Embodiment and Erasure: Understanding Health Inequity for Queer and Trans Communities through a Queer Ecosocial Lens.

Transgender Healthcare Does Not Stop at the Doorstep of the Clinic

Introduction to “Queer Healing and Transformative Justice”: A Special Issue of <i>QED</i>

Unpacking Solidarities of the Oppressed:Notes on Trans Struggles in India Gee Imaan Semmalar (bio) Thirty-seven years after our black feminist sisters wrote the Combahee River Collective Statement, here I am, a Savarna, middle-class, undocumented trans man in India writing about the possibilities and impossibilities of certain solidarities. I draw strength from the resilient political courage of black sisters like Harriet Tubman and Miss Major, from anti-caste leaders like Jotirao and Savitribai Phule and Babasaheb Ambedkar. The questions raised by the Combahee River Collective Statement still resonate with the struggles of black and Dalit sisters, and they have been able to organize themselves through perseverance and stubborn determination, overcoming several attempts at exclusion and co-optation. As a trans man, I write about the structural exclusions, the institutional violence, the individual assaults on dignity and selfhood, the struggle for self-determination of gender of my community and what solidarity means to us. In the struggle against class, caste, race, gender, and heterosexist patriarchy, trans people, because of lack of resources and blatant exclusions in existing struggles, seem to be the least politically organized. The individual oppressions of trans persons, of course, vary according to particular positions of class, gender, race, and the geographical area that we occupy, but collectively, trans communities face exclusions of such enormous proportions that most of us find it reason enough to celebrate that we are alive. Trans communities in India are diverse and have local terms of reference that include hijra, thirunangai, kinnar, mangalamukhi, Aravani, kothi, jogappas, shiv shaktis, thirunambis, bhaiyya, and paiyyan. In India, trans women have historically organized themselves into gharanas (houses). [End Page 286] There are seven major gharanas spread across India that act as support systems for the hijra community. The guru-chela (mother-daughter) relationship in hijra communities is set up to provide mutual care. Young trans women who face intense familial and public violence in childhood leave their homes and live in hijra houses after choosing their gurus and being accepted by them as chelas. Our trans sisters have admirably organized themselves so they have their own internal legal system called Jamaats, where senior hijras play the role of judges and solve disputes between them. I will be unable to go into a long description of the hijra system for several reasons, among which is the complexity of the system, not easily explained, but more importantly, out of respect for the system as something that is internal to the trans community and that I see no reason to be made more legible to the outside world. It is only to contextualize trans politics and communities in India as radically different from those in the West that I felt the need for this short introduction. Trans women in India live, work, and occupy public space together. This is a strategy for survival arrived upon out of a deep understanding of public violence, discrimination, and vulnerability. Most trans people in India come from poor families (one of the reasons for this may be that trans people who are from economically well-off families might be concerned about inheritance issues and losing out on financial support if they were to assert their gender openly), or if they are not from poor families, they become economically, socially, and politically dispossessed as a result of their trans identity. Dalit trans activist and artist Living Smile Vidya talks about transphobia as a type of brahmanism, with the hijra becoming the untouchable subject. Because of transphobia, even hijras and trans men who come from well-off, Savarna families are unable to pursue their education or procure jobs. It is only in Dalit colonies that trans people are able to rent out houses. This might be the result not of an acceptance of our trans identity but rather of the economic necessity of the poorer house owner to rent out his or her house. The fact that there is more visibility of hijras in Dalit colonies has to a certain extent normalized their presence, though they are still ridiculed on an everyday basis. Heteropatriarchal boxes of acceptable gender categories are disrupted by our very presence. Unlike sexuality, which can be a private identity that...

Reexamining Gender and Sexual Orientation:Revisioning the Representation of Queer and Trans People in the 2005 Edition of Our Bodies, Ourselves Elizabeth Sarah Lindsey (bio) Big Platform Shoes to Fill When Heather Stephenson asked me to revamp what had been a four-page introduction on gender and sexual orientation into a full-length chapter in the 2005 edition of Our Bodies, Ourselves, I was flattered, elated, and absolutely terrified. OBOS is, as Heather lovingly refers to it, the bible on women's health of the late-twentieth century, and I am 24 years old, just two years out of college. I am also an anti-authoritarian African American high femme dyke from a working poor family. I do not fit what I and many others in my peer group see as the target audience for OBOS—white middle-class women who grew up reading this book, and their teenage daughters. Yet when Heather asked me to write this chapter, I tearfully accepted because I realized that OBOS was committed to expanding the breadth and depth of its audience by becoming more inclusive of young women, women of color, and trans and queer people. Challenging and Honoring the Past Before I began to work on my chapter, I decided to research the representation of queer and trans people in earlier editions of OBOS. In one of the first editions of the book published more than 30 years ago, the chapter on lesbians was titled "In Amerika They Call Us Dykes" (BWHBC 1973). There were a few major themes that ran through this section. First, the writers of the chapter self-disclosed that they were all middle-class white women. They wrote the chapter as a collective, and some were out of the closet while others were deeply burrowed within. Another interesting theme, one that I don't hear echoed among the young political queers that I know, was that deciding to embrace one's lesbianism was a decidedly political and feminist choice. Many of the writers in the chapter suggested that becoming queer was the next logical step in their politicization as feminists. Consequently, choosing to be a lesbian (or at least live and/or come out as one) was also equated with a conscious rejection of men and "male" values, such as oppression and patriarchal domination within interpersonal relationships. Also, anyone who was not gendered as a woman in this particular lesbian context—butches, transgendered people, and even femmes—was completely invisible from the discussion. In fact, gender expression and identity were hardly discussed in the chapter. [End Page 184] As I read through the chapter, my first impulse was to discount it as politically and socially backward, the words of lesbians whose lives could not possibly have any connection to my own struggles as a femme, a woman of color, a dyke who dates and loves butches and tranny boys and trans men, a woman who grew up working poor. However, as I began to write my chapter, my respect and appreciation for the authors of this chapter grew. These women lived in a world in which "coming out" was not something proudly flaunted on primetime television. To be themselves, they gave up their families, their careers, and their friends. They recognized that they came from privileged positions in society and did not hesitate to admit to their shortcomings. Moreover, women across the country tell me that this chapter saved their lives. While I do lead a different life in a different time, I realized that I share with these dyke pioneers the same desire to be heard. New Voices and New Themes for a New Generation Though my chapter is fairly short (about thirteen pages in the book), it includes introductions and definitions of topics such as gender identity, sexual orientation, bisexuality, coming out, queer and trans communities, and homophobia and transphobia. My hope, and the hope of the OBOS editors, is that people from a wide range of backgrounds and identities can pick up this chapter and walk away with a basic understanding of the difference between gender and sexual orientation, the idea that gender is not always determined by sex, and at least an overview of...

Public Health Finance

BackgroundResearch on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions.MethodsIn this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women’s health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects.ResultsThe different forms of violence—symbolic, structural and interpersonal—are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women.ConclusionPublic health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the ‘lived experiences’ of violence for women.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-015-0256-4) contains supplementary material, which is available to authorized users.

Notes from the Field: Planting, Nurturing, and Watching Things Grow

Transgender (trans) people in the United States experience staggering marginalization. To survive, trans people turn to their communities for support. In this study, I use in-depth interviews with 10 trans people living in “Townsville” to explore the social support trans and LGBTQ communities provide to trans members. What types of support are available? How does this support enable survival? How do differences in communities influence support? I found four types of support: emotional, institutional, bodily, and financial. The focus and composition of communities determined the types of support provided, and communities were divided based on gender and class. By concentrating on the contexts in which support occurs, my study adds to trans studies and sexualities scholarship concerned with how local trans and LGBTQ communities are experienced.

This article reflects on contestations that mark queer and trans community building in post- National Legal Services Authority (NALSA) and post-377 India. In the past decade, queer and trans communities in India have witnessed two landmark judgements: the NALSA v. Union of India judgement 2014 and the Navtej Singh Johar and Ors. v. Union of India judgement 2018. The former granted transgender persons legal recognition and a promise of civil and substantive rights. The latter read down the draconian Sec. 377 of the Indian Penal Code that criminalized consensual adult homosexual sex acts. In light of these two judgements, this article traces challenges faced by queer and trans communities and challenges to queer and trans community building in contemporary India by tracing recent developments in the contexts of health, public policy, jurisprudence, social institutions, education, popular culture, and the precarity of gender and sexually transgressive communities during the recent COVID-19 pandemic. Finally, the authors also trace narratives of hope that demonstrate how queer and trans people in post legal reform India continue to build enabling and affirmative communities in the face of an increasingly neoliberalizing country.

Aims: Mental health support for trans and non-binary people has been under scrutiny for many years. Trans and non-binary people often present to mental health services with co-morbid mental health difficulties. Medical practitioners often report a lack of training and understanding. GPs, psychiatrists and allied health professional frequently request more information to help educate and inform their practice and to support them in offering the best care for their patients and their families and carers.Methods: A small working group was set up by AWP (Avon and Wiltshire Partnership NHS Trust) and SARI (a Bristol-based charitable organisation Stand Against Racism &amp; Equality) with members of the trans and non-binary community in the South West of England. The group’s objectives were to develop novel training for staff and to produce some written guidance that reflected all the evidence-base. This guidance was identified as needing to be for education and guidance only rather than anything prescriptive. It also needed to be easy to read, accessible and available in different formats to reach a wide target audience.Results: The working group was led by the trans and non-binary community and, in collaboration with the AWP, SARI and other health professionals, staff training and a guidance booklet was produced.The training was aimed at providing health professionals with the knowledge and understanding to support gender diverse people that they may meet as patients, colleagues or friends. The training was unique in that it was the first training of its type to be written and delivered by trans and non-binary people. It has been a huge success and the feedback has been consistently outstanding.The written guidance includes a booklet as an education tool for all health professionals. It is for guidance and understanding only rather than anything prescriptive. This was co-written by health professionals and the trans/non-binary community. The guidance includes important information about how to support a trans or non-binary person, common questions and misconceptions, the latest information about trans health care, and the interface with mental health services. This is particularly important in the current political climate where trans and non-binary people are feeling that their health care needs are threatened and that they are feeling increasingly vulnerable. It is important for psychiatrists, GPs and other health professionals to feel confident in supporting gender diverse people who may present to them experiencing significant mental health difficulties. This guidance addresses all the aspects of mental health co-morbidity and how to equip clinicians with the knowledge and skills to provide genuine care.Conclusion: The training has been an enormous success and has attracted attention and positive feedback. Staff report that they now feel equipped with skills to support trans and non-binary people as patients, colleagues or in their personal lives. The fact that the training was delivered by trans and non-binary people has been described as unique and trail-blazing. Members of the trans community are also delighted to feel included and listened to.The guidance booklet: Supporting Trans and Non-Binary People – Best Practice Guidance for Health &amp; Wellbeing Practitioners was launched at various Pride events in the South West and shared with health professionals working in GP surgeries, mental health services and charitable organisations. The guidance itself has been praised widely reflected by a number of awards including AWP staff awards (winner) and the National Diversity Awards (finalist). The guidance has been cited as an essential education and guidance tool. It is updated regularly to reflect service changes and continues to be in high demand. This is something to be celebrated in this current climate where equality, diversity and inclusion remain central in how we support and look after our patients and each other.(Copies of the booklet will be available to take away or can be accessed via the QR code on the day).

Passing is a contentious issue within the trans community. Some trans people strive to pass as cisgender as an inherent goal or to reduce dysphoria, enhance safety, and potentially to facilitate acceptance. Others argue that trans people should not need to pass and that expectations to do so can cause harm to the trans community. This review aimed to systematically source and synthesize the existing qualitative literature that explores the costs and benefits of passing for trans people. Searches were conducted in PsycINFO, PsycEXTRA, ProQuest Psychology Database, Web of Science, Scopus, and EBSCO Psychology and Behavioral Sciences Collection to obtain articles in English. Studies that met the inclusion criteria presented qualitative data, were conducted with binary trans participants, referred directly to passing, and presented costs and/or benefits of passing for trans people. The search yielded 24 studies, and thematic analysis revealed nine costs and five benefits of passing for trans people. More costs than benefits were identified, but many of these costs were typically associated with not having adequate knowledge of, or access to, safe gender affirming techniques, or engaging in risky practices to pass. Passing was consistently identified as gender-affirming, and as reducing gender dysphoria and suicide risk, but also acknowledged as re-enforcing the gender binary and cisnormative expectations of gender. These findings have important implications for public healthcare and considerations for trans people and their support networks when considering medical interventions or other forms of gender affirmation.

Greater consideration of transgender communities within planning has been called for from research highlighting their absence in policy and practice. However, there is little work that outlines how trans is considered within current planning practice. This article presents an empirical case study of how trans becomes articulated into city-level policy and practice in Brighton &amp;amp; Hove, the “LGBTQ capital” of England. A poststructural approach is used to analyse how trans is problematized within planning documents and interviews with planning practitioners. We develop the concept of “choreographing” to reflect the constrained rhythms and selective positioning at work in the articulation of trans in and out of planning policy and practices. By tracing the only consideration of a specific identified need of the transgender population in Brighton &amp;amp; Hove planning policy, we evidence the previous siloing of these concerns that positioned them in relation to other municipal services, but not planning. We show how interpretive practices within a Health and Equalities Impact Assessment process do not allow the specific needs of trans people and communities to be considered, instead positioning trans people as having greater “sensitivity” to generic changes in the built environment. This research concludes that current planning practices can facilitate the consideration of trans communities in planning and policy-making, yet simultaneously constrain and inhibit the ability to enhance trans liveability in the city. This article opens up theorizing into how consideration of trans and LGBTQ communities and knowledge are integrated into planning processes and calls for a creative disruption of current practice.

Unboxed: Transgender in a Gay Museum? (January 18–March 1, 2019, Schwules Museum Berlin) was a small exhibition that showed about 150 archival objects in two rooms of the Schwules Museum (SMU) at the beginning of 2019. The objects displayed were created by, or contained information about, trans-identified people, and for the most part (except for one loan from the Lili Elbe Archive for Trans, Inter, and Queer History Berlin) were taken from the Schwules Museum's own collection. The aim of the exhibition was to encourage debate about the SMU's archival practice by posing several questions. Can an archive, as a place where meaning seems fixed and people come to seek out "truths," be challenged to accommodate new voices and perspectives? Can archivists reveal trans narratives without breaking up collections? And how do they deal with changing terminology? In an attempt to address these questions, the exhibition mapped a four-stage journey of archival objects at the SMU: their arrival in the archive, their documentation and classification, reflections on how they have been displayed in the past, and, finally, speculation about what might become of them in the future. An important feature was visitors' feedback, for which we provided preprinted slips and ample wall space. Visitors were encouraged to engage with the objects and offer their own interpretations (see fig. 1). Some feedback led to changes in the SMU's archival practice (Schwules Museum 2019). In the first part of this field report, we describe the planning and execution of the show. In the second part, we reflect on communities and finding aids and, more generally, how identity politics intersects with archival technology.When it was founded and began collecting in the mid-1980s, the SMU drew most of its material from the gay community of Berlin. As a community endeavor with limited resources, the museum collected "passively." It mostly accepted donations of whatever their public would offer and only occasionally sought out and purchased specific materials. As a result, trans-related materials were acquired in a haphazard fashion. This sets it apart from archives whose collection policies are expressly focused on documentation of transgender lives and the transgender movement (such as the Lili Elbe Archive). Larger bequests (such as the Charlotte von Mahlsdorf estate) are well cataloged, while other materials are poorly documented. This discrepancy became apparent when increasing numbers of requests began to be made by researchers interested in trans-related collections. The museum therefore began to take measures to make less well-documented materials more accessible.From autumn 2017 to summer 2018, Sebastian Felten worked as a volunteer in the archive. The SMU's archivists suggested a survey and consolidation of trans-related materials that they suspected were dispersed across different general collections (such as the postcard collection). This work was carried out between November 2017 and June 2018, with help from Niki Trauthwein of the Lili Elbe Archive. In the summer of 2018, the SMU suggested a show of some of their trans-related material. As a historian working on very different themes, Sebastian did not feel qualified to use the material as the basis for an exhibition about trans history. He and the museologist Rebecca Kahn developed the idea to focus instead on archival practice at the museum, not least to raise awareness of the museum's increasingly urgent need of resources for cataloging and digitization, especially for some of the trans-related collections.The original intention of the exhibition was to publicly examine the body of trans materials in the collection for possible silences, mislabeling, and invisibilities. We wanted to give the museum and its visitors an opportunity to think about the collection in ways that moved the focus away from identity politics and toward the role of archival practice in the development, description, and use of a complex collection like the SMU's. We chose specific objects to spark conversations primarily about the collection, not about the historical trans lives that they embodied. In this manner, Unboxed aimed to be an invitation to the public to engage in an ongoing process of surveying trans-related material in the collections of the SMU. At the same time, we intended to make visible the tensions faced by archivists when trying to rethink and revisit collections. The archival imperative to keep historical materials discoverable was positioned against the need to reflect on when terms may or may not be outdated, inaccurate, or cause harm. As curators, we tried to hold on to the fact that the objective of the exhibition was not to critique the work done by the volunteers, staff, and curators but to reveal these processes and highlight their complexities.From the outset, all parties agreed that it was imperative to involve representatives of the Berlin trans community in the planning of the exhibition. It was considered problematic that the project was conceived and developed by cis scholars at an institution that has, at times, been perceived as trans-exclusionary. Furthermore, it was unclear to what degree some of the materials were originally categorized using a cis gaze. To facilitate discussions around these themes, members of the museum's board established contact with Zoya, a community activist, who agreed to act as a consultant to the project. Zoya, Sebastian, and Rebecca met a number of times to discuss the aims and method of the exhibition as well as to jointly decide on which materials to include in the exhibition. Furthermore, Zoya commented on and critiqued Sebastian's and Rebecca's texts and authored one of the introductory texts that was on display.The exhibition consisted of several parts. An introductory wall explained how Unboxed came about and what its aims were. A first section named "Arrival" contrasted different ways in which the museum had acquired materials, which, at the time of their acquisition, were classified and cataloged as being trans or trans-related. As far as possible we tried to find the backstories to these collections, but this was not always possible, for reasons detailed in the next section. The self-identified gay transvestite Charlotte von Mahlsdorf had donated some of her material before her death. Another donor gave scrapbooks and copies of Transvestia magazine but wished to remain anonymous. Three albums from the 1970s containing photographs of unknown people engaging in cross-dressing, BDSM, and race play had been purchased from a deceased estate. The more than thirty private photo albums of trans-identified circus artiste Suleika Aldini were acquired after a process of lengthy and sometimes fraught meetings with archivists from the museum. Transsexual activist Nadja Schallenberg had donated her papers to a community center whose archive was later acquired by the SMU. The second section, "Boxed," displayed Sebastian's own ongoing archival work by showing materials that were being regrouped and relabeled. The third section, "On Show," focused on a number of important past exhibitions in which trans-related material had been on display: Homosexualität_en (2015), which one of the SMU founders described as "a milestone on our path from being a gay project to being a forum that is open for all facets of the LGBTIQ scene" (Theis 2015); Trans*_Homo (2012), which investigated what gay and lesbian could mean for trans people; and The Lightest Shade of Aflatoon (2017), which was the SMU's first exhibition to focus on the perspectives of queer refugees. The fourth section, "Transformations," speculated about possible future uses of the museum's collection by showing Dear Lou Sullivan, a video work by Los Angeles–based artist Rhys Ernst (2014) that drew on archival footage. We gave guided tours through the exhibition, accompanied by Nadja Schallenberg who talked about her experience and activist work as a transsexual lesbian in the German Democratic Republic and reunited Germany. During the exhibition, Schallenberg also showed a biographical film, MaPa (Strohfeldt 2008), and donated new material to the museum, one of which was showcased as "Object of the Month" (Schallenberg 1990).Rather than asking visitors for overall impressions, we wanted to elicit direct responses to specific objects and displays, and show these responses publicly, as a means of enabling visitors to talk back to and possibly inform current archival practice at the museum. We provided wall space and encouraged visitors to write on paper slips, which they stuck on the feedback walls or next to specific objects. The slips were printed with a series of questions to prompt feedback, such as "what do you see here?" or "what's missing?," and also included a space in which visitors had the option to indicate their gender identity. A sealed box for anonymous feedback was also included. We were pleased by the volume of the feedback and the level of engagement we read in the responses. One of the displays that elicited the most feedback was the selection from the Suleika Aldini collection, which had originally included her legal name. As a result of the feedback received (fig. 2), the museum took the decision to rename the collection.Looking back on our experience, we would like to raise three related points about communities, institutional memory, and archival technology. At some point in the exhibition planning discussions, the idea emerged that the museum did not have a lot of trans material to begin with, that the little material there was had been neglected, was poorly cataloged, if at all, and that this work had been done by cis people. This idea stuck, in part because it struck a nerve at an institution that was riven by two factions: the self-proclaimed "queer feminists" and (for lack of a better term) the "gay traditionalists." Discussions revolved around silencing (or not), collecting policy, and identity politics. This gave the exhibition a clearer goal of "doing the right thing" (a concern for the queer feminists) and an extra impetus for working closely with the collection as it was (a concern for the gay traditionalists).However, when we began to put the exhibition together, we were quickly disabused of our preconceptions. We found plenty of material, some of it beautifully cataloged, and some of it even cataloged by trans-identified people. For example, there was a sizeable amount of material from West Berlin drag theatres (Travestie). We knew of course that "drag is not trans" (as one of our feedback slips reminded us), but it turned out that these theatres offered some trans-identified folk space for self-expression and, more importantly, a livelihood. Work there was not always easy: Aldini reported being harassed during police raids, and transsexual performers tended to disappear from the scene after the West German Transsexuality Law (1980) enabled them to take up more "respectable" work. Another pocket of trans-related material was about Tunten (a German form of political drag), though we didn't understand the relevance of this material until after the show was set up. One long-term volunteer expressed their disappointment that Tunten had not been more prominent in our show as self-identified transgender people. This disappointment was poignant because this community had long been affiliated with the SMU but effectively silenced by our show. And, finally, we realized late in the production process that an important earlier exhibition, Trans*_Homo, had already done a lot of our conceptual legwork. In short, there had been vigorous involvement of trans people and trans agendas at this gay museum. At the same time, though, we regularly encountered the persistent opinion that the museum has been systematically excluding trans voices. When we called Schallenberg to ask for permission to show some of her papers, she said, "I'm glad the museum is finally telling this story. It was about time."We cannot resolve this tension, but we can offer two possible ways of explaining it. First, it became clear that our exhibition brought together not one trans community but rather many different ones. Each had its own trajectory and left different traces in the archive. Schallenberg's stories about the legal intricacies of leading a transsexual life under two German systems seemed several steps removed from Zoya's concerns about intersectional trans inclusivity. Aldini's experience as a Romani woman and drag artiste in West Berlin did not seem to intersect much with the international but clandestine network of white transvestites that were documented in the anonymous photo albums. And so forth. Only some trans communities have inscribed themselves in the archive, which means that we have to think in more precise terms about mechanisms of exclusion. The most glaring absence from the collection is material relating to transmen, who make scant appearances in newspaper clippings and are overshadowed (if this is the apt term) by gay transvestites and transwomen. As Zoya rightly pointed out, gay is not per se a trans-exclusionary term. It can be made to be so, but there are many trans folk who have, or have moved through, gay identities. How, then, do we explain the absence of (gay) transmasculinity?Second, we realized that the SMU's institutional memory worked in ways that we did not anticipate. We knew from earlier fieldwork that even in a well-funded, hyper-professional colossus like the British Museum, institutional memory could be difficult to maintain (Blagoev, Felten, and Kahn 2018). It turned out that in a community-run archive with few permanent staff and a high turnover of external curators and volunteers, it was even more difficult to make information available for curation and research. We learned about object provenance and past exhibitions in conversations held in the corridors, in phone calls with former staff, and by making visits to former curators. One artwork could not be located until we asked the right person. It would be standard practice to store all this information in a central objects record. Instead, the SMU stores it in paper folders, albums, Word documents, Excel spreadsheets, and people. It was fun and sociable to ferret out the information we needed, but sometimes it was a little frustrating, too. In retrospect, it is difficult for us to distinguish between physical absence of trans material and its momentary inaccessibility. Had we talked to the right person or chanced upon the right folder, we might have unearthed more material or richer stories. Since this applies to the entire collection, it would be difficult for us to see this as systematic exclusion or neglect of trans material in particular.We raise these points not to shame the SMU or its hard-working archivists (particularly archivist Kristine Schmidt, whose help was invaluable). Rather, we want to invite reflection on how the modus operandi that makes queer archives such vibrant places articulates with discussions about identity politics and community relations. Looking back, we suspect that misplacing was a bigger problem than misgendering. Queer archives and museums around the world have to respond to calls from previously underrepresented communities for inclusion. Our experience at the SMU suggests that one important focus of critique should be on the technical means that enable access to the collections, not only the collections themselves or how they are presented. Some organizations are doing this work and think hard about ways to make museum information systems (i.e., catalogs) more reflective of the communities they (now) represent (in particular, the work of the Digital Transgender Archive and the GLBT Historical Society were constant reference points for us). Digital record keeping, which logs acquisition and exhibition data, makes it easier to tell object biographies. An integrated catalog makes it easy to survey what objects are held in a collection and to adapt terms used to address them. We are pleased that the SMU is taking steps toward this goal. Historically gay, lesbian, or gay and lesbian community archives have much to talk about how they could be more welcoming places for previously excluded communities. But they also have to talk about ways to improve their information technology. The latter may be an easier conversation to have.The exhibition production team consisted of Rebecca Kahn and Sebastian Felten (curation), Zoya (post-hoc intervention and consultation), Anina Falasca (project management), Larissa Wunderlich (exhibition design), and Jörg Krüger (production).

Transgender and nonbinary people experience inequity in terms of treatment and outcomes when interacting with healthcare services. Clinicians should treat Trans people with sensitivity in a context of cultural safety to minimise repeat trauma and ensure the delivery of quality, person-centred care. The aim of this paper is to explore the general and specific needs of Transgender and nonbinary people when interacting with renal services and identify practice recommendations and further research needs. This paper reviews a selection of literature relating to the care of Trans people both generally within healthcare and with respect to specific issues that arise within renal care. Estimation of renal function relies on eGFR formulae that include a sex-signifier, so there are issues as to which are the appropriate versions of the formulae to use in Trans people. Research indicates that for Trans men (assigned female at birth) 6 months or more into transition-related hormonal therapy, equations used should be based on gender identity rather than sex assigned at birth. For Trans women and people who identify as nonbinary, the research is less clear and alternative means of assessing GFR may be needed. Complications of urogenital gender-affirming surgery can also have implications for acute and chronic kidney disease progression and for the management of such patients in the clinical environment. Trans people within the renal setting should be treated with sensitivity. Specific considerations are required in terms of assessing kidney function and considering the potential implications of urogenital surgery.

Background: This article is by a group of trans and nonbinary researchers and experts in the field of trans health who have conducted an analysis of trans health research needs. Aims: To highlight topics that need further research and to outline key considerations for those conducting research in our field. Methods: The first author conducted semi-structured interviews with all coauthors, and these were used to create a first draft of this manuscript. This draft was circulated to all authors, with edits made until consensus was reached among the authors. Results: More comprehensive long-term research that centers trans people’s experiences is needed on the risks and benefits of gender affirming hormones and surgeries. The trans health research field also needs to have a broader focus beyond medical transition or gender affirmation, including general health and routine healthcare; trans people’s lives without, before, and after medical gender affirmation; and sexuality, fertility, and reproductive healthcare needs. More research is also needed on social determinants of health, including ways to make healthcare settings and other environments safer and more supportive; social and legal gender recognition; the needs of trans people who are most marginalized; and the ways in which healing happens within trans communities. The second part of this article highlights key considerations for researchers, the foremost being acknowledging trans community expertise and centering trans community members’ input into research design and interpretation of findings, in advisory and/or researcher roles. Ethical considerations include maximizing benefits and minimizing harms (beneficence) and transparency and accountability to trans communities. Finally, we note the importance of conferences, grant funding, working with students, and multidisciplinary teams. Discussion: This article outlines topics and issues needing further consideration to make the field of trans health research more responsive to the needs of trans people. This work is limited by our authorship group being mostly White, all being Anglophone, and residing in the Global North.