Table Of Content“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,
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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.
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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
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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.
3
To the wifey (C ) 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)
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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. For their inspiration and guidance, I
am thankfully indebted. My chair, Lawrence Cohen, deserves an exceptional thank you. His
unwavering support of this project has been honoring and humbling. He pushed my thinking on
the politics of gender, health, and biology in directions I had been unable or unwilling. At times,
when I fell myopic, he reminded me of what it is I was really doing and why it mattered, and,
perhaps more importantly, to whom it mattered. I cannot thank him enough for his response
when I arrived at this office aggravated and dejected, following a reader’s reaction to my work
who derided it as “theoretically promiscuous” and “too beautiful.” Without, missing a beat, he
responded, “would you want it any other way?” And of course, I would never, ever! His
scholarship and teaching deeply influence how I think about and do anthropology. I hope to be
able to model – if only a bit – his kind guidance, theoretical generosity, and ethnographic
poetics, all of which unsettle and open up worlds.
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Aihwa Ong was an avid supporter, dedicated reader, and beyond all else, a tough critic. I
am indebted to her demands to take seriously the urban and transnational dimensions and
provocations of my research.
Sharon Kaufman is an ideal mentor. Her insight comments, keen editorial eye, humble
theoretical breadth, and deep commitment to ethnography as an art of writing has made this
dissertation possible. When I was sure I had lost the forest for the trees, she encouraged and
disciplined me and reminded me of why I began this project. For this, I am grateful and will
remain her biggest fan. Her exceptional writing seminar could not have arrived at a better time.
I thank Eric Plemons, Martine Lappe, and Xochitl Marsilli Vargas for their insightful comments
on early chapters.
Judith Butler, my so-called “outside member,” was never outside. Her inspiration has
shaped this project from beginning to end. Over many years, my thinking has undeniably and
indelibly been shaped by her intellectual-ethical provocations. As a mentor she has taught me
humility, to think critically against (my own) Thought, and, above all, to be kind to myself.
Often while writing, when I found myself stuck in myopic morass, I imagined her my audience
and things unhitched a bit.
During my anthropological education, Stefania Pandolfo opened up anthropological
theory to the poetic, and Donald Moore taught me to always be attentive to how the question of
“the human” is always irreducibly, an ethical and political interrogation of power. I thank Paul
Rabinow for inviting me to rethink the question of (queer) kinship and biology, which ended up
transforming – if not opening up – Chapter 4.
I am grateful for generous institutional and foundational support, which made research
and writing possible. Field research was supported by a training grant from the California
HIV/AIDS Research Program, a dissertation improvement grant from the National Science
Foundation, and a Magisterreti Fellowship at UC Berkeley’s Center for the Study of Sexual
Cultures. Departments of Anthropology and Gender & Women’s Studies as well the Graduate
Division and Arcus Foundation supported research and dissemination of preliminary findings.
Writing was supported by a fellowship at the Townsend Center for the Humanities. And a much
earlier grant from the California Wellness Foundation supported my M.P.H. training internship
at the STOP-AIDS Project. This experience unexpectedly helped support what would become
formative research for my dissertation.
Lastly and firstly, I thank Cecilia Chung, interlocutor, friend, kin, inspiration. Although
she may find little here with which she will agree (but I trust she knows that I know she is always
right), she is the one to whom I write, over and over. My attempts to get it right will always
remain incomplete as is my love for her.
Lisa Dee Moore has been a cherished mentor and dear friend. She continues to compel
me to face ethical accountabilities, or in other words, “to keep it real.” My thinking has been
spurred by our conversations, ranging from Virchow to Engles to Krieger, from Buddhist
practices to Boondock comics to Gil Scott Heron’s revolutionary poetics, from Marx to Fanon to
Davis to Haraway. Thanks for exemplifying all the graceful fierceness of a public-intellectual
(though I know she would loathe that I called her that 18 letter word!).
Lucinda Ramberg has supported and encouraged my rantings over many years, beginning
when I was but a naïve and spirited graduate student in Medical Anthropology. It is perhaps from
her that I best learned how to be an anthropologist. When caught amid fieldwork dilemmas, I
often would ask myself, “what would Lucinda do?” Conversations on kinship and ethical
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practices in matters of life and death have found their way not only into my thinking but in my
everyday conduct, where I hoped to have become not only a better anthropologist but a better
friend, companion.
Big love to Rani Neutill for dolls and dogs and sleepovers, for hip hop and deep house
and Sunday tea dances, for always being there in the midst of all sorts of solitary and shared
crazies, for pushing me to get over my deep suspicions of psychoanalysis, for reminding me to
be critically aware of my own and familiars’ racialization even, and most importantly, within
intimate relationships deeply-cut by all sorts of asymmetries of power. In love and in camp, I
name the bar after her to honor the fierce gracefulness she and Girls share.
Heather Butler’s truly brilliant and radical provocations continue to spur me to do and
think more, and to turn thought against Thought.
I am grateful that Marvin White has always reminded me to strive towards the poetic in
words and deeds. His craftwork in language and acts of witnessing provide continual inspiration.
I’m honored to have shared spirit-moving moments while tea dancing through Sunday
afternoons. And most undoubtedly Roberto Ordeñana has been a beloved friend across years and
adventures from Summer Camp to Tuesday’s at Liquid to sharing a home to heart-fully
supporting “Dirty Knees” and me. His friendship and lessons in diplomacy have made me all the
better. Catron Booker taught me what sharing a Home was all about. Our Thursday nights with
Ledisi, sitting on the stoop “conversating” about bell hooks, performance, and all that and more,
and dancing to Sade and Jill Scott remain some of my favorite evenings.
Finally, it is perhaps impossible to state the impact that Jessica Davies has had my
thinking and writing. Even in absence, she touches almost every page to follow.
I have had the opportunity to work with, learn from, and teach under a number of
dynamic mentors, including Cori Hayden, Charis Thompson, Trinh T. Minh-ha; all of whom
whose work I hope to have done some justice to in what follows. Cori taught me to think against
and beyond the binary of nature/culture while taking seriously the irreducibly of both. Charis
taught me feminist theory as liberatory pedagogy and gave me “ontological choreography.” She
continues to be a gracious model for interdisciplinary collaboration and collegiality. Minh-ha’s
guidance provoked me to rethink academic work, research and writing, and opened up
ethnography as a critical practice of “speaking near-by” and engaging “identities across
difference.” I thank Wendy Brown for opening up the world to feminist and queer critique when
I was an eager undergraduate at UCSC as well as for years of sustained engagement and for
teaching me the praxis of critique. As an undergraduate, Donna Haraway taught me to take
seriously what’s at stake and for whom, amid precarious lifeworlds in which science is politics,
and politics is biological. I thank Saba Mahmood for three intense weeks of living and breathing
feminist and post-colonial theory during what I hope will be the first of many summers together.
I am grateful to have had the opportunity to be a teaching assistant for Nancy Scheper-Hughes on
two truly memorable occasions. I thank her for introducing me to rebel bodies, engaged
witnessing, good enough ethnography, and the political—poetic practices that are the heart of
anthropology.
Donna Jones has taught me how generative SF, theories of vitalism, and poetics and
philosophies of negritude are for thinking questions of life. I thank Paola Bacchetta for
conversations about transnational queerness, feminism, and kin-making across normalizing
borders.
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