In pre-colonial Peru the distinctions between male and female were far more flexible than they are today. A traditional ‘travesti’ or transgender/transvestite identity and culture existed and played an important role in Andean religion and society. Colonial and subsequently development influences suppressed these identities and communities, although the Peruvian travesti remained. In contemporary Peru travestis face violence from the public and police, as well as economic exclusion and discrimination by health services. Travestis have assimilated the worst of both gender roles. Sometimes they are seen as male and thus fair game for violence from the police. However, they have also assumed some aspects of the stereotypical “hysterical” woman, such as body transformation even at the cost of their health, choosing macho and possibly violent partners, and passivity in sex. Travestis need a new kind of post-feminism to enable them to make active choices about which genders they wish to claim, and to live out their chosen genders in ways that validate themselves. Rights are needed for all people to choose and transit between gender identities whether male, female, or a combination.