To protect lesbian-feminism and women at large, Raymond proposed a simple solution. “The problem of transsexualism,” she concluded, “would best be served by morally mandating it out of existence.”42 For Raymond, sex roles and the medical empire were the causes of transsexuality; limiting medical access to transition procedures would reduce the numbers of trans people.
In 1980, the Reagan administration gave Raymond the opportunity to help bring about that dream. In the case of some extremely persistent patients, Medicare policies and state courts had sometimes deemed sex transition procedures medically necessary and paid the associated bills, as did some private insurance companies. But under Reagan, the National Center for Health Care Technology reviewed the efficacy of mandated Medicare coverage, looking to cut costs by shrinking the health services available to the poor. Trans healthcare came under scrutiny. The center asked Raymond to participate in the preparation of a report on transsexual surgery. Her task was to produce a paper on the social and ethical aspects of medical transition, a paper intended to determine whether sex transition procedures were “reasonable and necessary” and so appropriate for Medicare (and other insurers’) reimbursement. Raymond unleashed her argument: insurance coverage of trans healthcare was “controversial” and “unnecessary,” for transsexuality wasn’t a legitimate medical condition as sexologists argued—it was the perverted spawn of society’s restrictive sex roles and a form of “mutilation.” Medical transition merely subdued deluded individuals into accepting these stereotypes, much like heroin functioned as “a pacifier of black people,” tranquilizing them into accepting a racist system.43
The National Center for Health Care Technology’s final report closed the door trans people were fighting so hard to keep ajar. Drawing on the work of Raymond, other experts, and other organizations compiled in the center’s report, at the end of the decade the Reagan administration withdrew Medicare coverage of transition healthcare and gave insurers permission to deny the procedures on account of their “controversial” nature and lack of medical necessity. Private insurance companies followed suit, glad to have a federal blessing to reduce their liability. Meanwhile, state Medicaid coverage of trans medicine had been eroding since 1979. For the next twenty-five years, almost all US insurance companies refused to cover trans medicine in the private or public market, making sex transition healthcare available only to those wealthy enough to pay out of pocket, often by flying overseas. Transgender studies scholar Cristan Williams underscores the fatal impact of this policy change. Multiple studies, she emphasizes, demonstrate that access to transition dramatically reduces trans people’s rates of suicide.44 To restrict access to medical transition, for some, is to make life unlivable. The policy wasn’t reversed until 2013, when a provision of the Obama administration’s Affordable Care Act set a new precedent for federal, state, and private insurance coverage.
But trans people didn’t disappear quietly just because medicine was far more expensive to access. Trans medicine doesn’t produce trans people—the dogged insistence of trans people themselves led to the development of trans medicine. Gender transition clinics only came into existence in the first place after decades of “intense and unremitting pressure of trans-sexuals,” as radical British sociologist and trans scholar Carol Riddell pointed out while refuting Raymond’s book in 1980.45
Similarly, even as medical access retracted in the late 1980s and 1990s, transgender politics and theory pushed forward. And one of the most significant innovations in conceiving of trans politics as a multifaceted critique of power that addresses the intersections of sex, gender, capital, and colonialism, came from Sandy Stone.
When Sandy Stone moved north to Santa Cruz in 1974, she set out on a mission to find transition healthcare. She knew it was now possible to access sex transition in the United States. While earlier generations of trans people needed to travel to Copenhagen, Casablanca, Tijuana, and other international cities for hormones and reconstructive surgeries, rising domestic demand had led to the opening of trans clinics at US universities. But the clinics didn’t exactly advertise in the daily newspapers, and Stone had never met a transsexual person. After multiple phone calls—and a guided tour of trans sex workers’ poverty-stricken apartments in San Francisco’s Tenderloin neighborhood, intended to scare her off—she found the Stanford Gender Dysphoria Program, now six years running and located just over the Santa Cruz Mountains.
But it wasn’t a homecoming. She’d been warned by other “transies” that Stanford preferred Christine Jorgensen types, the tall, willowy, hyperfeminine blonde who became the first person famous for being transsexual back in the early 1950s. Stone knew her short, androgynous, Jewish body might pose a problem. In common with some other gender identity programs, Stanford ran grooming sessions to train preoperative trans women in delicate comportment, ladylike dress, and subservient heterosexual dating behavior that staff psychologists deemed appropriate to femininity.46 Their goal was to admit and treat patients who they were certain would pass as genetic females. Stone had a choice: she could stage a performance that would satisfy Stanford’s demands, or she could confront the clinic’s sex stereotypes head-on.
Stone walked into her first appointment with plastic surgeon Donald Laub, who directed the clinic, wearing her traditional uniform of jeans, heavy boots, and a beard grazing her chest. Surgeon and patient sized one another up.
“I am interested in a sex change,” she announced, in Doc Storch’s deepest, most authoritative rock ’n’ roll sound-guy voice.
“To what?” Dr. Laub replied.47
Stone gained admittance into Stanford’s two-year presurgery program, but at subsequent appointments she met further obstacles. Allies she met in the clinic’s waiting room, however, encouraged her to join them in refusing the rigid binaries the physicians imposed.48
“Why aren’t you dressed like a woman?” Dr. Laub interrogated, surveying Stone’s jeans and T-shirt.
“I am dressed like a woman,” she informed him.
“No, you’re not,” he insisted.
“Have you looked out the window recently?”
The tension came to a head at Stone’s final presurgery appointment. “Are you 100 percent sure that you want surgery to change sex?” Laub asked.
“No, I’m not,” she replied. She distrusted absolutes and suspected that being 100 percent sure of anything actually demonstrated insanity, not sound conviction. She felt 99 percent sure.
“I’m an adult,” Stone assured him. “I can take responsibility for my actions. This is informed consent. If I made a mistake, it’s my fault, not yours. Let’s go.”
“I’m sorry,” he told her. “You’re not eligible” for surgery. And Stone drove back over the mountains to Santa Cruz.
Three months later, Stanford’s program coordinator called Stone to redo the interview. When reviewing the transcript, the coordinator realized the impasse was procedural, not substantive. She drafted a script for both surgeon and patient to follow so that Stone would meet clinic qualifications.
“Are you ready for surgery?” Dr. Laub asked when Stone returned to the Palo Alto offices.
“Yes!” Stone confirmed. She was approved.49 But it would be another few years, when Olivia Records contributed the balance due in a last-minute rush before their national tour, before Sandy received surgery.
A decade later, Stone pulled this experience into her next career: as an academic feminist theorist. At the age of fifty, she entered the University of California–Santa Cruz’s famed interdisciplinary PhD program, History of Consciousness, a paradigm-busting department whose faculty included Angela Davis and Donna Haraway. It was Haraway who encouraged Stone to join them at the sprawling redwood-filled campus on the bluff overlooking town. Haraway was in the midst of writing her soon-to-be famous “Cyborg Manifesto,” which demolishes the “antagonistic dualisms” between human and machine, human and animal, the natural and artificial, and man and woman to envision a feminist world organized by affini
ty rather than essentialized identity. “There is nothing about being ‘female’ that naturally binds women” together, she insists, launching her critique directly at white feminism’s attachment to the fantasy that to be a woman is to have suffered identically at the hands of patriarchy.50 And there is nothing inherently threatening about the new machine age, she urged. While late capitalism powered Reagan’s launching of the Cold War into the stars, feminists and socialists could appropriate human-techno relations toward preventing, rather than enabling, unending war and massive wealth disparity.
Among the academics breaking conventional frameworks of thought, Stone had at last found her home. Working with Haraway, and alongside department colleagues like Gloria E. Anzaldúa—who was drafting her book Borderlands/La Frontera, one of the essential texts of intersectional feminism—Stone built on these theorists’ work on mixture and hybridity to confront essentialism where it pierced her most directly: in myths about transsexuality. She now knew how to confront Janice Raymond. In 1991 Stone published the essay “The Empire Strikes Back: A Posttranssexual Manifesto” challenging Raymond’s portrayal of the transsexual empire head-on. Stone was still completing her dissertation, and she and Haraway worried it would destroy any possibility of a future career in the academy. Her essay had the opposite effect. “The Empire Strikes Back” became the founding document of a brand-new academic field: transgender studies.
The manifesto did something much bolder than merely refute Raymond. Stone overturned the dominant narrative, supported by trans medicine and by many trans people at the time, that to be trans meant to be “born in the wrong body.” Instead, she articulated the radical potential of trans lives to break through binary notions of sex in which to be male was the polar opposite of female. Emphasizing self-determination over biological determinism and developing nuanced analyses of gender, race, and capitalism, Stone’s manifesto joined a vibrant tradition of pushing back against the confines of white feminism—and extended intersectional feminist analysis into the realm of transgender politics.
Drawing on decades of published sex change narratives, “The Empire Strikes Back” eviscerated the standard accounts of trans identity promoted by physicians and patients alike. In these tales, radical transformations cleave a male past from a female future. Surgeons enact divine resurrection, first putting to death a heterosexual male and then animating a passive, delicate, high-voiced, femme fatale who awakens from surgery an entirely new person. In these magical journeys from one pole of sex experience to the other, Stone illuminated, “the male must be annihilated or at least denied, but the female is that which exists to be continually annihilated.”51 For femaleness in these texts is marked by a subservience so extreme that trans women are devoid not only of agency but of their very bodies; their corporeal form is mere putty formed in the wake of the surgeon’s scalpel.
“No wonder feminist theorists have been suspicious” of transsexuality, Stone observed. “Hell, I’m suspicious.” It was a gesture of generosity to TERFs—one that simultaneously risked undercutting fellow trans people.52
Janice Raymond was absolutely right that leading sex transition psychologists such as John Money and Robert Stoller insisted upon retrograde, antifeminist gender roles. But since Raymond understood trans people only as artificial products animated by trans medicine—not as fully fledged agents of their own lives—she couldn’t see that trans people, too, resisted these roles. Sometimes that resistance took the shape of inhabiting gender stereotypes.
For years, Stone related, trans people advised one another on how to navigate gender clinics’ strict requirements: study the manual of transsexuality that the doctors themselves used to assess patients’ likelihood to succeed in society as feminine women—Dr. Harry Benjamin’s 1966 The Transsexual Phenomenon—and perform the type, down to a T. Clinic staff were so eager to codify transsexuality as a new mental health disorder defined by identical characteristics that their own needs for objective, reproducible, standardized criteria made them highly gullible. It took the surgeons and psychiatrists years to figure out that they’d been had.
For Stone, the clinics offered a fascinating example of how gender is constructed in real time. Dr. Benjamin identified “born in the wrong body” as the defining self-understanding of transsexuality. Since his manual was the clinics’ manual, patients repeated this refrain year after year in order to access transition care. Even after physicians realized that their patients, too, read Benjamin, they continued to pose questions that screened out any ambiguity, as Stone herself had experienced. Through these rote scripts, performed by doctor and patient alike, transsexuality solidified into the state of passing from one side of the sex binary to its alleged opposite, a transformation that demolishes any body or experience that came before. In physicians’ hands, transsexuality reinforced, rather than broke down, the gender binary.
The “wrong body” narrative solidified into orthodoxy. In the 1970s, Stone shared, clinics even instructed transsexual women to invent a “plausible history” of their earlier lives.53 They were to fabricate new childhoods as if they had always been female. In the medical discourse, to transition was not only to erase one’s own past—it was to masquerade as an imaginary person.
“But it is difficult to generate a counterdiscourse if one is programmed to disappear,” Stone objected. Universal, unrelenting passing is not the goal, she urged. Never-ending passing is a form of assimilation—an acquiescence to the status quo. Passing internalizes, rather than resists, the harmful structure of binary gender that delineates masculinity and femininity, man and woman, as fundamentally at odds. She argued that to pass perpetually, in all circumstances and interactions, forecloses the center of a person’s individual power, the complexities, ambiguities, and nuances of actual life experience. And while passing admits one to the realm of gendered respectability, it means being forced to found relationships on lies, instead of on the truths that transsexuality exposes: that all bodies are malleable texts inscribed by power.54
Instead, Stone urged, “in the transsexual’s erased history we can find a story disruptive to the accepted discourses of gender… which can make common cause” with other oppressed groups. She called this new identity the “posttranssexual”—the monstrous body reclaimed, in all its complexity. Closing her manifesto with a thrilling turn, Stone wrote collectively to other academic transsexuals—an audience she had to dream into being in 1991. Stone asked “us” to write our complex realities into history instead of being scripted as monolithic caricatures by physicians, feminists like Raymond, and even ourselves. Refusing assimilation is radical politics, “begun by reappropriating difference and reclaiming the power of the refigured” body—turning transsexuality into a site of resistance and alliance. She called for “solidarity” with queers and people of color—not individual, stealth access to the status quo through the edifice of binary sex. “Although individual change is the foundation of all things,” she concluded, “it is not the end of all things.”55
Trans lives, for Stone, became a jumping-off point for interrogating gender—the social dimensions of sex—and forging collective resistance to racism, capitalism, and colonialism. By contrast, trans-exclusionary feminism honed its project into one goal alone: liberating women from the oppression of men.
The singular identity “women,” removed from the reality of all other social forces besides biological sex, became a mythic category that actually obscured, rather than pried open, the workings of power. But gender—a term many TERFs and “gender critical” feminists today deem tainted by transsexuality—usefully exposed the process through which the identities of man and woman are assigned meaning. The concept of gender provided an angle onto the way social institutions shape personal identity and experience. Trans feminism like Stone’s helped advance intersectional feminist analysis, and she was far from alone.
The UC Santa Cruz campus nestled among the redwoods wasn’t the only place cultivating intersectional trans politics. The narrow
streets and dark piers of lower Manhattan, too, had been providing potent ground for those who defied the rules of binary sex.
In June 1973, just three months after the West Coast Lesbian Conference, trans activist and sex worker Sylvia Rivera mounted the stage at the Christopher Street Liberation Day rally clad in a long-sleeved sparkly bodysuit. Rivera wasn’t on the scheduled list of speakers on this fourth anniversary of the Stonewall antipolice riots, but she commandeered the mike anyway, causing a commotion onstage and off. She was greeted by a raucous mixture of jeers, boos, and some applause.
“Y’all better quiet down!” Rivera began in frustration. Leaning into the mike, putting the full force of her thin body into her voice and keeping time with her right index finger as if the crowd were her orchestra, Rivera gave them a piece of her mind. “I’ve been trying to get up here all day for your gay brothers and your gay sisters in jail that write me every motherfucking week and you don’t do a god damned thing for them!” Drag queens and trans women of color, including Rivera and her friend and ally Marsha P. Johnson, had led the Stonewall rebellion—but now the gay and women’s liberation movements wanted nothing to do with sex workers. Rivera herself first lived on the street and turned tricks to survive at age eleven. To keep trans, gender nonconforming, and queer kids of color from a similar fate, Rivera and Johnson had organized Street Transvestite Action Revolutionaries (STAR) for the past three years. The pair were squatting a trailer in Greenwich Village, stealing food, and soliciting johns to support a group of street youth Rivera called her “children.” Their solidarities were clear: “We share in the oppression of gays and we share in the oppression of women,” STAR declared. But gay liberation and the women’s movements wanted nothing to do with Rivera, Johnson, and their band of outcasts. “I have been raped. And beaten.… I have been thrown in jail. I have lost my job. I have lost my apartment for gay liberation and you all treat me this way?” Rivera exclaimed. She built to a crescendo: the true potential of gay power manifest when it acted in solidarity with “all of us,” not when it shrunk into the “middle-class white club” that “you all belong to!” In closing, she led the crowd of thousands in a rousing cheer of GAY POWER.56
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