CNN  — 

America has witnessed unprecedented levels of transgender visibility in recent years.

But for 32-year-old Jess Dugan, who has been photographing the country’s trans communities for the past 15 years, one demographic remains marginalized: seniors.

“I think, in general, a lot of the discussions around trans people are very youth-focused,” she said in a phone interview. “And our culture, in general, is youth-focused.

“I wanted to both highlight and record the stories of older people who, in many cases, came out a long time ago – and, in some cases, were directly responsible for creating this moment that we’re in now, but who are somewhat overlooked. I think that older (trans) adults are often left out of that conversation.”

Courtesy the Catherine Edelman Gallery, Chicago
The image used on the cover of Jess T. Dugan and Vanessa Fabbre's forthcoming book, "To Survive on This Shore: Photographs and Interviews with Transgender and Gender Nonconforming Older Adults."

Scroll through the gallery to see more images from the book, with quotes from the accompanying interviews.
Courtesy the Catherine Edelman Gallery, Chicago
"I think people talk in either/or terms, right? Before transition and after. But to me, it's really development. I'm proud of both lives. I'm proud of both 'me's, if you see what I'm saying. And I feel it has been a remarkable thing to have happened to a person. I'm grateful."
Courtesy the Catherine Edelman Gallery, Chicago
"People need to know they're not alone. Because that was my battle. For 50 years. I was in it by myself."
Courtesy the Catherine Edelman Gallery, Chicago
"I'd go the clinic for my HIV, I would do stuff. I'd push patients, walk them to the car, sing church songs. I was just having a ball while I was waiting for my appointment. And a guy saw me one day who ran an agency, and he said, 'Miss Dee Dee, you work down here?' I said, 'No.' He said, 'I got a job for you.' And that was God just setting me in right there in that clinic with my own desk and I was my own boss. I could go to work as myself."
Courtesy the Catherine Edelman Gallery, Chicago
"I just know I'm me. I don't think in terms of names and forms and all that. It doesn't matter. I'm just myself and that's who I am. I am at peace with myself. It is the most wonderful feeling in the world, because you're never in a hurry to get somewhere, you know, to prove to anyone that you're who you know you are."
Courtesy the Catherine Edelman Gallery, Chicago
"I still see myself as on a journey. When I received an award a few years ago at a conference I said, 'In the '60s they called me a sissy. In the '70s they called me a f****t. In the '80s I was a queen. In the '90s I was transgender. In the 2000s I was a woman, and now I'm just Grace'."
Courtesy the Catherine Edelman Gallery, Chicago
Samm: "Hank and I have been together 44 years. We met after her time in the military, through some Chicago lesbians I had met ... She was different from anybody I have ever met in my whole life and I knew that she would be in my life for the rest of my life. There was this immediate connection that would always be there. The way we are today, we started out that way."
Courtesy the Catherine Edelman Gallery, Chicago
"I got cancer and I was facing discrimination where doctors wouldn't even give me my biopsy results. The man who was supposed to be my breast surgeon wanted to send me out to psychiatry. Wanted to send me to psychiatry before giving me any breast cancer care! And he didn't even call me to give me my biopsy results. I didn't even know that I was sick for a long time."
Courtesy the Catherine Edelman Gallery, Chicago
"You have to have a thick skin to survive in the South being transgender. Unfortunately, I know too many who don't. And most of them are young. I think that over the years, I've developed this thick skin because it's either that or die."
Courtesy the Catherine Edelman Gallery, Chicago
"In school, we were forced to wear dresses. Even if the snow was two feet deep, you couldn't come to school in pants. I was mortified on a daily basis that I had to dress the way I did. In high school, other adults began to pick at me and be cruel. When I was a junior, the teacher gave me an F in gym. I was a straight-A student and an excellent athlete. She gave me an F in gym because I wouldn't take showers, but I wouldn't take showers because I didn't want to expose myself publicly with the body I had."
Courtesy the Catherine Edelman Gallery, Chicago
"When I was younger and I looked in the mirror, I saw a boy. And I remember when I came out to my parents, my mother was like, 'I always knew that there was something a little different,' but she didn't know what. I was born in 1964, so my parents, being born and raised down south, they had no idea whether it was transgender or gay or lesbian or anything. And so now we know what it is."
Courtesy the Catherine Edelman Gallery, Chicago
"I failed miserably as a lesbian. I had sex with too many men. So it just wasn't right. I moved to San Francisco in 1986 and became very involved in the women's SM community. I am one of the founders of International Ms. Leather. I had to hide being a trans man for a while because I thought they would take my 'card' away. Well, I finally committed and said, 'This is not right.' So that's when I began to transition and never looked back."
Courtesy the Catherine Edelman Gallery, Chicago
SueZie: "Years of self-administering hormones caused a complication that threatened my chances for surgery. I said to Cheryl, 'I'll die as female. Nothing is stopping that surgery." If there was a 95% chance of failure, of dying on the operating table, that was a risk I was willing to take. I could not go on how I was. My greatest challenge, it came from within. It was having the confidence to face the world out there."
Courtesy the Catherine Edelman Gallery, Chicago
"I'm a trans woman. I've always identified as female, but it took a while to get to that point, because I am originally from the Caribbean and the church is very strong there. I always knew that I was different. I remember going through puberty and asking my mom, 'How come I don't have breasts?' and she said, 'Well, it's because you're a boy.' That didn't seem right to me. It just didn't match."
Courtesy the Catherine Edelman Gallery, Chicago
"Even though I've transitioned, I can't deny or completely separate myself from the past because it did happen and those memories are with me. It wasn't until I got into my 50s that, through internet research, I discovered there was a name for all this. It was a great relief. "
Courtesy the Catherine Edelman Gallery, Chicago
"In the Hispanic community, you know, a lot of cisgender men, they don't take trans very easy. So that's why I just make sure I'm careful. It's really a safety issue. I don't trust too much. Being Hispanic, I have to be more masculine."
Courtesy the Catherine Edelman Gallery, Chicago
" I joined the military when I was 19 and did six years. I was a woman on the weekends. I looked forward to getting my hotel room and being Vanessa. And six years of weekends, you know, it just got old. The reason I didn't stay in the military was because I had to be Vanessa full-time."
Courtesy the Catherine Edelman Gallery, Chicago
"Before trans was even labeled as trans, it was sissy. I was a sissy. But my mother knew enough to be supportive ... I was like, 'Well, you know, I'm living as a girl now.' And my mother said, 'We are not going to say living 'as' a girl. We are going to say you are living in your womanhood, your sisterhood. It gives you power, it gives you authenticity'."

To counter this narrative – or lack thereof – 32-year-old Dugan launched a photo project “To Survive on This Shore,” which is now being published as a book of the same name. Shot over the course of five years, Dugan’s portraits accompany interviews conducted by her partner Vanessa Fabbre, a social worker and assistant professor at Washington University in St. Louis.

The pair’s only restriction was that subjects self-identified as transgender or gender non-conforming. Accordingly, the book’s diverse cast of more than 60 people spans various ethnicities, US states and socio-economic backgrounds.

From 75-year-old Jude, who started hormone therapy in the early 1970s, to 77-year-old Amy, who came out as transgender in 2012 following the death of her partner, their varied experiences depict what Dugan describes as the “struggles and joys” of being an older transgender person.

Courtesy the Catherine Edelman Gallery, Chicago
Jude, 75, began hormone therapy in 1971, aged 31.

“One interesting thing about working on this project was realizing how different everyone’s stories were,” Dugan said. “But I do think that there was a common thread of people struggling to figure out their identity, or come to terms with it. Their transitions often resulted in a lot of social fallout – people losing homes or families.

“So there was this kind of dual experience: of finding freedom and community, and then also losing comfort or security.”

A hidden population

Recent research by UCLA’s Williams Institute found that transgenderism is almost as prevalent among the elderly as the young. The study estimated that 0.5% (or one in every 200) of Americans aged 65 or over identified as transgender, compared to 0.7% among 13- to 24-year-olds.

Yet, older people’s experiences were often profoundly different from those of today’s transgender youth. Many of those profiled in Dugan and Fabbre’s book discuss coming out (or transitioning) at a time when families, communities and even legal systems struggled to comprehend transgenderism.

“For a long time, society identified me as a lesbian and seemed to ignore my transgender status,” 59-year-old Jay Kallio, a transgender man who passed away after interviewing for the book, is quoted as saying. “Back then, in the 1950s and ’60s, society wasn’t really all that nuanced in how it looked at LGBT people. We were all sort of lumped into the same boat.”

Courtesy the Catherine Edelman Gallery, Chicago
Jay Kallio, 59, who passed away after being interviewed for Dugan's book.

As 63-year-old Monica (who, like others in the book, is only identified by her first name) put it: “I came out to my aunt she told me she had had conversations with my mother, but back then in 1955 they didn’t have the language. By the time I had a conversation with a professional, I was an adult.”

Despite the struggles documented, the book’s subjects also display a pervasive sense of acceptance – both of their gender identities and of the ongoing social stigma that surrounds transgenderism.

“I want to be accepted as a woman, but if I am not, I don’t mind,” 86-year-old Rachel told Dugan and Fabbre. “One of the neighbors won’t have anything to do with me, but I don’t care, because who is she? She doesn’t know me.”

Relatable role models

Dugan, who identifies as “queer and gender non-conforming” (or “loosely part of the transgender umbrella,” as she also put it) came out as gay aged 13. She thereafter began questioning her own gender identity, a process that has directly influenced her art.

“When I was growing up, I didn’t see many representations of people who looked like me,” she said. “This was 15 years ago, give or take, and so much has changed since then. But it was in fine art photography books that I first discovered images of LGBT people who I could relate to.

“Photographic portraiture had a really profound effect on me by validating my own identity and allowing me to realize I was part of larger community.”

Courtesy the Catherine Edelman Gallery, Chicago
Stephanie, 64, says that she struggled to find work after transitioning.

So while the book is centered around seniors, Dugan hopes that by collaborating with non-profit and education groups, it can help bring these stories to a wider – and crucially younger – audience.

“We want younger trans folks to have representations of older trans folks who they can look to,” Dugan said. “We heard from younger people that they’d never even seen older transgender people – they had no roadmap for what their lives would look like.

“This project may be over, in terms of making it,” she added. “But I hope the effect is just beginning.”

To Survive on This Shore: Photographs and Interviews with Transgender and Gender Nonconforming Older Adults,” published by Kehrer Verlag, is available from Aug. 28, 2018.