Transgender man Lou Sullivan first applied and was denied for the program at Stanford in 1976. In 1979, Steve Dain encouraged him to re-apply only to once again be rejected. Rather than take the news and move on, Sullivan chose to write Stanford a rightfully indignant response at their refusal to medically acknowledge Sullivan’s condition. His response highlights many obstacles trans people face when attempting to receive healthcare. Even today, doctors frequently invalidate trans folks in their quest to receive hormones or surgery, and most insurance policies dictate that someone must have multiple letters of recommendation from qualified medical professionals in order to access hormones or surgery.

The implicit homophobia of the Stanford clinic comes out here too, as Sullivan feared he would be rejected on account of the fact that he was interested in men. Furthermore, the response indicates that transgenderism isn’t valid only if recognized medically; Lou’s friends, coworkers, and even his family acknowledge and respect his gender, yet the medical center does not. Sullivan is a white trans man who had access to hormones, support groups, and even his family’s financial and emotional support during the time of this letter, so he is extremely privileged as a trans person, and access to healthcare was less of a hardship for him than many other trans people.