Trans activists like Marsha P. Johnson and Sylvia Rivera were central figures in the 1969 Stonewall uprising. They later founded Street Transvestite Action Revolutionaries (STAR), the first organization in the U.S. dedicated to supporting homeless queer and trans youth.

Originating in Harlem in the 1960s and 70s, ballroom was a sanctuary for Black and Latinx trans women and gay men who were excluded from white-dominated gay bars. Categories like "Realness"—where contestants competed to pass as cisgender professionals, students, or executives—were both an art form and a survival tactic. Ballroom gave LGBTQ culture voguing (popularized by Madonna), a unique lexicon ("shade," "reading," "legendary"), and a family structure of "houses" that provided shelter and love to rejected queer and trans youth.