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Amazon’s Transparent, about a family adjusting to their AARP-card-carrying father’s metamorphosis into a woman, won a Golden Globe for best TV series. military dropped its transgender ban, allowing trans men and women to openly serve in the armed forces; Medicaid began covering gender-reassignment surgery; and President Barack Obama called for an end to conversion therapy, the dreadfully unsuccessful practice of trying to “repair” gay, lesbian, and transgender youth.These sweeping changes weren’t limited to popular culture; across the nation, great strides were made in what is now widely seen as the next civil rights frontier. After decades of living on the margins—ridiculed, rejected, and disproportionately targeted in hate crimes—trans people had, in just a few years, achieved the unthinkable: increased social acceptance, and even respect.But the city’s evangelicals had risen up against the ordinance and succeeded, with the help of the Texas Supreme Court, in having the matter put to a referendum.An ugly battle for public opinion had ensued, with opponents claiming that the measure would allow men to enter ladies’ restrooms by masquerading as women.They had come from all over Texas and beyond to network and attend panels ranging from “Gender 101” to “Know Your Rights: Transgender Youth and the Law.” At the welcome table, registrants were each asked to select a big, round, purple pronoun sticker.

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It was a talk he had given at countless hospitals and medical organizations in Texas and across the country.t was a gray morning in late October—just ten days before the country’s fourth-largest city would vote on the landmark Houston Equal Rights Ordinance—and Hurricane Patricia, the most intense cyclone ever recorded in the Western Hemisphere, was roiling through Mexico.Already, at a.m., the air in Houston was on the verge of a tantrum.Plastic surgeon Peter Raphael had driven in from Plano, where every year he performs more than 150 “top surgeries,” or mastectomies for trans men.An admirer of his, a Houston medical practitioner, approached him in the courtyard to discuss the intricacies of gender-reassignment surgery.

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