Christine Jorgenson: An Analysis of the Role that Privilege and Media Play in Access To Gender Confirmation Procedures

Authors: Arin Young
Subject: History
Topic:  Integrated
Grade Levels:  High School: 11th Grade


This lesson plan covers gender affirmation processes and the barriers in place to physical and social transitioning in the 1950s up to the 21st century, focusing on the impact that areas of privilege have on this access. The goal of his lesson plan is to explain the historical context of privilege and the role society plays in what is deemed as acceptable.

Time: 1 Class Period, 50-60 Minutes

Lesson Plan Resources:

Lesson Plan PDF

Lesson Slide Deck

Lesson Objectives:

  • Students will be able to identify the role that various privileges play in the access to sexual reassignment and gender affirmation procedures.
  • Students will understand the historical context of the social transformation following World War II  as it relates to LGBTQ identity and be able to identify barriers in place for the transgender community.

Essential Questions:

  1. What barriers are in place for the transgender community in accessing gender confirmation/affirmation procedures?
  2. What role does privilege play in access?
  3. How did the growth of transgender presence in media impact the evolution of the Diagnostic and Statistical Manual of Mental Disorders?


HSS 11.2: Students analyze the relationship among the rise of industrialization, large scale rural-to-urban migration, and massive immigration from Southern and Eastern Europe. 

  • (3) Trace the effect of the Americanization movement.

HSS 11.5: Students analyze the major political, social, economic, technological, and cultural developments of the 1920s. 

  • (7) Discuss the rise of mass production techniques, the growth of cities, the impact of new technologies (e.g., the automobile, electricity), and the resulting prosperity and effect on the American landscape.

HSS 11.8: Students analyze the economic boom and social transformation of post–World War II America. 

  • (7)  Describe the effects on society and the economy of technological developments since 1945, including the computer revolution, changes in communication, advances in medicine, and improvements in agricultural technology.

HSS 11.11: Students analyze the major social problems and domestic policy issues in contemporary American society. 

  • (6) Analyze the persistence of poverty and how different analyses of this issue influence welfare reform, health insurance reform, and other social policies.

CCSS SL 1: Initiate and participate effectively in a range of collaborative discussions (one-on- one, in groups, and teacher-led) with diverse partners on grades 11–12 topics, texts, and issues, building on others’ ideas and expressing their own clearly and persuasively.

  • (a) Come to discussions prepared, having read and researched material under study; explicitly draw on that preparation by referring to evidence from texts and other research on the topic or issue to stimulate a thoughtful, well-reasoned exchange of ideas. 
  • (b) Work with peers to promote civil, democratic discussions and decision-making, set clear goals and deadlines, and establish individual roles as needed. 
  • (c) Propel conversations by posing and responding to questions that probe reasoning and evidence; ensure a hearing for a full range of positions on a topic or issue; clarify, verify, or challenge ideas and conclusions; and promote divergent and creative perspectives. 
  • (d) Respond thoughtfully to diverse perspectives; synthesize comments, claims, and evidence made on all sides of an issue; resolve contradictions when possible; and determine what additional information or research is required to deepen the investigation or complete the task.

CCSS SL 2: Integrate multiple sources of information presented in diverse formats and media (e.g., visually, quantitatively, orally) in order to make informed decisions and solve problems, evaluating the credibility and accuracy of each source and noting any discrepancies among the data

CCSS SL 3: Evaluate a speaker’s point of view, reasoning, and use of evidence and rhetoric, assessing the stance, premises, links among ideas, word choice, points of emphasis, and tone used.

CCSS RH 4: Determine the meaning of words and phrases as they are used in a text, including analyzing how an author uses and refines the meaning of a key term over the course of a text (e.g., how Madison defines faction in Federalist No. 10).

CCSS RH 7: Integrate and evaluate multiple sources of information presented in diverse formats and media (e.g., visually, quantitatively, as well as in words) in order to address a question or solve a problem.

CCSS RH 9: Integrate information from diverse sources, both primary and secondary, into a coherent understanding of an idea or event, noting discrepancies among sources.

HISTORY FRAMEWORK: CH 16 P 406: The liberal consensus allowed the middle class to grow and the American dream to be realized by people who had just survived the traumas of war and depression. Government spending remained high throughout the postwar era and included new investments, such as President Eisenhower’s interstate highway system at the federal level, and the California Master Plan for education at the state level. Spending on defense remained high as well, which led Eisenhower to warn about the rise of a “military–industrial complex” that would endanger American democracy. This spending led to the growth of both new and existing industries that affected the American economy and society for decades, including the rise of the aerospace and computer industries in California. Although this consensus lasted for more than twenty years, students will learn that as the 1960s progressed, the Right moved farther to the right and the Left moved farther to the left, thus unraveling the consensus.

HISTORY FRAMEWORK: CH 16 P 413: 1952 – Christine Jorgensen became one of the most famous transgender people when she underwent a sex change operation and went on to a successful career in show business.


Cisgender: describes a person who identities with their gender assigned at birth

Gender Dysphoria: a term used within the Diagnostic and Statistical Manual of Mental Disorders to explain clinically significant distress caused when a person’s assigned birth gender is not the same as the one with which they identify

Gender Non-Conforming/ Gender Variant: appearance or other characteristics that differ from those stereotypically associated with being masculine or feminine; this term can be used to describe people whose gender expression differs from stereotypical expectations about how boys and girls are “suppose to” look or act. Also referred to as gender expansive or gender transcendent.

Gender Expression: a person’s gender related appearance and behavior whether or not stereotypically associated with the persons aligned set at birth; gender expression refers to the external characteristics that are socially defined as masculine and feminine, including clothing, hairstyles, activities, mannerisms, speech patterns, and social interactions

Gender Identity: a person’s genuine, internal, deeply rooted identification as man, woman, both, or neither; all people have a gender identity, not just transgender people

Queer: an umbrella term for people who fall outside the gender and sexuality “norms”; historically a negative term, it has been reclaimed by the LGBTQ community; although some still consider it derogatory

Teacher Background:

The teacher should have knowledge of World War II and the Americanization movement and technological and media advancement period in the United States following.


  • This lesson plan requires a computer and projector. Please print out the copy of the Mental Health letter for students to write on to assist with their discussion.


Slide 1-2. Introduction to Lesson Plan (2 Minutes)

  1. As this lesson plan is reflection and discussion inclusive, teacher should use this as an opportunity to customize an opening statement of discussion guidelines with respect to individuality and empathy for students. 
    1. Sample: “As we embark on conversations today, it is important to go into these spaces with open-mindedness and an assumption of good intentions. We are all at different places with our understanding and our background and experiences. Empathy is important in order to understand and acknowledge what is happening all around us and to grow together in our understanding.”

Slide 3. Conduct Empathy Exercise (12 Minutes)

  1. Connecting further with the idea of holding empathy at the forefront of students’ minds as discussions unravel around privilege and transgender experiences, the teacher should conduct an empathy exercise. Teacher should have all students pair off. While in their pair, students should be prompted to introduce themselves to their partner. After five minutes, pairs should join another pair for five minutes and each group member will then introduce their partner to the rest without using gendered wording.
  2. Facilitate either a discussion or personal reflection with guiding questions:
    • What did it feel like to hear yourself being talked about without gendered wording?
    • How does the modern audience respond?
    • How do we unconsciously edit our surroundings?

Slide 4.  Establish Background of Challenging Gender and Gender Roles Post WWII (1 Minute)

  1. The climate of the 1950s was a culture of post-war conformity as during WWII women had taken on jobs and responsibilities traditionally reserved for men. This bothered many people so, at the conclusion of the war, women were being pushed back toward femininity and domestic roles while surviving military men readjusted to civilian life. This time of transition and returning to conformity developed an increase in gray area as to what it meant to be a man or woman and what gender roles were for men and women.

Slides 5-6. Introduction to Chrisitne Jorgenson (6 Minutes)

  1. Who is Christine Jorgenson?
    1. Christine Jorgenson was an affluent American transgender woman who was the first person to become widely known in the United States for having gender confirmation procedures, formally known as sex reassignment surgery. After serving in the U.S. Army during World War II, she attended school in New York where she learned about confirmation procedures, formerly known as sex reassignment surgery. Due to her status in society, she was able to travel to Denmark where she received permission to undergo a series of operations beginning in 1952. She received hormone replacement therapy under the direction of Christian Hamburger, who she honored by the choosing of the name Christine. She later went on to perform as an actress and nightclub singer. In the New York Daily News, Jorgenson was incorrectly announced as the first recipient of a “sex change” but two surgeries had been done prior for Dorchen Richter and Lili Elbe in the late 1920s and early 1930s.
  2. Rise in Media
    1. In her 1982 interview with Tom Snyder, Jorgenson discussed  how “if it hits the eighteenth page of the newspaper or at all hits the newspaper, it’s a miracle.” However, upon her return from Denmark, a media frenzy began with the front page headline “Ex-GI Becomes Blonde Beauty.” Christine Jorgensen then rose to fame through what has been categorized as “millions of words of press coverage” not only because she was a transgender person but additionally because of her status as a former soldier in the United States Army. Jorgenson became a figurehead of the post-WWI culture. Jorgenson had defied the constraints of biology and social norms to become her true self. 
  3. Play Interview Clip with Jorgenson and Tom Snyder 0:00-2:15, 3:07-4:25
    1. Introduce transgender representation in the media
    3. Play video at timestamps 0:00-2:15 to allow students to witness the talent and fame of Christine Jorgenson to establish an understanding of her status in society
    4. Play video at timestamps 3:07-4:25 to hear Jorgenson discuss presence in media
    5. Facilitate discussion with class using the following guiding questions 
      1. How did technological advancements and the growth of the media contribute to Jorgenson’s rise in fame?
      2. How do you think her fame and status as a woman and performer affected her overall social transition and acceptance into Post-WWII society?
      3. Where do we see transgender voices being represented in the media today?
  4. Share images on Slide 7 to exemplify the rise of voice surrounding transgender people in the media. 
    1. Potential to use these images as an opportunity to discuss Freedom of Speech and Freedom of Press.

Slide 8. Social Expectations and Control (2 Minutes)

  1. Similarly to how society held expectations of civilians during WWII for supporting the war efforts, there were and are expectations held over people in regard to how they live their lives. 
    1. What examples can you think of where society expects something of people? 
      1. Ex. Doing your best on your schoolwork
  2. In the case of transgender lives, historically there has been expectation and control set in place by society that have made seeking out and receiving treatments and affirmation/confirmation procedures more stigmatized and all that much harder. There is societal control overexpression and acceptance in the body. 
    1. Open up for discussion 
      1. Who gets to decide what is deemed as “right”? 
  3. The control has been set in place by the Diagnostic and Statistical Manual of Mental Disorders (DSM).  The DSM sets the rules and expectations and defines the changes that can be made to meet those expectations. Whereas Reparative or Conversion Therapy is what makes the change. Reparatie or Conversion Therapy is seen in cases of individuals using psychological, physical, or spiritual interventions in attempt to change someone’s sexuality from homosexual or bisexual to heterosexual or someone’s gender identity from transgender or nonbinary to cisgender.

Slide 9. Reading and Discussion on Role of Privilege  (8 Minutes)

  1. Article Reading: “Transgender People Experience How Men and Women are Treated Differently”
    1. Have student volunteer to read article aloud for the group or have students read along while teacher reads article aloud. 
  2. Highlight the line “People who transition from male to female can have the opposite experience: losing male privilege they didn’t even know they had,” then open for discussion and reflection. 
  3. As we have learned from this article, there are inherent privileges that can come with the gender identity we hold. But as we know from intersectionality, the various identities we hold can play different roles in our day-to-day lives.
  4. Facilitate group conversation using the  guiding questions:
  • How do race, gender, affluence, and/or religion affect access to gender confirmation/affirmation procedures and a positive social transition? How can race, gender, affluence, physical location, and/or religion all impact transgender people in social activities like going grocery shopping, going to a bank, walking outside, etc.?
  • How can race, gender, affluence, physical location, and/or religion all affect access to reassignment and confirmation procedures for transgender people?

Slide 10-11. Introduce The Diagnostic and Statistical Manual of Mental Disorders (5 Minutes)

  1. What is the DSM?
    1. The Diagnostic and Statistical Manual of Mental Disorders (DSM) is a handbook/guide used by healthcare professionals in the United States and much of the larger world to aid in the diagnosis of mental disorders in patients. 
  2. Analyze the evolution of the DSM from the year 1952 to 2013 to show how terminology and diagnosis processed have changed 
    1. Special emphasis should be placed on the diagnosis of Gender Identity Disorder and Gender Identity Disorder as it pertains to the case of Christine Jorgenson
  3. Gender Identity Disorder Removed, Gender Dysphoria Added
    1. In 2013, “gender identity disorder” was removed from the DSM-5. A new condition, “gender dysphoria,” was added to diagnose and treat transgender individuals who felt distress with their identities and physical bodies. This language change in the DSM moved the emphasis from treatment for fixing a disorder to treatment to resolve the distress.
    2. Gender Dysphoria “refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later.”

Slide 12 Transition Roadmap Visual

Slide 13. The Personal and Social Transition (3 Minutes)

  1. Personal
    1. Personal transitioning could include self-reflection,  reaching out to and connecting with support groups, finding community, or seeking out and working with a therapist who specializes in gender identity issues.
    2. There is no timeline associated with personal exploration and transitions but is a private, personal, and individualized experience and process. This exploration could take as little as months but up to years.
    3. Questions to aid exploration of gender identity could include but are not limited to:
      1. Am I transgender/gender non-binary?
      2. What exactly is my gender identity?
      3. How can I develop the needed coping skills, resilience, and social support to help me through transition and to cope with a world that can be biased against or even dangerous for transgender and gender non-binary people?
  2. Social
    1. Presenting in public can include:
      1. Changing clothing or hairstyle
      2. Packing or Tucking (techniques used to give feminine or  masculine genital contour)
      3. Binding (using a tight chest garment to flatten breasts and give a masculine chest contour)
      4. Breast, hip, or buttock prostheses (inserts into clothing or bra to change breast, hip, or buttock size)
      5. Coming out to spouse, partner(s), children, friends, family, classmates, coworkers, community members
      6. Changing legal documents to reflect name, gender identity, and pronouns

Slides 14-15. Gender Dysphoria Diagnosis in Adults versus in Children (4 Minutes)

  1. These slides can be used to differentiate the Gender Dysphoria Diagnosis process between adults over 18 years of age and youth under 18 years of age. The main difference in diagnosis criteria is the length of which Gender Dysphoria symptoms are present, therefore requiring a longer extent of discomfort for youth before they can seek out gender confirmation/affirmation procedures.

Slides 16-17. Analysis of Modern Processes for Gender Confirmation/ Affirmation Procedures (4 Minutes)

  1. Requirements for Breast Removal:
  1. Single letter of referral from a qualified mental health professional and
  2. Persistent, well-documented gender dysphoria and
  3. Capacity to make a fully informed decision and to consent for treatment; and
  4. For members less than 18 years of age, completion of one year of testosterone treatment; and

*A trial of hormone therapy is not a prerequisite to qualifying for a mastectomy in adults.

       b.Requirements for Breast Augmentation (Implants/Lipofilling):

  1. Single letter of referral from a qualified mental health professional; and
  2.  Persistent, well-documented gender dysphoria; and
  3.  Capacity to make a fully informed decision and to consent for treatment; and
  4.  Member is 18 years of age or older; and

*Completion of one year of feminizing hormone therapy prior to breast augmentation surgery (unless the member has a medical contraindication or is otherwise medically unable to take hormones)

       c. Ophorectomy or Orchiectomy:

  1. Two referral letters from qualified mental health professionals, one in a purely evaluative role and
  2. Persistent, well-documented gender dysphoria and
  3. Capacity to make a fully informed decision and to consent for treatment; and
  4. Age 18 years or older; and

*Twelve months of continuous hormone therapy as appropriate to the member’s gender goals (unless the member has a medical contraindication or is otherwise unable or unwilling to take hormones).

        d. Requirements for Genital Reconstructive Surgery:

  1. Two referral letters from qualified mental health professionals, one in a purely evaluative role and
  2.  Persistent, well-documented gender dysphoria and
  3. Capacity to make a fully informed decision and to consent for treatment; and
  4. Age 18 years and older; and

*Twelve months of continuous hormone therapy as appropriate to the member’s gender goals (unless the member has a medical contraindication or is otherwise unable or unwilling to take hormones); and

*Twelve months of living in a gender role that is congruent with their gender identity (real-life experience).

Slide 18. Emphasize Procedures Considered Solely Cosmetic (1 Minute)

  1. This slide does not necessarily need to be read in entirety but should be used as an opportunity for students to see the mass amount of procedures that would not be covered by insurance and are therefore limiting to the physical and social transition for transgender individuals.
    1. Opening up the difficulty of the process for having documents legally changed

Slide 19. Barriers in Place to Modern Advancements (2 Minutes)

  1. A study conducted over a two-year span from 2018-2020 concluded that the barriers most commonly endorsed by top surgery patients were insurance coverage and age whereas the barriers most commonly presented for bottom surgery patients were getting mental health letters and readiness for surgery. Bottom surgery patients were also more likely to report barriers of readiness for surgery including out-of-pocket cost of/access to hair removal, surgical consultations, and surgery itself.
  2. Specific Barriers in Place:
    1. Insurance Coverage, Age, Access to Mental Health Letters, Cost of Surgical Consultations 
    2. Many Procedures Considered Solely Cosmetic and Not Covered by Insurance
    3. Access to Avenues of Readiness for Surgery
      1. Cost of Surgery
      2. Cost of Hair Removal
        1. (

Slides 20-22. Facilitate Sample Mental Health Letter Activity (6 Minutes)

  1. The Sample Mental Health Letter Acknowledging Readiness for Gender Affirmation Surgery from the University of Wisconsin Health Department can either be printed in advance and given to students so they can write on it, or it can be projected through the PowerPoint. 
  2. On Slide 22, specific sections have been bolded to highlight challenges and open space for discussion.
  3. Utilize guiding discussion questions:
    1. What are your initial thoughts or first impressions after reading the sample mental health letter?
    2. What challenges in place for patients can you identify?
    3. Who holds power in the process of obtaining the Mental Health letter?

Relevant Resources:

“Conversion Therapy | GLAAD”. Glaad.Org, 2021,

“DSM-5 FAQ”. Psychiatry.Org, 2021,,criteria%20for%20diagnosing%20mental%20disorders.

Mallory, Christy et al. “Conversion Therapy And LGBT Youth – Williams Institute”. Williams Institute, 2019,

Russo, Francine. “Where Transgender Is No Longer A Diagnosis”. Scientific American, 2021,

Tabaac, Ariella R. et al. “Barriers To Gender-Affirming Surgery Consultations In A Sample Of Transmasculine Patients In Boston, Mass.”. Plastic And Reconstructive Surgery – Global Open, Publish Ahead of Print, 2020. Ovid Technologies (Wolters Kluwer Health), doi:10.1097/gox.0000000000003008. 

“Transition Roadmap | Transgender Care”. Transcare.Ucsf.Edu, 2021,

“What Is Male Privilege? Transgender People Experience How Men And Women Are Treated Differently”. St. Louis Public Radio, 2021,

“Christine Jorgenson, Tom Snyder- 1982 Interview and Song.” YouTube, uploaded by Alan Eichler, 10 July 2015,

Author Information

Arin Young was an Education Intern at Our Family Coalition. She is a graduate of Longwood University with a Bachelor’s Degree in Social Work and was pursuing a Master’s Degree at Tufts Univesity in Diversity and Inclusion.

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