Transgender and Transsexual Identities: The Next Strange Fruit— Hate Crimes, Violence and Genocide Against the Global Trans Communities

Abstract

In this paper, we review the literature on global transgender hate crimes, violence, and abuse. We point out that it is possible to infer that this problem is not localized to the United States but rather, represents a global pandemic of focused prejudice. We point out that it can be viewed not only as an extremely serious and immediate public health problem, but also as genocide against a consistently invisibilized minority population. We provide concrete examples from the researchers' field studies as well as from the published literature.

Full text

Transgender and Transsexual Identities: The Next Strange Fruit—
Hate Crimes, Violence and Genocide Against the Global Trans-
Communities*
Jeremy D. Kidd, A.B.1
Tarynn M. Witten, Ph.D., M.S.W., F.G.S.A.2 3
ABSTRACT
In this paper, we review the literature on global transgender hate crimes, violence, and abuse. We point out
that it is possible to infer that this problem is not localized to the United States but rather, represents a global
pandemic of focused prejudice. We point out that it can be viewed not only as an extremely serious and
immediate public health problem, but also as genocide against a consistently invisibilized minority
population. We provide concrete examples from the researchers’ field studies as well as from the published
literature.
I. INTRODUCTION
A. Overview
1. Normative Understandings
Typically, “gender-based violence” or “gender violence” is understood to mean any form of
violence against women (WHO, 2007). However, the implicit definition of “woman” is based upon
reproductive (gonadal) genitalia and the social construction of personhood/identity via the binary
social edifice resulting from the gonadal status of the individual. Thus, it is rare for gender-based
violence research to include non-normative (i.e., non-Western) or non-traditional gender identities
(androgeny, agendered, gender-benders, gender-blending, etc.; see Witten & Eyler, 1999; 2007abc)
and their resultant sexualities, pair-bonding, or socioeconomic and demographic status.
It follows that little is known about violence against these communities. Moreover, what is known
is gathered either through anecdotal evidence or through a few (though growing number of) surveys
and indicates that the violence against these communities is significant, increasing, and constitutes a
serious public health problem in the U.S. (Witten & Eyler, 1997). Moreover, the treatment of the
transgender population, with respect to violence and abuse, could be viewed, under the Convention
on the Prevention and Punishment of the Crime of Genocide (1951, article 2, items a, b, & c), as
crimes of genocide against the transgender-community members in the U.S. and other countries.
We begin with a brief discussion of “hate” as it applies to this population, followed by a short
overview of the transgender-identified community.
II. DIFFERENTIATING ANTI-TRANS VIOLENCE FROM OTHER TYPES
OF VIOLENCE
Before we can truly understand what differentiates a hate crime from any other crime, we must first
understand what is meant by the term “hate” and how that understanding applies to the trans-
identified population. Academicians, politicians, activists, the media, and the general public do not
always use the word “hate” with uniformity (Perry, 2005, 2006). Recently, critics of hate crimes
* Journal of Hate Studies [Vol.6:31. June 2008] 31-63.
1 Jeremy D. Kidd, AB, Department of Gerontology, Virginia Commonwealth University Randolph Minor Access, 301
College Street PO Box 980228 Virginia Commonwealth University Richmond, VA 23298-0228 kiddj@vcu.edu.
2 Tarynn M. Witten, PhD, MSW, FGSA, School of Social Work, Virginia Commonwealth University, and Executive
Director, TranScience Research Institute. tmwitten@vcu.edu.
3 All correspondence and requests to this author at this address: Dr. Tarynn M. Witten, Center for the Study of Biological
Complexity, Suite 111, PO Box 842030, Trani Life Sciences Bldg, 1000 West Cary Street, Richmond, VA 23284-2030.

laws have adopted an emotive, individualized conception of “hate,” saying that to prosecute a hate
crime is to criminalize “thought” and “belief” (Rosebury, 2003, p. 37). This interpretation
misguidedly conflates the phrase “hate crime” with any crime “motivated by dislike of another
person.” Perry points out that hate crimes are not about emotive responses only, but also are about
power and asserting one’s own identity over the identity of another. She also demonstrates that
reducing a hate crime to an emotional dislike of another narrowly pathologizes the perpetrator as an
unstable individual acting out irrationally when, in reality, “racist or gendered violence, for
example, is not aberrant. It is not unusual or abnormal in cultures like ours, that is, in cultures which
are permeated by bigotry and prejudice” (p. 125).
In the song “Strange Fruit,” written by Lewis Allen and published in 1937, the writer expresses his
horror at the 1930 lynchings of two black men named Thomas Shipp and Abraham Smith. While
there are no “bodies swinging in the southern breeze” and we don’t see the “bulging eyes and the
twisted mouths” of the trans-community members murdered over time, the following examples of
violence against some community members, as well as those listed on the Remembering our Dead
website (2007), document the degree of similarity between these lynchings and modern day
violence against the transgender-identified community. In order to initiate our discussion, consider
the following examples of actual anti-transgender hate crimes:
—August 12, 2002: Two male-to-female transgender teens were shot ten times as they sat in the front seat of
their vehicle in a Washington, D.C. neighborhood. This was the third transgender shooting in Washington,
D.C. that week (Fahrenthold, 2002).
—October 4, 2002: A 15-year-old male-to-female transgender woman named Gwen Araujo was beaten, tied
up, and strangled by four men in Newark, California after her biological sex was revealed. Two of the
convicted perpetrators had sex with Araujo during the summer of 2002 (Locke, 2006).
—December 6, 2003: A female-to-male transgender man, Lucas McCauley, left a Largo, Florida night club
with William McHenry. Later, while at McCauley’s home, McHenry stabbed the transgender man to death.
Authorities did investigate this as a hate crime (Johnson, 2006).
—September 13, 2007: “A transgender person was thrown through a plate-glass window” in Washington,
D.C. (Schrank, 2007). No other information was found to have been reported in the mainstream local or
regional media.
—Summer 2005: Three transgender people were sexually assaulted at gunpoint in San Diego, California. The
Associated Press (2006) reports that prosecutors felt the perpetrator “preyed on people who were less likely to
report crimes and threatened to kill some.”
—October 29, 2006: After leaving a Washington, D.C. nightclub with a man, a transgender woman was
punched by her companion. The assailant also wrapped his belt around the victim’s neck and took her purse.
All of this occurred after he discovered the victim’s biological sex (The Washington Post, 2006).
One 50-year-old male-to-female postoperative transsexual reported (in Wave 1 of the TranScience
Longitudinal Aging Research Survey), “Every time I leave the house I leave with three strikes
against me. I can be raped for being a woman. I can be raped and murdered because I am perceived
as ‘gay’ (a drag queen) or I can be violently murdered because I am read as trans.” From these
examples (along with the upcoming examples) and the many other cases of anti-transgender hate
violence reported in the United States, two basic trends seem to emerge. These trends appear to
differentiate anti-transgender hate violence from other types of crime.
First, the motive behind each of these above crimes lies, first and foremost, in the transgender
identity of the victim coupled with the perpetrator’s sense of betrayal and disgust when the victim’s
natal genital sex is revealed. Consider the October 2006 crime cited above, in which perpetrators
took money or other belongings from their victims. Based on the Washington Post’s (2006) report
of the crime, theft was a secondary crime committed only after addressing the perpetrator’s feelings
of betrayal and disgust upon discovering that his female-identified companion was biologically
male.

Secondly, the goal of these attacks is not principally to harm or even to simply murder the victim.
Instead, the actions of many perpetrators in antitransgender hate crimes point to a desire to eradicate
the transgender-identified individual in order to alleviate the perpetrator’s disgust and to avenge the
sense of betrayal that precipitated the attack in the first place. Two pieces of evidence support this
conclusion. The first is the level of violence used in the murders and assaults of transgender victims,
the intensity of which is striking. Actual examples include throwing the victim through a window,
strangulation with a belt, and group-rape. These methods are to be seen as indicators of a desire to
deface and mutilate the bodies of transgender people because they challenge the normative world-
view of the perpetrator with respect to gender. While non-transgender identified individuals are
sometimes subjected to similar treatment, and while it is epidemiologically not possible to prove
that the trans rates are significantly higher than the non-trans rates, due to the general invisibility of
the transidentified population and the lack of reporting of transgender-related hate crimes (Witten,
2003, 2004; Witten & Eyler, 1997; Lombardi, Wilchins, Priesing, & Malouf, 2001), it is generally
understood within the trans-population that
transgendered individuals can enrage others by their mere existence.. . .The extent of this violence should not
be under-estimated. In my five years in Atlanta, there have been no fewer than 10 violent deaths of
transgendered persons reported in the press. Six of these were the apparent work of a serial killer (victims
were shot and dumped in various locations). . . The extent to which transgendered persons are devalued by
our society becomes apparent when one considers that the last time such a large number of persons were
serially murdered in Atlanta, the entire nation was in an uproar about the Atlanta child killings. (Denny, 2007,
para. 12)
Witten and Eyler (1997) point out that
Perpetrators often believe that a person who transgresses the norms of gendered sexuality, either by engaging
in sexual relationships with members of the “non-opposite” gender, or by behaving “as” the other gender, is
deviant or morally defective, and thus a deserving victim of violence and aggression. Xenophobic elements,
such as the persecution of transgenders [sic] by neo-Nazis, have also been reported, as has a preference by
assailants, in some cases, for attacking male-to-female transgenders [sic] or transsexuals who are members of
racial minorities. The degree to which these elements (gender, sexuality, and race/ethnicity) converge in the
decision by assailants to attack transgendered persons is presently unknown. (p. 3)
The second piece of evidence for this goal of annihilation is the visceral disgust described by many
perpetrators. Such a psychosomatic response is best exemplified by Jose Merel, convicted of
manslaughter in the killing of transgender teenager Gwen Araujo. Merel was reported to have
“vomited and wept when he discovered Araujo’s biological identity, slapping her and hitting her
with a glancing blow with a pan” (Locke, 2006). The desire to remove from society that group of
people which provokes such disgust is what appears to motivate perpetrators to carry out acts of
such uncharacteristic brutality. Sadly, it is not possible to interview most of the perpetrators of such
crimes, as the crimes are frequently not reported or, if reported, are not reported as transgender-
related crimes (Witten & Eyler, 1997; Witten, 2007b). Thus, we can only conjecture that a visceral
disgust is a principal component of the violence.
The high degree of perceived/actual violence and abuse against the trans-community suggests that
the hypothesis is not without grounds. For example, in Wave 1 of the TLARS survey, 66% of the
respondents indicated that they had suffered some form of abuse, mistreatment, and/or violence
perpetrated against them in social settings and of those, 70% indicated that they felt it was hate
crime-related. We will return to this discussion in a moment, broadening it to include other
examples of violence and abuse. However, in the next section, we provide a brief overview of the
variety of non-traditional (non-Western) identities that are included in the broad interpretation of
the transgender community as a whole.

III. OVERVIEW OF TRANSGENDER IDENTITIES
The traditional Western biomedical construction of identity routinely conflates sexuality, gender,
and birth body or “birth sex/reproductive sex” (Basu, 2000; Doyal, 2001; Greenberg, 1998; Grant,
2001; Pesquerra, 1999; Pryzgoda & Chrisler, 2000; Witten, 2004, 2005; Witten & Eyler, 1999). A
trivial example is the conflation of sex and gender on numerous medical forms worldwide that
routinely ask for “gender” when they obviously mean “birth sex/birth body” (Witten, 2005).
Furthermore, even if they ask for birth sex, they provide only the two choices of male and female,
thereby ignoring the existence of the world-wide intersex population (ISNA, 2007).
Transgender is a term used broadly “to describe people who transcend the conventional boundaries
of gender, irrespective of physical status or sexual orientation” (Feldman & Bockting, 2003). The
term is used to refer to groups such as transsexuals, cross-dressers, drag queens, drag kings, and
gender queers, as well as myriad other members of the “gender community” (a phrase found in
Kidd & Witten, 2007; Sims, 2007; Witten & Eyler, 1999; Witten & Eyler, 2007; Witten, 2003).
However, it is important to understand that these terms are dynamic in location, cultural
interpretation and context, in time, and in personal/political meaning, and therefore must always be
carefully applied. The construct of an essential gender, gender identity, or gender self-perception
becomes seemingly absurd when one considers the breadth and diversity of gender constructions in
this community. A normative, binary conceptualization of essentialized gender duality espouses that
each person falls neatly into either a male or female gender/sex category. Under this system, each
category also carries with it a set of innate rules that govern every facet of an individual’s life from
dress to mannerisms, from sexual orientation to social roles. Furthermore, this paradigm holds that
one’s gender is inherently immutable. There is no blending or overlap either between the male-
female categories themselves or among the various constituent socio-political roles associated with
each gendered/sexed identity. Such a system falls exceedingly short when attempting to categorize
the material existences of transgender and gender-variant people.
For example, how would one apply a binary gender system to a biologically XY-male individual
who identities as a gay but who performs fulltime as a drag queen and has undergone surgery to
acquire breasts and more feminine facial features? Like most binary systems, the rigid male-female
conceptualization of gender proves reductionist when applied to the more complex “gray areas” of
Western culture. Moreover, when one includes non-Western identities such as the Hijra of
India/Pakistan, the Fa’afafine and Fa’afatama of Tonga/Samoa, or the Mak Nyah of Malaysia, it is
easy to see that gender constructs span a broad variety of body form, sex, and sexual identities. A
larger discussion may be found in Witten (2007).
B. Estimating Population Sizes of Transgender-Identified Individuals:
Understanding Hate Crime Statistics in an Invisible Minority
In order to obtain accurate hate crime statistics concerning people who identify as transgender, it is
essential not only to be able to identify who those people are, but also to be able to count them
(Nolan, Akiyama & Berhanu, 2002). Because of the breadth of gender constructs and the stigma
associated with outwardly identifying as a member of the trans-community, the exact number of
transgender-identified individuals is difficult to estimate (Witten & Eyler, 1999; Witten, 2003). An
international survey administered by Witten and Eyler (1999) found that 8% of the TranScience
Longitudinal Aging Research Study (TLAR) survey respondents identified their gender identity as
something other than completely feminine or masculine. Based upon these estimates, Witten (2003)
projected a range of 4.1-12.3 million elder transgender-identified persons (65 years and older)
worldwide. Her work did not include the various cultural conceptualizations of the term
“transgender” discussed in Witten and Eyler (2007ab) and is therefore likely to underestimate the
actual size of the global elder transgender-identified population. Moreover, the overall transgender-
identified population, worldwide, may exceed 20 million when all cultural definitions are included.

C. Violence, Abuse and Hate Crimes
A hate crime is defined by Black’s Law Dictionary (Garner, 1999) as “a crime motivated by the
victim’s race, color, ethnicity, religion or national origin.” In recent decades, states such as
California, Connecticut, Hawaii, Minnesota, Missouri, New Mexico, Pennsylvania, Iowa, Oregon,
Vermont, and New Jersey have expanded hate crimes legislation to include gender identity, gender
expression, sex, disability, and/or sexual orientation (Transgender Law and Policy Institute, 2006;
National Center for Transgender Equality, 2007). In addition, the Local Law Enforcement Hate
Crimes Prevention Act of 2007 has cleared the U.S. House of Representatives and, if passed, would
add “gender identity,” and thereby transgender people, to the list of protected classes of people
protected by the federal hate crimes statute. However, the recent exclusion of the transgender
category from the federal Employment Nondiscrimination Act indicates that there are still
significant obstacles to federal inclusion of transgender identities.
D. Anti-Lesbian, Gay, & Bisexual Hate Crimes — A Bridge toAnalyzing Anti-Transgender Violence
Hate speech and hate violence are frequently experienced by members of the gay and lesbian
community. In an early study of 125 lesbians and gay men, nearly three-fourths (75%) of the study
respondents had experienced hate speech (D’Augelli, 1989). Another study (Comstock, 1989) found
that half of the lesbians and gay men surveyed had experienced physical violence. The frequency of
incidents among the study’s participants was also found to be higher for lesbians and gay men of
color as compared with white individuals.
Frequently, the overt actions and speech of perpetrators of anti-gay and anti-lesbian hate violence
resemble those of anti-transgender offenders (Witten & Eyler, 1999). This similarity is rooted in the
commonality of the two groups’ transgression of traditional gender norms, whether this takes the
form of sexual intimacy with a person of the “non-opposite” gender or whether one’s own gender
identity is considered non-normative under the binary gender system. Minter (2007) proposes that
this similarity is rooted in the perpetrators’ ignorance concerning transgender identities and
experiences. In addition, reporting rates of hate crimes against sexual and gender minority
individuals may differ from those regarding other types of hate crimes because LGBT victims must
essentially “come out” before reporting an anti-LGBT hate crime (Rubenstein, 2002, p. 72). Despite
these similarities, Witten and Eyler (1999) concluded, from both anecdotal and survey evidence,
that transgender people were simultaneously more likely to be victimized and less likely to have
access to consequent medical care and legal services.
E. Prevalence of Anti-Transgender Hate Crimes
Hate crimes, violence, and abuse are facts of life for a great number of transgender-identified
individuals. Witten and Eyler (1999) state that in a snowball sample of 213 transgender-identified
individuals from the TLAR survey (sample age range 20-85 years, m = 39.6 years, ´o = 11.1 years,
primarily Caucasian, middle-to-upper class, male-to-female transgenderidentified persons), there
was a high degree of perceived and actual violence and abuse suffered (91% of the respondents,
Table 1). Sadly, much of this abuse and violence is suffered prior to the age of eighteen years, and
is of both multiple category and multiple occurrence. Of the 86 respondents answering the question
on abuse before the age of 18, 60 of the respondents (69.76%) stated that they had suffered some
sort of violence or abuse (multiple choices of form of violence/abuse could be checked) prior to age
18. Furthermore, the top perpetrators of this violence/abuse were–in order of importance—the
father, another adult, a relative, the mother, or a peer.
Within the overall trans-community, there are many sub-populations. One of the least visible has
been the female-to-male transgender-identified individuals. Female-to-male (FTM) transgender
individuals typically respond well to hormonal treatment, masculinizing relatively quickly and
effectively. Other than typically being short in stature, they “pass” very well. However, this does
not protect them from the abuse and violence associated with being transgender-identified. In a
recent study by Kidd and Witten (2007) that investigated violence in the FTM population, 33

surveys were distributed to members of two FTM support groups in Virginia, of which 13 were
returned (a 39% response rate, mail survey). While this sample size is small and possibly non-
representative, it merits consideration for its possible heuristic value, being one of the first studies
of its kind to investigate specifically the experiences of FTMs with regard to hate violence.
Nine of the thirteen respondents (69.23%) reported some form of social mistreatment, ranging from
verbal abuse to sexual violence (including rape) to physical violence (multiple choices of form of
violence/abuse could be checked). Collectively, these nine respondents reported experiencing at
least 439 violent incidents (Table 2). The phrase “at least” is used because some of the respondents
gave ranges as to the number of times they experienced a particular type of mistreatment. The
number 439 represents the total frequency of violent incidents using the lower number of the ranges
provided by respondents. Respondents were given 11 categories of violence from which to choose,
including the categories of verbal abuse, following, stalking, individual and gang mugging,
threatening, beating, sexual harassment, sexual abuse, attempted rape, and rape. All eleven of these
categories were represented in the incidents collectively reported by the respondents. Consider the
following quotations from both the TLAR and the FTM survey (spelling and grammar preserved as
written):
—When I was about 14, a boy (stranger) asked me if I were a boy or a girl. When I didn’t answer, he
threatened to shove his hand in my pants, “to see if there is a hole there.” I punched him and ran.
—Once arrested and had police physically assault, sexual abuse (inappropriate touching, removing my
clothing infront of other inmates) and repeatedly threaten to rape me, due to my ambiguous gender
presentation.
—The abuse was exploitation by a brother. I was defrauded of money (approx. $2000) and though I would
not have taken action to recover it, he assured my silence by threatening to present a letter to my employer
and “outing” me. I would call it extortion. It was several yrs ago. Not reported to authorities. Family members
voiced their disapproval.
—Stabbed in eighth grade by schoolmate mugged by a group in 1973. While crossdressed verbally abused
1995, 1990.
Other researchers have corroborated what these two studies show. Lombardi, Wilchins, Priesing,
and Malouf (2001) reported overall transgender violence rates where 59.5% of the sample
experienced either violence or harassment (26.6% experienced a violent incident, 14% reported rape
or attempted rape, 19.4% reported assault without a weapon, 17.4% reported having items thrown at
them, and 10.2% reported assault with a weapon) and 37.1% reported some form of economic
discrimination. The National Coalition of Anti-Violence Programs (2005) found that 10% of the
crimes tracked by the organization in 2004 had transgender victims. While this number represents a
3% decline from the 2003 report, the researchers noted that the decline may actually be a result of
many transgender people attempting to remain undetected (go stealth) rather than of an actual
decrease in anti-transgender attitudes. This conclusion is not surprising, given the perceptions and
experiences illustrated in the following cross-sectional sample of quotations from both the
longitudinal TLAR survey and from this FTM survey (grammar and spelling retained as written):
—I live in the worst neighborhood in Vancouver the only way I will ever be safe is to get off welfare and
move away from the East Side. I have been a target all my life and don’t know how to avoid or deflect the
unreasoning hatred that permeates all levels of society.
—Mugged in NYC by a gang of black people who took all my cash. Brutally sexually mutilated in what the
police said was a “drug related” hit on the wrong person. Police didn’t consider it serious enough to follow
up on even though my penis was bisected several centimeters with a knife or razorblade. Numerous assaults
while growing up.
—Was sexually harassed at work place, employer and employees found out that I was a transsexual, and co-
workers tried to find out if I was really a man or woman by grabbing at my chest and hair and other body
parts.

The organization Gender Education and Advocacy (2005) reports another sobering statistic: “Over
the last decade, more than one person per month has died due to transgender-based hate or
prejudice, regardless of any other factors in their lives” (About the Day of Remembrance, para. 3).
F. Statistics on the Characteristics of Anti-Transgender Hate Violence
While each person’s experience of anti-transgender hate violence is unique, research has provided
insight into similarities among and predictors of these violent acts. Four primary themes emerged
after a review of the literature.
The first theme that became apparent was that the majority of antitransgender hate crimes studied
took place in social settings. According to the findings of the TLAR, such acts take place in the
workplace, on the street, in bars, or in any other public, interpersonal scene. Religious institutions,
educational settings, other public environments, organizations, and institutions were also included
as options in this section. When asked whether the respondents had had any acts of mistreatment,
abuse, or vio lence perpetrated against them in social settings, survey participants responded as
follows: Yes (n = 89; 66%), No (n = 42; 31%), and Not Applicable (n = 4; 3%; total n = 135).
Consider the following statements from the FTM survey (grammar and spelling retained as written):
Police verbal: paraded around police station for amusement - “This guy is really a woman.” Police also
informed my employer of my transsexualism. I had been stopped and asked for ID - There had been no crime
nor suspicion of crime, just a request for I.D. I had a female drivers license, so I was taken into custody for
proof of identity. Released without charges.
Verbally: told directly and through others that I should be killed (murdered).
Beaten/Hit: Once during physical endurance (job) training an instructor was disgusted with me for working
out with the men and punched me in the face.

The second theme emerged in a report by Lombardi et al. (2001), who concluded that
socioeconomic status was among the best predictors of a transgender person’s experiencing
violence. Among the factors noted as contributing to this trend were homelessness as a result of
parental disapproval of the youth’s gender identity and the resultant survival crimes such as sex
work which may be undertaken, along with all of the associated health and personal risks (Denny,
2007; Lombardi et al., 2001; Witten & Eyler, 1999).
The third theme to emerge was the lifelong occurrence of hate violence in the biographies of many
transgender individuals (Witten & Eyler, 1999; Witten, 2004). Because transgender people often
exhibit non-normative gender behavior in childhood, many are victimized by parents, relatives, and
others (see previous discussion of abuse and violence before the age of 18). On the other end of the
spectrum, elderly transgender people were also noted as victims of abuse and/or violence as their
access to medical and mental health services is often reduced because of their transgender status
(Bradley, 1996; Cahill, South, & Spade, 2000; Cooke-Daniels, 1995; Witten, 2002, 2003, 2004,
2005ab; Witten & Whittle, 2004). Consider the following examples drawn from the work of Witten
& Whittle (2004) and discussed more extensively therein:
Case 1: UK — James, a trans-man of 71 who had undergone chest reconstruction but not genital surgery, was
in the stages of early Alzheimer’s. He was placed within a local authority care home where every other client
was female. The staff at the care home was very uncomfortable with meeting his bodily needs and was very
unhappy with his constant removal of his incontinence pads. They had also taken to not passing on his post
which included a support group magazine, deciding that he was not able to read and understand it. A local
volunteer visitor contacted a support group after discovering James very distressed.
Case 2: US — laughed at by emergency staff — treated unnecessarily roughly and ignored during
hospitalization. (63-year-old Male-to-Female trans-person)
The fourth theme was the level of underreporting that accompanied victimization of transgender
people. Respondents of the TLAR survey were asked to identify whether they had ever told another
individual about the violence, abuse, or mistreatment that they had experienced and to whom these
events had been reported. Of the n = 121 participants who answered this question, n = 93 (77%)
indicated that they had told others of their abuse experiences, and n = 28 (23%) stated that they had

not. With respect to reasons for non-reporting (total n = 132; multiple responses permitted), n =28
(21%) indicated that they were afraid to report for fear of reprisal by the perpetrator, n = 14 (11%)
feared abuse by the medical/legal system, n = 5(4%) were unable to report, n = 38 (29%) felt that it
would not make a difference if they had reported the incident or incidents, n = 10 (8%) wanted to
protect the perpetrator, and n = 22 (17%) indicated that there had been reasons other than those
listed.
The FTM survey of Kidd and Witten (2007) further confirmed this underreporting. Of the nine
FTM respondents (69.23%) who reported social mistreatment of some sort, nearly all (8 of 9,
88.89%) said their experiences matched the following operational definition of a hate crime given
to them in the survey: “abuse, harassment based on bigotry or bias with respect to one’s actual or
perceived race, religion, ethnicity, disability, sexual orientation or gender identity or expression.
This can take a physical, verbal, emotional, or sexual form.” Nonetheless, not one of the 9
victimized respondents reported their collectively 439 violent victimizations to law enforcement.
These statistics illustrate the existence of a description or perception incongruence among
respondents with regard to violent incidents.
Despite being able to provide very graphic descriptions of highly traumatic events, none of the
respondents felt their victimization warranted reporting. Some respondents also indicated that these
incidents, which appear very serious, were in fact nearly inconsequential, and therefore did not
merit reporting. Table [3] lists the reasons given by the FTM survey respondents for not reporting
the hate violence they experienced. Fear of reprisal and fear of abuse from the police and legal
systems were frequently mentioned in both the TLAR and the FTM survey comments:
—Arrested a few yrs ago for possession of cocaine—I was verbally harassed by police (“you mean you have
a pussy and not a dick?”) and forced to pull my pants down in front of 4-5 cops to prove my gender status. 4
yrs ago at a demonstration cops began beating on me with clubs.
—[re a lawyer] He took my $600 and failed to take any action on my behalf.

Rubenstein (2002) also highlights the underreporting of anti-LGBT hate crimes. He points out that,
unlike victims of hate crimes based on race or sex, LGBT victims must essentially “come out” to
law enforcement in order to report victimization. This public openness with regard to one’s
transgression of heternormative, binary sexual and gender norms can itself carry risks and actually
increase the likelihood of future hate crime victimization (Kidd & Witten, 2007; Witten & Eyler,
1999).
IV. GLOBAL ANALYSIS OF ANTI-TRANS VIOLENCE
Transgender violence is not just an epidemic confined to the United States. It is, in fact, a pandemic
which spans the globe, cutting across continents, cultures, and languages. The following are a few
examples of the extent to which hate violence affects the lives of transgender-identified people
around the world. A report on the plight of transgender people in Argentina summarized by the
Valente (2006) identified 420 transgender deaths in the Buenos Aires metropolitan region “in recent
years.” Of these 420, “62 percent of the total died of AIDS, 17% were murdered, and the rest either
committed suicide or died in car accidents, of drug overdoses, as a result of medical malpractice
during plastic surgery or other procedures to change their physical appearance, or of cirrhosis of the
liver, cancer, and other diseases.” The report also notes that 70% of these deaths occurred between
the ages of 22 and 41, much younger than the country’s overall healthy life expectancy of 66.7
years (The World Health Organization, 2000). The tremendous scope of anti-transgender violence
and discrimination in Argentina is corroborated by a similar study conducted by the International
Gay and Lesbian Human Rights Commission (2005).
According to an article by the Indo-Asian News Service (2007), activists in Chennai, Tamil Nadu,
India are also working to raise awareness about violence against the Aravani community, a category
denoting people of a third sex in the Indian state. In this article, the non-governmental organization
Tamil Nadu AIDS Initiative (TAI) describes the case of Aahilya and Nathan. The two Aravanis
were beaten and abused by a shopkeeper when they attempted to buy “trinkets and asked for a 50
paisa [regional currency] concession.” TAI has also started a fund to assist Aravani victims of
violence. So far, the organization has enrolled 10,000 Aravani victims.
Another example of the global scope of anti-transgender hate violence is the Nepalese “sexual
cleansing” reported by the New York-based organization Human Rights Watch (HRW) (2006). In
Nepal, transgender people are commonly referred to as metis. This word specifically refers to
individuals who are biologically male but who present a more feminine gender expression. HRW
reports that Nepalese police are involved in a systematic campaign to target and arrest metis. On
March 14, 2006, 26 metis were arrested, detained, and denied legal counsel. In the end, they were
charged with “public nuisance.” The report also details a 2004 incident in which police “rounded
up” 39 metis and arrested them. Several of these individuals told reporters stories of the abuse they
endured during their two-week detention. Many of the metis arrested during this campaign were
also HIV prevention outreach workers. In light of this, the HRW report warns, “By jailing outreach
workers campaigning against the spread of HIV/AIDS, the police threaten public health as well as
civil liberties.”
Organized campaigns of violence against transgender people are not confined to Nepal; in fact, they
are present even in countries commonly athought of as socially progressive on issues of gender
identity. In Liverpool, England, a 51-year-old transgender woman named Penelope Bassi was
attacked on numerous occasions. In addition to these attacks, her home windows were smashed with
bricks and her car was set on fire. “She was hit, laughed at and ridiculed–not only by her neighbours
and their children, but also by police officers whose job it was to protect her” (Mansey, 2006, p. 5).
Fortunately, this violence did not escalate to murder. Instead, the victim was able to forge a
relationship with the police authority to assist in developing new guidelines for officers responding
to anti-transgender hate crimes. Similar reports have been made by members of military
organizations, worldwide, who have come out as trans-identified after or during their military
service; many of these individuals are decorated war heroes (Witten, 2007c).

These case studies, as well as numerous others not reported here, illustrate the global pandemic of
anti-transgender violence. This widely prevalent hate violence, as pointed out by Human Rights
Watch, not only threatens the safety of transgender people, but also detrimentally affects the greater
pursuit of universal civil liberties, public health, and democratic governance. Denny (2007)
summarizes the challenge well:
Violence against transgendered persons is not an Atlanta problem, however, or even a national problem; it is
an international one. Death squads in South American countries have executed transsexual persons and
crossdressers in larger numbers, and police in other countries (especially in the Middle East) harass, torture,
and murder transgendered persons with little fear of reprisal. (para. 14)
G. Violence, Abuse, and the Healthcare System
The institution of healthcare is not immune from participation in transgender abuse and violence. In
fact, as the Gay and Lesbian Medical Association (2000) clearly points out, the federal government
routinely invisibilizes the LGBT population and in doing so silently sanctions anti-LGBT behaviors
(Belongia & Witten, 2006). This neglect is also evident in the recent failure to include transgender
identities in the federal ENDA bill.
Many transgender-identified individuals have experienced various forms of both subtle and overt
abuse and violence at the hands of healthcare workers. TLAR respondents indicated that 5.2% were
placed in a psychiatric hospital (n=210), 15.7% were forced to see a counselor or therapist who tried
to change them (n=210), and 2.4% (n=210) were forced to have surgery (intersex identification,
Greenberg, 1998; ISNA, 2007). Consider the following comment from “B” (an FTM-identified
respondent in the TLAR study):
It is always important to realize that, within the trans-population, different sub-populations will have different
healthcare related problems. For example, female-to-male transsexuals who have had mastectomy will always
have the problem of secrecy . . . Either his chest scars are obvious, or his genitals give him away. Thus,
accessing normatively sexed and gendered healthcare services is nearly impossible. Add to this the difficulty
of FTMs who have taken only hormones but could not afford or do not want surgeries. Billy Tipton comes to
mind as one who never accessed healthcare in his lifetime and probably died prematurely because of it. There
are scads of FTMs who suffer in isolation because they refuse to subject themselves to medical scrutiny,
possible mistreatment and ridicule. Also, there is Robert Eades who recently died of medical neglect, after
seeking help from at least 20 doctors who refused to treat him for ovarian cancer.
Consider the following example from the TLAR (grammar and punctuation retained as written):
When I lived as a woman and was out as gay I’ve been spat on, hit raped, fired, evicted from house and
refused treatment for healthcare.
Among the most famous healthcare abuse stories is that of Tyra Hunter, a Washington, D.C. hit-
and-run victim, who was allowed to bleed to death by an EMT team when they discovered that she
was a pre-operative male-tofemale transsexual. The EMT team argued that they thought she was
gay and had AIDS (Fernandez, 1998).
Belongia and Witten (2006) also report the invisibilization of transgender elders in eldercare
facilities (see also Shankle, Maxwell, Katzman, & Landers, 2003; Watt, 2001; Witten, 2002, 2003;
Witten, Eyler & Weigel, 2000). In a study of 29 regional eldercare facilities, 80% of the facilities
contacted stated that participation in a one-hour lunchtime training in transgender eldercare was not
relevant to their patient population and/or staff.
Again, it is important to understand that violence and abuse against transgender persons and against
elderly transgender persons is not just a U.S. problem. Rather, it is a worldwide problem (Witten &
Whittle, 2004).

H. Possible Roots of Anti-Transgender Violence and Hate
Upon surveying the available literature, and considering the data from the qualitative and
quantitative parts of multiple surveys, five possible causes of anti-transgender violence began to
emerge.
The first emerging cause is the ignorance of the general public about transgender identities (Denny,
2007; Minter, 2007). Minter points out that many perpetrators of anti-transgender hate violence in
the Los Angeles area used homophobic language (e.g., fag, dyke, faggot, cocksucker) during violent
incidents. “It is possible that perpetrators knew that these victims were not exhibiting ‘proper’
gender normative behaviors, but had no words other than homosexual slurs to express themselves”
(Witten and Eyler, 1997).
Television shows such as The Maury Povich Show seek to perpetrate and to make use of this
homophobic and “freak” perception by bringing on transgender-identified individuals that are not
representative of the population and allowing audiences to heckle and make fun of them in front of
international audiences. Transgendered victims appeared to have been targeted because of their
gender differences, but the perpetrators were not necessarily able to label their actions anti-
transgender as they themselves did not possess the vocabulary and knowledge to do so. This, of
course, complicates the perceived mutual exclusivity of the categories “gender identity” and “sexual
orientation” in many hate crimes statutes.
Linked to the first idea, the second emerging theme of causality is the problem of institutionalized
bias and terminology conflation with respect to gender and sex (Basu, 2000; Doyal, 2001; Gannon,
Luchetta, Rhodes, Pardee, & Segrist, 1992; Grant, 2001; Pryzgoda & Chrisler, 2000; Velkoff &
Kinsella, 1998; Witten, 2003, 2005a, 2007), which can be demonstrated early on in healthcare
students. Witten (2004) describes a recent study in which over 2000 anonymous response surveys
were sent out to all of the students in the five colleges (Medicine, Nursing, Dentistry, Allied Health
Professions, and Biomedical Sciences) of a major southwestern university medical center (IRB
approved). Respondents were asked, among other questions, to rate their perception of their gender
using the Eyler-Wright gender continuum measurement instrument (Eyler & Wright, 1997).
Qualitative comments were also collected. Of the 271 individuals who responded, approximately
10% of them expressed vehement emotions concerning the concepts of gender and sexuality
(Witten, 2007c). A 22-yearold, self-identified biological male medical student wrote:
Biology teaches us that men are XY and women are XX. There are no other possibilities, anything else is
sick! It is important to understand that this type of reaction is frequently the normative response
experienced by members of the transgender-identified communities (Witten, 2004; Witten & Eyler,
1999).
Third, we have already established that transgender-identified persons frequently suffer a spectrum
of abuse and violence (Witten, 2004). Further, we have seen how these individuals are further
marginalized by the healthcare system as they age (Yagoda, 2005; Willging, Salvador & Kano,
2006ab; Witten, 2007b). However, these effects can be further exacerbated and confounded by
additional life factors. An excellent overview of some of the relevant issues can be found in Cahill,
South, and Spade (2000).
Fourth, hate crimes serve the function of preserving and reinforcing the gender binary system.
Contemporary Western society reifies malefemale gendered duality through popular culture, the
media, employment practices, and fashion, as well as in many other ways. Hate violence punishes
those individuals who transcend and/or subvert this binary because they are then “othered,” and
thereby considered inferior to their normatively gendered counterparts. It is particularly important
to note that violence against transgender people strengthens adherence to this false gender
dichotomy in the general population as well as within the transgender community (Herek et al.,
2002). This effect is further contextualized later in this article.

The fifth factor behind anti-transgender violence is proposed by Minter (2007). Minter concludes
that transgender people are targeted not only for their violation of the social norm of gender
dualism, but because they are stereotypically perceived as easy targets, much in same way elderly
people may be singled out for muggings or home invasions. For hate crimes advocates, this
conclusion may appear to add legal complexity when attempting to create hate crimes policy.
However, Minter’s analysis is somewhat superficial, as the targeting of transgender people because
of perceived weakness still represents a stereotyped powerlessness of the group as a minority
category. Therefore, this hypothetical motivation for victimization continues to fit within the
framework of a “hate crime”: an assertion of one person’s identity (i.e., powerful gender-normative
person) over another (i.e., weaker transgender person) because the perpetrator views the victim’s
identity as inferior.
I. Consequences of Anti-Transgender Hate Violence
A hate crime against a transgender (LGBT) person has both short-term and long-term psychological
effects for the victim(s), as well as for society as a whole. The fear and trauma engendered by a hate
crime can impede an individual’s ability to carry out normal day-to-day activities (Bradford, Ryan,
& Rothblum, 1994). Moreover, it can have longer-term, later-life effects (Witten, 2004).
Furthermore, hate crimes also have far-reaching implications for all LGBT as well as heterosexual
people as a form of “terrorism” (Herek et al., 2002). Studies have shown that anti-gay and lesbian
hate crimes reinforce adherence to normative gender behaviors (Witten & Eyler, 1999) in people
across the sexual orientation and gender identity spectra because of fear of being perceived as gay
or lesbian (i.e., non-gender normative). According to Herek (1989), “men might not touch other
men; women might not excel at tasks that require physical exertion.” Thus, hate violence is able to
affect groups of people far beyond the individual(s) initially targeted by the perpetrators. Witten and
Eyler (1999) further point out that hate crimes and hate violence are public health problems that
need significant international attention. In-depth implications of this multiple violence and abuse for
health services practice are discussed in both Witten and Eyler (1999) and Witten (2004, 2007b).
These violence and abuse results are supported by the work of Lombardi et al. (2001) and the
Washington Transgender Needs Assessment Survey (Xavier & Simmons, 2001). Data is illustrated
in Table [4]. We close with a discussion of transgender hate crimes within the construct of
societal/institutional genocide.
V. TRANSGENDER HATE CRIMES AS GENOCIDE
As mentioned earlier, the treatment of the transgender population with respect to violence and
abuse, both in the U.S. and globally, should be viewed through the lens of the United Nations
Convention on the Prevention and Punishment of the Crime of Genocide (1951), specifically Article

2, Sections A-C. Article 2, in its entirety, explains:
Article 2
In the present Convention, genocide means any of the following acts committed with intent to destroy, in
whole or in part, a national, ethnical, racial or religious group, as such:
• (a) Killing members of the group;
• (b) Causing serious bodily or mental harm to members of the group;
• (c) Deliberately inflicting on the group conditions of life calculated to bring about its physical destruction in
whole or in part;
• (d) Imposing measures intended to prevent births within the group;
• (e) Forcibly transferring children of the group to another group
While the United Nations resolution does not specifically include groups of people defined by either
sexual orientation or gender identity, the hypothetical inclusion of these two terms would have
profound implications for a conceptualization of anti-transgender violence as genocide under
Article 2.
It should be noted that any one of the actions specified in Article 2, alone or in combination with
other items in the list, is considered sufficient for classifying a situation as “genocide.” Upon
inspection, the material existences of transgender people as described throughout this article bear
tremendous resemblance to the acts outlined in the Genocide Convention. (More evidence of this
can be found in the reference section at the end of this article.) For instance, it has been
demonstrated that transgender people are being targeted for violence and murder based solely on
their transgression of traditional gender norms.
This is exemplified most profoundly in the aforementioned state-sponsored “sexual cleansing” of
transgender metis taking place in Nepal (Human Rights Watch, 2006). Additionally, this article has
sought to demonstrate that even in the U.S., acts of anti-transgender violence are not isolated
incidents of random violence, but instead share the common impetus of the perpetrators’ desiring to
eradicate a group of people who violate a widely held and popularly reinforced norm of binary
gender with a connection to heteronormative sexuality. The net effect of these crimes is to evoke a
sense of fear that percolates throughout the transgender community, encouraging transgender
people to renounce open expressions of their gender identity lest they face similar violence.
Additionally, it is posited that the common motive of eradication/annihilation is also transmitted
socio-culturally to other potential perpetrators through media and film representations of anti-
transgender violence, which potentiates the fear of victimization described by transgender people,
including those quoted in this article. In summation, this “killing” and “serious bodily or mental
harm” certainly satisfies the conditions set forth in Article 2, Sections A and B of the Genocide
Convention.
As if this were not enough to classify anti-transgender violence as genocide, it has also been
presented that transgender people are targeted for employment, housing, and healthcare
discrimination. In addition, transgender people experience severe violence and abuse across social
institutions such as the legal system, the penal system, and the military. This constellation of
systemic oppressions makes it nearly impossible for transgender people to attain basic life
necessities while asserting a transgender gender identity. Article 2, Section C of the Genocide
Convention allows for the possibility that acts of genocide may adopt a form other than physical
violence and killing. Such “conditions of life” that might bring about transgender people’s
“destruction in whole or in part” would certainly include the denial of vital services and resources
based on their identification as transgender.
Complicating matters is that while thirteen U.S. states and the District of Columbia have
employment nondiscrimination laws that include transgender people, there is currently no federal
law prohibiting any type of antitransgender discrimination (Transgender Law and Policy Institute,
2006).

Consequently, transgender people are left with no explicit method of legal recourse following such
abuses. This puts openly transgender people in the precarious position of either living openly as
transgender or facing the very real possibility of being unemployed, homeless, and unable to access
healthcare. These dire conditions have been shown to increase the risk of a transgender person’s
experiencing violence (Lombardi et al., 2001) and have been demonstrated to increase the risk of
higher mortality and morbidity among later-life trans-persons (Witten, 2007abc). In this way, a
cycle of systemic discrimination and violence characterizes the lives of many transgender people.
Of course, one must acknowledge the complexities which arise out of the restriction of the
Genocide Convention to “a national, ethnical, racial, or religious group” (1951, Article 2). Each of
these group signifiers (with the possible exception of religion) contains an extrinsic component of
construction and application. For example, in the late 20th-century Rwandan genocide, it was the
Rwandan government, through the issuing of identification documents, that determined who was
Hutu or Tutsi for the purposes of extermination. The tension between the two groups was, of
course, predicated on a racial hierarchy established years earlier by colonial powers (Destexhe &
Daley, 1995). Similarly, the genocide committed against Native Americans in colonial America as
described by Howard Zinn (2005) depended upon the colonists’ ability to “other” and label the
indigenous people as “Indians.” If the determination of group membership used in the commission
of genocide were universally perceived, constructed, and applied externally, the current Genocide
Convention would be sufficient.
However, sexual and gender identity do not operate via this extrinsic labeling. Individuals are not
labeled by dominant culture as transgender (or, for that matter, as gay, lesbian or bisexual) against
their will. In fact, there exists in society a “compulsory heterosexuality” (Rich, 1994) and an
endemic re/enforcement of “heteronormativity” (Warner, 1993) that seeks to discourage even the
mere acknowledgment of transgressive sexual and gender identities. Instead of being labeled
“transgender” by the dominant culture, transgender people must actively assert their gender identity
in order to self-identify as such. While it is clear that perpetrators of antitransgender violence choose
their victims based on a perceived violation of the binary gender norm (the very definition of
“transgender”), it is not clear that these same perpetrators fully understand their victims to be
“transgender,” as such. This difference from the mechanics of traditionally-conceived genocide
indicates the need for a reexamination of how we define genocide.
Given the breadth of discrimination, abuse, violence, and hate crimes, and the clear-cut absence of
policy designed to regulate it, it is within reason to conclude that absence of policy is, in fact,
policy. As one of the TLAR survey respondents stated:
Condoned social institutions that foster hate and intolerance should be looked at. They cause as much
psychological damage as anything. Prevailing attitudes by society need to be changed so that all people can fit
in without fear of violence, loss of job/family etc. There is room enough for everybody to live peaceable lives
as they see fit.
VI. CLOSING THOUGHTS
Based on a review of the literature available regarding anti-transgender hate violence, several
conclusions can be drawn. First of all, transgender-identified persons undergo lifelong exposure to
multiple forms of abuse and violence that are frequently repeated across the life course and are
relatively unreported to authorities for fear of reprisal. Furthermore, victims feel that they will be
abused, humiliated or not believed by the very authorities who are supposed to protect them.
Secondly, socioeconomic status was found to be a predictor of violence, as low-income individuals
have reduced access to healthcare and other support services (Lombardi et al., 2001). In addition,
these individuals are more likely to engage in “survival crimes,” such as drug dealing, sex work,
and panhandling, which place them at an increased risk for victimization by individuals both
affiliated and unaffiliated with the law enforcement system (Lombardi et al., 2001; Xavier &
Simmons, 2000).

Anti-transgender hate violence also has profound consequences, not only for transgender people,
but for society as a whole. This violence reinforces the male-female gender binary and engenders
fear in those who even consider venturing beyond its confines. This applies to transgender people
who wish to cosmetically, surgically, or hormonally alter their gender presentation, but also, for
example, to non-transgender men who wish to enter traditionally female occupations or non-
transgender women who enjoy wearing their hair short (Herek, 1989; Herek et al., 2000).
Hate violence also decreases the likelihood that transgender people will obtain health and support
services after violent incidents, as they fear revictimization by hospital staff or law enforcement
(Witten, 2008). A negative cycle is established in which victims of violence endure their pain in
silence, putting them at risk for depression and other mental illnesses as well as making them even
more likely to experience a second victimization during their lifetime.
The degree of severity of the violence meets the definition of hate crime and, as such, warrants
classification of much of trans-violence as hate-crime related. The large number of such crimes
warrants the inclusion of trans-violence as part of the hate crimes statutes throughout the United
States and the rest of the world. Moreover, accurate hate crime statistics should be collected for
trans-related crimes.
These findings point to the need for further research into the causes and consequences of anti-
transgender hate violence, as well as a need for a re-examination of how support services can be
made more accessible to transgender hate violence victims. Furthermore, socioeconomic status,
race/ethnicity, differing ability, and other further marginalizing factors need to be given greater
attention in studies involving transgender people in order to capture more representative images of
the gender community.
In addition, the persistent and ongoing lack of political, legal, and social attention to the hate crime
violence against the global transgenderidentified populations appears to meet the definition of
genocide under the Convention on Prevention and Punishment of the Crime of Genocide (Article II,
items a & b), thereby warranting increased global attention to this issue through the world court,
WHO, the United Nations, and other international agencies dealing with “gender violence.”
Based on this evidence, there is also a need for a radical reconsideration of how the international
community conceptualizes a group’s eligibility as a potential target of genocide. The current
definition of genocide is predicated on the heterosexist and heteronormative belief that subgroups of
humans are always able to be extrinsically labeled before being systematically targeted for
extermination. Currently, transgender people, who selfidentify as such, are targeted in ways that
clearly qualify as genocide under the criteria set forth in Article 2 of the U.N. Genocide
Convention. Unfortunately, their victimization cannot be regarded as such under current
international law, both because “gender identity” is not included in the Genocide Convention and
because the perpetrators of such acts of genocide do not have a single label by which they
collectively identify their victims due to the presence of a dominant culture which normatively
limits gender to only male and female.
CONTACTING THE PROJECT
To find out more about the TranScience Research Institute, the research being sponsored and
conducted, and/or to participate in any of its projects, you may visit the TSRI website at
http://www.transcience.org/ or you may reach Dr. Tarynn M. Witten at either of the following email
addresses: transcience@earthlink.net or transcience@transcience.org.
ACKNOWLEDGMENTS
First and foremost, the author would like to thank all of the FTM survey respondents as well as the
global TLARS survey respondents. Without their honesty and willingness to participate in this
research effort, we would be unable to provide any information on this subject of importance. TMW
would also like to acknowledge her colleagues, A. Evan Eyler, Deirdre Condit, and David Bromley,
for their ongoing dialogue and support of this research.

REFERENCES
Associated Press State & Local Wire. (2006, August 19). San Diego man sentenced to 206
years in sex assaults.
Augelli, A. (1989). Lesbians’ and gay men’s experiences of discrimination and harassment in a
university community. American Journal of Community Psychology, 17(3), 317-325.
Basu, A.M. (2000). Gender in population research: Confusing implications for health policy.
Population Studies, 54, 19-38.
Belongia, L., & Witten, T. M. (2006, Fall). We don’t have that kind of client here:
Institutionalized bias against and resistance to transgender and intersex aging research
and training in elder care facilities. American Public Health Association Gerontological Health
Newsletter. Retrieved February 15, 2008, from www.transcience.org
Bockting, W. O., Rosser, S., & Coleman, E. (1999). Transgender HIV prevention: Community
involvement and empowerment. International Journal of Transgender, 3(1+2). Retrieved
from http://symposion.com/ijt/hiv_risk/bockting.htm
Bradford, J., Ryan, C., & Rothblum, E. (1994). National Lesbian health care survey:
Implications for mental health care. Journal of Consulting and Clinical Psychology, 62(2), 228-
242.
Bradley, M. (1996). Caring for older people: Elder abuse. British Medical Journal, 313, 548-550.
Burbank, P. M. (Ed.). (2006). Vulnerable older adults: Health care needs and interventions. New York:
Springer Publishing Co.
Butler, S. S., & Hope, B. (1999). Health and well-being for late middle-aged and old lesbians in
a rural area. Journal of Gay and Lesbian Social Services, 9(4), 27-46.
Cahill, S., South, K., & Spade, J. (2000). Outing age: Public policy issues affecting gay, lesbian, bisexual,
and transgender elders. Retrieved February 15, 2008, from
http://www.thetaskforce.org/downloads/reports/reports/OutingAge.pdf
Comstock, G. (1989). Victims of anti-gay/lesbian violence. Journal of Interpersonal Violence, 4(1),
101-106.
Connor, R. P., & Sparks, D. H. (2004). Queering Creole spiritual traditions: Lesbian, gay, bisexual, and
transgender participation in African-inspired traditions in the Americas. Binghampton, N.Y.:
Harrington Park Press.
Convention on the Prevention and Punishment of the Crime of Genocide. (1951). Retrieved
October 10, 2007, from http://www.unhchr.ch/html/menu3/b/p_genoci.htm
Cook-Daniels, L. (1995). Lesbian, gay male, bisexual and transgendered elders: Elder abuse and
neglect. Retrieved February 8, 2008, from
http://www.forgeforward.org/handouts/tgelderabuse-neglect.html
DC Crime Watch. (2006, November 16). The Washington Post, p. T17.
Denny, D. (2007). Transgendered youth at risk for exploitation, HIV, hate crimes. Retrieved
December 5, 2007, from http://www.aidsinfonyc.org/Q-zone/youth.html
Destexhe, A., & Daley, A. (1995). Rwanda and genocide in the twentieth century. New York: NYU
Press.
Dittman, R. J. (2003). Policing hate crime. From victim to challenger: A transgendered
perspective. Probation Journal, 50, 282-288.
Doyal, L. (2001). Sex, gender, and health: The need for a new approach. British Medical Journal,
323, 1061-1063.
Dunbar, E. (2006). Race, gender and sexual orientation in hate crime victimization: Identity
politics or identity risk? Violence and Victims, 23(3), 323-337.
Earle, K. A., Bradigan, B., & Morgenbesser, L. I. (2001). Mental health care for American
Indians in prison. Journal of Ethnic & Cultural Diversity in Social Work, 9(3/4), 111-132.

Earth, B. (2006). Diversifying gender: Male to female transgender identities and HIV/AIDS
programming in Phnom Penh, Cambodia. Gender and Development, 14(2), 259-271.
Elason, M. J. (2000). Substance abuse counselor’s attitudes regarding lesbian, gay, bisexual, and
transgendered clients. Journal of Substance Abuse, 12, 311-318.
Ettrich, K. U., and Fischer-Cyrulies, A. (2005). Substance abuse in middle and old age –
everyday drug alcohol and nicotine: Use and abuse. Zeitschrift f ¨ur Gerontologie und
Geriatrie, 38(1), 47-59.
Everard, K. M., Lach, H. W., Fisher, E. B., & Baum, M. C. (2000). Relationship of activity and
social support to the functional health of older adults. Journal of Gerontology, 55B(4),
S208-S212.
Eyler, A. E., & Wright, K. (1997, July-Sept.). Gender identification and sexual orientation
among genetic females with gender-blended self-perception in childhood and
adolescence. International Journal of Transgender, 1(1),
http://symposion.com/ijt/ijtc0102.htm
Fahrenthold, D. A. (2002, August 13). Transgender teens killed on D.C. street. The Washington
Post, p. B01.
Feldman, J., & Bockting, W. (2003). Transgender health. Minnesota Medicine, 86(7), 25-32.
Fernandez, M. E. (1998, December 12). Death suit costs city $2.9 million; mother of
transgendered man wins case. Washington Post, Metro Section, p. C01.
Fiori, K. L., Antonucci, T. C., & Cortina, K.S. (2006). Social network typologies and mental
health status among older adults. Journal of Gerontological Psychological Sciences, 61B, P25-
P32.
Gannon, L., Luchetta, T., Rhodes, K., Pardee, L., & Segrist, D. (1992). Sex bias in
psychological research. American Psychologist, 4(3), 389-396.
Garner, B. A. (1999). Black’s law dictionary (2nd ed.). St. Paul, MN: Thomson West.
Gay and Lesbian Medical Assocation (GLMA). (2000). Healthy people 2010: Companion documents
for lesbian, gay, bisexual, and transgender (LGBT) health. U.S. San Francisco. Retrieved
February 8, 2008 from http://www.glma.org
Gender Education and Advocacy. (2005). Transgender day of remembrance: About DOR. Retrieved
February 20, 2006, from http://www.gender.org/remember/day/what.html
Goins, R. T., & Krout, J. A. (Eds.). (2006). Service delivery to rural older adults: Research, policy and
practice. New York: Springer Publishing Co.
Grant, A. M. (2001). Health of socially excluded groups: Lessons must be applied. British
Medical Journal, 323, 1071.
Greenberg, Julie A. (1998). Male and female: Intersexuality and the collision between law and
biology. Arizona Law Review, 41(2), 265-328.
Grossman, A. H., D’Augelli, A. R., & Hershberger, S. L. (2000). Social support networks of
lesbian, gay, and bisexual adults 60 years of age and older.
Journal of Gerontology, 55B(3), 171-179.
Herek, G. (1989). Hate crimes against lesbians and gay men. American Psychologist, 44(6), 948-
955.
Herek, G., Cogan, J. C., & Gillis, J. R. (2002). Victim experiences in hate crimes based on
sexual orientation. Journal of Social Issues, 58(2), 319-339.
Holtzman, R. E., Rebok, G. W., Saczynski, J. S., Kouzis, A. C., Doyle, K. W., & Eaton, W. W.
(2004). Social network characteristics and cognition in middleaged and older adults.
Journal of Gerontological Psychological Sciences, 59B(6), 278-284.

Human Rights Watch. (2006, May 18). Nepal: ‘Sexual cleansing’ drive continues– new arrests
of transgender people/HIV workers. Retrieved October 11, 2007, from
http://hrw.org/english/docs/2006/03/17/nepal13020.htm
Indo-Asian News Service. (2007, May 31). Helpline to reduce violence against transgender
people.
The International Gay and Lesbian Human Rights Commission. (2005). The situation of
lesbian, gay, bisexual, transgender and intersex rights defenders. Retrieved October 12,
2007, from
http://www.iglhrc.org/files/iglhrc/program_docs/IGLHRC%20HumanRightsDefen
d.doc
ISNA - Intersex Society of North America (ISNA). (2007). How common is intersex?
Retrieved October 10, 2007, from http://www.isna.org/faq/frequency
Jacobs, S-E., Thomas, W., & Lang, S. (Eds.). (1997). Two-spirit people: Native American gender
identity, sexuality and spirituality. Urbana, IL: University of Illinois Press.
Jenness, V. (2003). Engendering hate crime policy: Gender, the “Dilemma of Difference,” and
the creation of legal subjects. Journal of Hate Studies, 2, 73-97.
Johnson, N. (2006, September 20). Transgender man’s killer gets life. St. Petersburg Times
(Florida), Largo Times, p. 1.
Kausch, O. (2002). Cocaine abuse in the elderly: A series of three case reports. Journal of
Nervous and Mental Disease, 190(8), 562-565.
Kelley-Moore, J. A., & Ferraro, K. F. (2001). Functional limitations and religious service
attendance in later life: Barrier and/or benefit mechanism. Journal of Gerontology: Social
Sciences, 56B(6), S365-S373.
Kidd, J. D., & Witten, T. M. (2007). Understanding spirituality and religiosity in the
transgender community: Implications for aging. Journal of Religion, Spirituality & Aging
[in press].
Kleinman, A., & Sung, L. H. (1979). Why do indigenous practitioners successfully heal? Social
Science and Medicine, 13B, 7-26.
Kubzansky, L. D., Berkman, L. F., & Seeman, T. E. (2000). Social conditions and distress in
elderly persons: Findings from the MacArthur studies of successful aging. Journal of
Gerontology, 55B(4), P238-P246.
Kulick, D. (1998a). Transgender in Latin America: Persons, practices and meanings. Sexualities,
1, 259-260.
Kulick, D. (1998b). Fe/male trouble: The unsettling place of lesbians in the selfimages of
Brazilian travesti prostitutes. Sexualities, 1, 299-312.
Lancaster, R.N. (1998). Transgenderism in Latin America: Some critical introductory remarks
on identities and practices. Sexualities, 1, 261-274.
Lawson, A.W. (1989). Substance abuse problems of the elderly: Considerations for treatment
and prevention. In G. W. Lawson & A. W. Lawson (Eds.), Alcoholism and substance abuse
in special populations. Rockville, MD: Aspen Publishers.
Locke, M. (2006, January 28). Three sentenced in transgender killing in U.S. Associated Press
Worldstream.
Lombardi, E., Wilchins, R., Priesing, D., & Malouf, D. (2001). Gender violence: Transgender
experiences with violence and discrimination. Journal of Homosexuality, 42(1), 89-101.
Manfredi, R. (2002). HIV disease and advanced age: An increasing therapeutic challenge. Drugs
& Aging, 19(9), 647-669.
Mansey, K. (2006, November 9). Sex-change woman to advise on hate crime. Dairy Post
(Liverpool).

McGhee, D. (2003). Joined-up government, ‘community safety’ and lesbian, gay, bisexual and
transgender ‘active citizens’. Critical Social Policy, 23(3), 245-274.
McPhail, B. A. (2002). Gender-bias hate crimes: A review. Trauma, Violence, & Abuse, 3, 125-
143.
Melendez, R. M., Exner, T. A., Erhart, A. A., Dodge, B., Remien, R. H., Rotheram- Borus, M.-
J., Lightfoot, M., Hong, D., & The National Institute of Mental Health Healthy Living
Project Team. (2006). Health and healthcare among male-to-female transgender
persons who are HIV positive. American Journal of Public Health, 96(6), 1034-1037.
Minter, S. (2007). Personal communication to T.M. Witten. Moran, L. J., & Sharpe, A. N.
(2004). Violence, identity and policing: The case of violence against transgender
people. Criminal Justice, 4, 395-417.
National Center for Transgender Equality. (2007, June 7). New updates from around the
country. Retrieved June 17, 2007, from http://nctequality.org/news.html
National Coalition of Anti-Violence Programs. (2005). Anti-lesbian, gay, bisexual and
transgender violence in 2004. Retrieved October 10, 2007, from http://www. ncavp .
org / common / document _ files / Reports / 2004NationalHV%20Report.pdf
Nemoto, T., Operario, D., Keatley, J., & Villegas, D. (2004). Social context of HIV risk
behaviours among male-to-female transgenders of colour. AIDS Care, 16(6), 724-735.
Nolan, J. J., Akiyama, Y., & Berhanu, S. (2002). The Hate Crime Statistics Act of 1990:
Developing a method for measuring the occurrence of hate violence. American
Behavioral Scientist, 46(1), 136-153.
Oggins, J., & Eichenbaum, J. (2002). Engaging transgender substance users in substance use
treatment. International Journal of Transgender, 6(2). Retrieved February 9, 2008, from
http://www.symposion.com/ijt/ijtvo06no02_03.htm.
Patton, C. (2006). Anti-lesbian, gay, bisexual and transgender violence in 2005: A report of the
national coalition of anti-violence programs. Retrieved June 16, 2007, from
http://www.ncavp.org
Perry, B. (2006). A crime by any other name: The semantics of “hate.” Journal of Hate Studies,
4(1), 120-137.
Pinquart, M., & Sorenson, S. (2000). Influences of socio-economic status, social network, and
competence on subjective well-being in later life: A metaanalysis. Psychology and Aging,
14(2), 187-224.
Pryzgoda, J., & Chrisler, J. C. (2000). Of gender and sex: The subtleties of meaning. Sex Roles,
43(7/8), 553-569.
Rautio, N., Heikkinen, E., & Heikkinen, R-L. (2001). The association of socioeconomic factors
with physical and mental capacity in elderly men and women. Archives of Gerontology and
Geriatrics, 33, 163-178.
Remembering Our Dead. (2007). Retrieved Oct. 12, 2007, from
http://www.rememberingourdead.org
Rich, A. (1994). Compulsory heterosexuality and lesbian existence. Blood, bread, and poetry:
Selected prose 1979-198 (pp. 23-75). New York: W. W. Norton and Company.
Rosebury, B. (2003). On punishing emotions. Ratio Juris, 16(1), 37-55.
Rubenstein, W. B. (2002). Do gay rights laws matter?: An empirical assessment. Southern
California Law Review, 75(65), 65-120.
Rubenstein, W. B. (2004). The real story of U.S. hate crimes statistics: An empirical analysis.
Tulane Law Review, 78, 1213-1246.

Seeman, T. E., Kaplan, G. A., Knudsen, L., Cohen, R., & Guralnik, J. (1987). Social network
ties and mortality among the elderly in the Alameda county study. American Journal of
Epidemiology, 126(4), 714-723.
Settersten, R. A. (2006). When nations call: How wartime military service matters for the
lifecourse and aging. Research on Aging, 28(1), 12-36.
Schrank, D. (2007, September 25). Police investigate as a hate crime attack on man leaving
nightclub. The Washington Post, p. B04.
Shankle, M. D., Maxwell, C.A., Katzman, E.S., & Landers, S. (2003). An invisible population:
Older lesbian, gay, bisexual, and transgender individuals. Clinical and Regulator Affairs,
20(2), 159-182.
Sims, A. M. (2007). Gender non-conformists: Male and female reconsidered. Available at
http://www.gpac.org/press/asap_2007.01.24.html
Simoni, J. M., Walters, K. L., Balsam, K. F., & Meyers, S.B. (2006). Victimization, substance
abuse, and HIV risk behaviors among gay/bisexual/two-spirit and heterosexual
American Indian men in New York City. American Journal of Public Health, 96, 2240-
2245.
Sobsey, D. (1994). Violence and abuse in the lives of people with disabilities: The end of silent acceptance?
Baltimore, MD: P.H. Brookes.
Teh, Yik Koon. (2001, July-Sept.). Nyahs (male transsexuals) in Malaysia: The influence of
culture and religion on their identity. International Journal of Transgender, 5(3). Available at
http://www.symposion.com/ijt/ijtvo05no03_04.htm
Transgender Law and Policy Institute. (2006, October 22). Hate crimes laws. Retrieved January
31, 2007, from http://www.who.int/gender/violence/en/hatecrimeslaws/index.htm
TLARS - TranScience Longitudinal Research Survey. Retrieved October 11, 2007, from
http://www.transcience.org/
Turrell, G., Lynch, J. W., Kaplan, G. A., Everson, S. A., Helkala, E.-L., Kauhanen, J., &
Salonen, J. T. (2002). Socioeconomic position across the lifecourse and cognitive
function in late middle age. Journal of Gerontology: Social Sciences, 57B(1), S43-S51.
Velkoff, V. A., & Kinsella, K. (1998). Gender stereotypes: Data needs for ageing research.
Aging International, 24(4), 18-38.
Virginia Transgender Health Initiative Study. (2007). Retrieved March 7, 2007, from
http://www.vdh.virginia.gov/epidemiology/DiseasePrevention/documents/pdf/THI
SFINALREPORTVol1.pdf
Warner, M. (1993). Introduction. In M. Warner (Ed.), Fear of a queer planet: Queer politics and social
theory (pp. vii-xxxi). Minneapolis, MN: University of Minnesota Press.
Watt, G. (2001). Policies to tackle social exclusion. British Medical Journal, 323, 175-176.
Whipple, B., & Scoura, W. K. (1989). HIV and the older adult. Journal of Gerontological Nursing,
15, 15-18.
WHO - World Health Organization. (2000, June 4). WHO issues new healthy life expectancy
rankings. Retrieved October 12, 2007 from http://www.who.int/inf-
pr2000/en/pr2000-life.html
WHO – World Health Organization. (2007). Gender-based violence. Retrieved Oct. 12, 2007,
from http://www.who.int/gender/violence/en
Wikan, U. (1991). The Xanith: A third gender role? In Unni Wikan, Behind the veil in Arabia:
Women in Oman (pp. 168-187). Chicago: University of Chicago Press.
Willging, C. E., Salvador, M., & Kano, M. (2006a). Unequal treatment: Mental health care for
sexual and gender minority groups in a rural state. Psychiatric Services, 57, 867-870.

Willging, C. E., Salvador, M., & Kano, M. (2006b). Pragmatic help-seeking: How sexual and
gender minority groups access to mental health care in a rural state. Psychiatric Services,
57, 871-874.
Wilhelm, A. D. (2004). Tritiya-Prakriti: People of the third sex: Understanding homosexuality, transgender
identity and intersex conditions through Hinduism. Philadelphia, PA: Xlibris Corporation.
Winter, S. (2006). Language and identity in transgender: Gender wars and the Thai kathoey. In
A. Lin (Ed.), Everyday struggles in language, culture, and education: Problematizing identity.
Mahwah, NJ: Lawrence Erlbaum.
Witten, T. M. (2002). Geriatric care and management issues for the transgender and intersex
populations. Geriatric Care and Management Journal, 12(3), 20-24.
Witten, T. M. (2003). Transgender aging: An emerging population and an emerging need.
Review Sexologies, XII(4), 15-20.
Witten, T. M. (2004). Life course analysis: The courage to search for something more: Middle
adulthood issues in the transgender and intersex community. Journal of Human Behavior
in a Social Environment, 8(3-4), 189-224.
Witten, T. M. (2005a). Birth sex is not gender. Comments on “Efforts to address gender
inequalities must begin at home.” The Lancet, 366 (9496), 1505. Available at
http://www.thelancet.com/journals/lancet/article/PIIS014063605676052/comments?
action=view&totalComments=1
Witten, T. M. (2005b). TransPanthers: The graying of transgender. American Psychological
Association, Division 44 Newsletter, 21(3), 12-13.
Witten, T. M. (2007a). Gender identity and the military – Transgender, transsexual and
intersex-identified individuals in the U.S. armed forces. Retrieved Feb. 2, 2008, from
http://www.palmcenter.org/files/active/0/TransMilitary2007.pdf
Witten, T. M. (2007c). Under and non-representation of sex and gender minorities in U.S.
research studies. PLOS Medicine, submitted. Available at http://www.transcience.org/
Witten, T. M. (2008). Transgender bodies, identities, and healthcare: Effects of perceived and
actual violence and abuse. In J. J. Kronenfeld, Research in the sociology of healthcare:
Inequalities and disparities in health care and health– Concerns of patients (pp. 225-249). Oxford,
England: Elsevier JAI.
Witten, T. M., Ekins, R. J. M., Ettner, R., Harima, K., King, D., Land´en, M., Nodin, N.,
P’yatokha,V., & Sharpe, A. N. (2003). Transgender and transsexuality. In C. R. Ember
& M. Ember (Eds.), The encyclopedia of sex and gender: Men and women in the world’s cultures
(pp. 216-229). New York: Kluwer/Plenum.
Witten, T. M., & Eyler, A. E. (1997, Nov.). HIV, AIDS and the elderly
transgendered/transsexual: Risk and invisibility. Presentation at the 1997
Gerontological Society of America, Cincinnati, OH.
Witten, T. M., & Eyler, A. E. (1999). Hate crimes and violence against the transgendered. Peace
Review, 11(3), 461-468.
Witten, T. M., & Eyler, A. E. (2007). Transgender gerontology and geriatrics: Towards
successful aging. In R. Ettner (Ed.), Principles of transgender medicine and surgery. New York:
Haworth Press.
Witten, T. M., Eyler, A. E., & Weigel, C. (2000, Winter). Transsexuals, transgenders, cross-dressers:
Issues for professionals in aging, OutWord. Retrieved Feb. 2, 2008, from
http://www.asaging.org/networks/index.cfm?cg=LGAIN
Witten, T. M., & Whittle, S. P. (2004). TransPanthers: The graying of transgender and the law.
The Deakin Law Review, 9(2), 503-522. Retrieved Feb. 2, 2008, from
http://www.austlii.edu.au/au/journals/DeakinLRev/2004/23.html#Heading76

Xavier, J. M., & Simmons, R. (2000). The Washington transgender needs assessment survey, personal
communication.
Yagoda, L. (2005). Older adults and health disparities: The impact on access to care.
InterSections in Practice, National Association of Social Workers, 4, 6-9.
Zinn, Howard. (2005). A people’s history of the United States of America: 1492 to present. New York:
HarperCollins Publishers, Inc.