   
Walter Bockting Narrator   Andrea Jenkins Interviewer 
    
The Transgender Oral History Project Tretter Collection in GLBT Studies University of Minnesota 
May 12, 2016 
 
 
   

 
  
The Transgender Oral History Project of the Upper Midwest will empower individuals to tell their story, while providing students, historians, and the public with a more rich foundation of primary source material about the transgender community.  The project is part of the Tretter Collection at the University of Minnesota.  The archive provides a record of GLBT thought, knowledge and culture for current and future generations and is available to students, researchers and members of the public. 
The Transgender Oral History Project will collect up to 400 hours of oral histories involving 200 to 300 individuals over the next three years.  Major efforts will be the recruitment of individuals of all ages and experiences, and documenting the work of The Program in Human Sexuality.  This project will be led by Andrea Jenkins, poet, writer, and trans-activist.  Andrea brings years of experience working in government, non-profits and LGBT organizations.  If you are interested in being involved in this exciting project, please contact Andrea. 
Andrea Jenkins jenki120@umn.edu (612) 625-4379 
   
 
Andrea Jenkins -AJ 1 
Walter Bockting  -WB 2 
 3 
 4 
AJ: So, hello. My name is Andrea Jenkins and I am the oral historian for the Transgender Oral 5 History Project at the Tretter Collection at the University of Minnesota.  Today is May 12, 2016, 6 and I am at Columbia University in New York City in the office of Dr. Walter O. M. Bockting.  I 7 believe the M stands for Maria but you can tell us a little bit more about that.  So, welcome Dr. 8 Bockting. 9 
WB: Thank you. 10 
AJ: Can you please just state your name, maybe spell it for our transcriptionist and then state your 11 gender identity and your pronouns and Im going to ask you the same questions I ask all my 12 other interviewees  what was your gender assigned at birth? 13 
WB: OK.  So Im Walter Bockting.  You spell my last name B-o-c-k-t-i-n-g.  I would describe my gender 14 identity as male and I prefer male pronouns, but I was very gender non-conforming as a child.   15 
AJ: Really? 16 
WB: Yes. 17 
AJ: Wow, OK. 18 
WB: Thats probably part of whats part of the impetus of getting involved in my work with the 19 transgender community. 20 
AJ: Your own personal . . . 21 
WB: Yeah, and I would say more importantly what has sustained me over the years because its just . 22 . . I have great curiosity about gender and a lot of that has to do with my own experience 23 growing up. 24 
AJ: Wow, thats fascinating.  Speaking of growing up, tell me your earliest memory in life.   25 
WB: My earliest memory in life?  I think my earliest memory was playing in a . . . it was in the 26 Netherlands where I was born in a small town and I played with peers in an area with a lot of 27 sand, kind of like beach sand and there was a little forest associated with it.  It was only a short 28 walk from my home and I would play there with my friends.  I think thats one of my earliest 29 memories. 30 
AJ: How old do you think you were at that time? 31 
WB: Maybe five or something like that.  And older kids in the neighborhood would pick me up and 32 we would go over there and play there most of the day  in the sun.  We would play house, 33 among other things. 34 
AJ: OK.  Thats a pretty typical childhood game around the world, I guess. 35 
WB: Yes, yes.   1 
AJ: What was your role in the house game?  The game of house? 2 
WB: You know, I dont remember.  Even though I was gender non-conforming, its not that I was 3 playing the mother or . . . but I do remember also at my home, so my mom was into sewing, 4 taught that, and design, so whenever I came back from school we were sitting at the kitchen 5 table, my mom would be behind a sewing machine and my dad had made me a little shop, it 6 was a butcher shop so often times I was playing like I was working in a store and I was fulfilling 7 orders of customers. 8 
AJ: Oh wow, so customer service kind of . . . 9 
WB: Yes.  And I remember doing that a little bit also when playing house.  I was definitely taking care, 10 I guess, of the environment but other than that I do not remember specific gender roles. 11 
AJ: So what people may consider womens work or . . .? 12 
WB: Maybe a little bit, yes.   13 
AJ: So you grew up in the Netherlands? 14 
WB: Correct.   15 
AJ: What was your school life like? 16 
WB: I think my school life . . . I enjoyed going to school.  It was just a little walk from where I lived 17 with my family, with my parents.  I remember at some point though that I became very aware of 18 being different.  There were some . . . when I was 6 or 7, I think that was hard.  I was teased.  19 There was no violence, but I was definitely considered different and called a girl.  I later learned 20 that when I was four-years old that my mother went to the family doctor and discussed with the 21 family doctor that I was a very feminine boy and asked whether maybe a shot of testosterone 22 might help. 23 
AJ: Oh wow. 24 
WB: And the family doctor said, No, you have to accept him the way he is.  25 
AJ: Really? 26 
WB: And my parents really did.  So they were in tune with that and they always supported me, but in 27 school I still felt different.  I had favorite teachers and I excelled in school, so I always had very 28 positive experiences and people looking out for me.  But I think especially at that age, then there 29 is an increasing segregation between boys and girls and the school . . . so the girls were playing 30 in front of the school on the playground, the boys in the back were usually playing soccer, and I 31 was always on the side  in-between, with a number of other people that were there too. 32 
AJ: Oh wow.  You guys were the in-betweeners. 33 
WB: Yes, exactly.   34 
AJ: Thats really interesting, Walter.  Is it OK if I call you Walter? 35 
WB: Absolutely. 1 
AJ: One of the reasons why we are talking to you today and including your voice in this process, this 2 program, is because of the positions that youve held at the University of Minnesotas Program 3 in Human Sexuality.  What was your position there, your title? 4 
WB: I was the Coordinator of the Transgender Health Services.  5 
AJ: And now youre here at Columbia University and whats your title here? 6 
WB: I am the co-director of the Program for the Study of LGBT Health. 7 
AJ: OK, wow.  So you have this sort of broad awareness.  When I talk about you to friends, I 8 generally describe you as one of the preeminent scholars in the world that thinks about, writes 9 about, researches about transgender identity, particularly as it relates to HIV and AIDS.  You 10 have been the former past-president of the Harry Benjamin Association which is now the World 11 Professional Association for Transgender Health.  Am I correct?   12 
WB: Yes, correct. 13 
AJ: And so we really thought that your voice is an important piece to this project as we think about 14 transgender identity, what was its origins in terms of the medicalization of transgender people, 15 and then even more specifically that origin story that happened at the University of Minnesota.   16 
WB: Yes, I can tell you that story. 17 
AJ: Can you talk to me about that a little bit? 18 
WB: Yes, I can tell you that story.  I really first heard about the Program in Human Sexuality when . . . 19 I will start at the very beginning. When I was an undergraduate student in psychology at the 20 University in Amsterdam, I had to write a paper for a class and I didnt have the foggiest idea of 21 what to write it on.  I was watching a talk show, this was in the 1980s  early 1980s, and there 22 was an author who wrote a book about his relationship with a transgender woman.  So I 23 thought, Huh, why dont I do my paper about this?  I went out and got the book and wrote a 24 paper, gave it to my professor, and the professor said, Why on earth would you write a paper 25 about transgender people?  He said, You might as well write a paper about injection drug 26 users.  And I said, I think both are excellent topics for a psychology student. 27 
AJ: Oh wow, good for you. 28 
WB: He actually turned out . . . after he read my paper, he said, You know, you should know that the 29 psychologist that does most of the evaluations for the sex re-assignment program here in 30 Amsterdam, is a professor in our department.  You should really go and talk with him.  His name 31 was Anton Verschoor.   32 
AJ: How do you spell his name?   33 
WB: V-e-r-s-c-h-o-o-r.  Anton Verschoor.   34 
AJ: A-n-t-o-n.  OK. 35 
WB: Yeah, and as you may know that Vrije Universiteit in Amsterdam is still one of the very 1 prominent, very well-known transgender program where a lot of research is done, where they 2 really invented the early medical intervention for transgender youth.  So that history goes all the 3 way back.  At that time there was an endocrinologist at the university, and a surgeon, but all 4 their mental health work in the psychology department was done in the private practice of 5 Anton Verschoor.  And so I went and saw him and he said, Oh, youre coming to do your 6 dissertation?  I said, Well, no, Im an undergraduate student.  And he completely took me 7 under his wing, he invited me to observe sessions in his private practice, he introduced me to 8 the transgender community in Amsterdam in the early 1980s.  I went there with my partner who 9 was a cosmetologist, a make-up artist, so we spent time with the community there and we went 10 on tour with some of the performers.  So I completely immersed myself in the transgender 11 community in Amsterdam.  Then several years later when it was time for me to do my thesis, I 12 went back to Dr. Verschoor and said, Im ready to do this now, and I then did research on 13 gender non-conformance among gay men as a comparison group to the transgender people that 14 he was working with  a survey in the Netherlands. 15 
AJ: Fascinating. 16 
WB: And so when I was presenting the idea for that study at a meeting, thats where I met Eli 17 Coleman who was the director of the Program in Human Sexuality.  Eli was there on a sabbatical 18 and he was doing a study on gay and bi-sexual identity development among female to male 19 transgender people, now transgender man.  And these were Dutch transgender men and he 20 needed somebody that spoke both Dutch and English and so he asked me to do the interviews 21 with him.  At that time, it was assumed that all transgender men were attracted to women and 22 were heterosexual and when a transgender man was attracted to other men, then there were 23 questions about whether this person would be a good candidate for hormones and for making a 24 transition.   25 
AJ: Yeah.  I was going to say, even beyond being assumed, it was sort of encouraged, right? 26 
WB: Well, it was considered a potential conflict indication, that youd have to move very cautiously 27 and later on we found that in the United States, some transgender men told us that they were 28 denied access to a particular surgery because they revealed that and that was, at that time, not 29 known as part of what a transsexual profile is like.  In the Netherlands they had done this and 30 we interviewed nine or so of them.  And then Eli invited me to come to the United States to 31 write up the results of those interviews.  We also had done an interview . . . when I came to the 32 United States we did an interview with a transgender man who was diagnosed with AIDS and so 33 that is also another story that we wrote up and that was in the second half of the 1980s, and 34 published that.  So during that trip, I visited the Program and that was, it still is, a place where 35 people come with a variety of health concerns.  They have a very large clinic, they also do 36 research, and it has a critical mass of people that are all passionate about gender and sexuality.  37 So when I came back the following year for my second visit to the United States, I more or less 38 interviewed, informally interviewed, for . . . well, not only informally, there was a formal 39 interview that followed, and they hired me then as one of their very first post-doctoral fellows 40 as I was graduating in Amsterdam. 41 
AJ: Wow. 42 
WB: So this was August, they offered me the job.  I took the job, I went back to the Netherlands for 1 five weeks, packed my things and moved to the United States.  That was in 1988. 2 
AJ: 1988. 3 
WB: It happened to be just at the time that Sharon Satterfield was the director of the transgender 4 program from 1979 or so to 1988.  Left on sabbatical on Friday and I arrived on Sunday 5 afternoon and Monday I was seeing her patients. 6 
AJ: Is that right? 7 
WB: Yes.  And Monday evening I had my first therapy group with transgender people.  Now I had 8 done some work during my internship in the Netherlands, but I really had this incredible 9 opportunity to start there with a full caseload of wonderful transgender clients and their 10 families that I worked with.  After the fellowship, thats when I became the coordinator of the 11 transgender services.  I think what I really found at the time, which was just typical of that time, 12 is that it was a program very much focused on . . . initially there was a 12-week intensive issues 13 group, where people sorted out and learned a lot about being transgender and where they were 14 on the spectrum.  And after that 12-week group, people then were either moved to a pre-15 surgical group, started hormones and moved to a group where they would be preparing for 16 surgery  or to another group which was a non-surgical group, which was a very interesting 17 group.  Those groups met monthly and I remember the first group where I was with Kathy 18 Rowski, my co-therapist, and wed come into the group room and there were two circles.  There 19 are so many people in this group, like 18 people or something  20 people, that they couldnt sit 20 in the room in one circle.  And then everybody started to check-in and the session was only two 21 hours.  So one person would talk about . . . that they had gone out and that they had had 22 difficulty finding shoes for the size of their feet, and another person had a new hair, and this and 23 this and that.  I thought, This is all wonderful, but this is not what therapy is.  I mean Im 24 overstating it a little bit, but I felt that with that many people in the room you cannot go very 25 deep. 26 
AJ: Right, exactly. 27 
WB: So we then re-structured it and we did sort of a review of the program and where things were at 28 and we decided that we should have groups that meet twice a month, that it shouldnt matter 29 where people were going  that we should have a mixture, a diverse smaller group of people in 30 each of the groups, and that on an on-going basis they could explore where they were at and 31 they could talk about how they were dealing with their family and so forth.  So we changed from 32 that non-surgical, pre-surgical concept to more of seeing transgender as an ongoing thing.  And 33 then I think there was one critical . . . 34 
AJ: So surgery became less of a driving . . . is that accurate to say? 35 
WB: It was . . . I think surgery remains an important intervention for some, but it was not the old 36 model of we screened people and either they are going to change their sex, and that includes 37 surgery, or they are not going to change their sex and theyre going to find some other way of 38 managing it.  It became more like we were supporting people in finding themselves and 39 actualizing their identity in whatever way they need to, want to, is comfortable for them, and 40 recognizing that that could also change over time.  I think by that time, the early programs that 1 started in the late 1960s and 1970s, in the early 1980s most of them had closed so there were 2 only . . .  3 
AJ: So like the Johns . . .  4 
WB: Hopkins and all these programs.  I think only Galveston and Minnesota remained, and remain to 5 this day.  I think, though, that in the 1990s, if it werent for the changes that we made, that that 6 approach had seen its days.   7 
AJ: Sure. 8 
WB: And there was one really . . . I think the most important part in my career development you 9 could say, but also I think for the program  very critical, is that people who had gone through 10 the program early on, came back to see me.  And they began to talk about their experience.  11 They had transitioned, many of them  or most of them, had had surgery a long time ago.  They 12 wanted to re-connect with the program, re-connect with each other, and they asked me to 13 provide opportunity for them to meet in a support group.  They invited me to be present but I 14 was like an observer.  I wasnt a therapist.  Facilitator . . . but I mainly learned from this group of 15 . . . initially it was only transgender women. 16 
AJ: Post-operative transgender women. 17 
WB: Yes.  There was one person in the group who had back to me earlier who really struggled with 18 regrets, which is very rare.  But this person felt she made a big mistake and was very unhappy.  I 19 think one of the reasons why she came back to the program is that the program hesitated, 20 actually, to support her surgery.  And she went to a different program then and she was upset 21 with the program and then she had the surgery and she was, by all accounts, very successful in 22 living her life as a woman and then it all fell apart years after that.  I think part of why she 23 returned to the program is that she remembered that the program had some questions.  But 24 there was a great deal of pain and grief that she was dealing with, so she was in the group.  And 25 then there was somebody in the group who, at one point, just said, In all honesty, I cannot 26 consider myself a woman.  And she said, Its not that I regret what I did, its not that I see 27 myself as male, but Im not a woman either and in all honesty, I cannot claim womanhood.  28 And she said, Im transsexual, thats what I am.   29 
AJ: Im transsexual.   30 
WB: Yes.  And the other person in the group had a complete meltdown and it turned out that this 31 person really recognized, was very upset for the fact that here for all these years the 32 community, the health  professionals, the discourse, had prepared her and in her words, had her 33 believing that you could change sex and now she found out that that was not really what it was 34 and so she felt very betrayed, and at the same time this rang true, what this other member said 35 really rang true for her, and it ultimately really helped her because she realized . . . she 36 considered should I have my breasts removed, should I go back to living as a man, she 37 experimented with that.  But she realized no matter what I do, whatever I do, Im transgender 38 and I will always be, and then made peace with that.  So I learned, I think, in that group that this 39 is much more of its own identity, that there is a spectrum in terms of how people identity.  If 40 you have two choices  OK, transgender man fits better in a mans body and transgender 1 women in a womans body but maybe we have more than those two.  There is a spectrum and 2 we should help people really to explore and actualize who they are, no matter where theyre at 3 on that spectrum of gender diversity.  We then changed the program thinking about it more as a 4 coming out model, if you will.  So thats group and . . . I guess maybe its not the most 5 speculative but I think of the old timers . . .  6 
AJ: The returners, well say. 7 
WB: Thank you.  Really informed our program and that led to further changes in the 1990s.   8 
AJ: Wow.  So, those women, primarily you said, who came back really helped you and the program 9 to be able to shift ideas around what it means to be a transgender person and how treatment 10 should occur.  How did that shift . . . the broader field of transgender services and medical . . .? 11 
WB: I should also mention that in the early 1990s when several of our transgender clients tested HIV-12 positive, that we applied for a grant from the American Foundation for AIDS Research to 13 develop a model prevention program that would address the HIV risks of transgender people.  14 The requirement of that project was that you had to have a community advisory board and we 15 put that together with a whole range of different pockets of the Minnesota transgender 16 community.  So there were the transsexual people, there were the cross dressers, there were 17 the drag queens and the female impersonators, there were transgender men.  So we had a very 18 diverse group and they were involved in every stage of this program.  For some of them, this 19 was the first time that they were sitting at the same table and they were sitting at the program.  20 People always have had all kinds of perceptions and experiences with the program and I think 21 this was also the beginning, I think, of the transgender movement  really a lot of empowerment 22 out of a very difficult place, the community empowering themselves in the 1990s.  And we were 23 doing that in a smaller way with that group. 24 
AJ: So in New York City, Ricky . . .  25 
WB: That was happening at the same time. 26 
AJ: That was kind of coming up. 27 
WB: Yes, and the Gender Identity Project here in New York, definitely.  In Minnesota, at that time 28 also, the state human rights act included gender identity. 29 
AJ: Right, I think that was 1992. 30 
WB: Exactly.  So all of these things were happening and it took me a while to realize that even though 31 some of that was happening in New York and maybe some other places in the country, that it 32 wasnt happening everywhere.  I thought we were part of a movement that was definitely 33 nationwide, I knew that Europe was behind in this regard.  But I thought it was nationwide and 34 when I would venture out to national meetings or to other states at times, I assumed that but I 35 actually learned that that was not necessarily the case. 36 
AJ: People were fascinated by your work and your research and bringing all these people together. 37 
WB: Yes, and I think it actually was very unique and pioneering, even to the point that when I came 1 to New York many years later, now three years ago, that certainly within the health care system 2 what we have grown accustomed to in Minnesota really doesnt exist here.  So I think that . . . 3 
AJ: Certainly not in the same way. 4 
WB: No.  So I think that involving the community as partners in the program that then also began to 5 encompass research and always had encompassed training and clinical services, really we were 6 able to gain a lot of experience with deaths, that now when Im here, is just incredible the 7 wealth of knowledge that I have just based on working with the people in Minnesota for those 8 two decades.  I mean, there is nothing like it and it goes very deep.  And also when I train people 9 now, I mean you cannot just pass that on in one supervision session, right? 10 
AJ: Yeah. 11 
WB: But I think its amazing and it still inspires my research questions and it still also inspires 12 whatever I can do to contribute to the human rights issue that transgender and gender diversity 13 has become today. 14 
AJ: Sure.  I know that . . . so this pioneering work that you talk about, it actually shifted how the 15 standards of care were, or are, designed and developed.  Talk about that a little bit. 16 
WB: Yeah, so actually . . .  17 
AJ: What are standards of care? 18 
WB: Ill get to that as well but I think I should start at the beginning.  This was in the mid-1990s, early 19 to mid-1990s, I wanted to organize, at the Harry Benjamin meeting, a panel of transgender 20 community members to bring this perspective.  So I had invited Kate Bornstein, I was thinking 21 about inviting Susan Kimberly, and people who gave that kind of a perspective of thinking 22 beyond transition and getting a community voice on what its like to live your life as a 23 transgendered person.  They were not very supportive of doing that.  I also later on suggested 24 that the Benjamin Association would get a community advisory board because we had such a 25 good experience from that in Minnesota. 26 
AJ: Right. 27 
WB: And they also felt that that wasnt really necessary.  And there were some other concerns that I 28 had and then I was approached by the Gay and Lesbian Health Association to do more about 29 transgender.  And so there was a choice between do I . . . am I going to be part of starting a new 30 organization, the American Transgender Health Organization or something like that, or are we 31 going to help the Benjamin Association shift.  Eli and I discussed it, we chose the latter, and 32 thats when we . . . I think shortly thereafter Eli ran for president and became president of the 33 organization and Dean Robinson at the Program because the Executive Director and we brought 34 the office of the Benjamin Association to Minnesota and then also under Elis leadership, the 35 name was changed to the World Professional Association of Transgender Health.  And then later 36 on, I ran for president and we made further changes . . . I think it took about more than a dozen 37 years or so to, I think, really change that organization from within - from a rather small elite 38 group certainly of pioneers who were concerned about transgender health when nobody else 39 was, to where now this huge professional organization that it is today that is really thriving.  So I 1 think the approach that was developed from the program, that started with that group  that 2 support group, really then ultimately had an effect on WPATH and then when I was president 3 we revised the standards of care in a major way to reflect much more thinking about gender as 4 gender diversity and a much less binary approach and a more holistic approach to transgender 5 health.  And that the standards should also speak to more than what people might need as part 6 of medical transition.  So thats when we really re-vamped and it was a large process and many 7 people around the world were involved in doing that.  And then, we were able to launch those 8 new standards, which are really guidelines for transgender care  that traditionally . . . you 9 asked what they are.  So traditionally more guides eligibility to hormones and surgery but the 10 new version is broader than that and just talks about the role that health care providers can play 11 to facilitate gender affirmation for the transgender community and for gender non-conforming 12 people. 13 
AJ: Were you ever able to institute the community advisory group? 14 
WB: No, but what happened over the years is that, of course, there are many transgender people 15 who at the same time are health providers or who are scholars and researchers, so they made 16 sure in the organization there are a growing number . . . 17 
AJ: So more transgender identified people have become . . .  18 
WB: Professionals.  Its a membership organization and it now includes more and more transgender-19 identified members and officers of the board and so forth. 20 
AJ: Wow.  Talk about sort of how you feel . . . and youve touched on this a little bit, but just being 21 sort of . . . I would say a pioneer in this new understanding of transgender identity that 22 happened along the same time as the community began to find a voice.  How do you feel 23 personally being engaged in that?  And what do you see as sort of the future of our 24 understanding around transgender identity? 25 
WB: It is my lifes work.   26 
AJ: Right. 27 
WB: My training is broad in sexuality, Ive always had an interest but transgender people have always 28 been my first love and I remain very interested in understanding gender identity development 29 and understanding the transgender experience and ways to really, I guess, empower the 30 transgender phenomenon, the transgender experience, to be more integrated in society.  I think 31 what we recently, in the last couple of years, have seen is something thats what was, at one 32 point, beyond my wildest dreams  that transgender would become such a prominent issue.  So 33 when I started doing this work, including Eli told me this is not a good area to pursue, youre not 34 going to be able to get research funding and this is not good for your academic career  youve 35 got to be broader.  I listened only partially to that.   36 
AJ: Right. 37 
WB: But it actually turned out that I was able, through HIV I think, to succeed and get federal funding 1 and do research on a larger scale.  I think nowadays suddenly everyone, NIH is now doing it 2 more but they still have a way to go. 3 
AJ: The National Institute of Health  NIH. 4 
WB: Yes.  But everybody, especially the younger generation of scholars, theyre all interested  5 everybody is doing transgender.  So as a result Im reinventing myself really.  I really think that 6 we need to take it to the next level, but there is a lot of community-based research that is 7 excellent and its good that everybody is getting involved but I think we still have not brought 8 the resources of academia, particularly of academic health centers, fully to the benefit of the 9 transgender community.  So, for example, hormone therapy is still off-label use, so the kind of 10 research . . .  11 
AJ: Im sorry, can you just . . . off-label use? 12 
WB: It means that the hormones are not developed specifically to feminize or masculinize.  These 13 medications are there for other indications. 14 
AJ: Other use, exactly. 15 
WB: Like hormone replacement therapy. 16 
AJ: Right, menopausal treatment. 17 
WB: Right.  And so as a result, the kind of research that, for example, they put in medications that 18 they use for cancer or something, they have done a lot of research on this  very thorough and 19 there is much more known, not everything is known, but much more known about the benefits 20 and risks and the indications and what it does and what it doesnt do, and there are many 21 options available.  But for transgender people, they have not really done the research and I 22 think that now it shows most . . . Im very concerned about the way puberty suppression for 23 transgender youth is being rolled out in this country and I think, no doubt, it is a life-saving 24 intervention for some transgender youth.  They started doing this in the Netherlands in the 25 1980s and they have quite some experience with this now and I think it is safe and really 26 beneficial for youth who really have a very adverse negative reaction to puberty.  But in this 27 country it is like when you are gender non-conforming, or maybe Im overstating it a little bit, 28 but when youre not a typical boy or typical girl you must be transgender and you suppress your 29 puberty.  I think when we do not know really what the impact of those medications is on overall 30 development or brain development.  We know that in addition to suppressing puberty that 31 these GnRH analog medications, they have other roles to play in ones development.   32 
AJ: I never thought of that. 33 
WB: Yes.  And so when you have a child that is 12 or 13 that is just in terrible distress, way beyond . . 34 . you know, any adolescent might have some distress about puberty, then its easy because you 35 have these medications available, you can alleviate that distress so when you weigh the risks 36 and the benefits  yes.  But when you have kids that are transgender that probably could go 37 through puberty, that may wonder, Well, whats happening to my body might not be what I 38 ultimately want, but theyre not down and out distressed, then it becomes, I think, a different 39 decision because when you then weigh the potential benefits  OK, for trans man, I wont have 1 scars here because my breast development will prevent it from happening, you weigh that then 2 against the unknowns as well as, I guess, the social consequences of putting puberty on hold for 3 a little while.  I think that the cross-sex hormones are, in some ways, much safer because it 4 mimics more, even though people take much higher doses, but it mimics more what non-5 transgender people go through.  But I think the puberty suppression hormones, there is so much 6 that we do not know and we do not know in the long run how that affects peoples quality of life 7 and their vulnerability to chronic disease in later life.  So unless you have a very strong indication 8 . . . now with that, back to our discussion, I think is that were back, so as we developed in 9 Minnesota and we were able to get a better understanding of the richness of gender, the 10 spectrum of gender, the diversity, and the added value of being a person of transgender 11 experience, now within the youth were back at, Is it a boy or a girl?  And lets put puberty in 12 alignment with that.  So in some ways were going back only a little bit, but were going back a 13 little bit and thinking about gender in a binary way and when you are not a typical boy, puberty 14 suppression and those hormones at an early age, can make you a typical girl  so maybe sex 15 change is possible as long as you start early enough. 16 
AJ: Right. 17 
WB: And I do not know that.  I think that based on all my work with people of all ages, and the work 18 in Minnesota, I know that thats not a solution for at least a sizable sub-group of this 19 community.  Theyre not going to be comfortable or for them it will be too limiting or it wont be 20 quite who they are to really change sex in a binary way like that.  It is sometimes difficult when 21 you work with really young people for them to . . . they have internalized the gender binary and 22 so for them to get a sense of what its like to be 35 or 45 or 55 and live as a transgender person 23 in this world where gender is changing, they cannot comprehend that necessarily.  And so at a 24 very early age, in the case of a male born young transgender person, their puberty . . .  25 
AJ: Maybe Jazz Jennings, as an example. 26 
WB: Yes.  Well I do not know the medical situation of the person is but we are also preventing the 27 development of their genitalia and it has implications for fertility.  So in other words, in the 28 Netherlands there was also the idea that when you do that its the first step, and yes its 29 reversible for a while but if you then continue youre going to have surgery when you are 18 or 30 20.  But what if, as what happens for so many people, eventually thats not really what they 31 need or want, what is it like to live as a transgender women with underdeveloped genitalia?  32 Maybe its not fine and wonderful. 33 
AJ: Right. 34 
WB: But I think that these are the unknowns.  So I think that I really came to Columbia because I 35 wanted to bring the resources of a very research intensive organization, institution, to really 36 study these things also on a very basic science level.  So what does the puberty suppression due 37 to the brain?  And by working with animal models we can see what it does on a cellular level and 38 we can get a better understanding so that we can be more informed.  Of course its a long way 39 from dealing with mice or a rat to a human being, but I think that for most health issues, this 40 research is part of what is being undertaken and for transgender people, somehow we dont 41 need to do that and we can do harm reduction and we can do things that we dont really know 1 what were doing.  That treatment may have to go on at the same time, but we should at the 2 same time strive to build the evidence base that informs treatment so people can make the best 3 decisions for themselves.  4 
AJ: So not only imagine a brighter future but actually work towards that? 5 
WB: Yes.   6 
AJ: More scientific-based knowledge around . . .  7 
WB: And then Im not even talking about . . . thats always been the other part of my work is what 8 can we learn from transgender people about gender for everyone, about development and 9 about . . . it goes deeper, even the meaning of life.  I find that most of the transgender people 10 that Ive worked with, you come to a point in psychotherapy that youre really talking about . . . 11 its a very spiritual path. 12 
AJ: Yes, what does it mean to be human? 13 
WB: Yes, exactly.  I think that thats why I enjoy working with transgender people because the 14 questions that they wrestle with immediately give you access, rather quickly  thats what were 15 talking about.  And I think that the more . . . in some ways, when it comes to identity, the more 16 we sit with what we dont know that we can feel it, appreciate it.  I think what Im saying is that 17 we do not necessarily have the vocabulary to articulate very well how being transgender is 18 different from being a non-transgender man or woman.  Were struggling to try to put it into 19 words  gender queer is the latest word, but do we really know what it is?  If I have to explain it 20 then its difficult. 21 
AJ: Its difficult, yeah. 22 
WB: But I think its part of . . . last night I was in a discussion with my Norwegian colleague and we 23 have a neighbor who is an older gay man that has lived in the village for 35 years.  And my friend 24 started to talk about, my colleague, being Jewish and how that really is embedded in the way 25 she approaches relationships and the role of survival and all of that.  I was thinking then, and we 26 talked about the fact that there is a similar thing in terms of being LGBT  that we are a different 27 tribe and a different sensibility, we bring a different history.  We might be younger as a group in 28 terms of the awareness then maybe Jewish  that goes so many centuries back.  Of course there 29 have always been LGBT people, but I mean . . .  30 
AJ: Right, in Jewish culture there are eight different words for gender . . . in ancient Judeo Jewish 31 torah.   32 
WB: I didnt know that. 33 
AJ: But you were having this conversation about tribes? 34 
WB: Yes.  So in other words, I really helped, at least thats what he says, my neighbor, who had never 35 met a transgender person.  He said, Well Ive lived my life as a gay man in the village and Ive 36 certainly seen a lot, but this transgender thing  I have to be honest with you, I have difficulty 37 with it.  And I said, Well have you ever met a transgender person?  He said, Well, Ive seen 38 them but Ive not really met.  And you know, an hour later, this was in my neighborhood bar, 1 there are three transgender women that come in and one is this beautiful Black, big transgender 2 woman, and sits at the bar and I said, How are you?  And she says, Oh, Im just done 3 performing and I make a living performing.  And so my neighbor says, Well what kind of 4 performing?  Well, I do drag shows.  And he asked her, What is it like as a woman to work in 5 this mans world?  So in other words, he didnt really recognize that she was a transgender 6 woman and thought that she was a woman and shes doing drag shows so, What is it like to be 7 a woman doing drag shows?   8 
AJ: Right, exactly. 9 
WB: And so then she says, Well, I do have a dick.  She said . . . you know. 10 
AJ: Oh my goodness. 11 
WB: So it illustrated what we . . . I think it illustrates what weve been talking about now too.  It was 12 an ah-ha moment for my neighbor.  For the first time he really connected with a transgender 13 woman and then I talked with him about how I admired that and respected that she was so 14 comfortable  that this transgender woman was so comfortable with herself and they could talk 15 about it so openly.  And that even though transgender women might really identify as female 16 and transgender men might really identify as male and might in many ways live that way, that 17 there is another dimension.  Im thinking now, but Im not transgender so I can only . . . this is 18 just a thought that I have, that I think transgender people, in some ways, have more in common 19 with LGB people than they have with other men and women.  So, in other words, back to this 20 idea of tribe, and I think maybe transgender is their own tribe, but I think . . . 21 
AJ: I think its both/and. 22 
WB: Depending on how big . . . or within Jewish tribes, you could narrow it down to Orthodox Jews 23 or particular . . . yes.  So I think thats hard.  We are different people, we are different gender, 24 and I think that we are now thinking of gender in a much more diverse way and I think still today 25 in the discourse, especially around the youth, that gets lost and Im concerned about that.  26 Thats what, in my clinical work, I try to bring in and I have to say, with the young people that I 27 work with . . . I mean yesterday . . . Tuesday, not yesterday, Tuesday.  I saw a 17-year-old client 28 who came out in school, in a girls school, and she doesnt like her period.  He also prefers male 29 pronouns, so Ill use that.  He doesnt like his period and so I said, Well we can certainly address 30 that, I can refer you to a doctor you can talk to about that.  And I said, But first I have to 31 formally assess a little bit more, I hadnt really done a formal assessment of his gender feelings 32 and so forth.  And he said, Do I have to feel totally male in order to do that?  Do I have to 33 identify as completely male in order to get that help?  I said, No, it doesnt matter.  If you are 34 distressed by your period we can do something about it no matter what your gender identity is.   35 
AJ: Right.  Wow. 36 
WB: He loved hearing that and he was checking that out.  And then the family came back into the 37 room, the parents, and a very similar thing.  They have difficulty thinking about their daughter as 38 male but they can think about their daughter as a transgender man or a gender queer person or 39 what have you.  So as long as there is that qualifier, they also still feel that they have their child 40  its not that the child that they thought they had is gone and there is somebody else.  So thats 1 another way of thinking about, think about the continuity.  So I think my current motto is 2 transgender health beyond the binary and beyond transition.   3 
AJ: Wow, thats fascinating. Dr. Bockting, what is your sexual orientation? 4 
WB: Well Im attracted to men. 5 
AJ: Youre attracted to men.  Are you in love? 6 
WB: Well right now actually I am in limerence.   7 
AJ: Limerence. 8 
WB: Do you know what that means? 9 
AJ: I think I have a sense of what it means  sort of in the in-between stage maybe? 10 
WB: No, limerence means the first phase of being in love.  In a relationship typically if things continue 11 it matures more into love, but this is this feeling of being in love and having butterflies in your 12 stomach thinking about somebody all the time.  So Im newly in love.   13 
AJ: So youre in limerence? 14 
WB: Yes  yes.   15 
AJ: We should probably end this interview so you can call your . . . 16 
WB: No, I think I have learned some self-control  yes. 17 
AJ: OK.  You talked about the future and sort of looking at how were treating, particularly young 18 people, and I know a lot of that work is happening back at the University of Minnesota in the 19 Program in Human Sexuality.  Are you guys doing some of that work here at Columbia 20 University? 21 
WB: Yes.   22 
AJ: How many patients would you say are coming in . . . how many young people? 23 
WB: Its interesting, and I spoke with my Norwegian colleague who directs the program in Oslo, that 24 we mainly . . . I have seen some adults, some of them are people that I actually have known 25 from before that are coming back.  Ive seen some people who are making, one or two, that are 26 making a transition later in life and struggles with an aspect of that.  But the vast majority, 90% 27 of our referrals are all young people. 28 
AJ: Wow  90%? 29 
WB: Yes. 30 
AJ: Thats incredible. 31 
WB: This is just now standard, that transgender people come at an early age.  Childhood or 32 adolescence.   33 
AJ: That is so incredible.  Ive got to say, Walter, I really believe that . . . I had the good fortune, the 1 honor, to be a part of some of the research that you talked about a little earlier in our interview, 2 under the auspices of the All-Gender Health Seminars, which lasted for about 10 years and 3 really, I think  if I were to try to describe it, focused less on medical transitioning as it did social 4 transitioning. 5 
WB: Yes, Im glad you picked that up. 6 
AJ: And so, even though medical sort of was a part of it, and is a part of the transgender experience, 7 but a much larger aspect of it is how do people feel in the world and how they are treated and 8 respected in the world. 9 
WB: Right. 10 
AJ: So I think that work, even though it was localized, in Minnesota, actually reverberated out and 11 really helped to start this whole . . . because you would bring in people from national speakers 12 and other parts of the country to participate, and I think it sort of reverberated out to really 13 start people to thinking about this broader aspect of sort of social transitioning and social 14 awareness and then has brought us to the point today where now legislators all around the 15 country are really sort of creating this backlash to the transgender community because of the 16 empowerment, because of the outspokenness that so many in the transgender community have 17 began to express about demanding our human rights.  Where do you see this argument going in 18 the future from just a purely social and political perspective? 19 
WB: I think thats . . . two things to connect some dots.  I think one was that after this HIV-prevention 20 program, a half-day workshop that we developed and that was disseminated into many places 21 around the world  that model, what we learned when we evaluated that, that transgender 22 health was much broader and that HIV is not necessarily the first priority  its one of the 23 priorities that transgender people have but yet we needed to address transgender sexuality.   24 
AJ: Sure. 25 
WB: So thats then what we did and thats how All-Gender Health came into being.  It is interesting 26 that this was in the mid-1990s and I still remember Pauline who coined that term.  We were 27 looking for a name for this and she said, Why dont you call it All-Gender Health, and we now 28 know that now we have all-gender bathrooms everywhere, including in the White House, and 29 theyre using that term. 30 
AJ: Yeah, absolutely. 31 
WB: And I think you are very right, that it is first and foremost a psychosocial social experience and I 32 always tell my clients now that taking hormones is the easy part  you just take it or inject it.   33 
AJ: Inject it, put a patch one. 34 
WB: Right, and in some places that are new to transgender care, they think transgender care is 35 hormones but no, its really a lot more than that.  So youre very right about that.  And yes, we 36 had this coming out model  we had speakers from other places around the country, we 37 evaluated, we published, we trained people in other states in this model, and then we created 1 an online version that we did. 2 
AJ: Right. 3 
WB: So it has really . . . and it originates from the SAR. 4 
AJ: Yes, the Sexual Attitude Reassessment  yes. 5 
WB: All the way to the early 1970s at the program.  But I remember, I said earlier, that things have 6 become so visible, beyond my wildest dreams, in the way we talk about gender and that 7 everybody is aware of this.  Its on television, the President and . . . I had a conversation with 8 Virginia Prince, who is one of the founders of the current transgender community, and a 9 pioneer, the person that definitely identifies as transgender and was open about it and, for her, 10 that did not include genital surgery. 11 
AJ: Right.   12 
WB: I had conversations until deep into the night with Virginia and I said, Do you ever think that we 13 will think beyond two genders, or that what we are talking about here will be common place?  14 And Virginia said, Walter, the train has left the station.   15 
AJ: Oh wow. 16 
WB: At first I thought . . . I think I may have said it, Theres a long way to go.  But she had that 17 foresight and she was absolutely right.  I think the train has just been running with increasing 18 speeds.  Every time I think that weve hit a ceiling, LaVerne Cox on the cover of Time Magazine  19 boom, now we have the attorney general. 20 
AJ: Loretta Lynch. 21 
WB: Saying, Transgender people  we see you, we stand by you, we will protect you. 22 
AJ: Yes. 23 
WB: So I see this as a movement and today with social media, which transgender people always have 24 been very active, its just part of . . . I would say a global movement.  Now, Virginia thinking 25 about some of these countries that have great difficulty with this, but Virginia believed it and I 26 believe it too.  I see these things, as you called it, its just a backlash  so its really a reaction to 27 the incredible progress that cannot be stopped.  Now in that process, of course, there can be 28 sacrifices  people can get hurt, people are getting killed. 29 
AJ: Women of color, in particular, are really suffering and being murdered. 30 
WB: Yes, absolutely.  So that is the very hard and dark part, but I think ultimately its only going in 31 one direction and yes we do need to take measures, that people dont get hurt in the process.  I 32 think when I was at the program in the beginning, we always dealt with these personal safety 33 and potential violence issues, or access to care and surgery, in a very under the radar 34 individualized way.  I would make phone calls and doors open because the phone call came from 35 the University of Minnesota Medical School.  I think we are in a different age and time and now 36 it is time for policy changes and for policies to really cement them and provide those 37 protections.  Now I do still think that policies dont change peoples attitudes, I think peoples 1 attitudes have changed to the point that we have the majority on our side, you see that in the 2 outrage over the North Carolina bathroom issues.  So we actually have this moment, so visible, 3 to get these policies into place.  I dont think that transgender people will forever be the number 4 one hot topic.  So we need to capitalize on this, we worked very hard for this, this is not 5 something that just happened three years ago.  This is something that people have been 6 working on from a very, very long time ago  starting with Christine Jorgensen, frankly  or 7 maybe even before that.  But I think we need to cement this into policies and then with that 8 comes, of course, all the education and training to help people implement those policies.  That is 9 not a very gratifying thing, that we get calls and inquiries from schools and other organizations  10 that now, in the past it was always, Oh, we have a transgender student thats coming out, we 11 need help.  Now it is, We want to be prepared because we expect that we will have 12 transgender students coming out.  So I think people are getting more proactive and we have 13 more resources to actually give them guidelines, pointers, and I still think after gay marriage, 14 LGBT  the larger spectrum, the anti-discrimination, equal rights protection legislation is really 15 important, like in the civil rights movement.  Its not a parallel and this is, I guess, the civil rights 16 issue of our time. 17 
AJ: Of our time.  Wow.  That actually is a really, really sort of beautiful to wrap up this conversation.  18 But I do want to offer the opportunity . . . is there anything else that you might want to share 19 that I didnt have the foresight to ask you about? 20 
WB: I think Ive said it, but I think that its really from people like you that I draw my inspiration  21 from meeting people like you. 22 
AJ: Thank you. 23 
WB: Thats why even though Im doing primarily research, that I want to continue to work directly 24 with people in the community and also do clinical work because thats really what keeps me 25 going  and it also tells me, you feel it on the gut level, that we are nowhere done with the big 26 work that I feel very privileged to be a part of.  Yeah, thats I think the main think I want to say.  27 Weve known each other for decades . . .  28 
AJ: Decades now. 29 
WB: And it has been a beautiful ride and its been a two-way street. 30 
AJ: It has absolutely been a two-way street because you inspire me to continue to do this work.  31 There are moments, and still are, where it feels completely daunting and then we see these 32 significant changes.  I was just thinking about a mutual friend of ours, Dean Spade, who is 33 probably a little more radical than you or I, but still driving this train down the path of creating a 34 more righteous and just society for all of us. 35 
WB: Yeah, and I tend to be an optimist but I agree with you and think I know that . . . I see your posts 36 on Facebook and its often about these issues.  Of course there is still a lot of violence and 37 injustice, but what do they say  thats direction . . .  38 
AJ: The arc of history is long but it bends towards justice. 39 
WB: Thank you. 1 
AJ: Dr. Martin Luther King. 2 
WB: Exactly. 3 
AJ: Thank you, Walter. 4 
WB: Youre welcome. 5 

