Chapter 47 covers the topic of gender dysphoria. Through a case vignette with topical MCQs for consolidation of learning, readers are brought through the management of patients with gender dysphoria from first presentation to subsequent complications of the conditions and its treatment. Topics covered include diagnosis, differentials, course, co-morbidities, management with hormonal treatment, sex-reassignment surgery.

Readers have very credibly seen their most innovative concepts about gender reflected in James Joyce’s works. Joyce presented gender as it affects our attempts to live collectively and on shared terms, suggesting that gender flexibility is crucial to understanding human community, the polis, and thus the political. He explored gender as a physical experience, a socially intersectional construction, a performative speech act, and a phenomenological gesture while consistently challenging the stability of gender difference. Joyce’s famously ambiguous prose remains the creative strength of his oeuvre, which may put political and social wrongs to right by witnessing to a long history of gender-based violence, but equally may perpetuate old ideals in the service of strange comedy. His texts place responsibility on the reader to make meaning and justice in the world, while his words also provide readers with more fluid possibilities to counter the old inequities of the sex/gender system.

In this chapter we ask if people have rights to their social identities – in particular, their gender identities. We cash out what such gender identity rights entail by discussing the appropriate level of constitutional scrutiny to apply to laws that target transgender people.

This chapter offers an intersectional feminist reading of West Side Story that shows how women of color and the gender non-conforming character Anybodys are central to the (partial) redemptive arc of the musical. The narrative and characterizations—as expressed through songs, dances, and score—suggest a path to a better “Somewhere” that requires us to step outside the confines of normative masculinity and femininity which reinforce the boundaries of race and class. Throughout the musical, Anita and Maria must navigate the tensions within the concepts of assimilation and multiculturalism, as well as a social landscape dominated by an anxious and often violent masculinity. Careful attention to performances of these roles, and the character Anybodys, make clear that the belonging they (and we the audience) seek might be found somewhere beyond the reductive and destructive strictures of the gender binary.

Marriage equality was a significant achievement, one that yielded both practical and symbolic benefits for hundreds of thousands of queer households. At the same time, marriage equality is not the same as full equality. In the years since the Obergefell decision, LGBTQ rights advocates have continued to fight difficult and demoralizing battles against harmful laws and policies, which have increasingly targeted transgender rights. However, the movement’s past successes should offer hope for the future. The history of gay and lesbian rights advocacy reveals that small victories at the state and local level, brought about by working with nonlegal actors, can transform both the law and society. Although advocates have not yet achieved gay liberation’s visions of the future, they have attained meaningful reforms. The movement’s history thus offers a crucial reminder that the law can change society for the better.

This chapter meditates on how Black erotic bodies manifest in a white supremacist world. It contends that said bodies congeal through an amalgamation of fungible gender and material/discursive dispossession. These inheritances afford Black people the opportunity to conjure fugitive freedom practices, such as multiplicity, which enable Black people to harness erotic power in the pursuit of self-determined notions of pleasure and intimacy with themselves and within Black communities. To buttress my argument, I draw on the work of Akwaeke Emezi – namely, their debut novel Freshwater and an essay about their gender transition surgeries – and Audre Lorde’s classic essay, “The Uses of the Erotic: The Erotic as Power,” to illustrate how multiplicity is a freedom practiced undergirded by erotic power such that practitioners need not minimize or eliminate contradictory or complex aspects of themselves in order to access pleasure and intimacy along personal and interpersonal registers.

Eighteenth-century Paris was the site of multiple sexual cultures ranging from permissive to conservative. All these sexual cultures operated within a set of prescriptive legal, religious, and moralistic discourses that prohibited sex outside of marriage while often supporting sexual pleasure within it. Many Parisians ignored these prescriptions, often with impunity. The police concerned themselves with public sex and intervened in private affairs only when asked to do so. Paris was home to a diverse permissive sexual culture. It was comprised of a portion of the financial, social, political, and intellectual elite, often identified as libertines, for whom sex outside marriage was both widespread and widely accepted. It also included men who had sex with each other as part of Paris’s extensive sodomitical subculture, though there is little evidence of a modern homosexual identity. Prostitution was endemic in Paris, encompassing numerous forms of transactional sex that translated into a sort of hierarchy, with women kept as mistresses by men of the elite at the top and those catering to marginal men at the bottom. We know least about the sex lives of other ordinary people, though evidence suggests many had sex outside of marriage and many cared deeply for their spouses.

This chapter examines the origins and legacy of sexology – the scientific study of sexuality – in the modern world. First consolidated into a coherent programme in the late nineteenth century, sexology has its roots in the re-organization of knowledge about nature in the frameworks of taxonomy, evolutionism, and race. A pervasive preoccupation with heredity gave rise to powerful eugenics movements around the world. The interest in controlling variability and unlocking the secrets of the soul generated parallel developments in biomedicine, especially psychoanalysis and endocrinology. Sex experts worldwide converged in diagnosing cultural signs of homosexuality for the purpose of national modernization. As the centre of gravity in sexual science began to shift from Europe to North America, researchers gave growing support to the sex/gender distinction and redefined the meanings of normality. In the waning days of hereditarian theories, the rise of cultural anthropology coupled with a renewed scientific investment of colonial powers to reverse hierarchical templates of sexual practices and norms emanating from the metropoles. A public health crisis (HIV/AIDS), social movements (gender and sexual minority rights), and the systematization of research protocols (bioethics) shaped a comeback of biological sexology in the closing decades of the twentieth century.

This chapter explores the histories of transgender expression, identities, communities, and activism globally in both premodern and modern eras. Histories of settler colonialism, slavery, war, and imperialism have transformed the terms and conditions by which people of transgender expression and experience understood themselves and were perceived by others. While an abundance of archival records chart widespread practices of “transing” gender globally, a complex web of factors influenced how a given community or individual defined, understood, and judged such efforts. Race, religion, region, culture and class are some of the key contextual forces that gave meaning to trans and gender variant sexualities throughout history. A wide range of concepts have been used to describe and make meaning of gender variant people throughout history, from two-spirit, hijra, and third gender to the more recent transgender, nonbinary, gender expansive. Many other terms that have been used throughout history were deemed derogatory by those individuals and/or communities to which they refer at the time or have since been determined to be derogatory by later generations looking back. This creates a fundamental tension for everyone writing these histories between the importance of recognizing the past on its own terms and the importance of not further perpetuating harm against a long-stigmatized group.

Feminist ethics, the project of living with gender in all its varieties while also seeking to undo gender-related limitations, seems simultaneously retrograde, repetitive, and utterly necessary. This chapter seeks to make connections among several major feminist philosophers and transgender theorists, including Mary Wollstonecraft, Anna Julia Cooper, Simone de Beauvoir, whose work unfolds these interconnections and differences in ways that also work through the contradictions of wanting to recognize how diverse women are but also not wanting to remain within the complex and constitutive but insufficient cultural definitions of gender.