Explore the vast range of titles available.

Examining trans- healthcare as a key site through which struggles for health and justice take shape Over the past two decades, medical and therapeutic approaches to transgender patients have changed radically, from treating a supposed pathology to offering gender-affirming care. Based on ethnographic fieldwork in New York City and Buenos Aires, Care without Pathology moves across the Americas to show how trans- health activists have taken on the project of depathologization. In New York, Christoph Hanssmann examines activist attempts to overturn bans on using public health dollars to fund trans- health care. In Argentina, he traces how trans- activists marshaled medical statistics and personal biographies to reveal state violence directed against trans- people and travestis. Hanssmann also demonstrates the importance of understanding transphobia in the broader context of gendered racism, ableism, and antipoverty, arguing for the rise of a thoroughly coalition-based mass mobilization. Care without Pathology highlights the distributive arguments activists made to access state funding for health care, combating state arguments that funding trans- health care is too specialized, too expensive, and too controversial. Hanssmann situates trans- health as a crucible within which sweeping changes are taking place-with potentially far-reaching effects on the economic and racial barriers to accessing care.

In the week that I was writing what I thought were the final lines of this book, I received a flurry of texts. “What did you think about the manifesto?” It was the fall of 2022, and a new version of the care standards for the international provision of transgender health had just come out. The organization that has published these guidelines for the past four decades was hosting its annual conference for health-care providers in Montreal. During the opening session, one white transgender woman, a surgeon named Marci Bowers, introduced another—pediatrician Rachel Levine, assistant secretary for health for

In Buenos Aires in 2015, I attended the opening of an art exhibit called Furia Travesti. Loosely translated, this activist rallying cry means “travesti rage” or “fury.” About a hundred people filled the Tierra Violeta community center in Buenos Aires where the show was held. Travesti artist Florencia Agustina Guimaraes García was showing photos from her collection—some of her own and others from her trove of vintage Polaroids and prints of travesti life in Buenos Aires over the past decades. As attendees milled about and gazed at Guimaraes’s images, she entered the space and walked toward a sound system

I spoke with Ana (interview, July 31, 2015), a travesti activist, at a downtown café in Buenos Aires. She had been part of the coalitional efforts to pass a comprehensive Gender Identity Law and was active in several other travesti struggles for access to health and employment. During our interview, she told me that she was fighting not just for depathologization but against criminalization and abbreviated life chances “and in favor of real economic, political, and social justice.”¹ Ana said that during her work on the Gender Identity Law, she found herself at odds with the mainstream, mostly gay- and

Clarissa, a newly practicing nurse practitioner in New York, described some of her various difficulties with medical charting as she cared for trans- patients. We sat in the kitchen of her first-floor apartment as she explained to me: There’s no template for a trans- person. … There’s not even a question, it’s just male/female. And all the providers, they’re like, just write it in the notes. Or in the problem list, is where it would go. (Interview, July 25, 2013) Why did this matter to her? As a new provider, she hoped to support trans- patients as they sought various

On a winter day in downtown Manhattan in 2013, the New York State Department of Health hosted a population-health summit called “Making New York the Healthiest State: Achieving the Triple Aim.” Presented by state health commissioner Nirav Shah, the event convened health-department workers, care providers, insurers, and other stakeholders to kick off New York State’s four-year “Prevention Agenda” (Department of Health, New York State 2013). Governor Cuomo had entered office two years before and had promptly introduced a statewide initiative to save costs and improve outcomes in New York’s Medicaid program. Commissioner Shah headed up this Medicaid Redesign Team (MRT)