What It Means to Be Transgender

Medically reviewed by Monica Johnson, PsyD

To be transgender means that your gender identity does not align with the sex you were assigned at birth. At birth, people are assigned male or female, which is referred to by the acronyms AFAB and AMAB, meaning "assigned female at birth" or "assigned male at birth." These assignments are based on the way a baby's body appears, specifically in relation to visible reproductive organs.

If you pay attention to news at all, you've likely noticed that many bills in the government seek to stop different types of gender-affirming care for transgender people. The legislative efforts of states have brought trans issues to the forefront of our culture, and it has many people wondering what exactly being trans (a common way to shorten the term 'transgender') means.

While this might seem like a new issue, it isn't: transgender people have existed throughout history and were celebrated by many indigenous cultures. But because of the impact of colonialism and its heteronormative values, being a transgender person came to be seen as unnatural in the same way that being gay was.

A trans person may feel that their gender is the opposite of what they were assigned or that they do not fit into the binary of male and female. People whose identities are outside the binary might identify as nonbinary, agender, gender expansive, gender nonconforming, bigender, or genderqueer. Additionally, a person's gender identity may not be fixed and stationary, leading them to identify as gender fluid.

Related:What Does It Mean to Be Bigender?

Prevalence of Transgender People (in the U.S.)

Research shows that 1.6 million people in the United States over 13 identify as transgender. That consists of 1.3 million adults and 300,000 youths between the ages of 13 and 17. Of those who identify as trans, 39% are trans women, 36% are trans men, and 25% are gender non-conforming.

Younger people are more likely to identify as transgender than older people, which may be due to the changing attitudes about trans people in recent years. Now that it is more widely discussed and resources are available for transgender care, it is a very different scenario than 50 years ago.

Transgender vs. Intersex vs. Transsexual

In reference to identities, it's important to understand the language you're using. To be sure we're clear about what being transgender is, let's look at how it relates to a couple of other words used to describe genders that are outside the standard definition of cisgender.

Intersex

The word intersex describes someone born with physical traits that do not fit solidly into only male or female. This can mean their sex organs are not reflective of those deemed standard for AMAB/AFAB or that their chromosomal or hormonal composition is not strictly aligned with that of someone who is assigned male or female.

Intersex is typically ascribed at birth, but the traits may not present until later in life, and a person may be considered intersex when that occurs. Unlike being transgender, intersex is not a gender identity.

Transsexual

The word transsexual is one that used to be more commonly used than it is now. It has been mostly replaced by the word transgender, which is considered a more inclusive term than transsexual.

A person who identifies as transsexual is someone who not only doesn't identify with the sex they were assigned but also who actively seeks or has sought to permanently change their body to be in accordance with their gender.

Some transgender people may also identify as transsexual, but even many of those who have undergone medical care for their gender do not necessarily use this term anymore. Unless you are speaking to someone who specifically tells you they are transsexual, this word should be avoided.

Related:Glossary of Must-Know Gender Identity Terms

Gender Dysphoria in Transgender People

Gender dysphoria is a sense of experiencing negative feelings or distress about your gender because it doesn't align with the sex assigned to you. It can present at any age and may occur in small children as they become socialized.

Gender dysphoria can be as simple as not wanting to play with the toys considered appropriate for your gender or as complex as wanting medical care to change your body to align with your identity. It is a common occurrence for transgender people. Not feeling that your identity is aligned with your assigned sex can be a stressful, if not overwhelmingly difficult, experience.

There are numerous treatments available for gender dysphoria that can help improve the quality of life for trans people.

Related:Call Me By My Name: Name Changes Positively Affect Trans People

Treatments

Gender-affirming care can take multiple forms. Typically, when we speak about treatments available for trans people, we are referring to medical ones. These are usually accompanied by gender-affirming mental health care, and some medical procedures require mental health practitioners to sign off on a trans patient's readiness for care. A trans person may receive multiple types of medical treatment, one type, or none.

A person's interest in medical treatment, or lack thereof, does not denote their identity as a trans person.

Puberty Blockers

If a child discovers that they are transgender at a young enough age that they have not yet experienced puberty as their assigned sex, puberty blockers may be given to the child to prevent that from happening.

This intervention has been shown to lead to better mental health outcomes than when transition begins after puberty. Once puberty has been delayed for a set duration of time decided by medical professionals, the next step is usually hormonal therapy.

Hormone Therapy

Also referred to as HRT, hormone therapy involves prescribing hormones corresponding to a person's gender identity. For trans men, this is testosterone, and for trans women, it is estrogen, progesterone, and testosterone blockers.

Hormone therapy causes a person's body to shift toward their gender. Trans men can grow facial hair, their upper bodies may get larger, and their voices usually deepen. Trans women may experience growth of the mammary glands (breasts), skin softening, and facial hair reduction.

Related:What Are Puberty Blockers?

Surgery

Surgical intervention is the most significant step someone can take to have their body align with their gender identity.

Trans men can get a mastectomy, colloquially referred to as "top surgery," to remove their breasts, while trans women may seek out breast implant surgery. "Bottom surgery" for trans women is called vaginoplasty to construct a vagina, whereas trans men can get phalloplasty to create a penis, metoidioplasty to craft a larger organ out of their clitoris, and scrotoplasty for scrotum.

Additional surgeries for trans women involve facial feminization, shaving down of the Adam's apple, and voice surgery.

Related:What It Means to Be Transgender

Coping With Stigma and Discrimination

As you may have seen on the news, there is an incredible amount of discrimination that trans people face. From banning trans girls from playing on sports teams to "bathroom laws" that attempt to police which restroom a trans person can use, trans people face discrimination for everything from employment to medical care.

The stigma and discrimination that trans people face can lead to a reduced quality of life. Trans people experience higher rates of poverty, less family support than cis people, more negative experiences with healthcare, and nearly nine times the average rate of attempted suicide. They are more likely to be unemployed and less likely to hold higher-paying positions. Additionally, nearly one-third of transgender people experience homelessness at some point in their lives.

To cope with these challenges, transgender people often seek out the company and support of one another. They may choose to engage socially with other trans people, attend support groups, or become activists for policy and law changes.

Related:Growing Prevalence of Anti-Transgender Legislation Takes a Toll on Mental Health

A Word From Verywell

Gender is a complicated subject, and you might need time to sit with all the information you've learned. If you are learning about trans issues in order to handle your child coming out as trans, there are many steps you can take to help you through the process.

Frequently Asked Questions

What defines a transgender woman?

A transgender woman is defined as a person who is a woman but was assigned male at birth. A trans woman may undergo some, all, or none of the available medical treatment options to "become" a woman.

Can a transgender woman get a period?

A trans woman can't get a period. This is because the feminizing surgeries available to trans women do not include ovaries. However, due to hormone therapy, a trans woman may experience premenstrual symptoms. That can include breast swelling, cramping, and depression.

How does a transgender man become a man?

A transgender man is a man. He may choose to undergo some, all, or none of the medical treatments available to him. There is no point at which a trans man "becomes" a man, and a person can rightfully be considered a man at any point after they begin identifying as one. A trans man will be more likely to be viewed as a man, or to "pass" as a man, if he has undergone HRT, which leads to masculinizing traits such as facial hair and a deeper voice.

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