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: The Silence of the Lambs (1991) featured Buffalo Bill, a character who skins women to create a "woman suit," a portrayal that critics argue links trans identity with extreme violence and dehumanization.

The intersection of trans identity and extreme cinema—specifically within the horror genre—often oscillates between harmful tropes and radical, empowering re-representation. Historically, mainstream "extreme" cinema has frequently utilized trans-coded characters as symbols of "abjection" or mental instability to elicit fear. Historical Tropes and "Trans-Coded" Extremity extreme movies shemale

More recently, trans creators and allies have reclaimed the "extreme" and horror genres to explore gender identity through a more nuanced, often "body horror" lens. : The Silence of the Lambs (1991) featured