During an interview with Michel Martin on the NPR talk show "Tell Me More", she revealed that she grew up in Mobile, Alabama.
She has a twin brother, musician M. Lamar, who appeared on Orange Is the New Black (2013) in a flashback as the pre-gender transition version of her character, Sophia.
She was named one of OUT Magazine's 100 most influential gay, lesbian, bisexual, or transgender people for 2013.
She attended high school at the Alabama School of Fine Arts, a state-wide, public, magnet, boarding and day school in Birmingham. Admission to ASFA is by competitive application and - depending on the area of arts interest - audition. She started as a creative writing major, before later switching to the dance program.
She has spoken in many interviews about the bullying and lack of support she received from both peers and teachers as a child in Alabama. Her third grade teacher warned her mother that she was sick and "would end up in New Orleans wearing a dress if we don't get him into therapy right away." As an adult, in her capacity as an LGBT activist, she has lectured at many universities, including New Orleans's Tulane, where she did indeed wear a dress.
She appeared on the cover of the June 9, 2014, issue of Time magazine, and was interviewed for the article "The Transgender Tipping Point" by Katy Steinmetz. This makes her the first openly transgender person to appear on the cover of Time in the magazine's history.
Her nomination for Outstanding Guest Actress in a Comedy Series - for her performance in Orange Is the New Black (2013) - at the 2014 Primetime Emmy Awards makes her the first openly transgender person to be nominated for an acting award in the history of the Emmys.
The role of Cameron Wirth - her character in Doubt (2017) - was written specifically for a transgender actress.