Frequently Asked Questions about Transgender People

July 9, 2016

Transgender people come from every region of the United States and around the world, from every racial and ethnic background, and from every faith community. Transgender people are your classmates, your coworkers, your neighbors, and your friends. With approximately 1.4 million transgender adults in the United States—and millions more around the world—chances are that you've met a transgender person, even if you don't know it.

What does it mean to be transgender?

Transgender people are people whose gender identity is different from the gender they were thought to be at birth. “Trans” is often used as shorthand for transgender.

When we're born, a doctor usually says that we're male or female based on what our bodies look like. Most people who were labeled male at birth turn out to actually identify as men, and most people who were labeled female at birth grow up to be women. But some people's gender identity – their innate knowledge of who they are – is different from what was initially expected when they were born. Most of these people describe themselves as transgender.

A transgender woman lives as a woman today, but was thought to be male when she was born. A transgender man lives as a man today, but was thought to be female when he was born. Some transgender people identify as neither male nor female, or as a combination of male and female. There are a variety of terms that people who aren't entirely male or entirely female use to describe their gender identity, like non-binary or genderqueer.

Everyone—transgender or not—has a gender identity. Most people never think about what their gender identity is because it matches their sex at birth.

Being transgender means different things to different people. Like a lot of other aspects of who people are, like race or religion, there's no one way to be transgender, and no one way for transgender people to look or feel about themselves. The best way to understand what being transgender is like is to talk with transgender people and listen to their stories.

How does someone know that they are transgender?

People can realize that they're transgender at any age. Some people can trace their awareness back to their earlier memories – they just knew. Others may need more time to realize that they are transgender. Some people may spend years feeling like they don't fit in without really understanding why, or may try to avoid thinking or talking about their gender out of fear, shame, or confusion. Trying to repress or change one’s gender identity doesn’t work; in fact, it can be very painful and damaging to one’s emotional and mental health. As transgender people become more visible in the media and in community life across the country, more transgender people are able to name and understand their own experiences and may feel safer and more comfortable sharing it with others.

For many transgender people, recognizing who they are and deciding to start gender transition can take a lot of reflection. Transgender people risk social stigma, discrimination, and harassment when they tell other people who they really are. Parents, friends, coworkers, classmates, and neighbors may be accepting—but they also might not be, and many transgender people fear that they will not be accepted by their loved ones and others in their life. Despite those risks, being open about one’s gender identity, and living a life that feels truly authentic, can be a life-affirming and even life-saving decision.

Thought Exercise: Thinking About Your Own Gender

It can be difficult for people who are not transgender to imagine what being transgender feels like. Imagine what it would be like if everyone told you that the gender that you’ve always known yourself to be was wrong. What would you feel like if you woke up one day with a body that’s associated with a different gender? What would you do if everyone else—your doctors, your friends, your family—believed you’re a man and expected you to act like a man when you’re actually a woman, or believed you’re a woman even though you’ve always known you’re a man?

What's the difference between sexual orientation and gender identity?

Gender identity and sexual orientation are two different things. Gender identity refers to your internal knowledge of your own gender—for example, your knowledge that you're a man, a woman, or another gender. Sexual orientation has to do with whom you’re attracted to. Like non-transgender people, transgender people can have any sexual orientation. For example, a transgender man (someone who lives as a man today) may be primarily attracted to other men (and identify as a gay man), may be primarily attracted to women (and identify as a straight man), or have any other sexual orientation.

What's the difference between being transgender and being intersex?

People sometimes confuse being transgender and being intersex. Intersex people have reproductive anatomy or genes that don’t fit typical definitions of male or female, which is often discovered at birth. Being transgender, meanwhile, has to do with your internal knowledge of your gender identity. A transgender person is usually born with a body and genes that match a typical male or female, but they know their gender identity to be different.

Some people think that determining who is male or female at birth is a simple matter of checking the baby's external anatomy, but there's actually a lot more to it. Every year, an estimated one in 2,000 babies are born with a set of characteristics that can't easily be classified as "male" or "female." People whose bodies fall in the vast continuum between "male" and "female" are often known as intersex people. There are many different types of intersex conditions. For example, some people are born with XY chromosomes but have female genitals and secondary sex characteristics. Others might have XX chromosomes but no uterus, or might have external anatomy that doesn't appear clearly male or female. To learn more about what it's like to be intersex, check out this video or click here.

While it's possible to be both transgender and intersex, most transgender people aren't intersex, and most intersex people aren’t transgender. For example, many intersex people with XY (typically male) chromosomes but typically female anatomy are declared female at birth, are raised as girls, and identify as girls; in fact, many of these girls and their families never even become aware that their chromosomes are different than expected until much later in life. However, some intersex people come to realize that the gender that they were raised as doesn’t fit their internal sense of who they are, and may make changes to their appearance or social role similar to what many transgender people undergo to start living as the gender that better matches who they are.

What is the difference between being transgender and being gender non-conforming?

Being gender non-conforming means not conforming to gender stereotypes. For example, someone’s clothes, hairstyle, speech patterns, or hobbies might be considered more "feminine" or "masculine" than what's stereotypically associated with their gender.

Gender non-conforming people may or may not be transgender. For example, some women who were raised and identify as women present themselves in ways that might be considered masculine, like by having short hair or wearing stereotypically masculine clothes. The term “tomboy” refers to girls who are gender non-conforming, which often means they play rough sports, hang out with boys, and dress in more masculine clothing.

Similarly, transgender people may be gender non-conforming, or they might conform to gender stereotypes for the gender they live and identify as.

What does it mean to have a gender that's not male or female?

Most transgender people are men or women. But some people don't neatly fit into the categories of "man" or "woman" or “male” or “female.” For example, some people have a gender that blends elements of being a man or a woman, or a gender that is different than either male or female. Some people don't identify with any gender. Some people's gender fluctuates over time.

People whose gender is not male or female may use many different terms to describe themselves. One term that some people use is non-binary, which is used because the gender binary refers to the two categories of male and female. Another term that people use is genderqueer. If you're not sure what term someone uses to describe their gender, you should ask them politely.

It's important to remember that if someone is transgender, it does not necessarily mean that they have a "third gender." Most transgender people do have a gender identity that is either male or female, and they should be treated like any other man or woman.

For more information about what it's like to have a gender other than male or female or how you can support the non-binary people in your life, read NCTE's guide Understanding Non-Binary People.

Why don’t transgender people get counseling to accept the gender they were assigned at birth?

Counseling aimed at changing someone’s gender identity, sometimes known as conversion therapy, doesn’t work and can be extremely harmful. The belief that someone’s gender identity can be changed through therapy runs counter to the overwhelming consensus in the medical community. Telling someone that a core part of who they are is wrong or delusional and forcing them to change it is dangerous, sometimes leading to lasting depression, substance abuse, self-hatred and even suicide. Because of this, a growing number of states have made it illegal for licensed therapists to try to change a young person’s gender identity (laws apply to those under 18). However, many transgender people find it helpful to get counseling to help them decide when to tell the world they are transgender and deal with the repercussions of stigma and discrimination that comes afterward.

What does "gender transition" mean?

Transitioning is the time period during which a person begins to live according to their gender identity, rather than the gender they were thought to be at birth. While not all transgender people transition, a great many do at some point in their lives. Gender transition looks different for every person. Possible steps in a gender transition may or may not include changing your clothing, appearance, name, or the pronoun people use to refer to you (like “she,” “he,” or “they”). Some people are able to change their identification documents, like their driver’s license or passport, to reflect their gender. And some people undergo hormone therapy or other medical procedures to change their physical characteristics and make their body better reflect the gender they know themselves to be.

Transitioning can help many transgender people lead healthy, fulfilling lives. No specific set of steps is necessary to “complete” a transition—it’s a matter of what is right for each person. All transgender people are entitled to the same dignity and respect, regardless of which legal or medical steps they have taken.

What are some of the official records transgender people may change when they're transitioning?

Some transgender people make or want to make legal changes as part of their transition, like by changing their name or updating the gender marker on their identity documents.

Not all transgender people need or want to change their identity documents, but for many, it's a critical step in their transition. For many transgender people, not having identity documents like driver's licenses or passports that match their gender means that they might not be able to do things that require an ID, like getting a job, enrolling in school, opening a bank account, or traveling. Some transgender people who use an ID that doesn't match their gender or their presentation face harassment, humiliation, and even violence.

Transgender people may need to change a number of documents in order to live according to their gender identity, such as their:

  • Driver’s license
  • Social Security card
  • Passport
  • Bank accounts and records
  • Credit cards
  • Paychecks and other job-related documents
  • Leases
  • Medical records
  • Birth certificate
  • Academic records

It's important to know that not all transgender people be able to make the changes they need to their IDs and other official documents. Unfortunately, these changes are often expensive, burdensome, and complicated, putting them out of reach for many people. For example, some states still require proof of surgery or a court order to change a gender marker. In many states, the process can be time-consuming and involve many steps, or cost hundreds of dollars. As a result, only one-fifth (21%) of transgender people who have transitioned have been able to update all of their IDs.

NCTE works to modernize all of these outdated requirements. States are increasingly adopting more accessible and straightforward policies for changing one's name and gender marker.

To find out the requirements for updating a driver’s license or birth certificate in your state or territory, as well as get information on changing federal IDs and records, visit NCTE’s ID Documents Center.

What medical treatments do some transgender people seek when transitioning?

Some, but not all, transgender people undergo medical treatments to make their bodies more congruent with their gender identity and help them live healthier lives.

While transition-related care is critical and even life-saving for many transgender people, not everyone needs medical care to transition or live a fulfilling life.

Different transgender people may need different types of transition-related care. People should make decisions about their care based on their individual needs. Medical procedures can include:

  • hair growth or removal treatments
  • hormone therapy
  • various surgeries to make one's face, chest, and anatomy more in line with one's gender identity

While not everyone needs transition-related medical treatments, there is an overwhelming consensus in the medical community that they are medically necessary for many transgender people and should be covered by private and public insurance. Every major medical organization in the United States has affirmed that transition-related medical care is safe and effective, and that everyone who needs it should be able to access it. Unfortunately, this critical care is often denied by insurance companies, often in spite of state and federal laws.

What is gender dysphoria?

For some transgender people, the difference between the gender they are thought to be at birth and the gender they know themselves to be can lead to serious emotional distress that affects their health and everyday lives if not addressed. Gender dysphoria is the medical diagnosis for someone who experiences this distress.

Not all transgender people have gender dysphoria. On its own, being transgender is not considered a medical condition. Many transgender people do not experience serious anxiety or stress associated with the difference between their gender identity and their gender of birth, and so may not have gender dysphoria.

Gender dysphoria can often be relieved by expressing one’s gender in a way that the person is comfortable with. That can include dressing and grooming in a way that reflects who one knows they are, using a different name or pronoun, and, for some, taking medical steps to physically change their body. All major medical organizations in the United States recognize that living according to one’s gender identity is an effective, safe and medically necessary treatment for many people who have gender dysphoria.

It's important to remember that while being transgender is not in itself an illness, many transgender people need to deal with physical and mental health problems because of widespread discrimination and stigma. Many transgender people live in a society that tells them that their deeply held identity is wrong or deviant. Some transgender people have lost their families, their jobs, their homes, and their support, and some experience harassment and even violence. Transgender children may experience rejection or even emotional or physical abuse at home, at school, or in their communities. These kinds of experiences can be challenging for anyone, and for some people, it can lead to anxiety disorders, depression, and other mental health conditions. But these conditions are not caused by having a transgender identity: they're a result of the intolerance many transgender people have to deal with. Many transgender people – especially transgender people who are accepted and valued in their communities – are able to live healthy and fulfilling lives.

Why is transgender equality important?

Transgender people should be treated with the same dignity and respect as anyone else and be able to live, and be respected, according to their gender identity. But transgender people often face serious discrimination and mistreatment at work, school, and in their families and communities.

For example, transgender people are more likely to:

  • Be fired or denied a job
  • Face harassment and bullying at school
  • Become homeless or live in extreme poverty
  • Be evicted or denied housing or access to a shelter
  • Be denied access to critical medical care
  • Be incarcerated or targeted by law enforcement
  • Face abuse and violence

For statistics about these types of discrimination, go to the National Transgender Discrimination Survey page.

Living without fear of discrimination and violence and being supported and affirmed in being who they are is critical for allowing transgender people to live healthy, safe, and fulfilling lives. In recent years, laws, policies and attitudes around the country have changed significantly, allowing more transgender people than ever to live fuller, safer, and healthier lives.

The transgender movement is part of a long tradition of social justice movements of people working together to claim their civil rights and better opportunities in this country. These challenges are connected. Discrimination that transgender people of color face is compounded by racism, and lower-income transgender people face economic challenges and classism. NCTE believes that progress towards transgender equality requires a social justice approach that fights all forms of discrimination.

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