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: Non-binary and transgender identities have existed for centuries across various cultures, such as the Hijra in South Asia, the koekchuch of Siberia, and Two-Spirit individuals in Indigenous North American cultures.

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: The world's first institute for studying LGBTQ+ identities, the Institut für Sexualwissenschaft , was founded in Germany in 1919 and provided early affirming medical services before being destroyed by the Nazi party. Key Challenges and Advocacy Cultural Competence in the Care of LGBTQ Patients - NCBI : Non-binary and transgender identities have existed for