Chris Anderson: So I guess what we're going to do is we're going to talk about your life, and using some pictures that you shared with me. And I think we should start right here with this one. Okay, now who is this? Martine Rothblatt: This is me with our oldest son Eli. He was about age five. This is taken in Nigeria right after having taken the Washington, DC bar exam. CA: Okay. But this doesn't really look like a Martine. MR: Right. That was myself as a male, the way I was brought up, before I transitioned from male to female and Martin to Martine. CA: You were brought up Martin Rothblatt. MR: Correct. CA: And about a year after this picture, you married a beautiful woman. Was this love at first sight? What happened there? MR: It was love at the first sight. I saw Bina at a discotheque in Los Angeles, and we later began living together, but the moment I saw her, I saw just an aura of energy around her. I asked her to dance. She said she saw an aura of energy around me. I was a single male parent. She was a single female parent. We showed each other our kids' pictures, and we've been happily married for a third of a century now. (Applause) CA: And at the time, you were kind of this hotshot entrepreneur, working with satellites. I think you had two successful companies, and then you started addressing this problem of how could you use satellites to revolutionize radio. Tell us about that. MR: Right. I always loved space technology, and satellites, to me, are sort of like the canoes that our ancestors first pushed out into the water. So it was exciting for me to be part of the navigation of the oceans of the sky, and as I developed different types of satellite communication systems, the main thing I did was to launch bigger and more powerful satellites, the consequence was that the receiving antennas could be smaller and smaller, and after going through direct television broadcasting, I had the idea that if we could make a more powerful satellite, the receiving dish could be so small that it would just be a section of a parabolic dish, a flap of a plate embedded into the roof of an automobile, and it would be possible to have nationwide satellite radio, and that's SiriusXM today. CA: Wow. So who here has used Sirius? (Applause) MR: Thank you for your monthly subscriptions. (Laughter) CA: So that succeeded despite all predictions at the time. It was a huge commercial success, but soon after this, in the early 1990s, there was this big transition in your life and you became Martine. MR: Correct. CA: So tell me, how did that happen? MR: It happened in consultation with Bina and our four beautiful children, and I discussed with each of them that I felt my soul was always female, and as a woman, but I was afraid people would laugh at me if I expressed it, so I always kept it bottled up and just showed my male side. And each of them had a different take on this. Bina said that I love your soul and whether the outside is Martin and Martine, it doesn't it matter to me, I love your soul. My son said, if you become a woman, will you still be my father? And I said yes, I'll always be your father, and I'm still his father today. My youngest daughter did an absolutely brilliant five-year old thing. She told people, "I love my dad and she loves me." So she had no problem with a gender blending whatsoever. CA: And a couple years after this, you published this book: The Apartheid of Sex. What was your thesis in this book? MR: My thesis in this book is that there are seven billion people in the world, and actually, seven billion unique ways to express one's gender. And while people may have the genitals of a male or a female, the genitals don't determine your gender or even really your sexual identity. That's just a matter of anatomy and reproductive tracts, and people could choose whatever gender they want if they weren't forced by society into categories of either male or female the way South Africa used to force people into categories of black or white. We know from anthropological science that race is fiction, even though racism is very, very real, and we now know from cultural studies that separate male or female genders is a constructed fiction. The reality is a gender fluidity that crosses the entire continuum from male to female. CA: You yourself don't always feel 100 percent female. MR: Correct. I would say in some ways I change my gender about as often as I change my hairstyle. CA: (Laughs) Okay, now, this is your gorgeous daughter, Genesis. And I guess she was about this age when something pretty terrible happened. MR: Yes, she was finding herself unable to walk up the stairs in our house to her bedroom, and after several months of doctors, she was diagnosed to have a rare, almost invariably fatal disease called pulmonary arterial hypertension. CA: So how did you respond to that? MR: Well, we first tried to get her to the best doctors we could. We ended up at Children's National Medical Center in Washington, DC. The head of pediatric cardiology told us that he was going to refer her to get a lung transplant, but not to hold out any hope, because there are very few lungs available, especially for children. He said that all people with this illness die, and if any of you have seen the film "Lorenzo's Oil," there's a scene when the protagonist kind of rolls down the stairway crying and bemoaning the fate of his son, and that's exactly how we felt about Genesis. CA: But you didn't accept that as the limit of what you could do. You started trying to research and see if you could find a cure somehow. MR: Correct. She was in intensive care ward for weeks at a time, and Bina and I would tag team to stay at the hospital while the other watched the rest of the kids, and when I was in the hospital and she was sleeping, I went to the hospital library. I read every article that I could find on pulmonary hypertension. I had not taken any biology, even in college, so I had to go from a biology textbook to a college-level textbook and then medical textbook and the journal articles, back and forth, and eventually I knew enough to think that it might be possible that somebody could find a cure. So we started a nonprofit foundation. I wrote a description asking people to submit grants and we would pay for medical research. I became an expert on the condition. Doctors said to me, Martine, we really appreciate all the funding you've provided us, but we are not going to be able to find a cure in time to save your daughter. However, there is a medicine that was developed at the Borroughs Wellcome Trust Company that could halt the progression of the disease, but Borroughs Wellcome has just been acquired by Glaxo Wellcome. They made a decision not to develop any medicines for rare and orphan diseases, and maybe you could use your expertise in satellite communications to develop this cure for pulmonary hypertension. CA: So how on earth did you get access to this drug? MR: I went to Glaxo Wellcome and after three times being rejected and having the door slammed in my face because they weren't going to out-license the drug to a satellite communications expert, they weren't going to send the drug out to anybody at all, and they thought I didn't have the expertise, finally I was able to persuade a small team of people to work with me and develop enough credibility. I wore down their resistance, and they had no hope this drug would even work, by the way, and they tried to tell me, "You're just wasting your time. We're sorry about your daughter." But finally, for 25,000 dollars and agreement to pay 10 percent of any revenues we might ever get, they agreed to give me worldwide rights to this drug. CA: And so you put this drug on the market in a really brilliant way, by basically charging what it would take to make the economics work. MR: Oh yes, Chris, but this really wasn't a drug that I ended up, after I wrote the check for 25,000, and I said, "Okay, where's the medicine for Genesis?" they said, "Oh, Martine, there's no medicine for Genesis. This is just something we tried in rats." And they gave me, like, a little plastic Ziploc bag of a small amount of powder. They said, "Don't give it to any human," and they gave me a piece of paper which said it was a patent, and from that, we had to figure out a way to make this medicine. A hundred chemists in the U.S. at the top universities all swore that little patent could never be turned into a medicine. If it was turned into a medicine, it could never be delivered because it had a half life of only 45 minutes. CA: And yet, a year or two later, you were there with the medicine that worked for Genesis. MR: Chris, the astonishing thing is that this absolutely worthless piece of powder that had the sparkle of a promise of hope for Genesis is not only keeping Genesis and other people alive today, but produces almost a billion and a half dollars a year in revenue. (Applause) CA: So here you go. So you took this company public, right? And made an absolute fortune. And how much have you paid Glaxo, by the way, after that 25,000? MR: Yeah, well every year we pay them 10 percent of 1.5 billion,, 150 million dollars, last year a hundred million dollars. The best return on an investment they ever received. CA: And the best news of all, I guess, is this. Mr: Yes. Genesis is an absolutely brilliant young lady. She's alive, healthy today at 30. You see me, Bina, and Genesis there. She's, the most amazing thing about Genesis is that while she could do anything with her life, and believe me, if you grew up your whole life with people in your face saying that you've got a fatal disease, I would probably run to Tahiti and just not want to run into anybody again. But instead she chooses to work in United Therapeutics. She says she wants to do all she can to help other people with orphan diseases get medicines, and today, she's our project leader for all telepresence activities, where she helps digitally unite the entire company to work together to find cures for pulmonary hypertension. CA: But not everyone who has this disease has been so fortunate. There are still many people dying, and you are tackling that too. How? MR: Exactly, Chris. There's some 3,000 people a year in the United States alone, perhaps ten times that number worldwide, who continue to die of this illness because the medicines slow down the progression but they don't halt it. The only cure for pulmonary hypertension, pulmonary fibrosis, cystic fibrosis, emphysema, COPD, what Leonard Nimoy just died of, is a lung transplant, but sadly, there are only enough available lungs for 2,000 people in the U.S. a year to get a young transplant, whereas nearly a half million people a year die of end stage lung failure. CA: So how can you address that?