For decades, the transgender community existed within the "gay ghetto" out of necessity. In the mid-20th century, medical establishments refused to treat trans people. Homosexuality was a psychiatric disorder; gender identity was barely a concept. Trans people found refuge in gay bars, drag balls, and underground networks because the straight world offered none. This proximity forged a shared slang, a shared enemy (police, the medical establishment, social conservatism), and a shared geography.