If you’ve found yourself wondering why there is such an explosion in the trans population recently, this is it right here. The beginning of modern transgender care is rooted in the 1948 when Alfred Kinsey (yes, that Kinsey) asked a dutch endocrinologist, Dr. William Benjamin, to assist a child who “wished to be a girl.” The mother of the girl was adamant that she wanted to help her daughter be comfortable in her skin, NOT convince them otherwise. Benjamin created a treatment program of estrogen therapy to help the girl transition, and noted just how profound of an impact it had on her behavior and well being. He continued to refine his treatment and went on to help hundreds of trans people find peace with themselves, despite laws at the time that banned transsexual reassignment.

In the 1960s Benjamin founded an organization to establish guidelines for how to care for transgender patients, then called the Harry Benjamin International Gender Dysphoria Association. Unfortunately, the HBIGDA was co-opted by some psychologists who did NOT have trans people’s best interests at heart, and the Standards of Care that the organization produced were restrictive and homophobic. One of these individuals was a psychologist named Ray Blanchard, who had developed an extremely coercive idea the origins of transness in women (he completely ignored trans men, dismissing them as victims of internalized misogyny). Blanchard believes still to this day that trans women are still men at heart and that our gender issues are entirely sexually rooted. His theories caused many MANY trans women, including myself, to see themselves as simply fetishists.

Patients were required to have extreme dysphoria around their bodies, especially their genitals. Reassignment surgery HAD to be an end goal for a patient to receive treatment, and if you expressed any doubts in that, treatment would be denied. Transition also was only allowed if it would make you straight, if you were assigned female at birth, you had to be attracted to women, and vice versa. Bisexuality was also rejected. There were presentation requirements as well (hyper-femininity for women) and the protocol demanded that you sever ties with all friends and family and disappear into stealth. They called it woodworking. You could find doctors willing to shuck these requirements, but they were extremely rare.

In 2011 the HBIGDA renamed itself to the World Professional Association of Transgender Health (WPATH) and released a completely new Standards of Care. This eliminated the previous requirements, affirming that dysphoria takes on many different shapes and recognizing that sexuality is completely independent of gender identity. It also recognized the existence of bon-binary identities and granted them the right to medical care. Suddenly transition became available to everyone who needed it, and a new era of trans recognition began.

The news of this change began to spread throughout communities and the number of people seeking treatment quickly grew at an exponential pace. Trans people started being extremely visible, getting their stories known, bolstered in part by major changes in legislative recognition of trans rights. In the US, the Obama administration took many great steps towards making trans people more accepted. California and several other states passed laws against trans discrimination, and in late 2015/ early 2016 a critical mass of awareness was reached.

The population EXPLODED, and now we are EVERYWHERE. I see fellow trans folk all the time here in suburban San Diego. 2018 saw a massive shortage of injectable estradiol – as well as shortages of the drug Spironolacotone, commonly used as a testosterone inhibitor – because demand has suddenly spiked significantly and pharmaceuticals weren’t prepared.

Trans people have always existed, there are historical texts describing people with gender dysphoria going back through all of written history, but it is just in the last seven years that we have been allowed to exist institutionally. When you hear people label transness as a “trendy fad”, or hear the phrase “Rapid Onset Gender Dysphoria”, this is people being skeptical of this explosion. Conservatives are shocked, SHOCKED that this could have been there the entire time just waiting for the opportunity to burst forth.

We have been given liberty, we have obtained freedom, and we will not be shoved back into the closet. We will not be erased.