I was not born into a body so much as positioned within one.
I was assigned female at birth. Assigned. The word has always fascinated me. Assigned as if gender were a slot on a bureaucratic spreadsheet, an administrative designation attached to skin before a child has spoken a single word about who they are. Assigned as if identity were a fixed destination rather than a lifelong process of becoming.
When I was five years old, I ran into the house and announced, “I want to be a boy.” Back then, my family called me Blue.
Blue rode a Huffy BMX bike through the neighborhood, chased birds across vacant lots, played football shirtless with the boys, and smeared toothpaste across my face while pretending to shave like my father.
I watched men move through the world and felt an undeniable pull toward them. It wasn’t because I wanted to imitate them. It was because I believed I was one of them.
Looking back, I realise the problem was not what I said. The problem was that I said it decades before most Americans had the language to hear it.
That was the early 1970s. Gender identity was not part of public conversation, school curriculum, pediatric care, or family life. No teacher ever discussed it. No counsellor pulled me aside. No book in the school library reflected anything remotely close to my experience. There were no role models and no roadmap.
My father fought my masculinity whenever he could. Dresses appeared. Expectations appeared. Rules appeared. Every attempt to force me into girlhood pushed me further away from myself. I remember being wrestled into dresses for family gatherings only to throw myself into the yard and roll through dog excrement rather than wear them. It sounds absurd now. It was not absurd then. It was resistance before I had language for resistance.
I searched elsewhere for recognition. Music became one refuge. David Bowie, Boy George, Tracy Chapman, and Annie Lennox challenged assumptions about gender long before I had words for my own experience. Films offered glimpses of lives that seemed to exist just beyond the boundaries of what I had been told was possible.
Sports became my camouflage. Football, swimming, and running helped me mask the breasts, waist, and broad hips that intensified my dysphoria and reminded me daily of a body I never experienced as my own. Athletics kept my body lean and offered relief from a struggle I could not yet name; movement allowed me to outrun the confusion waiting for me everywhere else.
As I moved through college and into adulthood, the gap between who I knew myself to be and who the world expected me to be widened. I became adept at performing a version of myself that others could understand while carrying a growing sense of dislocation.
By my 20s, that dislocation became unbearable.
I attempted suicide twice.
It wasn’t because I lacked strength or ambition. I was building a career, earning advanced degrees, teaching students, and creating what looked from the outside like a successful life. However, success and survival are not the same thing. Outwardly, I was thriving. Internally, I was disappearing.
Then, during the 1990s, something began to shift. Language that had once existed only at the margins slowly entered public conversation. For the first time, the word “transgender” entered into public discourse and health care.
The word positioned and grounded experiences I had carried my entire life. What I had once understood only as confusion began to take shape as recognition. The word did not solve everything, but it gave me a framework for understanding myself. At 40 years old, after years of reflection, therapy, and struggle, I began medically transitioning. The day after receiving tenure, I started testosterone.
Shortly afterward came the first signs of liberation: a double mastectomy, hysterectomy, and oophorectomy. Six months later, I underwent a metoidioplasty and pelvic release. At 51, I underwent phalloplasty and scrotoplasty. I will inject testosterone every week for the rest of my life. The cumulative billed value of my transition-related healthcare exceeds $5.5 million.
I recognise that access to healthcare is a privilege. I paid co-pays and deductibles while insurance absorbed costs that would have been impossible for many people to shoulder. Every time I think about those numbers, I think about the countless transgender people denied the same opportunities that allowed me to survive.
But the greatest costs were never financial.
Transition cost me more than 90% of my family. Relationships that had defined entire chapters of my life disappeared. Phone calls stopped. Invitations stopped. Some relatives chose distance. Others chose silence. The losses accumulated slowly, then all at once. I grieve them still. Yet if the choice was between preserving those relationships and preserving my life, I would make the same decision again.
Over time, I came to understand that transition was never simply about altering a body. We are not operating on people so much as operating on histories. Surgery, language, community, and self-recognition become ways of rewriting narratives imposed upon us long before we could speak for ourselves. Surgery is about sculpting gender from within, not because we were broken, but because we knew how to wield a chisel. My body carries those histories. Some scars are faint. Others zigzag across flesh, thickened by time. They carry more history than any policy document ever could.
Several years after beginning my transition, I decided to amend my Louisiana birth certificate from female to male. The process became one of the most humiliating experiences of my life. Louisiana required me to appear before a court-approved physician whose role was to verify my transition. In his office, I was instructed to remove my clothing so he could inspect my body and confirm that I had undergone a mastectomy and metoidioplasty. Afterward came notarised letters from physicians, therapists, and surgeons, operative reports, legal filings, photographs, identification records, attorney fees, and court costs. Standing there, I understood that the state was not asking me to identify myself. It was auditing me.
My body became evidence. My scars became exhibits. My surgeries became supporting documentation. My therapist’s letters, physician affidavits, operative reports, photographs, and court filings became part of a bureaucratic ledger through which strangers evaluated whether I qualified for recognition.
Looking back, I realise Louisiana was never the beginning of the audit. It was simply the moment I recognised it. The audits had followed me for decades. Family members audited my masculinity. Schools audited my behaviour. Medical professionals audited my certainty. Insurance companies audited my eligibility for care. Courts audited my legitimacy. At every turn, institutions demanded proof that I was who I said I was. Diagnoses, evaluations, signatures, approvals, surgeries, and legal documents all became part of a system that repeatedly asked the same question: prove yourself.
In 2005, I became the first openly trans*+ academic in teacher education. Around the same time, I began noticing something else. There was almost no positive discussion of queer or transgender lives in teacher preparation programs. The absence I had experienced as a child was still present. It had simply become institutionalised. That realisation eventually led me to write my forthcoming book, We Refuse to Disappear: Resistance Amid Anti-Trans Policy.
While researching it, I watched anti-trans legislation move from a political fringe project to a national movement. During the final years of the Obama administration, anti-trans bills remained relatively uncommon. Under President Trump, they steadily increased. Under President Biden, they exploded. Then, in 2025 alone, lawmakers introduced more than 1,000 anti-trans bills nationwide, with 126 becoming law. As of 2026, hundreds more are already (predictably) moving through state legislatures. What began as isolated legislative efforts has become a sustained campaign to regulate healthcare, athletics, names, pronouns, curriculum, bathrooms, and public existence itself.
I think often about Bidzii and Juno (pseudonyms), two young people whose family I encountered during my research. Bidzii, a transgender girl, lost access to gender-affirming medical care after Texas Senate Bill 14 prohibited such treatment for minors. Juno, her intersex sibling, watched Senate Bill 12 reshape what could be discussed, taught, or acknowledged in school.
Every evening, their family gathered around the kitchen table and studied maps of New Mexico. They compared rental prices, searched for healthcare providers, and researched school districts. They were not planning a vacation. They were planning survival.
At school, one teacher quietly refused to abandon them. When Bidzii submitted a worksheet asking what happens when your body begins changing and then is forced to stop, the teacher refused to erase the question. When students raised developmental questions that exceeded what state law comfortably allowed, the teacher refused to treat those questions as violations. When fear narrowed the classroom, the teacher refused to surrender curiosity. When the family needed support beyond what the school could legally provide, the teacher connected them to a community wellness circle outside district control.
These acts did not make headlines. They preserved humanity.
When I look at Bidzii and Juno, I do not simply see two young people caught in the crosshairs of legislation. I see a generation inheriting possibilities my generation fought to create. The language they have access to did not appear on its own.
We must honour the generations who came before us – the trans elders who forged the path we now walk with their bodies, their scars, their silence, and their courage. They paid dearly for the possibilities my generation inherited. Some underwent surgeries when procedures were still developing and carried the complications that followed. Some protested in small marches, wrote from the shadows, or survived through lives of stealth. Some were murdered, their deaths unreported and their names faded into obscurity. Some lost families. Some lost careers. Without them, there would have been no path for us to follow.
We became the next experiment. Not because we wanted to be, but because of those very few went undetected before us. We learned publicly, survived publicly, and challenged institutions that often had no framework for understanding us. The surgeries, scars, amended documents, and medical records became pathways future generations could follow.
Today, Bidzii and Juno face a familiar pattern. Their healthcare is questioned. Their identities are questioned. Their schools, teachers, and families are questioned. Different generation. Same demand for proof.
The audit never really ended.
Today, my driver’s license carries an X marker. So does my passport. Those documents reflect who I am far more honestly than the ones I carried for decades, yet they also create new vulnerabilities. In the current political climate, travelling internationally with those documents means accepting the possibility of additional scrutiny simply for existing outside a binary some governments find easier to administer than understand.
As a result, I remain here, but not passively. I remain as a teacher, a scholar, an advocate, and someone who refuses to disappear. The same systems that once audited my body now seek to regulate the lives of a new generation of young people. The difference is that I am no longer standing alone. I stand alongside educators, families, healthcare providers, librarians, journalists, faith leaders, and students themselves.
Coalitions are the realisation of refusals.
A teacher refuses to erase a student. A librarian refuses to remove a book. A counsellor refuses to abandon a child in crisis. A physician refuses to withdraw care. Parents refuse to stop fighting. Journalists refuse to let misinformation go unchallenged. Faith leaders refuse to close their doors. Students refuse disappearance itself. Together, those refusals become something larger than any individual act. They become protection. They become community. They become the conditions through which future generations can determine themselves.
I know this because I was once Blue. I know this because I survived. And I know this because every child deserves the right to become.
Trans people are often portrayed as controversies, threats, or political problems to be solved. We are none of those things. We are human beings. We are children who grow up. We are neighbours, teachers, parents, artists, nurses, scholars, and friends. And despite every attempt to erase us, we continue to exist.
We are like gazelles crossing an open plain, vulnerable because we are visible yet moving forward anyway. We leap. We run. We build. We love. We remain. That is not weakness. That is trans joy. That is persistence.
Note: Trans*+ combines the historical inclusion signifier (*) with a superscript plus (+) to represent expansive, evolving, nonfixed, and unbounded gender identities that resist/ed essentialized and binary gender dichotomies.
sj Miller, Ph.D., is an award-winning scholar-activist, Learning Specialist 3 at Los Alamos National Laboratory, and part-time faculty at the University of Washington-Bothell. Their work centers gender identity justice, the pedagogy of refusal, and inclusive educational frameworks. Miller has authored eight books, over 50 peer-reviewed articles, and over 30 book chapters. Miller serves as senior associate editor of The International Journal of LGBT Youth and co-editor of the series Social Justice Across Contexts in Education. Miller has received numerous awards in the fight for gender identity justice including the 2019 Distinguished Contributions to Gender Equity Award from the American Education Research Association. Miller’s forthcoming book, “We Refuse to Disappear: Resistance Amid Anti-Trans Education Policy” with Harvard Ed Press is due out later this month. For more on sj see; www.sjmiller.info.
Note: This essay was updated to clarify some details of the author’s experience.
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