Silenced by Law: The Forgotten History of Forced Stealth in Trans Healthcare

While today's discourse on "stealth" living often centers around personal choice or intimate partner dynamics, there exists a darker chapter in transgender history: the era when medical and legal systems themselves mandated stealth living through formal agreements and regulations. Before the 1990s, transgender individuals seeking medical transition often faced a draconian set of requirements that institutionalized erasure of their past and effectively criminalized their transgender identity. This article examines the historical legal barriers, coercive agreements, and systemic oppression that trans women faced when seeking gender-affirming care before 1990.

The Gatekeeping Framework: "Passing" as a Prerequisite

In the decades before 1990, access to gender-affirming care operated under what today would be considered shockingly restrictive protocols. The dominant model for transgender healthcare stemmed from university-based gender clinics that emerged in the 1960s and 1970s, most notably…