Last week my friend, Professor Jenny Boylan of Barnard College, penned an op-ed in the Los Angeles Times entitled "Trans Community Can Change Minds by Changing Discourse." I think it's very important that our scholars are finally being provided with a platform to reach a far wider audience, and Jenny is one of our most articulate spokeswomen. It's also important to note that -- gasp! -- trans women are Ivy League college professors. I will even go so far as to say that what she said is less important than the fact that she is published in The New York Times and the Los Angeles Times. That will have a great impact on accomplishing what she stressed as the goal of her piece: changing the nature of the public discourse around trans persons and the experience of being trans.

I do take issue, however, with her analysis. She uses the promotion of marriage equality as the gay analogue to what the trans community now needs. With all due respect, I think she's got it backwards.

Yes, during my youth, when straight people talked about homosexuality at all, they talked about gay sex. The only issue of concern was the sex act; they considered gay people less than human. Stonewall, however, changed all that. Gay people started coming out and presented themselves to their family, friends and society. They were more than just actors in a sexual experience. When they started fighting for their rights, they did so in the context of employment, housing and public accommodations -- just like other minorities, and that largest "minority" group of all: women. By the '90s the debate had shifted to military service and marriage rights. The "sex" had been removed from "homosexuality," and only religious fundamentalists who were obsessed with sex acts continued to use the word "homosexuals." At the same time, trans activists also jettisoned "transsexual" for "transgender."

Today, where all the talk is about "gay" rights and "gay" pride and "gay" marriage, few people think of gay persons in sexual terms -- not because of all the news about "don't ask, don't tell" or Windsor but because all the gay people they know, in their families, workplaces, schools and neighborhoods, are fully developed human beings, just like them. That came about because of the coming out of millions of gay Americans -- first slowly, then in a flood. Today 87 percent of Americans say they know a gay person (up from 61 percent in 1993, when "don't ask, don't tell" was instituted).

Things are different for the trans community. Fewer than 10 percent of Americans know a trans person. There are far fewer of us: We make up just 0.3 percent of the general population, whereas lesbian, gay and bisexual people make up 3.5 percent. As Mara Keisling, Executive Director of the National Center for Transgender Equality (NCTE), said last year:

A huge number of Americans now have gay family members, gay co-workers ... but most of them don't know a transgender person, and that means we're ripe for scapegoating. There are a lot of people in this country who just are ignorant about us. They hear people in authority demeaning and dehumanizing us, and they believe it. I think for the next few years, until transgender people are more visible, come out at work, we're still going to have a lot of ignorance out there.

The bulk of the media focus for the past 20 years has been on the "gay" rather than on the "trans," and the trans exposure has generally been negative, going back as far as Hitchcock's Psycho in 1960. However, the situation has been improving, if in an irregular manner, over the past decade. According to the AP:

GLAAD [where Professor Boylan serves as the board co-chair] examined 20 recent [i.e., in the last year] TV episodes that included transgender characters and deemed 60% of them to be negative or defamatory. Common themes, according to GLAAD, are portrayals of transgender people either as clownish or sociopathic.

Summarizing the report, Matt Kane at GLAAD writes:

[O]nly 10% (2) of the episodes tracked this year were considered outstanding. ... Anti-transgender slurs, language and dialogue was even more prevalent in the past year than what was found in the previous report. Of the 20 episodes tracked, 75% (15) of them contained problematic language -- often spoken by popular or sympathetic characters.

But, according to Kane, there was some reason for optimism:

On a more positive note, the transgender characters themselves were less likely to occupying the stereotypical roles of victims of villains. Only 10% (2) of the roles were those of murderers or villains compared to 21% in last year's report. Additionally, only 15% (3) of the roles were categorized as victims compared to 40% of the roles from 2002 to 2012.

Much of our legislative progress has occurred by joining with the gay equality movement. Americans who support the gay community generally support the trans community (though not as much, primarily due to ignorance). Now that the gay-rights movement has nearly accomplished all its major legislative goals, short of national marriage equality and comprehensive civil rights, media attention has been turning to trans issues. Also, since the media tires of a narrative that has been active for decades, they start looking for the new and controversial. The trans community fits those needs and thus has become a greater object of attention (and backlash). But because so few of us have come out (and that includes the tens of thousands who have transitioned over the past half-century and are not out), the ground has not been adequately prepared, and the ignorance of the media and general population persists.

Not surprisingly, those who do have the opportunity to speak publicly often chafe at the personal nature of the questions. Yet it is the nature of the trans experience of sex and gender that interests the general population, which has not yet had the opportunity to meet adult trans persons and get to know them as persons. Making trans health care (which includes transition services) a primary community goal also necessitates a willingness to discuss the issues of anatomy and physiology. Some of our activists want to avoid the personal questions entirely and move on to the political. I don't think that's practical, nor do I think changing the discourse as Jenny suggests will solve that problem. Yes, it's rude for someone to ask you about your genitals, and particularly on television. But rather than get testy, we can speak of anatomy in general terms, as an effort at education.

So much of my political advocacy has required a willingness to engage people where they are, not where I'd like them to be. In so doing, I've been able to move though the salacious and uncomfortable issues (being a surgeon makes it much easier for me, I will admit) toward advocating for freedom and equality. This has been critical not only with fundamentalist Christians who view sex solely (and inaccurately) as a function of genital anatomy but with certain radical feminists who believe the same. Refusal to engage the left on this issue almost derailed the gender-identity bill in the Maryland legislature again this past year.

And, as uncomfortable as it is to admit, as I did the past two weeks, and as is evident in broad national surveys, the gay population is hardly any more understanding of the trans experience than the straight population. In some cases it's even less so, because issues of gender expression strike very close to home for many of them. Only roughly half of the gay population, male and female, feels it has anything in common with trans persons, and, remarkably, only a fourth to a third of the bisexual population. Only 2 percent of the LGB community is in a committed relationship with a trans person. Ironically, the protections that are available to trans and gender-nonconforming gay persons, under Title VII, are due to the increasingly expansive way the federal judiciary understands gender expression and sex stereotyping. It's those gay and lesbian folks who are better at assimilating and are not protected against discrimination under Title VII who seem the most uncomfortable with issues of gender expression. As they have described it to me, it far too often rekindles memories of childhood bullying.

For me the bottom line is that we need to come out, stay out and speak out. We need to do it for ourselves and future generations. We need to build on the scientific consensus and improvement in health are access and be willing to engage with those who are ignorant yet desirous of understanding. Freedom and equality are more than adequate frames for our movement, as has been evident in legislatures and, most importantly, the courts. When more of us are out, fewer people will reflexively imagine the worst, which is expected when the worst is all they know. It's incumbent upon those of us who can afford to do this work to change those impressions.

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