Sex vs. Gender

In order to understand someone who identifies as transgender, it is important to understand the distinction between sex and gender. Sex refers to a person’s biological and anatomical traits: their hormones (androgens and estrogens level), chromosomes (XX or XY, etc), and their genitalia.4 An individual is typically assigned to a category of sex base on their genitalia before or right after birth. Typically, an individual with a penis and testes is considered a male, and an individual with a vulva is considered a female. In some cases, some individuals might possess both or parts of the male and female genitalia. These individuals are categorized as intersex.

Gender, however, is a socially constructed set of categories which are defined both by a person’s outward appearance (feminine or masculine) and their psychological attributes.4 Most people’s gender identities match their biological sex characteristics (e.g. most biological females identify as women), while some do not. A small but significant portion of people feel that their biological sex characteristics do not match their gender identity. It is also important to note that sex and gender identity are separate from sexual orientation. Gender identity does not imply specific sexual orientations and thus identifying as transgender does not necessarily indicate any specific sexual orientation.

Different types of Non-Gender-Conforming Identities

It is important to remember that different people who dress or act outside of traditional gender or sex norms do so for a variety of reasons. In addition to those who identify as transgender or transsexual, there are people who identify as cross dressers, drag queens, drag kings, transvestites, gender non-conforming, genderfluid, genderqueer, or androgynous.

To cross-dress is to intentionally don the clothes of the opposite gender, for any reason. However, it is now seen as offensive to label someone a “cross-dresser” without their consent.5

Transvestite is another word that is commonly confused with transgender and transsexual. Transvestite used to be a popular term for a person who cross-dressed, though the term is now seen as an offensive word by the LGBTQ community. Fetishistic transvestitism is a paraphilia in which a person (usually a man) is sexually aroused by wearing the clothes of the opposite sex.4 For a person with this fetish, dressing in the clothes of the opposite sex is not a matter of gender identity but of sexual gratification. People who have this fetish may be of any sexual orientation.4

A drag queen is a biological male who wears typically feminine clothing in a performative manner.4 Drag queens generally do not express any desire in becoming women, rather, they enjoy the part-time performance of femininity at drag balls or drag strip clubs.4 A drag king is a biological female who cross-dresses as a male in the same performative fashion.

A person who identifies as androgynous is someone who presents both masculine and feminine physical and mental characteristics and therefore cannot be classified as one or the other. Androgynous people seek to combine the traits of both genders and disregard socially constructed gender norms.5

Similarly, people who identify as gender fluid or genderqueer seek to further blur the lines of gender in order to more accurately express themselves. Gender fluidity allows people to understand their gender identities as constantly changing on a scale between masculine and feminine, even from day to day. Genderqueer people also incorporate the fluidity of their sexual orientation into their fluid gender identities.5

Cisgender is considered the opposite of transgender. The term refers to someone whose biological sex matches their gender identity.


“Transgender” is an umbrella term for people whose biological sex and/or appearances do not necessarily conform to dominant gender roles. Trans, meaning “across” in Latin, paired with gender or sex refers to the way that people who identify as the opposite gender from their birth sex are moving across gender or sex boundaries.  The trans* community may include, but is not limited to, people who are: Female-to-male (FTM, or transmen) and male-to-female (MTF, or transwomen). Many people within trans- identified communities do not believe in a gender binary, but rather see gender as a continuum of different fluid identities.


A transgender-identified person is someone whose gender identity is different than their biological sex. Many feel as though they are trapped in a body of the wrong sex. In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, this confusion is understood as gender dysphoria.3 A person who is transgender  may see the world from the perspective that typically matches that of the other sex. Thus, a male bodied transgender person feels that she is a woman. Some transgender women may even develop resentment of her own male sexual characteristics. This resentment can be overwhelming and difficult to handle and can lead the person to pursue sex-reassignment surgery or hormone treatment. This person may identify as a male-to-female transsexual and make an effort to complete her transition by aligning the different concepts of her life with those traditionally thought to be feminine.


Many people often confuse transgender with transsexual, but they are not necessarily the same identities. While the term transgender includes all who are transsexual, some people who identify as transgender may not identify as transsexual. Many people who are transsexual alter their primary or secondary sex characteristics with hormone treatments, surgery, or both. These surgeries might include transitioning to either female-to-male (FTM) transsexual or male-to-female (MTF) transsexual.1 However, these changes are not necessarily a part a trans-identified lifestyle, since someone who is transgendered may not have the desire to change their anatomical sex.2

Sex-Reassignment Surgery

Sex-reassignment surgery is not a one-step process, nor is it taken lightly in the medical field. Possible candidates for surgical alterations must first be extensively interviewed for any psychological abnormalities or actual confusions about their gender identity. Once they are properly screened, individuals are asked to adopt the lifestyle of their desired gender for several months to a year. If at the end of this period the individual has adjusted to the new lifestyle, hormone therapy begins. After a year of hormone treatments, many bodily changes (such as changes in body hair, hip size, or amount of fatty tissue) occur.  At this point, the person may be eligible for sex-reassignment surgery.2 It is important to note that the changes produced by hormones are very difficult to reverse. Thus, it is important that a person about to undergo surgery is committed and mentally prepared to make the full transition.

Research has found that the majority of transsexual people are satisfied with their sexual reassignment, and report a greater ability to adjust to life than prior to surgery. In fact, one study found that 94% of transsexual people indicated that they would make the same choice to have the surgery if given the chance again.2

The Social Climate for Transgender People

Many decades ago, psychologists attempted to treat transgender individuals with aversion therapy and medication. Health professionals hoped these treatments would return them to “normal.” Such methods of treatment were mostly ineffective. This mindset of looking at transgender people as someone or something to be cured can be extremely painful and confusing to transgender individuals. It may be a contributing factor for the higher than average suicide rate in this community. The consequences of discrimination against transgendered individuals as a group in the United States are discussed in this article. As research leads to a better understanding of the world of transsexuality, the goal of “treatment” has now shifted. It is no longer geared toward altering the mentality of the individual, but rather to aid in the struggle for their acceptance of their gender identity in a society of strict norms for each gender. This can be achieved through counseling, hormone therapy, and/or sex-reassignment surgery.

Personal Gender Pronouns and Political Correctness

When talking about or to a trans* person, it is important to be respectful and thoughtful. In general, when meeting someone new, it is a good idea to ask them what their Personal Gender Pronouns (PGPs) are. Some examples are she, her, hers or they, them, theirs. Knowing people’s PGPs are a way for people of all gender identities to feel more comfortable and accepted in social situations. Another important aspect of helping people feel comfortable is asking them what they identify as, so you can refer to them correctly. If someone identifies as a man, it is important to call them a man, even if you know they are a transman. Likewise, it is important to refer to someone who is transgender as “a transgender person” rather than “a transgender.” Being transgender (or any other identity) is only one aspect of their identity, and so should be used as a descriptor rather than a defining label. Lastly, it is important to be respectful of someone’s boundaries, regardless of their gender identity. It is not okay to ask someone intimate questions about their former gender identity, body, or sex lives (questions like: Can I see a picture of you before you were a woman? or How do you have sex? or Have you had bottom surgery? are all not okay).

Being Transgender Is Not a Choice

The controversy that has sparked debate over this question is very similar to the controversy over whether homosexuality is a lifestyle choice. Many transgender people report feelings of discomfort and confusion with their gender identity from a very early age. Telling the trans* community that being trans is a chosen lifestyle only marginalizes them. These individuals often experience further discomfort and oppression when society determines their gender role based on anatomical sex at birth, and in turn forces them to conform to that assigned gender. This socially constructed role is usually determined by our given sex characteristics. Many transgender individuals struggle with their family’s expectations of their gender, and may be denied true expression of their identity at home. They also experience pressure from society as a whole, including friends and classmates, to conform to strict gender norms, and may experience cruelty when they do not. This may culminate in the feeling that they are being denied the ability to live life and express themselves as they wish.

There is some recent (though not conclusive) evidence that being transgender has a biological cause. One study done in 2009 found a significant association between the length of an androgen receptor gene and transsexuality. They found that male-to-female transgender individuals tended to have a longer androgen receptor gene than cisgender males, which may be responsible for reducing testosterone levels in the brain during development. This lower level of testosterone may change the extent to which their brain is masculinized. The researchers note that this one gene isn’t the ultimate cause of trans identities, but rather that it may be one of the many genetic factors involved. Another study focused on female-to-male transgender individuals. They focused on a gene variant for an enzyme involved with sex hormone metabolism, and found an association between trans men and this particular variant. The presence of this enzyme leads to higher tissue concentrations of both the male and female sex hormones, and therefore could influence early brain development. While this variant is more commonly found in males than females, it does not seem to influence male-to-female transgender people. Once again, the researchers suggested that there are more factors than just this gene variant involved.

The process of sex differentiation in humans is intricate, and researchers continue to look at slight hormonal differences in fetal development that could explain transgender identities.

Some Myths and Facts About Transgender People

Myth: A trans woman is a male homosexual.
Fact: Being transgender is related to gender identification, and is different from sexual preference. Although the sexual preference of a gay man may defy societal norms, his gender identification still remains male.

Myth: A transgender person is the same thing as a transvestite.
Fact: Although both cases involve wearing clothing of the opposite sex, each does so for different purposes. The term transvestite refers only to those who cross-dress to achieve sexual arousal, whereas a transgender person performs the same action to obtain a sense of psychosocial gratification/fulfillment especially that they wish to transition to the other sex.

Myth: Being transgender is a lifestyle choice.
Fact: A male bodied transgender person feels that she is a woman in every way, even though she was born with the genes and body of a male. Thus, being transgender should not be seen as a choice, but rather as a realization of one’s true self.

Resources For Transgender-Identified People


  1. Andrology. Mar 2002. Andromeda Andrology Center. Date of Access: 24 Apr 2002.
  2. Crooks, Robert and Karla Baur. Our Sexuality. California: Wadsworth Group, 2002.
  3. “Gender Dysphoria.” American Psychiatric Association (2013): 1-2. Web.
  4. LeVay, Simon, Janice Baldwin, and John Baldwin. Discovering Human Sexuality, Second Edition. Sinauer Associates, Inc., 2012.
  5. “Terminology – Gender Diversity.” Gender Diversity. N.p., n.d. Web. 24 Nov. 2015.

Last Updated: 02 December 2015.