Transgender pride flag

Transgender is a term broadly used to describe people whose gender identity or internal sense of gender does not match the sex they were assigned at birth. Some transgender people elect to transition with surgery and/or hormones in order to match their bodies more closely to their gender, but many do not. A transgender person who does not take hormones or have surgery is still a transgender person. There is no “right” way to be trans, and a person who is female-bodied can still identify as male, and vice versa.

Approximately 700,000 transgender people live in the United States.

Gender Identity

A person who is transgender identifies with a gender that does not align with the gender assigned at birth, having instead a personal knowledge of being a woman, man, or someone who exists outside the gender binary. A transgender person may identify with a different gender, or no gender, from an early age, and know their physical body does not match their gender identity.

Transgender is an umbrella term, and while some transgender people may choose to use the term transgender or trans when describing themselves (the term transsexual is still in use by some, but the term has largely fallen out of favor over the decades since it was introduced by the medical community in the 1950s), others do not. Some individuals whose assigned sex at birth does not match their internal sense of gender identity may not identify with the term transgender at all. It is generally best to wait until a person shares their identity and their correct pronouns, rather than make an assumption about a person’s gender.

People who identify as genderqueer, gender nonconforming, or agender may eschew gender altogether, believing that gender boundaries are restrictive, oppressive, or antiquated notions. Their sense of gender identity may fall well outside of categorical norms, or they may identify somewhere between male and femaleand woman. An agender person may or may not identify as transgender, and the terms genderqueer and gender non-conforming are not synonymous with transgender.

Most people in the world experience a gender identity that aligns with gender assigned at birth, and transgender advocates sometimes use the term “cisgender” to refer to people who are not transgender. The term was coined in the 1990s to draw attention to the privilege cisgender people experience as a result of feeling comfortable in their own bodies. The cis- prefix comes from the Latin “on this side of,” which is the opposite of trans, “on the other side of.” The term may also help undermine some of the stigma associated with being a transgender person, as it attempts to eliminate phrasing such as “non-transgender” or “transgender people and normal people,” both of which implicate transgender people as abnormal. Use of the term cisgender emphasizes the fact that every person has a gender identity, whether it matches the sex they were assigned at birth or not.

Coming Out as Transgender

As with revealing one’s sexual orientation, coming out as transgender is a process that can only be done on one’s own time. Some may choose to share their gender identity before they begin a transition process. Others may start to make changes before they announce a differing gender identity, which can mean that their physical appearance will alter before others know they have begun transitioning. In this case, it is common for people to question or make assumptions about one’s identity or intentions for transitioning. Such speculation is not only invasive; it also has the potential to be hurtful and damaging to someone who is transgender. “People should be in charge of their own coming-out journeys and public profiles,” says Sharon Glassburn, MA, MFT. “In a way, bringing further attention [to the coming out process] even indirectly seems like it has the potential to disrespect someone who has not opted to come out and is in no way responsible to the public to do so.”

Ultimately, one’s coming out is a very personal process; it is not an individual’s responsibility to come out in order to put others’ minds at ease, to answer questions, or address speculation.

In instances where the media are involved in drawing attention to one’s changing appearance or identity, discretion is even more imperative. For example, when media outlets picked up on changes in the appearance of celebrity Caitlyn Jenner (who was still using her birth name, Bruce, at the time) in the 2010s, they immediately began to circulate speculations and assumptions about Jenner’s transition from male to female. From a mental health standpoint, this media craze can make the coming-out process very complicated and unusually difficult. Damon Constantinides, PhD, LCSW says, “The media’s attention to and portrayal of Jenner’s gender identity is an example of the way that transphobia is a part of the fabric of our daily lives. The fact that this story is a story at all speaks to the ways in which transgender people are objectified.”

Glassburn agrees that the media contribute to damaging ideas about gender identity and expectations that such revelations should occur in the public eye. “As consumers of media we feel entitled—and are even invited!—to comment about people we don’t know,” Glassburn says. “We think we need labels; we think we need answers. I can’t imagine the degree of anxiety this external pressure could place on an individual. I think this unraveling story should be an experiment in noticing our own questions and discomforts, sitting on our hands, and allowing ambiguity to exist.”

Ultimately, one’s coming out is a very personal experience; it is not an individual’s responsibility to come out in order to put others’ minds at ease, to answer questions, or address speculation. Constantinides concludes, “Gender identity is the very personal understanding that we each have of our masculinity or femininity. No one’s gender exists to titillate, confuse, or entertain anyone else.”

Misconceptions about Sexuality

Transgender is not a sexual orientation, and transgender people may identify with the same continuum of sexual orientations that non-transgender people do. In other words, a transgender person may identify as straight, gay, lesbian, bisexual, or another orientation. For example, a transgender man who is solely attracted to men would likely identify as a gay man.

Transgender People and Mental Health

transgender suicide statisticA person’s gender identity may or may not be a source of personal distress, but the stigmatization and discrimination that many transgender people experience is likely to be a significant source of distress for many. Workplace discrimination affects 90% of transgender people, and transgender people are still not allowed to serve openly in the United States military. More than 50% report being harassed in a public place, such as a hotel, bus, or airport. A disproportionately high number of transgender women are victims of hate crimes and physical violence; in 2013, transgender women made up 72% of LGBT homicide victims.

Receiving competent medical care can be an ongoing challenge for a transgender person, and 50% of respondents in a 2011 survey reported needing to educate medical providers about transgender health care. Many insurance providers regard transgender care, such as hormone replacement therapy and gender confirmation surgery (also called sex reassignment surgery), to be “cosmetic,” and the language in their insurance plans frequently excludes or restricts transgender people from receiving medically necessary care.

Damon Constantinides, PhD, LCSW says gender variance “does not demonstrate mental illness; however, the experience of living in a transphobic culture can be scary, lonely, and challenging.” The rampant discrimination and social rejection that many transgender people face can lead to poor mental health outcomes, such as low self-esteem, depression, shame, and anxiety. The 2011 National Transgender Discrimination Survey revealed that negative life experiences, such as harassment, led 41% of survey respondents to attempt suicide at some point in their lives. This number is more than 25 times the national average.

Gender Dysphoria in the DSM

The American Psychiatric Association (APA) lists “gender dysphoria” in its Diagnostic and Statistical Manual (DSM) to account for the “clinically significant distress” a person may experience as a result of a gender identity that does not match the sex assigned at birth. Many people objected to the APA’s inclusion of gender dysphoria in the manual, but the DSM points out that identifying as transgender is not indicative of a mental disorder. Instead, the listing in the DSM acknowledges the fact that many people may feel distressed or impaired by the experience, and its inclusion in the book is meant to ensure that transgender people face fewer barriers to medical and mental health treatment than they might if the listing were not included.

For many transgender people, hormonal and surgical procedures may bring their external, physical selves into alignment with their internal gender identity. Not all transgender people elect to or can afford to undergo medical treatment, though. When transgender people do pursue gender reassignment surgery, they are typically required to undergo psychological treatment prior to and during their transition.

Transgender Pronouns and Terminology

As transgender identities continue to gain acceptance in our culture, it is important to be aware of the assumptions we make about how others identify. Transgender or gender non-conforming people may accept traditionally male/female pronouns (he/him, she/her), or they may use plural pronouns (they/them) or another gender-neutral set of pronouns, such as xe/xer. Transgender activists and allies encourage people not to assign gender expectations or pronouns to someone based on their physical appearance or presentation. Instead, they suggest, try to use gender-neutral language as much as possible until an individual makes their gender identity and pronouns known.

Becoming an Ally

The first step a person might take in becoming an ally to transgender people and helping to prevent transphobic behavior is to always use someone’s correct pronouns and name, once privy to that information.

It is generally best to avoid questions that could be considered invasive or rude, as well as suggestions that critique a person’s appearance and ability to pass. 

Although some trans people might not mind talking about their transition, especially with family or close friends, it is generally best to avoid questions that could be considered invasive or rude, as well as suggestions that critique a person’s appearance and ability to pass. A trans person may not enjoy serving as an educator or repeating the same details again and again.

Outing a person as trans can be dangerous and should not be done without that person’s permission. Similarly, referring to a person as the wrong gender might also endanger that person in certain situations. It is also intolerant and disrespectful, as is describing a time before that person came out as trans. If one should misgender another individual, it may be best to simply correct the mistake and move on, as over-apologizing may draw attention to the person’s identify, which can be harmful, unsafe, and distressing for that person.

People may also wish to challenge themselves to avoid assessing gender, especially in an obvious manner, when meeting others. In most situations, it is not necessary to identify another person’s gender, and in those situations where it is necessary, asking politely and privately is a respectful way to do so.

Transgender Issues in News and Pop Culture

The 21st century has brought transgender characters and issues into the spotlight in a variety of ways, including in fiction and television as well as in real-life examples of progressive acceptance of trans people and culture. For instance, while early versions of the the Employment Non-Discrimination Act (ENDA) did not have provisions in place to protect transgender people from discrimination, a bill introduced in 2007 amended the ENDA to include protection against discrimination related to gender identity. This bill passed in the United States Senate in 2013; it awaits a vote in the House of Representatives.

Notable figures who have come out as transgender include Chelsea Manning (née Bradley Manning), a soldier in the U.S. Army who released a statement in 2013 stating she would be transitioning and beginning hormone therapy. Celebrity parents Angelina Jolie and Brad Pitt have told the media that one of their children has expressed a wish to be called John. Though John has not come out as transgender, Pitt and Jolie have expressed their support of John’s wishes—a controversial move to some who say children are too young to state a gender identity that differs from the sex they were born with.

While most transgender characters in movies and on television are still portrayed by cisgender actors, this is beginning to change, and transgender representation seems to be growing overall. Movies like Dallas Buyers Club and Boys Don’t Cry feature transgender characters—male-to-female and female-to-male, respectively. TV shows like GleeTransparent, and The L Word have all featured characters in various stages of their transitions, and Orange Is the New Black has gained recognition for featuring transgender actress Laverne Cox in the role of a transgender woman.

In March 2015, transgender teen Jazz Jennings announced that she would be one of the new faces of Clean & Clear’s new ad campaign, “See The Real Me.” A reality show about her life is also forthcoming.


  1. Allyship: First Steps. (n.d.). Retrieved from
  2. Gender Dysphoria. (2013). American Psychiatric Association. Retrieved from
  3. GLAAD Media Reference Guide – Transgender Glossary Of Terms. (n.d.). GLAAD (Gay & Lesbian Alliance Against Defamation). Retrieved from
  4. Grant, Jaime M.; Mottet, Lisa A.; and Tanis, Justin. (2011). Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Retrieved from
  5. Lancaster, R. N., & Di, L. M. (1997). The gender/sexuality reader: Culture, history, political economy. New York: Routledge.
  6. Manning, Chelsea (2013). Chelsea Manning announces gender transition – full statement. Retrieved from
  7. Nuttbrock, L., Bockting, W., Rosenblum, A., Hwahng, S., Mason, M., Macri, M., & Becker, J. (2014). Gender abuse and major depression among transgender women: A prospective study of vulnerability and resilience. American Journal of Public Health, 104(11), 2191-8. Retrieved from
  8. Rep. Polis, Jared (2013). H.R.1755 – Employment Non-Discrimination Act of 2013. Retrieved from
  9. Trans 101: Cisgender. (2011, October 9). Retrieved from

Last Updated: 11-1-2017

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