My first transgender friend I met in 1976 when I was a graduate student at the University of Illinois. Formerly “Donny,” Lydia lived at the periphery of the campus community. For part of that bicentennial summer I dated a friend of hers. On one dramatic night, I talked Lydia out of killing herself when her boyfriend left her for a man.
The ambiguities of her life haunted me. Raised as a boy, but identifying as a woman. Wanting a husband, but living among gay and lesbian people.
Last year at the beginning of the semester, one of my students (with an officially male name) emailed me to let me know that she had begun the transition and wanted to be addressed by a female name. I recognized in myself some unexpected measure of discomfort with this ambiguity. My cisgender privilege and my unacknowledged investment in a gender binary became suddenly apparent.
These same ambiguities prevail in the arena of transgender health. As the Institute of Medicine’s The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding (2011) explained, transgender people are underreported in the research literature and underserved by health professionals.
Afraid of discrimination by health care providers, transgender people may be less likely to seek preventive or even acute health care. Precariously employed (transgender status is not protected in labor law) without adequate health insurance, transgender people who want body modification consistent with their gender identity (e.g., hormones or implants) may be more inclined to seek medically risky remedies.
A recent documentary film, Transgender Tuesdays: A Clinic in the Tenderloin (2012), provides an informed and informative first-person account of San Francisco’s Tom Waddell Health Center and the lives of its community. The tagline of the film announces, “They came for the hormones and stayed for the healthcare.” More aptly, the acknowledgements of the film’s website characterizes its participants as “Faces from the across the gender spectrum.”
Binary no more, but a spectrum.
Institute of Medicine. (2011). The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding. Washington, DC: National Academies Press. Retrieved from http://www.iom.edu/Reports/2011/The-Health-of-Lesbian-Gay-Bisexual-and-Transgender-People.aspx
Transgender Tuesdays: A Clinic in the Tenderloin. (2012). http://transgendertuesdaysmovie.com/index.html
Lavender Health - LGBTQ Resource Center 
Eric Plemons, assistant professor of anthropology at the University of Arizona, has written for The Feminist Wire a series of articles on the federal expansion of medical coverage for transgender-related surgery: “How Sex Reassignment Surgery Works in America” http://thefeministwire.com/2015/05/how-sex-reassignment-surgery-works-in-america/ | “Medicare’s New Coverage for ‘Transsexual Surgery’ Relies on Dated Notions of Gender” http://thefeministwire.com/2015/05/medicares-new-coverage-for-transsexual-surgery-relies-on-dated-notions-of-gender/ | and “Transgender Medicine: Medicare Access to What?” http://thefeministwire.com/2015/06/transgender-medicine-medicare-access-to-what/