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Josephine Tittsworth was born in Pasadena, Texas and was assigned and raised as a male. She struggled with gender issues and dressed secretly as a woman for most of her life. In 1981 life changed when she contacted an editor of Playboy magazine who put her in touch with Carol Beecroft in California. Beecroft shared the names of some cross-dressers in Houston; Josephine invited them to meet at the La Quinta Inn at I-10 and Wirt Rd. Melanie and Peggy Rudd came and the first Texas chapter of TRI-ESS, the Society for the Second Self was born. (She was known as Judy Daniels at the time.)

When attending UH-Clear Lake University Tittsworth realized that feeling unsafe, unwelcome or uncomfortable in a classroom or during academic advising, was a hindrance to receiving the best education possible. She began a quest to add gender identity and gender expression to the school's nondiscrimination policy. She succeeded in 2006 and accomplished the same while attending the University of Houston,
Main Campus.

In 2009 she founded and became the Executive Director of the Texas Transgender Non-discrimination Summit (TXTNS.) It formed a grassroots effort to look at strategic approaches to the issues of social justice and policy implementation in regards to the concepts of gender identity and gender expression, working to end discrimination in those areas. In 2009 there were only three universities in Texas with inclusive policies - Rice University, the University of Texas, and South Texas College of Law. In the spring of 2016 there were 38 university systems and five Texas independent school districts.

In April of 2014 The Student Government Association at the University of Houston passed the Josephine Tittsworth Act. The student bill addresses the safety concerns of transgender people on campus. The bill allows transgender students to use their proper name, title, and gender when completing official university documents. She has been featured in radio, print and television for her work on transgender issues and has spoken at numerous colleges, businesses, and organizations. She founded numerous peer support groups for crossdressers across the USA and is an experienced lobbyist for transgender rights in Austin, Texas and Washington DC. She has worked diligently for equality but most importantly she has guided others to develop their leadership skills.