Atransgender (often shortened totrans) person has agender identity different from that typically associated with thesex they wereassigned at birth.[2] The opposite oftransgender iscisgender, which describes persons whose gender identity matches their assigned sex.[3]
Being transgender is distinct fromsexual orientation, and transgender people may identify asheterosexual (straight),homosexual (gay or lesbian),bisexual,asexual, or otherwise, or maydecline to label their sexual orientation.[10] Accurate statistics on the number of transgender people vary widely,[11] in part due to different definitions of what constitutes being transgender.[6] Some countries collectcensus data on transgender people, starting withCanada in 2021.[12][13][14][15] Generally, less than 1% of the worldwide population is transgender, with figures ranging from <0.1% to 0.6%.[16][17]
Before the mid-20th century, various terms were used within and beyond Western medical and psychological sciences to identify persons and identities labeledtranssexual, and latertransgender from mid-century onward.[29] Imported from the German and ultimately modeled after GermanTranssexualismus (coined in 1923),[30] the English termtranssexual has enjoyed international acceptability, thoughtransgender has been increasingly preferred overtranssexual.[31] The wordtransgender acquired its modern umbrella term meaning in the 1990s.[32]
Health-practitioner manuals, professional journalistic style guides, 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.[33][34]
Transgender
Although the termtransgenderism was once considered acceptable, it has come to be viewed aspejorative, according to GLAAD.[35] Psychiatrist John F. Oliven ofColumbia University used the termtransgenderism in his 1965 reference workSexual Hygiene and Pathology, writing that the term which had previously been used,transsexualism, "is misleading; actually,transgenderism is meant, because sexuality is not a major factor in primary transvestism".[4][36] The termtransgender was then popularized with varying definitions by transgender, transsexual, and transvestite people, includingChristine Jorgensen[37] andVirginia Prince,[4] who usedtransgenderal in the December 1969 issue ofTransvestia,[38] a national magazine for cross-dressers she founded.[39] By the mid-1970s bothtrans-gender andtrans people were in use as umbrella terms, whiletransgenderist andtransgenderal were used to refer to people who wanted to live their lives as cross-gendered individuals withoutgender-affirming surgery.[40]Transgenderist was sometimes abbreviated asTG in educational and community resources; this abbreviation developed by the 1980s.[41] In 2020, theInternational Journal of Transgenderism changed its name to theInternational Journal of Transgender Health "to reflect a change toward more appropriate and acceptable use of language in our field."[42]
By 1984, the concept of a "transgender community" had developed, in whichtransgender was used as an umbrella term.[43] In 1985, Richard Ekins established the "Trans-Gender Archive" at theUniversity of Ulster.[39] By 1992, the International Conference on Transgender Law and Employment Policy definedtransgender as an expansive umbrella term including "transsexuals, transgenderists, cross dressers", and anyone transitioning.[44]Leslie Feinberg's pamphlet, "Transgender Liberation: A Movement Whose Time has Come", circulated in 1992, identifiedtransgender as a term to unify all forms ofgender nonconformity; in this waytransgender has become synonymous withqueer.[45] In 1994, gender theoristSusan Stryker definedtransgender 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 Americanberdache or the IndianHijra".[46]
Transgender can also refer specifically to a person whose gender identity isopposite (rather thandifferent from) the sex the person had or was identified as having at birth.[47] 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 calledcisgender.[48]
Inspired byMagnus Hirschfeld's 1923 termseelischer Transsexualismus,[49] the termtranssexual was introduced to English in 1949 byDavid Oliver Cauldwell and popularized byHarry Benjamin in 1966, around the same timetransgender was coined and began to be popularized.[4] Since the 1990s,transsexual has generally been used to refer to the subset of transgender people[4][50][51] 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 termstransgender andtranssexual are commonly based ondistinctions between gender and sex.[52][53] 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.[54] Many transgender people reject the termtranssexual.[5][55][56]Christine Jorgensen publicly rejectedtranssexual in 1979 and instead identified herself in newsprint astrans-gender, saying, "gender doesn't have to do with bed partners, it has to do with identity."[57][58] Some have objected to the termtranssexual on the basis that it describes a condition related to gender identity rather thansexuality.[59][better source needed] Some people who identify as transsexual people object to being included in thetransgender umbrella.[60][61][62]
In his 2007 bookImagining Transgender: An Ethnography of a Category, anthropologist David Valentine asserts thattransgender 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 termtransgender should not be included in the transgender spectrum.[60] Leslie Feinberg likewise asserts thattransgender is not a self-identifier (for some people) but a category imposed by observers to understand other people.[61] According to the Transgender Health Program (THP) atFenway Health 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 have since been deemed offensive. The THP recommends that clinicians ask clients what terminology they prefer, and avoid the termtranssexual unless they are sure that a client is comfortable with it.[59][undue weight? –discuss]
Harry Benjamin invented a classification system for transsexuals and transvestites, called theSex Orientation Scale (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.[63] Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions.[64] 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.[65]
Other terms
Transfeminine 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.[66]Transmasculine refers to a person, binary or non-binary, who was assigned female at birth who has a predominantly masculine gender identity or presentation.[66]
Transgendered is a common term in older literature. Many within the transgender community deprecate it on the basis thattransgender is an adjective, not a verb.[67] Organizations such asGLAAD andThe Guardian also state thattransgender should never be used as a noun in English (e.g., "Max istransgender" or "Max is atransgender man", not "Max isa transgender").[68][69] "Transgender" is also a noun for the broader topic of transgender identity and experience.[70]
Assigned Female At Birth (AFAB),Assigned Male At Birth (AMAB),Designated Female At Birth (DFAB), andDesignated Male At Birth (DMAB) are terms used to represent a person's sex assigned at birth; they are considered to be more gender-inclusive than the related termsbiological male orbiological female.[71]
The termtrans* (with anasterisk) emerged in the 1990s as aninclusive term used to encompass a wide range of non-cisgender identities. The asterisk represents awildcard, indicating the inclusion of various identities, beyond just transgender and transsexual, such asgender-fluid oragender, within the transgender umbrella. The use of the asterisk in "trans*" has been debated; some argue that it adds unnecessary complexity, while others say that it enhances inclusivity by explicitly recognizing non-normative gender identities.[72][73]
Shift in use of terms
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 been superseded by "trans man" and "trans woman", 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.[74]
Gender, gender identity, and being transgender are distinct concepts from sexual orientation.[80] Sexual orientation is an individual's enduring pattern of attraction, or lack thereof, to others (beingstraight,lesbian,gay,bisexual,asexual, etc.), whereas gender identity is a person's innate knowledge of their own gender (being a man, woman, non-binary, 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 lesbians, and trans men exclusively attracted to women would identify as straight.[81] Many trans people describe their sexual orientation asqueer, in addition to or instead of, other terms.[82][83][74]
For much of the 20th century, transgender identity was conflated withhomosexuality andtransvestism.[84][85] In earlier academic literature, sexologists used the labelshomosexual andheterosexual transsexual to categorize transgender individuals' sexual orientation based on their birth sex.[86] Critics consider these terms "heterosexist",[87] "archaic",[88] and demeaning.[89] Newer literature often uses terms such asattracted to men (androphilic),attracted to women (gynephilic),attracted to both (bisexual), orattracted to neither (asexual) to describe a person's sexual orientation without reference to their gender identity.[90] Therapists are coming to understand the necessity of using terms with respect to their clients' gender identities and preferences.[91]
The 2015U.S. Transgender Survey reported that of the 27,715 transgender and non-binary respondents, 21% saidqueer best described their sexual orientation, 18% saidpansexual, 16% saidgay,lesbian, orsame-gender-loving, 15% saidstraight, 14% saidbisexual, and 10% saidasexual.[83] 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% astwo-spirit, and 9% as unsure orquestioning.[74] A 2009 study in Spain found that 90% of trans women patients reported being androphilic and 94% of trans men patients reported being gynephilic.[92]
Some non-binary (or genderqueer) people identify as transgender. These identities are not specifically male or female. They can beagender, androgynous, bigender, pangender, or genderfluid,[93] and exist outside ofcisnormativity.[94][95] 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).[96] Non-binary gender identities are independent of sexual orientation.[97][98]
A transvestite is a person who cross-dresses, or dresses in clothes typically associated with the gender opposite the one they were assigned at birth.[99][100] The termtransvestite is used as a synonym for the termcross-dresser,[101][102] althoughcross-dresser is generally considered the preferred term.[102][103] The termcross-dresser is not exactly defined in the relevant literature. Michael A. Gilbert, professor at the Department of Philosophy, York University, Toronto, offers this definition: "[A cross-dresser] is a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to [that] sex, but who wears the clothing of the opposite sex because it is that of the opposite sex."[104] This definition excludes people "who wear opposite sex clothing for other reasons", such as "thosefemale impersonators 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."[105] 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.[106]
The termtransvestite and the associated outdated termtransvestism are conceptually different from the termtransvestic fetishism, astransvestic fetishist refers to those who intermittently use clothing of the opposite gender for fetishistic purposes.[107][108] In medical terms,transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3 in theDiagnostic and Statistical Manual of Mental Disorders (DSM)[108] and F65.1 in theICD.[107][needs update]
Adrag queen performer. Drag performers are not inherently transgender.
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.[109] 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 bysecond-wave feminism. Drag artists have a long tradition inLGBTQ culture.
Generally the termdrag queen covers men doing female drag,drag king covers women doing male drag, andfaux queen covers women doing female drag.[110][111] 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 termtranny for drag queens or people who engage in transvestism or cross-dressing; this term is widely considered an offensiveslur if applied to transgender people.
A precise history of the global occurrence of transgender people is difficult to assess because the modern concept of being transgender, and of gender in general in relation to transgender identity, did not develop until the mid-1900s. Historical depictions, records and understandings are inherently filtered through modern principles, and were largely viewed through a medical and (often outsider) anthropological lens until the late 1900s.[112][113]
Worldwide, a number of societies have had traditionalthird gender roles, some of which continue in some form into the present day.[119] TheHippocratic Corpus (interpreting the writing ofHerodotus) describes the "disease of theScythians" (regarding theEnaree), which it attributes to impotency due to riding on a horse without stirrups. This reference was well discussed by medical writings of the 1500s–1700s.Pierre Petit 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 trans women and trans men were cited in European insane asylums of the early 1800s. One of the earliest recorded gender nonconforming people in America wasThomas(ine) Hall, a seventeenth century colonial servant.[120] The most complete account of the time came from the life of theChevalier d'Éon (1728–1810), a French diplomat. 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 1800s, cross-dressing and being transgender became viewed as an increasing societal danger.[112]
William A. Hammond wrote an 1882 account of transgenderPueblo "shamans" [sic] (mujerados), comparing them to the Scythian disease. Other writers of the late 1700s and 1800s (including Hammond's associates in theAmerican Neurological Association) 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.[112]
Critical studies first began to emerge in the late 1800s in Germany, with the works of Magnus Hirschfeld. Hirschfeld coined the term "Transvestit" in 1910, borrowed from 19th-century French wordtravesti with the same meaning,[121] as the scope of transgender study grew, and it was translated to English as "transvestite". His work would lead to the 1919 founding of theInstitut für Sexualwissenschaft 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.[122] Transgender issues went largely out of the public eye until after World War II. Even when they re-emerged, they reflected aforensic psychology approach, unlike the moresexological that had been employed in the lost German research.[112][123]
1879 photograph ofEdward de Lacy Evans, upon his admittance into Kew Lunatic Asylum. Evans identified as a man for the majority of his life, later becoming known in Melbourne as the "Wonderful Male Impersonator".[124]
Mental healthcare
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. While individuals may find counseling or psychotherapy helpful, it is no longer recommended as a prerequisite for further transition steps.[125] Research on gender identity with regard to psychology, and scientific understanding of the phenomenon and its related issues, is relatively new.[126][needs update?] The termgender incongruence is listed in the ICD by theWHO. In the American (DSM), the termgender dysphoria is listed under code F64.0 foradolescents and adults, and F64.2 forchildren.[127](Further information:Causes of gender incongruence.)
France removed gender identity disorder as a diagnosis by decree in 2010,[128][129] but according to French trans rights organizations, beyond the impact of the announcement itself, nothing changed.[130] In 2017, the Danish parliament abolished the F64 Gender identity disorders. TheDSM-5 refers to the topic asgender dysphoria (GD) while reinforcing the idea that being transgender is not considered a mental illness.[131]
Transgender people may meet the criteria for a diagnosis of gender dysphoria "only if [being transgender] causes distress or disability."[132] 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 behaviours 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.[126]
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.[133] Many mental healthcare providers know little about transgender issues. Those who seek help from these professionals often educate the professional without receiving help.[126] 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.[134]
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.[135] Therapy was not always sought by transgender people due to mental health needs. Prior to the seventh version of theStandards 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.[136]
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 experiencingtransphobia 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!"[135] 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.[135] Rarely, some choose todetransition.[137]
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 therapists – Master's degree, PhD level – they'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."[135] 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.[135] 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.[138] In May 2009, France became the first country in the world to remove transgender identity from the list of mental diseases.[139][140]
A 2014 study carried out by theWilliams Institute (aUCLA 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.[141] A 2019 follow-up study found that transgender people who wanted and received gender-affirming medical care had significantly lower rates of suicidal thoughts and attempts.[142] Another study on the impact of parental support on trans youth found that among trans children with supportive parents, only 4% attempted suicide, a 93% decrease.[143]
Suicidal thoughts and attempts by gender affirmation milestones[142]
Intervention Category
Suicidal Thoughts (Past 12 Months)
Suicidal Attempts (Past 12 Months)
Lifetime Suicidal Thoughts
Lifetime Suicidal Attempts
Want hormones and have not had them
57.9
8.9
84.4
41.1
Want hormones and have had them
42.9
6.5
81.9
42.4
Want reassignment surgery, have not had
54.8
8.5
83.9
41.5
Want reassignment surgery, have had
38.2
5.1
79.0
39.5
Have not "de-transitioned"
44.2
6.7
81.6
41.8
Have "de-transitioned"
57.3
11.8
86.0
52.5
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.[144][better source needed]
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.Hormone replacement therapy for trans men induces beard growth and masculinizes skin, hair, voice, and fat distribution.Hormone replacement therapy for trans women feminizes fat distribution and breasts, as well as diminishes muscle mass and strength.Laser hair removal orelectrolysis removes excess hair for trans women. Surgical procedures for trans women feminize thevoice,skin,face,Adam's apple,breasts,waist,buttocks, andgenitals. Surgical procedures for trans men masculinize thechest andgenitals and remove thewomb,ovaries, and fallopian tubes. The acronyms "Gender-affirming surgery (GAS)" 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 transition. Use of the term "sex change" has been criticized for its emphasis on surgery, and the term "transition" is preferred.[145][146] Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder,[147] and standards of care in the relevant jurisdiction.
Health risks among transgender people largely align with those of cisgender people with the same hormonal makeup, and the same routine cancer screenings are generally recommended as for cisgender people with the same organs.[148] It has been suggested that trans men who have not had a hysterectomy and who take testosterone may be at increased risk forendometrial cancer due to the presence of external estrogen, but this theoretical risk has not been proven in a clinical setting, and providers do not recommend any additional preventive measures or routine screening.[149]
Detransition refers to the cessation or reversal of a sex reassignment surgery or gender transition. Formal studies of detransition have been few in number,[150] of disputed quality,[151] and politically controversial.[152] Estimates of the rate at which detransitioning occurs vary from less than 1% to as high as 13%.[153] Those who undergo sex reassignment surgery have very low rates of detransition or regret.[137][154][155][156]
The 2015 U.S. Transgender Survey, with responses from 27,715 individuals who identified as "transgender, trans, genderqueer, [or] non-binary", found that 8% of respondents reported some kind of detransition. "Most of those who de-transitioned did so only temporarily: 62% of those who had de-transitioned reported that they were currently living full time in a gender different than the gender they were thought to be at birth."[83] Detransition was associated with assigned male sex at birth, nonbinary gender identity, and bisexual orientation, among other cohorts.[155] Only 5% of detransitioners (or 0.4% of total respondents) reported doing so because gender transition was "not for them"; 82% cited external reason(s), including pressure from others, the difficulties of transition, and discrimination. "The most common reason cited for de-transitioning was pressure from a parent (36%)."[157][158][83]
Camille Cabral, a French transgender activist at a demonstration for transgender people in Paris, October 1, 2005
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 oftranssexualism, 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.[159] In 1994, the DSM IV entry was changed from "Transsexual" to "Gender Identity Disorder". In 2013, the DSM V removed "Gender Identity Disorder" and published "Gender Dysphoria" in its place.[160] In many places, transgender people are not legally protected from discrimination in the workplace or in public accommodations.[25][page needed] A report released in February 2011 found that 90% of transgender Americans 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.[23] Members of the transgender community also encounter high levels of discrimination in health care.[161]
As of 2017[update], 36 countries in Europe require a mental health diagnosis for legal gender recognition and 20 countries require sterilisation.[162] In April 2017, the European Court of Human Rights ruled that requiring sterilisation for legal gender recognition violates human rights.[163]
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,Bill C-16, having passed the legislative process in theHouse of Commons of Canada and theSenate of Canada, became law upon receivingRoyal Assent, which put it into immediate force.[164][165] The law updated theCanadian Human Rights Act and theCriminal Code to include "gender identity and gender expression" as protected grounds from discrimination, hate publications and advocatingtransgender 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.[166]
In the United States, transgender people are protected from employment discrimination by Title VII of theCivil Rights Act of 1964. Exceptions apply to certain types of employers, for example, employers with fewer than 15 employees and religious organizations.[167] In 2020, the U.S. Supreme Court affirmed that Title VII prohibits discrimination against transgender people in the caseR.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission.[168]
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,[169] but Maines won her lawsuit against the Orono school district in January 2014 before the Maine Supreme Judicial Court.[170] On May 14, 2016, theUnited States Department of Education andDepartment of Justice issued guidance directing public schools to allow transgender students to use bathrooms that match their gender identities.[171]
On June 30, 2016, theUnited States Department of Defense removed the ban that prohibited transgender people from openly serving in the US military.[172] On July 27, 2017, PresidentDonald Trump tweeted that transgender Americans would not be allowed to serve "in any capacity" in theUnited States Armed Forces.[173] Later that day, Joint Chiefs of Staff ChairmanJoseph Dunford announced, "there will be no modifications to the current policy until the president's direction has been received by theSecretary of Defense and the secretary has issued implementation guidance."[174]Joe Biden later reversed Trump's policy when he became president in 2021.[175][176]
While the topic of trans rights in the United States has often been contentious, it has become a deeply partisanwedge issue in recent years;[177] many pieces of legislation have been passed, and more proposed, that seek to limit the rights of transgender individuals, especially minors.[178]
In April 2014, theSupreme Court of India declared transgender to be a 'third gender' in Indian law.[179][180][181] The transgender community in India (made up ofHijras and others) has a long history in India and inHindu mythology.[182][183] JusticeKS 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".[184] Hijras have faced 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.[185]
Despite the distinction between sexual orientation and gender, throughout history gay, lesbian and bisexual subcultures were often the only places where gender-variant people were socially acceptedin thegender role they felt they belonged to[clarify]; especially during the time when legal or medical transitioning was almost impossible. This acceptance has had a complex history. Like the wider world, thegay community in Western societies did not generally distinguish between sex and gender identity until the 1970s, and the role of the transgender community in the history of LGBT rights is often overlooked.[186][failed verification]
Transgender individuals have been part of various LGBTQ movements throughout history, with significant contributions dating back to the early days of thegay liberation movement.[187]
The LGBTQ community is not a monolithic group, and there are different modes of thought on who is a part of this diverse community. The changes that came with the Gay Liberation Movement andCivil Rights movement saw many gay, lesbian, and bisexual people making headway within the public sphere, and gaining support from the wider public, throughout the latter half of the twentieth century. The trans community only experienced a similar surge in activism during the start of the twenty-first century.[187] Due to the many different groups that make up the broader LGBTQ movement, there are those within the larger community who do not believe that the trans community has a place within the LGBTQ space.[188]
Feminist views on transgender women have changed over time, but have generally become more positive. Second-wave feminism saw numerous clashes opposed to transgender women, since they were not seen as "true" women, and as invading women-only spaces.[189][190] Though second-wave feminism argued for the sex and gender distinction, 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.[191] By the emergence ofthird-wave feminism (around 1990), opinions had shifted to being more inclusive of both trans and gay identities.[192][193]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.[194][192][195] Feminists who do not accept that trans women are women have been labeled "trans-exclusionary radical feminists" (TERFs) or gender-critical feminists by opponents.[196][197]
Transgender individuals experience significant rates of employment discrimination. According to a 2011 aggregation of several studies, approximately 90% of transgender Americans had encountered some form of harassment or mistreatment in their workplace. 47% had 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.[198]
Studies in several cultures have found that cisgender women are more likely to be accepting of trans people than cisgender men.[199][200][201][202]
The start of the twenty-first century saw the rise in transgender activism and with it an increase in support.[187] Within the United States, groups such as theTrevor Project have been serving the wider LGBT community including people who identify with the term transgender. The group offers support in the form of educational resources including research, advocacy, and crisis services.[203][204]The American Civil Liberties Unions (ACLU) also often represents members of the trans community.[205][206]
Other groups within the United States specifically advocate for transgender rights. One of these groups directly related to transgender support is the National Center for Transgender Equality (NCTE), which is committed to advocating for policy changes that protect transgender people and promote equality. Through their research, education, and advocacy efforts, the NCTE works to address issues such as healthcare access, employment discrimination, and legal recognition for transgender individuals.[207][208] One prominent organization within Europe is Transgender Europe (TGEU), a network of organizations and individuals committed to promoting equality and human rights for transgender people within European borders. TGEU works to challenge discrimination, improve transgender healthcare access, advocate for legal recognition of gender identity, and support the well-being of transgender communities.[209][210]
Little is known about the prevalence of transgender people in the general population and reported prevalence estimates are greatly affected by variabledefinitions of transgender.[211] According to a recent systematic review, an estimated 9.2 out of every 100,000 people have received or requested 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.[211] 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.[211] Common terminology across studies does not yet exist, so population numbers may be inconsistent, depending on how they are being counted.
A study in 2020 found 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 equal the number of trans women seeking this treatment.[212]
The cultures of the Indian subcontinent include a third gender, referred to ashijra in Hindi. In India, theSupreme 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."[230] In 1998,Shabnam Mausi became the first transgender person to be elected in India, in the central Indian state ofMadhya Pradesh.[231]
Europe
According toAmnesty International, 1.5 million transgender people lived in theEuropean Union as of 2017[update], making up 0.3% of the population.[16] A 2011 survey conducted by theEquality 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).[232]
North America
The 2021 Canadian census released byStatistics Canada found that 59,460 Canadians (0.19% of the population) identified as transgender.[13] According to theSurvey 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.[233]
In theUnited States, over 1.6 million persons (ages 13 and up) identify as transgender, or 0.6 percent of people ages 13+, as of 2022[update].[234][235]: 1 It's the case for 0.5% of adults (about 1.3 million persons) and 1.4% of youth (about 300,000 persons aged 13 to 17).[234][235]: 1 Among adults, 38.5% (515,200) aretransgender women, 35.9% (480,000)transgender men, and 25.6% (341,800)gender nonconforming.[235]: 1 TheSocial Security Administration has tracked the sex of US citizens since 1936.[236] A 1968 estimate, 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.[237] One effort to quantify the modern population in 2011 gave a "rough estimate" that 0.3% of adults in the US are transgender.[238][239] In 2016, studies estimated the proportion of Americans who identify as transgender at 0.5 to 0.6%.[240][241][242][243]
In the United States and Canada, someNative American andFirst Nations cultures traditionally recognize the existence of more than two genders,[244] such as theZuni male-bodiedlhamana,[245] theLakota male-bodiedwinkte,[246] and theMohave male-bodiedalyhaa and female-bodiedhwamee.[247] These traditional people, along with those from otherNorth American Indigenous cultures, are sometimes part of the contemporary,pan-Indiantwo-spirit community.[246] Historically, in most cultures who have alternate gender roles, if the spouse of a third gender person is not otherwisegender variant, they have not generally been regarded as other-gendered themselves, simply for being in a same-sex relationship.[247] In Mexico, theZapotec culture includes a third gender in the form of theMuxe.[248]Mahu is a traditional third gender in Hawai'i and Tahiti. Mahu are valued as teachers, caretakers of culture, and healers, such asKapaemahu. Diné (Navajo) haveNádleehi.[119]
Latin America
In Latin American cultures, atravesti 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.[249]
Other transgender identities are becoming more widely known, as a result of contact with other cultures of the Western world.[250] These newer identities, sometimes known under the umbrella use of the term "genderqueer",[250] along with the oldertravesti term, are known as non-binary and go along with binary transgender identities (those traditionally diagnosed under the obsolete label of "transsexualism") under the single umbrella oftransgender, 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.[251]
Oceania
On the2023 New Zealand Census, 26,097 people self-identified as transgender, defined byStats NZ as someone whose gender identity does not match their sex recorded at birth. This is 0.7 percent of all census-takers who were 15 years of age and older and usually residents of the country.[252]
Coming out is the process of sharing one's identity with others, and can include sharing new pronouns and a new name.[253] Individuals who have come out are known asout.[254] The experience of coming out can change depending on whether the transgender individual is perceived as the gender with which they identify, which is known aspassing.[253] In certain environments, some passing transgender individuals can choose to bestealth, which means to deliberately avoid coming out, often to avoid transphobia; these individuals are often out in other environments.[253] The decision for transgender people to come out to current or potential romantic or sexual partners can be especially difficult.[253]
The decision to come out is based on navigating others' gender expectations, reactions, and the threat of violence. Coming out is not a 'one-and-done' decision; rather, individuals make ongoing strategic decisions about their gender enactment and identity disclosure based on social contexts.[255]
The age at which transgender people come out can vary; some transgender individuals will know about and share their identities at a young age, while for others, the process is longer or more complicated.[256] Different transgender individuals choose to come out at different times during thetransition process and to different people.[253] Some transgender individuals will choose to come out as bisexual, lesbian, or gay before recognizing their gender identity or choosing to come out as transgender.[256] Although there are some similarities, coming out as transgender is different than coming out as a sexual minority, such as lesbian, gay, or bisexual.[253] This is partly due to the relatively lower level of information that people have about transgender people compared to people who are sexual minorities.[253] Some come out in anonline identity first, providing an opportunity to go through experiences virtually and safely before risking social implications in the real world.[257]
It may take time for people to understand and respond when a transgender person comes out.[253] Most transgender people feel healthier and happier when they come out and their gender identity is validated by others.[253]
Some transgender people choose not to come out at all.[253] For some, this decision can be because of stigma, lack of knowledge (by whom?) or fear of rejection by friends and family.[256] Upon coming out, transgender people can face discrimination, rejection, and violence.[253] These risks are heightened when transgender individuals are members of othermarginalized communities.[253]
ActressLaverne Cox, who is trans, in July 2014Trans March "Existrans" 2017
In 2014, the United States reached a "transgender tipping point", according toTime.[258][259] 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.[260]
Annual marches, protests or gatherings take place around the world for transgender issues, often taking place during the time of localPride parades for LGBT people. These events are frequently organised by trans communities to build community, addresshuman rights struggles, and create visibility.[261][262][263][264]International Transgender Day of Visibility is an annual holiday occurring on March 31[27][265] dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide. The holiday was founded by Michigan-based transgender activist[266]Rachel Crandall Crocker in 2009.[267]
Transgender Day of Remembrance (TDOR) is held every year on November 20 in honor of Rita Hester, who was killed on November 28, 1998. Her murder remains unsolved, but was described in 2022 as "a result of transphobia and anti-trans violence" by the Office of theMayor of Boston,Michelle Wu.[26] TDOR memorializes victims of hate crimes and prejudice and raises awareness of hate crimes committed upon living transgender people.[268]Transgender Awareness Week is a one-week celebration leading up to TDOR, dedicated to educating about transgender and gender non-conforming people and the issues associated with their transition or identity.[269] Severaltrans marches occur in cities around the world, including Paris, San Francisco, and Toronto, in order to raise awareness of the transgender community.[270][271]
A common symbol for the transgender community is theTransgender Pride Flag, which was designed by the American transgender woman Monica Helms in 1999, and was first shown at a pride parade inPhoenix, Arizona, in 2000. The flag consists of five horizontal stripes: light blue, pink, white, pink, and light blue.[28] Other transgender symbols include the butterfly (symbolizing transformation or metamorphosis)[274] and a pink/light blueyin and yang symbol.[275] Severalgender symbols have been used to represent transgender people, including ⚥ and⚧.[276][277]
^abcdeBevan 2014. "The termtranssexual was introduced by Cauldwell (1949) and popularized by Harry Benjamin (1966) [...]. The termtransgender was coined by John Oliven (1965) and popularized by various transgender people who pioneered the concept and practice of transgenderism. It is sometimes said that Virginia Prince (1976) popularized the term, but history shows that many transgender people advocated the use of this term much more than Prince." ReferencingOliven 1965, p. 514.
^abPolly & Nicole 2011, p. 57. "The use of terminology by transsexual individuals to self-identify varies. As aforementioned, many transsexual individuals prefer the term transgender, or simply trans, as it is more inclusive and carries fewer stigmas. There are some transsexual individuals, however, who reject the term transgender; these individuals view transsexualism as a treatable congenital condition. Following medical and/or surgical transition, they live within the binary as either a man or a woman and may not disclose their transition history."
^abFranklin 2014, p. 740. "Transgender is an umbrella term for people whose gender identities, gender expressions, and/or behaviors are different from those culturally associated with the sex that they were assigned at birth. Transgender encompasses a wide variety of identities including, but not limited to,transsexual,genderqueer,bi-gender,third gender,cross-dresser, anddrag king/queen."
Petersen & Hyde 2010, p. 486. "Transgender is a broad term characterized by a challenge of traditional gender roles and gender identity [...] For example, some cultures classify transgender individuals as a third gender, thereby treating this phenomenon as normative."
Towle & Morgan 2013, p. 666. "The authors note that, increasingly, in social science literature, the termthird gender is being replaced by or conflated with the newer termtransgender."
Reisner et al. 2014, p. 99. "Transgender was defined broadly to cover those who transition from one gender to another as well as those who may not choose to socially, medically, or legally fully transition, includingcross-dressers, people who consider themselves to begenderqueer,androgynous, and those whosegender nonconformity is a part of their identity."
^Lamm & Eckstein 2015, p. 745. "Many transgender people experience gender dysphoria – distress that results from the discordance of biological sex and experienced gender. Treatment for gender dysphoria, considered to be highly effective, includes physical, medical, and/or surgical treatments [...] some [transgender people] may not choose to transition at all."
^APA 2024. "According to the APA Style guide, the termtranssexual is largely outdated, but some people identify with it; this term should be used only for an individual who specifically claims it."
Mills 2015, p. 12. "Indeed, it is arguably only since the 1990s, with the coining of the umbrella termtransgender, that gender variance has come to be understood, in certain activist and institutional settings, as being ontologically different from homosexuality."
Currah 2006, p. 4. "From signifying a subject position between cross-dresser and transsexual, the meaning oftransgender expanded radically in the early 1990s to include them, along with other cross-gender practices and identities."
^Simon 2017. "According to scholars, the word first appeared in print in John F. Oliven's 1965 book,Sexual Hygiene and Pathology. Oliven writes: 'Where the compulsive urge reaches beyond female vestments, and becomes an urge for gender ("sex") change, transvestism becomestranssexualism. The term is misleading; actually,transgenderism is what is meant, because sexuality is not a major factor in primary transvestism.' Although Oliven's understanding oftransgender is not the same as our understanding of it today, his use of it is still significant. As K.J. Rawson and Cristan Williams note in their book,Transgender*: The Rhetorical Landscape of a Term, Oliven didn't use the word in the book's 1955 edition; it was added later, when the second edition was revised and published. Gradually, some members of this marginalized community began to apply the wordtransgender to themselves. For example, Virginia Charles Prince, publisher of the long-running periodicalTransvestia, occasionally used a variation of the word,transgenderal." QuotingOliven 1965, p. 514, and referencingRawson & Williams 2014.
^Prince 1969, p. 65. "I, at least, know the difference between sex and gender and have simply elected to change the latter and not the former. If a word is necessary, I should be termed atransgenderal."
^Ekins & King 1999. "Virginia Prince pioneered the term 'transgenderist' and 'transgenderal' (Prince, 1976: 145) to refer to people who lived full-time in the gender opposite their biological sex, but did not seek sex/gender re-assignment surgery. Richard Ekins established the Trans-Gender Archive, at the University of Ulster, in 1986 (Ekins, 1988). The term was chosen to provide an umbrella concept which avoided such medical categories as transsexual and transvestite; which included the widest possible range of transgender phenomena; and which took the sociological view that aspects of sex, sexuality and gender (not just gender), including the binary divide, all have socially constructed components. Not long afterwards, the 'transgender community' came to be used as an umbrella term to include transsexuals, transvestites, transgenderists, drag queens, and so on, as well as (in some uses) to include their partners and friends and professional service providers."
^ICTLEP 1992. "Transgendered persons include transsexuals, transgenderists, and other crossdressers of both sexes, transitioning in either direction (male to female or female to male), of any sexual orientation, and of all races, creeds, religions, ages, and degrees of physical impediment."
Mallon 1998, pp. 275–276. "Transgender: Is a person whose gender identity is different from her/his biological gender. Many transgender individuals are persons who report feeling trapped in the wrong body. These people psychologically identify themselves with the opposite biological gender and desire to be a person of that gender."
Merriam-Webster n.d. "especially: of, relating to, or being a person whose gender identity is opposite the sex the person had or was identified as having at birth".
Gazzaniga 2018, p. 367. "Atransgender person was born as one biological sex but feels that her true gender identity is that of the other sex."
^For example, Virginia Prince usedtransgender to distinguish cross-dressers from transsexual people ("glbtq > social sciences >> Prince, Virginia Charles". glbtq.com. Archived fromthe original on 11 February 2015.), writing inMen Who Choose to Be Women (inSexology, February 1969) that "I, at least, know the difference between sex and gender and have simply elected to change the latter and not the former."
^"Sex -- Medical Definition". medilexicon.com.Archived from the original on 22 February 2014.: defines sex as a biological or physiological quality, while gender is a (psychological) "category to which an individual is assigned by self or others...".
^Swenson, A. (2014). "Medical Care of the Transgender Patient".Family Medicine.While some transsexual people still prefer to use the term to describe themselves, many transgender people prefer the term transgender to transsexual.
^Parker, Jerry (18 October 1979)."Christine Recalls Life as Boy from the Bronx".Newsday/Winnipeg Free Press.Archived from the original on 25 April 2012. Retrieved28 May 2012.If you understand trans-genders," she says, (the word she prefers to transsexuals), "then you understand that gender doesn't have to do with bed partners, it has to do with identity.
^"News From California: 'Transgender'".Appeal-Democrat/Associate Press. 11 May 1982. pp. A–10.Archived from the original on 12 April 2012. Retrieved28 May 2012.she describes people who have had such operations' "transgender" rather than transsexual. "Sexuality is who you sleep with, but gender is who you are," she explained
^abStryker, Susan (2006). "Introduction". In Stryker, Susan; Whittle, S. (eds.).The Transgender Studies Reader. New York:Routledge. pp. 1–17.ISBN1-135-39884-4.
^Winters, Kelley (2008).Gender Madness in American Psychiatry : essays from the struggle for dignity. Dillon, Colorado: GID Reform Advocates. p. 198.ISBN9781439223888.Some Transsexual individuals also identify with the broader transgender community; others do not.
^Benjamin, H. (1966).The transsexual phenomenon. New York: Julian Press, page 23.
^Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativitySexualities July 2005 vol. 8 no. 3 306-328doi:10.1177/1363460705049578
^GLAAD n.d., ¶ "Term to avoid:transgendered". "The adjectivetransgender should never have an extraneous-ed tacked onto the end. An-ed suffix adds unnecessary length to the word and can cause tense confusion and grammatical errors. Not using the-ed suffix also brings transgender into alignment withlesbian,gay,bisexual, andqueer. You would not say thatElton John isgayed orEllen DeGeneres islesbianed, therefore you would not sayLaverne Cox istransgendered. (Similarly,cisgender never needs an-ed at the end.)"
^"Guardian and Observer style guide: T". London: Guardian News & Media. 20 November 2015.Archived from the original on 9 July 2017.[U]se transgender [...] only as an adjective: transgender person, trans person; never 'transgendered person' or 'a transgender'.
^Bockting, Walter; Benner, Autumn;Coleman, Eli (28 March 2009). "Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality".Archives of Sexual Behavior.38 (5):688–701.doi:10.1007/s10508-009-9489-3.PMID19330439.S2CID27207925.
^Haefele-Thomas, Ardel (5 February 2019).Introduction to Transgender Studies. Contributions by Combs, Thatcher. Illustrated by Rains, Cameron. Foreward by Stryker, Susan. Introduction by Clifford, Jo. New York, NY, US: Harrington Park Press. pp. 107–110.ISBN978-1-939594-28-0.OCLC1048658263.
^Bagemihl, B. (1997). "Surrogate phonology and transsexual faggotry: A linguistic analogy for uncoupling sexual orientation from gender identity". In Livia, Anna; Hall, Kira (eds.).Queerly Phrased: Language, Gender, and Sexuality.Oxford University Press. pp. 380–401.doi:10.1093/oso/9780195104707.003.0023.ISBN0195104714.
^Wahng SJ (2004). Double Cross: Transmasculinity Asian American Gendering inTrappings of Transhood. in Aldama AJ (ed.)Violence and the Body: Race, Gender, and the State. Indiana University Press.ISBN025334171X
^Leiblum SR, Rosen RC (2000).Principles and Practice of Sex Therapy, Third Edition.ISBN1-57230-574-6, Guilford Press of New York, c2000.
^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..." inDSM-IV: Sections 302.6 and 302.85Archived 2007-02-11 at theWayback Machine published by the American Psychiatric Association. Retrieved viaMental Health MattersArchived 2007-04-07 at theWayback Machine on 2007-04-06.
^Goethals, Susanne C.; Schwiebert, Valerie L. (September 2005). "Counseling as a Critique of Gender: On the Ethics of Counseling Transgendered Clients".International Journal for the Advancement of Counselling.27 (3):457–469.doi:10.1007/s10447-005-8206-8.S2CID143746919 – via springerlink.com/....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...
^McCrea, Amy (2013)."Under the Transgender Umbrella: Improving ENDA's Protections".Georgetown Journal of Gender and the Law. Retrieved7 February 2025 – viaHein Online.This article will begin by providing a background on transgender people, highlighting the experience of a subset of non-binary individuals, bigender people, ...
^Wilchins, Riki Anne (2002). "It's Your Gender, Stupid". In Nestle, Joan; Howell, Clare; Wilchins, Riki (eds.).Genderqueer: Voices from Beyond the Sexual Binary. Los Angeles: Alyson Publications. pp. 23–32.
^Nestle, J. (2002). "Genders on My Mind". In Nestle, Joan; Howell, Clare; Wilchins, Riki (eds.).Genderqueer: Voices from Beyond the Sexual Binary. Los Angeles: Alyson Publications. pp. 3–10....pluralistic challenges to the male/female, woman/man, gay/straight, butch/femme constructions and identities...
^abHall, B. (2007)."Discussion Paper: Toward a Commission Policy on Gender Identity".Ontario Human Rights Commission. et al. Archived fromthe original on 27 September 2007. Retrieved13 August 2007....Many say this term (crossdresser) is preferable to transvestite, which means the same thing ...transvestite (TV) – same as cross-dresser. Most feel cross-dresser is the preferred term...
^Green, E.; Peterson, E. N. (2006)."LGBTTSQI Terminology".Trans-Academics.org. Archived fromthe original(PDF) on 5 September 2013. Retrieved13 August 2007....The preferred term is 'cross-dresser', but the term 'transvestite' is still used in a positive sense in England...
^abAPA 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..." inDSM-IV: Sections 302.3Archived 2007-02-11 at theWayback Machine published by the American Psychiatric Association. Retrieved 2007-08-13.
^Varner, Eric (2008). "Transcending Gender: Assimilation, Identity, and Roman Imperial Portraits".Memoirs of the American Academy in Rome. Supplementary Volume.7. Ann Arbor, Michigan, US:University of Michigan Press:200–201.ISSN1940-0977.JSTOR40379354.OCLC263448435.Elagabalus is also alleged to have appeared as Venus and to have depilated his entire body. ... Dio recounts an exchange between Elagabalus and the well-endowed Aurelius Zoticus: when Zoticus addressed the emperor as 'my lord,' Elagabalus responded, 'Don't call me lord, I am a lady.' Dio concludes his anecdote by having Elagabalus asking his physicians to give him the equivalent of a woman's vagina by means of a surgical incision.
^Godbout, Louis (2004)."Elagabalus"(PDF).GLBTQ: An Encyclopedia of Gay, Lesbian, Bisexual, Transgender, and Queer Culture. Chicago: glbtq, Inc.Archived(PDF) from the original on 17 November 2015. Retrieved6 August 2007.
^"La France est très en retard dans la prise en charge des transsexuels".Libération (in French). 17 May 2011.Archived from the original on 30 November 2014.En réalité, ce décret n'a été rien d'autre qu'un coup médiatique, un très bel effet d'annonce. Sur le terrain, rien n'a changé. [In reality, this decree was nothing more than a media stunt, a very nice announcement effect. On the ground, nothing has changed.]
^Carroll, L.; Gilroy, P. J.; Ryan, J. (2002). "Transgender issues in counselor education".Counselor Education and Supervision.41 (3):233–242.doi:10.1002/j.1556-6978.2002.tb01286.x.
"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.'"Clark-Flory 2015
"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."Dhejne et al. 2014
^GLAAD n.d., ¶ "Term to avoid:sex change,pre-operative,post-operative".
^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...." inSex 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.
^"Detransitioning after surgical interventions ... is exceedingly rare....Detransitioning is actually far more common in the stages before surgery, when people are still exploring their options."Clark-Flory 2015
^Winter, Sam (2003). Research and discussion paper:Language and identity in transgender: gender wars and the case of the Thai kathoey. Paper presented at the Hawaii conference on Social Sciences, Waikiki, June 2003.Article onlineArchived 29 March 2012 at theWayback Machine.
^Harrison, F. (2005)."Iran's sex-change operations".BBC. Archived fromthe original on 17 August 2007. Retrieved22 July 2007....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...
^Mitsuhashi, J. (2006). "The transgender world in contemporary Japan: the male to female cross-dressers' community in Shinjuku".Inter-Asia Cultural Studies.7 (2). Translated by Hasegawa, K.:202–227.doi:10.1080/14649370600673847.S2CID143080943....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...
^Haviland, C. (2005)."Crossing sexual boundaries in Nepal".BBC. Archived fromthe original on 28 August 2007. Retrieved22 July 2007....The Gurung people of western Nepal have a tradition of men called maarunis, who dance in female clothes...
^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..." inS. Korea in dilemma over transgender citizens right to chooseArchived 2007-08-17 at theWayback Machine from theYonhap News AgencyArchived 2007-07-17 at theWayback Machine. Retrieved 2007-07-22.
^Heng, R. (2005)."Where queens ruled! - a history of gay venues in Singapore".IndigNation. Archived fromthe original on 11 October 2007. Retrieved22 July 2007....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....
^Emerton, R. (2006). "Finding a voice, fighting for rights: the emergence of the transgender movement in Hong Kong".Inter-Asia Cultural Studies.7 (2):243–269.doi:10.1080/14649370600673896.S2CID145122793....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)."Trans-Boy Fashion, or How to Tailor-Make a King".Gender Studies programme of The Chinese University of Hong Kong. Archived fromthe original on 27 September 2007. Retrieved22 July 2007....there are many archetypal flamboyant embodiments of female-to-male transgender physicality living and displaying their unrestrained, dashing iconic presence...
^Ho, J. (2006). "Embodying gender: transgender body/subject formations in Taiwan".Inter-Asia Cultural Studies.7 (2):228–242.doi:10.1080/14649370600673888.S2CID43951816....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...
^Hahn, L. (13 June 2005)."Jin Xing TalkAsia Interview Transcript".CNN. Archived fromthe original on 11 October 2007. Retrieved22 July 2007....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...
^Goldkorn, J. (2006)."Transsexuals in the Chinese media again".Danwei. Archived fromthe original on 27 August 2007. Retrieved22 July 2007....At one point in 2003, there was so much media coverage of transsexuals in China that Danwei started a special section for it...
^abParker, H. N. (2001). "The Myth of the Heterosexual: Anthropology and Sexuality for Classicists".Arethusa.34 (3):313–362.doi:10.1353/are.2001.0016.S2CID161526282.
^Marciano, A. (2014). "Living the VirtuReal: Negotiating transgender identity in cyberspace".Journal of Computer-Mediated Communication.19 (4):824–838.doi:10.1111/jcc4.12081.S2CID206022665.
^"I'm Scared to Be a Woman".Human Rights Watch. 24 September 2014.Archived from the original on 6 September 2015. Retrieved8 September 2015.a 22-year-old transgender woman sports a tattoo of a butterfly – a transgender symbol signifying transformation
^Sperry, Len (2016).Mental health and mental disorders : an encyclopedia of conditions, treatments, and well-being. Santa Barbara, California: Greenwood. p. 1150.ISBN9781440803826.OCLC915943054.
Currah, Paisley (2006). "Gender Pluralisms Under the Transgender Umbrella". In Currah, Paisley; Juang, Richard M.; Minter, Shannon (eds.).Transgender rights. Minneapolis: University of Minnesota Press.ISBN0-8166-4311-3.OCLC68221085.
Dame-Griff, Avery (2023).The Two Revolutions: A History of the Transgender Internet.NYU Press. pp. 9, 22.ISBN9781479818341.
Hirschfeld, Magnus (1923). "Die Intersexuelle Konstitution" [The Intersexual Constitution].Jahrbuch für sexuelle Zwischenstufen [Yearbook for Intermediate Sexual Types] (in German).
Travers, Robb; Bauer, Greta; Pyne, Jake; Bradley, Kaitlin; Gale, Lorraine; Papadimitriou, Maria (2 October 2012)."Impacts of Strong Parental Support for Trans Youth"(PDF).TransPulse Canada.Archived(PDF) from the original on 16 June 2023. Retrieved7 June 2023.
Whittle, Stephen (2002).Respect and Equality: Transsexual and Transgender Rights. London Portland, OR: Cavendish Pub.ISBN978-1-85941-743-0.OCLC810082841.
Lerario, Z Paige, "Voice Training for Transgender People: Speech therapy and language strategies can help save lives",Scientific American, vol. 328, no. 1 (January 2023), p. 55. "Voice training is less costly and invasive than a throat operation... Through sessions with a licensed speech-language pathologist, transgender people learn to control pitch, resonance, word choice and other vocal behaviors.... Such training can improve quality of life, reduce voice-related disability and boost self-confidence."
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