Jamison Green: Where Are All the Trans Men?

Jamison Green has spent his career fighting to make the healthcare world a safer, more accessible place for transgender people.

“My goal was to change the world,” he told me.

I spoke with him in 2022 after reading his excellent memoir, Becoming a Visible Man. (Jennifer Finney Boylan, writing in The New York Times, called it “the first great memoir by a trans man.” As a Jenny Boylan devotee, I quickly bought a copy after reading that.)

Jamison served as the head of FTM International from 1991 to 1999. This was a pioneering organization founded by Lou Sullivan to provide resources and build community among trans men. He went on to co-author a groundbreaking non-discrimination ordinance in San Francisco in 1994 that made it the first U.S. city to explicitly protect “gender identity”.

And he’s spent many years on the board of the World Professional Association for Transgender Health. WPATH’s Standards of Care are the most widely used clinical protocols for gender-affirming medicine in the world and Jamison played a key role in modernizing the protocols to be less pathologizing, more accessible, and, perhaps most notably, to include trans men (much had previously focussed on the experience of trans women).

This interview has been edited and condensed.

Jeffrey Masters: I want to talk about, the community of trans men that you were part of in the ’80s, but before we talk about that, what was your first exposure to transness, and specifically to trans men?

Jamison Green: I saw Steve Dain on television. Steve Dain was the most famous trans man in the world until Renée Richards transitioned, which happened the day after his story made it to the front page of the New York Times. So his story makes it to the front page, then Renée Richards comes out, and you never hear about Steve Dain again.

Because people don’t care about trans men. Especially in New York, when Renée Richards is a well-known socialite ophthalmologist, tennis player, very exciting person for New Yorkers. And Steve Dain is a high school gym teacher in Emeryville, California. But Steve Dain was an extremely impressive individual, and he transitioned in 1976. When I saw him on television, it was like, “That’s the person I need to talk to. That’s the person who will know how to explain this to me.” I called myself cross-gendered. I felt as though there were wires crossed between my brain and my body. I didn’t have any language and I hadn’t known anybody else who felt the way I did.

JM: We think about famous trans people through history, and you hear the name Christine Jorgensen, and then you think there was not a single trans person until Laverne Cox.

JG: Right.

JM: Obviously that’s not true. But it seems like the reality is that there is, and has always been, trans people in the media, but we have forgotten them really quickly.

JG: That’s right, yes. And particularly trans men. Back in the ’70s, also, there were two other very active trans men, active in trying to do education, using the media as much as they had access to it. They were Jude Patton and Jason Cromwell. Jude was from Southern California, Jason was from Seattle, and then also lived in Sacramento for a while.

JM: And what decade was this?

JG: Mid-’70s. But are they remembered? No. Jude Patton is 81 years old. Jason Cromwell’s younger than I am, I think.

JM: I mean, I think that someone who you knew personally, Lou Sullivan is somebody who has also been forgotten to history.

JG: Unfortunately. Lou Sullivan’s group, FTM, was focused on trans men, because trans men had no information, and trans men were not covered in the media. Trans men were not even really referred to in the standards of care, such as they existed at the time. It was like trans men didn’t exist.

JM: Lou Sullivan published the FTM Newsletter, which was one of the first of its kind. This was in the ’80s. Eventually you did take it over. But one of the things that Lou Sullivan is remembered for today is for being both trans and gay, which for the time stood out in a way that sounds rather crazy to our modern ears.

JG: Yeah. He identified as gay, and the medical establishment said, “If you are gay identified, you cannot transition. We’re not in the business of making queers.” But sexual orientation and gender identity are two different things. And he promoted that in a really big way with medical providers to make them aware that just because one has a sexual orientation that is homosexual, that doesn’t mean one cannot transition.

JM: Speaking now, I think the audience hears that and is like, “Yeah, of course.”

JG: That’s right. That’s because he started promoting it, and many other people picked it up.

JM: The other conception of trans masculinity back then, and correct me if I’m wrong, was that this was a solitary experience that you were supposed to go off and do alone.

JG: Yes, you should do it alone. And you should never hang out with other trans people, because then people might think you were trans. The idea of transition was to become normal. Trans people were told, “You have to change your occupation, move to a different city, destroy all your photographs of your family growing up.” You didn’t have that childhood that you actually experienced, you have to make up a story about your childhood, so that people will accept you as a full human being once you transition, so you can be normal. And to my mind, that was not normal.

JM: When did you break out of that way of thinking? Reading your book, it seems like you never bought into that.

JG: I don’t know. But I think part of it may be because I spent most of my life prior to my transition being visibly non-binary. People did not know what sex I was, people could not tell. And so I didn’t think there was anything wrong with me, I was just different. And so I wasn’t about to be told that I didn’t belong, that I couldn’t have a job, that I couldn’t be something in the world. I wasn’t going to accept that just because people couldn’t tell what sex I was.

JM: You also wrote that as you matured physically growing up, the difference between your body and your gender created problems for you and nearly everyone around you. We tend to think of gender as an individual experience, not about it creating problems for other people.

JG: It’s a social communication, gender. It’s a language. It’s a language that we use to tell something about ourselves, and to perceive other people without knowing certain things about them. We use gender to perceive people, as well as how people communicate. It’s a two-way street.

JM: And so what is it about gender nonconformity, any sort of gender transgression, that makes somebody feel like they’re being threatened?

JG: They feel that they can’t understand what’s going on. They don’t have control of the situation, because they don’t have the information they need. They don’t know how to treat you. And so they assume. And if they have an association with any kind of variance like that, with perversion or criminal behavior, and this was common for years, for hundreds of years, anybody who didn’t quite fit a gender norm, there comes a point where you cross a line and you don’t fit a gender norm, you can’t be categorized, you become a threat because you upset the order of the world.

Gender is a power symbol, too. Particularly, if you know whether someone’s a man or a woman, you know how on guard you need to be, if you’re going to have to get into a fight or not, whether or not you can approach them, if you happen to be attracted to them, depending on the cultural constructs within your society, which are also always in flux. But people aren’t aware of how in flux it is, because we all have our assumptions about how the world relates to us and we relate to the world. And if we can’t let go of some of that control, then that’s when we start to run into social problems.

JM: Just to use a simple example, I might walk into a building and hold a door open for a woman, but not a man. And so if I don’t have experience with gender nonconformity, I don’t know how to treat this person, and I’m there at the door, and my brain just kind of short-circuits.

JG: Yeah. And some people find, when they’ve experienced that short-circuiting, it throws them completely off, and they can get very angry in response. They think they’re being assaulted. I think there’s a neurological function going on here for a lot of people with respect to how they interpret gender. And some people’s neurological pathways actually have more difficulty than others, and it can indicate a learning disorder, a sociopathic disorder. I think there’s a lot of things going on that we simply don’t know about yet in science, frankly.

JM: With this growing, with the increased visibility, we’re seeing an increase in the pushback against the trans community. Were there perks to transitioning back then, when people didn’t know what trans meant?

JG: I think to some degree there were perks, because it was beyond someone’s consciousness that this could happen, and therefore you didn’t get questioned. But, of course, the idea was that you wouldn’t seek any questions, that you didn’t want to be questioned, you just wanted to live your life. So staying under the radar was the ideal.

JM: We’ve talked a couple times about the seeming invisibility of trans men in culture. I know there’s not just one reason for that, but can you talk about what some of those reasons are or might be?

JG: Fundamentally, I think to some extent it relies on misogyny. It’s very, very interesting, if someone wants to cut off their penis, “Why would they do that? Oh my God,” that’s what often people think about a trans woman. But what do people think about girls? Well, of course, women always want to be men, because men are superior, so that’s just typical, why not, and they’re not a threat because they’re just a woman. Whereas a guy transitioning away from the cohort of men, where he has to hold up the specter of masculinity, he’s failed, now he’s making fun of us, we have to ostracize him because at the same time he may become something attractive.

JM: We talk about how important representation is all the time. I’ve seen maybe one trans man ever on a late-night talk show. But I’ve seen a number of trans women .

JG: Right.

JM: However, it’s not that there is a lack of trans men in the media or the world.

JG: Right. People don’t think they’re interesting. I can’t tell you how many times Oprah’s producers have called me over the years, but they always end up choosing to bring on a trans woman.

JM: I also think that trans men have access to male privilege. And with men we are just taught to respect them, we’re almost bored by them, we let them go. But for women, we’re taught to gawk at them and stare at them and talk about their appearance and what they’re wearing.

JG: There is something to that. And this is something I try to talk about within trans men circles, and also outside of it, that trans men have an option, trans men have not been enculturated exactly the same way, and have a responsibility, in my opinion, to be conscious of that false masculinity, that false objectification of women, that you should know better.

JM: Is that something you had to learn for yourself?

JG: I think I knew it. I don’t think I learned it exactly, I think I just knew it. I always knew I wasn’t really a woman, even though I tried to do things sometimes that would be supportive of women. I was very supportive of women, in the sense that I agree with the tenets of feminism, but I never really fit. Even when I was living as a lesbian, there were lots of times when my lesbian friends said, “You don’t want to come to this women-only event, because you’ll be bored.”

JM: Isn’t it amazing what other people in our lives can see in us before we can see it?

JG: Yeah, absolutely.

JM: We talk a lot about the violence against trans women, necessarily. It’s a huge issue. However, we don’t talk enough about the rates of self-harm and suicide that do affect the trans male community.

JG: And also domestic violence is something that really affects trans men. It hasn’t been studied that much, but that’s something that, you get into trans men circles, you’ll hear about. And often the violence is perpetrated by women, by female partners.

JM: I didn’t know that.

JG: Gay-identified trans men also can end up in a partnership with a gay man and end up in a violent situation.

JM: That also points to the larger issues of domestic violence. The rate for women, I think it’s one out of four or five will experience it. It’s massive. And the majority of violence against trans women specifically is intimate partner violence.

JG: That’s right.

JM: These speak to larger cultural issues, not just anything to do with transness.

JG: But people will use transness as an excuse for violence.

JM: In terms of the trans-masculine community specifically, in your 2004 book, you wrote that, “Though we’ve made great progress, I still don’t believe we have a real community yet. But I believe we should keep invoking it, keep trying to build it, because we are on our way to achieving it.” It’s been 20 years since you wrote that. Do you still feel that way, that we’re almost there, but not there yet?

JG: Yes, I still do. And my book has been reissued, in 2020, in a revised edition, because it was one of Vanderbilt’s best-selling books ever on their entire list.

And 2020 was their 80th anniversary year, and so they gave me an opportunity to update the text. And in the foreword I wrote, “At least two generations of transgender, nonbinary-identified, and other gender-nonconforming people have emerged since this book was first published. I see the YouTube videos, the Facebook groups, the conversations on Reddit and many other forums, the growth of community-based organizations, and the new scholarship flourishing in all the regions of the globe. And I love the energy and the commitment so many people are bringing to their self-explorations and efforts to improve the quality of life that trans people and their families experience. At the same time, I see that far too many people are asking the same questions that my own cohort of trans people asked 30, 40, 50 years ago.

And far too many people still believe that there is no information to be found about transgender lives. I know how tempting it is, in the US especially, to want to discard the past and forge new ground. But I’m also heartened by the recent attention to our collective history from today’s students and transgender-identified people who have been surprised and gratified to realize that they have not been alone all this time. We have ancestors and pioneers, and there is a context for our lives.”

So yes, I am still optimistic that we can form community. I think that the social media revolution that took place between the first and second editions of my book has changed things a bit. Online support groups are ubiquitous, they’re also not always very well moderated. So we’re in a difficult time.

JM: I have one more question about the first edition of the book, this was the one published in 2004, and the word you use the most is transsexual. Is that how you prefer to identify?

JG: Well, that was my diagnosis. I didn’t have gender dysphoria, the diagnosis didn’t exist, gender identity disorder hadn’t been invented, all those things were not there. And so there’s a lot of people who do identify with the term transsexual, and there’s a lot of people right now who will tell you that it’s an obsolete term, it’s insulting, people don’t care about it. Those terms are all relative, and our terminology is all over the place. I don’t go around saying, “I am a transsexual.” It was my diagnosis. If I had cancer, I wouldn’t go around saying, “I’m a cancer.” But the term is what is used in the medical literature.

And transgender is not a medical term, it’s not a diagnostic term, it’s a community-based term. And I’ve been really, really serious about, well, I was, I kind of lost the battle, about telling the medical profession that’s not their term to use or appropriate. They should not be treating transgender as a condition. Yeah, I lost that battle. But I still believe they should not be treating transgender as a condition. I think transgender health, that’s what they should be focusing on, is transgender health. Treat the condition, of transgender health you advocate, because it’s a transgender community.

JM: I’ve never heard anyone make that argument before. You’re saying that for the trans community, there issues to be treated, but the “issue” of being trans is not an issue, and not something to be treated.

JG: Right, it’s something for a trans person to manage in their own way. It’s something to be aware of, because it’s going to affect your social relationships.

JM: Similar to different sexualities. It affects much about your life, but it’s not a condition.

JG: Right.

JM: You’ve made transgender health policy a cornerstone of your work.

JG: Yes, yes.

JM: When did that begin? When did that become a focus?

JG: Well, the first thing was, when I started my transition, I had just started a new job, and so I got the insurance documents, and I saw something that I had never noticed before in any insurance plan, consciously, but that there was an exclusion for transsexual treatment, that was the language. All transsexual treatment would be excluded. And I thought, “Well, that’s a bummer,” because the language was written so broadly.

Because it was written so broadly that it meant, basically, that if I got a sore throat, I couldn’t go to the doctor, if I broke my leg, I couldn’t go to a doctor, it would be transsexual treatment, because I was transsexual. And in fact, many people experienced that. Many people have been thrown out of emergency rooms with lacerations and broken arms and stuff, because, “We don’t treat people like you, we can’t treat you, we can’t treat a trans person.” So I tried to figure out how to get insurance exclusions removed, and was fairly successful in that.

Then I realized, if we got exclusions removed, and it was okay for trans people to be treated in emergency basic medical care, as well as transition-related care, then we would need more providers. So that’s why I got involved with the Harry Benjamin International Gender Dysphoria Association. We needed somebody to be a champion organization, we needed somebody with some clout and authority, and they’d been producing the standards of care since 1979. So I joined that organization, I was on the board, and I was elected to another four-year, it was a four-year term, I was elected to another four-year term in 2007, and then in 2011 I was elected president, and had a presidential term that lasted seven years. And during that time I got them to start issuing policy statements, which I wrote.

JM: What were the biggest goals you had with those statements?

JG: Well, the first one was about the issue of medical necessity and insurance coverage in the United States, WPATH being a global organization, if something’s just about the United States, it has to be specified. These statements then go out, and they are available for activists to use, to leverage arguments to move things forward in their own jurisdictions, in their regions, and also to influence medical education about human rights, about the rights of trans people, about actual care. My goal was to change the world.

JM: Where are you at on that now?

JG: I’ve been pretty successful in a lot of ways, and we have a long way to go. Something that I have been advocating about for a long, long time is to be ready for conservative backlash, and to be ready for the religious right machine that has basically orchestrated all of these laws that are coming out in these statehouses. We’re just very lucky that we have a federal administration that isn’t buying into this. But we have a lot of battles to fight on the ground, in some of these states where these legislatures have just used us to create a moral panic to raise funds for themselves, and basically to tie themselves into these religious groups that are trying to take over the Supreme Court.

JM: It’s a tragic arc, from where you were in the ’70s and ’80s and people couldn’t define trans, to now. It’s being legislated against in statehouses everywhere.

JG: And it’s still not defined. They don’t know what they’re talking about. They haven’t the first clue what they’re talking about. They haven’t the first clue what actual treatment is. Just like they don’t know what critical race theory is.

JM: You talk in the book about bodies, how everybody can relate to being unhappy with some part of their body. And you write about women wanting to look like Barbie and men in the gym pumping weights looking like Arnold Schwarzenegger. And you write, “Body modification is a complex phenomenon. People have done it since the beginning of time, for various reasons and with various results. Changing one’s sex is just one way of changing one’s body.”

I think that’s profound, and that anybody can relate to that. And I wanted to bring it up because we have done such a great job moving the public conversation about trans people away from bodies and surgeries, and for a good reason, but we’ve also, quite possibly, removed the one thing from the conversation that everyone can relate to.

JG: Yeah. Interesting. I don’t know what to say in response to that. I really appreciate you noticing that.

JM: I guess what I’m saying is, how do we put the body back into the public conversation? Because, no, we don’t need to talk about what’s in your underwear, but we can talk about other aspects of the body in respectful ways, and it might even be our strongest tool.

JG: Yes, we can, and we should. It’s a human thing. This is what happens when you start editing education and saying, “You can’t talk about this and you can’t talk about that.” It means people don’t…they’re cut off from their own bodies, and they can’t learn about their own families, and they can’t learn about their feelings, and they can’t test anything about who they are. Like children are always trying to test boundaries, right?

JM: We have to move off gender because I also want to talk about sexuality. You came into your bisexuality in your 50s.

JG: Yeah.

JM: And I wanted to ask about that, because some people report changes to their sexuality with transition, but also your sexuality is allowed to expand and evolve as you get older. Can you talk about what your experience was like?

JG: Yeah. It was interesting to me. I have read, too, that it’s common—this was in an article many years ago, that ten years after hormones, so after ten years of cross-sex hormone experience, that people often will notice a change in their sexuality. And that’s sort of what happened to me. I mean, it isn’t that I was attracted to males growing up, looking back on it there were times when I was, but I was never actually interested enough to actually touch one, other than in playing football or in a fight. So I didn’t want to really have that sexual experience.

And then I got to a point where I was comfortable enough in my own body, and I think, basically, having the proper hormone balance for me was part of that, that I could relate to the idea of actually being physically intimate with a man. Now, I had had some physical intimacy experience with men, but it wasn’t ever very interesting or satisfying. After ten years of testosterone, I could recognize, “Ah, now I get it.” I don’t know how to explain it. But I was willing to experiment. And men came on to me frequently, so I always had plenty of opportunity. And I had broken up with a woman, and I was just thinking, “I should get a dog, or maybe I should…”

JM: Or date men?

JG: Maybe I should date men, one or the other. Maybe I was like, I kept having problems with women, mostly because women have problems with men. But it was really, really good to be able to let go of fears that I had about that, and to allow myself to be intimate with a man, or more than one, not at the same time.

JM: And to be able to enjoy it.

JG: And to be able to enjoy it, and to recognize that there is a difference between man-on-man sex and male-female sex. And I know the difference between male-female sex and woman-on-woman sex, it’s just different, there’s a different quality.

JM: Different how?

JG: For me, with men it is something just a little bit more like sport, it’s like fun. And then for me with a woman, well, there can be fun, definitely, there’s also what feels like a sort of, it’s a deeper kind of intimacy that comes from vulnerability. And I think with men that deeper intimacy, the vulnerability, is a place that doesn’t come up quickly, that comes up much later in a relationship.

I have had very deep emotional relationships with men that are very vulnerable emotionally, and I value that tremendously. There’s just more layers to get through before you get there with men.

JM: Oh, but with women that vulnerability is more frequently there.

JG: Yeah. And for a long time I thought what attracted me to women was the difference between them and me, that that difference was so important to that sort of excitement. And with men I don’t have that same feeling of difference. I know that to a certain extent some guys have been very, very forthcoming with me and said, your penis is different from my penis, I don’t know what to do, so help me, tell me what to do to make you feel good, and that’s great.

JM: That’s an amazing question to ask.

JG: Yeah. It’s very powerful.

JM: I think people think, oh my God, what do I do or not do with these body parts, and they stress out. And the answer is, ask.

JG: That’s right, that’s right. And I did learn that with women, I learned it with women, but I experienced it more reflexively with another man.

JM: Now, in your 70s, how has your relationship to sex changed?

JG: Well, I’m very monogamous, and I am very happily married to a woman who is also bisexual identified, and we share queer culture, she’s also a political activist and all that, so we share all that. And we have a very, very deep, fulfilling relationship, and I’m very, very happy in that respect.

I’m very glad to be also with someone who understands so many aspects of my experience through her own experience. She doesn’t understand everything, she hasn’t had genital reconstruction, she hasn’t had to have surgery in order to make herself visible, but she knows a lot about those different dynamics, and I really am grateful for that.

JM: Your gender took up so much mental space for so long. Do you even think about your own transness anymore?

JG: As a general rule, no. Except that I’m still dealing with it so much on a professional level, not about me, but about transness. And then I have to draw from my own experience and my contacts and things. So yes, it’s very present, but I don’t wake up every day and go, “Oh, I’m a transsexual.” I don’t wake up every day and think, “Oh, I went through all these processes.” I just am a human being, and it’s really great.

JM: You describe everything that we’ve talked about as a spiritual quest, coming to terms with one’s gender, you write, is no less meaningful than a spiritual quest. And so you transitioned almost 35 years ago now, has that spiritual quest been ongoing for you?

JG: Yes, yes. My spiritual quest continues, because life continues. Because people around me die, because people around me are born, because people are going through all these beautiful and sometimes horrible experiences, that’s all part of life. And life is a spiritual quest, but we don’t always recognize every aspect of life as spiritual in our busy, busy world.

Although I’m not affiliated with any religious denomination, I feel very, very much connected to the spirit of life. And I think that’s an important thing to recognize in every transaction, in every long-term goal, in every policy decision.

JM: Sounds like, for the first part of your life, that quest was focused on your own gender, and now it’s focused on your community.

JG: Yes. I had to figure out how I fit. All that struggle prior to my transition was all about, how do I fit into the world because people can’t see me, because people misinterpreted me, because people aren’t conscious of my experience. Well, nobody’s conscious of anybody else’s experience, you can’t demand that. But when you’re young, I think a lot of times that is what you want, you want to be seen, you want to have everybody understand everything, and you don’t know the difference between something deeply internal and something that isn’t acknowledged.

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LGBTQ&A features interviews with the most interesting lesbian, gay, bisexual, transgender, and queer people in the world. Hosted and produced by Jeffrey Masters. ⁠⁠⁠⁠⁠⁠@jeffmasters1⁠⁠⁠

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