Transgender is a general term that describes people whose gender identity, or their internal sense of being male, female, or something else, does not match the sex they were assigned at birth. By contrast, the term cisgender describes people whose gender identity aligns with the sex they were assigned at birth.
According to the National Center for Transgender Equality, there are about 1.4 million transgender people in the United States, who fall into several categories.
A transgender woman was labeled as male at birth but has the gender identity of a female. A transgender man was assigned female sex at birth but identifies as male. Some transgender people don’t identify with one gender exclusively. Their gender identity may combine both female and male elements, for instance, or they may not feel like either gender. These transgender people are often described as being “non-binary.” Another term that is sometimes used to describe people in this category is “genderqueer.”
There is a wide spectrum of gender identities that continues to grow. In 2023, the list of genders numbers more than 100 and growing.
Transgender people may be gender non-conforming, meaning that they adopt customs and habits that are not typically associated with their assigned birth sex. That is, they may express their gender identity through the way they talk, act, dress, style their hair, and other behaviors. Choosing a new name that better suits one’s gender identity is common, too. Some transgender people, though not all, elect to undergo medical treatments that change their bodies to make them more compatible with their gender identity. Treatments can include hormone therapy, surgery, and other interventions.
Gender Identity vs. Sexual Orientation
The term transgender does not describe a person’s romantic or sexual preferences. That’s because gender identity is not the same as sexual orientation. The latter term is used to describe a person’s innate preference for romantic or sexual relationships with men, women, or both sexes. For example, heterosexual (“straight”) people are attracted to members of the opposite sex. Homosexual people (gays and lesbians) are attracted to people of the same sex. Bisexual people are attracted to both men and women. Transgender people may be straight, gay or lesbian, or bisexual.
Just as there are many genders beyond those listed in this article, the list of sexual orientations is extensive.
Transgender vs. Intersex
While these terms are often confused, they do not mean the same thing. A transgender person is typically born with a body that has unambiguous sexual characteristics (either male or female) but they don’t match the person's gender identity. By contrast, an intersex person is born with a body that is not clearly male or female. For instance, a baby with male chromosomes may have genitals and other sexual characteristics that appear female. The opposite can be true of babies born with female chromosomes. In some cases, an intersex person’s reproductive anatomy may combine male and female characteristics. Between one in 1,500 and one in 2,000 babies are born with a mix of sexual characteristics.
A transgender person may also be intersex, and vice versa, though that’s not usually the case. An intersex person may live in a way that’s in accord with the sex he or she was assigned at birth. For example, an intersex baby assigned female sex at birth might be raised as a girl and continue to behave, dress, and groom in a traditionally feminine manner for life. However, some who were raised as one sex later embrace the gender identity of the opposite sex, making changes to their appearance, behaviors, and bodies similar to those made by many transgender people.
What Is Gender Dysphoria?
For some transgender people, the mismatch between the sex they were assigned at birth and their gender identity may cause a medically recognized form of psychological distress called gender dysphoria. Children and adolescents can develop gender dysphoria, though the condition may not arise until adulthood. People with gender dysphoria feel an intense and persistent desire to be rid of the sexual characteristics they were born with and become another gender.
Feeling rejected by family and society can exacerbate gender dysphoria and increases the risk of substance abuse, self-harm, suicide, and other adverse outcomes. Treatment involves working with a supportive psychotherapist and often includes taking steps to “affirm” one’s gender identity through various forms of expression, from changing one’s name to seeking body-altering medical therapy.
Stigma and Discrimination
An additional source of psychological distress for transgender people is the stigma they face in everyday life. Advocates point out that few states offer legal protections to prevent discrimination against transgender people, making them vulnerable to unfair treatment when they look for a place to live, a job, or medical treatment.
In some states, access to medical treatment has been banned or severely restricted, making it even harder for transgender people to live as themselves.