Toward a Trans of Color Critique of Medicine
Amid the accelerating and contested public visibility that trans life has accrued in the United States in recent years, certain figures have become oversaturated. Made to carry starkly different narratives for mass consumption, while simultaneously offering very narrow windows to contest the terms of their representation, images of black trans women and trans women of color on the one hand and transgender children on the other circulate seemingly without end. These very different figures are, somehow, meant to signify and embody the so-called newness and now-ness of trans life. As Laverne Cox and Janet Mock speak out from their perspective as black trans women or CeCe McDonald writes letters from prison, Jazz Jennings stars in a reality television show about entering high school as a trans girl and Gavin Grimm pursues a legal case against the school board of Gloucester County, Virginia, over its transphobic bathroom policy. While there may be a growing awareness of the rising and unmatched violence black trans women and trans women of color face, a seemingly never-ending stream of documentaries, independent films, journalistic profiles, novels, and digital platforms simultaneously circulates images and narratives about a “new” generation of children growing up as transgender during their childhoods. The public figurations of black trans women, trans women of color, and trans children have become pervasive but markedly distinct, with profoundly different significance and impact.
The contrast is instructive about the fault lines of the seismic shifts underway in U.S. trans visibility but also incredibly misleading. The publicness of black trans women and trans women of color is registered, paradoxically, through ongoing forms of social death that reduce their personhood to the barest zero degree, hiding it from view and converting their images and names more often into objects of necropolitical value. As scholars in black trans studies, including Treva Ellison, Kai M. Green, Matt Richardson, C. Riley Snorton, Elías Cosenza Krell, Syrus Marcus Ware, and Erin Durban-Albrecht, have argued, this visibility is specifically predicated on antiblack modes of subjection whereby the surveillance and exposure of being visible elicits the extreme and paradoxical charge of nonexistence. Trans children, meanwhile, are presented as powerful emblems of futurity. Sanitized, innocent, and always highly medicalized, they are domesticated figures, either reassuring that the so-called trans tipping point heralds a new generation of liberal progress and acceptance or, to the transphobic agitators involved in political campaigns focusing on bathrooms and schools, acting as proof that trans life deserves to be repressed in its incipient forms for the threat to the social order that its future would represent. Children, by design deprived of civil rights and infantilized, are easy targets for political violence—just as easily, it turns out, as concerned adults can claim them for protection.
The problem with this figural contrast, of course, is that it arbitrarily separates black trans and trans of color life from trans childhood. The dominant figure of the trans child trafficked in the public sphere today underwrites, as the child has long done in the United States, a potent “racial innocence” that empties trans childhood of its content, including race, rendering it conceptually white while simultaneously libeling the existence of black trans and trans of color childhood. There is tremendous damage in the figurative separation of racialized trans negativity and white trans childhood futurity. And the part played by the figure of the child in this process has received very little, if any, attention. Despite the overwhelming material vulnerability of actual trans children, most of whom live at a great distance from the imagined world represented in dominant media narratives, the figure of the trans child as emblem of a new and futuristic generation is part of a larger strategy that continues to disavow and naturalize the reduction of black trans women and trans women of color’s personhood to nothingness, what Eva Hayward calls “an attack on ontology, on beingness, because beingness cannot be secured.”
Yet an even more fundamental assumption about trans children that floats this contrast has yet to be challenged: that they are, in fact, new and future-bound. The narrative that we are in the midst of the first generation of trans children is so omnipresent as to be ambient. It is repeated ad nauseam in the media, online, by doctors, and by parents. Trans children, these various gatekeepers say in unison, have no history at all. Trans children are unprecedented and must be treated as such, with caution or awe. What happens if this consensus turns out to be baseless? The bleached and medicalized image of the trans child circulating as unprecedented in the twenty-first century is actually prefaced by an entire century of trans children, including black trans children and trans children of color. And trans children played a decisive role in the medicalization of sex and gender, rather than being its newest objects. These are two of the key ruptures that Histories of the Transgender Child uncovers. If the contrasting effect of contemporary figurations of black trans and trans of color life, placed next to trans childhood, is so damaging in its staging of an antinomy between negativity and futurity, this book argues that the twentieth century provides a surprising archive of trans childhood that undoes them from the inside.
Histories of the Transgender Child rewrites the historical and political basis for the supposed newness of today’s generation of trans kids by uncovering more than a century of what came before them. From the 1910s, children with “ambiguous” sex were medicalized and experimented upon by doctors who sought in their unfinished, developing bodies a material foothold for altering and, eventually, changing human sex as it grew. In the 1930s, some of the first trans people to seek out American doctors connected their requests for medical support to reports that “sex changes” on children were being regularly performed at certain hospitals. In the 1940s and 1950s, five decades of experimental alteration of children’s sex directly led to the invention of the category gender, setting the stage for the emergence of a new field of transsexual medicine and the postwar model of binary transition. And in the 1960s and 1970s, as that field of medicine became institutionalized, many children took hormones, changed their names, attended school recognized in their gender identities, and even underwent gender confirmation surgeries. Trans children not only were present but also were an integral part of the transgender twentieth century and the broader twentieth-century history of sex, gender, and race in medicine.
If there are so many trans children hiding in plain sight in the past, how have we failed to see them? I argue that trans children were central to the medicalization of sex and gender during the twentieth century in a very specific way, made valuable through a racialized discourse of plasticity. Examining the history of trans children through the shifting terrain of that plasticity helps to explain, precisely, why trans children have so easily gone unnoticed or been ignored. By limiting trans children’s value to an abstract biological force through which medicine aimed to alter sex and gender as phenotypes, those children became living laboratories, proxies for working out broader questions about human sex and gender that had little investment in their personhood. Children were by the design of medical discourse meant to recede into the background of the alteration of sex and gender by being reduced to reservoirs of plasticity, the raw material of phenotype. Children became the incarnation and etiology of sex’s plasticity as an abstract form of whiteness, the capacity to take on new form and be transformed by medical scientific intervention early on in life. And the twentieth-century discourse of child development naturalized this function in the medical clinic.
In the early part of the century this resulted in reading trans (and intersex, as we shall see) children’s “abnormal” or “mixed” sexual development through eugenic and evolutionist paradigms that sorted sexual morphology through racial typology. By the 1960s, it allowed the inaugural gatekeepers of transsexual medicine to imagine an etiology of transsexuality in the indeterminacy of childhood gender acquisition, opening the door to the genocidal fantasy of eradicating trans life altogether in its developing forms, even as children also successfully transitioned and secured access to gender confirmation surgery. Far from being a progressive vector of malleability or change, the racial plasticity of sex and gender was a decidedly disenfranchising object of governance from the perspective of trans children. At its institutional best, it granted access to a rigid medical model premised on binary normalization. At its institutional worst, it allowed gatekeeping clinicians to reject black and trans of color children as not plastic enough for the category of transsexuality, dismissing their self-knowledge of gender as delusion or homosexuality. The value of plasticity came to stand in for the value of trans children’s personhood, enabling their continual instrumentalization in the service of medical science over and above any recognition of their embodied self-knowledge or desire. This book’s uncovering of a century of untold stories is therefore not a recuperative or reparative project. I instead underline a massively overlooked way that children’s bodies, because of their unfinishedness and plastic potential to be changed as they grow, have been key sites of the modernizing violence of medicine. Trans children have been forced to pay one of the heaviest prices for the sex and gender binary, silenced as the raw material of its medical foundation.
At the same time, however, framing trans children through a discourse of plasticity was a risky wager for medical science, as embodied plasticity itself, despite being ostensibly domesticated through its racialization as whiteness, retained a demonstrable autonomy that threatens normalizing models of the sex and gender binary, along with medical technique, to this day. In key moments throughout the twentieth century, trans children’s plasticity enacted forms of partial material refusal that threatened to cause a crisis for doctors in the categories sex and gender. Plasticity, an invisible force in the trans child’s body, seemed to always retain a certain material agency for itself, partly indifferent or oblivious to scientific rationality. Whether the strange forms of plastic growth that resulted from these moments, interrupting the orderly flow of medical reason, actually provided trans children any leverage is a complex problem that this book unfolds slowly, over a century’s worth of clinical history. While I argue against the current romance with plasticity in the humanities and STEM fields, showing how the concept and its material referent encourage no particular form of political agency, the book’s archive testifies to how difficult it is to imagine that trans children, already lacking patient rights, could have resisted its capture by medicine.
Still, there are important and startling moments in the archive when some trans children’s plasticity afforded them brief movements outward and away from the capture of modern medicine. While there is no clear-cut scene that rises to the pitch of resistance or even subversion, and there is otherwise a great deal of violence, both epistemic and material, there remains something vital to consider about the limits of plasticity in building different futures around childhood transition and pediatric medicine. To that end, this book does investigate the enigma of trans children’s plasticity, not so much to affirm its value as to look through it for ways to undermine the rationality of medicine, challenge the racialization of sex and gender as phenotypes, and imagine different futures for trans children that do not instrumentalize their living bodies and dismiss their self-knowledge.
The Generational Trouble of Trans Children
Histories of the Transgender Child wades into a subject about which we have almost nothing in the way of reference points. There are no existing accounts of trans children’s history in the United States, only speculation and retrospective theorizing from the point of view of the present. The myth that there were no trans children until recently is so widespread and unchallenged that it is present even in the small but rich and growing scholarship on the trans child, most of which focuses on the twenty-first-century pediatric endocrine clinic or media representation. In “Child,” a keyword entry in the inaugural issue of Transgender Studies Quarterly, Tey Meadow observes that, “A relatively new social form, we see no references to transgender children prior to the mid-1990s.” Although in a strict sense this is correct, because the term “transgender” did not come into widespread use until the 1990s and would have been unavailable to attach itself to children before then, the second dimension of Meadow’s claim—that adults are confronted with a “new social form” in trans children—is an important clue as to why their history has been forgotten or erased. Much of the celebration and controversy over trans children today departs from the fact that they express self-knowledge about something as profound as their gender, flouting social, medical, and parental gender assignment. This initial focus frequently travels to fixate on medical therapies to pause puberty and pursue childhood transition as either a biologically “reversible” or “irreversible” process. The ostensible concern is that the effects of these “new” hormonal technologies are in some important way unknown or that children are too young to undergo hormonal therapy or even make the decision to alter their bodies—as if sex and gender were otherwise natural, unmodified forms in cisgender bodies. This narrative also grants immense authority to medicine in making the trans child an ontological possibility, as if trans children were unthinkable, nonexistent even, prior to puberty suppression therapy. The novelty of today’s medical technique is deeply questioned by this book, which traces an entire century of medicalizing trans children and their biological development, while also stressing the many ways in which trans children had no need for medicine to live trans lives. Even if medical technologies do not play a causal role in the production of new social forms, however, the social meaning invested in them does seem to be very important for many adults today.
In “Trans*—Gender Transitivity and New Configurations of Body, History, Memory and Kinship,” Jack Halberstam seizes on a speculation in Meadow’s work to dramatize this point. Halberstam’s interest is in a perceived “disjunction in transgender histories” between today’s trans children, who are growing up in an environment where the trans child is a distinct and partially recognized social and medical category, and older trans and gender-variant adults who came of age in a different political, cultural, and medical milieu during the second half of the twentieth century. The issue boils down to a generational split. If today’s trans children can have a recognizable trans childhood, with options to transition, Meadow proposes that “this new generation may have wider latitude to disidentify with transgender history and those who came before them.” That “is quite a mind-blowing statement,” Halberstam interjects, developing Meadow’s speculation further:
Unlike other social justice formations where young people might acknowledge and even thank the adults who came before them and made the world a more hospitable place, Meadow proposes that the support that many trans children now enjoy from their families and communities affords them a radically different experience of childhood than that of trans people even a decade older. While transgender individuals of my generation, now in their forties and fifties, who often could not transition until they were adults, lacked a complex language for their gender variance and had to live large parts of their lives in relations to gender identities with which they were at odds, today’s gender nonconforming children, Meadow reminds us, with parental support, may grow up trans rather than struggling through long periods of enforced gender normativity. While that is a cause for some amount of celebration, it also, Meadow hints, puts them at odds with the history that produced the conditions for their smooth(er) passage from trans childhood to adulthood.
While I agree that a potentially difficult generation gap is growing in the twenty-first century between trans children and adults, and I do not wish to interrogate Halberstam’s generational experience, this book puts significant pressure on the historical premises upon which this reflection rests. Setting aside for a moment the problem of which trans children Halberstam is calling upon, given how highly racialized and class-stratified access to competent medical care is in the United States, I would point out that the apparent disidentification of today’s trans children with the trans past may in large part be premised on a fundamental misrecognition of that past. We do not know trans children’s history because we have assumed they do not, generationally, belong in the trans past. The fact that trans children have been forced in the twenty-first century to fare without a history may itself be a major cause of the generational tension that Halberstam identifies. How different would this passage look in light of several key points that this book works to unfold? Today’s trans children are not the first generation to identify and live openly as trans during childhood. They are not even close to the first generation to transition or to be medicalized during childhood and grow up as publicly trans. In fact, trans children outright precede the category “transsexuality” and the contemporary medical model. Trans children have a documentable past stretching the entirety of the twentieth century, long before today’s trans and gender-variant adults were even born.
With a distinctly different take on Meadow and Halberstam’s reflections, then, Histories of the Transgender Child departs by considering the extent to which the twenty-first-century framing of trans children as new and lacking historicity is actually complicit with their ongoing political infantilization, particularly by medicine. Investing in the idea that today’s trans children either are new or represent a major break with the past may actually be a significant obstacle to forming cross-generational relationships between trans adults and children that do not do the latter harm or continue to render their actions and embodied self-knowledge unintelligible. And, particularly of concern in this book, the myth that trans children have no history has significantly reinforced the rationality of medicine by allowing the twentieth and twenty-first centuries to be defined by the limiting parameters of transsexuality and puberty suppression therapy, discourses that rely on children being the nearly invisible, plastic bedrock of medical technique or an etiology for gender in general.
This presumes, of course, that there is a meaningful “transgender child” in the past, rather than another projection of contemporary categories backward. I deploy an array of terms in a careful way to explore how we have arrived at a moment where it is possible to claim trans children are somehow new. But before focusing on the historiographical problems of the period that this book covers, it is worth laying out exactly what I mean conceptually both by “transgender” and “child” in this book. “Trans” is invoked throughout in an expansive sense, as it has been theorized in transgender studies, sometimes as a prefix and sometimes with an asterisk, to mark a political distinction from medical or pathological meanings that have accrued to the term “transgender” in recent years, many of which have been borrowed from the earlier term “transsexual.” While it is technically anachronistic to name a child in 1930 “trans,” I do so precisely to make an intervention, as Susan Stryker puts it so well: to “[tell] a story about the political history of gender variance that is not limited to one experience.”
The terms “transvestism” and “transvestite” also appear in this book, as they had both medical and lay connotations in the first half of the twentieth century, as well as relatively uneven adoption in the United States compared to Europe. I use them in precise historical contexts, largely before “transsexuality” and “transsexual” came into use. Similarly, I use the terms “hermaphrodite,” “intersex,” “sexual inversion,” and “homosexuality” when their appearance in archival documents matters. In many instances these terms bleed over into trans domains, making their overlap important. Finally, I name “transsexuality” to explicitly mark a medical discourse and biopolitical apparatus, a colonial form of knowledge with racializing and disenfranchising effects. Transsexuality arrogantly pretends to know and seize trans life as an object, making it a difficult concept to write with and against, as Sandy Stone first theorized through the concept of the “posttranssexual.” More than some of the other terms used in this book, “transsexuality” is an artifact of a dominant knowledge system to be constantly questioned and undermined from the inside. Transgender studies has excelled at the critical use of terminology to make sense of and challenge scientific and medical authority, but perhaps my attention to now obsolete categories or now politically incorrect terms may, at times, strike readers as awkward. What’s more, it is likely that the categorical landscape will continue to change in the future, at some point rendering the language of this book anachronistic, something that I embrace. Here I follow Leslie Feinberg’s lead in Transgender Warriors: “Since I am writing this book as a contribution to the demand for transgender liberation, the language I’m using in this book is not aimed at defining but at defending the diverse communities that are coalescing.”
If it seems odd, by contrast, to take the time to define what a child is, there is good reason to be equally critical and careful. Rather than taking for granted the existence of children as a demographic group defined somehow by age, this book takes a fairly simple approach to defining who is a trans child. Anyone under the medical age of consent during the twentieth century—typically twenty-one, but sometimes eighteen—is a child in the pages that follows. I draw on the medical age of consent not because it refers to a meaningful distinction but precisely because its arbitrariness and obvious construction illuminate how the figure of “the child” and actual living “children” are entangled products of historical processes of Western subjectification, rather than representing a natural category of human life. While there are infants, toddlers, five-year-olds, teenagers, and even twenty-year-olds throughout this book, I refer to all of them as children because they were subject to a specifically infantilizing form of governance (this is also why the category “adolescent” did not meaningfully come into play in trans medicine during this period). The medical age of consent, which deprived children of the ability to make medical decisions for themselves, proved to be a deciding factor in shaping their experiences and limiting their ability to act. Drawing on Paul Amar’s critical reading of the field of childhood studies, I agree that the child is a dehumanized social form, the product of historical and political processes of infantilization “designed to control various populations” through sexual and racial difference, rather than to index meaningful age differences. As Amar points out, one of the most pernicious effects of the production of children through infantilization is “a failure to recognize children as agents,” to render their lives politically informal—effectively unintelligible to adults. The Western form of the child and childhood is a powerful obstacle to seeing “the mechanism and practices by which social actors branded as children challenge the regime of infantilization,” whether through collective organization or individual itineraries that stray from developmentalism. For that reason, this book names the trans child not as a distinct subgroup within the trans community but as a politically disenfranchised person subject to a regime of racially and gender normative governance by medicine and other social institutions, including the family.
While the children who populate this book, particularly those in the early twentieth century, may not look recognizably trans by today’s dominant definition, this is precisely because the signature effect of medicalization over the past century has been to restrict trans life to a singular definition while simultaneously placing an etiological question mark upon trans people, and children especially, forcing them to constantly prove and account for their embodied self-knowledge instead of taking their transness seriously. The social reality of trans children across the twentieth century in this book begins to suggest some of the many ways that children whose lives differed from the normative patterns for the sex and gender they were assigned at birth actually multiply the meanings of “trans,” moving it in many different directions. In so doing, I stress that the being of trans children—the content of their “transness,” as such—is not the place to ground the meaning of trans childhood, for that etiological discourse is precisely the one in whose name medicine has inflicted incredible harm. The trans child represents a further case of what Kathryn Bond Stockton has described as the ghostliness of certain “impossible” children during the twentieth century. Not meant to exist at all in the present tense of their childhoods, the ghostliness of trans children over the past one hundred years takes unique residence in the medical archive, hiding in plain sight, invisible to the inverse degree of being pervasively present, yet always slightly out of reach even as they come into discourse. To pursue the trans twentieth century through the perspective of trans children, as this book does, shows how Halberstam’s assumed “history that produced the conditions for their smooth(er) passage from trans childhood to adulthood” is really not at all what we adults have come to imagine.
The Trans (and Intersex) Twentieth Century
This book begins at the turn of the twentieth century, when sex was brought under the jurisdiction of a modernizing project of medicine that sought to alter its form, and traces the medicalization of trans children until 1980, the year in which the publication of a new edition of the Diagnostic and Statistical Manual with an entry on “Gender Identity Disorder of Childhood” inaugurated the medical matrix in which we still live today. By beginning in the early twentieth century, the moment in which sex was redefined through the concept of plasticity by fields like endocrinology and urology, I read the medical archive to contest the historiography of the trans past monopolized by the parameters of transsexuality. While this book is first and foremost an account of trans children’s past, its broader historiographical intervention within transgender studies has four specific ends: to continue the work of displacing the 1950s as a default starting point for trans history; to undermine the rationality of medical science from its inside by reading trans people as complex participants in the production of scientific knowledge, rather than its objects; to highlight the overlooked entanglement of intersex and trans bodies during the first half of the twentieth century; and to uncover the vital but unexamined role of the child’s body in the medicalization of sex and gender as racially plastic, alterable phenotypes. These four characteristics of the trans twentieth century played decisive roles in shaping the lives of trans children, and vice versa.
The 1950s have been granted too much weight in transgender studies and popular accounts as the reference point for the twentieth century, overrepresenting the advent of transsexual medicine and Christine Jorgensen’s celebrity. The shadow cast by the midcentury also comes in the form of historical argumentation, like Paul B. Preciado’s in Testo Junkie, which imagines something especially distinct about the postwar era that enabled the emergence of transsexuality and its correlate medical techniques. This thinking runs perilously close to reproducing the kind of technodeterminism that characterizes Bernice Hausman’s reading of the history of trans medicine in Changing Sex, which has been roundly critiqued from Jay Prosser on for what he terms the transphobic “conception of transsexuals as constructed in some more literal way than nontranssexuals.” It is also historically inaccurate, as Joanne Meyerowitz points out, considering that medical procedures to change human sex long predated the willingness of American doctors to actually provide them to trans people, a shift that this book reexamines. In reality there was no revolutionary technological or medical shift in midcentury. Transsexuality is, rather, a medical discourse that distracts from forms of knowledge and being that are disqualified by its rationality and its timescale, minimizing a half-century of trans life and interaction with medicine that both precedes and informs it.
Since institutional medicine typically involves meticulous record keeping and voluminous discursive practices, and because it claims unrivaled authority to know and govern trans life, it represents a significant source of information on the trans past. The distinct challenge of the early twentieth century, before transsexuality, is that we still do not know very much about trans life or actual medical practice in this era. While there is an established sense that in some places in Europe, particularly Germany, trans people had access to various forms of medical support and built vibrant social worlds in urban centers as early as the 1920s, their experiences in the United States were not always comparable, as the second chapter of this book explores. What we do know about the concept of “sex change” and the hormonal theories of interwar endocrinology is framed in largely schematic, discursive terms through published medical texts and journalistic sources. Meyerowitz argues on this basis that the entire concept of changing sex for trans people took root first in Germany, not the United States, because of a “vocal campaign for sexual emancipation.” Yet there are no clinical histories in the United States that examine what actually went on in the hospitals and doctor’s offices where sex was made plastic and alterable or what happened when trans people began to seek out those doctors for assistance with their transitions. Nor do we have a concrete sense of how trans people understood their relationship to medicine beyond their interaction with popular-press accounts of dramatized “sex changes.” In the face of this prevailing lack of evidence, one of the central contributions of Histories of the Transgender Child is to reconstruct clinical histories at key places around the country, including a long-term look at the Johns Hopkins Hospital from the 1910s to the 1960s. I show that trans people readily sought out American doctors in the absence of a category like transsexuality as early as the 1930s—but not because they needed a medical discourse to make sense of their lives—that there were trans social worlds in the same period that Berlin was renowned for its trans community, and that even in the early twentieth century a few trans childhoods made it into the medical archive.
Still, there is disagreement over the very viability of claiming early twentieth-century figures as trans, rather than lesbian and gay, because of the absence of a clear separation between categories. Or rather, it would be more precise to say that our contemporary sense of categories that line up around separable phenomena of “sex,” “gender,” and “sexuality” did not exist until incredibly recently, coming into being perhaps only over the past forty years. This has resulted in a very slow recognition of obviously trans individuals who led public lives well before the availability of synthetic hormones or the concept of transsexuality, and several of them appear in the first few chapters of this book. And this problem has dogged the crossroads of queer theory and trans studies in particular. Take Ralph Werther, who went by the name Jennie June and whose peculiar 1919 text, Autobiography of an Androgyne, details her life as an “invert” and lower-class “fairie” in New York City from around the 1890s to the 1910s. In his introduction to a reissued edition, Scott Herring underlines the fascinating ways in which June’s text at first glance serves a modernizing discourse of transatlantic sexology, adopting and commenting on Richard von Krafft-Ebing’s typology of inversion from Psychopathia Sexualis and making frequent use of Latin to describe frank scenes of sex and cross-sex social life in the “underworld.” Perhaps to skirt obscenity censors, the Autobiography was published by a medical press, complete with an authorizing introduction by a well-respected physician, who framed the text as an account of “the congenital homosexualist” (11). Yet Herring also points out how June turns on the sexological premises of the narrative in key moments, authoring powerful critiques of the legal and social ostracism of the era, making the Autobiography “one of the inaugural acts of queer social theory in the United States” (xv).
Why queer social theory? Why not trans social theory? Although Herring is careful to point out that we know very little about the real person behind the nom de plume “Ralph Werther,” he nonetheless claims June for the history of queer sexuality as a figure whose life writing undermines the sexological framing of modern gay American sexuality (xv, xxxi). Yet it is far less clear, within the text itself, why June’s repeated professions to be “really a woman whom Nature disguised as a man” (25)—having wished to be a girl from early childhood (29), using the name “Jennie” from a young age (34), wearing women’s clothing from childhood on, wishing to have her genitals recognized as a woman’s (45), and eventually choosing to be medically castrated—would not invite a strongly trans reading. Alfred Herzog, the doctor who wrote the introduction to the original text, speculates about June’s castration procedure that “he hated above all the testicles, those insignia of manhood, and had them removed to be more alike to that which he wished to be,” a woman (14). Or, as June puts it herself: “were it not for certain masculine conformations of the body, I ought to go about in dresses as a woman, and always identify myself with the female sex” (13). In the retrospective frame of postwar American identity politics, where transgender has frequently been styled as a successor to gay and where trans studies has sometimes been cast as a successor to queer theory, June’s account of inversion has inaccurately been routed through the same implicitly teleological model.
In Transgender History, Susan Stryker names Jennie June as a trans woman in her review of the era before transsexuality. And there are compelling reasons to make that claim, not the least of which is that even June’s definition of inversion reflects not quite proto-homosexuality as we would expect it from our contemporary vantage point but an entirely different epistemology of sex, one that is not well known anymore. June employs a scientific thesis on the natural bisexuality of the species that was very much in vogue at the time of the publication of the Autobiography, explaining that “there exists, in the human race, no sharp dividing line between the sexes.” Within that paradigm, June observes that “there are innumerable stages of transitional individuals” (21) between masculinity and femininity, including those described as inverts by sexology. June actually goes so far as to explain her life through a concept of sexual plasticity: a “protoplasm” theory of inversion, according to which “the presence in the male body of a particular kind of governing corpuscles or germs ordinarily found only in the protoplasm of females” (31) results, at birth, in a mixed body and person, somewhat male, somewhat female. While Herring reads this inversion as a harbinger of modern homosexuality, the very resistance to modernizing sexological narratives he identifies in the Autobiography also undermines the reading of June’s life as gay instead of trans. The specifically trans quality of this life narrative is based in a lived epistemology of sex’s plasticity, not a binary of homosexual and heterosexual personhood.
The point is not to decide for trans over gay in a categorical sense but to understand that the European sexological concept of “inversion” was a much more complex blend of what today is separated into sex or gender on the one hand and sexuality or sexual object choice on the other. What’s more, as Emma Heaney explains in The New Woman, the discourse of sexology that produced inversion is premised on a staggering misrecognition and confinement of the rich social reality of trans feminine life and experience in this era. Quite unlike Herring, Heaney argues that “Jennie June bridges vernacular and medical understandings of trans femininity.” Histories of the Transgender Child follows Heaney’s important historiographical intervention into the early twentieth century, that “the emergence of the trans feminine as a field distinct from both male homosexuality and cis womanhood is a weighty historical corollary to the emergence of homosexuality.” Heaney shows that the growth of sexological and medical paradigms at the turn of the century was not the teleological apprehension of trans life by science, as it has often been framed, but rather the emergence of a distinction between cis and trans femininity that did not previously exist socially in Europe and the United States. In this context, I argue for reading certain historical individuals as trans when the available evidence is clear, because otherwise we risk missing key evidence, such as June’s reliance on a concept of plasticity to narrate her embodied trans feminine knowledge. More important than litigating any competition between queer and trans studies, as Peter Coviello argues about the consolidation of modern American sexuality, is that in an obsession over the emergence of discourses we have grown accustomed to overlooking what was simultaneously curtailed by modern forms of knowledge and being around sex. In undermining the inevitability of today’s dominant discourses by looking at the transitional overlap between epistemes, Coviello directs attention to “any number of broken-off, uncreated futures, futures that would not come to be.” Histories of the Transgender Child takes a similar position from within transgender studies. Indeed, trans children’s history is a powerful case of a completely overlooked field of lived experience, knowledge, and embodiment that has been lost through the positivist mythologies of twenty-first-century medical discourse, narratives of American identity politics, and the partial biopolitical normalization of certain trans subjects.
Many early twentieth-century trans people, like June, also drew on the language of intersex embodiment (then most often called “hermaphroditism”) to describe themselves as sexually intermediate types, somewhere between male and female. This was in addition to a growing medical discourse on hermaphroditism in the early twentieth century that was based around experiments on infants and children born with ambiguous genitalia and other morphological characteristics that could take on many nonbinary forms. For that reason alone, this book reads intersex children alongside trans children. Yet it turns out that it was precisely the same doctors and psychiatrists who saw both groups of children, too. What’s more, experimental medicine practiced on intersex children, typically without either their consent or even their knowledge, directly founded the modern medical protocol for assigning a sex and then reassigning a child’s body to fit that sex, first surgically and, later, hormonally. The second chapter of this book, which covers the 1910s to the 1940s, shows that the applicability of intersex medical protocols and techniques to trans people was actually proposed by trans lay persons, long before doctors were willing to consider the same. In this moment, trans people actually anticipated important medical links that would not be institutionalized by doctors for more than two decades. By seeing trans people as active participants in the construction and contestation of medical discourse in this way, rather than as passive objects of knowledge, I emphasize that at many key moments trans people’s embodied fluency in medical science far outpaced institutional medical knowledge. The broader point is that trans life had no causal reliance upon medicine during the twentieth century and that the trans people who did interact with doctors brought their own embodied knowledge of the social realities of their transness with them to the clinic. What’s more, the medical model consisted of a strategy to deny the social reality of trans life and confine it to a wrong body narrative by suggesting that trans women and men were not already woman and men (as their lives frequently testified) but that they somehow aspired to become women and men. For the first half of the century, trans people’s embodied knowledge borrowed heavily from intersex discourses to negotiate this growing power of the doctor and the clinic.
The ongoing intersex-trans dialogue led in the 1950s to the invention of gender, a signal event with deep consequences for all human life. Scholars working at the crossroads of intersex and trans studies, including Jennifer Germon, Sharon E. Preves, David A. Rubin, and Jemima Repo, have reconstructed how the concept of gender was built out of clinical experimentation on intersex infants and children born with ambiguous genitalia or secondary sex characteristics. Reassigning the sex of intersex infants led to a theory of gender that coordinated the development of the biological body with the psychological acquisition of an ineradicable identity, installing a new difference between sex and gender, a distinction that would have had very little intelligibility over the preceding fifty years.
The second and third chapters of this book, which reconstruct four decades of experimental medicalization of intersex children’s plasticity at the Johns Hopkins Hospital, greatly expand our understanding of how intersex children informed the invention of gender by the psychologist John Money and his colleagues in the 1950s. Reconstructing such a detailed history of intersex medicine also serves to undermine Money’s referential position—whether lauded or critiqued—as the ostensibly decisive factor in producing gender. I argue, instead, that Money only interpreted the results of many decades of complex surgical and hormonal experiments upon intersex children’s plasticity at Hopkins, importantly smuggling the racialized sense of sex as phenotype into the postwar era, so that gender was designed to function as phenotype, too. In this book, Money emerges not as a singular historical force but more as a relay point between the pre- and postwar eras, joining discourses and practices of intersex and transsexual medicine by way of the invention of gender. The persistence of the entanglement of intersex and trans life in the bodies of children has been underappreciated; in fact, it endured well into the 1950s, if not later. It lasted nearly as long as we have had the discourse of transsexuality, and yet it has radically faded from contemporary conversations about the plasticity of sex and gender.
Overall, Histories of the Transgender Child contests and carefully rereads the normative medical archive by beginning in the early twentieth century and working to undermine the model provided by transsexuality for making trans life intelligible. The final chapter attends specifically to trans boys, in part to open up the problem of how a transsexual definition of surgery has become an implicit measure by which to judge the relative degree of reality of trans life in the past, producing a highly gendered asymmetry revolving around bottom surgery for trans women and girls, making trans men’s and boys’ transitions, which are more likely to revolve around top surgery, less legible—not to mention all who do not seek out surgery or do not have access to medicine. This book militates against the implication, born of the discourse of transsexuality, that trans people need medical knowledge about themselves to name or understand their lives. Ironically, it is the medical archive itself that shows this to be untrue. The records of many trans people who interacted with American doctors contain their rich reminiscences of childhoods, adolescence, and years lived openly as trans, often with the acceptance of local communities, without searching for or even wondering about medical support or terminology. Very often medicine became important only after children and adults had lived significant trans lives. And medicine was transformed by its experience with their trans lives as much as the inverse was true.
These interventions into the trans twentieth century contribute to a broader movement in transgender studies that seeks to revisit the role played by trans people in scientific and medical research and to undermine the Western rationality and secularism too often reproduced by the field. Several key early figures in European and American trans medicine, after all, were trans men who became doctors and were in some cases able to experiment on themselves. In England Michael Dillon, likely the first trans man to undergo testosterone therapy in the 1940s, became a physician and penned what could be read as a major volume of trans knowledge before transsexuality, Self: A Study in Endocrinology and Ethics. In the United States, Alan L. Hart, a physician, radiologist, and tuberculosis researcher, was one of the first trans men to transition with medical support, including surgeries, even earlier, in 1917 to 1918. Other lay persons, such as Louise Lawrence, a major trans community leader in the San Francisco Bay Area and the head of a national network of trans correspondents, actively sought out and challenged medical experts and practicing clinicians, significantly shaping research on transsexuality at midcentury. “More and more I see the need (as Dr. [Alfred] Kinsey once told me about my appearance before the Staff at Langley Porter [Psychiatric Clinic in San Francisco]),” she wrote in a letter in 1953, “to educate the doctors, to give them a thought to work on that doesn’t come out of a text book.” Throughout this book are numerous trans people who decided, whether voluntarily or through exigent circumstances, to work with—and, almost as frequently, to antagonize—doctors. Some of them were trans children like “Vicki,” who appears in chapter 4 and whose persistent letters to the endocrinologist Harry Benjamin in the 1960s interrogated his gatekeeping role from the perspective of a trans girl living in rural Ohio.
Appreciating the active role played by trans people in twentieth-century medical science calls not just for an expanded sense of the medical archive but also for an interpretive practice that works against the rationality of the categories “transsexual” and “transgender.” In their writing on the life of Reed Erickson, a wealthy businessman and trans man who founded the Erickson Educational Foundation (EEF) in 1964 after his own medical transition, Aaron Devor and Nicholas Matte have worked to shift thinking in this direction. By personally overseeing the dispensation of millions of dollars in philanthropic funding from the 1960s to 1980s, they argue, Erickson directly financed much of American transsexual medicine in the postwar era. His funding provided Harry Benjamin, often canonized as a founding figure, with the actual resources he needed for his clinical work; the EEF provided Hopkins with the money needed to open its Gender Identity Clinic in 1965; and the vital professional networks for researchers and doctors treating trans people in these decades were likewise financed by the foundation. Devor and Matte argue that the contemporary landscape of trans medicine and social services in the United States is in large part the result of Erickson’s specific philanthropic vision, not only Benjamin’s or Hopkins’s approach. Rather than support a field of medical science with his money, Erickson took an active role in shaping it, meaning that his perspective on transition, transsexuality, and trans masculinity all played a role for too long underappreciated.
Erickson’s place in transgender studies, in particular, has remained marginal in comparison to the influence that Devor and Matte reclaim. In part, Abram J. Lewis argues, this is because of Erickson’s many nonscientific and ostensibly irrational pursuits. As he got older, he funded a massive amount of New Age research into mystical, magical, and supernatural practices and knowledge. Erickson also became a chronic drug user, exploring psychedelic and transcendental practice before becoming a serious addict and, by the accounts of his contemporaries, descending into a period of paranoia and delusion toward the end of his life. Rather than reading Erickson’s notorious “eccentricity” as evidence that these irrational matters were separate from or contaminated his work with medical science and represented a failure to live up to his empirical commitments to transsexual science, Lewis argues that Erickson’s life instead precisely challenges the epistemological coherence of trans life as an object of knowledge. “Erickson’s interest in psychedelia and para-psychology were not, as they have appeared in the historiography,” he explains, “mere footnotes to his work on transsexualism.” Lewis asks how positivist connotations of the discourse of transsexuality might change if New Age mysticism, psychedelic drugs, and research into animal communication were understood as integral threads of the ostensible rationality of transsexuality rather than its convenient foil.
Reflecting on the experience of researching in the trans archive of the twentieth century, Lewis underlines an odd contrast between primary documents and the historiographical narratives in existing scholarship. “Possibly in an effort to resist popular notions of transgender people as at once insane, tragic, and absurd, this literature has seemed, if anything,” he suggests, “to promote histories of agential and politicized communities—of subjects with sensible, self-interested aspirations.” While that may be understandable in its context, “perhaps unsurprisingly, then,” he adds, “much of the transgender archive is even more perplexing than secondary accounts suggest.” This tendency has both overvalued and overrepresented the authority of medical science, while underplaying the role of trans people who, like Erickson, may have had complex political agendas that in unexpected ways undercut medicine’s rationality through ostensibly irrational or nonsecular commitments. As Lewis suggests, trans studies need irrational concepts, such as “trans animisms,” to understand not only figures like Erickson but also trans activist efforts that took place outside the medical context, such as a 1970 protest against the police murder of gay and black trans people in Los Angeles, which involved an attempt to collectively “levitate” the Rampart Police Station in the hope that it might be made to disappear. Reina Gossett connects this manifestation to the present day as both a trenchant critique of “the normalized organizing tactics preferred by the Non Profit Industrial Complex” and a demonstration of being “accountable to the unborn, the dead and the living,” a potential “shift in connection [that] would create more space in our movements to hold more people, more levity, more magic, less isolation, and less shame.”
Histories of the Transgender Child contributes to and extends Devor and Matte’s, Lewis’s, and Gossett’s careful rereading of the archive, working to undermine medicine’s self-appointed authority and self-referential rationality from within by emphasizing the ways that trans people were actively involved with the contested production of medical knowledge despite lacking, in most cases, expert education and, especially in the case of trans children, often producing theories of trans life that drew as much from magic or fantasy as from science. While the trans twentieth century uncovered here is drawn primarily from archival research in major medical institutions, including the Johns Hopkins Hospital, the University of California, Los Angeles Medical School, and Harry Benjamin’s private practice in New York City, the depth and breadth of the archive’s contents move well beyond these focal points. Trans children lived in every single region of the United States. The coasts were also far from the only locations in which trans children (or adults) encountered and interacted with medicine or one another. Indeed, it would be difficult to maintain any pretension to a trans “metronormativity” during the twentieth century, even if major urban centers such as San Francisco and New York City were important places for trans social life, community building, and activism. In this book as much space is devoted to rural trans life and childhood in states like Ohio, Alabama, Missouri, and Wisconsin as to urban trans life and childhood in Los Angeles or Washington, D.C. What does typify the demography of the medical archive, however, is its overwhelming whiteness. To reckon with the implications of that pervasive whiteness in relation to trans of color life, this book draws on and contributes to trans of color studies.
Trans of Color Studies and Medicine
If the twentieth-century medical archive is compromised by the limited perspective of its rationality and by its overrepresentation of white, middle-class trans life, how can trans of color studies reckon with a reliance on that archive? Why not abandon the medical archive for alternative forms of knowledge? In reconstructing the history of trans children, this book could have begun, for instance, with Sylvia Rivera. Trans “street kids” are central to her political work and legacy. Rivera was also a trans street kid herself in the late 1960s. Running away from her grandmother’s home on Long Island to New York City at the age of eleven, Rivera found her way to Greenwich Village, where she “was adopted by a few young (but older than I was) drag queens” and soon thereafter joined a community of trans and queer street youth, including a teenage Marsha P. Johnson, as a sex worker on 42nd Street. Rivera lived openly and defiantly in her childhood, even wearing makeup to elementary school. She was also held at the Bellevue psychiatric ward after a suicide attempt and shortly before running away from home.
Rivera’s and Johnson’s participation in the Stonewall riots, their affinities with and critiques of gay liberation activism, and their trans of color liberation activism at the turn of the 1970s present a rich tangle of categories, politics, and priorities that undermine the increasingly sanitized and progressive narratives that collapse retrospectively into the U.S. “LGBT” movement or the creation of “a generalized ‘transgender’ subject in the narrative of Stonewall and the gay liberation movement,” which, as Ehn Nothing points out, “celebrate Sylvia Rivera’s visibility as transgender, conceal[ing] her status as a broke woman of color.” Rivera is also a difficult figure to reconcile with contemporary political taxonomies of sex, gender, and sexuality. As a child, she recalled, “I was an effeminate gay boy. I was becoming a beautiful drag queen, a beautiful drag queen child. Later on, of course, I knew that Christine [Jorgensen] was already around, but those things were still waiting on the backs of people’s minds.” Donning and contesting the political identity of “gay” in the early 1970s and referring to herself here and there as a “drag queen” and a “transvestite” in the expansive idioms of the era, not adopting the term transgender until the 2000s, Rivera remained mostly aloof from the medicalization of transsexuality. In an interview about their work in Street Transvestite Action Revolutionaries (S.T.A.R.), Johnson asks Rivera about the difference between the terms “drag queen” and “transvestite,” and she responds:
A drag queen is one that usually goes to a ball, and that’s the only time she gets dressed up. Transvestites live in drag. A transsexual spends most of her life in drag. I never come out of drag to go anywhere. Everywhere I go I get all dressed up. A transvestite is still like a boy, very manly looking, a feminine boy. You wear drag here and there. Where you’re a transsexual, you have hormone treatments and you’re on your way to a sex change and you never come out of female clothes.
When in response Johnson asks, “You’d be considered a pre-operative transsexual then? You don’t know when you’d be able to go through the sex change?” Rivera responds, “Oh mostly likely this year. I’m planning to go to Sweden. I’m working very hard to go.” Johnson points out that surgery in Sweden would be “cheaper” than at “Johns Hopkins,” to which Rivera agrees, “It’s $300 for a change [in Sweden], but you’ve got to stay there for a year.” Yet some time later, in 1990, during an interview, the historian Martin Duberman asked Rivera about hormones. Duberman’s notes record that Rivera said she “took them for a while but came to the conclusion that she did not want to be a woman. ‘I like pretending, the whole world for me is a stage I like to dress up. I don’t want to be a woman. I didn’t think about the sex change, that’s not what I want.”
Even if Rivera is a complex figure around whom to write a history of trans children, why are the street kids of major cities like New York not already recognized as proof that trans children have a past? Why are they not brought up in present-day conversations about the “newness” of trans children? Their radical politics, which would hardly be compatible with the modernizing, progressive narrative of medicine and corporate political lobbying, is surely one reason. Rivera’s and Johnson’s work in S.T.A.R. undoes progress narratives of gender and sexuality. They prioritized a trenchant critique of the police, gay gender normativity, and institutional racism and pursued a celebration of Latinx and black trans life that led to their own marginalization within activist circles almost as soon as they began organizing. Another reason, however, is that their lives are incredibly ephemeral—most “street kids” are anonymous as historical subjects, an unknowable diversity of experience hiding behind the collective noun. Even though Rivera and Johnson have generated perhaps the largest amount of archival documents and scholarly interest of any known street kids, even the account to which we have access is organized around a relatively sparse set of repetitive narratives that provides only small snapshots of what the lives of black trans and trans of color street kids were like in the 1960s and 1970s.
S.T.A.R.’s work on behalf of trans children nevertheless offers an important set of contrasts to the clinical history that anchors this book. Formed in 1970 and led by Rivera and Johnson, S.T.A.R. “focused on survival, countered societal injustice, and asserted a revolutionary and unapologetic transvestite identity” in the face of an increasingly hostile and gender-normative gay liberation movement dominated by cisgender, white men. S.T.A.R.’s efforts were guided, argues Jessi Gan, by Rivera’s hope “of enacting a very grounded kind of social change: creating a home for ‘the youngsters,’ the underage street queens who, like her, had begun working on the streets at age ten, and who not long afterward ended up dead.” She and Johnson materialized this aim through the creation of a S.T.A.R. home, a place where street kids could live together, pool resources, and develop practices for addressing violence in the sex work industry, police brutality, and overincarceration. In its first iteration, the S.T.A.R. home “was a parked trailer in an outdoor parking lot in Greenwich Village,” where around two dozen street kids lived. When the trailer was suddenly driven away by a trucker, Rivera and Johnson “decided to get a building,” hoping also “to get away from the Mafia’s control of the bars.” They found a place to rent in the East Village. Teaching themselves to make repairs and renovate the space, Leslie Feinberg explains, “they envisioned the top floor as a school to teach the youth, many of whom had been forced to leave home and live on the streets at a very early age, to read and write.” Johnson and Rivera worked to make sure that the children were fed and clothed. “We went out and hustled the streets. We paid the rent. We didn’t want the kids out in the streets hustling.”
By prioritizing the lives of trans of color street kids and sex workers, S.T.A.R. had an extremely fractious relationship with the Gay Liberation Front and the Gay Activists Alliance, which culminated in Rivera’s infamous exclusion from the 1973 Christopher Street Liberation Day rally, to which she responded by physically fighting her way on stage to deliver a scathing speech indicting gay men for ignoring the beating and rape of trans people in jail. Because S.T.A.R. built itself through the situated knowledges of the arguably poorest marginal constituency of the trans community, it also did not address institutional medicine much during its short existence. Like Rivera, S.T.A.R. did not identify itself through the medical model of transsexuality, although it was certainly aware of it. What little work S.T.A.R. or its affiliates directed at medicine at the turn of the 1970s instead addressed access to other basic, life-sustaining health care. For instance, Bob Kohler, a gay activist and friend of Rivera and one of the only people who maintained a friendly relationship with the homeless and with the street kids of New York, worked with the Mattachine Society and the East Side Village Youth Project to bring a mobile medical trailer to serve the medical and psychotherapeutic needs of street kids in late 1969. Rivera also focused some of her activist energy on psychiatric institutions, particularly Bellevue Hospital, where family members or the state had many gay and trans people confined on spurious pretenses.
S.T.A.R.’s black trans and trans of color political organizing to provide livable worlds for street kids also took place at the end of the historical period that this book covers, making it too late to serve as a starting point for some of the interventions I make. Still, the many differences between this account of trans of color childhood and the accounts that are assembled across Histories of the Transgender Child are instructive in avoiding the reduction of black trans or trans of color life to singular narratives. S.T.A.R. and the ephemeral perspectives of trans street kids of color are also an important model for trans of color studies as it works to dismantle medical, state-sponsored systems of being and knowledge that continue to marginalize and extract necropolitical value from black trans and trans of color life and death, something with which transgender studies must continue to reckon as it becomes further institutionalized in the university.
“Trans of color studies,” of course, does not name a unified or even necessarily an extant field. It functions here instead as an invocation across several fields of a vital point of departure for this book, one that Rivera’s and Johnson’s lives reflect: race is not a new matter to add to transgender studies. Multiple and differing racial formations, including blackness, coloniality, latinidad, indigeneity, and immigrant diasporas, are not and should not be new areas of inquiry for transgender studies to encounter or discover. In “We Got Issues: Towards a Black Trans*/Studies,” Ellison, Green, Richardson, and Snorton argue instead for seeing black trans theory as an impetus to investigate “a series of questions about repressed genealogies that might come into view through a more sustained engagement with blackness, as an ‘issue’ that is both overseen and unknown.” Drawing on Édouard Glissant’s work, they offer his concept of transversality “as a collateral genealogy, or an encounter with the past that also contains an ethical confrontation with the collateral damages involved in blackness as overseen and unknown.” The relation of blackness to trans life, as well as the relation of antiblackness to transsexuality and transgender, represents political problems of knowledge and being to be opened up through historical and politically engaged scholarship, rather than a frontier of new thinking to be discovered by more inclusive methodologies. Blackness problematizes the category trans—and vice versa.
Trans of color studies not only argues that race is integral to transgender studies, then, but also responds to a particular problem of black and trans of color hypervisibility with which the field is frequently complicit. In the introduction to The Transgender Studies Reader 2, Susan Stryker and Aren Z. Aizura observe that “current trans of color critique resists imperialist forms of knowledge production precisely by calling attention to which transgender bodies—and they are almost always the non-white ones—are made to represent the traumatic violences through which claims for rights are articulated.” In that volume, Snorton and Jin Haritaworn’s essential essay “Trans Necropolitics” names as the “most urgent present task” of trans of color critique “explaining the simultaneous devaluation of trans of color lives and the nominal circulation in death of trans people of color.” As they argue, “this circulation vitalizes trans theory and politics” precisely “through the value extracted from trans of color death.” This critique is particularly prescient in the wake of the ongoing biopolitical turn in transgender studies, which has been incredibly generative in identifying how trans life has been operationalized by normalizing and governmental techniques but also tends to follow Michel Foucault’s lead in abstracting the category “race” out of its own historicity, abandoning the centrality of colonialism and transatlantic slavery to the racialized modernity of the human.
Instead of taking Foucault’s account of the modern biopolitical body for granted, scholars working toward decolonizing the field and the concept of transgender are increasingly looking to Sylvia Wynter’s work on the overrepresentation of Western Man and the production of alternate genres of the human for scholarly coordinates that extend the work of trans studies in more productive directions. Alongside growing conversations involving trans studies, Afro-pessimism, and indigenous studies is work that draws on a decolonial framework to think of transgender and transsexuality as imperial formations of knowledge that circulate transnationally, but unevenly, across the global north and the global south. Joseli Maria Silva and Marcio Jose Ornat explain the “decolonialist approach” succinctly as “the opportunity to develop a strategy with which to overcome the notion of the primacy of scientific knowledge over those who suffer the effects of epistemic violence.” As the editors of Transgender Studies Quarterly’s special issue “Decolonizing the Transgender Imaginary” put it, “The term transgender—grounded as it is in conceptual underpinnings that assume a sex/gender distinction as well as an analytic segregation of sexual orientation and gender identity/expression . . . [is] simply foreign to most places and times.” Histories of the Transgender Child adds that one of those “places and times” might actually be the twentieth-century United States, if we read the medical archive through an interpretive practice aimed at its decolonization.
This book makes two arguments about the racialized genealogies of transsexuality and trans medicine on the one hand and the disqualification of trans of color life and knowledge from them on the other. First, its trans of color critique of medicine illuminates how the medicalization of trans life has always fundamentally racialized it, in more than one sense. Sex and gender were reconceived as plastic phenotypes during the twentieth century, which makes all human embodiment, including cisgender forms, a racial formation. Second, because the concept of plasticity was abstractly racialized by medical science as a synonym for whiteness, in the clinic it had real demographic effects. The overwhelming majority of trans patients seen at institutions of medicine were white. Even in the most pathologizing and disenfranchising medical models, the abstract whiteness projected onto the white trans body justified the attention given by doctors. Black trans and trans of color patients were much rarer because they were by design not welcome within that discourse. The broader racialized and class disparities in access to American medicine were also particularly acute in trans medicine, making it far more difficult for trans people of color to find competent and caring professional attention, whether in 1920 or in 1975—or, for that matter, today. In this way, the medical model built during the twentieth century disavows its own racial knowledge and racial violence, a set of practices that, as C. Riley Snorton has shown, run much longer, into the eighteenth century at least, where “chattel slavery functioned as one cultural apparatus that brought sex and gender into arrangement.” The Johns Hopkins Hospital, which is a central focal point of this book, is emblematic of the disavowed racial genealogy of modern American medicine. Built in a historically black neighborhood in the late nineteenth century on the presumption of special access to black people’s bodies for experimental research that was frequently nontherapeutic, practiced without consent, painful, and destructive, Hopkins produced many “modern” medical protocols out of experiments that were seen through a lens not of white plastic potential but of black fungibility. This held true for the Hopkins clinics involved in the production of protocols for altering human sex, where I show that black trans and black intersex life was framed in atavistic terms. This is a particularly pernicious racial effect of medicine in light of Snorton’s rigorous detailing, in Black on Both Sides, of how “captive flesh figures a critical genealogy for modern transness, as chattel persons gave rise to an understanding of gender as mutable and as an amendable form of being.” The racial plasticity of sex and gender whose history this book locates in the twentieth century is very much part of the inheritance from that racial history.
A trans of color critique of medicine, then, insists on naming, following Susan Stryker, the “spectacular whiteness” of transsexuality as a colonial form of knowledge whose claims to jurisdiction over trans life must be contested. Through a detailed historical investigation of the construction of trans medicalization from the opening of the twentieth century to the end of the 1970s, this book works from within the historicity of transsexuality and its predicates to demonstrate that medicine’s reason is actually a highly impaired, partial perspective on trans life—and trans childhood especially—that can only masquerade as universal and objective through the constitutive violence that it disavows. Not only does the whiteness of medicine interfere with the intelligibility and livelihood of black, brown, indigenous, and other marginal trans people, but it substitutes for them a point of view rendered detached and transcendent through their exclusion. Trans children stand out as powerful examples of this process of producing objective vision out of the forced disappearance of the personhood of patients. Trans children became valuable to doctors for an abstract quality, plasticity, which they exceptionally incarnated in their growth from infancy to adulthood. Medicine made of children’s living bodies proxies for the experimental alteration of racial plasticity and human sex, not by listening to children’s desires or demands for gender self-determination but by making them into the raw material of medical techniques. The same plasticity of sex that was racialized as white, making white trans children valuable in the clinic, also silenced them, making their experimental treatment a means to other ends.
Marking the limited and partial perspective of medical science is a project whose roots I also find in feminist science studies and woman of color feminism. Donna Haraway argues for a concept of “situated knowledges” to both open up this problem in dominant Western forms of scientific knowledge and find a theory of feminist objectivity that can usurp its place without having to reject the practice of science altogether. For Haraway, the difference between a dominant form of objectivity and a feminist objectivity is that the latter is concerned with the ethical problem of being held accountable for the production of a standpoint. Unlike institutional science or medicine, in the production of situated knowledge “the scientific knower seeks the subject position not of identity, but of objectivity; that is, partial connection,” which is quite distinct from the totalizing act of fully grasping an object of knowledge. In other words, through a feminist practice of situated knowledge, which does not pretend to proceed from a transcendent, detached position or to split the observer and the object of knowledge, “we might become answerable for what we learn to see.” Naming dominant epistemological practices and forms of scientific knowledge as situated, not universal or independent in their objectivity, is a powerful critique. Yet Haraway also offers the concept for building alternate forms of embodied knowledge, especially from the position of those whose lives have been long disqualified as unscientific, such as women, people of color, and colonized peoples. Still, Haraway is careful about not romanticizing the alternate production of knowledge from perspectives that have been subjugated:
Many currents in feminism attempt to theorize grounds for trusting especially the vantage points of the subjugated; there is good reason to believe vision is better from below. . . . The positionings of the subjugated [however] are not exempt from critical re-examination, decoding, deconstruction, and interpretation. . . . The standpoints of the subjugated are not innocent positions. On the contrary, they are preferred because in principle they are least likely to allow denial of the critical and interpretive core of all knowledge. . . . Subjugated standpoints are preferred because they seem to promise more adequate, sustained, objective, transforming accounts of the world. But how to see from below is a problem requiring at least as much skill with bodies and language . . . as the ‘highest’ techno-scientific visualizations.
This is a point that Chela Sandoval develops through a woman of color feminist lens in Methodology of the Oppressed, explaining that the production of situated knowledge from the perspective of the oppressed must be careful to avoid reducing that perspective to an identity. Sandoval cautions against this persistent problem, where minority forms of knowledge such as black feminist theory, queer of color critique, or indigenous epistemologies are misrecognized as correlate to a particular identitarian scope that reduces their sphere of applicability, rather than constituting “a theoretical and methodological approach in [their] own right.” For Sandoval, “These skills, born of de-colonial processes,” would “insist on new kinds of human and social exchange that have the power to forge a dissident transnational coalitional consciousness.” A trans of color methodology of the oppressed might also be called a “science of the oppressed,” a concept that micha cárdenas has adapted and developed in recent work connecting art, activism, poetics, and digital making.
Trans of color studies grows out of these multiple genealogies, prioritizing as much as possible the “(De)Subjugated Knowledges” named in Susan Stryker’s introduction to the first Transgender Studies Reader. There is a rich and growing bibliography of work that problematizes transsexuality as an artifact of colonial forms of knowledge and governance, critiques the disqualification of trans of color life and knowledge as unscientific and unworthy of personhood, and authors situated knowledges from the perspective of trans of color lives that are never reducible to a single or transcendent position but instead implicate the researcher and the reader, asking them to confront their responsibility to trans of color subjects, and the varying “response-ability” of those trans of color subjects. This book’s trans of color framework is built not out of a unified voice or referent, then, but out of a generative and internally discordant bibliography drawn from trans of color scholarship, black feminist theory, black queer studies, woman of color feminism, queer of color studies, and decolonial studies. While I aim to cultivate responsibility to those fields, I also affirm the partially incompatible and contradictory elements involved in their mobilization together. There are distinct points of friction that I do not always try to resolve and that are the particular risk of the formulation “trans of color.” I do, however, mean to avoid flattening the category “race,” much as I aim to expand the meanings of “trans.” In this book there are several distinct forms of racialization at hand whose historical entanglement is the object of inquiry. Naming modern sex and gender as racialized white though the medicalization of plasticity in children’s bodies, for instance, implies an exclusionary and dehumanizing relation to the racialization of black trans life. The racial formations of blackness and indigeneity, in particular, are highly specific in the U.S. context and do not map onto Latinx or immigrant forms of race that have often been forced into competitive relationships by the state.
There are also important conceptual and political tensions within the theoretical perspectives mobilized in this book. Haraway and Sandoval’s emphasis on situatedness, for instance, sits in tension with work in black studies on what Fred Moten calls “the refusal of standpoint” and the proposition “to think from no standpoint” in the case of blackness. There is also an important tension in thinking about the relation of forms of symbolic or social death that have attached to black trans and trans of color life and the material lives of black trans and trans of color people. Admittedly, these larger and ongoing conversations across fields are mostly beyond the scope of this book. Still, they insist as an importantly recurring problem. The frequent absence of black trans and trans of color children in the clinic’s archive, in particular, is not only a product of medical gatekeeping or the whiteness of transsexuality. It is also a product of a distance practiced by black trans and trans of color people from institutional medicine, which was well understood to be a dangerous and frequently violent apparatus. By the 1960s and 1970s, as formal gender clinics began to open in the United States, their overwhelmingly white clientele was contrasted with the continuing use of willfully faulty homosexuality and schizophrenia diagnoses to reject outright black trans children’s personhood and to subject them to potentially infinite detention in psychiatric facilities, as well as more literal forms of incarceration.
The black trans children who appear in this book, particularly in the fourth and fifth chapters, occupy a difficult and risky position in its narrative, one magnified by the protocols of medical archival research, where the need to anonymize dilutes even the smallest details of black life whose traces are left behind. Black trans children are situated in these chapters in contrast to the white trans children whose lives are overrepresented in clinical archives. Although to preserve anonymity I do not use any real names from medical records in this book, it is worth pointing out that these black trans children frequently had no name recorded in those documents to begin with. They were also the least likely to have any pretense of their own voice recorded in interviews or to be discussed with even the most basic trappings of personhood. This is a dangerous situation to reconstruct out of the archive, for it risks reassigning a necropolitical value to black trans children, letting them vitalize the work of transgender studies without challenging their reduction to social death in the archive. To read contrary to the facticity of the archive and locate some form of escape or resistance is also exceedingly difficult because of the brevity and sheer misdirection of the medical discourse in those documents. To argue that their blackness therefore always sits in an irruptive position in relation to transsexuality, in certain instances threatening to puncture the racial order of things, also risks casting these black trans childhoods in a romanticized role as always-already outside the category transgender—not an easy position from which to find a livable life for a child.
Taking these risks on as part of the ethical project of cultivating responsibility toward the real lives behind historical discourses, I draw on Robert Reid-Pharr’s “post-humanist archival practice.” Informed by rich thinking in black studies on how black social formations are forced to survive within the violent matrix of Western humanism’s concept of “Man,” how “the black operates in Western humanism as a nonsubject who gives meaning to the awkward and untenable concept of ‘Man’” (8), for Reid-Pharr the historical archive of black sociality can reinforce the parameters of that humanism only if it is acquiesced to in advance. He argues convincingly that “though the conceits of humanism would have us believe that our ability to address human being must by necessity be a radically demarcated endeavor, the lived reality of black life demonstrates an unusually broad set of procedures that have challenged and critiqued not only white supremacy but also the smugness and certainty of the entire Western humanist apparatus” (9, emphasis in original). Drawing on Hortense Spillers’s distinction between body and flesh and a renewed sense of the archive as a location for interpreting alternate accounts of social life that find their conceptual coordinates in historically lived difference, Reid-Pharr names the responsive object of his posthumanist practice “archives of flesh” (10–11). Rather than taking the ejection of blackness from the human as the final word on the matter, these archives of flesh bring to the fore “many moments of illogic, indeed of wildness and bestiality, that one finds in humanist discourse” (10), inviting its undermining through archival interpretative practices attuned to alternate forms of the human already existent in the past.
If this book’s archives of black trans childhood are, to a considerable extent, overwhelmed by the sheer force of medicine as a domineering form of humanism, yielding only the slightest glimpses of the situated perspective of black trans childhood, this is, as Reid-Pharr importantly reminds, less a reason to abandon the archive than an invitation to invent better interpretive practices that break from dominant epistemes and ontologies by recognizing that domination has to be historically produced but is never a done deal. It is also, however, a reminder that this book provides only one account of black trans childhood’s historicity. We need more of these histories, and we do need different archives that produce alternate forms of knowledge richer in the grain of black trans and trans of color embodied objectivities than what this book can provide by focusing on the history of medicine.
I turned to S.T.A.R. to frame my thinking about the collective project of trans of color studies not only because it provides subjugated historical knowledge from before the contemporary liberal LGBT movement but also because Rivera’s life as a street kid reminds us that there are countless untold stories latent in the past that could be what Snorton terms “fugitive moments in the hollow of fungibility’s embrace.” And even when they contrast with or outright contradict the account that I provide in this book, that contributes toward displacing the whiteness and rationality of transsexuality, suggesting black trans and trans of color futures that do not reiterate the exhausted closure of humanism. It matters, but precisely in ways that we can scarcely yet imagine in their profundity, that as some of the trans children I write about in the last chapter of this book were visiting Harry Benjamin’s private practice on the Upper West Side of Manhattan in 1970, across town and some thirty-odd blocks south Rivera was picketing Bellevue Hospital, where she had been held by medical authorities as a child.
With these methodological and historiographical coordinates in mind, this book’s conclusion argues against the etiological framing of trans children, whether by medicine, the helping professions, or the media. As I began to suggest in the preface, Histories of the Transgender Child asks us to turn against and away from figurative thinking about trans children in general. Trans children must no longer bring us to some new knowledge of trans life or sex and gender, making them a means to some other abstract end. Rather, through the twentieth-century history of the chapters that follow I propose an ethical relation that calls upon adults to stop questioning the being of trans children and affirm instead that there are trans children, that trans childhood is a happy and desired form—not a new form of life and experience but one richly, beautifully historical and multiple.