Renee Ramsay

Eventually, Renee Ramsey settled in South Carolina, where today she lives quietly, and quite happily, in a small town outside Charleston. Just another typical older woman, except, that is, for the remaining forearm tattoo that reads, “Death Before Dishonor.”

Ramsey is likely one of the oldest people in this country to undergo male-to-female gender reassignment surgery, but she is hardly alone. In May, Medicare announced it would begin covering gender reassignment surgery. Two months later, President Obama signed a bill giving employment protection not only to gay federal workers, but also to transgender men and women.

One of the reasons for the surge of attention to transgender rights has to do with the inroads neuroscience is making. Researchers now say that gender identification is something that happens in the brain of a fetus weeks after the sexual organs have differentiated into either male or female.
Sexual anatomy and gender identity, therefore, are both products of the brain and are the result of two different brain processes. (Sexual orientation is a third.) And brain processes, we now know, especially in a developing fetus, can be affected by myriad genetic and environmental influences. Just like sexual attraction, these scientists say, gender identity isn’t something we choose. It’s something we’re born with.