Born to Be: gender, hope and a musical surgeon

'Born to Be' follows a groundbreaking New York surgeon and his transgender patients. We talk to the director of the documentary now showing at MIFF.

Documentary director and producer Tânia Cypriano was born and raised in Brazil but has lived in the United States for more than 35 years, working around the world in a long career in both film and television. Her debut film Viva Eu! (1989), about the first man diagnosed with HIV/AIDS in Brazil won five international awards, including Best Documentary at Joseph Papp’s Festival Latino in New York.

Health, wellbeing and identity are recurring concerns in Cypriano’s work, with subjects ranging from tattoos to breastfeeding, ecology and disability. Her latest film, the feature documentary Born to Be, follows groundbreaking New York surgeon Dr Jess Ting and the patients whose lives he changes, not just with his scalpel but with his accepting and humane manner.

Trained as a plastic surgeon, Ting is head of the recently established transgender surgery program at Mt Sinai Hospital. He only became interested in this area of medicine when none of the other doctors at the hospital wanted to take it on. Seeing that transgender people had some of the highest suicide rates in the world, Ting wanted to become part of the targeted care that helps to redress the situation.

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An eye-opening but sensitively handled film, produced by Michelle Hayashi, and currently screening online at the Melbourne International Film Festival, Born to Be first premiered in 2019 at the NY Film Festival. It takes viewers inside surgical theatres and beyond, observing a number of patients’ procedures, from initial meetings to post-operation check-ups. Dr Ting emerges as a humble hero, a musician who never even wanted to be a doctor. It’s a film that demystifies and humanises a subject many find incredibly challenging. 

We caught up with Cypriano by email to to ask about the making of this mind-changing film.

Q: In what ways did the process of making Born to Be change your own way of seeing the trans community and the issues around surgery?

Tânia Cypriano: When I first started meeting patients at the Mount Sinai Center for Transgender Medicine and Surgery, I was struck by the diversity of the patients and their needs. Listening to transgender folks there and beyond, I learned how the issue of surgery and identity is complex. Not all transgender people want or need hormone treatment or medical procedures because one’s identity may not depend on appearance or how their body looks. But for those who want or need them, they should be respected because these medical interventions can be life changing and even life saving.

I don’t know if I’d call this a change in me personally – but the experience of making this film made me more deeply understand the importance of educating ourselves on what it means to be trans and respecting people for who they are. The message we communicate about the need for the larger society to change their perspective on transgender identity can make the world a better place for transgender people and help bring about true health care for all, which right now is mostly available for those who can afford or are chosen by a system that operates under the disguise of moral values.

‘The issues of surgery and Identity are complex.’ Born to Be. Image via MIFF. 

Regarding the editing process, was it a difficult story to shape?

Tânia Cypriano: I was fortunate enough to be given a chance to work with two amazingly gifted editors on this project: Scott Foley and Christopher White. Because most of the film was shot in cinéma vérité style, we had a lot of footage to go through. You can walk into an edit room with a pre-meditated ‘script’ in your head but you will never get into the deeper truths if you don’t spend a long time studying the footage you got and making that real effort to understand the stories it really tells us. We started with an 8-hour assembly that was fantastic because it had everything we wanted. As we began to cut scenes out – and the most difficult of all, remove fully developed characters – we kept getting shorter versions where every edit was painful because we had to sacrifice so much good material.

What were the key questions or principles guiding what was put in and left out of the final film?

Tânia Cypriano: One principle that guided me, and which I kept reminding the editors of, was the importance of portraying facets of our characters that were universal rather than particular or unique to them. I believe that’s one element that has helped cisgender audiences to understand this community better. When Cashmere shares her dream of finding someone who can fall in love with her – who doesn’t hope to find someone to fall in love with? When Mahogany talks about sacrificing her career in order to be happy – who has not experienced sacrificing something in order to achieve something else?

The question regarding who our audience is was always there. And we took into account who we as filmmakers are and that there were several topics that were new to us; we used that to our advantage when we saw a need to explain things to audiences that would be learning things for the first time. But I also always tried to make sure the film could be of an interest to transgender audiences as well.

‘It’s a difficult thing to make a film that can speak to an audience that knows nothing about the subject and to one who IS the subject.’

Throughout the editing process, and with the help of executive producer J Winkelried, we organized several screenings where we brought in groups of transgender and queer viewers into the process of our editing to make sure we were going in the right direction, that we were being respectful, and that the film was covering topics and issues that were interesting and important for trans audiences as well. 

What were the key difficulties faced by your cinematographer Jeffrey Johnson, and what advice would you give others trying to capture footage in a similar medical territory?

Tânia Cypriano:  I shared this question with Jeffrey Johnson who responded that for filming the medical scenes, the most important thing for him was our discussions before going in (knowing our communication would be limited during). So finding the goals of the scene and figuring out our story line between not showing enough of the procedures and being too graphic was really important. After that, it was a matter of finding compositions that brought the viewer closer to our subjects emotionally without exploiting the access they granted us.

I spent a lot of time developing trust with the people in our film. And beyond that, came the natural friendship and bond I still have with all of them. The people in Born to Be have become part of my life as I have of theirs. Building these types of relationships may give you access to a lot, but it comes with a larger responsibility, by which I mean that it’s not just because you are given access to something that you can use it. And my respect and gratitude for them have always come first. So even though they shared a lot, I also made sure I protected them.

Director Tânia Cypriano and DOP Jeffrey Johnson on location. Image used with permission.

Having watched the MIFF Q&A I was surprised to hear the producer Michelle Hayashi is also the partner of Dr Ting. He is a fascinating and very endearing character. But was it difficult to have your producer in such a relationship with the main subject?

Tânia Cypriano: Yes and no. But I think one of the most difficult things was convincing Michelle, who had the idea for the film and had initially envisioned it as a film that focused more on the patients going through medical transition, to accept Dr. Jess Ting being a character.

When I first met Michelle and Jess, he was introduced to me as the head of the surgery department at the Mount Sinai Center for Transgender Medicine and Surgery and someone who was going to help us with getting access to the hospital.

Michelle, who had never worked on a film before, had her heart set on making a movie that could help the transgender community after hearing a lot of stories through Jess, and learning about the high rate of suicide in the community. From there, Jess went on to introduce me to the director of Mount Sinai Hospital, who gave us a green light on the project, and introducing me to everyone who worked both in the clinics and the surgery department, and of course – his patients.

Once the camera started to roll, it was obvious to both cinematographer Jeffrey Johnson and myself that not only was the work Jess did extraordinary but that his character could be a gateway to reaching a larger audience.

‘Here we had an Asian-American man, Christian, and (divorced) father of three children, who knew little about the transgender community or their health needs prior to taking his role at Mount Sinai.’

He learns about the community, begins to care deeply about it, and goes on to advocate for trans people as well as trying to improve healthcare for them!

Michelle was using personal contacts to fundraise for the film and felt awkward to present the film if he was in it. Dr. Ting agreed. So it took a while to convince both of them.

Once I learned of his musical background, I had to also convince Michelle to convince Dr. Ting to play his instrument. And their relationship, worked to the film’s advantage! Here you have a man who had a huge passion for music and wished to be a classical bass player. Life would not allow him to pursue his dream and what he wanted to do most. What does he do today? He helps people to be who they are. Having Jess as a character, and a key character was the film I wanted to make. And Michelle kindly understood that if her purpose was to make a movie to help a community she also cared about, this was the way to go.

You’ve been making films for more that 25 years across many countries. What are the main issues or concerns you see for independent documentary filmmakers right at this historical moment?

Tânia Cypriano: I was born and raised in Brazil, and for over 35 years, I’ve lived in the United States. As an immigrant with a family of transnational experiences, issues around identity have been part of my work and my life. I agree and support one hundred percent the latest movement among the community of Black, Indigenous, and people of color (BIPOC) documentary filmmakers, and the way people are calling for visibility, equity and self-representation.  I just hope we find a path that does not fall into a system of censorship. My identity influences everything I do, but so do my life experiences, and I think that bringing in respect and humanity in what we do is above everything. 

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Is there any advice you’d give for new filmmakers starting in factual filmmaking?

Tânia Cypriano: Take risks and enjoy the ride on the first film you make! Once we understand the craft better and become more aware of the filmmaking world, so much begins to distract us from why we do what we do and how we use our voice and creativity. I always go back to the experience I had when making my first film because it helps remind me to be true to my vision and to continue a path of wonder and quest for genuine dialogue.

Born to Be is screening online as part of the Melbourne International Film Festival 68.5, which streams Australia-wide from 6 – 23 August.

Rochelle Siemienowicz is a journalist for Screenhub. She is a writer, film critic and cultural commentator with a PhD in Australian cinema. She was the co-host of Australia's longest-running film podcast 'Hell is for Hyphenates' and has written a memoir, Fallen, published by Affirm Press. You can find her on Twitter and Instagram