<= span style=3D'mso-spacerun:yes'> Darlene was discussed earlier, she= is the tall MTF transexual who struggles with violence daily. As mentioned before, she is white = and comes from a middle class background. One year in Darlene’s life is particularly illustrative.
At the beginning of this year, Darlene was approaching transition. She f= elt great stress related to her gender conflict as well as stress from her partners’ opposition to any attempts she made to appear female. To ease this stress she is both cu= tting herself with exacto blades and starving herself. In her words, “Emotionally a= nd physically I felt unalive.” At the behest of her therapist, she goes on anti-depressants. This helped her stop cutting herse= lf but also made one thing clear: she needed to transition to being a female full time. She approached her wife= about this subject but the discussions were “stillborn.” While her family initially reacted = to the gender variant news with support, her father was unable to cope with the ne= ws she was transitioning, and reacted by beating her and telling her to stay away. It would be years befor= e she would see both parents again.
Then one day, her wife returned from a trip to = see her mother. With the kids and mother in a car downstairs, Darlene understands something is wrong. The wife took Darlene to a coffee = shop to break the news: she wants a divorce, Darlene must move out the next day,= and she has already frozen their over half-million dollars in financial assets.= Darlene was dumbstruck, and felt s= he had been “led like a lamb to the slaughter.” For six days she did not eat at al= l, and sank further into depression as she tried to find a lawyer. Unfortunately, the lawyers she nee= ded did not serve her well in the coming months, either quitting the case, or n= ot knowing enough about the law in this area to adequately protect DarleneR= 17;s interests.
A few months later, Darlene finally agreed to m= ove out. But there again she hit = an obstacle, no one would rent her an apartment when she dressed in women̵= 7;s clothing, she was too visibly gender variant. Out of frustration she “dres= sed as a boy again,” and got an apartment right away. By then she was getting hassled on= the street all the time, and so started to go out only at night. Unable to hide the physical change= s, she began to come out to her many friends from her old life as a man. But “people just couldn̵= 7;t handle it…. They started to migrate away from me… Most people didn’t say outright I can’t deal with this, they just disappeared.” Eventually, only one of the many friends from her old l= ife remained.
The partner that she owned her technical busine= ss with was very upset on learning of the transition, trying to insist he shou= ld have a say in this decision. = As Darlene became more visible in her transition he banned her from seeing any clients, taking over more of the business until finally he announced he was taking all the clients and their partnership was at an end. Since this partnership had n= ever been legalized, Darlene found herself without recourse and suddenly unemployed. A later small fin= ancial settlement for the business ended up being paid to the ex-wife, leaving Dar= lene not only unemployed, but completely destitute.
Shortly after this point, her ex-wife also deni= ed Darlene access to the kids, deciding it was inappropriate for them to see h= er now that she was living full time as a woman. In the years to come, Darlene̵= 7;s mounting battle with legal fees and her inability to find work would coerce= her to eventually sign over all custody rights, a decision that still haunts her. “I have to tell yo= u, I consider my children dead. That’s how I felt. And I can cry at the dr= op of a hat around my children, I’m really shutting down here.”
Over the next two years, Darlene desperately looked for work, and sent out over 200 resumes. But she was known in= her small technical industry as a transexual, and she feels that was a contribu= tor to the fact that she only got four interviews over two years. She would never get further than t= he first interview, even as she pursued less and less demanding jobs. People made little attempt to hide= their anti-trans discrimination. At= one job they abruptly deciding the position was filled, at another the intervie= wer offering her the job informally only to abruptly rescind the offer after talking with co-workers. One = major firm even wrote her a letter telling her she was the most qualified for the job, but it ended with the line, “Unfortunately, because of your pers= onal circumstances, we could never hire you.” For Darlene, the message was clear, “We can’t hire you because you’re trans.”
Throughout the time that Darlene’s resume= was being ignored by companies across the city, one group of people kept offeri= ng her money: johns. Initially s= he bridled at the offers for sex work at the transexual club she frequented, “A lot of trannies in clubs are prostitutes. I wasn’t. I was re= ally insulted by it. But obviously, the seed had been planted, that this is my community. It was assumed I w= as a prostitute.” Finally, t= he need to survive changed her mind,
I had no money available to me, I was past du=
e, my
landlord had an office upstairs and kept knocking at my door, I was frantic=
. I
went to, at the time it was Carolyn’s, which is on the west side,
For Darlene, her decision to transition trigger=
s an
avalanche of social exclusion, affecting every single facet of her life.
Unemployment or underemployment due to gender variance was a common theme across narratives and in conversations with community members. This was n= ot, however, a simple phenomena in these narratives, but instead was influenced= by several intertwining issues. = The first link in the chain was the widespread phenomena of interrupted educati= on, leaving affected people at a relative disadvantage for securing employment = from very early in their lives. Of= the thirteen narratives, the phenomena of interrupted education crossed all str= ata. gender vector, race and class categories. Ten of the thirte= en life history participants had experienced some level of interruption to the= ir education that could be related to their gender variance. For some this was a short disrupti= on, for many it terminated their education altogether. People from lower initial SES often experienced this interruption at a younger age. As before, the high correlation be= tween SES and race in this sample means people of color were more likely to have their education interrupted at a younger age.
Saffron, a young Puerto Rican MTF woman, eventu=
ally
graduated high school but harassment limited how much she could learn. She had been getting beatings and =
name
calling for her gender variance since the age of 13. She knew she could achieve, but po=
ints
to the constant harassment she
experienced as a key factor that caused her failing junior high school. The hostile school environment
eventually pushed her and her sister to run away from home, further
interrupting her schooling. F=
or
Shashatika, both home and school became unbearable very early. At school she was taunted merciles=
sly
for her feminine appearance. =
At her
aunt would scream “Stop walking like that!” every time she dete=
cted
feminine behavior. At age 12,
Shashatika left school permanently and ran away from home. Like Nirvana Rose, Shashatika quic=
kly
learned how to take care of herself in downtown
For some people, the interruption to their educ= ation comes later, and is more a result of destructive coping strategies than dir= ect harassment. Marnie describes = how she dropped out of college due to drug use. On the face of it, this is not rel= ated to her gender variance. But i= n the larger narrative there is a relationship.&= nbsp; Her crossdressing emerged in high school, earning her frequent beati= ngs in response. Possibly as a su= rvival tactic, she then suppressed it during the college years. It is exactly during this period of suppression of her gender variance that her drug use spirals out of control= . This pattern echoes the stor= ies of how Carrington and Anna both experienced interruptions in their education. =
It becomes valuable to examine the exceptions, = and ask who did not have their education interrupted by issues related to their gender variance? Two stories constitute interesting examples of how education can be supportive of gender variance.
Craig is a 38-year-old African American FTM
transexual male introduced earlier.
While eventually he did leave his college as a result of an issue
related to gender variance, he describes the year he spent in this in this =
unexpectedly
welcoming educational environment as one of the happiest of his life. Craig was relatively
accepted in high school. He t=
hinks
this was largely due to the fact that he submersed himself in sports where
lesbian teachers were unofficially mentoring the next generation. One of these teachers turned him a=
way
from his dream of joining the army, urging him to go away to school for at
least a year. In her words,
“that way you can discover a lot more things about yourself.”
Craig was accepted into the school, a small historically Black women’s college in the south. Unbeknownst to him, the college was unofficially known for its specific affiliation: “I didn’t know that I was actually going to be going to school with a whole bunch of lesbians.” For years, t= he tradition of enrolling only friends or family of previous graduates had fostered an environment where this diversity was accepted. “It was known. But it was kept well… not hi= dden per se, just not out in the open.” The school’s longstanding place in the community made this phe= nomenon unremarkable to townspeople as well.
[The school] had been there for so long that = they had known generations of girls who had come through that school, and they w= ere so friendly and so helpful to everybody. I mean, we had a guy who his wife worked in the school and used to go to the school, and he would teach the g= irls how to play pool because he was a pool shark. It was not a big deal, it rea= lly wasn’t a big deal.
Craig easily took his place among the Black but= ches at the school. There he was i= nitiated into his role as a butch lesbian as the wisdom of previous generations was passed down through the elders.
“I actually went through like= a class on how to be a proper butch…. It was very good because they tau= ght you how to behave, how to be responsible for yourself, how to protect yours= elf, how to take care of your woman, how if something happens how you always make sure that your lady doesn’t get hurt, you take the brunt of whatever = is going down. And if something happened they were there to help you. If you got hurt or if you got put in = jail or something like that ever happened, they would be right there to jump in.= So it was very valuable.”
This relative idyll did not ultimately last for long. After Craigs’ fir= st year, an experiment with opening the admission to outsiders quickly created social strife about the college’s half-hidden secret.
A lot of these girls were coming from places = that they didn’t want to be around all these “women loving women”… And [the college] got caught. It was out to where areas= in other states and stuff people were calling in and talking about it and everything, and a lot of people were alumni and they were upset that it was even being discussed. Because everybody knew it was there, but nobody was having a big conversation about it, and then all these new people came in a= nd … started fights, started problems, it was a mess.
Craig would end up leaving the school after a y= ear as a result of this strife. Yet,= while it did not last for long, Craig’s experience with this unexpectedly supportive community shows how for some school can be a haven. It also is a wonderful example of = how communities unofficially organize to provide support for each other in an otherwise hostile environment. In this case, a key facet of this support was to link people from different generations, enabling the protective mentorship that is otherwise difficult= to obtain.
Derek is an FTM man in his late twenties, in his
words he is “Black. Ver=
y,
very Black.” Our paths =
had
crossed several times during my time in
Derek was born into a tribe of cowherders in we=
stern
Tribe is very big…. I see someone West African or something, and the first thing I’ll ask is what is your na= me, they give me one name, I’ll ask what’s your surname, because I = want to know the tribe. I’m not interested in you as much if you are from another tribe, we’ll exchange pleasantries and such, but the minute I meet someone from my tribe, I’ll give you anything. You are like my sister, my brother= . You want my music system? Take it.= You want this? Take it. Whatever happens, whatever you can do to me, its okay, because we are of the same people.
Within this tribe, Derek was one of twenty five
children in his family, the third of six children born to his mother. Derek enjoyed privilege derived fr=
om his
family’s high ranking on the social scale, “It’s a very
communal system, and my father, because he had so many wives… It̵=
7;s
seen as a great deal of prestige in African society so we were held up by t=
he
community considerably... It did make for a rather ideal way of living, bec=
ause
we didn’t really have a struggle.” He acknowledges that this comfort =
was
measured on a different metric than in much of the world…. “we
didn’t have electricity, very few villages in Africa do, even now, we
didn’t have running water, very few villages do in
But while life in the tribe offered a type of c= omfort he misses today, it also included strict social rules around gender. Derek talks about an early act of = gender defiance in his life, his mother’s decision to leave the tribe. “I really think that she got= into the marriage to have kids and then to raise them in a particular way, and w= hen she saw this wasn’t going to be done, she left.” Derek’s mother was very cons= cious of not being first wife, and therefore knowing she would constantly have to struggle to earn her kids the right to scarce resources, such as an education. “She didn= 217;t want to have that struggle, “ so she did something that was unusual at that time, she left. Derek= 217;s life was complicated by this decision, in part since it left him and the ot= her children without a key advocate. Despite these difficulties, he speaks respectfully of her choice, re= flecting that perhaps it played a role in his later decision to also leave his tribe. “But I think tha= t she did the right thing in one way. She saved herself, which is good. You have = to do those sort of things, and it’s beyond culture.”
Derek cannot remember a time when he did not understand he was male, which was a stark contradiction to his natal female body. Since his elder brother= s had died, his father gave him some duties that were more those of the sons than= the daughters, and he felt that this made sense. But his male self-image often caus= ed difficulties in this otherwise rigid gender environment. “So, I acted ‘like a boy’ but what I saw was I was acting like myself. And I was reprimand= ed, beaten for it, and thrown out of the place and told to sleep outside, for d= oing what I thought was right.” He did not have words for this schism, there was no language in his culture th= at made sense of this phenomenon. The experience of Derek’s little brother made a big impression on him, reinforcing the difficulties one encountered when the needs of an individual fell outside longstanding tribal traditions. The little brother had been acting= oddly since an early age. While Der= ek now understands he had mental health problems, the lack of language to understa= nd it then was an obstacle. In t= his culture, his brother was not ill, but “demon-possessed.” Without any ability to care for the youth and challenged with the demands of subsidence living, it became Derek’s job to tie his little brother to a tree each day to keep him safe. This example causes Der= ek to talk about his conflict with his tribal systems and traditions. On one hand he had great respect f= or them, but on the other hand, they led to situations like that with his brot= her which felt to be “wrong”. As his understanding of his own gen= der variance grew, he eventually chose to leave his culture instead of trying to change it from within, a decision that he is conflicted about today.
I honored that system as it is. And I donR= 17;t think that its wrong that I honored the system, but I think that its wrong = that I let that system, in a sense, control me, because if you let a system over= take you anyway, any system whatsoever, the African system is a beautiful system, I’m not denigrating the system per se, but I mean there are certain circumstances where the system is out of context.
For Derek, education became the route through w= hich he could leave his tribe and pursue his goal of living as a male. He could apply himself and excel at school from a very early age, and this created opportunities beyond any he = had at home. After excelling at t= he standard eight exams, he was chosen as the only person from his country to = go to a prestigious all-white school. He talks about the values instilled into him as a Black African and = how they were a critical to his perspective of education as an opportunity.
I lived in a world where because you are poor= , you should try twice, three, four times harder… [At the school] we had to work in the kitchen. Now in this system, in this country, that would be see= n as slavery, they would revolt. B= ut what were we getting in return? For the first time, I had three meals a day. For the first time I had bacon. I had a knife and fork. For the first time I was sitting in a classroom with books that were paid for. Uniforms paid for= . So what’s the trade off? I work in the kitchen. Hell, yeah, I’ll w= ork in the kitchen. For them, it had to do with us being low. For me, it had to= do with something completely different. It was an opportunity, it was great, a= nd I look back at that time, and I say thank God I didn’t grow up here.
As Derek continued to push to learn all he coul=
d, he
advanced through the school system, eventually becoming eligible to take ex=
ams
to qualify for university. While he found relative peace passing as male in=
his
travels to
In hindsight, Derek thinks it was a mistake to isolate himself from his family before transitioning.
I think I got some casualties, myself mostly,= from that whole thing. Because in = a way, if I had had people journey with me… I would have had more rejection, but… I would have at least had some support. But I didn’t have the courage. I was a coward. And I think that was a mistake.
He is also distressed about issues related to t= he new system he finds himself in, issues I will explore later under social location. But for Derek, scho= ol was not hostile, even in those times where he experienced distinct racial or ge= nder oppression. In part because o= f his socialization he found school to be an opportunity, one that ultimately cou= ld allow him to live in greater peace with himself.
Any educational interruption can become a barri= er for employment. If the education = is interrupted early enough, as in the case of the two people who ran away at = the age of twelve, the person will only be able to attain work in a very small subset of jobs. But this rela= tive disadvantage only begins to address the barriers to employment for transgen= der people. The narratives have a= lready brought up instances of how transgender people often face flagrant discrimination from employers. The study interviews with professionals working with the transgender community provide valuable insight on the breadth of this phenomenon.
Dr. Bartalos is one of the few doctors in the <=
st1:place
w:st=3D"on">
In Dr. Bartalos’ experience, the resistan= ce to hiring transgender people means a person is usually not considered for a job unless they are exceptionally qualified, and even then employers will only consider people for jobs with little or no public interaction. A few of his patients work in professional fields, often the computer industry, “but there are very very few that would get into a job where there is personal contact.”<= span style=3D'mso-spacerun:yes'>
Dr. Bartalos re-emphasizes in our interview that
transgender people “are the first to be fired” and tells a stor=
y to
demonstrate this vulnerability.
After September 11th many people lost their jobs in the
faltering economy. But even s=
eeing
this from the intimate perspective of living in
Barbara Cassis, the trans identified outreach w= orker for Housing Works, talks about the key factor in whether a trans person can= be employed.
It’s how passable you are. Whether it b= e as a trans man or a trans woman. It’s based on how you look. Even though we’re given these rights and things, society still has one more thing= for you, you better look good, because if you don’t look this way, we’re not hiring you. If we can tell, no job for you.
Despite the passage of recent legislation prote=
cting
transgender people from discrimination in
I really do not believe [the legislation] has helped anybody. There are still are no jobs, when trans people go for jobs they’re denied jobs, and maybe these people don’t have to say ‘Oh, we’re not going to hire you because you’re a transgender’, but that’s what it is… And it’s horri= ble, it’s really horrible, and I don’t think it’s ever going to change.
She is one of the se=
veral
participants who tells stories about people she knows who cannot get any wo=
rk
despite having the highest of education levels. Doctors and lawyers attend her sup=
port
groups complaining about this issue.
She is working with one person right now, who, despite being a certi=
fied
accountant, cannot even get a temp agency to send her out for daily work.
This rampant employment discrimination creates = yet another pressure to hide one’s gender variance, either through passin= g or suppressing it. Those who do = not hide their variance are at risk of being forced into the lowest of SES stra= ta through job discrimination alone. At this point, people are forced to make money to survive in any way possible. For many transgender people, just being near the community gathering places will start to expose them to one such opportunity for making money, sex work.
The narratives have repeatedly demonstrated how=
sex
work plays an important role in the transgender community, constituting a
common denominator in otherwise divergent narratives. When the twelve-year-old youth is =
alone
in
Notably, in this research, sex work was a part =
of
almost every story told by MTFs, but none told by FTMs. This is perhaps related to three
factors. First, there was a
relatively small sample of FTMs interviewed for the longer life history
interviews, only five in total.
Second, four of these FTMs shared the ability to completely pass as =
male
on the streets or in jobs if they so chose. As we have seen, this would protec=
t them
from some of the most financially destabilizing effects of discrimination
against transgender people. W=
hile
the fifth did not pass as male, her butch female appearance is less likely =
to
trigger a strong discriminatory response, since women have a certain amount=
of
freedom to adopt men’s clothing
and/or mannerism. Thir=
d,
there is a distinct group of people who sexually desire or fetishize MTF tr=
ansexuals,
creating a consistent demand for sex work from members of the MTF
community. In the words of on=
e MTF
focus group participant, “We’re a race of people that get picke=
d on
for sex.” I do not know of any such converse group who would create h=
igh demand
for sex work from FTMs. This =
lack
of pull towards sex work likely results in absence of a high concentration =
of
low-SES FTMs in one specific illicit industry. The protective effects of being ab=
le to
pass more easily likely shield many FTMs from having to resort to sex work =
for
survival, but there is no doubt that other social determinants do destabili=
ze
FTMs as well as MTFs. Also,
Carrington talks about how a new breed of FTMs chooses not to hide but rath=
er
proudly displays markers of both genders such as a mustache and breasts.
The narratives presented earlier cover many of = the factors that lead people to the sex work industry, so I will not go into any more depth on that here. Suff= ice it to say that there are two strong motivators that result in many MTF transge= nder people entering the sex work industry.&nbs= p; First and most importantly, there is need resulting from extreme financial destabilization related to gender variance. Second, there is the = high demand for MTF sex workers that has no parallel for FTM people.
Two additional factors related to sex work will= be explored here. First, the phe= nomena of deriving a sense of personal value from sex work. Second, the difficulties of leavin= g the industry once a person enters it. Each of these two factors influence decision-making about remaining = in the high-risk sex work industry.
As a researcher, one of the counterintuitive me= ssages I heard in the interviews was the repeated theme that people derived a sens= e of personal value from going into the sex work industry. By popular standards, it would not= be expected that a person could build their self-esteem by becoming a prostitute. However, given the particular challenges faced by MTF transgender people, this theme is not surprising. For people = so consistently devalued in every facet of their life, being valued in any capacity becomes very important. Thus being desired and valued as a sex worker can be important to ma= ny transgender people. One of th= e MTF focus group members says it well:
That’s what drew it to me the first tim= e was the fact that I would be validated, I would be a part of my community…= ; For so long when I was growing up, = its like transgenders are bad, transgenders are bad, and that was always in my mind. And then when I became a transgender, and I was getting paid for who I was, that made me feel good that they were actually paying me for my attent= ion.
Again and again, this theme is repeated. Darlene, whose story was related earlier, talks about how she = hated having the sex in sex work, but “I was getting a lot of validation th= at I was valuable, I was getting validation that I was a woman, albeit a trans woman, but still validation.” Young Shashatika talks about how sex work and life on the streets as= a homeless teenager actually gave her a sense of affirmation that contrasted sharply with her home life; “It’s like you get more respect aro= und here.” But many also re= alize this respect is an illusion and are wary of its lure. In the words of one MTF focus group participant:
I don’t care if they treat me with resp= ect, that’s why I charge them so much. I have his money, that’s why I’m there. I don’t care if he goes back to his wife, more power= to you, have a nice day. But they don’t treat you with respect. We all h= ave tricks that talk to us, but they don’t hardly care about us.
As the MTF focus group participants talk about
positive and negative influences on their life, it is interesting how sex w=
ork
comes up on both sides of the equation.&nb=
sp;
One participant provides eloquent insight into this contradiction.
Early in my life, the negative thing was soci= ety, and the positive thing was me being able to go on the streets and make my m= oney and support myself. That was the positive thing for me at that moment. And = now that I’ve been given this opportunity to change, now the positive thi= ng is society and the type of work that I do, trying to reach out to other transgenders.
When other opportunities for self-affirmation a= rise, sex work is seen as a less attractive option.
The ability of sex workers to derive some measu= re of validation from their work is one positive facet of this high-risk activity. In contrast, many participants viewed sex work = not just as a tool, but as a trap. Sex work can include elements of affirmation, quick access to money, greater earning power than in traditional jobs, escape from discrimination in the traditional work arena, a higher risk of addiction, and the possibility of success without formal education. Once a person engages in survival sex, any or all of these factors c= an combine to make it difficult to amass the personal or financial resources to step out of this cycle. Altho= ugh Shashatika has little idea what else she might have done after running away= at the age of 12, she wishes she had not gone into sex work. “I regret doing the stroll b= ecause of the fact that I feel like, you know, I can’t stop it. You know what I’m saying. I’m so used to it, I feel like I just can’t s= top it now. You know. I can maybe stop for two or three days, but I can’t stop. It’s like an addiction.” Barbara Cassis from Ho= using Works sees this phenomena frequently, “I think that once you start th= at, you get so used to the money and the ‘this and that’. And when it’s not there anym= ore, you are lost.” She worr= ies about how it is a trap for community members,
There are some people that I know that have prostituted to put themselves through college and went on to get jobs and things…. But that’s a minority… of sex workers. The major= ity of sex workers are doing survival sex. And they are out there just trying to get enough money to pay their room rent, or put something in their stomach = or pay for hormones, or whatever. There’s no future in it…. let’s face it, we all get old, and you don’t see too many 70 ye= ar old prostitutes walking up and down the street. You don’t receive soc= ial security from prostitution, you don’t pay taxes, there’s just so many limitations to prostitution.
Sometimes community members get frustrated with= the women who stay and get trapped by this sex work. Local party promoter Glorya Wholes= um sees this as a big community problem.
The thing is that unfortunately what happens = is a lot of people are led to that they were rejected by employers, their esteem plummeted, and they took to sex work, and the sex work comes with many other things… and then they get sloppy and then they get sick. And then the= ir fate is sealed.
Gloria uses her position as a public figure in = the community to advocate for and expose women to other options, talking proudly about one performer from her show who now works as an outreach worker. She hopes that by talking about the= full range of community members, including the many people she knows with succes= sful jobs, she can combat the persistently negative media stereotyping: “Luckily they are able to fi= nd through that exposure that they’re not the freak that Jerry Springer = says they are.”
But the ability to get legitimate employment re= mains the dominant theme in this discussion.&nbs= p; It is best encapsulated in the words of one person who works with homeless trans youth, “If you want someone to stop sex working, then = you have to eliminate transphobia from the job market.”
For some people, the odds of escaping sex work = are very high indeed, but not impossible. One participant talks proudly of her success.
[After telling my family]... I was told to get out… I didn’t have no money or nothing. I had to go into sex wo= rk. It took me years to get myself together but I did. I had to sleep on benches sometimes. I had no roof over my head. No welfare. And I made it. After all these years I made it. I finally got a job as a home attendant.
But even this story is tinged with the reminder= of the high stakes of survival. = When I ask her about it she says she does see herself as quite a survivor, but then slows down and adds “A lot of my friends are gone, a lot are gone.= 221;
Two additional facets of the systematic social
exclusion of transgender people are housing and healthcare. As in every arena previously discu=
ssed,
if a person is read as gender variant, landlords or medical professionals o=
ften
feel quite free to express a strong anti-trans prejudice. For some, housing problems start e=
ven
before a landlord is involved, as low SES or family rejection forces them o=
ut
on the streets to survive. Th=
en, on
the streets, issues related to exposure and the threat of violence complica=
te
the ability to manage that situation.
One MTF focus group participant talked about her coping skills after=
her
family kicked her out at the age of 35; she just tried to hide. “I don’t know how to
survive, and yet I’m learning, and I’m not really being a menac=
e in
the street, I’m just trying to live and eat out the garbage cans, and=
not
letting people, like say sleeping on your building, not let you know that
I’m there.” The
traditional support offered by the shelter system is not always available to
transgender people. Outreach =
worker
Christopher Leonard talks of one trans woman he knows, “she chose to
sleep on the roofs of apartment buildings that she could get into rather th=
an
go back to the shelter, because she was violated, and she was deathly afrai=
d of
shelters.” Shashatika a=
grees,
at the time of our interview she does not know where she will sleep that ni=
ght,
but she would rather sleep in the train station than risk people’s
hostile attitudes towards her at the shelter. Sometimes shelters are not availab=
le at
all. Shira Hassan deplores th=
e lack
of “safe havens” during her time working with homeless trans
youth. While there were promi=
ses of
future remedies, when she was doing on the streets of
When asked about the biggest health issue for t= he transgender community, Barbara Cassis from Housing Works talks about proble= ms with healthcare first.
So when say a MTF goes to a doctor, he’s seeing that client as a male. So he’s going to treat that person as a male, he’s going to address that person as a male, which because that person is being turned out by society anyway, and they’re going to th= is person for help, and this person is now degrading them by treating them this way, they don’t go back. So what happens is there’s a lot of untreated HIV, untreated venereal disease, untreated cancer, untreated, there’s just so many untreated diseases out there because these people will not go back to these doctors because they feel like they’re degrading them.
This fear of the medical establishment is const= antly fed by new stories of community members that have suffered real abuse in medical situations. During the interviews,Shira Hassan brings up a recent example of this phenomenon.
Somebody had a seizure, I think it was about = 2 or 3 months ago, a trans woman had a seizure and the emergency workers got there, and she basically died because they wouldn’t treat her because they w= ere so transphobic and freaked out, and she basically died from an epileptic seizure. And then what happens is people hear that story and then they are = even less likely to go.
Importantly, she points out, these are not urban myths but verifiable events.
It’s always somebody that you knew. Like it’s always someone, because the community is only so big, so you know it’s someone’s ex, or someone’s current, or someone’= ;s best friend or old roommate or cellmate or whatever… that’s par= t of it also that the reality is kind of so horrific that it makes it even harde= r to shrink it down to a reasonable size because everything is so out of proport= ion.
These difficulties are compounded by how often = some transgender people need healthcare as a result of violence. Shira says, “I can’t t= ell you how many times jaws have been wired shut from getting beat up or this o= ne was raped, that one was attacked on the subway.” But the stories of harassment by t= he medical establishment are so prevalent that both Shira and Barbara talk abo= ut those that avoid healthcare in response.&n= bsp; As Barbara says,
Some of them don’t go. And the ones tha= t do go, they go get the care, but they won’t stay for the after care, they’ll get treated for whatever happened but then you won’t see them again. And then when you see them again, it’s because they have = an infection, or something wrong because they haven’t gone back to follo= w up from the care.
In the medical setting, transgender people who = can otherwise pass are exposed as gender variant. Several FTM focus group members ec= hoed this aversion to getting care, once talking about how it would be “unbearable” to go to the emergency room, another frankly stati= ng “I always tell anyone close to me, if anything happens don’t ta= ke me to the emergency room.”
Dr. Bartalos sees this phenomenon in his practi= ce as well. Once, a medical emergen= cy arose while he was out of town, and he urged the patient to go the emergency room immediately. Despite his insistence, the person would not risk getting care in a potentially hostile environment: “the patient refused to go to the emergency room, because she was sure she would have died there.”
This experience of aversion to hospital care is=
not
absolute. There are some time=
s when
participants chose to go into the hospital, and some have had good
experiences. In one case, a
participant’s decision to check themselves into the youth psychiatric
ward resulted in early needed social support, specifically as a result of
making contact with other LGBT youth. In another case, Barbara speaks about
getting surprisingly respectful treatment at a hospital in
Two doctors and one mental health professional = who work with the transgender community were interviewed for this study. These professionals echoed the transgender people’s concern with discrimination in the medical environment. For Katie Dougla= ss, the mental health provider, the biggest health issue for the transgender community is how underserved they are medically. “A lot of my work seems to be repairing the work that happened to people in previous medical environments.” Being in mental health, she often works with clients as they proceed through the med= ical gatekeeping process around obtaining authorization for hormones or gender confirmation surgery. S= he knows of too many providers who are inept or cavalier in this area. She tells the story of one provide= r who was recently meeting with a patient prior to a gender confirmation surgery. During the exam, the doctor started to stimulate the person’s prostrate while asking about= the patients’ sexual history. When the person started to get aroused, the doctor decided they must actually be gay and refused to do the surgery without an additional year of mental health care. Katie too= often sees mental health providers react similarly, sometimes systemically denying their patients the letters they need to obtain surgery or hormone intervent= ions. She is unequivocal about her frust= ration with this, calling it nothing less than “abuse.” As a solution, she advocates for transgender community members to set up their own system of policing providers.
Each of these three providers has had challenge= s in finding adequate referrals for their own patients. They have had to become profession= al advocates for the community to try and build this referral base. One doctor talks about how he send= s his less vulnerable patients to new doctors in an effort to “scout”= out the situation. Dr. Bartalos is constantly using his personal connections in the medical community to build= his referral base of people who are “not judgmental.” But even with his extra effo= rt and long time in the arena, he tells the story about how it is still difficult = to predict if a provider will be competent.
One of them had an erectile problem, and so I searched for a proctologist. = And surprisingly, he said he had experience with transgender patients. But then my patient came back and = said please don’t send anyone else there, he treated me like a horror and = had a bunch of students come in and he’s going on and on, “he was a male and he’s a female now…” and all the while she’s laying there with her butt up in the air and students around here. She said it was the most horrifying experience she’d ever had. And the doctor didn’t ask the patients permission.
Both gross discrimination and a dearth of compe=
tent
providers influence the decisions a transgender person makes when choosing =
to
seek healthcare. For some,
difficulties with these issues will make the option of getting
gender-confirming hormones or silicone from black market sources more
attractive. Most transgender =
people
spend extra effort finding providers who are reputed to already work with t=
he
trans population. For some, f=
ear of
encountering discrimination might lead them to avoid or delay healthcare.
Several of the stories presented here have demonstrated how people are can experience gross social exclusion related to their gender variance. The st= ories of three FTMs from the narratives add interesting depth to the understandin= g of this phenomenon. Each of these three people has experienced different types of social exclusion related to their gender variance. But a phenomenon of interest is how they each perceived a change in their social status as a result of their transition.&nb= sp; Chris, Carrington, and Derek all share the commonality of recently working in a situation where their co-workers did not question their male presentation. For Chris and Carrington, working as a white male had clear benefits. Chris talks about how her employer= , a major pharmaceutical company, reacted tolerably well to the news of her transition to male, and then even gave her a promotion.
If I was butch I wouldn’t have gotten t= hat promotion. I was put into a, really, into a place where I was seen by a lot= of people. A lot of different heads of departments, and people that were just really high up in the company… people that did have meetings with the CEO. So like I was getting in contact with like these higher up people, and then all of a sudden I was in meetings with all men. There were no other wo= men around me. So because of that, I have to assume that I don’t know if = they would have put me into that position [before I transitioned].
Carrington saw his horizons expand in a similar fashion. After transitioning,= he has a new job making a lot more money.&nbs= p; He understands that be= ing male is key to this success.
I realized as I worked there that I never wou= ld have gotten a job as a woman. Because of the culture. Every meeting that I’m in that degenerates to discussion of po= rn and tits and ass.
Unfortunately, as discussed previously with Chr= is, Carrington’s environment comes with its own stressors. He talks about the compromises he = has made to keep this job, sometimes going “overboard” in his effor= ts to fit into the oppressive culture.
I realized this at like one point I’m s= itting in my boss’s office, and he says to me, ‘God damn it, women shouldn’t be allowed in the workplace, they just shouldn’t be allowed here’… And I sat back and I go ‘But they’re nice to look at.’ And I’m like ‘Oh, I can’t believe I said that. My sisters are definitely going to kill me, they would definitely throw me under a bus at = this point.’
Since this interaction Carrington has started to experiment more with gently expanding the horizons of his co-workers. But he still routinely confronts situations that in his words, “make me feel like I’m betraying myself. Not even betraying my sisters, like I’m betraying me.”<= /p>
Both Carrington and Chris were able to identify
tangible benefits of moving up the social scale from white female to white
male. While Derek also transi=
tioned
to male, he is very aware of how race interacts with status, because his
transition to male moved him down the social scale. “The Black women is put, at =
least
in the professional sense, she’s put up above the Black man. So
we’re transitioning, but we’re moving down socially.” A friend warned him to expect this=
, but
he still talks about being unprepared for the magnitude of the change. “You sit in subways, and you =
see
people standing, ‘Excuse me sir, do you need a quarter? You look like=
you
need a quarter.’ That never happened to me before. And I’m tell=
ing
you, some of the shit women pull on you.&n=
bsp;
White women. Come in an
elevator, and they play ‘Do you want to fuck me?’ They tell you,
like you’ve got no choice.”&nb=
sp;
Derek’s socialization in
So say you go out with [your white coworkers]= , and you pick up a girl for some reason, oh, it’s because you have a big d= ick. It couldn’t be because of you, it couldn’t be maybe you clicked, especially if it’s a white girl. NO, it’s because you have a big dick. Because it couldn’= ;t be anything else. Because what d= o you have over them?
For him, this shift downward creates a schism w= ith the white FTMs he meets at transgender community events, because they have = no concept of how his experience diverges from theirs.
Derek does respect many elements of American culture. But his internal des= ire to overcome all challenges stands at odds with the strength of the race- and gender-based discrimination he faces. Ultimately, he is left with a feeling of failure. “It doesn’t matter what forces of resistance are in front of us… we should be somewhere where= we are not… I feel bad. I graduated [from an excellent university], and now I’m a messenger.= 221;
Derek, Chris, and Carrington’s experience= s show a less-understood facet of how gender variance can change a person’s perceived social status. For = many white FTMs, the ability to hide within the dominant culture may provide protection against some forms of social exclusion. But the management of the persiste= nt devaluing messages from this culture causes stress and a sense of isolation. For Derek, his mov= ement down the social spectrum triggered a level of racial discrimination he finds difficult to manage. FTMs fro= m the focus group talked about yet another complicated dimension to gender varian= ce and social status; the phenomena of being perceived as a youth due to their physical similarity to adolescent boys.&nb= sp; “In terms of social echelon, I often feel like the child in the room… It’s like we’ll go somewhere and there’ll be = the men, and there’ll be like the women, and then there’s me.”
Several MTF participants in the study talked ab= out others perceive that they moved down the social scale by displaying their gender variance. This percept= ion of them having status and then deliberately spurning it may play a role in how natal males respond to them with greater hostility. But the evidence presented in this section shows that social location can change in many ways when a person ta= kes a different gender role. Some= of these changes bring significant challenges. Also, upward movement on the social spectrum is not wholly protective against social exclusion, which may just = take more subtle forms.
Rampant discrimination results in social exclus= ion for transgender people at many different levels. For many people, hostile home or s= chool environments interrupt their education.&nb= sp; This confounds later experiences with employment discrimination, mak= ing lack of access to jobs a leading concern for community members. Housing discrimination is also a r= isk for the stability of many community members. As in previous examples, people wh= o are more visibly gender variant are likely to experience each of these issues in greater measure. If one can a= nd chooses to pass as gender normative, this can have a protective effect from= these phenomena. Social exclusion is likely to completely destabilize people who cannot pass as gender normative, pushing them to the lowest SES levels.&nbs= p; Issues related to demand and need have resulted in sex work being a widely-used tool for survival, especially among MTFs in these circumstances. Sex work both generates income and gives some participants a much-needed sense of validation. But sex work is an inherently high-risk industry= , that is ultimately difficult to leave. Social exclusion related to healthcare is a large problem for the transgender communities. Gross discrimination from medical providers against transgender people is a significant barrier to care. = This problem is so pervasive that some transgender people will avoid medical car= e even in life-threatening situations.
Issues related to social status interact with s= ocial exclusion. If a person is per= ceived to be gender normative and has moved up the social scale, they can reap two benefits related to social role. First their ability to hide protects them from a piece of the deleterious effects of social exclusion, and second, their upward social movement can provide rewards such as a higher paying job. But the interaction of social stat= us and social exclusion encompasses many factors, so the outcome is not always eas= y to predict. Even changes upwards= in social location came with some measure of new stressors, often related to isolation or self-esteem.
Social support joins stress and social exclusio= n to form a triumvirate of adverse social determinants that characterize the liv= es of transgender people in this study. As with the previous determinants, a lack of social support was a dominant theme among the narratives. The phenomenon arose in many different capacities over a large span = of time. More than one person be= gan their narrative by talking about losing the support of their family early in life, then hours later would conclude this narrative with rumination about their current concerns about finding a life partner. In the sections below, I will exam= ine this topic by grouping the stories into two categories; support from family= of origin and support from personal relationships.
Many of the stories that have been used to illu= strate other phenomena also include narratives related to family alienation or rejection. In this study, fam= ily alienation was a consistent theme in the life histories. This phenomenon was remarkably egalitarian, cutting across every criterion that could be used to categorize the respondents. Of all thirt= een life histories, only one did not include some level of family alienation or rejection related to their gender variance. For all but one of the rest,= this rejection or alienation was by no means short-lived, but usually persisted = over a number of years. Admittedly= , the stories of early life were often very complicated. Trouble with addictions, challenge= s with other siblings, or poverty often complicated a parent’s relationship = with the participant. But each of = these people was able to cite their gender variance as causal in at least a piece= of this alienation. Importantly,= for all but two of these people, this phenomenon occurred very early in life, giving it the additional power of being a formative experience.
One manifestation of this phenomenon was how, f= or some, the fear of family rejection led the youth to feel alienated. Nirvana Rose is one such example. She talks about how = her family was taught to respect all people and how she was close with her many other brothers and sisters during her youth. She also seems content at school d= uring this time, mentioning some fighting, but in all saying she had few problems. Yet in an apparent contradiction, she ran away from home at the age of twelve. In her words, this was because = 220;I wasn’t ready to tell my moms and my dad [about my gender variance].” She was con= vinced they would not accept her, “Because there’s no one in my family that’s gay. We have no gays or lesbians or nothing in my family.” This learned f= ear of rejection is likely based in the persistent school, family, or societal messages that gender variance is unacceptable. Despite having personal support, N= irvana Rose internalized this message clearly.&nb= sp; And the message was so strong that it was easier to leave her house = and risk life on the streets than tell her parents how she was different. This is a good example of how even= when a child does not mention explicit messages of family rejection, social influences can conspire to create a barrier to experiencing family support.
For many other participants, rejection based on gender variance was not an abstract fear, but a direct message from parents= to child. The mildest form of th= is message was the creation of a passively hostile environment. This happened with Anna as she end= ured years of her mother’s passive attempts to restrict or monitor her crossdressing. Another exampl= e is Jenna’s aunt’s attempts to humiliate her by sending her outside= in high femme play clothes. The = next step in the spectrum of rejection was persistent altercations or verbal abuse. Both Craig and Shashat= ika lived in a similar environment. For Craig, persistent altercations with his mother played a role in his hospitalization for stress in his midteens. For Shashatika, this verbal abuse = was the reason she cites for running away at the age of twelve. For a larger subset of participant= s, their gender variance clearly provoked physical beatings from their parents. This emerges in the stories told by Derek, Marnie, Francine, and Saffron, among others.
Of the life history participants, only Derek ta= lked about being thrown out of his house, and then only temporarily. But focus group participants and k= ey informants reinforced the frequency of this phenomenon. Shira Hassan discussed what often = happens when parents confront their child’s gender variance. “There was frequently a peri= od of rejection that either culminated in the young person picking up and leaving= , or the parent rejecting them formally.”= But she cautions that homelessness among transgender youth is a complicated phenomenon; other issues related to low SES or parental addicti= ons can often mix with gender variance to create this outcome. For some, an unrelated placement i= nto foster care creates an untenable environment, “the foster care system regulates their gender presentation and so they run away.”
Systemic alienation or rejection by a persons&#= 8217; family of origin creates a void of social support for many transgender people. The phenomenon is widespread. This issue emerge= d as such a community norm that I noticed an interesting pattern in the transcripts. While interviewi= ng people on this issue I found I was repeatedly probing participants to descr= ibe the all-to-rare exceptions, those people who did enjoy social support from their family.
This lack of social support during early life y= ears is a destabilizing factor for many transgender people. But as with every social determina= nt, not everyone experiences this problem.&nbs= p; Also, in the case of social support from ones family of origin, some people are able to re-establish it later in lives. Examples of this will be presented next.
Isabella is a 25 year old MTF woman of Puerto R= ican descent. Her story stands out= as one of uncomplicated family acceptance of gender variance. Isabella’s relationship with= her mother has provided her with needed social support through much of her life. While there were interruptions in this support, they were unrelated to her gender variance.<= span style=3D'mso-spacerun:yes'> This is perhaps more notable becau= se this acceptance and support comes in an environment that otherwise includes little support.
Isabella’s mother and father divorced whe=
n she
was young. Her mother liked to
“go out and party.”
Isabella’s early life was governed by who her mother was datin=
g,
which determined where they lived and how much money they had. At age eight, a breakup precipitat=
ed a
move to
Despite facing extreme challenges on many level= s, Isabella talks about her mother’s unwavering support of her. When she came out as gay, her moth= er said “why didn’t you tell me earlier?” Later, as she transitioned from ma= le to female, her mother “didn’t care.” Today, although Isabella distances herself from her mother’s tumultuous relationships, they still talk frequently. Isabella’s = story of support from her mother stands out among participants, and it also demonstrates how critical the need for positive social determinants can be = in the difficult circumstances faced by some transgender people.
The discussions of family support in the life histories and both focus groups included consideration of later life support from families of origin. Some people chose to attempt to reconcile early breaches with their family later= in life. This was very successfu= l for Nirvana Rose. She waited unti= l she had enough stability to re-approach her family, then after an initially poor reaction she took control of the situation:
So if you raise your hand to me, I’m go= ing to forget who you are, and I’m going to act accordingly to a situation. = And however it comes out, I’m going to come out on top, because you’= ;re in my house. And my lieutenant friend at the [local] precinct, he’s my trick. So if you don’t like it, you can get the fuck out. Or you can raise your hands and ac= t like a fool, and we can take it to that level. Well, when my mother and my father were like really surprised then, and my mother started crying, and I don’t know where it came from, but my father started crying, so I wen= t to my mother, and I held my mother, and my father came and he held me.
This reconciliation led to reconnection with her siblings as well, who provide key support for Nirvana Rose to this day. Several of her brothers were actua= lly with us in the apartment during her interview for this project.
Many focus group participants viewed the intera=
ction
with their family as a continuum of acceptance. Sometimes participants would choos=
e to
come out as gender variant to only a few family members they deemed safe,
either hiding as gender normative to others or avoiding them altogether.
Personal relationships emerged in several themes during the interviews. For so= me people, stress around their gender variance isolated them from personal relationships early, leaving them friendless and socially isolated. Carrington’s story of extreme isolation in youth is a good example of this. For many, even if they did accumul= ate early life friends, their transition to gender variant was marked by the lo= ss of those friendships. Sometim= es the friends left, but sometimes the transgender person left first. Darlene’s story is a good ex= ample of how a strong friendship network can be completely shorn off by the act of transitioning. Derek’s = story of moving to another country stands as an illustration of how some people t= ake the initiative and distance themselves from all friends before facing transition.
In many of the life stories, participants empha= sized a key moment in their life; the moment they realized other gender variant people existed. For Darlene a= nd Anna, this awareness came through media contact, and sent them into a frenz= y of library research on the subject. For Nirvana Rose, Isabella, Francine and others, this contact came through stumbling across another transgender person in their neighborhood.<= span style=3D'mso-spacerun:yes'> For many people, this was a waters= hed experience, opening their eyes to a new paradigm of self-acceptance. Carrington’s story provides = one example of the repeated theme, “I remember seeing my first FTM. I remember, I’ll never forget it. I was like, that’s not a woman,= I don’t know if it’s a man, I think it’s a man, wait…= And I was totally fascinated.” Sometimes people describe two levels of this experience. At the first level they read about= or meet a few isolated transgender people. Then, they describe a similar feeling on connecting with the larger transgender community. This contact with people can somet= imes spur emotional turmoil, as in the example of Chris’s “crying and flipping out” after meeting other FTMs. Sometimes it creates relief. Marnie’s narrative recounts = her long struggles with health problems but she is quick to note that her recent late-in-life contact with other crossdressers has made her feel “healthier” and more “emotionally stable”.
Several people talked about mentors easing their
transition into the gender variant community. I have already discussed how Nirva=
na
Rose’s precipitous arrival in
I asked The Thing, I said… ‘Don&#= 8217;t you have a brother who looks just like you, don’t you have a twin. He dances real nice and he’s nice looking.’ She laughed in my face= and said ‘Child, please. That’s me, I put these clothes on.’ I said ‘What?’ She = says, “it’s me.” = My mind went out the window, I didn’t understand it, because she wore men’s clothes and then she put on women’s clothes. I was really dumb. I said ‘Yeah, I like it’. So I talked to her, and I said ‘Do you think you could make me just like that?’ She said ̵= 6;Of course I can, I’ll just take you home with me and I’ll dress you up.’
And The Thing did just that, showing Francine h= ow “ohhhh… it takes that little bit of paint to make a boy what he really ain’t.” Eventually The Thing would become a friend and as Francine moved in = with her, she started to teach the young boy in earnest.
So my friend broke me all the way down to being this feminine person that I am no= w. Oh, you can’t do that. Look at how you sit. What kind of woman are yo= u, sitting with your damn ass, what’s the matter with you, close them da= mn legs. She just drilled me like a drill sergeant and made me into the girl t= hat I am today. Thank you very much.
Some of the MTF participants expressed concerns= that established systems of mentorship were falling by the wayside. Barbara Cassis talks about a phenomenon others referred to as t= he “old school way”.
When I came out as a transsexual person, R= 30;we weren’t like transsexual people or transgender people, we were queens. The old queens took t= he young queens, and they sort of trained them. They taught us to do makeup, t= hey taught us how to walk, talk. = Which is one of the reasons that I worked. Because the girls that brought me u= p were girls that had jobs. I mean they were lawyers, so they had really good jobs. But they taught you… [to] become real enough to do what you got to do. Because no one is going to take care of you. And that’s how I was bro= ught up.
One MTF focus group member also refers to how t= his system has changed. She talks= about opening her apartment to other transgender people in need, but how the comm= on practice of deriding others (“throwing shade” in slang) made th= is a bitter experience.
They used to shading and that style and even = though I opened my apartment to them well there was that suspicion there. And with that suspicion, it’= s hard to get beyond, it was hard to get to a level of creating a strong bond. A lot of girls have been so disillusioned by their community. So I have tried so many times, I just have sorta given up.
While Barbara expresses concerns that the syste= m is changing because some women “tend to forget where they came from̶= 1;, she has been able to mentor others through involvement in the House Ball community, particularly through the fictive kin families the members create. Barbara is involved i= n more than one House, and takes her role as grandmother, mother, or aunt to the younger members of the House very seriously.
So I have like all these… I call them b= abies, because they’re like young, they’re like 13, 14 years old, trans people, and they’re running around thinking life should be this glamo= rous music video. You can have cosmetic surgery until you’re blue in the f= ace, but that’s not what’s important, what’s important is that= you develop your education, go to school. Its not about being trans, its about being a person. And you need to become a person, a respectable educated per= son that’s going to go out there and get a job and do what you have to do= .
The hostility and discrimination a gender varia= nt person can face makes it particularly important that learned wisdom be pass= ed down from one generation to the next. The narratives from this research have demonstrated several examples= of how this can have a protective effect.&nbs= p; They have also shown how communities use ingenuity to create mentors= hip in unlikely places. But despi= te the need, access to mentors is often unpredictable. In addition, some previously stron= g MTF mentorship systems may be waning, as demonstrated by people’s concerns that there is less MTF mentoring now than in years past.
When the topic of post-transition friendships e=
merged
in the narratives, it was more often than not in relation to the challenges
involved in forming friendships.
Several people just counted their friends, which was simple since the
number was usually between zero and three.=
Some would talk about how it was hard for them to learn how to make
friends or keep them. Like Ni=
rvana
Rose, Francine, and Jenna, some people talked about having a full circle of
friends pass away. Sometimes =
the
narratives seemed incongruous, while a person would talk about having frien=
ds
when asked, they were rarely referred to when talking about life events.
In general, thinking back on all the interviews= , I realized I was left with an impression that many people had access to fewer friends = in their life than they might have wanted.&nb= sp; Part of this impression was drawn from participant’s direct statements. The sentiments of= one focus group participant were not unique, “I don’t know for a fa= ct that I have friends that would be there if I said that I need them, I can’t really say that.” Another part of this impression arose from the less tangible phenome= non of how people reacted when we were talking about friends. Several participants talked about f= riends and friendships much like one might talk about illicit drug use, like it wa= s a sensitive subject to them. It= was in part this nonverbal communication which I was unconsciously using to supplement the conclusions from the transcripts I would analyze later.
A few people did speak of having lots of friends currently. Yet, it was curiou= s how this fact reconciled with the relative lack of friends in their narratives. In looking at tho= se narratives more closely I realized that this was likely a result of the phenomena of having to rebuild one’s friend networks after transition. Craig’= ;s story is a good example of this phenomenon. He has a large number of friends n= ow, mostly FTM transexuals or “transmen” he has met through his community activism work. But despite having a large group of friends now, these people only go back three years in his narrative. Like = so many others, his transition forced him to create a new base of friends. Since his transition was roughly t= hree years ago, his relationships with these friends were at most only three yea= rs old.
The act of shearing off from one friendship bas= e and building another around the time of transition serves to suppress social support for many transgender people. Other life factors are also likely = to complicate a transgender person’s ability to make friends. Addictions, a history of social isolation, fear of rejection, or mental health issues related to depression= are all common in this population. Any of these issues could further suppress the ability of transgender people to acquire the social support they seek in personal friendships.
Shashatika has two friends with whom she spends= much of her time. She and her two friends stay close together and help watch out for each others’ safety. She talks about how o= ne friend already saved her life once when a john got out of hand. “He got mad, and he tried to= stab me. But my best friend was there. Remember I told you I have two friends? O= ne was there. And he tried to stab me, but my best friend was there. She wouldn’t let nothing happen to me.”
I= n her situation as a street sex worker, staying close to these friends is a key survival tool for Shashatika.
It’s best to be with friends. Because y=
ou can
just disappear and vanish out there. I’m scared one day somebody will
just really, really hurt me, and then just leave me for dead or something. =
Or
take me out to
Barbara Cassis talks almost wistfully about thi= s same phenomenon.
I think the sex workers that are like street = sex workers or survival sex workers, they tend to be nicer to each other, they = tend to really love each other, like create families within their environments… , like I have three friends, three best friends. End of story.
The high potential for violence in sex work mak= es it clear why people on the streets start to form and rely on these close friendships. It is nonetheless ironic that one of the most vulnerable categories of transgender people have something that others can envy, strong social support.
It is challenging to present the themes related= to romantic relationship because, as with discussion of friendship, the interv= iews left me with impressions on the subject that are not as easily supported through analysis of the text. In short, my perception of relationship challenges was partially informed by what was not said. In particular, the narratives included fewer references to relationships than = one might expect among a group of thirteen life histories, even given the fact = that I did not specifically probe on this issue. . For example, only four of the thir= teen people mentioned any current romantic attachment. This dearth of relationships echoed backwards in the narratives as well.
A series of obstacles make it more difficult fo= r a transgender person to identify possible romantic partners. First, partners are not immune to = the same discriminatory forces affecting every other facet of the life of transgender people. Many peop= le simply reject outright any possibility of partnering with a transgender per= son. Second, a partner has to be willin= g to accommodate the fact that the physical body of a transgender person may be incongruent with their gender identity.&nb= sp; Intimacy and sex may both be affected by this incongruence. Third, a partner of a visibly gend= er variant person can be exposed to physical risk or social disdain simply by = association.
For some in the study, these difficulties were insurmountable. Two of the MTF participants in their fifties spoke of lives largely devoid of romantic attachments, and little hope for this to change. Early in the fieldwork I was struc= k by a conversation with a white MTF crossdresser in his early twenties. He frankly said he did not expect = to ever find a partner who would want him.&nb= sp; This low self-esteem was distressing in itself, but the breadth of t= his hopelessness had even more impact. It seemed an overbroad generalization to make from the perspective of one’s early twenties. Y= et weeks later, I found myself listening to the mature life histories of people who externally shared some similar characteristics. And their stories taught me the co= ncerns of the youth were not necessarily unrealistic.
For most of the MTF participants, a history wit= h sex work adds to the barriers in developing personal relationships. Darlene talks about how one’s sense of intimacy changes after sex work.
Well I had always seen sex as something that = was really a moment of ultimate intimacy for me with somebody. And I really gave that up, I stopped thinking about that once I started prostituting… R= ight now in my life I feel like I have no idea what good sex would feel like. Or= why I should have sex. Because sex to me, I can have for so many different reas= ons, I can have it to make money, I can have sex to have surgery, I can have sex= to stay in my apartment, have a place to live… I can’t have sex to have a family, because that feels denied to me. And I’m not so sure I= can have relationship sex, I don’t know. I begin to question whether that’s really available to me.
For some of the MTF participants, their attempt= s to establish partnerships with people who paid for sex created a myriad of complications. Nirvana Rose h= ad the best experience in this regard when her early status as a beauty rewarded h= er with men who would set her up as their mistress. Shashatika’s experience show= s the other side of this equation. = Her desperate longing for intimacy led her to develop a relationship with one of the johns. Now, despite her o= wn homelessness, she prefers to support him so he stays off the streets. “I stopped him because IR= 17;m scared. He did three years in jail, and he used to sell drugs too, and I’m scared that he might get locked up. And I would be really lonely.” The precarious nature of this intimacy is soon revealed.&= nbsp; After getting back from one of her too-frequent-to-count trips to ja= il, Shashatika’s best friend confesses to having sex with her boyfriend.<= span style=3D'mso-spacerun:yes'> Now, worried that she might lose h= im to another, she tries to balance watching him with the many other concerns of a sex worker.
I’ll be paying attention to him, heR= 17;ll be standing there near me, scaring the tricks away, and I’ll be tryin= g to pay attention to the cop, what’s going on around me, who’s who,= you know, the DTs and stuff like that, and he’ll go down the block where = all the girls are, and that puts me through it, because I think he’s doing something. So I’m not trying to make no money because of the fact that I’m trying to see what he’s doing.
With income now down to an average of $50 a wee= k, Shashatika appears to be in a vicious circle that can only end in her much-feared loneliness.
Across the sample of participants, it was peopl= e on the FTM vector who were most likely to report currently dating. In Barbara Cassis opinion, this is related to the greater status of FTMs among queers. She talks about her experience wit= h a previous FTM lover, “His community was more respected in a sense, not= so much in the hetero community, but in the gay community they were more respected.” Katie Dougl= as goes back to another facet of the FTM experience, talking about how it ease= s so many stressors related to gender variance.= “[FTMs] just seem to fare better in the end. There’s a l= ot of shame in both, but I think a lot of it comes down to passing.”
The myriad of issues involved in relationships = likely make them more challenging for all transgender people. As Carrington muses on the subject= of a personal relationship he expresses how complicated it can be. He talks about three factors that = all interact in this arena. First= , his long history of isolation is a barrier to him having any type of personal relationship. Second, his alienation from his body makes the idea of sexually expressing himself challenging. Third, his curre= nt identification as simultaneously gay male, straight male, and lesbian challenges traditional ideas of how one even starts to seek a mate.
The previous findings on stress and social excl= usion demonstrate the many challenges transgender people can face in even the most routine acts. Research has pr= oven that social support can have a buffering effect in exactly these types of h= igh stress situations, helping people avoid adverse health outcomes50, 68<= !--[if supportFields]>. This only highlights the deleterio= us impact of this third major social determinant of transgender health. Despite the higher than average ne= ed for this important health buffer, social support for this population is most of= ten defined by its absence. The narratives from this project demonstrate a host of problems transgender peo= ple face in building and maintaining social support in a variety of different l= ife areas. This leaves them most = often with less support than they need to face the challenges that emerge as a re= sult of stress or social exclusion.
Transgender people are often either alienated f=
rom or
rejected by their family of origin for at least a period of their lives.
= ; &n= bsp; = ; &n= bsp; = ; &n= bsp; -