transgender

File:Bell Gallery, Anderson Library U of Minnesota-Transgender Oral History Project-03.jpg, Minneapolis, MN]]

Before the mid-20th century, various terms were used within and beyond Western medical and psychological sciences to identify persons and identities labeled transsexual, and later transgender from mid-century onward.{{sfn|Polly|Nicole|2011}} Imported from the German and ultimately modeled after German Transsexualismus (coined in 1923),{{sfn|Hirschfeld|1923}} the English term transsexual has enjoyed international acceptability, though transgender has been increasingly preferred over transsexual.{{harvnb|APA|2024}}. "According to the APA Style guide, the term transsexual is largely outdated, but some people identify with it; this term should be used only for an individual who specifically claims it." The word transgender acquired its modern umbrella term meaning in the 1990s.Variously:

• {{harvnb|Mills|2015|p=12}}. "Indeed, it is arguably only since the 1990s, with the coining of the umbrella term transgender, that gender variance has come to be understood, in certain activist and institutional settings, as being ontologically different from homosexuality."
• {{harvnb|Currah|2006|p=4}}. "From signifying a subject position between cross-dresser and transsexual, the meaning of transgender expanded radically in the early 1990s to include them, along with other cross-gender practices and identities."

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.{{cite journal |last1=Glicksman |first1=Eve |date=April 2013 |title=Transgender terminology: It's complicated |url=http://www.apa.org/monitor/2013/04/complicated |url-status=live |journal=Monitor on Psychology |publisher=American Psychological Association |volume=44 |issue=4 |page=39 |archive-url=https://web.archive.org/web/20130925130527/http://www.apa.org/monitor/2013/04/complicated.aspx |archive-date=25 September 2013 |access-date=17 September 2013 |quote=Use whatever name and gender pronoun the person prefers}}{{cite web |title=Meeting the Health Care Needs of Lesbian, Gay, Bisexual, and Transgender (LGBT) People: The End to LGBT Invisibility |url=http://www.ama-assn.org/resources/doc/glbt/tfi-grand-rounds-makadon.ppt |url-status=dead |archive-url=https://web.archive.org/web/20131020025808/http://www.ama-assn.org/resources/doc/glbt/tfi-grand-rounds-makadon.ppt |archive-date=20 October 2013 |access-date=17 September 2013 |publisher=The Fenway Institute |page=24 |format=PowerPoint Presentation |quote=Use the pronoun that matches the person's gender identity}}

Although the term transgenderism was once considered acceptable, it has come to be viewed as pejorative, according to GLAAD.{{harvnb|GLAAD|n.d.|loc=¶ "Term to avoid: transgenderism, gender ideology"}}. {{harvnb|GLAAD|2023}}. Psychiatrist John F. Oliven of Columbia University used the term transgenderism in his 1965 reference work Sexual 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".{{harvnb|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 becomes transsexualism. The term is misleading; actually, transgenderism is what is meant, because sexuality is not a major factor in primary transvestism.' Although Oliven's understanding of transgender 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 word transgender to themselves. For example, Virginia Charles Prince, publisher of the long-running periodical Transvestia, occasionally used a variation of the word, transgenderal." Quoting {{harvnb|Oliven|1965|p=514}}, and referencing {{harvnb|Rawson|Williams|2014}}. The term transgender was then popularized with varying definitions by transgender, transsexual, and transvestite people, including Christine Jorgensen{{sfn|Blakemore|2022}} and Virginia Prince, who used transgenderal in the December 1969 issue of Transvestia,{{harvnb|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 a transgenderal." a national magazine for cross-dressers she founded.{{sfn|Ekins|King|2006|pp=13-14}} By the mid-1970s both trans-gender and trans people were in use as umbrella terms, while transgenderist and transgenderal were used to refer to people who wanted to live their lives as cross-gendered individuals without gender-affirming surgery.{{harvnb|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." Transgenderist was sometimes abbreviated as TG in educational and community resources; this abbreviation developed by the 1980s.{{harvnb|Rayner|1979}}. {{harvnb|Dame-Griff|2023}}. In 2020, the International Journal of Transgenderism changed its name to the International Journal of Transgender Health "to reflect a change toward more appropriate and acceptable use of language in our field."{{sfn|Bouman|2020|at=¶ 5}}

By 1984, the concept of a "transgender community" had developed, in which transgender was used as an umbrella term.{{sfn|Peo|1984}} In 1985, Richard Ekins established the "Trans-Gender Archive" at the University of Ulster.{{sfn|Ekins|King|2006|pp=13-14}} By 1992, the International Conference on Transgender Law and Employment Policy defined transgender as an expansive umbrella term including "transsexuals, transgenderists, cross dressers", and anyone transitioning.{{harvnb|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." Leslie Feinberg's pamphlet, "Transgender Liberation: A Movement Whose Time has Come", circulated in 1992, identified transgender as a term to unify all forms of gender nonconformity; in this way transgender has become synonymous with queer.{{sfn|Stryker|2008b}} In 1994, gender theorist Susan Stryker defined transgender 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 American berdache or the Indian Hijra".{{sfn|Currah|2006|p=4}}

Transgender can also refer specifically to a person whose gender identity is opposite (rather than different from) the sex the person had or was identified as having at birth.Variously:

• {{harvnb|Mallon|1998|pages=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."
• {{harvnb|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".
• {{harvnb|Gazzaniga|2018|p=367}}. "A transgender person was born as one biological sex but feels that her true gender identity is that of the other sex." 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 called cisgender.{{sfn|Martin|2015}}

{{See also|Transsexual#Terminology}}

Inspired by Magnus Hirschfeld's 1923 term seelischer Transsexualismus,{{Cite web |title=The Road to Inclusion: Transgender Health Care in Canada |url=https://www.thecanadianencyclopedia.ca/en/article/the-road-to-inclusion-transgender-health-care-in-canada |access-date=19 December 2024 |website=www.thecanadianencyclopedia.ca |language=en}} the term transsexual was introduced to English in 1949 by David Oliver Cauldwell and popularized by Harry Benjamin in 1966, around the same time transgender was coined and began to be popularized. Since the 1990s, transsexual has generally been used to refer to the subset of transgender peopleTransgender Rights (2006, {{ISBN|0-8166-4312-1}}), edited by Paisley Currah, Richard M. Juang, Shannon Minter{{cite journal |last1=Alegria |first1=Christine Aramburu |title=Transgender identity and health care: Implications for psychosocial and physical evaluation: Transgender identity and health care |journal=Journal of the American Academy of Nurse Practitioners |date=April 2011 |volume=23 |issue=4 |pages=175–182 |doi=10.1111/j.1745-7599.2010.00595.x |pmid=21489011 |s2cid=205909330 |url=https://pubmed.ncbi.nlm.nih.gov/21489011/ |access-date=4 April 2023 |quote=Transgender, Umbrella term for persons who do not conform to gender norms in their identity and/or behavior (Meyerowitz, 2002). Transsexual, Subset of transgenderism; persons who feel discordance between natal sex and identity (Meyerowitz, 2002) |archive-date=4 April 2023 |archive-url=https://web.archive.org/web/20230404185132/https://pubmed.ncbi.nlm.nih.gov/21489011/ |url-status=live}} 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 terms transgender and transsexual are commonly based on distinctions between gender and sex.For example, Virginia Prince used transgender to distinguish cross-dressers from transsexual people ({{cite web |title=glbtq > social sciences >> Prince, Virginia Charles |url=http://www.glbtq.com/social-sciences/prince_vc.html |url-status=dead |archive-url=https://web.archive.org/web/20150211063223/http://www.glbtq.com/social-sciences/prince_vc.html |archive-date=11 February 2015 |publisher=glbtq.com}}), writing in Men Who Choose to Be Women (in Sexology, 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."{{cite web |title=Sex -- Medical Definition |url=http://www.medilexicon.com/medicaldictionary.php?t=81336 |url-status=live |archive-url=https://web.archive.org/web/20140222012037/http://www.medilexicon.com/medicaldictionary.php?t=81336 |archive-date=22 February 2014 |publisher=medilexicon.com}}: defines sex as a biological or physiological quality, while gender is a (psychological) "category to which an individual is assigned by self or others...". 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.{{cite web |url=http://dl.uncw.edu/etd/2006/swanstromn/novaswanstrom.pdf |archive-url=https://web.archive.org/web/20140221213319/http://dl.uncw.edu/etd/2006/swanstromn/novaswanstrom.pdf |url-status=dead |title=UNCW: Developing and Implementing a Scale to Assess Attitudes Regarding Transsexuality |archive-date=February 21, 2014}} Many transgender people reject the term transsexual.{{cite book |first=A. |last=Swenson |chapter=Medical Care of the Transgender Patient |title=Family Medicine |date=2014 |quote=While some transsexual people still prefer to use the term to describe themselves, many transgender people prefer the term transgender to transsexual.}}{{sfn|GLAAD|n.d.|loc=¶ "Transsexual (adj.)"}} Christine Jorgensen publicly rejected transsexual in 1979 and instead identified herself in newsprint as trans-gender, saying, "gender doesn't have to do with bed partners, it has to do with identity."{{cite news |last=Parker |first=Jerry |date=18 October 1979 |title=Christine Recalls Life as Boy from the Bronx |newspaper=Newsday/Winnipeg Free Press |url=http://research.cristanwilliams.com/2011/08/21/christine-jorgensen-transgender-woman/ |url-status=live |access-date=28 May 2012 |archive-url=https://web.archive.org/web/20120425161528/http://research.cristanwilliams.com/2011/08/21/christine-jorgensen-transgender-woman/|archive-date=25 April 2012|quote="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."}}{{cite news |date=11 May 1982 |title=News From California: 'Transgender' |pages=A–10 |newspaper=Appeal-Democrat/Associate Press |url=http://research.cristanwilliams.com/2012/02/06/1982-transgenders-transsexuals-christine-jorgensen/ |url-status=live |access-date=28 May 2012 |archive-url=https://web.archive.org/web/20120412004837/http://research.cristanwilliams.com/2012/02/06/1982-transgenders-transsexuals-christine-jorgensen/ |archive-date=12 April 2012 |quote=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}} Some have objected to the term transsexual on the basis that it describes a condition related to gender identity rather than sexuality.{{cite web |date=January 2010 |publisher=Fenway Health |location=Boston, Mass. |title=Glossary of Gender and Transgender Terms |url=http://www.fenwayhealth.org/site/DocServer/Handout_7-C_Glossary_of_Gender_and_Transgender_Terms__fi.pdf |url-status=dead |archive-url=https://web.archive.org/web/20131019120607/http://www.fenwayhealth.org/site/DocServer/Handout_7-C_Glossary_of_Gender_and_Transgender_Terms__fi.pdf |archive-date=19 October 2013 |page=15}}{{Better source needed|date=November 2020}} Some people who identify as transsexual people object to being included in the transgender umbrella.{{cite journal |last1=Valentine |first1=David |title=Imagining Transgender: An Ethnography of a Category |journal=Duke University Press |date=2007 |doi=10.1215/9780822390213|isbn=978-0-8223-9021-3}}{{cite book |last=Stryker |first=Susan |chapter=Introduction |editor1-last=Stryker |editor1-first=Susan |editor2-first=S. |editor2-last=Whittle |title=The Transgender Studies Reader |location=New York |publisher=Routledge |date=2006 |pages=1–17 |isbn=1-135-39884-4}}{{cite book |last1=Winters |first1=Kelley |title=Gender Madness in American Psychiatry : essays from the struggle for dignity |date=2008 |publisher=GID Reform Advocates |location=Dillon, Colorado |isbn=9781439223888 |pages=198 |quote=Some Transsexual individuals also identify with the broader transgender community; others do not.}}

In his 2007 book Imagining Transgender: An Ethnography of a Category, anthropologist David Valentine asserts that transgender 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 term transgender should not be included in the transgender spectrum. Leslie Feinberg likewise asserts that transgender is not a self-identifier (for some people) but a category imposed by observers to understand other people. According to the Transgender Health Program (THP) at Fenway 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 term transsexual unless they are sure that a client is comfortable with it.{{Undue weight inline|date=November 2020}}

Harry Benjamin invented a classification system for transsexuals and transvestites, called the Sex 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.Benjamin, H. (1966). The transsexual phenomenon. New York: Julian Press, page 23. Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions.Ekins, Richard (2005). Science, politics and clinical intervention: Harry Benjamin, transsexualism and the problem of heteronormativity Sexualities July 2005 vol. 8 no. 3 306-328 {{doi|10.1177/1363460705049578}} 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.{{Cite journal |last=Hansbury |first=Griffin |date=2008 |title=The Middle Men: An Introduction to the Transmasculine Identities |journal=Studies in Gender and Sexuality |volume=6 |number=3 |pages=241–264 |doi=10.1080/15240650609349276}}

• {{visanc|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.{{cite book |last=Hardell |first=Ash |author-link=Ash Hardell |url=https://search.worldcat.org/title/962263268 |title=The ABC's of LGBT+ |date=2016 |publisher=Mango Media Inc. |isbn=9781633534094 |location=Coral Gables, Florida |pages=96 |access-date=13 April 2024 |archive-url=https://web.archive.org/web/20240413205407/https://search.worldcat.org/title/962263268 |archive-date=13 April 2024 |url-status=live}} {{visanc|Transmasculine}} refers to a person, binary or non-binary, who was assigned female at birth who has a predominantly masculine gender identity or presentation.
• Transgendered is a common term in older literature. Many within the transgender community deprecate it on the basis that transgender is an adjective, not a verb.{{cite book |last1=Vincent |first1=Ben |title=Non-Binary Genders: Navigating Communities, Identities, and Healthcare |date=2020 |publisher=Policy Press |isbn=978-1-4473-5192-4 |location=Bristol, UK |page=[https://books.google.com/books?id=V53uDwAAQBAJ&pg=PA17 17, note 10] |doi=10.2307/j.ctv138wrbg |jstor=j.ctv138wrbg |s2cid=225850961}} Organizations such as GLAAD and The Guardian also state that transgender should never be used as a noun in English (e.g., "Max is transgender" or "Max is a transgender man", not "Max is a transgender").{{harvnb|GLAAD|n.d.|loc=¶ "Term to avoid: transgendered"}}. "The adjective transgender 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 with lesbian, gay, bisexual, and queer. You would not say that Elton John is gayed or Ellen DeGeneres is lesbianed, therefore you would not say Laverne Cox is transgendered. (Similarly, cisgender never needs an -ed at the end.)"{{cite web |date=20 November 2015 |title=Guardian and Observer style guide: T |url=https://www.theguardian.com/guardian-observer-style-guide-t |url-status=live |archive-url=https://web.archive.org/web/20170709224453/https://www.theguardian.com/guardian-observer-style-guide-t |archive-date=9 July 2017 |publisher=Guardian News & Media |quote=[U]se transgender [...] only as an adjective: transgender person, trans person; never 'transgendered person' or 'a transgender'. |location=London}} "Transgender" is also a noun for the broader topic of transgender identity and experience.{{cite OED|term=transgender, adj. and n.|id=247649|date=March 2003|edition=3rd}}
• Assigned Female At Birth (AFAB), Assigned Male At Birth (AMAB), Designated Female At Birth (DFAB), and Designated 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 terms biological male or biological female.{{Sfn|Cleveland Clinic|2022}}
• The term Trans (*) (with an asterisk) emerged in the 1990s as an inclusive term used to encompass a wide range of non-cisgender identities. The asterisk represents a wildcard, indicating the inclusion of various identities, beyond just transgender and transsexual, such as gender-fluid or agender, 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.{{Cite magazine |last=Steinmetz |first=Katy |date=3 April 2018 |title=The OED Just Added the Word 'Trans*.' Here's What It Means |url=https://time.com/5211799/what-does-trans-asterisk-star-mean-dictionary/ |access-date=5 December 2024 |magazine=TIME |language=en |archive-url=https://web.archive.org/web/20241207080057/https://time.com/5211799/what-does-trans-asterisk-star-mean-dictionary/ |archive-date=7 December 2024}}{{Cite journal |last=Tompkins |first=Avery |date=1 May 2014 |title=Asterisk |url=https://read.dukeupress.edu/tsq/article/1/1-2/26/91872/Asterisk |journal=TSQ: Transgender Studies Quarterly |volume=1 |issue=1–2 |pages=26–27 |doi=10.1215/23289252-2399497 |issn=2328-9252}}

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.

In place of transgenderism, terms such as transness,{{Cite journal |last=Rivest |first=Paul |date=June 2024 |title=Discourses of disclosure: the un/revolutionary potential of transmasculine sexual scripts |url=https://hal.science/hal-04612848/ |journal=Quaderni del Dipartimento di Sociologia e Ricerca Sociale |issue=8 |pages=219–230}} transgenderness, or transidentity,{{Cite book |last=Cromwell |first=Jason |url=https://books.google.com/books?id=0G--BowVYg8C&dq=%22transness%22+%22transidentity%22&pg=PP11 |title=Transmen and FTMs: Identities, Bodies, Genders, and Sexualities |date=1999 |publisher=University of Illinois Press |isbn=978-0-252-06825-6 |language=en}} have been suggested,{{Cite journal |last=Leal |first=Dodi T. B. |date=October 2021 |title=Gender in Danger: Transdanger People in Performing Arts in Brazil |url=https://www.cambridge.org/core/journals/theatre-research-international/article/abs/gender-in-danger-transdanger-people-in-performing-arts-in-brazil/6F6A9491CE5D25DCBA45883FF9162ED0 |journal=Theatre Research International |language=en |volume=46 |issue=3 |pages=398–406 |doi=10.1017/S0307883321000341 |issn=0307-8833}} corresponding to their cisgender counterparts, such as cisness, cisgenderness and cisidentity.{{Cite journal |last=Alessandrin |first=Arnaud |date=January 2013 |title=La question cisgenre |url=https://hal.science/hal-00789539/ |journal=¿ Interrogations ? Revue pluridisciplinaire de sciences humaines et sociales |issue=15}}{{Cite journal |last=Groneberg |first=Michael |date=2018 |journal=Normed Children: Effects of Gender and Sex Related Normativity on Childhood and Adolescence |title=The Concept of Human Gender: Its Epistemological and Ethical Impact |series=Gender Studies |access-date=7 February 2025 |pages=63–80 |doi=10.14361/9783839430200-006 |isbn=978-3-8376-3020-6 |url=https://library.oapen.org/bitstream/handle/20.500.12657/37406/1/9783839430200.pdf#page=64 |editor1-last=Schneider |editor1-first=Erik |editor2-last=Baltes-Löhr |editor2-first=Christel}}

{{Main|Transgender sexuality}}

Gender, gender identity, and being transgender are distinct concepts from sexual orientation.{{cite web |url=http://www.apa.org/topics/sexuality/transgender.aspx |title=Answers to Your Questions About Transgender Individuals and Gender Identity |archive-url=https://web.archive.org/web/20100615045832/http://apa.org/topics/sexuality/transgender.aspx |archive-date=15 June 2010 |website=American Psychological Association |quote=What is the relationship between transgender and sexual orientation?}} Sexual orientation is an individual's enduring pattern of attraction, or lack thereof, to others (being straight, 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.{{sfn|GLAAD|n.d.|loc=¶ "Sexual Orientation"}} Many trans people describe their sexual orientation as queer, in addition to or instead of, other terms.{{cite journal |last1=Bockting |first1=Walter |last2=Benner |first2=Autumn |last3=Coleman |first3=Eli |author-link3=Eli Coleman |title=Gay and Bisexual Identity Development Among Female-to-Male Transsexuals in North America: Emergence of a Transgender Sexuality |journal=Archives of Sexual Behavior |date=28 March 2009 |volume=38 |issue=5 |pages=688–701 |doi=10.1007/s10508-009-9489-3 |pmid=19330439 |s2cid=27207925}}

For much of the 20th century, transgender identity was conflated with homosexuality and transvestism.{{cite book |last=Haefele-Thomas, Ardel |url=https://www.worldcat.org/oclc/1048658263 |title=Introduction to transgender studies |date=5 February 2019 |publisher= |others=Combs, Thatcher,, Rains, Cameron,, Stryker, Susan,, Clifford, Jo, 1950- |isbn=978-1-939594-28-0 |location=New York, NY, US |pages=107–110 |oclc=1048658263}}{{cite book |last=Gill-Peterson, Julian |url=https://www.worldcat.org/oclc/1027732161 |title=Histories of the transgender child |date=23 October 2018 |publisher= |isbn=978-1-4529-5815-6 |location=Minneapolis |pages=80–90 |oclc=1027732161}} In earlier academic literature, sexologists used the labels homosexual and heterosexual transsexual to categorize transgender individuals' sexual orientation based on their birth sex.{{cite journal|doi=10.1007/BF01541951 |title=The classification and labeling of nonhomosexual gender dysphorias |year=1989 |last1=Blanchard |first1=Ray |journal=Archives of Sexual Behavior |volume=18 |issue=4 |pages=315–334 |pmid=2673136 |s2cid=43151898}} Critics consider these terms "heterosexist",{{cite book |last=Bagemihl |first=B. |publisher=Oxford University Press |isbn=0195104714 |editor1-last=Livia |editor1-first=Anna |chapter=Surrogate phonology and transsexual faggotry: A linguistic analogy for uncoupling sexual orientation from gender identity |title=Queerly Phrased: Language, Gender, and Sexuality |date=1997 |pages=380–401 |editor2-last=Hall |editor2-first=Kira |doi=10.1093/oso/9780195104707.003.0023}} "archaic",Wahng SJ (2004). Double Cross: Transmasculinity Asian American Gendering in Trappings of Transhood. in Aldama AJ (ed.) Violence and the Body: Race, Gender, and the State. Indiana University Press. {{ISBN|025334171X}} and demeaning.Leiblum SR, Rosen RC (2000). Principles and Practice of Sex Therapy, Third Edition. {{ISBN|1-57230-574-6}}, Guilford Press of New York, c2000. Newer literature often uses terms such as attracted to men (androphilic), attracted to women (gynephilic), attracted to both (bisexual), or attracted to neither (asexual) to describe a person's sexual orientation without reference to their gender identity.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..." in [http://www.mental-health-today.com/gender/dsm.htm DSM-IV: Sections 302.6 and 302.85] {{webarchive|url=https://web.archive.org/web/20070211020457/http://www.mental-health-today.com/gender/dsm.htm|date=2007-02-11}} published by the American Psychiatric Association. Retrieved via [http://www.mental-health-matters.com/ Mental Health Matters] {{webarchive|url=https://web.archive.org/web/20070407163232/http://www.mental-health-matters.com/|date=2007-04-07}} on 2007-04-06. Therapists are coming to understand the necessity of using terms with respect to their clients' gender identities and preferences.{{cite journal |last1=Goethals |first1=Susanne C. |last2=Schwiebert |first2=Valerie L. |title=Counseling as a Critique of Gender: On the Ethics of Counseling Transgendered Clients |journal=International Journal for the Advancement of Counselling |date=September 2005 |volume=27 |issue=3 |pages=457–469 |doi=10.1007/s10447-005-8206-8 |s2cid=143746919 |quote=...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... |via=springerlink.com/}}

The 2015 U.S. Transgender Survey reported that of the 27,715 transgender and non-binary respondents, 21% said queer best described their sexual orientation, 18% said pansexual, 16% said gay, lesbian, or same-gender-loving, 15% said straight, 14% said bisexual, and 10% said asexual.{{cite web |title=The Report of the 2015 U.S. Transgender Survey |url=https://transequality.org/sites/default/files/docs/usts/USTS-Full-Report-Dec17.pdf|url-status=live |archive-url=https://web.archive.org/web/20161209150153/http://www.transequality.org/sites/default/files/docs/USTS-Full-Report-FINAL.PDF |archive-date=9 December 2016 |access-date=6 March 2016 |website=National Center for Transgender Equality}} 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% as two-spirit, and 9% as unsure or questioning.{{cite web |date=10 March 2020 |title=Trans PULSE Canada Report No. 1 or 10 |url=https://transpulsecanada.ca/results/report-1/ |access-date=10 March 2020 |archive-date=14 March 2020 |archive-url=https://web.archive.org/web/20200314014752/https://transpulsecanada.ca/results/report-1/ |url-status=live}} A 2009 study in Spain found that 90% of trans women patients reported being androphilic and 94% of trans men patients reported being gynephilic.{{Cite journal |last1=Gómez-Gil |first1=Esther |last2=Trilla |first2=Antoni |last3=Salamero |first3=Manel |last4=Godás |first4=Teresa |last5=Valdés |first5=Manuel |date=June 2009 |title=Sociodemographic, Clinical, and Psychiatric Characteristics of Transsexuals from Spain |url=http://link.springer.com/10.1007/s10508-007-9307-8 |journal=Archives of Sexual Behavior |language=en |volume=38 |issue=3 |pages=378–392 |doi=10.1007/s10508-007-9307-8 |pmid=18288600 |s2cid=8700968 |issn=0004-0002}}

{{Main|Non-binary gender|Androgyny}}

Some non-binary (or genderqueer) people identify as transgender. These identities are not specifically male or female. They can be agender, androgynous, bigender, pangender, or genderfluid,{{cite journal|last=McCrea |first=Amy |title=Under the Transgender Umbrella: Improving ENDA's Protections |journal=Georgetown Journal of Gender and the Law |date=2013 |quote="This article will begin by providing a background on transgender people, highlighting the experience of a subset of non-binary individuals, bigender people, ..." |url=https://heinonline.org/HOL/LandingPage?handle=hein.journals/grggenl15&div=25&id=&page= |access-date=7 February 2025 |via=Hein Online}} and exist outside of cisnormativity.{{cite book |last=Wilchins |first=Riki Anne |chapter=It's Your Gender, Stupid |pages=23–32 |editor-last1=Nestle |editor-first1=Joan |editor-last2=Howell |editor-first2=Clare |editor-last3=Wilchins |editor-first3=Riki|url=https://www.sweetstudy.com/files/wilchins-4introessaysgenderqueer-pdf |title=Genderqueer: Voices from Beyond the Sexual Binary |location=Los Angeles |publisher=Alyson Publications |date=2002}}{{cite book |last=Nestle |first=J. |chapter=Genders on My Mind |pages=3–10 |editor1-last=Nestle |editor1-first=Joan |editor2-last=Howell |editor2-first=Clare |editor3-last=Wilchins |editor3-first=Riki |url= |access-date= |title=Genderqueer: Voices from Beyond the Sexual Binary |location=Los Angeles |publisher=Alyson Publications |date=2002 |quote=...pluralistic challenges to the male/female, woman/man, gay/straight, butch/femme constructions and identities...}} 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).{{cite journal |last=Lindqvist |first=Anna |date=18 February 2020 |title=What is gender, anyway: a review of the options for operationalising gender |journal=Psychology & Sexuality |volume=12 |issue=4 |pages=332–344 |doi=10.1080/19419899.2020.1729844 |doi-access=free}} Non-binary gender identities are independent of sexual orientation.{{cite web |website=Human Rights Campaign |title=Sexual Orientation and Gender Identity Definitions |url=https://www.hrc.org/resources/sexual-orientation-and-gender-identity-terminology-and-definitions |access-date=10 July 2020 |archive-date=30 April 2019 |archive-url=https://web.archive.org/web/20190430180322/https://www.hrc.org/resources/sexual-orientation-and-gender-identity-terminology-and-definitions |url-status=live}}{{cite news |last=Adams |first=Cydney |date=24 March 2017 |title=The difference between sexual orientation and gender identity |url=https://www.cbsnews.com/news/the-difference-between-sexual-orientation-and-gender-identity/ |access-date=21 November 2020 |work=CBS News |publisher=Viacom CBS |archive-date=9 March 2022 |archive-url=https://web.archive.org/web/20220309201625/https://www.cbsnews.com/news/the-difference-between-sexual-orientation-and-gender-identity/ |url-status=live}}

{{Main|transvestism|l1 = Transvestism}}

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.E. D. Hirsch, Jr., E.D., Kett, J.F., Trefil, J. (2002) "Transvestite: Someone who dresses in the clothes usually worn by the opposite sex." in [http://www.bartleby.com/cgi-bin/texis/webinator/sitesearch?query=transvestite&filter=col59 Definition of the word "transvestite"] {{Webarchive|url=https://web.archive.org/web/20071012042109/http://bartleby.com/cgi-bin/texis/webinator/sitesearch?query=transvestite&filter=col59|date=2007-10-12}} from [http://www.bartleby.com/59/ The New Dictionary of Cultural Literacy, Third Edition] {{webarchive|url=https://web.archive.org/web/20070818065027/http://www.bartleby.com/59/|date=August 18, 2007}}. Retrieved 2007-08-13.various (2006) "trans·ves·tite... (plural trans·ves·tites), noun. Definition: somebody who dresses like opposite sex:" in [http://encarta.msn.com/dictionary_/transvestite.html Definition of the word "transvestite"] {{webarchive|url=https://web.archive.org/web/20071109164009/http://encarta.msn.com/dictionary_/transvestite.html|date=2007-11-09}} from the [http://encarta.msn.com/encnet/features/dictionary/dictionaryhome.aspx Encarta World English Dictionary (North American Edition)] {{webarchive|url=https://web.archive.org/web/20110410031005/http://encarta.msn.com/encnet/features/dictionary/dictionaryhome.aspx|date=April 10, 2011}}. Retrieved 2007-08-13. The term transvestite is used as a synonym for the term cross-dresser,Raj, R (2002) "transvestite (TV): n. Synonym: crossdresser (CD):" in [http://www.symposion.com/ijt/ijtvo06no02_04.htm Towards a Transpositive Therapeutic Model: Developing Clinical Sensitivity and Cultural Competence in the Effective Support of Transsexual and Transgendered Clients] from the International Journal of Transgenderism 6,2. Retrieved 2007-08-13. {{webarchive|url=https://web.archive.org/web/20070927183942/http://www.symposion.com/ijt/ijtvo06no02_04.htm|date=September 27, 2007}}{{cite web |last1=Hall |first1=B. |others=et al. |date=2007 |quote=...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... |url=http://www.ohrc.on.ca/en/resources/discussion_consultation/genderidentity?page=dfhh-Appendix-2.html |title=Discussion Paper: Toward a Commission Policy on Gender Identity |archive-url=https://web.archive.org/web/20070927031902/http://www.ohrc.on.ca/en/resources/discussion_consultation/genderidentity?page=dfhh-Appendix-2.html |archive-date=27 September 2007 |website=Ontario Human Rights Commission |access-date=13 August 2007}} although cross-dresser is generally considered the preferred term.{{cite web |last1=Green |first1=E. |last2=Peterson |first2=E. N. |date=2006 |quote=...The preferred term is 'cross-dresser', but the term 'transvestite' is still used in a positive sense in England... |url=http://www.trans-academics.org/lgbttsqiterminology.pdf |title=LGBTTSQI Terminology |archive-url=https://web.archive.org/web/20130905233210/http://www.trans-academics.org/trans_and_sexuality_termi |archive-date=5 September 2013 |website=Trans-Academics.org |access-date=13 August 2007}} The term cross-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."{{cite journal |last=Gilbert |first=Michael A. |year=2000 |title=The Transgendered Philosopher |url=http://iiav.nl/ezines/web/IJT/97-03/numbers/symposion/gilbert.htm |url-status=live |journal=International Journal of Transgenderism |archive-url=https://web.archive.org/web/20160126101549/http://www.iiav.nl/ezines/web/IJT/97-03/numbers/symposion/gilbert.htm |archive-date=26 January 2016 |access-date=16 December 2015}} This definition excludes people "who wear opposite sex clothing for other reasons", such as "those female 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."Gilbert, Michael 'Miqqi Alicia' (2000) "The Transgendered Philosopher" in [http://www.symposion.com/ijt/gilbert/gilbert.htm Special Issue on What is Transgender?] {{webarchive|url=https://web.archive.org/web/20071011211239/http://www.symposion.com/ijt/gilbert/gilbert.htm|date=2007-10-11}} from [http://www.symposion.com/ijt/ The International Journal of Transgenderism, Special Issue July 2000] {{webarchive|url=https://web.archive.org/web/20071011211319/http://symposion.com/ijt/index.htm|date=2007-10-11}}. Retrieved 2007-10-09. 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.{{sfn|Docter|1997}}

The term transvestite and the associated outdated term transvestism are conceptually different from the term transvestic fetishism, as transvestic fetishist refers to those who intermittently use clothing of the opposite gender for fetishistic purposes.World Health Organization (1992) "...Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines...." in [https://www.who.int/classifications/apps/icd/icd10online/ ICD-10, Gender Identity Disorder, category F65.1] {{webarchive|url=https://web.archive.org/web/20090422160923/http://www.who.int/classifications/apps/icd/icd10online/|date=2009-04-22}} published by the [https://www.who.int/ World Health Organization] {{webarchive|url=https://web.archive.org/web/20160705141348/http://www.who.int/|date=2016-07-05}}. Retrieved 2007-08-13.APA 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..." in [http://www.mental-health-today.com/gender/dsm.htm DSM-IV: Sections 302.3] {{webarchive|url=https://web.archive.org/web/20070211020457/http://www.mental-health-today.com/gender/dsm.htm|date=2007-02-11}} published by the American Psychiatric Association. Retrieved 2007-08-13. In medical terms, transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3 in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and F65.1 in the ICD.{{update inline|date=January 2023|reason=The specified diagnostic codes refer to the DSM-4-TR and ICD-10 only. Neither code, nor the term "transvestic fetishism" appears in the current version of those manuals DSM-5-R and ICD-11.}}

{{See also|Drag king|Drag queen|AFAB queen}}

File:Victoria Sin, sandwich.jpg 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.{{cite web |date=28 April 2017 |title=Understanding Drag |url=https://transequality.org/issues/resources/understanding-drag |access-date=3 September 2020 |website=National Center For Transgender Equality |archive-date=10 March 2018 |archive-url=https://web.archive.org/web/20180310044748/https://transequality.org/issues/resources/understanding-drag |url-status=live}} 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 by second-wave feminism. Drag artists have a long tradition in LGBTQ culture.

Generally the term drag queen covers men doing female drag, drag king covers women doing male drag, and faux queen covers women doing female drag.{{cite news |date=12 November 2019 |title=The Many Styles Of Drag Kings, Photographed In And Out Of Drag |url=https://www.huffpost.com/entry/drag-kings_l_5db9c682e4b00d83f72159c8 |access-date=3 June 2020 |work=HuffPost |language=en |archive-date=8 March 2021 |archive-url=https://web.archive.org/web/20210308080628/https://www.huffpost.com/entry/drag-kings_l_5db9c682e4b00d83f72159c8 |url-status=live}}{{cite web |date=12 November 2012 |title=How Drag Queens Work |url=https://people.howstuffworks.com/drag-queen.htm |access-date=3 June 2020 |website=HowStuffWorks |language=en |archive-date=25 February 2021 |archive-url=https://web.archive.org/web/20210225003301/https://people.howstuffworks.com/drag-queen.htm |url-status=live}} 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 term tranny for drag queens or people who engage in transvestism or cross-dressing; this term is widely considered an offensive slur if applied to transgender people.

{{Main|Transgender history|Third gender}}

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.{{sfn|Stryker|2008a}}

Some historians consider the Roman emperor Elagabalus to have been transgender. Elagabalus was reported to have dressed in a feminine manner, preferred to be called "Lady" instead of "Lord" and may have even sought a primitive form of gender-affirming surgery.Abbie E. Goldberg, Genny Beemyn, The SAGE Encyclopedia of Trans Studies (2021), page 32M. Nugent, [https://www.academia.edu/28632384/From_Filthy_Catamite_to_Queer_Icon_Elagabalus_and_the_Politics_of_Sexuality_1960_1975_ Helios] 35 (2008) pages 171-172{{cite journal |last=Varner |first=Eric |date=2008 |title=Transcending Gender: Assimilation, Identity, and Roman Imperial Portraits. |journal=Memoirs of the American Academy in Rome. Supplementary Volume. |location=Ann Arbor, Michigan, US |publisher=University of Michigan Press |volume=7 |pages=200–201 |issn=1940-0977 |jstor=40379354 |oclc=263448435 |quote=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.}}{{cite encyclopedia |year=2004 |title=Elagabalus |encyclopedia=GLBTQ: An Encyclopedia of Gay, Lesbian, Bisexual, Transgender, and Queer Culture |publisher=glbtq, Inc. |location=Chicago |url=http://www.glbtqarchive.com/ssh/elagabalus_S.pdf |access-date=6 August 2007 |last=Godbout |first=Louis |archive-url=https://web.archive.org/web/20151117023701/http://www.glbtqarchive.com/ssh/elagabalus_S.pdf |archive-date=17 November 2015 |url-status=live}}{{cite journal |last=Benjamin |first=Harry |url=http://www.symposion.com/ijt/benjamin/ |title=The Transsexual Phenomenon |journal=Transactions of the New York Academy of Sciences |publisher=The Julian Press Inc. |year=1966 |isbn=978-0-446-82426-2 |volume=29 |location=New York |pages=428–430 |doi=10.1111/j.2164-0947.1967.tb02273.x |pmid=5233741 |access-date=27 April 2005 |archive-url=https://web.archive.org/web/20050424080535/http://www.symposion.com/ijt/benjamin/ |archive-date=24 April 2005 |issue=4}}{{Excessive citations inline|date=November 2023}}

Worldwide, a number of societies have had traditional third gender roles, some of which continue in some form into the present day.{{cite web |title=The Trans History You Weren't Taught in Schools |url=https://www.yesmagazine.org/social-justice/2021/06/07/trans-history-gender-diversity |access-date=23 January 2022 |website=YES! Magazine |language=en-US |archive-date=23 January 2022 |archive-url=https://web.archive.org/web/20220123215909/https://www.yesmagazine.org/social-justice/2021/06/07/trans-history-gender-diversity |url-status=live}}

{{Main|Transgender health care}}

{{further|Gender transition}}

File:Edward de Lacey Evans (1879) admitted into Kew Asylum, portrait 1.png, 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".{{cite news |url=https://trove.nla.gov.au/newspaper/article/10568650 |title=Death of De Lacy Evans |work=The Argus |location=Melbourne |via=National Library of Australia |date=27 August 1901 |page=5 |access-date=4 October 2013}}]]

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.{{cite journal |last1=Coleman |first1=E. |last2=Radix |first2=A. E. |collaboration=WPATH |title=Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 |journal=International Journal of Transgender Health |date=19 August 2022 |volume=23 |issue=Suppl 1 |pages=S1–S259 |issn=2689-5269 |doi=10.1080/26895269.2022.2100644 |doi-access=free |pmid=36238954 |pmc=9553112 |url=}} Research on gender identity with regard to psychology, and scientific understanding of the phenomenon and its related issues, is relatively new.Brown, M.L. & Rounsley, C.A. (1996) True Selves: Understanding Transsexualism – For Families, Friends, Coworkers, and Helping Professionals Jossey-Bass: San Francisco {{ISBN|0-7879-6702-5}}{{update inline|date=January 2023|reason=Is a citation that's 27 years old really supporting the idea that the "phenomenon" is "relatively new"?|?=yes}} The term gender incongruence is listed in the ICD by the WHO. In the American (DSM), the term gender dysphoria is listed under code F64.0 for adolescents and adults, and F64.2 for children.{{cite book |title=Diagnostic and statistical manual of mental disorders |chapter=Gender Dysphoria |publisher=American Psychiatric Association Publishing |author=American Psychiatric Association |edition=5th ed., text rev. |doi=10.1176/appi.books.9780890425787.x14_Gender_Dysophoria |date=18 March 2022 |isbn=978-0-89042-575-6}} {{Crossreference|text=(Further information: Causes of gender incongruence.)}}

France removed gender identity disorder as a diagnosis by decree in 2010,{{cite web |last=Atwill |first=Nicole |date=17 February 2010 |title=France: Gender Identity Disorder Dropped from List of Mental Illnesses {{!}} Global Legal Monitor |url=https://www.loc.gov/law/foreign-news/article/france-gender-identity-disorder-dropped-from-list-of-mental-illnesses/ |url-status=dead |archive-url=https://web.archive.org/web/20170511065253/http://www.loc.gov/law/foreign-news/article/france-gender-identity-disorder-dropped-from-list-of-mental-illnesses/ |archive-date=11 May 2017 |access-date=18 October 2017 |website=Library of Congress |language=en}}{{cite news |date=16 May 2009 |title=La transsexualité ne sera plus classée comme affectation psychiatrique |trans-title=Transsexuality will no longer be classified as a psychiatric condition |newspaper=Le Monde |url=http://www.lemonde.fr/societe/article/2009/05/16/la-transsexualite-ne-sera-plus-classee-comme-affectation-psychiatrique_1193860_3224.html |url-status=live |access-date=14 March 2018 |archive-url=https://web.archive.org/web/20180226213224/http://www.lemonde.fr/societe/article/2009/05/16/la-transsexualite-ne-sera-plus-classee-comme-affectation-psychiatrique_1193860_3224.html |archive-date=26 February 2018 |language=fr}} but according to French trans rights organizations, beyond the impact of the announcement itself, nothing changed.{{cite news |date=17 May 2011 |title=La France est très en retard dans la prise en charge des transsexuels |language=fr |work=Libération |url=http://www.liberation.fr/societe/2011/05/17/la-france-est-tres-en-retard-dans-la-prise-en-charge-des-transsexuels_736344 |url-status=live |archive-url=https://web.archive.org/web/20141130231929/http://www.liberation.fr/societe/2011/05/17/la-france-est-tres-en-retard-dans-la-prise-en-charge-des-transsexuels_736344 |archive-date=30 November 2014 |quote=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. |trans-quote=In reality, this decree was nothing more than a media stunt, a very nice announcement effect. On the ground, nothing has changed.}} In 2017, the Danish parliament abolished the F64 Gender identity disorders. The DSM-5 refers to the topic as gender dysphoria (GD) while reinforcing the idea that being transgender is not considered a mental illness.{{sfn|Garloch|2016}}

Transgender people may meet the criteria for a diagnosis of gender dysphoria "only if [being transgender] causes distress or disability."{{cite web |url=http://www.apa.org/topics/sexuality/transgender.aspx |title=Answers to Your Questions About Transgender Individuals and Gender Identity |archive-url=https://web.archive.org/web/20100615045832/http://apa.org/topics/sexuality/transgender.aspx |archive-date=15 June 2010 |website=American Psychological Association |quote=Is being transgender a mental disorder?}} 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.

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.{{cite journal |last1=Carroll |first1=L. |last2=Gilroy |first2=P. J. |last3=Ryan |first3=J. |year=2002 |title=Transgender issues in counselor education |journal=Counselor Education and Supervision |volume=41 |issue=3 |pages=233–242 |doi=10.1002/j.1556-6978.2002.tb01286.x}} Many mental healthcare providers know little about transgender issues. Those who seek help from these professionals often educate the professional without receiving help. 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.{{cite journal |last1=Kozee |first1=H. B. |last2=Tylka |first2=T. L. |last3=Bauerband |first3=L. A. |year=2012 |title=Measuring transgender individuals' comfort with gender identity and appearance: Development and validation of the Transgender Congruence Scale |journal=Psychology of Women Quarterly |publisher=SAGE Publications |volume=36 |issue=2 |pages=179–196 |doi=10.1177/0361684312442161 |s2cid=10564167}}

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.{{cite journal |last1=Benson |first1=Kristen E. |year=2013 |title=Seeking support: Transgender client experiences with mental health services |journal=Journal of Feminist Family Therapy |volume=25 |issue=1 |pages=17–40 |doi=10.1080/08952833.2013.755081 |s2cid=144491629}} Therapy was not always sought by transgender people due to mental health needs. Prior to the seventh version of the Standards 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.{{cite web |title=Standards of care for the health of transsexual, transgender, and gender nonconforming people – 7th version |url=http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf |url-status=dead |archive-url=https://web.archive.org/web/20120303035205/http://www.wpath.org/documents/Standards%20of%20Care%20V7%20-%202011%20WPATH.pdf |archive-date=3 March 2012 |access-date=30 November 2014 |website=The World Professional Association for Transgender Health}}

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 experiencing transphobia 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!" 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. Rarely, some choose to detransition.Detransition estimates:

• "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.{{' "}} {{harvnb|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." {{harvnb|Dhejne et al.|2014}}

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{{snd}}Master's degree, PhD level{{snd}}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." 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. 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.{{cite journal |last1=Hanssmann |first1=C. |last2=Morrison |first2=D. |last3=Russian |first3=E. |year=2008 |title=Talking, gawking, or getting it done: Providing trainings to increase cultural and clinical competence for transgender and gender-nonconforming patients and clients |journal=Sexuality Research and Social Policy |volume=5 |pages=5–23 |doi=10.1525/srsp.2008.5.1.5 |s2cid=52025741}} In May 2009, France became the first country in the world to remove transgender identity from the list of mental diseases.{{cite web |website=ILGA |date=16 May 2005 |title=France: Transsexualism will no longer be classified as a mental illness in France |url=http://trans.ilga.org/trans/welcome_to_the_ilga_trans_secretariat/news/france_transsexualism_will_no_longer_be_classified_as_a_mental_illness_in_france |url-status=dead |archive-url=https://web.archive.org/web/20130910105007/http://trans.ilga.org/trans/welcome_to_the_ilga_trans_secretariat/news/france_transsexualism_will_no_longer_be_classified_as_a_mental_illness_in_france |archive-date=10 September 2013 |publisher=ilga.org}}{{cite news |date=December 2, 2010 |title=Le transsexualisme n'est plus une maladie mentale en France |language=fr |trans-title=Transsexualism is no longer a mental illness in France |newspaper=Le Monde |url=http://www.lemonde.fr/societe/article/2010/02/12/le-transsexualisme-n-est-plus-une-maladie-mentale-en-france_1305090_3224.html |url-status=live |access-date=12 February 2010 |archive-url=https://web.archive.org/web/20100213052734/http://www.lemonde.fr/societe/article/2010/02/12/le-transsexualisme-n-est-plus-une-maladie-mentale-en-france_1305090_3224.html |archive-date=13 February 2010}}

A 2014 study carried out by the Williams Institute (a UCLA 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.{{cite book |last1=Haas |first1=Ann P. |url=https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf |title=Suicide Attempts among Transgender and Gender Non-Conforming Adults: Findings of the National Transgender Discrimination Survey |last2=Rodgers |first2=Philip L. |last3=Herman |first3=Jody L. |year=2014 |publisher=American Foundation for Suicide Prevention and the Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy |pages=2–3, 11 |access-date=9 October 2017 |archive-url=https://web.archive.org/web/20171008072751/https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf |archive-date=8 October 2017}} 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.{{cite web |last1=Herman |first1=Jody L. |last2=Brown |first2=Taylor N. T. |last3=Haas |first3=Ann P. |date=September 2019 |title=Suicide Thoughts and Attempts Among Transgender Adults |url=https://williamsinstitute.law.ucla.edu/wp-content/uploads/Suicidality-Transgender-Sep-2019.pdf |archive-url=https://web.archive.org/web/20200513172602/https://williamsinstitute.law.ucla.edu/wp-content/uploads/Suicidality-Transgender-Sep-2019.pdf |archive-date=13 May 2020 |access-date=13 May 2020 |publisher=Williams Institute on Sexual Orientation and Gender Identity Law and Public Policy}} 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.{{sfn|Travers|2012}}

{| class="wikitable"

|+ Suicidal thoughts and attempts by gender affirmation milestones

|-

! 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.{{cite web |last=Urquhart |first=Evan |date=21 March 2018 |title=A Disproportionate Number of Autistic Youth Are Transgender. Why? |url=https://slate.com/human-interest/2018/03/why-are-a-disproportionate-number-of-autistic-youth-transgender.html |url-status=live |archive-url=https://web.archive.org/web/20180321223559/https://slate.com/human-interest/2018/03/why-are-a-disproportionate-number-of-autistic-youth-transgender.html |archive-date=21 March 2018 |access-date=10 January 2018 |website=Slate}}{{better source needed|date=March 2023}}

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 or electrolysis removes excess hair for trans women. Surgical procedures for trans women feminize the voice, skin, face, Adam's apple, breasts, waist, buttocks, and genitals. Surgical procedures for trans men masculinize the chest and genitals and remove the womb, 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.{{sfn|GLAAD|n.d.|loc=¶ "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...." in [https://web.archive.org/web/20070503090247/http://www.symposion.com/ijt/pfaefflin/1000.htm Sex 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. Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder,APA task force (1994) "...preoccupation with getting rid of primary and secondary sex characteristics..." in [http://www.mental-health-today.com/gender/dsm.htm DSM-IV: Sections 302.6 and 302.85] {{webarchive|url=https://web.archive.org/web/20070211020457/http://www.mental-health-today.com/gender/dsm.htm|date=2007-02-11}} published by the American Psychiatric Association. Retrieved via [http://www.mental-health-matters.com/ Mental Health Matters] {{webarchive|url=https://web.archive.org/web/20070407163232/http://www.mental-health-matters.com/|date=2007-04-07}} on 2007-04-06. 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.{{cite web |last1=Hedian |first1=Helene Frances |title=Transgender Health Care |url=https://www.hopkinsmedicine.org/health/wellness-and-prevention/transgender-health-what-you-need-to-know#:~:text=Research%20shows%20that%20transgender%20and,toward%20trans%20and%20genderfluid%20people. |website=Johns Hopkins Medicine |publisher=Johns Hopkins University |access-date=7 February 2025}} It has been suggested that trans men who have not had a hysterectomy and who take testosterone may be at increased risk for endometrial 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.{{cite web |last1=Wesp |first1=Linda |title=Ovarian and endometrial cancer considerations in transgender men |url=https://transcare.ucsf.edu/guidelines/ovarian-cancer |website=UCSF Transgender Care & Treatment Guidelines |publisher=University of California - San Francisco |access-date=7 February 2025 |location=San Francisco |date=17 June 2016}}

{{main|Detransition}}

Detransition refers to the cessation or reversal of a sex reassignment surgery or gender transition. Formal studies of detransition have been few in number,

• "There is a paucity of literature." {{harvnb|Danker et al.|2018}}
• "We urgently need systematic data on this point in order to inform best practice clinical care." {{harvnb|Zucker|2019}} of disputed quality,"The research on outcomes post-transition is mixed at best." {{harvnb|Marchiano|2017}} and politically controversial."[R]esearch in this field is extremely controversial." {{harvnb|Danker et al.|2018}} Estimates of the rate at which detransitioning occurs vary from less than 1% to as high as 13%."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." {{harvnb|Clark-Flory|2015}} Those who undergo sex reassignment surgery have very low rates of detransition or regret.{{cite journal |last1=Hall |first1=R. |last2=Mitchell |first2=L. |last3=Sachdeva |first3=J. |date=1 October 2021 |title=Access to care and frequency of detransition among a cohort discharged by a UK national adult gender identity clinic: retrospective case-note review |journal=BJPsych Open |language=en |volume=7 |issue=6 |pages=e184 |doi=10.1192/bjo.2021.1022 |pmid=34593070 |pmc=8503911 |issn=2056-4724 |quote=Rates of detransitioning are unknown, with estimates ranging from less than 1% to 8%.}}{{cite journal |author1-link=Jack Turban |last1=Turban |first1=Jack L. |last2=Loo |first2=Stephanie S. |last3=Almazan |first3=Anthony N. |last4=Keuroghlian |first4=Alex S. |date=1 June 2021 |title=Factors Leading to "Detransition" Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis |journal=LGBT Health |volume=8 |issue=4 |pages=273–280 |doi=10.1089/lgbt.2020.0437 |issn=2325-8292 |pmc=8213007 |pmid=33794108}}{{cite journal |last1=Bustos |first1=Valeria P. |last2=Bustos |first2=Samyd S. |last3=Mascaro |first3=Andres |last4=Del Corral |first4=Gabriel |last5=Forte |first5=Antonio J. |last6=Ciudad |first6=Pedro |last7=Kim |first7=Esther A. |last8=Langstein |first8=Howard N. |last9=Manrique |first9=Oscar J. |date=19 March 2021 |title=Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence |journal=Plastic and Reconstructive Surgery - Global Open |language=en |volume=9 |issue=3 |pages=e3477 |doi=10.1097/GOX.0000000000003477 |issn=2169-7574 |pmc=8099405 |pmid=33968550}}

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." Detransition was associated with assigned male sex at birth, nonbinary gender identity, and bisexual orientation, among other cohorts. 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%)."{{harvnb|Boslaugh|2018|p=43}}; {{harvnb|James|Herman|Rankin|Keisling|2016|pp=111, 292–294}}{{cite book |last=Boslaugh |first=Sarah |url=https://books.google.com/books?id=agVnDwAAQBAJ&dq=detransition%20harassment&pg=PA43 |title=Transgender Health Issues |date=3 August 2018 |publisher=ABC-CLIO |isbn=9781440858888 |pages=43–44 |language=en |oclc=1031430413 |access-date=20 March 2023 |archive-url=https://web.archive.org/web/20230403224426/https://books.google.com/books?id=agVnDwAAQBAJ&dq=detransition%20harassment&pg=PA43 |archive-date=3 April 2023 |url-status=live}}

{{Main|Legal status of transgender people}}

{{further|Legal recognition of non-binary gender}}

File:Camille Cabral pour les Trans.JPG, 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 of transsexualism, 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.{{cite book |url=https://books.google.com/books?id=FUwOKayHVwcC&q=transgender+rights |title=Transgender Rights |publisher=Minnesota University Press |year=2006 |isbn=978-0-8166-4312-7 |editor1-last=Currah |editor1-first=Paisley |pages=51–73 |editor2-last=M. Juang |editor2-first=Richard|editor3-last=Minter |editor3-first=Shannon Price |access-date=7 November 2020 |archive-date=4 May 2021 |archive-url=https://web.archive.org/web/20210504201554/https://books.google.com/books?id=FUwOKayHVwcC&q=transgender+rights |url-status=live}} 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.{{cite web |last=Nokoff |first=Natalie J. |date=19 January 2022 |title=Table 2. [DSM-5 Criteria for Gender Dysphoria ()]. |url=https://www.ncbi.nlm.nih.gov/books/NBK577212/table/pediat_transgender.T.dsm5_criteria_for_g/ |access-date=26 March 2023 |website=www.ncbi.nlm.nih.gov |language=en |archive-date=31 March 2023 |archive-url=https://web.archive.org/web/20230331235403/https://www.ncbi.nlm.nih.gov/books/NBK577212/table/pediat_transgender.T.dsm5_criteria_for_g/ |url-status=live}} In many places, transgender people are not legally protected from discrimination in the workplace or in public accommodations.{{sfn|Whittle|2002}}{{Page needed|date=September 2024}} 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.{{sfn|Dallara|2011}} Members of the transgender community also encounter high levels of discrimination in health care.{{cite web |author=Gay and Lesbian Alliance Against Defamation. |url=http://glaadblog.org/2010/11/03/in-the-life-follows-lgbt-seniors-as-they-face-inequality-in-healthcare/ |title=IN THE LIFE Follows LGBT Seniors as They Face Inequality in Healthcare |archive-url=https://web.archive.org/web/20110804060104/http://glaadblog.org/2010/11/03/in-the-life-follows-lgbt-seniors-as-they-face-inequality-in-healthcare/ |archive-date=4 August 2011 |website=GLAAD |date=3 November 2010 |access-date=24 February 2011}}

{{Main|Transgender rights in Europe}}

File:Hate Hurts Wales - Portrayal of Transgender Hate Crime.webm advisory video on transgender hate crimes]]

{{as of|2017}}, 36 countries in Europe require a mental health diagnosis for legal gender recognition and 20 countries require sterilisation.{{cite web |title=– Trans Rights Europe Map & Index 2017 |url=https://tgeu.org/trans-rights-map-2017/ |url-status=live |archive-url=https://web.archive.org/web/20171019004745/https://tgeu.org/trans-rights-map-2017/ |archive-date=19 October 2017 |access-date=18 October 2017 |website=tgeu.org |date=18 May 2017 |language=en}} In April 2017, the European Court of Human Rights ruled that requiring sterilisation for legal gender recognition violates human rights.{{cite web |title=HUDOC - European Court of Human Rights|url=http://hudoc.echr.coe.int/eng?i=001-172556 |url-status=live |archive-url=https://web.archive.org/web/20171019060936/https://hudoc.echr.coe.int/eng?i=001-172556 |archive-date=19 October 2017 |access-date=18 October 2017 |website=hudoc.echr.coe.int}}

{{Main|Transgender rights in Canada}}

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 the House of Commons of Canada and the Senate of Canada, became law upon receiving Royal Assent, which put it into immediate force.{{cite web |url=https://www.parl.ca/LegisInfo/BillDetails.aspx?billId=8269852&Language=E&Mode=1 |archive-url=https://web.archive.org/web/20161224032029/http://www.parl.gc.ca/LegisInfo/BillDetails.aspx?Language=E&Mode=1&billId=8269852 |url-status=dead |title=House Government Bill C-16 (42-1): An Act to amend the Canadian Human Rights Act and the Criminal Code |website=LEGISinfo |publisher=Parliament of Canada |archive-date=24 December 2016}}{{cite news |last1=Tasker |first1=John Paul |date=16 June 2017 |title=Canada enacts protections for transgender community |newspaper=CBC News |url=http://www.cbc.ca/news/politics/transgender-rights-bill-senate-1.4163823 |url-status=live |access-date=16 June 2017 |archive-url=https://web.archive.org/web/20170617032107/http://www.cbc.ca/news/politics/transgender-rights-bill-senate-1.4163823 |archive-date=17 June 2017}} The law updated the Canadian Human Rights Act and the Criminal Code to include "gender identity and gender expression" as protected grounds from discrimination, hate publications and advocating transgender 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.{{cite web |date=January 2018 |title=Overview of Human Rights Codes by Province and Territory in Canada |url=https://ccdi.ca/media/1414/20171102-publications-overview-of-hr-codes-by-province-final-en.pdf |publisher=Canadian Center for Diversity and Inclusion |access-date=3 September 2020 |archive-date=19 September 2020 |archive-url=https://web.archive.org/web/20200919023941/https://ccdi.ca/media/1414/20171102-publications-overview-of-hr-codes-by-province-final-en.pdf |url-status=live}}

{{Main|Transgender rights in the United States}}

In the United States, transgender people are protected from employment discrimination by Title VII of the Civil Rights Act of 1964. Exceptions apply to certain types of employers, for example, employers with fewer than 15 employees and religious organizations.{{cite web|title=Civil Rights Act of 1964 – CRA – Title VII – Equal Employment Opportunities – 42 US Code Chapter 21|url=http://finduslaw.com/civil_rights_act_of_1964_cra_title_vii_equal_employment_opportunities_42_us_code_chapter_21|url-status=dead|archive-url=https://web.archive.org/web/20101021141154/http://finduslaw.com/civil_rights_act_of_1964_cra_title_vii_equal_employment_opportunities_42_us_code_chapter_21|archive-date=October 21, 2010|access-date=June 6, 2010|publisher=finduslaw}} In 2020, the U.S. Supreme Court affirmed that Title VII prohibits discrimination against transgender people in the case R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission.{{cite web |last=Neidig |first=Harper |date=15 June 2020 |title=Workers can't be fired for being gay or transgender, Supreme Court rules |url=https://thehill.com/regulation/court-battles/502729-supreme-court-rules-lgbt-workers-protected-by-civil-rights-law |access-date=15 June 2020 |work=The Hill |archive-date=15 June 2020 |archive-url=https://web.archive.org/web/20200615144030/https://thehill.com/regulation/court-battles/502729-supreme-court-rules-lgbt-workers-protected-by-civil-rights-law |url-status=live}}

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,{{cite web |last=June |first=Daniel |date=13 June 2013 |title=Transgender Girl in Maine Seeks Supreme Court's Approval to Use School's Girls Room |url=http://www.jdjournal.com/2013/06/13/transgender-girl-in-maine-seeks-supreme-courts-approval-to-use-schools-girls-room/ |url-status=live |archive-url=https://archive.today/20130615222439/http://www.jdjournal.com/2013/06/13/transgender-girl-in-maine-seeks-supreme-courts-approval-to-use-schools-girls-room/ |archive-date=15 June 2013 |access-date=13 June 2013 |work=JD Journal}} but Maines won her lawsuit against the Orono school district in January 2014 before the Maine Supreme Judicial Court.{{cite news |last=Sharp |first=David |date=31 January 2014 |title=Maine Court Rules In Favor Of Transgender Pupil |work=The Huffington Post |url=http://www.huffingtonpost.com/2014/01/31/maine-court-transgender-pupil_n_4703670.html |url-status=live |access-date=16 December 2015 |archive-url=https://web.archive.org/web/20151212073816/http://www.huffingtonpost.com/2014/01/31/maine-court-transgender-pupil_n_4703670.html |archive-date=12 December 2015}} On May 14, 2016, the United States Department of Education and Department of Justice issued guidance directing public schools to allow transgender students to use bathrooms that match their gender identities.{{cite news |last=Grinberg |first=Emanuella |date=14 May 2016 |title=Feds issue guidance on transgender access to school bathrooms |url=http://www.cnn.com/2016/05/12/politics/transgender-bathrooms-obama-administration/ |url-status=live |archive-url=https://web.archive.org/web/20160518070709/http://www.cnn.com/2016/05/12/politics/transgender-bathrooms-obama-administration/ |archive-date=18 May 2016 |access-date=19 May 2016 |work=CNN}}

On June 30, 2016, the United States Department of Defense removed the ban that prohibited transgender people from openly serving in the US military.{{cite web |date=30 June 2016 |title=Transgender Service Members Can Now Serve Openly, Carter Announces |first1=Terri Moon |last1=Cronk |work=U.S. DEPARTMENT OF DEFENSE |url=https://www.defense.gov/News/Article/Article/822235/transgender-service-members-can-now-serve-openly-carter-announces/ |url-status=dead |archive-url=https://web.archive.org/web/20170810090404/https://www.defense.gov/News/Article/Article/822235/transgender-service-members-can-now-serve-openly-carter-announces/ |archive-date=10 August 2017 |access-date=9 August 2017}} On July 27, 2017, President Donald Trump tweeted that transgender Americans would not be allowed to serve "in any capacity" in the United States Armed Forces.{{cite news |date=26 July 2017 |title=Trump: Transgender people 'can't serve' in US military |work=BBC News |url=https://www.bbc.com/news/world-us-canada-40729996 |url-status=live |access-date=9 August 2017 |archive-url=https://web.archive.org/web/20170729073833/http://www.bbc.com/news/world-us-canada-40729996 |archive-date=29 July 2017}} Later that day, Joint Chiefs of Staff Chairman Joseph Dunford announced, "there will be no modifications to the current policy until the president's direction has been received by the Secretary of Defense and the secretary has issued implementation guidance."{{cite news |date=26 July 2017 |title=The Joint Chiefs say there'll be no transgender policy changes until Trump clarifies his Tweets |first1=Courtney |last1=Kube |first2=Andrew |last2=Rafferty |first3=Meredith |last3=Mandell |work=NBC News |url=http://www.nbcnews.com/politics/national-security/joint-chiefs-no-transgender-policy-changes-until-trump-clarifies-tweets-n787076 |url-status=live |access-date=9 August 2017 |archive-url=https://web.archive.org/web/20170809032120/http://www.nbcnews.com/politics/national-security/joint-chiefs-no-transgender-policy-changes-until-trump-clarifies-tweets-n787076 |archive-date=9 August 2017}} Joe Biden later reversed Trump's policy when he became president in 2021.{{cite news |url=https://www.cnn.com/2021/01/25/politics/lloyd-austin-transgender-military-harris-biden/index.html |title=Biden lifts transgender military ban |first=Kate |last=Sullivan |work=CNN |date=25 January 2021 |access-date=28 August 2021 |archive-date=3 November 2021 |archive-url=https://web.archive.org/web/20211103120521/https://www.cnn.com/2021/01/25/politics/lloyd-austin-transgender-military-harris-biden/index.html |url-status=live}}{{cite news |url=https://www.nbcnews.com/video/biden-to-transgender-americans-your-president-has-your-back-111031877945 |title=Biden to transgender Americans: 'Your president has your back' |work=NBC News |access-date=18 August 2021 |archive-date=18 August 2021 |archive-url=https://web.archive.org/web/20210818123240/https://www.nbcnews.com/video/biden-to-transgender-americans-your-president-has-your-back-111031877945 |url-status=live}}

While the topic of trans rights in the United States has often been contentious, it has become a deeply partisan wedge issue in recent years;{{Cite news |last=Block |first=Melissa |date=29 June 2022 |title=Americans are deeply divided on transgender rights, a poll shows |url=https://www.npr.org/2022/06/29/1107484965/transgender-athletes-trans-rights-gender-transition-poll |work=National Public Radio}} many pieces of legislation have been passed, and more proposed, that seek to limit the rights of transgender individuals, especially minors.{{Cite news |last=Hassan |first=Adeel |date=27 June 2023 |title=States Passed a Record Number of Transgender Laws. Here's What They Say. |url=https://www.nytimes.com/2023/06/27/us/transgender-laws-states.html |access-date=15 September 2024 |work=The New York Times}}

{{Main|LGBT rights in India#Transgender rights}}

File:Jogappas at Bangalore.jpg is a transgender community in Karnataka and Andhra Pradesh. They are traditional folk singers and dancers.]]

In April 2014, the Supreme Court of India declared transgender to be a 'third gender' in Indian law.{{cite news |date=15 April 2014 |title=India recognises transgender people as third gender |newspaper=The Guardian |url=https://www.theguardian.com/world/2014/apr/15/india-recognises-transgender-people-third-gender |url-status=live |access-date=15 April 2014 |archive-url=https://web.archive.org/web/20140415221112/http://www.theguardian.com/world/2014/apr/15/india-recognises-transgender-people-third-gender |archive-date=15 April 2014}}{{cite news |last=McCoy |first=Terrence |date=15 April 2014 |title=India now recognizes transgender citizens as 'third gender' |newspaper=The Washington Post |url=https://www.washingtonpost.com/news/morning-mix/wp/2014/04/15/india-now-recognizes-transgender-citizens-as-third-gender/?tid=hp_mm |url-status=live |access-date=15 April 2014 |archive-url=https://web.archive.org/web/20140415141006/http://www.washingtonpost.com/news/morning-mix/wp/2014/04/15/india-now-recognizes-transgender-citizens-as-third-gender/?tid=hp_mm |archive-date=15 April 2014}}{{cite news |date=15 April 2014 |title=Supreme Court recognizes transgenders as 'third gender' |first1=Dhananjay |last1=Mahapatra |newspaper=The Times of India |url=http://timesofindia.indiatimes.com/india/Supreme-Court-recognizes-transgenders-as-third-gender/articleshow/33767900.cms |url-status=live |access-date=15 April 2014 |archive-url=https://web.archive.org/web/20140415112611/http://timesofindia.indiatimes.com/india/Supreme-Court-recognizes-transgenders-as-third-gender/articleshow/33767900.cms |archive-date=15 April 2014}} The transgender community in India (made up of Hijras and others) has a long history in India and in Hindu mythology.{{cite news |title=Why transgender not an option in civil service exam form: HC |website=The Times of India |date=15 June 2015 |url=http://timesofindia.indiatimes.com/india/Why-transgender-not-an-option-in-civil-service-exam-form-HC/articleshow/47677633.cms |url-status=live |archive-url=https://web.archive.org/web/20151203163129/http://timesofindia.indiatimes.com/india/Why-transgender-not-an-option-in-civil-service-exam-form-HC/articleshow/47677633.cms |archive-date=3 December 2015}}{{cite news |date=15 June 2015 |title=Why transgender not an option in civil service exam form: HC |newspaper=The Economic Times |url=http://economictimes.indiatimes.com/news/politics-and-nation/why-transgender-not-an-option-in-civil-service-exam-form-delhi-hc/articleshow/47677858.cms |url-status=live |archive-url=https://web.archive.org/web/20160125192422/http://economictimes.indiatimes.com/news/politics-and-nation/why-transgender-not-an-option-in-civil-service-exam-form-delhi-hc/articleshow/47677858.cms |archive-date=25 January 2016}} Justice KS 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".{{cite web |url=https://www.refworld.org/pdfid/5356279d4.pdf |title=In the Supreme Court of India Civil Original Jurisdiction Writ Petition (Civil) No.400 of 2012 |access-date=19 June 2019 |archive-date=25 June 2017 |archive-url=https://web.archive.org/web/20170625155637/http://www.refworld.org/pdfid/5356279d4.pdf |url-status=live}} 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.{{cite web |date=29 January 2014 |title=Hijras: The Battle for Equality |url=https://worldpolicy.org/2014/01/29/hijras-the-battle-for-equality/ |access-date=23 June 2019 |archive-date=23 June 2019 |archive-url=https://web.archive.org/web/20190623220946/https://worldpolicy.org/2014/01/29/hijras-the-battle-for-equality/ |url-status=dead}}

{{Expand section|date=October 2023}}

{{See also|LGBTQ|LGBTQ community|LGBTQ culture#Transgender culture}}

File:Melissa Venezian.jpg

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 accepted {{clarify span|reason=One does not 'belong' to a gender role, one performs it. Possible confusion with gender identity.|date=February 2025 |in the gender role they felt they belonged to}}; especially during the time when legal or medical transitioning was almost impossible. This acceptance has had a complex history. Like the wider world, the gay 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.{{sfn|Retro Report|2015}}{{failed verification|reason=Nothing in this paragraph is supported by the Retro Report.|date=February 2025}}

Transgender individuals have been part of various LGBTQ movements throughout history, with significant contributions dating back to the early days of the gay liberation movement.{{cite web |last1=Morris |first1=Bonnie J. |title=A brief history of lesbian, gay, bisexual, and transgender social movements |url=https://www.apa.org/topics/lgbtq/history |website=www.apa.org |publisher=American Psychological Association |access-date=26 May 2023 |archive-url=https://web.archive.org/web/20230519220750/https://www.apa.org/topics/lgbtq/history |archive-date=19 May 2023 |language=en |date=21 July 2017 |url-status=live}}

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 and Civil 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. 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.{{sfn|Gamson|1995}}

{{Main|Transgender people and religion}}

{{Main|Feminist views on transgender topics|Transfeminism}}

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.{{Cite magazine |first1=Michelle |last1=Goldberg |date=28 July 2014 |title=What Is a Woman?|url=https://www.newyorker.com/magazine/2014/08/04/woman-2 |access-date=23 January 2022 |magazine=The New Yorker |language=en-US |archive-date=13 November 2019 |archive-url=https://web.archive.org/web/20191113031943/https://www.newyorker.com/magazine/2014/08/04/woman-2 |url-status=live}}{{cite book |last=Marcus |first=Eric |title=Making Gay History: The Half-Century Fight for Lesbian and Gay Equal Rights |date=2002 |publisher=Harper |isbn=9780060933913 |location=New York |page=156 |oclc=1082454306 |author-link=Eric Marcus}} 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.{{cite book |last1=Hines |first1=Sally |url=https://archive.org/details/transforminggend00hine |title=TransForming Gender: Transgender Practices of Identity, Intimacy and Care |date=2007 |publisher=Policy Press |isbn=978-1861349163 |location=Bristol |pages=[https://archive.org/details/transforminggend00hine/page/n89 85]–101 |url-access=limited}} By the emergence of third-wave feminism (around 1990), opinions had shifted to being more inclusive of both trans and gay identities.{{cite news |last=Grady |first=Constance |date=20 June 2018 |title=The waves of feminism, and why people keep fighting over them, explained |work=Vox |url=https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth |url-status=live |access-date=26 April 2019 |archive-url=https://web.archive.org/web/20190405172242/https://www.vox.com/2018/3/20/16955588/feminism-waves-explained-first-second-third-fourth |archive-date=5 April 2019}}{{cite web |last1=Yenor |first1=Scott |date=31 July 2017 |title=The Rolling Revolution in Sex and Gender: A History |url=https://www.thepublicdiscourse.com/2017/07/19766/ |url-status=live |archive-url=https://web.archive.org/web/20181215060405/https://www.thepublicdiscourse.com/2017/07/19766/ |archive-date=15 December 2018 |access-date=21 April 2019 |website=Public Discourse |publisher=Witherspoon Institute}} 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.{{cite web |last1=Flaherty |first1=Colleen |date=6 June 2018 |title=By Any Other Name |url=https://www.insidehighered.com/news/2018/06/06/philosophy-really-ignoring-important-questions-about-transgender-identity |url-status=live |archive-url=https://web.archive.org/web/20190519075321/http://www.insidehighered.com/news/2018/06/06/philosophy-really-ignoring-important-questions-about-transgender-identity |archive-date=19 May 2019 |access-date=6 May 2019 |website=Inside Higher Ed |language=en}}{{cite news |date=7 February 2019 |title=Opinion {{!}} How British Feminism Became Anti-Trans |language=en-US |work=The New York Times |url=https://www.nytimes.com/2019/02/07/opinion/terf-trans-women-britain.html |url-status=live |access-date=5 May 2019 |archive-url=https://web.archive.org/web/20191115191351/https://www.nytimes.com/2019/02/07/opinion/terf-trans-women-britain.html |archive-date=15 November 2019 |issn=0362-4331 |last=Lewis |first=Sophie}} Feminists who do not accept that trans women are women have been labeled "trans-exclusionary radical feminists" (TERFs) or gender-critical feminists by opponents.{{cite journal |last1=Stryker |first1=Susan |last2=Bettcher |first2=Talia |date=2016 |title=Introduction: Trans/Feminisms |url=https://read.dukeupress.edu/tsq/article/3/1-2/5/91824/IntroductionTrans-Feminisms# |journal=Transgender Studies Quarterly |publisher=Duke University Press |volume=3 |issue=1–2 |doi=10.1215/23289252-3334127 |access-date=17 September 2020 |doi-access=free |archive-date=5 April 2019 |archive-url=https://web.archive.org/web/20190405174836/https://read.dukeupress.edu/tsq/article/3/1-2/5/91824/IntroductionTrans-Feminisms |url-status=live}}{{cite journal |last1=Zanghellini |first1=Aleardo |date=April 2020 |title=Philosophical Problems With the Gender-Critical Feminist Argument Against Trans Inclusion |url=https://centaur.reading.ac.uk/90937/4/2158244020927029.pdf |journal=SAGE Open |volume=10 |issue=2 |pages=215824402092702 |doi=10.1177/2158244020927029 |s2cid=219733494 |access-date=19 June 2022 |archive-date=3 November 2020 |archive-url=https://web.archive.org/web/20201103214816/http://centaur.reading.ac.uk/90937/4/2158244020927029.pdf |url-status=live}}

{{See also|Transphobia}}

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.{{Cite web |date=3 June 2011 |title=Gay and Transgender People Face High Rates of Workplace Discrimination and Harassment |first1=Jeff |last1=Krehly |first2=Crosby |last2=Buns|url=https://genprogress.org/gay-and-transgender-people-face-high-rates-of-workplace-discrimination/ |access-date=23 March 2021 |website=Generation Progress |language=en-US |archive-date=21 April 2021 |archive-url=https://web.archive.org/web/20210421133050/https://genprogress.org/gay-and-transgender-people-face-high-rates-of-workplace-discrimination/ |url-status=dead}}

Studies in several cultures have found that cisgender women are more likely to be accepting of trans people than cisgender men.{{cite journal |url=https://www.tandfonline.com/doi/abs/10.1080/19317611.2019.1701170?journalCode=wijs20 |title=Patrolling the Boundaries of Gender: Beliefs, Attitudes and Behaviors Toward Trans and Gender Diverse People in Portuguese Adolescents |first1=María Victoria |last1=Carrera-Fernández |first2=Ana |last2=Almeida |first3=Xosé Manuel |last3=Cid-Fernández |first4=Pablo |last4=Vallejo-Medina |first5=Yolanda |last5=Rodríguez-Castro |journal=International Journal of Sexual Health |volume=32 |issue=1|pages=40–56 |date=18 December 2019 |doi=10.1080/19317611.2019.1701170 |s2cid=214355852 |access-date=21 August 2021 |archive-date=25 January 2022 |archive-url=https://web.archive.org/web/20220125014940/https://www.tandfonline.com/doi/abs/10.1080/19317611.2019.1701170?journalCode=wijs20& |url-status=live}}{{cite journal |first1=Karolina |last1=Konopka |first2=Monika |last2=Prusik |first3=Michał |last3=Szulawski |title=Two Sexes, Two Genders Only: Measuring Attitudes toward Transgender Individuals in Poland |journal=Sex Roles |year=2020 |volume=82 |issue=9–10 |pages=600–621 |doi=10.1007/s11199-019-01071-7 |s2cid=199862108 |doi-access=free}}{{cite journal |url=https://bmjopen.bmj.com/content/10/4/e031569 |title=Paediatricians' attitudes and beliefs towards transgender people: a cross-sectional survey in Israel |first1=Nitsan |last1=Landau |first2=Uri |last2=Hamiel |first3=Itay Tokatly |last3=Latzer |first4=Elinor |last4=Mauda |first5=Noah |last5=Levek |first6=Liana |last6=Tripto-Shkolnik |first7=Orit |last7=Pinhas-Hamiel |journal=BMJ Open |doi=10.1136/bmjopen-2019-031569 |date=2020 |volume=10 |number=4 |pages=e031569 |pmid=32341041 |pmc=7204925 |access-date=21 August 2021 |archive-date=10 June 2021 |archive-url=https://web.archive.org/web/20210610143239/https://bmjopen.bmj.com/content/10/4/e031569 |url-status=live}}{{cite journal |url=https://onlinelibrary.wiley.com/doi/abs/10.1002/jcop.22546 |title=Individual factors and cisgender college students' attitudes and behaviors toward transgender individuals |first1=Laura |last1=Hackimer |first2=Cliff Y.-C. |last2=Chen |first3=Jay |last3=Verkuilen |journal=Journal of Community Psychology |date=5 March 2021 |volume=49 |issue=6 |pages=2023–2039 |doi=10.1002/jcop.22546 |issn=0090-4392 |pmid=33667012 |s2cid=232121524 |access-date=21 August 2021 |archive-date=10 June 2021 |archive-url=https://web.archive.org/web/20210610144707/https://onlinelibrary.wiley.com/doi/abs/10.1002/jcop.22546 |url-status=live}}

The start of the twenty-first century saw the rise in transgender activism and with it an increase in support. Within the United States, groups such as the Trevor 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.{{cite news |last1=Midgon |first1=Brooke |title=Calls to LGBTQ youth crisis hotline rose 33 percent on Inauguration Day: Trevor Project |url=https://thehill.com/homenews/lgbtq/5100814-trump-inauguration-day-lgbtq-suicide/ |access-date=7 February 2025 |work=The Hill |date=22 January 2025}}{{cite news |last1=McNeill |first1=Zane |title=Transgender Rights Under Threat: Preparing for Federal Crackdowns |url=https://nonprofitquarterly.org/transgender-rights-under-threat-preparing-for-federal-crackdowns/ |access-date=7 February 2025 |work=Nonprofit Quarterly |date=20 January 2025}}The American Civil Liberties Unions (ACLU) also often represents members of the trans community.{{cite news |last1=Chung |first1=Andrew |title=First openly transgender lawyer to argue at US Supreme Court |url=https://www.google.com/search?q=aclu+representing+transgender&tbm=nws&fbs=ABzOT_CWdhQLP1FcmU5B0fn3xuWpA-dk4wpBWOGsoR7DG5zJBnsX62dbVmWR6QCQ5QEtPRqInn_ud8BG5tWxPdEiOpZiqcs2-8hm_Lubj82L_E5oFQydz7e5kf7Eu4rplgi8HAIhO-O0Mb5vRDG8uTfyL54tUaQrQkJ11f0BLZ37orZsxJtMmmfE4iO-p2sheVTb5K8qj8AVzd9BUqfHMGZ55Ni8j8r9XA |access-date=7 February 2025 |agency=Reuters |date=21 October 2024}}{{cite web |title=ACLU Launches National Trans Justice Campaign Featuring Diverse Trans Youth & Their Families Ahead of Landmark Supreme Court Case |url=https://www.aclu.org/press-releases/aclu-launches-national-trans-justice-campaign-featuring-diverse-trans-youth-their-families-ahead-of-landmark-supreme-court-case-2 |website=Press Releases |publisher=American Civil Liberties Union |access-date=7 February 2025 |date=11 September 2024}}

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.{{cite web |title=National Center for Transgender Equality |url=https://oge.harvard.edu/links/national-center-transgender-equality#:~:text=The%20National%20Center%20for%20Transgender,empathy%2C%20opportunity%2C%20and%20justice. |website=Office for Gender Equity |publisher=Harvard University |access-date=7 February 2025}}{{Cite web |date=12 May 2023 |website=transequality.org |url=https://transequality.org |access-date=26 May 2023 |title=National Center for Transgender Equality |publisher=National Center for Transgender Equality |language=en |url-status=live |archive-url=https://web.archive.org/web/20091018085034/http://www.transequality.org/ |archive-date=18 October 2009}} 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.{{Cite web |title=About us |url=https://tgeu.org/about-us/ |access-date=20 May 2023 |website=TGEU |language=en |archive-date=18 May 2023 |archive-url=https://web.archive.org/web/20230518083634/https://tgeu.org/about-us/ |url-status=live}}{{cite news |last1=Wareham |first1=Jamie |title=Trans Rights Increased In Europe Despite Growing Backlash In 2022 |url=https://www.forbes.com/sites/jamiewareham/2023/05/11/trans-rights-increased-in-europe-and-asia-in-2022-despite-growing-backlash/ |access-date=7 February 2025 |work=Forbes |date=11 May 2023}}

{{See also|Transsexual#Prevalence}}

Little is known about the prevalence of transgender people in the general population and reported prevalence estimates are greatly affected by variable

definitions of transgender.{{Cite journal |last1=Collin |first1=Lindsay |last2=Reisner |first2=Sari L. |last3=Tangpricha |first3=Vin |last4=Goodman |first4=Michael |date=2016 |title=Prevalence of Transgender Depends on the "Case" Definition: A Systematic Review |journal=The Journal of Sexual Medicine |language=en |volume=13 |issue=4 |pages=613–626 |doi=10.1016/j.jsxm.2016.02.001 |pmc=4823815 |pmid=27045261}} 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. 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. 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.{{cite journal |last1=Leinung |first1=Matthew C |date=2020 |title=Changing Demographics in Transgender Individuals Seeking Hormonal Therapy: Are Trans Women More Common Than Trans Men? |journal=Transgender Health |volume=11 |issue=5 |pages=241–245 |doi=10.1089/trgh.2019.0070 |pmc=7906237 |pmid=33644314}}

File:Nongthoomfairtex.jpg, a Kathoey internationally recognized for her portrayal in the film Beautiful Boxer]]

In Thailand and Laos,Doussantousse, S. (2005) "...The Lao Kathoey's characteristics appear to be similar to other transgenders in the region..." in [http://web.hku.hk/~sjwinter/TransgenderASIA/paper_doussantousse.htm Male Sexual Health: Kathoeys in the Lao PDR, South East Asia – Exploring a gender minority] {{webarchive|url=https://web.archive.org/web/20070819021051/http://web.hku.hk/~sjwinter/TransgenderASIA/paper_doussantousse.htm|date=2007-08-19}} from the [http://web.hku.hk/~sjwinter/TransgenderASIA/ Transgender ASIA Research Centre] {{webarchive|url=https://web.archive.org/web/20070823115109/http://web.hku.hk/~sjwinter/TransgenderASIA/|date=2007-08-23}}. Retrieved 2007-07-22. the term kathoey is used to refer to male-to-female transgender peopleJackson, P. (2003) [http://wwwsshe.murdoch.edu.au/intersections/issue9/jackson.html Performative Genders, Perverse Desires: A Bio-History of Thailand's Same-Sex and Transgender Cultures] {{webarchive|url=https://web.archive.org/web/20070403051912/http://wwwsshe.murdoch.edu.au/intersections/issue9/jackson.html|date=2007-04-03}} in Intersections: Gender, History and Culture in the Asian Context, Issue 9, August 2003. and effeminate gay men.Winter, S. and Udomsak, N. (2002) [http://www.symposion.com/ijt/ijtvo06no01_04.htm Male, Female and Transgender: Stereotypes and Self in Thailand] in the International Journal of Transgender, Volume 6, Number 1, January – March 2002. {{webarchive|url=https://web.archive.org/web/20070228130914/http://www.symposion.com/ijt/ijtvo06no01_04.htm|date=February 28, 2007}} However, many transgender people in Thailand do not identify as kathoey.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. [http://web.hku.hk/~sjwinter/TransgenderASIA/paper_language_and_identity.htm Article online] {{webarchive|url=https://web.archive.org/web/20120329163435/http://web.hku.hk/~sjwinter/TransgenderASIA/paper_language_and_identity.htm |date=29 March 2012 }}. Transgender people have also been documented in Iran,{{cite web |last=Harrison |first=F. |date=2005 |quote=...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... |url=http://news.bbc.co.uk/1/hi/programmes/newsnight/4115535.stm |title=Iran's sex-change operations |archive-url=https://web.archive.org/web/20070817100337/http://news.bbc.co.uk/1/hi/programmes/newsnight/4115535.stm |archive-date=17 August 2007 |website=BBC |access-date=22 July 2007}} Japan,{{cite journal |last1=Mitsuhashi |first1=J. |date=2006 |title=The transgender world in contemporary Japan: the male to female cross-dressers' community in Shinjuku |journal=Inter-Asia Cultural Studies |volume=7 |issue=2 |pages=202–227 |doi=10.1080/14649370600673847 |s2cid=143080943 |translator-last1=Hasegawa |translator-first1=K. |quote=...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...}} Nepal,{{cite web |last=Haviland |first=C. |date=2005 |quote=...The Gurung people of western Nepal have a tradition of men called maarunis, who dance in female clothes... |url=http://news.bbc.co.uk/2/hi/south_asia/4202893.stm |title=Crossing sexual boundaries in Nepal |archive-url=https://web.archive.org/web/20070828102820/http://news.bbc.co.uk/2/hi/south_asia/4202893.stm |archive-date=28 August 2007 |website=BBC |access-date=22 July 2007}} Indonesia,Graham, S. (2002) "...Among the Bugis of South Sulawesi, possibly four genders are acknowledged plus a fifth para-gender identity. In addition to male-men (oroane) and female-women (makunrai)..., there are calalai (masculine females), calabai (feminine males), and bissu..." in [http://web.hku.hk/~sjwinter/TransgenderASIA/paper_priests_and_gender.htm Priests and gender in South Sulawesi, Indonesia] {{webarchive|url=https://web.archive.org/web/20071011215412/http://web.hku.hk/~sjwinter/TransgenderASIA/paper_priests_and_gender.htm|date=2007-10-11}} from the [http://web.hku.hk/~sjwinter/TransgenderASIA/ Transgender ASIA Research Centre] {{webarchive|url=https://web.archive.org/web/20070823115109/http://web.hku.hk/~sjwinter/TransgenderASIA/|date=2007-08-23}}. Retrieved 2007-07-22. Vietnam,Walters, I. (2006) "...In Vietnam, male to female (MtF) transgender people are categorised as lai cai, bong cai, bong lai cai, dong co, or be-de..." in [http://web.hku.hk/~sjwinter/TransgenderASIA/paper_vietnam.htm Vietnam Some notes by Ian Walters] {{webarchive|url=https://web.archive.org/web/20071011220422/http://web.hku.hk/~sjwinter/TransgenderASIA/paper_vietnam.htm|date=2007-10-11}} from the [http://web.hku.hk/~sjwinter/TransgenderASIA/ Transgender ASIA Research Centre] {{webarchive|url=https://web.archive.org/web/20070823115109/http://web.hku.hk/~sjwinter/TransgenderASIA/|date=2007-08-23}}. Retrieved 2007-07-22. South Korea,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..." in [http://english.yna.co.kr/Engnews/20060523/480100000020060523094019E8.html S. Korea in dilemma over transgender citizens right to choose] {{webarchive|url=https://web.archive.org/web/20070817101936/http://english.yna.co.kr/Engnews/20060523/480100000020060523094019E8.html|date=2007-08-17}} from the [http://english.yna.co.kr/Engservices/6800000000.html Yonhap News Agency] {{webarchive|url=https://web.archive.org/web/20070717185425/http://english.yna.co.kr/Engservices/6800000000.html|date=2007-07-17}}. Retrieved 2007-07-22. Jordan,{{Cite web |title=News reporting an average of 2-3 Jordanians per year officially change their gender |url=https://www.ammonnews.net/article/208487 |website=Ammon News |language=ar |access-date=31 August 2020 |archive-date=16 June 2018 |archive-url=https://web.archive.org/web/20180616033235/https://www.ammonnews.net/article/208487 |url-status=live}} Singapore,{{cite web |last=Heng |first=R. |date=2005 |quote=...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.... |url=http://www.yawningbread.org/guest_2005/guw-101.htm |title=Where queens ruled! - a history of gay venues in Singapore |archive-url=https://web.archive.org/web/20071011160736/http://yawningbread.org/guest_2005/guw-101.htm |archive-date=11 October 2007 |publisher=IndigNation |access-date=22 July 2007}} and the greater Chinese region, including Hong Kong,{{cite journal |last1=Emerton |first1=R. |date=2006 |title=Finding a voice, fighting for rights: the emergence of the transgender movement in Hong Kong |journal=Inter-Asia Cultural Studies |volume=7 |issue=2 |pages=243–269 |doi=10.1080/14649370600673896 |s2cid=145122793 |quote=...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...}}{{cite web |last=Hung |first=L. |date=2007 |quote=...there are many archetypal flamboyant embodiments of female-to-male transgender physicality living and displaying their unrestrained, dashing iconic presence... |url=http://www.cuhk.edu.hk/ant/gender/7Feb07.doc |title=Trans-Boy Fashion, or How to Tailor-Make a King |archive-url=https://web.archive.org/web/20070927052144/http://www.cuhk.edu.hk/ant/gender/7Feb07.doc |archive-date=27 September 2007 |website=Gender Studies programme of The Chinese University of Hong Kong |access-date=22 July 2007}} Taiwan,{{cite journal |last1=Ho |first1=J. |author-link=Josephine Ho |date=2006 |title=Embodying gender: transgender body/subject formations in Taiwan |journal=Inter-Asia Cultural Studies |volume=7 |issue=2 |pages=228–242 |doi=10.1080/14649370600673888 |s2cid=43951816 |quote=...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...}} and the People's Republic of China.{{cite news |last=Hahn |first=L. |quote=...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... |url=http://www.cnn.com/2005/WORLD/asiapcf/06/13/talkasia.xing.scirpt/ |title=Jin Xing TalkAsia Interview Transcript |archive-url=https://web.archive.org/web/20071011212746/http://www.cnn.com/2005/WORLD/asiapcf/06/13/talkasia.xing.scirpt/ |archive-date=11 October 2007 |work=CNN |date=13 June 2005 |access-date=22 July 2007}}{{cite news |last=Goldkorn |first=J. |date=2006 |quote=...At one point in 2003, there was so much media coverage of transsexuals in China that Danwei started a special section for it... |url=http://www.danwei.org/newspapers/post_28.php |title=Transsexuals in the Chinese media again |archive-url=https://web.archive.org/web/20070827131506/http://www.danwei.org/newspapers/post_28.php |archive-date=27 August 2007 |work=Danwei |access-date=22 July 2007}}

The cultures of the Indian subcontinent include a third gender, referred to as hijra in Hindi. In India, the Supreme 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."{{cite web |date=April 2014 |title=Transgenders are the 'third gender', rules Supreme Court |editor-first=Deepshikha |editor-last=Ghosh |url=http://www.ndtv.com/article/india/transgenders-are-the-third-gender-rules-supreme-court-508705 |url-status=live |archive-url=https://web.archive.org/web/20140415135613/http://www.ndtv.com/article/india/transgenders-are-the-third-gender-rules-supreme-court-508705 |archive-date=15 April 2014 |access-date=15 April 2014 |publisher=NDTV}} In 1998, Shabnam Mausi became the first transgender person to be elected in India, in the central Indian state of Madhya Pradesh.{{cite news |date=22 November 2018 |title=Telangana assembly elections 2018: Chandramukhi eyes Goshamahal glory, ready for tryst with 1st transgender party |url=https://timesofindia.indiatimes.com/city/hyderabad/chandramukhi-eyes-goshamahal-glory-ready-for-tryst-with-1st-transgender-party/articleshow/66743495.cms |access-date=22 November 2018 |work=The Times of India |archive-date=22 November 2018 |archive-url=https://web.archive.org/web/20181122100606/https://timesofindia.indiatimes.com/city/hyderabad/chandramukhi-eyes-goshamahal-glory-ready-for-tryst-with-1st-transgender-party/articleshow/66743495.cms |url-status=live}}

According to Amnesty International, 1.5 million transgender people lived in the European Union {{as of|2017|lc=y}}, making up 0.3% of the population.{{sfn|M.H.|2017}} A 2011 survey conducted by the Equality 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).{{cite web |last1=Glen |first1=Fiona |last2=Hurrell |first2=Karen |date=2012 |title=Technical note: Measuring Gender Identity |url=https://www.equalityhumanrights.com/sites/default/files/technical_note_final.pdf |access-date=30 May 2019 |publisher=Equality and Human Rights Commission |archive-date=2 August 2019 |archive-url=https://web.archive.org/web/20190802101054/https://www.equalityhumanrights.com/sites/default/files/technical_note_final.pdf |url-status=dead}}

The 2021 Canadian census released by Statistics Canada found that 59,460 Canadians (0.19% of the population) identified as transgender.{{sfn|Easton|2022}} According to the Survey 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.{{Cite web |url=https://www12.statcan.gc.ca/census-recensement/2021/ref/98-20-0002/982000022020002-eng.cfm |title=Sex at birth and gender: Technical report on changes for the 2021 Census |first=Statistics Canada |last=Government of Canada |date=20 July 2020 |website=www12.statcan.gc.ca |access-date=27 September 2021 |archive-date=17 July 2021 |archive-url=https://web.archive.org/web/20210717150155/https://www12.statcan.gc.ca/census-recensement/2021/ref/98-20-0002/982000022020002-eng.cfm |url-status=live}}

In the United States, over 1.6 million persons (ages 13 and up) identify as transgender, or 0.6 percent of people ages 13+, {{as of|2022|lc=y}}.{{Cite news |last=Ghorayshi |first=Azeen |date=10 June 2022 |work=The New York Times |title=Report Reveals Sharp Rise in Transgender Young People in the U.S. |url=https://www.nytimes.com/2022/06/10/science/transgender-teenagers-national-survey.html |access-date=18 November 2024}}{{cite report |first1=Jody L. |last1=Herman |first2=Andrew R. |last2=Flores |first3=Kathryn K.|last3=O'Neill |date=June 2022 |title=How Many Adults and Youth Identify as Transgender in the United States? |url=https://williamsinstitute.law.ucla.edu/wp-content/uploads/Trans-Pop-Update-Jun-2022.pdf |publisher=Williams Institute |pages=25 |access-date=18 November 2024}}{{rp|p=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).{{rp|p=1}} Among adults, 38.5% (515,200) are transgender women, 35.9% (480,000) transgender men, and 25.6% (341,800) gender nonconforming.{{rp|p=1}} The Social Security Administration has tracked the sex of US citizens since 1936.{{Cite web |last=Harris |first=Benjamin Cerf |date=2015 |title=Likely Transgender Individuals in U.S. Federal Administrative Records and the 2010 Census |url=https://www.census.gov/content/dam/Census/library/working-papers/2015/adrm/carra-wp-2015-03.pdf |website=Census.gov |access-date=23 August 2019 |archive-date=23 August 2019 |archive-url=https://web.archive.org/web/20190823182413/https://www.census.gov/content/dam/Census/library/working-papers/2015/adrm/carra-wp-2015-03.pdf |url-status=live}} 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.{{Cite journal |last=Pauly |first=Ira B. |date=1968 |title=The Current Status of the Change of Sex Operation |journal=The Journal of Nervous and Mental Disease |language=en |volume=147 |issue=5 |pages=460–471 |doi=10.1097/00005053-196811000-00003 |issn=0022-3018 |pmid=5726920 |s2cid=42050429}} One effort to quantify the modern population in 2011 gave a "rough estimate" that 0.3% of adults in the US are transgender.{{Cite news |url=https://www.nytimes.com/2015/06/09/upshot/the-search-for-the-best-estimate-of-the-transgender-population.html |archive-url=https://web.archive.org/web/20170224081511/https://www.nytimes.com/2015/06/09/upshot/the-search-for-the-best-estimate-of-the-transgender-population.html?_r=0 |url-status=live |title=The Search for the Best Estimate of the Transgender Population |first=Claire Cain |last=Miller |work=The New York Times |date=8 June 2015 |archive-date=24 February 2017}}{{Cite web |url=https://williamsinstitute.law.ucla.edu/publications/how-many-people-lgbt/ |archive-url=https://web.archive.org/web/20150425174542/http://williamsinstitute.law.ucla.edu/wp-content/uploads/Gates-How-Many-People-LGBT-Apr-2011.pdf |url-status=dead |title=How Many People are Lesbian, Gay, Bisexual, and Transgender? |first=Loyal |last=thisisloyal.com |archive-date=25 April 2015 |website=Williams Institute}} In 2016, studies estimated the proportion of Americans who identify as transgender at 0.5 to 0.6%.{{cite magazine |last=Steinmetz |first=Katy |date=30 June 2016 |title=1.4 Million Americans Identify as Transgender, Study Finds |url=https://time.com/4389936/transgender-americans-statistic-how-many/ |url-status=live |archive-url=https://web.archive.org/web/20160630205328/http://time.com/4389936/transgender-americans-statistic-how-many/ |archive-date=30 June 2016 |access-date=30 June 2016 |magazine=Time}}{{cite web |date=June 2016 |title=How Many Adults Identify as Transgender in the United States |url=http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf |url-status=live |archive-url=https://web.archive.org/web/20160718010850/http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf |archive-date=18 July 2016 |access-date=25 August 2016 |publisher=The Williams Institute}}{{cite journal |last1=Crissman |first1=Halley P. |last2=Berger |first2=Mitchell B. |last3=Graham |first3=Louis F. |last4=Dalton |first4=Vanessa K. |year=2016 |title=Transgender Demographics: A Household Probability Sample of US Adults, 2014 |journal=American Journal of Public Health |volume=107 |issue=2 |pages=213–215 |doi=10.2105/AJPH.2016.303571 |pmc=5227939 |pmid=27997239}}{{Cite web |url=https://medicalresearch.com/author-interviews/about-1-in-189-us-americans-identify-as-transgender/30672/ |archive-url=https://web.archive.org/web/20170103004810/https://medicalresearch.com/author-interviews/about-1-in-189-us-americans-identify-as-transgender/30672/ |url-status=dead |title=About 1 in 189 US Americans Identify as Transgender |first=Marie |last=Benz |archive-date=3 January 2017}}

In the United States and Canada, some Native American and First Nations cultures traditionally recognize the existence of more than two genders,{{sfn|Fulton|1992|pp=603-610}} such as the Zuni male-bodied lhamana,{{cite journal |last=Parsons |first=Elsie Clews |year=1916 |title=The Zuñi Ła'mana |journal=American Anthropologist |volume=18 |issue=4 |pages=521–8 |doi=10.1525/aa.1916.18.4.02a00060 |issn=1548-1433 |jstor=660121 |quote=Of these 'men-women' ....}} the Lakota male-bodied {{Lang|lkt|winkte}},{{cite web |last=Medicine |first=B. |date=2002 |url=http://www.ac.wwu.edu/~culture/medicine.htm |title=Directions in Gender Research in American Indian Societies: Two Spirits and Other Categories |archive-url=https://web.archive.org/web/20030330115133/http://www.ac.wwu.edu/~culture/medicine.htm |archive-date=30 March 2003}}, taken from Online Readings in Psychology and Culture Center for Cross-Cultural Research, Unit 3, Chapter 2, Western Washington University. and the Mohave male-bodied alyhaa and female-bodied hwamee.{{cite journal |last1=Parker |first1=H. N. |date=2001 |title=The Myth of the Heterosexual: Anthropology and Sexuality for Classicists |journal=Arethusa |volume=34 |issue=3 |pages=313–362 |doi=10.1353/are.2001.0016 |s2cid=161526282}} These traditional people, along with those from other North American Indigenous cultures, are sometimes part of the contemporary, pan-Indian two-spirit community. Historically, in most cultures who have alternate gender roles, if the spouse of a third gender person is not otherwise gender variant, they have not generally been regarded as other-gendered themselves, simply for being in a same-sex relationship. In Mexico, the Zapotec culture includes a third gender in the form of the Muxe.{{cite journal |last=Stephen |first=Lynn |year=2002 |title=Sexualities and Genders in Zapotec Oaxaca |journal=Latin American Perspectives |volume=29 |issue=2 |pages=41–59 |doi=10.1177/0094582x0202900203 |issn=0094-582X |jstor=3185126 |s2cid=145808692}} Mahu is a traditional third gender in Hawai'i and Tahiti. Mahu are valued as teachers, caretakers of culture, and healers, such as Kapaemahu. Diné (Navajo) have Nádleehi.

In Latin American cultures, a travesti 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.{{Cite book |last=Kulick |first=Don |url=https://www.worldcat.org/oclc/38842085 |title=Travesti: Sex, Gender, and Culture among Brazilian Transgendered Prostitutes |date=1998 |publisher=University of Chicago Press |isbn=0-226-46099-1 |location=Chicago |oclc=38842085 |access-date=27 September 2021 |archive-date=16 May 2009 |archive-url=https://web.archive.org/web/20090516183615/http://www.worldcat.org/oclc/38842085 |url-status=live}}

Other transgender identities are becoming more widely known, as a result of contact with other cultures of the Western world.{{Cite news |url=http://www1.folha.uol.com.br/ilustrissima/1231466-a-nova-geracao-gay-nas-universidades-dos-eua.shtml |archive-url=https://web.archive.org/web/20140222013956/http://www1.folha.uol.com.br/ilustrissima/1231466-a-nova-geracao-gay-nas-universidades-dos-eua.shtml |url-status=dead |title=A nova geração gay nas universidades dos EUA - 17/02/2013 |trans-title=The New Gay Generation on US College Campuses - 2/17/2013 |first1=Michael |last1=Schulman |archive-date=22 February 2014 |work=Folha de S.Paulo |language=pt-br}} These newer identities, sometimes known under the umbrella use of the term "genderqueer", along with the older travesti 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 of transgender, 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.João W. Nery: Viagem solitária: Memórias de um transexual 30 anos depois; São Paulo: Leya, 2012, p. 293.{{in lang|pt}}

On the 2023 New Zealand Census, 26,097 people self-identified as transgender, defined by Stats 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.{{Cite web |title=2023 Census shows 1 in 20 adults belong to Aotearoa New Zealand's LGBTIQ+ population (corrected) {{!}} Stats NZ |url=https://www.stats.govt.nz/news/2023-census-shows-1-in-20-adults-belong-to-aotearoa-new-zealands-lgbtiq-population/ |access-date=13 October 2024 |website=www.stats.govt.nz}}

{{Main|Coming out}}

Coming out is the process of sharing one's identity with others, and can include sharing new pronouns and a new name.{{Cite web |title=Coming Out as Transgender And/OR Nonbinary |url=https://www.plannedparenthood.org/learn/gender-identity/transgender/coming-out-trans |archive-url=https://web.archive.org/web/20241210071636/https://www.plannedparenthood.org/learn/gender-identity/transgender/coming-out-trans |archive-date=10 December 2024 |access-date=19 December 2024 |website=Planned Parenthood |language=en |url-status=live}} Individuals who have come out are known as out.{{Cite web |title=Out definition and meaning {{!}} Collins English Dictionary |url=https://www.collinsdictionary.com/dictionary/english/out |archive-url=https://web.archive.org/web/20210507000654/https://www.collinsdictionary.com/dictionary/english/out |archive-date=7 May 2021 |access-date=19 December 2024 |website=www.collinsdictionary.com |language=en |url-status=live}} 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 as passing. In certain environments, some passing transgender individuals can choose to be stealth, which means to deliberately avoid coming out, often to avoid transphobia; these individuals are often out in other environments. The decision for transgender people to come out to current or potential romantic or sexual partners can be especially difficult.

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.{{Cite journal |last1=Brumbaugh-Johnson |first1=Stacey M. |last2=Hull |first2=Kathleen E. |date=3 July 2019 |title=Coming Out as Transgender: Navigating the Social Implications of a Transgender Identity |url=https://www.tandfonline.com/doi/abs/10.1080/00918369.2018.1493253 |journal=Journal of Homosexuality |publication-date=27 July 2018 |volume=66 |issue=8 |pages=1148–1177 |doi=10.1080/00918369.2018.1493253 |pmid=30052497 |issn=0091-8369}}

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.{{Cite web |title=Transgender Children & Youth: Understanding the Basics |url=https://www.hrc.org/resources/transgender-children-and-youth-understanding-the-basics |access-date=19 December 2024 |website=Human Rights Campaign |language=en-US}} Different transgender individuals choose to come out at different times during the transition process and to different people. 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. Although there are some similarities, coming out as transgender is different than coming out as a sexual minority, such as lesbian, gay, or bisexual. This is partly due to the relatively lower level of information that people have about transgender people compared to people who are sexual minorities. Some come out in an online identity first, providing an opportunity to go through experiences virtually and safely before risking social implications in the real world.{{cite journal |last=Marciano |first=A. |year=2014 |title=Living the VirtuReal: Negotiating transgender identity in cyberspace |journal=Journal of Computer-Mediated Communication |volume=19 |issue=4 |pages=824–838 |doi=10.1111/jcc4.12081 |s2cid=206022665 |doi-access=}}

It may take time for people to understand and respond when a transgender person comes out. Most transgender people feel healthier and happier when they come out and their gender identity is validated by others.

Some transgender people choose not to come out at all. For some, this decision can be because of stigma, lack of knowledge (by whom?) or fear of rejection by friends and family. Upon coming out, transgender people can face discrimination, rejection, and violence. These risks are heightened when transgender individuals are members of other marginalized communities.

{{main|Transgender Awareness Week|International Transgender Day of Visibility|Transgender Day of Remembrance}}

{{see also|Media portrayals of transgender people|Trans march}}

File:Laverne Cox by Sachyn Mital.jpg, who is trans, in July 2014|left]]File:Existrans 2017 (37146607344).jpg

In 2014, the United States reached a "transgender tipping point", according to Time.{{cite magazine |last1=Steinmetz |first1=K. |date=28 May 2014 |title=The transgender tipping point |url=https://time.com/135480/transgender-tipping-point/ |url-status=live |archive-url=https://web.archive.org/web/20170813102939/http://time.com/135480/transgender-tipping-point/ |archive-date=13 August 2017 |access-date=13 August 2017 |magazine=Time}}{{cite news |last1=Snow |first1=N. |date=8 May 2015 |title=Laverne Cox: 'Time' magazine's 'transgender tipping point' cover girl |url=http://www.huffingtonpost.com/nicholas-snow/laverne-cox-time-magazine_b_7238884.html |url-access=subscription |url-status=live |archive-url=https://web.archive.org/web/20170520220949/http://www.huffingtonpost.com/nicholas-snow/laverne-cox-time-magazine_b_7238884.html |archive-date=20 May 2017 |access-date=13 August 2017 |work=The Huffington Post}} 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.{{cite web |last1=Townsend |first1=M. |date=3 November 2016 |title=GLAAD's 'Where We Are on TV' report finds progress in LGBTQ representation on TV, but much work still to be done |url=https://www.glaad.org/blog/glaads-where-we-are-tv-report-finds-progress-lgbtq-representation-tv-much-work-still-be-done |url-status=live |archive-url=https://web.archive.org/web/20170816152406/https://www.glaad.org/blog/glaads-where-we-are-tv-report-finds-progress-lgbtq-representation-tv-much-work-still-be-done |archive-date=16 August 2017 |access-date=13 August 2017 |website=GLAAD}}

Annual marches, protests or gatherings take place around the world for transgender issues, often taking place during the time of local Pride parades for LGBT people. These events are frequently organised by trans communities to build community, address human rights struggles, and create visibility.{{cite web |date=21 Jun 2006 |title=Trans March on Friday |url=https://www.ebar.com/news///237069 |access-date=10 July 2020 |archive-date=10 July 2020 |archive-url=https://web.archive.org/web/20200710225850/https://www.ebar.com/news///237069 |url-status=live}}{{Cite web |date=19 August 2016 |title=Transgender and Intersex Community Marks 20 Years of Marching in Paris (Video) |url=http://www.advocate.com/world/2016/10/19/transgender-and-intersex-community-marks-20-years-marching-paris-video |access-date=10 June 2020 |website=www.advocate.com |language=en |archive-date=8 August 2020 |archive-url=https://web.archive.org/web/20200808212604/https://www.advocate.com/world/2016/10/19/transgender-and-intersex-community-marks-20-years-marching-paris-video |url-status=live}}{{cite news |last1=Paul |first1=Gallant |date=18 June 2009 |title=Trans march 'overdue' |newspaper=Toronto Star |url=https://www.thestar.com/news/gta/2009/06/18/trans_march_overdue.html |access-date=11 June 2020 |archive-date=10 July 2020 |archive-url=https://web.archive.org/web/20200710225849/https://www.thestar.com/news/gta/2009/06/18/trans_march_overdue.html|url-status=live}}{{Cite news |date=14 September 2019 |title=London's first Trans Pride support 'overwhelming' |url=https://www.bbc.com/news/uk-england-london-49700743 |access-date=11 June 2020 |work=BBC News |archive-date=9 March 2022 |archive-url=https://web.archive.org/web/20220309201633/https://www.bbc.com/news/uk-england-london-49700743 |url-status=live}} International Transgender Day of Visibility is an annual holiday occurring on March 31{{sfn|CBC|2013}}{{cite web |date=31 March 2014 |title=Model: Why I came out as transgender |url=http://www.kspr.com/news/nationworld/Model-Why-I-came-out-as-transgender/21051646_25244330 |url-status=dead |archive-url=https://web.archive.org/web/20140403062937/http://www.kspr.com/news/nationworld/Model-Why-I-came-out-as-transgender/21051646_25244330 |archive-date=3 April 2014 |access-date=31 March 2014 |publisher=KSPR News}} dedicated to celebrating transgender people and raising awareness of discrimination faced by transgender people worldwide. The holiday was founded by Michigan-based transgender activist{{cite news |date=27 March 2014 |title=A time to celebrate |newspaper=The Hamilton Spectator |url=http://www.thespec.com/opinion-story/4432181-a-time-to-celebrate/ |url-status=live |access-date=31 March 2014 |archive-url=https://web.archive.org/web/20140403075929/http://www.thespec.com/opinion-story/4432181-a-time-to-celebrate |archive-date=3 April 2014}} Rachel Crandall Crocker in 2009.{{cite web |last=Carreras |first=Jessica |title=Transgender Day of Visibility plans erupt locally, nationwide |url=http://www.pridesource.com/article.html?article=34351 |url-status=dead |archive-url=https://web.archive.org/web/20130327152446/http://www.pridesource.com/article.html?article=34351 |archive-date=27 March 2013 |access-date=3 April 2013 |publisher=PrideSource}}

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 the Mayor of Boston, Michelle Wu.{{sfn|Sudborough|2022}} TDOR memorializes victims of hate crimes and prejudice and raises awareness of hate crimes committed upon living transgender people.{{cite web |date=28 November 1998 |title=About TDOR at Transgender Day of Remembrance |url=http://www.transgenderdor.org/?page_id=4|url-status=dead |archive-url=https://web.archive.org/web/20110723151936/http://www.transgenderdor.org/?page_id=4 |archive-date=23 July 2011 |access-date=6 July 2011 |publisher=Transgenderdor.org}} 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.{{cite web |title=Transgender Awareness Week |url=https://www.glaad.org/transweek |url-status=live |archive-url=https://web.archive.org/web/20190403012821/https://www.glaad.org/transweek |archive-date=3 April 2019 |access-date=3 April 2019 |publisher=GLAAD}} Several trans marches occur in cities around the world, including Paris, San Francisco, and Toronto, in order to raise awareness of the transgender community.{{Cite web |last=W. |first=M. L. |agency=Agence France-Presse |date=13 October 2018 |title=Trans et intersexes mobilisés contre les interventions chirurgicales non consenties |trans-title=Trans and intersex people mobilized against non-consensual surgical interventions |url=https://www.leparisien.fr/societe/trans-et-intersexes-mobilises-contre-les-interventions-chirurgicales-non-consenties-13-10-2018-7918182.php |access-date=15 December 2023 |work=Le Parisien |language=fr-FR}}{{sfn|Allday|2023}}

There are also significant portrayals of transgender people in the media. Transgender literature includes literature portraying transgender people, as well as memoirs or novels by transgender people, who often discuss elements of the transgender experience.{{Cite web |date=21 June 2023 |title=Trans visibility through literature |url=https://www.uscannenbergmedia.com/2023/06/21/trans-visibility-through-literature/ |access-date=15 December 2023 |website=USC Annenberg Media |language=en}} Several films and television shows feature transgender characters in the storyline, and several fictional works also have notable transgender characters.{{Cite news |date=13 April 2023 |title=Trans people have never been so visible — or so vulnerable |url=https://www.washingtonpost.com/lifestyle/2023/04/13/trans-representation-popular-culture/ |access-date=15 December 2023 |newspaper=The Washington Post |language=en}}File:Transgender symbol ⚧ on a trafic light in Trafalgar Square.jpg, London with the ⚧ symbol, installed for the 2016 Pride in London]]

{{Main||LGBT symbols#Transgender}}

{{See also|Transgender flag|Gendered associations of pink and blue}}

A common symbol for the transgender community is the Transgender Pride Flag, which was designed by the American transgender woman Monica Helms in 1999, and was first shown at a pride parade in Phoenix, Arizona, in 2000. The flag consists of five horizontal stripes: light blue, pink, white, pink, and light blue.{{sfn|Ford|2014}} Other transgender symbols include the butterfly (symbolizing transformation or metamorphosis){{cite web |date=24 September 2014 |title=I'm Scared to Be a Woman |url=https://www.hrw.org/report/2014/09/24/im-scared-be-woman/human-rights-abuses-against-transgender-people-malaysia |url-status=live |archive-url=https://web.archive.org/web/20150906002753/http://www.hrw.org/report/2014/09/24/im-scared-be-woman/human-rights-abuses-against-transgender-people-malaysia |archive-date=6 September 2015 |access-date=8 September 2015 |publisher=Human Rights Watch |quote=a 22-year-old transgender woman sports a tattoo of a butterfly – a transgender symbol signifying transformation}} and a pink/light blue yin and yang symbol.{{Cite book |title=Mental health and mental disorders : an encyclopedia of conditions, treatments, and well-being |last=Sperry |first=Len |year=2016 |isbn=9781440803826 |publisher=Greenwood |location=Santa Barbara, California |pages=1150 |oclc=915943054}} Several gender symbols have been used to represent transgender people, including ⚥ and ⚧.{{cite web|title=Symbols|url=http://www.glbtq.com/slideshows/symbols,7.html|url-status=dead|archive-url=https://web.archive.org/web/20080804080055/http://www.glbtq.com/slideshows/symbols,7.html|archive-date=August 4, 2008|publisher=glbtq.com}}{{sfn|Petronzio|2014}}

{{Portal|LGBTQ

}}

{{Sister project links |n=no |b=no |v=no

|commonscat=yes}}

• List of transgender and transsexual fictional characters
• List of transgender people
• List of transgender publications
• List of transgender-related topics
• List of transgender-rights organizations
• List of people killed for being transgender
• Transgender history
• Transgenderism in New York City

{{clear}}

{{Reflist}}

{{refbegin|30em}}

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• {{cite journal |last=Bouman |first=Walter Pierre |date=8 January 2020 |title=Sumamus exordio: International Journal of Transgender Health |journal=International Journal of Transgender Health |volume=21 |issue=1 |pages=1–2 |doi=10.1080/15532739.2020.1709316 |pmid=33015654 |pmc=7430473}}
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• {{cite web |last=Petronzio |first=Matt |date=13 June 2014 |title=A Storied Glossary of Iconic LGBT Flags and Symbols |url=https://mashable.com/2014/06/13/lgbt-pride-symbols/ |url-status=live |archive-url=https://web.archive.org/web/20190403014428/https://mashable.com/2014/06/13/lgbt-pride-symbols/ |archive-date=3 April 2019 |access-date=3 April 2019 |work=Mashable}}
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{{refend}}

{{refbegin|30em}}

• {{Cite news |last=Allday |first=Erin |date=24 June 2023 |title=S.F. Trans March draws thousands of participants |url=https://www.sfchronicle.com/bayarea/article/s-f-trans-march-draws-thousands-participants-18166474.php |access-date=15 December 2023 |work=San Francisco Chronicle |language=en}}

{{Cite news |ref={{harvid|AP|2024}} |date=5 June 2023 |title=Trans adults in Florida 'blindsided' that new law also limits their access to health care |url=https://www.nbcnews.com/nbc-out/out-news/trans-adults-florida-blindsided-new-law-also-limits-access-health-care-rcna87723 |access-date=25 September 2024 |agency=Associated Press |work=NBC News |language=en}}

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• {{cite web |ref={{harvid|CBC|2013}}|last=|title=Nenshi proclaims Trans Day of Visibility |url=https://www.cbc.ca/news/canada/calgary/nenshi-proclaims-trans-day-of-visibility-1.1329205 |url-status=live |archive-url=https://web.archive.org/web/20130404005217/http://www.cbc.ca/news/canada/calgary/story/2013/03/31/calgary-trans-day-awareness.html |archive-date=4 April 2013 |access-date=4 April 2013 |publisher=Canadian Broadcasting Corporation}}
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• {{cite magazine |title=Crossing Over |date=2 June 1979 |magazine=Radio Times |url=https://genome.ch.bbc.co.uk/c7bd5024c16745aeb82e7b8513470d20 |last=Rayner |first=Claire |access-date=6 June 2023 |publisher=BBC Radio 4 |publication-date=6 June 1979 |archive-url=https://web.archive.org/web/20230607045655/https://genome.ch.bbc.co.uk/c7bd5024c16745aeb82e7b8513470d20 |archive-date=7 June 2023 |url-status=live}}
• {{cite web |year=2017 |last=Simon |first=Ray |title=Stirring up the origin of the 'alphabet soup' |archive-url=https://web.archive.org/web/20211111041638/https://www.eriegaynews.com/news/article.php?recordid=201711lgbtalphabetsouporigin |archive-date=11 November 2021 |url=https://www.eriegaynews.com/news/article.php?recordid=201711lgbtalphabetsouporigin |work=Erie Gay News}}
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{{refend}}

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• {{Cite web |title=Transgender Rights |url=https://www.aclu.org/issues/lgbtq-rights/transgender-rights |access-date=20 May 2023 |website=American Civil Liberties Union |language=en-US |archive-date=20 May 2023 |archive-url=https://web.archive.org/web/20230520004324/https://www.aclu.org/issues/lgbtq-rights/transgender-rights |url-status=live}}
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• {{Cite web |last=Cleveland Clinic |date=8 November 2022 |title=AFAB and AMAB: What the Sex You're Assigned at Birth Means for Your Health |url=https://health.clevelandclinic.org/afab-and-amab-meaning |access-date=27 September 2024 |website=Cleveland Clinic |archive-url=https://web.archive.org/web/20240927174628/https://health.clevelandclinic.org/afab-and-amab-meaning |archive-date=27 September 2024}}
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{{refend}}

• {{cite book |last=Haimson |first=Oliver L. |year=2025 |title=Trans Technologies |publisher=MIT Press |isbn=9780262382571 |url=https://direct.mit.edu/books/oa-monograph/5913/Trans-Technologies}}
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• {{cite journal |last1=Thanem |first1=Torkild |last2=Wallenberg |first2=Louise |year=2016 |title=Just doing gender? Transvestism and the power of underdoing gender in everyday life and work |doi=10.1177/1350508414547559 |journal=Organization |volume=23 |issue=2 |pages=250–271 |s2cid=144150015 |url=http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-101903}}
• 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."

{{Transgender topics}}

{{Sexual identities}}

{{LGBTQ|main=expanded}}

{{Authority control}}

Category:LGBTQ studies

Category:Articles containing video clips