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A transgender (often abbreviated as trans) person is someone whose
gender identity Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. In most individuals, the various biological determinants of sex are congruent, and consistent with the ...
or
gender expression Gender expression, or gender presentation, is a person's behavior, mannerisms, interests, and appearance that are associated with gender, specifically with the categories of femininity or masculinity. This also includes gender roles. These cate ...
does not correspond with their
sex assigned at birth Sex assignment (sometimes known as gender assignment) is the discernment of an infant's sex at or before birth. A relative, midwife, nurse or physician inspects the external genitalia when the baby is delivered and, in more than 99.95% of bi ...
. Many transgender people experience
dysphoria Dysphoria (; ) is a profound state of unease or dissatisfaction. It is the semantic opposite of euphoria. In a psychiatric context, dysphoria may accompany depression, anxiety, or agitation. In psychiatry Intense states of distress and uneas ...
, which they seek to alleviate through transitioning, often adopting a different name and set of
pronouns In linguistics and grammar, a pronoun ( abbreviated ) is a word or a group of words that one may substitute for a noun or noun phrase. Pronouns have traditionally been regarded as one of the parts of speech, but some modern theorists would not ...
in the process. Additionally, they may undergo
sex reassignment therapies Transgender health care, also known as gender-affirming care, includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as sex reassignment therapies, for transgender individuals.Gorton N, Grubb HM (201 ...
such as
hormone therapy Hormone therapy or hormonal therapy is the use of hormones in medical treatment. Treatment with hormone antagonists may also be referred to as hormonal therapy or antihormone therapy. The most general classes of hormone therapy are oncologic ho ...
and
sex reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a transgender or transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender, and a ...
to more closely align their
primary Primary or primaries may refer to: Arts, entertainment, and media Music Groups and labels * Primary (band), from Australia * Primary (musician), hip hop musician and record producer from South Korea * Primary Music, Israeli record label Works ...
and
secondary sex characteristics Secondary sex characteristics are features that appear during puberty in humans, and at sexual maturity in other animals. These characteristics are particularly evident in the sexually dimorphic phenotypic traits that distinguish the sexes of a s ...
with their gender identity. Not all transgender people desire these treatments, however, and others may be unable to access them for financial or medical reasons. Those who do desire to medically transition to another sex may identify as
transsexual Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance (including sex reassignmen ...
. ''Transgender'' is an
umbrella term In linguistics, semantics, general semantics, and ontologies, hyponymy () is a semantic relation between a hyponym denoting a subtype and a hypernym or hyperonym (sometimes called umbrella term or blanket term) denoting a supertype. In othe ...
. In addition to
trans men A trans man is a man who was assigned female at birth. The label of transgender man is not always interchangeable with that of transsexual man, although the two labels are often used in this way. ''Transgender'' is an umbrella term that inclu ...
and
trans women A trans woman or a transgender woman is a woman who was assigned male at birth. Trans women have a female gender identity, may experience gender dysphoria, and may transition; this process commonly includes hormone replacement therapy and s ...
, it may also include people who are non-binary or genderqueer. Other definitions of ''transgender'' also include people who belong to a
third gender Third gender is a concept in which individuals are categorized, either by themselves or by society, as neither man nor woman. It is also a social category present in societies that recognize three or more genders. The term ''third'' is usuall ...
, or else conceptualize transgender people as a third gender, and the term may be defined very broadly to include
cross-dressers Cross-dressing is the act of wearing clothes usually worn by a different gender. From as early as pre-modern history, cross-dressing has been practiced in order to disguise, comfort, entertain, and self-express oneself. Cross-dressing has play ...
. Gender identity is distinct from
sexual orientation Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender. These attractions are generall ...
, and transgender people may be of any sexual orientation. The opposite of ''transgender'' is ''
cisgender Cisgender (often shortened to cis; sometimes cissexual) is a term used to describe a person whose gender identity corresponds to their sex assigned at birth. The word ''cisgender'' is the antonym of '' transgender''. The prefix '' cis-'' is L ...
'', which describes people whose gender identity matches their assigned sex. Statistics on the number of transgender people vary widely, in part due to differing definitions of ''transgender.'' Some countries, such as Canada, collect
census A census is the procedure of systematically acquiring, recording and calculating information about the members of a given population. This term is used mostly in connection with national population and housing censuses; other common censuses inc ...
data on transgender people. Transgender identity is generally found in less than 1% of the worldwide population, with figures ranging from <0.1% to 0.6%. Many transgender people face discrimination in the workplace, in accessing public accommodations, and healthcare. In many places, they are not legally protected from discrimination.


Terminology

Before the mid-20th century various terms were used within and beyond Western medical and psychological sciences to identify persons and identities labeled ''transsexual'', and later ''transgender'' from mid-century onward. Imported from the German and ultimately modelled after German ''Transsexualismus'' (coined in 1923), the English term ''transsexual'' has enjoyed international acceptability, though ''transgender'' (1965, by J. Oliven) has been increasingly preferred over ''transsexual''.


''Transgender''

Psychiatrist John F. Oliven of
Columbia University Columbia University (also known as Columbia, and officially as Columbia University in the City of New York) is a private research university in New York City. Established in 1754 as King's College on the grounds of Trinity Church in Manhatt ...
coined the term ''transgender'' in his 1965 reference work ''Sexual Hygiene and Pathology'', writing that the term which had previously been used, ''
transsexual Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance (including sex reassignmen ...
ism'', "is misleading; actually, 'transgenderism' is meant, because sexuality is not a major factor in primary transvestism." The term ''transgender'' was then popularized with varying definitions by various transgender, transsexual, and transvestite people, including
Virginia Prince Virginia Charles Prince (November 23, 1912 – May 2, 2009), born Arnold Lowman, was an American transgender activist. She published '' Transvestia'' magazine, and started the ''Foundation for Personality Expression (FPE)'' and later the Society ...
, who used it in the December 1969 issue of ''Transvestia'', a national magazine for cross-dressers she founded. By the mid-1970s both ''trans-gender'' and ''trans people'' were in use as
umbrella term In linguistics, semantics, general semantics, and ontologies, hyponymy () is a semantic relation between a hyponym denoting a subtype and a hypernym or hyperonym (sometimes called umbrella term or blanket term) denoting a supertype. In othe ...
s,* In April 1970, ''TV Guide'' published an article which referenced a post-operative transsexual movie character as being "transgendered."() * In the 1974 edition of ''Clinical Sexuality: A Manual for the Physician and the Professions'', ''transgender'' was used as an umbrella term and the Conference Report from the 1974 "National TV.TS Conference" held in Leeds, West Yorkshire, UK used "trans-gender" and "trans.people" as umbrella terms.(), (2006). The Transgender Phenomenon () * However ''A Practical Handbook of Psychiatry'' (1974) references "transgender surgery" noting, "The transvestite rarely seeks transgender surgery, since the core of his perversion is an attempt to realize the fantasy of a phallic woman."()) while ''transgenderist'' and ''transgenderal'' were used to refer to people who wanted to live cross-gender without
sex reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a transgender or transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender, and a ...
(SRS). By 1976, ''transgenderist'' was abbreviated as ''TG'' in educational materials. By 1984, the concept of a "transgender community" had developed, in which ''transgender'' was used as an umbrella term. In 1985, Richard Elkins established the "Trans-Gender Archive" at the University of Ulster. By 1992, the International Conference on Transgender Law and Employment Policy defined ''transgender'' as an expansive umbrella term including "transsexuals, transgenderists, cross dressers", and anyone transitioning.
Leslie Feinberg Leslie Feinberg (September 1, 1949 – November 15, 2014) was an American butch lesbian, transgender activist, communist, and author. Feinberg authored ''Stone Butch Blues'' in 1993.
's pamphlet, "Transgender Liberation: A Movement Whose Time has Come", circulated in 1992, identified ''transgender'' as a term to unify all forms of
gender nonconformity Gender variance or gender nonconformity is behavior or gender expression by an individual that does not match masculine or feminine gender norms. A gender-nonconforming person may be variant in their gender identity, being transgender or non-b ...
; in this way ''transgender'' has become synonymous with ''
queer ''Queer'' is an umbrella term for people who are not heterosexual or cisgender. Originally meaning or , ''queer'' came to be used pejoratively against those with same-sex desires or relationships in the late 19th century. Beginning in the l ...
''. In 1994, gender theorist
Susan Stryker Susan O'Neal Stryker (born 1961) is an American professor, historian, author, filmmaker, and theorist whose work focuses on gender and human sexuality. She is a professor of Gender and Women's Studies, former director of the Institute for LGBT ...
defined ''transgender'' as encompassing "all identities or practices that cross over, cut across, move between, or otherwise queer socially constructed sex/gender boundaries", including, but not limited to, "transsexuality, heterosexual transvestism, gay drag, butch lesbianism, and such non-European identities as the Native American berdache or the Indian
Hijra Hijra, Hijrah, Hegira, Hejira, Hijrat or Hijri may refer to: Islam * Hijrah (often written as ''Hejira'' in older texts), the migration of Muhammad from Mecca to Medina in 622 CE * Migration to Abyssinia or First Hegira, of Muhammad's followers ...
". Between the mid-1990s and the early 2000s, the primary terms used under the transgender umbrella were "female to male" (FtM) for men who transitioned from female to male, and "male to female" (MtF) for women who transitioned from male to female. These terms have now been superseded by "
trans man A trans man is a man who was assigned female at birth. The label of transgender man is not always interchangeable with that of transsexual man, although the two labels are often used in this way. ''Transgender'' is an umbrella term that inc ...
" and "
trans woman A trans woman or a transgender woman is a woman who was assigned male at birth. Trans women have a female gender identity, may experience gender dysphoria, and may transition; this process commonly includes hormone replacement therapy and s ...
", respectively. This shift in preference from terms highlighting biological sex ("transsexual", "FtM") to terms highlighting gender identity and expression ("transgender", "trans man") reflects a broader shift in the understanding of transgender people's sense of self and the increasing recognition of those who decline medical reassignment as part of the transgender community. ' is a term for any person, binary or non-binary, who was assigned male at birth and has a predominantly feminine gender identity or presentation; ''transmasculine'' is the equivalent term for someone who was assigned female at birth and has a predominantly masculine gender identity or presentation. ''Transgendered'' is a common term in older literature; many within the transgender community now deprecate it on the basis that ''transgender'' is an adjective, not a verb. Organizations such as
GLAAD GLAAD (), an acronym of Gay & Lesbian Alliance Against Defamation, is an American non-governmental media monitoring organization originally founded as a protest against defamatory coverage of gay and lesbian demographics and their portrayal ...
and ''
The Guardian ''The Guardian'' is a British daily newspaper. It was founded in 1821 as ''The Manchester Guardian'', and changed its name in 1959. Along with its sister papers '' The Observer'' and '' The Guardian Weekly'', ''The Guardian'' is part of the ...
'' also state that ''transgender'' should never be used as a noun (e.g., "Max is ''transgender''" or "Max is a ''transgender man''", not "Max is ''a transgender''"). However, ''transgender'' is also used as a noun equivalent to the broader topic of transgender identity and experience. Although the term "transgenderism" was once considered acceptable, it has come to be viewed as offensive, according to
GLAAD GLAAD (), an acronym of Gay & Lesbian Alliance Against Defamation, is an American non-governmental media monitoring organization originally founded as a protest against defamatory coverage of gay and lesbian demographics and their portrayal ...
. In 2020 the ''International Journal of Transgenderism'' changed its name to the ''
International Journal of Transgender Health The ''International Journal of Transgender Health'' (IJTH) is a quarterly peer-reviewed academic journal covering research on gender dysphoria and gender incongruence, the medical treatment of transgender individuals, social and legal acceptance ...
'' "to reflect a change toward more appropriate and acceptable use of language in our field." See paragraph 5. Health-practitioner manuals, professional journalistic
style guide A style guide or manual of style is a set of standards for the writing, formatting, and design of documents. It is often called a style sheet, although that term also has multiple other meanings. The standards can be applied either for gene ...
s, and LGBT advocacy groups advise the adoption by others of the name and pronouns identified by the person in question, including present references to the transgender person's past. In contrast, people whose sense of personal identity corresponds to the sex and gender assigned to them at birth – that is, those who are neither transgender nor non-binary or genderqueer – are called ''
cisgender Cisgender (often shortened to cis; sometimes cissexual) is a term used to describe a person whose gender identity corresponds to their sex assigned at birth. The word ''cisgender'' is the antonym of '' transgender''. The prefix '' cis-'' is L ...
''.


''Transsexual''

Inspired by
Magnus Hirschfeld Magnus Hirschfeld (14 May 1868 – 14 May 1935) was a German physician and sexologist. Hirschfeld was educated in philosophy, philology and medicine. An outspoken advocate for sexual minorities, Hirschfeld founded the Scientific-Humanitarian Com ...
's 1923 term ''seelischer Transsexualismus'', the term ''transsexual'' was introduced to English in 1949 by
David Oliver Cauldwell David Oliver Cauldwell (June 17, 1897 – August 30, 1959) was a prolific and pioneering sexologist, who coined the term transsexual as used in its current definition. Many of his monographs on sex, psychology, or health were published by Emanuel H ...
Magnus Hirschfeld Magnus Hirschfeld (14 May 1868 – 14 May 1935) was a German physician and sexologist. Hirschfeld was educated in philosophy, philology and medicine. An outspoken advocate for sexual minorities, Hirschfeld founded the Scientific-Humanitarian Com ...
coined the German term ''Transsexualismus'' in 1923, which Cauldwell translated into English.
and popularized by
Harry Benjamin Harry Benjamin (January 12, 1885 – August 24, 1986) was a German-American endocrinologist and sexologist, widely known for his clinical work with transgender people. Early life and career Benjamin was born in Berlin, and raised in a German ...
in 1966, around the same time ''transgender'' was coined and began to be popularized. Since the 1990s, ''transsexual'' has generally been used to refer to the subset of transgender people''Transgender Rights'' (2006, ), edited by Paisley Currah, Richard M. Juang, Shannon MinterA. C. Alegria, ''Transgender identity and health care: Implications for psychosocial and physical evaluation'', in the ''Journal of the American Academy of Nurse Practitioners'', volume 23, issue 4 (2011), pages 175–182: "Transgender, Umbrella term for persons who do not conform to gender norms in their identity and/or behavior (Meyerowitz, 2002). Transsexual, Subset of transgenderism; persons who feel discordance between natal sex and identity (Meyerowitz, 2002)." who desire to transition permanently to the gender with which they identify and who seek medical assistance (for example, sex reassignment surgery) with this. Distinctions between the terms ''transgender'' and ''transsexual'' are commonly based on distinctions between gender and sex. Transsexuality may be said to deal more with physical aspects of one's sex, while transgender considerations deal more with one's psychological gender disposition or predisposition, as well as the related social expectations that may accompany a given gender role. Many transgender people reject the term ''transsexual''.A Swenson, ''Medical Care of the Transgender Patient'', in ''Family Medicine'' (2014): "While some transsexual people still prefer to use the term to describe themselves, many transgender people prefer the term transgender to transsexual."
Christine Jorgensen Christine Jorgensen (May 30, 1926 – May 3, 1989) was an American trans woman who was the first person to become widely known in the United States for having sex reassignment surgery. She had a career as a successful actress, singer and re ...
publicly rejected ''transsexual'' in 1979 and instead identified herself in newsprint as ''trans-gender'', saying, "gender doesn't have to do with bed partners, it has to do with identity." Some have objected to the term ''transsexual'' on the basis that it describes a condition related to gender identity rather than
sexuality Human sexuality is the way people experience and express themselves sexually. This involves biological, psychological, physical, erotic, emotional, social, or spiritual feelings and behaviors. Because it is a broad term, which has varied wit ...
.The recurring concern that ''transsexual'' implies ''sexuality'' stems from the tendency of many informal speakers to ignore the
sex and gender distinction Though the terms '' sex'' and ''gender'' have been used interchangeably since at least the fourteenth century, in contemporary academic literature they usually have distinct meanings. ''Sex'' generally refers to an organism's biological sex, while ...
and use ''gender'' for any male/female difference and ''sex'' for sexual activity. ()
Some transsexual people object to being included in the ''transgender'' umbrella.Valentine, David. ''Imagining Transgender: An Ethnography of a Category'', Duke University, 2007Stryker, Susan. "Introduction". In Stryker and S. Whittle (eds.), ''The Transgender Studies Reader'', New York: Routledge, 2006. pp. 1–17. . In his 2007 book ''Imagining Transgender: An Ethnography of a Category'', anthropologist David Valentine asserts that ''transgender'' was coined and used by activists to include many people who do not necessarily identify with the term and states that people who do not identify with the term ''transgender'' should not be included in the transgender spectrum.
Leslie Feinberg Leslie Feinberg (September 1, 1949 – November 15, 2014) was an American butch lesbian, transgender activist, communist, and author. Feinberg authored ''Stone Butch Blues'' in 1993.
likewise asserts that ''transgender'' is not a self-identifier (for some people) but a category imposed by observers to understand other people. According to the Transgender Health Program (THP) at
Fenway Health Fenway Health (formally Fenway Community Health Center, Inc.) is an LGBT (lesbian, gay, bisexual and transgender) health care, research and advocacy organization founded by Northeastern University students and headquartered in Boston, Massachusett ...
in Boston, there are no universally-accepted definitions, and confusion is common because terms that were popular at the turn of the 21st century may now be deemed offensive. The THP recommends that clinicians ask clients what terminology they prefer, and avoid the term ''transsexual'' unless they are sure that a client is comfortable with it. Harry Benjamin invented a classification system for transsexuals and transvestites, called the
Sex Orientation Scale The Sex Orientation Scale (SOS) was Harry Benjamin's attempt to classify and understand various forms and subtypes of transvestism and transsexualism in biological males, published in 1966.Benjamin, Harry (1966). ''The Transsexual Phenomenon.'' The ...
(SOS), in which he assigned transsexuals and transvestites to one of six categories based on their reasons for cross-dressing and the relative urgency of their need (if any) for sex reassignment surgery.Benjamin, H. (1966). ''The transsexual phenomenon''. New York: Julian Press, page 23. Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions.Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativity '' Sexualities'' July 2005 vol. 8 no. 3 306-328 Sexual orientation is no longer regarded as a criterion for diagnosis, or for distinction between transsexuality, transvestism and other forms of gender-variant behavior and expression. Benjamin's scale was designed for use with heterosexual trans women, and trans men's identities do not align with its categories.Hansbury, Griffin (2008). The Middle Men: An Introduction to the Transmasculine Identities. ''
Studies in Gender and Sexuality Study or studies may refer to: General * Education ** Higher education * Clinical trial * Experiment * Observational study * Research * Study skills, abilities and approaches applied to learning Other * Study (art), a drawing or series of draw ...
'' Volume 6, Issue 3, 2005


Non-binary identity

Some non-binary (or genderqueer) people identify as transgender. These identities are not specifically male or female. They can be agender, androgynous, bigender, pangender, or genderfluid, and exist outside of
cisnormativity Cisnormativity or cissexual assumption is the assumption that everyone is, or ought to be, cisgender. The term can further refer to a wider range of presumptions about gender assignment, such as the presumption of a gender binary, or expectations ...
. Bigender and androgynous are overlapping categories; bigender individuals may identify as moving between male and female roles (genderfluid) or as being both masculine and feminine simultaneously (androgynous), and androgynes may similarly identify as beyond gender or genderless (agender), between genders (intergender), moving across genders (genderfluid), or simultaneously exhibiting multiple genders (pangender). Non-binary gender identities are independent of sexual orientation.


Related identities and practices


Transvestism and cross-dressing

A
transvestite Transvestism is the practice of dressing in a manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional, or ceremonial reasons. The term is considered outdated in Western ...
is a person who cross-dresses, or dresses in clothes typically associated with the gender opposite the one they were assigned at birth.E. D. Hirsch, Jr., E.D., Kett, J.F., Trefil, J. (2002) "Transvestite: Someone who dresses in the clothes usually worn by the opposite sex." i
Definition of the word "transvestite"
fro
The New Dictionary of Cultural Literacy, Third Edition
. Retrieved 2007-08-13.
various (2006) "trans·ves·tite... (plural trans·ves·tites), noun. Definition: somebody who dresses like opposite sex:" i

from th
Encarta World English Dictionary (North American Edition)
. Retrieved 2007-08-13.
The term ''transvestite'' is used as a synonym for the term ''cross-dresser'',Raj, R (2002) "transvestite (TV): n. Synonym: crossdresser (CD):" i

from the International Journal of Transgenderism 6,2. Retrieved 2007-08-13.
Hall, B. et al. (2007) "...Many say this term (crossdresser) is preferable to transvestite, which means the same thing..." and "...transvestite (TV) – same as cross-dresser. Most feel cross-dresser is the preferred term..." i

from th
Ontario Human Rights Commission
. Retrieved 2007-08-13.
although ''cross-dresser'' is generally considered the preferred term.Green, E., Peterson, E.N. (2006) "...The preferred term is 'cross-dresser', but the term 'transvestite' is still used in a positive sense in England..." i
LGBTTSQI Terminology
fro
Trans-Academics.org
. Retrieved 2007-08-13.
The term ''cross-dresser'' is not exactly defined in the relevant literature. Michael A. Gilbert, professor at the Department of Philosophy,
York University York University (french: Université York), also known as YorkU or simply YU, is a public research university in Toronto, Ontario, Canada. It is Canada's fourth-largest university, and it has approximately 55,700 students, 7,000 faculty and sta ...
, Toronto, offers this definition: " cross-dresseris a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to
hat A hat is a head covering which is worn for various reasons, including protection against weather conditions, ceremonial reasons such as university graduation, religious reasons, safety, or as a fashion accessory. Hats which incorporate mecha ...
sex, but who wears the clothing of the opposite sex because it is that of the opposite sex." This definition excludes people "who wear opposite sex clothing for other reasons", such as "those
female impersonators A drag queen is a person, usually male, who uses drag clothing and makeup to imitate and often exaggerate female gender signifiers and gender roles for entertainment purposes. Historically, drag queens have usually been gay men, and part ...
who look upon dressing as solely connected to their livelihood, actors undertaking roles, individual males and females enjoying a masquerade, and so on. These individuals are cross dressing but are not cross dressers."Gilbert, Michael 'Miqqi Alicia' (2000) "The Transgendered Philosopher" i
Special Issue on What is Transgender?
fro
The International Journal of Transgenderism, Special Issue July 2000
. Retrieved 2007-10-09.
Cross-dressers may not identify with, want to be, or adopt the behaviors or practices of the opposite gender and generally do not want to change their bodies medically or surgically. The majority of cross-dressers identify as heterosexual. The term ''transvestite'' and the associated outdated term ''transvestism'' are conceptually different from the term ''
transvestic fetishism Transvestic fetishism is a psychiatric diagnosis applied to men who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for enter ...
'', as ''transvestic fetishist'' refers to those who intermittently use clothing of the opposite gender for fetishistic purposes.World Health Organisation (1992) "...Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines...." i
ICD-10, Gender Identity Disorder, category F65.1
published by th
World Health Organisation
. Retrieved 2007-08-13.
APA task force (1994) "...The paraphiliac focus of Transvestic Fetishism involves cross-dressing. Usually the male with Transvestic Fetishism keeps a collection of female clothes that he intermittently uses to cross-dress. While cross dressed, he usually masturbates..." i

published by the American Psychiatric Association. Retrieved 2007-08-13.
In medical terms, ''transvestic fetishism'' is differentiated from cross-dressing by use of the separate codes 302.3 in the
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
(DSM) and F65.1 in the
ICD The International Classification of Diseases (ICD) is a globally used Diagnosis, diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and c ...
.


Drag

Drag is clothing and makeup worn on special occasions for performing or entertaining, unlike those who are transgender or who cross-dress for other reasons. Drag performance includes overall presentation and behavior in addition to clothing and makeup. Drag can be theatrical, comedic, or grotesque. Drag queens have been considered caricatures of women by
second-wave feminism Second-wave feminism was a period of feminist activity that began in the early 1960s and lasted roughly two decades. It took place throughout the Western world, and aimed to increase equality for women by building on previous feminist gains. ...
. Drag artists have a long tradition in
LGBT culture LGBT culture is a culture shared by lesbian, gay, bisexual, transgender, and queer individuals. It is sometimes referred to as queer culture (indicating people who are queer), while the term gay culture may be used to mean "LGBT culture ...
. Generally the term ''
drag queen A drag queen is a person, usually male, who uses drag clothing and makeup to imitate and often exaggerate female gender signifiers and gender roles for entertainment purposes. Historically, drag queens have usually been gay men, and part of ...
'' covers men doing female drag, ''
drag king Drag kings are mostly female performance artists who dress in masculine drag and personify male gender stereotypes as part of an individual or group routine. A typical drag show may incorporate dancing, acting, stand-up comedy and singing, ...
'' covers women doing male drag, and ''
faux queen A female queen, AFAB queen, bio queen, diva queen, faux queen or hyper queen is a drag queen who identifies as a cisgender woman or as a nonbinary person who was assigned female at birth ("AFAB"). These performers are generally indistinguishable f ...
'' covers women doing female drag. Nevertheless, there are drag artists of all genders and sexualities who perform for various reasons. Drag performers are not inherently transgender. Some drag performers, transvestites, and people in the gay community have embraced the pornographically-derived term ''tranny'' for drag queens or people who engage in transvestism or cross-dressing; however, this term is widely considered an offensive slur if applied to transgender people.


History

Transgender people are known to have existed since ancient times. A wide range of societies had traditional third gender roles, or otherwise accepted trans people in some form. However, a precise history is difficult because the modern concept of being transgender, and gender in general, did not develop until the mid-1900s. Historical understandings are thus inherently filtered through modern principles, and were largely viewed through a medical lens until the late 1900s.
Ancient Greek
Hippocrates Hippocrates of Kos (; grc-gre, Ἱπποκράτης ὁ Κῷος, Hippokrátēs ho Kôios; ), also known as Hippocrates II, was a Greek physician of the classical period who is considered one of the most outstanding figures in the history o ...
(interpreting the writing of
Herodotus Herodotus ( ; grc, , }; BC) was an ancient Greek historian and geographer from the Greek city of Halicarnassus, part of the Persian Empire (now Bodrum, Turkey) and a later citizen of Thurii in modern Calabria (Italy). He is known fo ...
) discusses transgender individuals briefly. He describes the "disease of the
Scythians The Scythians or Scyths, and sometimes also referred to as the Classical Scythians and the Pontic Scythians, were an ancient Eastern * : "In modern scholarship the name 'Sakas' is reserved for the ancient tribes of northern and eastern Cent ...
" (regarding the
Enaree The ''Enarei'', singular Enaree ( grc, Ἐνάρεες , , derived from the Iranian term , meaning "unmanly"), were Scythian androgynous/effeminate priests and shamanistic soothsayers who played an important role in the Scythian religion. Relig ...
), which he attributes to impotency due to riding on a horse without stirrups. Hippocrates' reference was well discussed by medical writings of the 1500s1700s.
Pierre Petit Pierre Petit may refer to: * Pierre Petit (engineer) (1594–1677), French military engineer, mathematician, and physicist * Pierre Petit (scholar) (1617–1687), French poet, doctor, and classicist * Pierre Petit (photographer) (1832–1909), Fr ...
writing in 1596 viewed the "Scythian disease" as natural variation, but by the 1700s writers viewed it as a "melancholy", or "hysterical" psychiatric disease. By the early 1800s, being transgender separate from Hippocrates' idea of it was claimed to be widely known, but remained poorly documented. Both MtF and FtM individuals were cited in European insane asylums of the early 1800s. The most complete account of the time came from the life of the
Chevalier d'Éon Charles-Geneviève-Louis-Auguste-André-Timothée d'Éon de Beaumont or Charlotte-Geneviève-Louise-Augusta-Andréa-Timothéa d'Éon de Beaumont (5 October 172821 May 1810), usually known as the Chevalier d'Éon or the Chevalière d'Éon ( is t ...
(17281810). As cross-dressing became more widespread in the late 1800s, discussion of transgender people increased greatly and writers attempted to explain the origins of being transgender. Much study came out of Germany, and was exported to other Western audiences. Cross-dressing was seen in a pragmatic light until the late 1800s; it had previously served a satirical or disguising purpose. But in the latter half of the 1800's, cross-dressing and being transgender became viewed as an increasing societal danger.
William A. Hammond William Alexander Hammond (28 August 1828 – 5 January 1900) was an American military physician and neurologist. During the American Civil War he was the eleventh Surgeon General of the United States Army (1862–1864) and the founder of the A ...
wrote an 1882 account of transgender
Pueblo In the Southwestern United States, Pueblo (capitalized) refers to the Native tribes of Puebloans having fixed-location communities with permanent buildings which also are called pueblos (lowercased). The Spanish explorers of northern New Spain ...
shamans (''mujerados''), comparing them to the Scythian disease. Other writers of the late 1700s and 1800s (including Hammond's associates in the
American Neurological Association The American Neurological Association (ANA) is a professional society of academic neurologists and neuroscientists devoted to advancing the goals of academic neurology; to training and educating neurologists and other physicians in the neurologic ...
) had noted the widespread nature of transgender cultural practices among native peoples. Explanations varied, but authors generally did ''not'' ascribe native transgender practices to psychiatric causes, instead condemning the practices in a religious and moral sense. Native groups provided much study on the subject, and perhaps the majority of all study until after WWII. Critical studies first began to emerge in the late 1800s in Germany, with the works of
Magnus Hirschfeld Magnus Hirschfeld (14 May 1868 – 14 May 1935) was a German physician and sexologist. Hirschfeld was educated in philosophy, philology and medicine. An outspoken advocate for sexual minorities, Hirschfeld founded the Scientific-Humanitarian Com ...
. Hirschfeld coined the term "transvestite" in 1910 as the scope of transgender study grew. His work would lead to the 1919 founding of the
Institut für Sexualwissenschaft The was an early private sexology research institute in Germany from 1919 to 1933. The name is variously translated as ''Institute of Sex Research'', ''Institute of Sexology'', ''Institute for Sexology'' or ''Institute for the Science of Sexua ...
in Berlin. Though Hirscheld's legacy is disputed, he revolutionized the field of study. The Institut was destroyed when the Nazis seized power in 1933, and its research was infamously burned in the May 1933 Nazi book burnings. Transgender issues went largely out of the public eye until after World War II. Even when they re-emerged, they reflected a
forensic psychology Forensic psychology is the development and application of scientific knowledge and methods to help answer legal questions arising in criminal, civil, contractual, or other judicial proceedings. Forensic psychology includes both research on various ...
approach, unlike the more
sexological Sexology is the scientific study of human sexuality, including human sexual interests, behaviors, and functions. The term ''sexology'' does not generally refer to the non-scientific study of sexuality, such as social criticism. Sexologists ap ...
that had been employed in the lost German research.


Sexual orientation

Gender, gender identity, and being transgender are distinct concepts from
sexual orientation Sexual orientation is an enduring pattern of romantic or sexual attraction (or a combination of these) to persons of the opposite sex or gender, the same sex or gender, or to both sexes or more than one gender. These attractions are generall ...
.Answers to Your Questions About Transgender Individuals and Gender Identity
report from the website of the American Psychological Association - "What is the relationship between transgender and sexual orientation?"
Sexual orientation is an individual's enduring pattern of attraction to others (being
straight Straight may refer to: Slang * Straight, slang for heterosexual ** Straight-acting, an LGBT person who does not exhibit the appearance or mannerisms of the gay stereotype * Straight, a member of the straight edge subculture Sport and games * ...
,
lesbian A lesbian is a Homosexuality, homosexual woman.Zimmerman, p. 453. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate n ...
,
gay ''Gay'' is a term that primarily refers to a homosexual person or the trait of being homosexual. The term originally meant 'carefree', 'cheerful', or 'bright and showy'. While scant usage referring to male homosexuality dates to the late 1 ...
,
bisexual Bisexuality is a romantic or sexual attraction or behavior toward both males and females, or to more than one gender. It may also be defined to include romantic or sexual attraction to people regardless of their sex or gender identity, whic ...
, asexual, etc.), whereas gender identity is a person's innate knowledge of their own gender (being a
man A man is an adult male human. Prior to adulthood, a male human is referred to as a boy (a male child or adolescent). Like most other male mammals, a man's genome usually inherits an X chromosome from the mother and a Y chromo ...
,
woman A woman is an adult female human. Prior to adulthood, a female human is referred to as a girl (a female child or adolescent). The plural ''women'' is sometimes used in certain phrases such as "women's rights" to denote female humans regardl ...
,
non-binary Non-binary and genderqueer are umbrella terms for gender identities that are not solely male or femaleidentities that are outside the gender binary. Non-binary identities fall under the transgender umbrella, since non-binary people typically ...
, etc.). Transgender people can have any orientation, and generally use labels corresponding to their gender, rather than assigned sex at birth. For example, trans women who are exclusively attracted to other women commonly identify as
lesbian A lesbian is a Homosexuality, homosexual woman.Zimmerman, p. 453. The word is also used for women in relation to their sexual identity or sexual behavior, regardless of sexual orientation, or as an adjective to characterize or associate n ...
s, and trans men exclusively attracted to women would identify as straight. Many trans people describe their sexual orientation as ''
queer ''Queer'' is an umbrella term for people who are not heterosexual or cisgender. Originally meaning or , ''queer'' came to be used pejoratively against those with same-sex desires or relationships in the late 19th century. Beginning in the l ...
,'' in addition to or instead of, other terms. For much of the 20th century, transgender identity was conflated with
homosexuality Homosexuality is Romance (love), romantic attraction, sexual attraction, or Human sexual activity, sexual behavior between members of the same sex or gender. As a sexual orientation, homosexuality is "an enduring pattern of emotional, romant ...
and
transvestism Transvestism is the practice of dressing in a manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional, or ceremonial reasons. The term is considered outdated in Western ...
. In earlier academic literature,
sexologist Sexology is the scientific study of human sexuality, including human sexual interests, behaviors, and functions. The term ''sexology'' does not generally refer to the non-scientific study of sexuality, such as social criticism. Sexologists a ...
s used the labels ''homosexual'' and ''heterosexual transsexual'' to categorize transgender individuals' sexual orientation based on their birth sex.Blanchard, R. (1989) The classification and labeling of nonhomosexual gender dysphorias from Archives of Sexual Behavior, Volume 18, Number 4, August 1989. Retrieved vi
SpringerLink
on 2007-04-06.
Critics consider these terms "
heterosexist Heterosexism is a system of attitudes, bias, and discrimination in favor of female–male sexuality and relationships. According to Elizabeth Cramer, it can include the belief that all people are or should be heterosexual and that heterosexual ...
",Bagemihl B. Surrogate phonology and transsexual faggotry: A linguistic analogy for uncoupling sexual orientation from gender identity. In ''Queerly Phrased: Language, Gender, and Sexuality''. Anna Livia, Kira Hall (eds.) pp. 380 ff. Oxford University Press "archaic",Wahng SJ (2004). Double Cross: Transmasculinity Asian American Gendering in ''Trappings of Transhood''. in Aldama AJ (ed.) ''Violence and the Body: Race, Gender, and the State''. Indiana University Press. and demeaning.Leiblum SR, Rosen RC (2000). ''Principles and Practice of Sex Therapy'', Third Edition. ,Guilford Press of New York, c2000. Newer literature often uses terms such as ''attracted to men'' (
androphilic Androphilia and gynephilia are terms used in behavioral science to describe sexual orientation, as an alternative to a gender binary homosexual and heterosexual conceptualization. Androphilia describes sexual attraction to men or masculinity; ...
), ''attracted to women'' ( gynephilic), ''attracted to both'' (bisexual), or ''attracted to neither'' (asexual) to describe a person's sexual orientation without reference to their gender identity.APA task force (1994) "...For sexually mature individuals, the following specifiers may be noted based on the individual's sexual orientation: Sexually Attracted to Males, Sexually Attracted to Females, Sexually Attracted to Both, and Sexually Attracted to Neither..." i
DSM-IV: Sections 302.6 and 302.85
published by the American Psychiatric Association. Retrieved vi
Mental Health Matters
on 2007-04-06.
Therapists are coming to understand the necessity of using terms with respect to their clients' gender identities and preferences.Goethals, S.C. and Schwiebert, V.L. (2005) "...counselors to rethink their assumptions regarding gender, sexuality and sexual orientation. In addition, they supported counselors' need to adopt a transpositive disposition to counseling and to actively advocate for transgendered persons..." Counseling as a Critique of Gender: On the Ethics of Counseling Transgendered Clients from the International Journal for the Advancement of Counselling, Vol. 27, No. 3, September 2005. Retrieved vi
SpringerLink
on 2007-04-06.
The 2015
U.S. Transgender Survey The National Center for Transgender Equality (NCTE) is a 501(c)(3), nonprofit social equality organization founded in 2003 by transgender activist Mara Keisling in Washington, D.C. The organization works primarily in the areas of policy advocacy ...
reported that of the 27,715 transgender and
non-binary Non-binary and genderqueer are umbrella terms for gender identities that are not solely male or femaleidentities that are outside the gender binary. Non-binary identities fall under the transgender umbrella, since non-binary people typically ...
respondents, 21% said ''queer'' best described their sexual orientation, 18% said ''pansexual'', 16% said ''gay'', ''lesbian'', or ''same-gender-loving'', 15% said ''straight'', 14% said ''bisexual'', and 10% said ''asexual''. A 2019 Canadian survey of 2,873 trans and non-binary people found that 51% described their sexual orientation as queer, 13% as asexual, 28% as bisexual, 13% as gay, 15% as lesbian, 31% as pansexual, 8% as straight or heterosexual, 4% as
two-spirit Two-spirit (also two spirit, 2S or, occasionally, twospirited) is a modern, , umbrella term used by some Indigenous North Americans to describe Native people in their communities who fulfill a traditional third-gender (or other gender-varia ...
, and 9% as unsure or questioning.


LGBT community

Despite the distinction between sexual orientation and gender, throughout history the gay, lesbian, and bisexual subculture was often the only place where gender-variant people were socially accepted in the
gender role A gender role, also known as a sex role, is a social role encompassing a range of behaviors and attitudes that are generally considered acceptable, appropriate, or desirable for a person based on that person's sex. Gender roles are usually cent ...
they felt they belonged to; especially during the time when legal or medical transitioning was almost impossible. This acceptance has had a complex history. Like the wider world, the gay community in
Western societies The Western world, also known as the West, primarily refers to the various nations and states in the regions of Europe, North America, and Oceania.
did not generally distinguish between sex and gender identity until the 1970s, and often perceived gender-variant people more as homosexuals who behaved in a gender-variant way than as gender-variant people in their own right. In addition, the role of the transgender community in the history of LGBT rights is often overlooked.


Healthcare


Mental healthcare

Most mental health professionals recommend therapy for internal conflicts about gender identity or discomfort in an assigned gender role, especially if one desires to transition. People who experience discord between their gender and the expectations of others or whose gender identity conflicts with their body may benefit by talking through their feelings in depth; however, research on gender identity with regard to psychology, and scientific understanding of the phenomenon and its related issues, is relatively new.Brown, M.L. & Rounsley, C.A. (1996) ''True Selves: Understanding Transsexualism – For Families, Friends, Coworkers, and Helping Professionals'' Jossey-Bass: San Francisco The term ''gender incongruence'' is listed in the International Statistical Classification of Diseases and Related Health Problems, International Statistical Classification of Diseases (ICD) by the WHO. In the American Diagnostic and Statistical Manual of Mental Disorders, ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM), the term ''gender dysphoria'' is listed under code F64.9.
Diagnostic and Statistical Manual of Mental Disorders The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...
, Fifth Edition (2013)
France removed gender identity disorder as a diagnosis by decree in 2010, but according to French trans rights organizations, beyond the impact of the announcement itself, nothing changed. In 2017, the Danish parliament abolished the F64 Gender identity disorders. The ''DSM-5'' refers to the topic as ''gender dysphoria'' (GD) while reinforcing the idea that being transgender is not considered a mental illness. Transgender people may meet the criteria for a diagnosis of gender dysphoria "only if [being transgender] causes distress or disability."Answers to Your Questions About Transgender Individuals and Gender Identity
report from the website of the American Psychological Association - "Is being transgender a mental disorder?"
This distress may manifest as depression or inability to work and form healthy relationships with others. This diagnosis is often misinterpreted as implying that all transgender people suffer from GD, which has confused transgender people and those who seek to either criticize or affirm them. Transgender people who are comfortable with their gender and whose gender is not directly causing inner frustration or impairing their functioning do not suffer from GD. Moreover, GD is not necessarily permanent and is often resolved through therapy or transitioning. Feeling oppressed by the negative attitudes and behaviors of such others as legal entities does not indicate GD. GD does not imply an opinion of immorality; the psychological establishment holds that people with any kind of mental or emotional problem should not receive stigma. The solution for GD is whatever will alleviate suffering and restore functionality; this solution often, but not always, consists of undergoing a gender transition. Clinical training lacks relevant information needed in order to adequately help transgender clients, which results in a large number of practitioners who are not prepared to sufficiently work with this population of individuals. Many mental healthcare providers know little about transgender issues. Those who seek help from these professionals often educate the professional without receiving help. This solution usually is good for transsexual people but is not the solution for other transgender people, particularly non-binary people who lack an exclusively male or female identity. Instead, therapists can support their clients in whatever steps they choose to take to transition or can support their decision not to transition while also addressing their clients' sense of congruence between gender identity and appearance. Acknowledgment of the lack of clinical training has increased; however, research on the specific problems faced by the transgender community in mental health has focused on diagnosis and clinicians' experiences instead of transgender clients' experiences. Therapy was not always sought by transgender people due to mental health needs. Prior to the seventh version of the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, Standards of Care (SOC), an individual had to be diagnosed with gender identity disorder in order to proceed with hormone treatments or sexual reassignment surgery. The new version decreased the focus on diagnosis and instead emphasized the importance of flexibility in order to meet the diverse health care needs of transsexual, transgender, and all gender-nonconforming people. The reasons for seeking mental health services vary according to the individual. A transgender person seeking treatment does not necessarily mean their gender identity is problematic. The emotional strain of dealing with stigma and experiencing transphobia pushes many transgender people to seek treatment to improve their quality of life, as one trans woman reflected: "Transgendered individuals are going to come to a therapist and most of their issues have nothing to do, specifically, with being transgendered. It has to do because they've had to hide, they've had to lie, and they've felt all of this guilt and shame, unfortunately usually for years!" Many transgender people also seek mental health treatment for depression and anxiety caused by the stigma attached to being transgender, and some transgender people have stressed the importance of acknowledging their gender identity with a therapist in order to discuss other quality-of-life issues. Others regret having undergone the procedure and wish to detransition. Problems still remain surrounding misinformation about transgender issues that hurt transgender people's mental health experiences. One trans man who was enrolled as a student in a psychology graduate program highlighted the main concerns with modern clinical training: "Most people probably are familiar with the term transgender, but maybe that's it. I don't think I've had any formal training just going through [clinical] programs ... I don't think most [therapists] know. Most therapistsMaster's degree, PhD levelthey've had ... one diversity class on GLBT issues. One class out of the huge diversity training. One class. And it was probably mostly about gay lifestyle." Many health insurance policies do not cover treatment associated with gender transition, and numerous people are under- or uninsured, which raises concerns about the insufficient training most therapists receive prior to working with transgender clients, potentially increasing financial strain on clients without providing the treatment they need. Many clinicians who work with transgender clients only receive mediocre training on gender identity, but introductory training on interacting with transgender people has recently been made available to health care professionals to help remove barriers and increase the level of service for the transgender population. In February 2010, France became the first country in the world to remove transgender identity from the list of mental diseases. A 2014 study carried out by the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy, Williams Institute (a University of California, Los Angeles, UCLA think tank) found that 41% of transgender people had attempted suicide, with the rate being higher among people who experienced discrimination in access to housing or healthcare, harassment, physical or sexual assault, or rejection by family. A 2019 follow-up study found that transgender people who wanted and received Sex reassignment therapy, gender-affirming medical care had substantially lower rates of suicidal thoughts and attempts. Autism is more common in people who are gender dysphoric. It is not known whether there is a biological basis. This may be due to the fact that people on the autism spectrum are less concerned with societal disapproval, and feel less fear or inhibition about coming out as trans than others.


Physical healthcare

Medical and surgical procedures exist for transsexual and some transgender people, though most categories of transgender people as described above are not known for seeking the following treatments. Masculinizing hormone therapy, Hormone replacement therapy for trans men induces beard growth and masculinizes skin, hair, voice, and fat distribution. Feminizing hormone therapy, Hormone replacement therapy for trans women feminizes fat distribution and breasts. Laser hair removal or Electrology, electrolysis removes excess hair for trans women. Surgical procedures for trans women feminize the Voice therapy (trans)#Vocal surgeries, voice, Dermabrasion, skin, Facial feminization surgery, face, Chondrolaryngoplasty, Adam's apple, Breast implant, breasts, Liposuction, waist, Buttock augmentation, buttocks, and Sex reassignment surgery male-to-female, genitals. Surgical procedures for trans men masculinize the Male Chest Reconstruction, chest and Sex reassignment surgery female-to-male#Genital reassignment, genitals and remove the Hysterectomy, womb, Oophorectomy, ovaries, and fallopian tubes. The acronyms "Gender reassignment surgery, GRS" and "Sex reassignment surgery, SRS" refer to genital surgery. The term "sex reassignment therapy" (SRT) is used as an umbrella term for physical procedures required for Transgender transition, transition. Use of the term "sex change" has been criticized for its emphasis on surgery, and the term "transition" is preferred.Pfäfflin F., Junge A. (1998) "...This critique for the use of the term sex change in connection to sex reassignment surgery stems from the concern about the patient, to take the patient seriously...." i
Sex Reassignment: Thirty Years of International Follow-Up Studies: A Comprehensive Review, 1961–1991
from the Electronic Book Collection of the International Journal of Transgenderism. Retrieved 2007-09-06.
Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder,APA task force (1994) "...preoccupation with getting rid of primary and secondary sex characteristics..." i

published by the American Psychiatric Association. Retrieved vi
Mental Health Matters
on 2007-04-06.
and Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, standards of care in the relevant jurisdiction. Trans men who have not had a hysterectomy and who take testosterone are at increased risk for endometrial cancer because androstenedione, which is made from testosterone in the body, can be converted into estrogen, and external estrogen is a risk factor for endometrial cancer.


Detransition

Detransition refers to the cessation or reversal of a
sex reassignment surgery Gender-affirming surgery (GAS) is a surgical procedure, or series of procedures, that alters a transgender or transsexual person's physical appearance and sexual characteristics to resemble those associated with their identified gender, and a ...
or gender transition. Formal studies of detransition have been few in number, of disputed quality, and politically controversial. Estimates of the rate at which detransitioning occurs vary from less than 1% to as high as 13%. Those who undergo sex reassignment surgery have very low rates of detransition or regret.Detransition estimates: * "Detransitioning after surgical interventions ... is exceedingly rare. Research has often put the percentage of regret between 1 and 2% ... Detransitioning is actually far more common in the stages before surgery, when people are still exploring their options. 'There are people who take hormones and then decide to go off hormones,' says Randi Ettner, a therapist who has served on the board of the World Professional Association for Transgender Health. 'That is not uncommon. * "There were 15 (5 [female-to-male] and 10 [male-to-female]) regret applications corresponding to a 2.2% regret rate for both sexes. There was a significant decline of regrets over the time period." (Dhejne et al. define "regret" as "application for reversal of the legal gender status among those who were sex reassigned" which "gives the person the right to treatment to reverse the body as much as possible."), "the median time lag until applying for a reversal was 8 years." The 2015 U.S. Transgender Survey collected responses from 27,715 individuals who identified as "transgender, trans, genderqueer, [or] non-binary". 13.1% of respondents who had pursued gender affirmation said they had ever detransitioned, even temporarily. Detransition was associated with assigned male sex at birth, nonbinary gender identity, and bisexual orientation, among other cohorts. Only 5% of detransitioners reporting doing so because gender transition was "not for them"; 82% cited external reason(s), including pressure from others, the difficulties of transition, and discrimination.


Law

Legal procedures exist in some jurisdictions which allow individuals to change their legal gender or name to reflect their gender identity. Requirements for these procedures vary from an explicit formal diagnosis of transsexualism, to a diagnosis of gender identity disorder, to a letter from a physician that attests the individual's gender transition or having established a different
gender role A gender role, also known as a sex role, is a social role encompassing a range of behaviors and attitudes that are generally considered acceptable, appropriate, or desirable for a person based on that person's sex. Gender roles are usually cent ...
. In 1994, the DSM IV entry was changed from "Transsexual" to "Gender Identity Disorder". In many places, transgender people are not legally protected from discrimination in the workplace or in public accommodations. A report released in February 2011 found that 90% of transgender people faced discrimination at work and were unemployed at double the rate of the general population, and over half had been harassed or turned away when attempting to access public services. Members of the transgender community also encounter high levels of discrimination in health care.


Europe

36 countries in Europe require a mental health diagnosis for legal gender recognition and 20 countries require sterilisation. In April 2017, the European Court of Human Rights ruled that requiring sterilisation for legal gender recognition violates human rights.


Denmark

Since 2014 it has been possible for adults without the requirement of a psychiatric evaluation, medical or surgical treatment, divorce or castration, to after a six-month 'reflection period' have their social security number changed and legally change gender.


Germany

In November 2017, the Federal Constitutional Court ruled that the civil status law must allow a third gender option. Thus officially recognising "third sex" meaning that birth certificates will not have blank gender entries for intersex people. The ruling came after an intersex person, who is neither a man nor woman according to chromosomal analysis, brought a legal challenge after attempting to change their registered sex to "inter" or ''wikt:divers#Adjective 5, divers''.


Canada

Jurisdiction over legal classification of sex in Canada is assigned to the provinces and territories. This includes legal change of gender classification. On June 19, 2017, An Act to amend the Canadian Human Rights Act and the Criminal Code, Bill C-16, having passed the legislative process in the House of Commons of Canada and the Senate of Canada, became law upon receiving Royal Assent, which put it into immediate force. The law updated the Canadian Human Rights Act and the Criminal Code (Canada), Criminal Code to include "gender identity and gender expression" as protected grounds from discrimination, hate publications and advocating Transgender genocide, genocide. The bill also added "gender identity and expression" to the list of aggravating factors in sentencing, where the accused commits a criminal offence against an individual because of those personal characteristics. Similar transgender laws also exist in all the provinces and territories.


United States

In the United States, transgender people are protected from employment discrimination by Title VII of the Civil Rights Act of 1964. Exceptions apply to certain types of employers, for example, employers with fewer than 15 employees and religious organizations. In 2020, the U.S. Supreme Court affirmed that Title VII prohibits discrimination against transgender people in the case ''R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission''. Nicole Maines, a trans girl, took a case to Maine's supreme court in June 2013. She argued that being denied access to her high school's women's restroom was a violation of Maine's Human Rights Act; one state judge has disagreed with her, but Maines won her lawsuit against the Orono school district in January 2014 before the Maine Supreme Judicial Court. On May 14, 2016, the United States Department of Education and United States Department of Justice, Department of Justice issued guidance directing public schools to allow transgender students to use bathrooms that match their gender identities. On June 30, 2016, the United States Department of Defense removed the ban that prohibited transgender people from openly serving in the US military. On July 27, 2017, President Donald Trump Twitter usage, tweeted that transgender Americans would not be allowed to serve "in any capacity" in the United States Armed Forces. Later that day, Joint Chiefs of Staff Chairman Joseph Dunford announced, "there will be no modifications to the current policy until the president's direction has been received by the James Mattis, Secretary of Defense and the secretary has issued implementation guidance." Joe Biden later reversed Trump's policy when he became president in 2021.


India

In April 2014, the Supreme Court of India declared transgender to be a 'third gender' in Indian law. The transgender community in India (made up of Hijras and others) has a long history in India and in Hindu mythology. Justice K. S. Panicker Radhakrishnan, KS Radhakrishnan noted in his decision that, "Seldom, our society realizes or cares to realize the trauma, agony and pain which the members of Transgender community undergo, nor appreciates the innate feelings of the members of the Transgender community, especially of those whose mind and body disown their biological sex", adding: Hijras face structural discrimination including not being able to obtain driving licenses, and being prohibited from accessing various social benefits. It is also common for them to be banished from communities.


Religion

The Catholic Church has been involved in the outreach to LGBT community for several years and continues doing so through Franciscan urban outreach centers, for example, the Open Hearts outreach in Hartford, Connecticut. The Vatican, however, holds that transgender people cannot become godparents and compares transitioning to self-harm. The Church of England passed a motion at the 2017 General Synod of the Church of England, General Synod, which would ensure Anglican churches accepted transgender people, even suggesting on their website that transgender people could be gifted a Bible with their new name inscribed to support them.


Feminism

Feminist views on transgender women have changed over time, but have generally become more inclusive. Second-wave feminism saw numerous clashes opposed to transgender women, since they were not seen as "true" women, and as invading women-only spaces. Though second-wave feminism argued for the
sex and gender distinction Though the terms '' sex'' and ''gender'' have been used interchangeably since at least the fourteenth century, in contemporary academic literature they usually have distinct meanings. ''Sex'' generally refers to an organism's biological sex, while ...
, some feminists believed there was a conflict between transgender identity and the feminist cause; e.g., they believed that male-to-female transition abandoned or devalued female identity and that transgender people embraced traditional gender roles and stereotypes. By the emergence of third-wave feminism (around 1990), opinions had shifted to being more inclusive of both trans and gay identities. Fourth-wave feminism (starting around 2012) has been widely trans-inclusive, but trans-exclusive groups and ideas remain as a minority, though one that is especially prominent in the UK. Feminists who do not accept that trans women are women have been labeled "trans-exclusionary radical feminists" (TERFs) or gender-critical feminists.


Discrimination


Employment discrimination

Transgender individuals experience significant rates of employment discrimination. Approximately 90% of trans people have encountered some form of harassment or mistreatment in their workplace. Moreover, 47% have experienced some form of adverse employment outcome due to being transgender; of this figure, 44% were passed over for a job, 23% were denied a promotion, and 26% were terminated on the grounds that they were transgender.


Support

Studies in several cultures have found that cisgender women are more likely to be accepting of trans people than cisgender men.


Scientific studies of transsexuality

A 1996 study of Swedes estimated a ratio of 1.4:1 trans women to trans men for those requesting sex reassignment surgery and a ratio of 1:1 for those who proceeded. A study in 2020 noted that, since 1990, of those seeking sex hormone therapy for gender dysphoria there has been a steady increase in the percentage of trans men, such that they now equal the number of trans women seeking this treatment. An observational study revealed that transgender people receiving hormone therapy from the Amsterdam University Medical Centre in the Netherlands had higher mortality rates than the general population, and that this did not decrease during the duration of the study (1972 to 2018). Other studies have also found increased mortality in transgender people.


Population figures and prevalence

Little is known about the prevalence of transgender people in the general population and reported prevalence estimates are greatly affected by variable definitions of transgender. According to a recent systematic review, an estimated 9.2 out of every 100,000 people have received or requested sex reassignment surgery, gender affirmation surgery or transgender hormone therapy; 6.8 out of every 100,000 people have received a transgender-specific diagnoses; and 355 out of every 100,000 people self-identify as transgender. These findings underscore the value of using consistent terminology related to studying the experience of transgender, as studies that explore surgical or hormonal gender affirmation therapy may or may not be connected with others that follow a diagnosis of "transsexualism", "gender identity disorder", or "gender dysphoria", none of which may relate with those that assess self-reported identity. Common terminology across studies does not yet exist, so population numbers may be inconsistent, depending on how they are being counted.


Asia

In Thailand and Laos,Doussantousse, S. (2005) "...The Lao Kathoey's characteristics appear to be similar to other transgenders in the region..." i
Male Sexual Health: Kathoeys in the Lao PDR, South East Asia – Exploring a gender minority
from th
Transgender ASIA Research Centre
. Retrieved 2007-07-22.
the term kathoey is used to refer to male-to-female transgender peopleJackson, P. (2003
Performative Genders, Perverse Desires: A Bio-History of Thailand's Same-Sex and Transgender Cultures
in Intersections: Gender, History and Culture in the Asian Context, Issue 9, August 2003.
and effeminate gay men.Winter, S. and Udomsak, N. (2002
Male, Female and Transgender: Stereotypes and Self in Thailand
in the International Journal of Transgender, Volume 6, Number 1, January – March 2002.
Transgender people have also been documented in Transsexuality in Iran, Iran,Harrison, F. (2005) "...He shows me the book in Arabic in which, 41 years ago, Ayatollah Khomeini wrote about new medical issues like transsexuality. "I believe he was the first Islamic scientist in the world of Islam who raised the issue of sex change," says Hojatulislam Kariminia. The Ayatollah's ruling that sex-change operations were allowed has been reconfirmed by Iran's current spiritual leader..." i
Iran's sex-change operations
, from th
BBC
. Retrieved 2007-07-22.
Japan, "...the male to female cross-dressing (MTFCD) community in Shinjuku, Tokyo, which plays an important role in the overall transgender world and how people in the community think and live..." Nepal,Haviland, C. (2005) "...The Gurung people of western Nepal have a tradition of men called maarunis, who dance in female clothes..." i
Crossing sexual boundaries in Nepal
, from th
BBC
. Retrieved 2007-07-22.
Indonesia,Graham, S. (2002) "...Among the Bugis of South Sulawesi, possibly four genders are acknowledged plus a fifth para-gender identity. In addition to male-men (oroane) and female-women (makunrai)..., there are calalai (masculine females), calabai (feminine males), and bissu..." i
Priests and gender in South Sulawesi, Indonesia
from th
Transgender ASIA Research Centre
. Retrieved 2007-07-22.
Vietnam,Walters, I. (2006) "...In Vietnam, male to female (MtF) transgender people are categorised as lai cai, bong cai, bong lai cai, dong co, or be-de..." i
Vietnam Some notes by Ian Walters
from th
Transgender ASIA Research Centre
. Retrieved 2007-07-22.
South Korea,Shim, S. (2006) "...Rush, catering especially to crossdressers and transgenders, is a cafe owned by a 46-year-old man who goes by the female name Lee Cho-rong. "...Many people in South Korea don't really understand the difference between gay and transgender. I'm not gay. I was born a man but eager to live as a woman and be beautiful," said Lee..." i

from th

. Retrieved 2007-07-22.
LGBT rights in Jordan, Jordan, Transgender people in Singapore, Singapore,Heng, R. (2005) "...Even if we take Bugis Street as a starting point, we should remember that cross-dressing did not emerge suddenly out of nowhere. Across Asia, there is a tradition of cross-dressing and other forms of transgender behaviour in many places with a rich local lexicon and rituals associated with them...." i
Where queens ruled! - a history of gay venues in Singapore
from IndigNation. Retrieved 2007-07-22.
and the transgender in China, greater Chinese region, including Hong Kong, "...Hong Kong's transgender movement at its current stage, with particular reference to the objectives and activities of the Hong Kong Transgender Equality and Acceptance Movement..."Hung, L. (2007) "...there are many archetypal flamboyant embodiments of female-to-male transgender physicality living and displaying their unrestrained, dashing iconic presence..." i
Trans-Boy Fashion, or How to Tailor-Make a King
from th
Gender Studies programme of The Chinese University of Hong Kong
. Retrieved 2007-07-22.
Taiwan, "...specificities of Taiwanese transgender existence in relation to body- and subject-formations, in hope to not only shed light on the actualities of trans efforts toward self-fashioning, but also illuminate the increasing entanglement between trans self-construction and the evolving gender culture that saturates it..." and the People's Republic of China.Hahn, L. (2005) "...Aware that he often felt more like a woman than a man, Jin Xing underwent a sex change in 1995; a daring move in a conservative Chinese society..." i
Jin Xing TalkAsia Interview Transcript – June 13, 2005
fro
CNN
. Retrieved 2007-07-22.
Goldkorn, J. (2006) "...At one point in 2003, there was so much media coverage of transsexuals in China that Danwei started a special section for it..." i
Transsexuals in the Chinese media again
fro
Danwei
. Retrieved 2007-07-22.
The cultures of the Indian subcontinent include a
third gender Third gender is a concept in which individuals are categorized, either by themselves or by society, as neither man nor woman. It is also a social category present in societies that recognize three or more genders. The term ''third'' is usuall ...
, referred to as hijra (South Asia), hijra in Hindi. In India, the Supreme Court of India, Supreme Court on April 15, 2014, recognized a third gender that is neither male nor female, stating "Recognition of transgenders as a third gender is not a social or medical issue but a human rights issue." In 1998 Madhya Pradesh Legislative Assembly election, 1998, Shabnam Mausi became the first transgender person to be elected in India, in the central Indian state of Madhya Pradesh.


Europe


European Union

According to Amnesty International, 1.5 million transgender people live in the European Union, making up 0.3% of the population.


UK

A 2011 survey conducted by the Equality and Human Rights Commission in the UK found that of 10,026 respondents, 1.4% would be classified into a gender minority group. The survey also showed that 1% had gone through any part of a gender reassignment process (including thoughts or actions).


North America


Canada

The 2021 Canadian census released by Statistics Canada found that 59,460 Canadians (0.19% of the population) identified as transgender. According to the ''Survey of Safety in Public and Private Spaces'' by Statistics Canada in 2018, 0.24% of the Canadian population identified as transgender men, women or non-binary individuals.


United States

The Social Security Administration, since 1936, has tracked the sex of citizens. Using this information, along with the Census data, Benjamin Cerf Harris tracked the prevalence of citizens changing to names associated with the opposite sex or changing sex marker. Harris found that such changes had occurred as early as 1936. He estimated that 89,667 individuals included in the 2010 Census had changed to an opposite-gendered name, 21,833 of whom had also changed sex marker. Prevalence in the States varied, from 1.4 to 10.6 per 100,000. While most people legally changed both name and sex, about a quarter of people changed name, and then five years later changed sex. An earlier estimate in 1968, by Ira B. Pauly, estimated that about 2,500 transsexual people were living in the United States, with four times as many trans women as trans men. One effort to quantify the population in 2011 gave a "rough estimate" that 0.3% of adults in the US are transgender. More recent studies released in 2016 estimate the proportion of Americans who identify as transgender at 0.5 to 0.6%. This would put the total number of transgender Americans at approximately 1.4 million adults (). A survey by the Pew Research Center in 2017 found that American society is divided on "whether it's possible for someone to be a gender different from the sex they were assigned at birth." It states, "Overall, roughly half of Americans (54%) say that whether someone is a man or a woman is determined by the sex they were assigned at birth, while 44% say someone can be a man or a woman even if that is different from the sex they were assigned at birth."


Native American and First Nations

In what is now the United States and Canada, some Native Americans in the United States, Native American and First Nations of Canada, First Nations cultures traditionally recognize the existence of more than two genders, such as the Zuni people, Zuni male-bodied ''lhamana'', the Lakota people, Lakota male-bodied ''winkte'',Medicine, B. (2002
Directions in Gender Research in American Indian Societies: Two Spirits and Other Categories
, taken from Online Readings in Psychology and Culture Center for Cross-Cultural Research, Unit 3, Chapter 2, Western Washington University.
and the Mohave people, Mohave male-bodied ''alyhaa'' and female-bodied ''hwamee''. These traditional people, along with those from other Indigenous peoples of North America, North American Indigenous cultures, are sometimes part of the contemporary, pan-Indian Two-Spirit community. Historically, in most cultures who have alternate gender roles, if the spouse of a third gender person is not otherwise gender variant, they have not generally been regarded as other-gendered themselves, simply for being in a same-sex relationship. In Mexico, the Zapotec people, Zapotec culture includes a third gender in the form of the Muxe. Mahu (person), Mahu is a traditional third gender in Hawai'i and Tahiti. Mahu are valued as teachers, caretakers of culture, and healers, such as Kapaemahu. Diné (Navajo) have Nádleehi.


Latin America

In Latin American cultures, a Travesti (gender identity), travesti is an individual who has been assigned male at birth and who has a feminine, transfeminine, or "femme" gender identity. Travestis generally undergo hormonal treatment, use female gender expression including new names and pronouns from the masculine ones they were given when assigned a sex, and might use breast implants, but they are not offered or do not desire sex-reassignment surgery. Travesti might be regarded as a gender in itself (a "third gender"), a mix between man and woman ("intergender/androgynes"), or the presence of both masculine and feminine identities in a single person ("bigender"). They are framed as something entirely separate from transgender women, who possess the same gender identity of people assigned female at birth. Other transgender identities are becoming more widely known, as a result of contact with other cultures of the Western world. These newer identities, sometimes known under the umbrella use of the term "genderqueer", along with the older ''travesti'' term, are known as non-binary and go along with binary transgender identities (those traditionally diagnosed under the now obsolete label of "transsexualism") under the single umbrella of ''transgender'', but are distinguished from cross-dressers and drag queens and kings, that are held as nonconforming gender expressions rather than transgender gender identities when a distinction is made. Deviating from the societal standards for sexual behavior, sexual orientation/identity, gender identity, and gender expression have a single umbrella term that is known as ''sexodiverso'' or ''sexodiversa'' in both Spanish and Portuguese, with its most approximate translation to English being "queer".


Ancient cultures

Among the ancient Middle Eastern Akkadian Empire, Akkadian people, a ''salzikrum'' was a person who appeared biologically female but had distinct male traits. ''Salzikrum'' is a compound word meaning ''male daughter.'' According to the Code of Hammurabi, ''salzikrūm'' had inheritance rights like that of priestesses; they inherited from their fathers, unlike regular daughters. A ''salzikrum's'' father could also stipulate that she inherit a certain amount. In Ancient Rome, the Galli, Gallae were castration, castrated followers of the Phrygian goddess Cybele and can be regarded as transgender in today's terms.Endres, N
Galli: Ancient Roman Priests
from the GLBTQ: an encyclopedia of gay, lesbian, bisexual, transgender and queer culture.
Brown, K

In early Medina, gender-variantPartial Translation of the Sunan Abu-Dawud, Book 41, Number 4910
USC-MSA Compendium of Muslim Texts, University of Southern California, translated by Prof. Ahmad Hasan.
male-to-female Islamic people were acknowledged in the form of the Mukhannathun. Also, in Fa'asamoa traditions, the Samoan culture allows a specific role for male to female transgender individuals as Fa'afafine.


Coming out

Transgender people vary greatly in choosing when, whether, and how to disclose their transgender status to family, close friends, and others. The prevalence of discrimination and violence (transgender people are 28% more likely to be victims of violence) against transgender persons can make coming out a risky decision. Fear of retaliatory behavior, such as being removed from the parental home while underage, is a cause for transgender people to not come out to their families until they have reached adulthood. Parental confusion and lack of acceptance of a transgender child may result in parents treating a newly revealed gender identity as a "phase" or making efforts to change their children back to "normal" by utilizing mental health services to Conversion therapy, alter the child's gender identity. The internet can play a significant role in the coming out process for transgender people. Some come out in an online identity first, providing an opportunity to go through experiences virtually and safely before risking social sanctions in the real world.


Media representation

As more transgender people are represented and included within the realm of mass culture, the stigma that is associated with being transgender can influence the decisions, ideas, and thoughts based upon it. Media representation, culture industry, and Social exclusion, social marginalization all hint at popular culture standards and the applicability and significance to mass culture as well. These terms play an important role in the formation of notions for those who have little recognition or knowledge of transgender people. Media depictions represent only a minuscule spectrum of the transgender group, which essentially conveys that those that are shown are the only interpretations and ideas society has of them. However, in 2014, the United States reached a "transgender tipping point", according to Time (magazine), ''Time''. At this time, the media visibility of transgender people reached a level higher than seen before. Since then, the number of transgender portrayals across TV platforms has stayed elevated. Research has found that viewing multiple transgender TV characters and stories improves viewers' attitudes toward transgender people and related policies.


Events


International Transgender Day of Visibility

International Transgender Day of Visibility is an annual holiday occurring on March 31 dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide. The holiday was founded by Michigan-based transgender activist Rachel Crandall in 2009.


Transgender Awareness Week

Transgender Awareness Week is a one-week celebration leading up to Transgender Day of Remembrance. The purpose of Transgender Awareness Week is to educate about transgender and gender non-conforming people and the issues associated with their transition or identity.


Transgender Day of Remembrance

Transgender Day of Remembrance (TDOR) is held every year on November 20 in honor of Rita Hester, who was killed on November 28, 1998, in an anti-transgender hate crime. TDOR serves a number of purposes: * it memorializes all of those who have been victims of hate crimes and prejudice, * it raises awareness about hate crimes towards the transgender community, * and it honors the dead and their relatives


Trans March

Annual marches, protests or gatherings take place around the world for transgender issues, often taking place during the time of local Pride parades for LGBT people. These events are frequently organised by trans communities to build community, address human rights defenders, human rights struggles, and create visibility.


Pride symbols

A common symbol for the transgender community is the Transgender flags#Transgender Pride Flag (Monica Helms), Transgender Pride Flag, which was designed by the American transgender woman Monica Helms in 1999, and was first shown at a pride parade in Phoenix, Arizona, in 2000. The flag consists of five horizontal stripes: light blue, pink, white, pink, and light blue. Helms describes the meaning of the flag as follows: Other transgender symbols include the Butterfly#In culture, butterfly (symbolizing transformation or metamorphosis), and a pink/light blue yin and yang symbol. Several gender symbols have been used to represent transgender people, including ⚥ and ⚧.


See also

* List of transgender and transsexual fictional characters * List of transgender people * List of transgender publications * List of transgender-related topics * List of transgender-rights organizations * List of people killed for being transgender * Transgender history


Notes


References


Further reading

* * *


External links

* * * * {{Authority control Transgender, LGBT studies