This research has its beginnings in an act of transgender activism, arising as it did out of dissatisfaction with the capacity of the 2005 Private Lives project to capture the complexity of transgender lives. A central pivot in the concerns of the transgender communities about health services is that of recognition. Practices of medicine are implicated in many of the attempts by transgender people to achieve positive health and self- and social recognition for their preferred gender. Additionally, recognition on formal documentary records is, in many cases, dependent upon certified medical intervention.