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Transgender people have a complicated history in U.S. law and policy. Once thought of as a symptom of homosexuality, gender nonconformity has long been the subject of social disapprobation and legal sanction, including criminalization. Beginning in the 1950s, an emergent interest by the medical community in individuals suffering from “gender dysphoria” precipitated an identity politics primarily organized around a goal of access to competent medical care and treatment for transsexual individuals. In ways both significant and ironic, this medicalization both promoted a binary ideology of gender, most obvious in concepts like male-to-female or female-to-male transsexualism, and created space for more transformative concepts of gender fluidity and transgender identity to emerge. Long conceptualized as a kind of subsidiary of the gay and lesbian rights movement in the United States, a status that entailed considerable turmoil, the transgender movement, especially since the 1990s, has emerged as a vocal and relatively effective rights lobby in its own right. The advent of the Trump administration presents a pivotal moment that will likely test not only the durability of recent policy gains but also whether those gains can be expanded in any significant measure.

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In the United States, increasing numbers of transgender people are coming forward and working to change legislation to better protect their lives and identities. These changes have come over a long period of time with the work of transgender people and allies. Societal acceptance and support for transgender people has evolved, first in the provision of medical resources allowing for physical changes, and later in legislation supporting and protecting people’s ability to publicly and legally express their gender. However, these changes have not been always been to benefit transgender people as others sought to control and limit people’s ability to express nonnormative genders. Policy changes occur in reaction to transgender people, but at the same time, transgender people have been working to allow themselves the freedom to express their genders freely. Major changes first began when scientists and medical professionals became interested in medical technologies such as hormones and its affects on people’s bodies. It was these discoveries that also interested people who felt dysphoric about their gender expression and saw these procedures as being able to reduce their pain and improve their lives. The movement to utilize surgical techniques soon followed. As more people sought these services, medical professionals developed guidelines to identify those who would benefit from the procedures and how to utilize these technologies safely to help people transition from one gender to another. As more people were able to transition, policies arose to prevent or limit people’s ability to express their identity, but transgender people and allies also organized to counter this movement and propose policies that are more supportive and protective for them.