Really came to like more awareness in the public with Christine Jorgensen like in the 1950's. She was a trans woman who was a GI and she had gone to Europe and had gender affirmation surgeries and came back and she was like this big media darling, like you know, she is in the press and like people were like super obsessed with her. And at that time then, you know, there weren't a lot of providers, like people weren't aware of like what it was like to be transgender but there was like one psychiatrist, was he a psychiatrist? Harry Benjamin. I think he was an endocrinologist. I'll look it up. Maybe? Yeah, I can't remember. Anyway, Harry Benjamin, he's called like the Father of Transgender Health. So he was the one doctor who was like providing services for transgender people. So he started getting flooded with all of these letters because like there was visibility, there was this person. Even though trans people had existed in all cultures and all time like way before that, but this is just sort of the medical piece of it. The medicalization of it. So when Harry Benjamin started seeing people, there were like a few other providers that started seeing people, and then kind of the emergence of the transgender health field occurred. And then the Harry Benjamin Association, which is now the World Professional Association for Transgender Health, you know, providers got together and they were like, oh, we should have some standards of care there should be some, you know, kind of agreement about like what is helpful to people. But so the initial versions of the standards of care really put a huge burden on the patient to sort of prove that they were trans and prove that they were sane. Like the burden of that proof of that is based in sort of the transphobic, transnegative assumption that if you were trans, there must be something wrong with you or that that was like a wild and crazy thing to do. And that it was very based on like gender binary assumptions, that like if you were male-assigned at birth and you were a trans woman, you identified as female, that you needed to embody like, you know, this very like stereotypical femininity and if you couldn't do that then you weren't really trans or that you weren't going to be successful. So there was a lot of like really painful trans negative assumptions underlying all of that. And over the years there's been a lot of challenges in that, from within the medical community and from trans community, and so the standards of care have shifted now, and so now the burden is more on the provider to be competent which is what we think is appropriate. And there's, you know, less of a gatekeeper model so like psychologists, therapists and medical providers sort of holding back interventions and sort of tritrating them out like as they saw fit and more of an informed consent model. So informing people about sort of the risks and benefits of different medical interventions and letting people make their own choices about that. And the ultimate shift that has happened is that, I think in the past, like I said there was this sort of gender binary assumption that you had to kind of, if you're a male sign at birth then you wanted to be female and it meant all of these things. If you're female, you were going to, if you were transitioning to a female that you would be attracted to men. So the heteronormativity that you would need to be straight. If you were female sign of birth and you wanted to be male that you would be attracted to women. And I think a really positive thing that's happened in the change is that there's been a lot of challenges to that and there's a shift in that. And so non-binary entities have been included. People can make different choices about like what kind of medical interventions fit for them or feel affirming for them or not. And we're at a really different place with that than we used to be.
