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In recent years, much of the political friction surrounding LGBTQ+ rights has shifted specifically toward trans-inclusive healthcare and sports.

For much of the 20th century, trans existence was mediated by the medical establishment. To receive hormones or surgery, a trans person had to be diagnosed with "Gender Identity Disorder" (now Gender Dysphoria) and often had to live as their identified gender for a year (the "Real-Life Test") without the hormones that would make passing easier.

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