In this article we present ethnographic research on Puerto Rican transwomen, focusing on how their gender trajectories are marked with various forms of routinized, systemic violence as well as resilient responses. Adapting Achille Mbembe's notion of necropolitics to consider the ways that the transgender body is systematically excluded and "designed to die," the authors aim to critically engage the embodied experience of transwomen and the mechanisms of exclusion that too frequently hasten them toward death, either through interpersonal forms of transphobic violence or, more often, the accumulation of everyday forms of abandonment and neglect. Using a framework of gender trajectories to provide a time-depth to the embodied experiences of transwomen in their efforts to express their evolving gender identities, we trace how they navigate heteronormative, cisgender masculinity during earlier stages of life and gradually engage with available technologies for gender transitioning, which in this context are deeply constrained by systemic exclusions from transgender-affirming medical systems. We view these biomedical exclusions as expressions of structural violence emerging from neoliberal, cisgender, and heteronormative systems and resultant mechanisms of social control, leading to moments of intense interpersonal and structural violence.