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Historically, to receive hormone replacement therapy (HRT) or gender-affirming surgery, trans people had to submit to degrading "real-life tests," forced psychotherapy, and sterilization laws. This medical gatekeeping created a culture of resilience and mutual aid. Underground networks shared information on safe hormones, DIY transition, and legal loopholes.

: Gender-variant people have existed throughout history, with records dating back as far as 1200 BCE in Egypt and appearing in cultures like India's hijra community. LGBTQ Cultural Landscapes