Gender identity is your internal sense of whether you are male or female. When you are transgender, this feeling doesn't match your actual sex. Your body is male or female, but inside you feel you are really the opposite sex. You feel "trapped" in the wrong body.

The feeling that something is different may begin early in life. Many adults who are transgender remember noticing a difference as children between what their bodies looked like on the outside and what they felt on the inside. Other transgender people make this discovery as adults.

Sometimes a person feels so strongly that his or her body is incorrect that the person decides to have medical treatment, from hormones to surgery, to make the body match how he or she feels inside. People who have gender reassignment surgery to make these changes may be described as "transsexual."

Sexual orientation and gender identity are related, but they aren't the same thing. For example, a person can be transgender without being homosexual.

Some people use makeup, haircuts, or clothing styles to look like members of the other gender. This is called cross-dressing and is not the same thing as being transgender. Cross-dressers may be heterosexual, homosexual, or bisexual.

Remember: You're not alone

The pressure and stress caused by feeling alone and sad can lead to depression, a very serious problem. Depression can lead to suicide. Teens with depression are at particularly high risk for suicide and suicide attempts.

If you are transgender, it's important to realize that there are lots of people like you. They have the same problems, emotions, and questions that you have, whether you are openly transgender, are still hiding the fact that you are transgender, or have a friend or family member who is transgender.

It can be very comforting and helpful to talk to people who know what you're going through. You can find such people through local or online groups. If you don't know where to find support, ask:

• Your doctor.
• Your school counselor or trusted teacher.
• A therapist or other counselor.
• Websites and online organizations. You can find a list of such organizations on the website for PFLAG (Parents, Families and Friends of Lesbians and Gays) at www.pflag.org.

Why is it important to understand stress and know how to cope with it?

Stress is a fact of life. Most of us have periods of stress at various times in our lives. But extra stress can have a serious effect on your health, especially if it lasts for a long time.

If you are openly transgender, you may be under a lot of extra stress because of discrimination in the community. If you are still in the closet, you may have stress from hiding who you really are. Rejection, discrimination, fear, and confusion cause long-term stress in many transgender people.