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Through combined theoretical and empirical study, this work argues that transgendered people are not so much "produced" by medicine or psychiatry as they are "erased", or made invisible, in a variety of institutional and cultural settings. An analysis is made of two theoretical perspectives on transgendered people - queer theory and the social sciences - displaying how neither of these has adequately addressed the issues most relevant to sex change: everything from employment to health care to identity papers. Namaste then examines some of the rhetorical and semiotic inscriptons of transgendered figures in culture - including studies of early punk and glam rock subcultures - to illustrate how the effacement of transgendered people is organized in different cultural sites. This text concludes with research on some of the day-to-day concerns of transgendered people, offering case studies in violence, health care, gender identity clinics and the law.