Table of ContentsView AllTable of ContentsDefinitionGender AffirmationTerminologyDiscriminationHow to Be an Ally

Table of ContentsView All

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Table of Contents

Definition

Gender Affirmation

Terminology

Discrimination

How to Be an Ally

Transgenderis a term used to describe people whose gender identity does not conform with the gender they were assigned at birth. A person designated male at birth who identifies as female is a transgender woman, while a person designated female at birth who identifies as male is a transgender man.

In recent years, transgender has become an umbrella term that includes not only people who are binary (male or female) but also those who arenon-binaryorgender-non-conforming.

Gender affirmation, or the process of aligning one’s outward expression of gender with one’s inward sense of gender, is central to the transgender identity. Medical treatments or surgery may be involved, but not always.

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People hold signs, banner and placards with lgbt rainbow and transgender flag during pride month celebration against violence, descrimination, human rights violation. Equality and self-affirmarmation.

What It Means to Be Transgender

Transgender traditionally means to identify as male if you were assigned female at birth or to identify as female if you were assigned male at birth. And, to many, that remainsthedefinition of “transgender,” described on the male-female binary.

But not everyone sees gender in the same way.

In the current vernacular, non-binary people may fall under the “transgender umbrella” when they consciously move away from expected gender roles and align themselves, their presentation, and sometimes their bodies with their owngender identity.

In the end, gender identity is one’s internal sense of gender even if that means no gender at all. Examples include:

Gender Identity vs. Sexual OrientationGender and sex are not the same thing, and neither are gender identity and sexual orientation.Gender identity is the personal sense of one’s own gender, which can correspond to a person’s assigned sex or differ from it. Sexual orientation is a person’s identity in relation to the gender or genders they are sexually attracted to.

Gender Identity vs. Sexual Orientation

Gender and sex are not the same thing, and neither are gender identity and sexual orientation.Gender identity is the personal sense of one’s own gender, which can correspond to a person’s assigned sex or differ from it. Sexual orientation is a person’s identity in relation to the gender or genders they are sexually attracted to.

Gender and sex are not the same thing, and neither are gender identity and sexual orientation.

Gender identity is the personal sense of one’s own gender, which can correspond to a person’s assigned sex or differ from it. Sexual orientation is a person’s identity in relation to the gender or genders they are sexually attracted to.

Gender Affirmation and Gender Expression

Whether binary or non-binary, the one characteristic that connects all transgender people is that the gender assigned to them at birth does not match their own internal sense of gender identity.

This mismatch can be felt from as early as three to five years in some transgender children.Others may not recognize it until puberty when changes in their bodies create a palpable sense of unease about their gender and all that implies. Others still may not recognize this until later in life.

In response to gender dysphoria, a transgender person may pursuegender affirmationin its different forms to align their gender identity (their inward sense of gender) with theirgender expression(their outward expression of their gender).

Gender affirmation (formerly known asgender transitioning) can include one or all of the following:

Do All Transgender People Have Surgery?Despite what many people think, a person does not have to undergo medical treatments to be transgender. Social and/or legal affirmation may be far more important to some people.While many transgender people will take hormones to align their physical expression with their gender identity, many don’t and have no desire to.

Do All Transgender People Have Surgery?

Despite what many people think, a person does not have to undergo medical treatments to be transgender. Social and/or legal affirmation may be far more important to some people.While many transgender people will take hormones to align their physical expression with their gender identity, many don’t and have no desire to.

Despite what many people think, a person does not have to undergo medical treatments to be transgender. Social and/or legal affirmation may be far more important to some people.

While many transgender people will take hormones to align their physical expression with their gender identity, many don’t and have no desire to.

Terminology and Appropriate Usage

Transgender is an adjective (as in “he is a transgender man”). It isnotused as a noun (such as “he is a transgender”)" or a verb (“he is transgendered”).

“Trans” is often used as a shorthand for transgender, so it is usually acceptable to describe a transgender man as a trans man and a transgender woman as a trans woman.

If someone identifies as transgender, you would typically use the pronouns “he” and “him” for a transgender man and “she” and “her” for a transgender woman. Even so, non-binary or gender-non-conforms people may prefer “them” and “they” or other pronouns, so ask first if you are unsure.

Mistakes can occur, but to intentionally or repeatedly use the wrong pronouns is a disrespectful act known asmisgendering.

Terms to Avoid

There are other terms that have been displaced because they mischaracterize was being transgender is about. Others still are considered offensive and should never be used.

These include:

What to Know About Metoidioplasty (Bottom Surgery)

Discrimination and Transphobia

It is estimated that about 0.5% of adults in the United States (1.3 million) and 1.4% of youth between the ages of 13 and 17 years (or 300,000) identify as transgender.

Studies have shown that being transgender in the United States is fraught with challenges, includingtransphobiaand discrimination in all realms of employment, education, healthcare, safety, and daily living.

The National Transgender Discrimination Survey is the largest survey to assess the experiences of transgender people in the United States. It has been performed twice—first in 2008 with 6,450 respondentsand then in 2013 with more than 27,000

Both reports described high rates of discrimination across every facet of life. Discrimination took the form of everything from verbal harassment to sexual assault, and many individuals were forced to leave school or jobs as a result of those experiences.

Transgender individuals also reported many experiences of discrimination in health care. Many individuals were denied access to gender-affirming medical and surgical care.

Perhaps even more disturbing, numerous people reported being denied access to emergency care and general medical care as well as verbal and physical harassment in healthcare spaces.

Because of this, many transgender people report avoiding medical care, for fear of experiencing additional discrimination or abuse. Others report avoiding care because they lacked financial or other resources.

Among the key statistics:

Discrimination is even worse for transgender people of color, who may experience bias based on both their skin color and their gender identity.

The survey found that Latinx, American Indian, multiracial, and Black respondents were more than three times as likely as the general U.S. population to be living in poverty.

Gender diversity is a normal part of a functioning society and has been reported throughout history. Although transgender individuals have an increased risk of certain negative health outcomes, research suggests that this does not reflect any inherent issue with being transgender. Instead, it reflects the minority stress related to being part of a society that may not be accepting.

Indeed, research suggests that one of the most important factors associated with the health of transgender people is access to an affirming environment and desired medical care. This is particularly true for transgender children and adolescents, who have been shown to do as well as their cisgender peers when their families are supportive and accepting.

While not all transgender individuals are interested in medical or surgical affirmation, all people need health care at some point during their lives. Therefore, it is important to make all healthcare facilities safe and affirming for people of diverse genders. Lack of access to affirming health care is a risk factor for health concerns for transgender people of all ages.

6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fast AA, Olson KR.Gender Development in Transgender Preschool Children.Child Dev.2018;89(2):620-637. doi:10.1111/cdev.12758Kaltiala-Heino R, Työläjärvi M, Lindberg N.Gender dysphoria in adolescent population: a 5-year replication study.Clin Child Psychol Psychiat. 2019;24(2):379-87. doi:10.1177/1359104519838593Sevelius JM.Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.Sex Roles. 2013 Jun 1;68(11-12):675-89. doi: 10.1007/s11199-012-0216-5Williams Institute/University of California, Los Angeles.How many adults and youth identify as transgender in the United States?Grant JM, Mottet L A , Tanis J, Harrison J, Herman JL, Keisling M.Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. National Center for Transgender Equality and National Gay and Lesbian Task Force. 2011.James SE, Herman JL, Rankin S, Keisling M, Mottet M, Anafi M.The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. 2016.Additional ReadingDepartment of Health and Human Services Departmental Appeals Board, Appellate Division.NCD 140.3, Transsexual Surgery, Docket No. A-13-87, Decision No. 2576. 2014.Hembree WC, Cohen-Kettenis PT, Gooren L, et al.Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2017;102(11):3869-3903. doi:10.1210/jc.2017-01658Mahfouda S, Moore JK, Siafarikas A, et al.Gender-affirming hormones and surgery in transgender children and adolescents.Lancet Diabetes Endocrinol. 2019;7(6):484-498. doi:10.1016/S2213-8587(18)30305-XRafferty J, Committee on Psychosocial Aspects of Child and Family Health; Committee on Adolescence; Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness.Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.Pediatrics. 2018;142(4):e20182162. doi:10.1542/peds.2018-2162Stotzer RL.Data sources hinder our understanding of transgender murders.Am J Public Health. 2017;107(9):1362-1363.

6 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Fast AA, Olson KR.Gender Development in Transgender Preschool Children.Child Dev.2018;89(2):620-637. doi:10.1111/cdev.12758Kaltiala-Heino R, Työläjärvi M, Lindberg N.Gender dysphoria in adolescent population: a 5-year replication study.Clin Child Psychol Psychiat. 2019;24(2):379-87. doi:10.1177/1359104519838593Sevelius JM.Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.Sex Roles. 2013 Jun 1;68(11-12):675-89. doi: 10.1007/s11199-012-0216-5Williams Institute/University of California, Los Angeles.How many adults and youth identify as transgender in the United States?Grant JM, Mottet L A , Tanis J, Harrison J, Herman JL, Keisling M.Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. National Center for Transgender Equality and National Gay and Lesbian Task Force. 2011.James SE, Herman JL, Rankin S, Keisling M, Mottet M, Anafi M.The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. 2016.Additional ReadingDepartment of Health and Human Services Departmental Appeals Board, Appellate Division.NCD 140.3, Transsexual Surgery, Docket No. A-13-87, Decision No. 2576. 2014.Hembree WC, Cohen-Kettenis PT, Gooren L, et al.Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2017;102(11):3869-3903. doi:10.1210/jc.2017-01658Mahfouda S, Moore JK, Siafarikas A, et al.Gender-affirming hormones and surgery in transgender children and adolescents.Lancet Diabetes Endocrinol. 2019;7(6):484-498. doi:10.1016/S2213-8587(18)30305-XRafferty J, Committee on Psychosocial Aspects of Child and Family Health; Committee on Adolescence; Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness.Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.Pediatrics. 2018;142(4):e20182162. doi:10.1542/peds.2018-2162Stotzer RL.Data sources hinder our understanding of transgender murders.Am J Public Health. 2017;107(9):1362-1363.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Fast AA, Olson KR.Gender Development in Transgender Preschool Children.Child Dev.2018;89(2):620-637. doi:10.1111/cdev.12758Kaltiala-Heino R, Työläjärvi M, Lindberg N.Gender dysphoria in adolescent population: a 5-year replication study.Clin Child Psychol Psychiat. 2019;24(2):379-87. doi:10.1177/1359104519838593Sevelius JM.Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.Sex Roles. 2013 Jun 1;68(11-12):675-89. doi: 10.1007/s11199-012-0216-5Williams Institute/University of California, Los Angeles.How many adults and youth identify as transgender in the United States?Grant JM, Mottet L A , Tanis J, Harrison J, Herman JL, Keisling M.Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. National Center for Transgender Equality and National Gay and Lesbian Task Force. 2011.James SE, Herman JL, Rankin S, Keisling M, Mottet M, Anafi M.The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. 2016.

Fast AA, Olson KR.Gender Development in Transgender Preschool Children.Child Dev.2018;89(2):620-637. doi:10.1111/cdev.12758

Kaltiala-Heino R, Työläjärvi M, Lindberg N.Gender dysphoria in adolescent population: a 5-year replication study.Clin Child Psychol Psychiat. 2019;24(2):379-87. doi:10.1177/1359104519838593

Sevelius JM.Gender affirmation: a framework for conceptualizing risk behavior among transgender women of color.Sex Roles. 2013 Jun 1;68(11-12):675-89. doi: 10.1007/s11199-012-0216-5

Williams Institute/University of California, Los Angeles.How many adults and youth identify as transgender in the United States?

Grant JM, Mottet L A , Tanis J, Harrison J, Herman JL, Keisling M.Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. National Center for Transgender Equality and National Gay and Lesbian Task Force. 2011.

James SE, Herman JL, Rankin S, Keisling M, Mottet M, Anafi M.The Report of the 2015 U.S. Transgender Survey. National Center for Transgender Equality. 2016.

Department of Health and Human Services Departmental Appeals Board, Appellate Division.NCD 140.3, Transsexual Surgery, Docket No. A-13-87, Decision No. 2576. 2014.Hembree WC, Cohen-Kettenis PT, Gooren L, et al.Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2017;102(11):3869-3903. doi:10.1210/jc.2017-01658Mahfouda S, Moore JK, Siafarikas A, et al.Gender-affirming hormones and surgery in transgender children and adolescents.Lancet Diabetes Endocrinol. 2019;7(6):484-498. doi:10.1016/S2213-8587(18)30305-XRafferty J, Committee on Psychosocial Aspects of Child and Family Health; Committee on Adolescence; Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness.Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.Pediatrics. 2018;142(4):e20182162. doi:10.1542/peds.2018-2162Stotzer RL.Data sources hinder our understanding of transgender murders.Am J Public Health. 2017;107(9):1362-1363.

Department of Health and Human Services Departmental Appeals Board, Appellate Division.NCD 140.3, Transsexual Surgery, Docket No. A-13-87, Decision No. 2576. 2014.

Hembree WC, Cohen-Kettenis PT, Gooren L, et al.Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline.J Clin Endocrinol Metab. 2017;102(11):3869-3903. doi:10.1210/jc.2017-01658

Mahfouda S, Moore JK, Siafarikas A, et al.Gender-affirming hormones and surgery in transgender children and adolescents.Lancet Diabetes Endocrinol. 2019;7(6):484-498. doi:10.1016/S2213-8587(18)30305-X

Rafferty J, Committee on Psychosocial Aspects of Child and Family Health; Committee on Adolescence; Section on Lesbian, Gay, Bisexual, and Transgender Health and Wellness.Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents.Pediatrics. 2018;142(4):e20182162. doi:10.1542/peds.2018-2162

Stotzer RL.Data sources hinder our understanding of transgender murders.Am J Public Health. 2017;107(9):1362-1363.

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