What Does It Mean to Be Transgender?
Key takeaways:
A transgender person is someone whose gender identity is different from the sex they were assigned at birth (typically male or female).
You don’t have to transition to be transgender. Gender-affirming care looks different for everyone. But transitioning is a holistic process that many transgender people pursue.
Transgender people risk discrimination and social stigma for being their authentic selves. So, it’s important to acknowledge and respect transgender identities.
A recent survey found that a little over 40% of adults in the U.S. say they personally know someone who’s transgender. As society becomes more aware of diverse gender identities, it’s important to understand what it means to be transgender.
There’s no “right way” to be transgender. How a transgender person chooses to express their gender identity is entirely up to them. Gender identity is their internal sense of self and their gender. It’s also incredibly personal.
Some people pursue gender-affirming care, like hormone therapy and surgeries. This can depend on their goals. But gender-affirming care isn’t required to be transgender. Someone is transgender when they say they are.
Keep reading to learn more about what it means to be transgender. We’ll also cover the different types of transitioning and resources available to the transgender community.
What does it mean to be transgender?
The term “cisgender” is used to describe someone whose gender identity aligns with their birth-assigned sex, usually male or female. A transgender person is someone whose gender identity doesn’t match their birth-assigned sex.
There are transgender people who identify within the gender binary — as men or women. There are also people who identify as non-binary, gender expansive, or gender nonconforming. For some people, these all fall under the transgender umbrella. But this isn’t the case for everyone.
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Some (but not all) transgender people experience gender dysphoria. Gender dysphoria is the consistent and severe distress resulting from gender identity not matching birth-assigned sex. This distress can negatively impact different parts of their lives.
Being able to express authentic gender identity can help alleviate gender dysphoria. For some, this includes transitioning. Transitioning is when someone starts living in a way that’s consistent with their gender identity. This can include social, physical, and/or legal transitioning.
Some people who transition may feel pressure to “pass” as someone who is cisgender. For example, a transgender woman may want to be perceived as a cisgender woman in society. Otherwise, it may result in people using the wrong pronouns (called misgendering). It can also put them at risk for violence or harassment.
But “passing” is also a concept that disregards the uniqueness of gender expression. It can also put unnecessary pressure on transgender people. Everyone’s goals of expressing their gender are different.
Transitioning isn’t required to be transgender. That’s because being transgender is part of someone’s identity. It’s an internal reality that they have.
What is the transitioning process for a transgender person?
The process for social, medical, and legal transitioning is incredibly varied. That’s because it’s completely dependent upon the individual. Everyone’s goals and processes look different.
Social transitioning
First, an individual comes out to themselves. Coming out to oneself refers to the moment a person realizes they may be transgender. Within themselves, they come to understand their own identity. This can take varied amounts of time.
If and when they’re ready, a transgender person may choose to come out to family, friends, and the public. This is what’s often referred to as “coming out.” Coming out should be done on their own terms. But not everyone feels comfortable or safe coming out. This doesn’t make their transgender identity any less valid.
Often, transgender people will choose a name and begin to assert their pronouns. And if they haven’t already, they may begin dressing and presenting themselves in a way that feels more aligned with their gender identity. This is referred to as gender expression.
Social transitioning can be very difficult for transgender people. That’s because it can put them at risk of discrimination, violence, and social stigma. This is often related to lack of understanding from others. The fear of rejection from society can have negative effects on their mental health, too.
If someone comes out to you, it’s important to listen and create a supportive environment. Show respect by addressing them by their name and pronouns. And if you’re unsure what these are, it’s appropriate to ask. This can have a positive impact on their confidence and acceptance in their identity.
Medical transitioning
Some transgender people will medically transition to varying degrees. This can depend on desire, access, affordability, and more. Medical transitioning may consist of gender-affirming hormone therapy (GAHT) and/or gender-affirming procedures.
Gender-affirming hormone therapy (GAHT)
GAHT isn’t used exclusively by any particular gender identity. But it’s commonly used by transgender people to cause desired physical changes. GAHT isn’t required to be transgender. But a recent study showed that it can have mental health benefits in transgender and non-binary youth.
GAHT is typically broken down into two categories: testosterone-based and estrogen-based.
Testosterone-based GAHT may be used to cause masculine physical changes. This can include facial hair growth, deeper voice, and more muscle mass. It consists of testosterone therapy, which is available as injections, patches, and gels.
Estrogen-based GAHT may be used to cause feminine physical changes. This can include chest development, less facial and body hair, and body fat redistribution. It primarily consists of estrogen. But it can also include testosterone blockers and progesterone.
It’s important to understand that everyone’s goals for GAHT are different. There’s no “one-size-fits-all” therapy plan. Transgender individuals pursue different degress of GAHT. And they can remain on it for varying amounts of time. This can depend on their unique circumstance, goals, and healthcare provider’s recommendations.
Gender-affirming surgical procedures
Surgical procedures may also be a part of someone’s gender-affirming care. They’re used to permanently change areas of the body.
Similar to GAHT, gender-affirming surgeries aren’t required to be transgender. But they’ve also been shown to have mental health benefits in transgender people. Yet, not everyone has access to or desires to undergo these procedures.
Examples of areas of the body that can be changed include:
Chest: masculinizing chest surgery (“top” surgery) or breast augmentation
Genitals: vaginoplasty (constructs a vagina) or phalloplasty (constructs a penis)
Reproductive organs: hysterectomy (removes uterus) or orchiectomy (removes testicles)
Face: facial feminization or masculinization surgery
General: liposuction
Legal transitioning
Every part of transitioning presents unique challenges. But the transgender community has the least amount of control over legal transitioning.
Legal transitioning involves changing a transgender person’s legal name and gender markers. This is done on a number of official documents and records.
Examples include:
Social security card
State license or other identification
Financial, school, employment, and insurance records
Passport
Birth certificate
The 2004 Gender Recognition Act in the United Kingdom helped spark change in this area. However, transgender rights in the U.S. still vary tremendously by jurisdiction.
Changing over legal documentation in many states can be very difficult. In fact, some states require proof of gender-affirming surgery. Again, this isn’t required to be transgender.
Other steps and/or obstacles can include:
Being seen by a physician
Getting a court order
Having notarized documentation
Paying for name and gender changes on documents
Paying for legal representation, as necessary
What support and resources are available for the transgender community?
Several nationally recognized organizations exist to support the transgender community. These include, but are not limited to:
The Trevor Project offers crisis support services to LGBTQ+ youth
Plume provides GAHT and letter writing services via telehealth visits
Marsha P. Johnson Institute works to defend the rights of Black transgender people
The Okra Project provides culturally specific meals and resources for Black transgender people
The Human Rights Campaign is one of the largest mainstream advocacy organizations for LGBTQ+ people.
The National Center for Transgender Equality promotes policy change to advance transgender equality.
GLAAD helps shape the media narrative for LGBTQ+ acceptance.
Transparent USA offers support to parents and caregivers through connection, resources, and visibility.
Local LGBTQ+ organizations and clinics are also doing important work in helping transgender individuals.
The bottom line
As society becomes more aware of gender-diverse people, it’s important to acknowledge and be respectful of transgender identities. Part of this process is understanding what it means to be transgender.
Some transgender people choose to transition. This can include social, medical, and legal transitioning. But transitioning isn’t required to be transgender. Neither is gender dysphoria. And everyone’s goals of expressing their transgender identity is different.
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References
Almazan, A., et al. (2021). Association between gender-affirming surgeries and mental health outcomes. JAMA Surgery.
GLAAD. (n.d.). GLAAD media reference guide.
Green, A., et al. (2021). Association of gender-affirming hormone therapy with depression, thoughts of suicide, and attempted suicide among transgender and nonbinary youth. Journal of Adolescent Health.
Lambda Legal. (n.d.). FAQ about identity documents.
National Center for Transgender Equality. (2016). Frequently asked questions about transgender people.
Russell, S., et al. (2016). Mental health in lesbian, gay, bisexual, and transgender (LGBT) Youth. Annual review of clinical psychology.
TransHub. (n.d.). Passing.
U.K. Government. (2022). Gender Recognition Act 2004.
University of California, San Francisco. (2016). Overview of gender-affirming treatments and procedures.
The Williams Institute. (2016). How many adults identify as transgender in the United States?
