Ribes, DavidKeyes, Os2025-01-232025-01-232024Keyes_washington_0250E_27799.pdfhttps://hdl.handle.net/1773/52675Thesis (Ph.D.)--University of Washington, 2024With ongoing conflict and debate over the legitimacy of gender-affirming medical treatments, there have been a multitude of calls for science. Specifically, for studies testing the efficacy and consequences of gender-affirming care. Although such studies and the treatments they assess are often portrayed as relatively novel, neither is the case. Both are close to a century old, with a complex and potent history to them that has resonance with current debates. This dissertation sets out and discusses that history–specifically the history of "trans science", by which I mean the way that access to gender-affirming care for transgender people has often been interwoven with, and conditioned on, involvement in scientific studies. Specifically, it looks at the history of studies to establish the consequences of medical interventions. Focusing on the 1960s–1980s, which constituted the heyday of such research in North America, this dissertation looks at the role scientific work played in institutionalising trans healthcare, the consequences that such desires had for patients (and research) given broader cultural anxieties around treatment, and the way that studies were interpreted and taken up inside and outside medicine. Based on over 170 interviews and material from some 30 archival repositories, I argue that the interweaving of medical treatment and scientific research–particularly under conditions of cultural opprobrium–produced difficulties that undermined both patients' aims and the aims of clinical researchers. The interpretation and deployment of these studies in policymaking was shaped by those same cultural pressures to such a degree that the results themselves played a minimal role in decisionmaking. I argue that the debate, at its core, was not over scientific purity or the sufficiency of evidence, but instead over the underlying values that actors hewed to, and whether trans lives could be conceived as good ones to live. These findings have substantial implications for how we evaluate proposals for further study, and how we understand the legitimacy, or responses to, claims of disputed science within the current conflict surrounding gender-affirming care.application/pdfen-USCC BY-NC-NDbioethicsgender identity clinichistory of medicinescience and technology studiestransgendertranssexualSociologyMedical ethicsScience historyHuman centered design and engineeringThesis