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, 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.
