In late 2014, New York became the ninth state to require all insurance plans, including Medicaid, to cover gender-affirming treatment and surgery for transgender and gender nonconforming (TGNC) people. The following year, New York City’s medical powerhouse Mount Sinai opened its Center for Transgender Medicine and Surgery, helmed by the cisgender Jess Ting, M.D., a classically trained musician who’d become a top cosmetic surgeon. But the world of TGNC people was new to him, and as he learned more and more about helping such folks transform their bodies to be in alignment with their gender identities, he underwent his own transformation, slowly realizing the personal pain endured by TGNC folks in a society that is only just beginning to grant them legal and personal equality and respect.
Directed by New York City–based Tania Cypriano, who has made numerous documentaries, including about HIV/AIDS in her native Brazil, Born to Be is not only the story of Ting, but of the diverse TGNC folks who agreed to participate in the documentary as they went through various surgeries with him and his staff, which includes TGNC employees. At a time when documentaries like Disclosure are spotlighting how TGNC folks have historically been depicted—and dehumanized—by cisgender people in TV and film, Born to Be is at once medically hyper-detailed and deeply compassionate and sensitive in its chronicling of a new area of medicine that struggles valiantly to meet the growing demand from New Yorkers yearning to be, in their own words, “reborn.”
TheBody talked with Cypriano about the film, which can be watched for $12 for a 48-hour online rental from the New York City indie cinema landmark Film Forum.
Tim Murphy: Hi there, Tania, thanks so much for talking to TheBody. So this is far from your first documentary.
Tania Cypriano: True, I’ve made a lot of experimental documentaries and have done a lot of commissioned work, but this was the first time I was able to direct a feature doc with funding behind it. I’ve never before been able to hire people. It was an amazing experience.
Murphy: Did you get money from Mount Sinai?
Cypriano: None. That would have been more like an advertisement for the center. Michelle Koo Hayashi, who is a philanthropist herself, had the idea for the film and approached me to direct it. She raised the money, which also came from a patient of Dr. Ting, J Winkelried, who wanted to do something for their transgender community. So, to start, I sat down with Michelle and Dr. Ting. It took about a year to begin filming. It’s not easy to get inside a hospital with a camera, and this was a very young program. But for Dr. David L. Reich, the president of Mount Sinai, this center is his baby, and he saw the potential for the doc. This was really a historical moment in New York—the first comprehensive center for transgender people in the country, with everything from hormone therapy to mental health to surgery.
So I was there from the very beginning, and I think by Day 2 we realized that Dr. Ting needed to be in the film. He was learning about a community and becoming an advocate for them, and he was also the father of three kids, so he was a voice that could dialogue with audiences that didn’t know anything about [this topic].
Murphy: Did you personally know any TGNC people before this project?
Cypriano: Yes, because I’d worked on films on HIV/AIDS and curated LGBTQ film programs in New York, Brazil, and Europe. But the whole world of transgender surgery was something I had no idea about.
Murphy: So, in this film, we follow several very different TGNC folks, including [Naomi], Garnet, Jordan, Mahogany, and Shawn. [Naomi] has been a New Yorker her whole life, once doing sex work on the streets but now sober for decades; Garnet is very young and newly arrived in New York from Texas; Jordan met their girlfriend on an LGBTQ birthright trip to Israel; and Mahogany was a very successful male model before she transitioned, to give a sense of the diversity of the people in the film. How did you engage the TGNC folks in the film to make public what is usually such a personal and private process?
Cypriano: Dr. Ting’s assistants were incredibly helpful. They let all the patients know there was going to be a film crew in the office and asked if anyone would be interested [in being filmed]. I think the patients knew this was important, because it was a historic time in New York [with health plans suddenly mandated to cover trans-related care]. Many of them had lived through years of hardship and were happy for the chance of change, so they wanted to speak. It was very organic. Dr. Ting would say to me, “I have a patient you have to meet.” Like Mahogany. I met her three days before her surgery. Everyone wanted to help us normalize this experience.
We also had quite a few internal screenings throughout the editing process to make sure everything we did was responsible.
Murphy: Nobody’s genitalia is ever shown, even though the film is very explicit and detailed about how the “bottom surgeries” [on genitalia] are done.
Cypriano: Everyone actually gave us authorization to show it, but I wasn’t interested in showing anything unless there was a reason for it. I was aware of the whole cisgender obsession with transgender people’s bodies. We were told by several trans people that they did want to see the genitalia. If you’re trans and you’re looking to do a surgery, there’s little visual information you can get. A lot of people go to porn to see what things look like. When we edited the film, we made two versions, with one showing bottom nudity.
But we decided to put out the version without it, because I saw there was a lot of sensitivity from other trans folks to not show it—and my intention is never to do something that people aren’t comfortable with.
Murphy: One of the most painful and moving story arcs is Garnet, who is still going by Devin in the film. I don’t want to give away everything that happens, but how is Garnet doing now?
Cypriano: She’s doing fine. She’s working, she has a boyfriend, and she’s growing up. When we talk, she always says, “I wish I were more mature” when the filming was going on. I don’t know much about hormones, but I often thought that [the trans people in the film] were like adolescents, growing up and getting the body they want.
Murphy: I have to say that even just the two of us, two cisgender people, talking now about trans bodies feels kind of objectifying and wrong. Do you know what I mean?
Cypriano: This is the only way I can survive as both a person and a filmmaker. When we started making this film, Michelle said, “I hope we can make a film that can help the trans community see that there is a future for them around health care, and then maybe we can make the suicide rates [among trans folks] go down.” And I said, “If we really want to bring change, we have to talk to the larger society, not just trans folks.” The most important thing for me in making films is to remind people that we are all human beings. When you hear [Naomi] saying, “I want somebody to fall in love with me.” Well, I want somebody to fall in love with me, too! When you hear Mahogany saying that she gave up being a famous male model in order to be happy. … How many of us have given up something super important in our lives in order to pursue full happiness? Those things unite us. We are all human beings.
Murphy: You were filming at a time when the Trump administration was trying to roll back Obama-era health care protections for trans people, which they have largely failed at in the courts, thankfully. Was it a choice not to bring that up in the film?
Cypriano: Yes. I wanted to make sure that this film lasted longer than the specific period that we were living in.
Murphy: The center of the film is definitely Dr. Ting. Did you worry that you might make a film overly centered around a kind of cisgender “savior” figure?
Cypriano: Oh, I hate when people say that. My only regret is that we lost some of his complexity as we edited the film down. Americans are more into identifying heroes and saviors than any other culture I know. For me, it’s the same idea of “the good cop.” I’m sorry, there are no good cops. I find it wrong to look at a doctor who is doing the right thing and call him a savior.
Murphy: No, but I’m asking if you can understand how the way you’ve centered the film around him makes him out to be a savior character?
Cypriano: I hope people don’t see it that way. Dr. Ting is somebody who practices his humanity in order to bring his practice to a level where it should be. He has integrity. Why do we think that a doctor who is doing the right thing is a savior?
Murphy: OK. I also wanted to ask you about the final scene, which is very moving and also kind of chilling. I don’t want to spoil it too much, but we see Dr. Ting getting a call from a 14-year-old who is very desperate for surgery. Why did you end with that scene?
Cypriano: Michelle actually filmed that scene, in the car at night with Dr. Ting. We had to go to the 14-year-old’s parents and ask them for permission to use the recording [of the child, who is not seen or identified]. As soon as I saw it, I said, that has to be the final scene. It’s night, he’s driving, and we don’t know where we’re going, and you have this child and you realize that the world is changing so much that kids are now able to ask about this. I know so many people now who say that their kids are bringing this topic up.
Murphy: Oh, that’s interesting—I thought it was to underscore at what an early age trans folks can have this feeling of not being in the right body, and the urgency around that, especially with high suicide-attempt rates among young trans people, which the film addresses in a very sensitive way.
What purpose do you want the film to serve in the world?
Cypriano: I would like for people to be able to learn something from it. We’re living in a time where people give their opinions based on zero education or knowledge, without respect to people who are different from them. The change needs to come from outside the trans world more than anywhere. People have to tolerate—no, that’s a horrible word. People have to understand and respect that the world of gender is bigger than they think it is. I hope the film can help do that.