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Trans* Lives in the Age of Epidemic by Christopher William Roebuck A

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Trans* Lives in the Age of Epidemic by Christopher William Roebuck A “Workin’ It:” Trans* Lives in the Age of Epidemic by Christopher William Roebuck A dissertation submitted in partial satisfaction of the requirements for the degree of Joint Doctor of Philosophy with University of California, San Francisco in Medical Anthropology in the Graduate Division of the University of California Berkeley Committee in charge: Professor Lawrence Cohen, Chair Professor Judith Butler Professor Sharon Kaufman Professor Aihwa Ong Spring 2013 Copyright (2013) by Christopher William Roebuck Abstract “Workin’ It”: Trans* Lives in the Age of Epidemic by Christopher William Roebuck Joint Doctor of Philosophy with University of California, San Francisco In Medical Anthropology University of California Professor Lawrence Cohen, Chair Situated in the interstices of anthropology, public health, and critical theory, this dissertation pursues questions of gender, health, transnationality, and governance. It does so through a critical medical anthropological study of trans* lives during what has been referred to as “the second wave of AIDS” in San Francisco. According to public health research and epidemiological studies, urban transgender women are reported to constitute one of most vulnerable populations for HIV infection in the United States. Combining research methods of medical anthropology and urban ethnography, this dissertation explores self-making and world- making practices of trans* individuals during a time, I call “the age of epidemic.” Multi-year ethnographic research was based primarily in San Francisco’s Tenderloin, a low-income, culturally diverse neighborhood that has been referred to as the “epi-center of the AIDS epidemic” in San Francisco. At the same time, it is home and center of social life for many trans* immigrants from Mexico, Central and South American, and South-east Asia, who migrate to the city in hopes of creating vibrant lives. Hence, the term, trans* is meant to reference three intersecting experiences: transgender identity; transnational conditions of migration; and the crossing of multiple political, geographical, linguistic, sex/gender, and bodily borders. As well, trans* refers to the Tenderloin itself as a translocal space networked by global processes of migration, diaspora, and economic restructuring. Ethnographic research was conducted with transgender and immigrant interlocutors, neighborhood denizens, public health researchers and healthcare providers, and local and international transgender activists. Clinic- based participant-observations and volunteer activities were conducted at a public health center, which provides care to homeless and underserved populations. In late 1994, it opened the first transgender primary healthcare clinic in the United States. This dissertation documents how trans* women create lives through “workin it,” a constellation of dynamic and heterogeneous tactics including: actions for making forms of sociality and publics in San Francisco’s rapidly transforming Tenderloin; practices for creating kinship and engaging in reciprocal practices of care outside normalizing regimes of sex, gender, 1 and laws of alliance and descent; activities for cultivating trans* bodies and becomings utilizing biomedical technologies often in unexpected ways; and conducts for fashioning a beautiful and ethical life when such a life is often deemed diseased, foreign, and other. Findings have lead to the conclusion that epidemics, such as HIV/AIDS, have a paradoxical force in contemporary life. Epidemics are destructive, pathological biosocial events, causing untold sickness, suffering and death. But they are also generative. Epidemics instantiate proliferative governing strategies and technologies, which discipline and manage bodies under logics of health promotion. At the same time, the immeasurable sickness, death, and loss caused by HIV/AIDS has provided evidence to support political claims for health and life by trans* communities. The calamitous impacts have offered a language through which to render visible social inequalities and social suffering. The biosocial crisis has engendered new social movements for justice and affirmations of trans* survivals. But most significantly, it has given rise to unique forms of resiliency, belonging, kinship, and care amid and against precarity. 2 TABLE OF CONTENTS “WORKIN’ IT”: TRANS* LIVES IN THE AGE OF EPIDEMIC (An ethnographic study of trans-gender & trans-national lives in San Francisco’s Tenderloin) DEDICATIONS iii ACKNOWLEDGEMENTS iv In Medias Res: “AIDS made me.” 1 1. SYMBIOGENESISES When pathogens, people, and power mix 4 1. Power, (trans)gender, and the question of life 2. AIDS in the making and unmaking of trans* identities 3. Epidemic as vital paradox 4. Methodology and terms 5. Chapters Maria’s Interlude 1 20 2. GENEALOGIES Anthropology, gender/sex, and the problem 23 of counting, or close encounters of the “third” kind Maria’s Interlude 2 52 3. ECOLOGIES This event called a life amid worlds 54 Maria’s Interlude 3 59 4. KINSHIPS Mothers, sisters, and other familiars 63 1. Tyranny of the couple, or Anthropology—Kinship—Marriage 2. Trans*gendering domestic publics and human kin i Maria’s Interlude 4 80 5. REGENERATIONS Birth of the transgender clinic 82 1. Biopolitics of gendered embodiment in the time of AIDS 2. Caught amid S/states, or some paradoxes of “transgender asylum” Maria’s Interlude 5 95 Maria’s Interlude 6 98 6. CODA Justice done otherwise, 102 or beyond tolerance and the Same Maria’s Interlude 7 109 BIBLIOGRAPHY 110 APPENDIX I Social-cultural Drivers 131 of HIV/AIDS Vulnerability among Trans Women in San Francisco APPENDIX 2 How to Start a Transgender Health Clinic 148 ii DEDICATIONS To the Girls, always to the Girls, for sharing lives – generously and kindly – with the ever prying anthropologist. I hope to have done a little justice to all that you teach me. To the clients, staff, providers, and volunteers at the “TG Clinic” for showing me how healthcare – as a practice of justice – gets done against odds. To the wifey (C3) and the cuz (GFR) for doing kinship all kinds of wrong and loving me all kinds of right – in spite of me. To mama: Mary Frances (January 27, 1947 – April 29, 2008) for teaching me that beauty has always been a verb, a doing, an ethical practice. Not a day begins or ends … Continuing to “speak” to maman (shared language being a kind of presence) is not affected by internal discourse (I have not talked “talked” to her that way), but in my way of life: I try to continue living day by day according to her values: to recover something of the nourishment she provided by producing it myself, her household order, that alliance of ethics and aesthetics that was her incomparable fashion of living, of constructing the quotidian.” - August 18, 1978: Roland Barthes, Mourning Diary (2009) iii ACKNOWLEDGEMENTS Anthropology poses a paradoxical predicament. As a practice of fieldwork, it is extraordinarily social. And yet at the same time, as a practice of writing, it requires, if not demands, time alone. To endure, the contradictions and tensions arising from movements between sociality and solitude, and back again, I have been nourished by the kindness, understanding, and love of those close. I have amassed a long list of colleagues and friends, mentors and familiars who have supported and cared for me in countless ways, and who have taught me more than I could ever speak towards here. Humbly, I will try, though, inspired by what Morrison (1993b) calls the “force and felicity” of narrative: its refusal to “give the final word.” First I must thank the Girls without whose kindness and patience none of this would have been possible. To protect their privacy, I am unable to thank the most important people by name. Though, I hope all, who took time out of their days and nights to deal with the ever prying anthropologist and invited me into their lives, know the depth of my gratitude and respect. I remain today and tomorrow grateful to the Girls for opening-up my eyes to how “workin’ it” is an ethical practice of fashioning selves and worlds. This dissertation is dedicated to them and to the memory of “Maria.” Members of the “TG Team” (social workers, nurses, nurse practitioners, doctors, and volunteers), taught me more than I could have ever imagined about healthcare and doing justice amid biopolitical crises. I thank them for allowing me to “hang out,” for inviting me to take part in “the Clinic,” and for answering my persistent questions candidly and sincerely. I am indebted to Laura Mae Alpert, Angie Davidson, Jim Franicevich, Mark Freeman, Linette Martinez, Mary Monihan, Jody Vormohr, and Barry Zevin. Linette Martinez’s friendship and support were indispensible, and from her I learned that providing medical care is an ethical practice amid deep asymmetrical relations of power. Mary Monihan’s practices of nursing are an inspirational model of “meeting people where they are.” One day, I hope she will let me write her biography. Mark Freeman’s was kind enough to allow me to participate in the extraordinary documentary, Transgender Tuesdays: A Clinic in the Tenderloin. Robyn Stukalin and Maria Porch taught me that social workers are frontline care-givers – not “gate-keepers” – who negotiate labyrinthine impersonal and often deadly institutional bureaucrats on behalf of clients. I have been moved by their acuity and skills, and the countless lives they have aided. My committee has been steadfast with their support, kindly generous with their encouragement, and critically engaged with their critiques.
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