What Does It Mean to Be Transgender?

Written by Nicole Schmidt
Medically Reviewed by Jabeen Begum, MD on January 24, 2025
12 min read

Transgender is a general term that describes people whose gender identity, or their internal sense of being male, female, or something else, does not match the sex they were assigned at birth. By contrast, the term cisgender describes people whose gender identity aligns with the sex they were assigned at birth.

The National Center for Transgender Equality estimates that there are about 1.4 million transgender people in the U. S. They have a diverse range of experiences and identities.

A transgender woman is a person who was labeled as male at birth, but who identifies as a woman. A transgender man is someone who was labeled as female at birth, but who identifies as a man. Some transgender people don’t fit into the traditional categories of male and female and may feel that their gender identity is a mix of both genders, or that it doesn’t match either. They may use the terms “nonbinary” or “genderqueer” to describe themselves.

For those who don’t identify with a specific gender, the way they look, act, or behave might not match the usual expectations that go with the sex they were assigned at birth. For example, they may express their gender identity through the way they talk, act, dress, or style their hair. It’s also common for someone to choose a new name that better suits their gender identity. Gender identity exists on a broad and growing spectrum. 

Not all transgender people pursue medical treatments, but some may use hormone therapies, surgeries, or other procedures to change their bodies to better match their gender identity. You can’t tell whether someone is trans just by looking at them.

Gender vs. sex

People often mix up “sex” and “gender,” but they mean different things. Sex is assigned at birth and is based on biological traits like chromosomes, hormones, and anatomy. Gender, on the other hand, is about the roles, behaviors, and expectations that society has for being male or female. For example, some people might think women should wear dresses, or that men shouldn’t show emotions. Unlike sex, gender is a spectrum, and some people identify in ways that don’t fit neatly into the labels of male or female. Everyone has their own relationship with gender, and they should feel free to express it in whatever way feels right for them.

Gender vs. sexual orientation

Gender and sexual orientation are different parts of a person’s identity. While gender is about who a person feels they are on the inside – whether that’s a man, a woman, or neither – sexual orientation refers to who a person is attracted to.For example, someone who identifies a heterosexual (“straight”) is attracted to people of the opposite sex (so, men who are attracted to women, and vice versa), while someone who identifies as gay or lesbian is attracted to people of the same sex. Bisexual people are attracted to more than one gender. Transgender people can have any sexual orientation, such as straight, gay or lesbian, or bisexual.

Just as there are many gender identities beyond the ones mentioned in this article, there is also a wide range of sexual orientations. 

Transgender vs. intersex

While these terms are often confused, they don’t mean the same thing. A transgender person is someone who is born with clear male or female biological traits, but their gender identity doesn’t match their assigned sex. By contrast, an intersex person is someone born with biological traits that don’t always fit into the usual male or female categories. So a baby with male chromosomes – which carry genetic information that determines traits like sex – may have genitals and other features that appear female, and vice versa for babies with female chromosomes. Some intersex people have both male and female reproductive traits, like male genitals and female hormone levels. It’s estimated that 1 in every 100 American babies are intersex.

A transgender person may also be intersex, though it’s not common. An intersex person might live according to the sex they were assigned at birth. For example, an intersex baby assigned female sex at birth might be raised as a girl and continue to express themselves in a traditionally feminine way. But some intersex people who were raised as one sex may later identify with the opposite sex and make changes to their appearance, behaviors, and bodies to align with their true gender identity, similar to what many transgender people experience.

Cross-dressing vs. being trans

A person who cross-dresses wears clothes that are normally linked to a gender different from the one they identify with. For example, a man may choose to wear a skirt or high heels. This is usually a personal choice and doesn’t necessarily reflect a person’s gender identity. While a trans person may express their gender through clothing, their identity is based on a deep sense of who they are, not just how they dress.

In recent years, views on gendered clothing have started to shift. It’s now more common to see women wearing traditionally masculine styles, or for clothing to be designed with no gender at all. But in most parts of the world, there is still some stigma around men wearing more feminine clothing.

The history of transgender people stretches back across many cultures and centuries, even though the term "transgender" itself is relatively new. In ancient societies, like Rome, some people dressed or lived as a gender different from the one they were assigned at birth, though their identities weren’t understood in the same way we think about gender today. Many Indigenous cultures around the world have long recognized and celebrated people with gender identities beyond just male or female. But during colonization, Europeans imposed rigid two-gender systems, erasing many of these traditions.

In the early 20th century, people who identified as trans or gender-nonconforming were often labeled as mentally ill. They were subjected to psychological treatments instead of receiving gender-affirming care. The first documented sex change surgery, performed in Germany in 1931, was groundbreaking, but it wasn’t until the 1950s that such procedures became more common. In the U.S., the country’s first gender identity clinic opened at Johns Hopkins University in 1966, offering medical and surgical care for trans people.

The 1950s also marked the rise of transgender activism, fueled by broader civil rights and LGBTQ+ movements. At the time, LGBTQ+ people faced widespread discrimination, including legal prosecution and exclusion from housing, employment, and public services. A turning point in U.S. transgender history came during the Stonewall riots of 1969 in New York City. When police raided a popular gay bar, its patrons – including transgender and gender-nonconforming people – fought back, with more protests happening over the following days. The Stonewall riots are credited with sparking the modern LGBTQ+ rights movement.

In the late 20th and early 21st centuries, transgender people became more visible, accepted, and legally recognized. But challenges such as discrimination, lack of access to health care, and social stigma persist. Today, transgender people around the world – including in the United States – continue to fight for equality, acceptance, and the right to live authentically.

Trans flag

The trans flag, introduced in 1999, has five horizontal stripes of equal size: two light blue, two light pink and one white. The blue and pink stripes represent the traditional colors for baby boys and girls, while the white stripe stands for those who are nonbinary, genderqueer, or transitioning. The flag was designed to look the same no matter how it’s flown, symbolizing the idea that trans people can find correctness in their lives in any orientation. It was designed by Monica Helms, an openly transgender American woman.

For some transgender people, the mismatch between the sex they were assigned at birth and their gender identity may cause a medically recognized form of psychological distress called gender dysphoria. Children and adolescents can have gender dysphoria, though the condition may not arise until adulthood. People with this condition feel a strong, persistent desire to be rid of the sexual traits they were born with and live as another gender. 

Rejection by family and society can make gender dysphoria worse, increasing a person’s chances of substance abuse, self-harm, suicide, and other negative outcomes. Treatment usually involves working with a supportive psychotherapist and taking steps to “affirm” one’s gender identity. These steps can include changes in self-expression, like changing one’s name or seeking out body-altering medical treatment.

Transitioning refers to when a trans person starts to live according to their gender identity, rather than the gender they were assigned at birth. This process is deeply personal and looks different for everyone. There’s no checklist or specific steps required to “complete” a transition – it’s about what feels right for the person who is transitioning.

Not all trans people choose to transition, and transitioning is not a requirement to be transgender. What defines being transgender is that your gender identity does not match the sex you were assigned at birth.

Socially transitioning

Social transitioning is when someone starts living publicly as their true gender, either part-time or full-time. This can involve steps like coming out to friends and family, changing your name, updating your wardrobe, or asking people to use pronouns that match your gender identity, like “she,” “he,” or “they.” Some people also adjust their physical appearance without surgery. For example, you might wear a snug garment to press down your chest for a more masculine look (called “binding”) or gently place your testicles inside your body and use tight-fitting underwear to create a smoother, more feminine silhouette (known as “tucking”).

Some people also update official documents, like their driver’s license or passport, to reflect their gender identity,

Gender-affirming surgery

Some trans people may choose to have gender-affirming surgery to better align their physical traits with their gender identity. This could include: 

  • Facial reconstruction surgery to make certain features look more masculine or feminine
  • Vocal surgery to change the pitch of your voice 
  • Chest surgery (or “top” surgery) to remove breast tissue or change the size and shape of the breasts 
  • Genital (or “bottom” surgery) to change or reconstruct sex or reproductive organs, such as removing the uterus or constructing a penis and testicles

It’s important to remember that surgery is not a requirement to be transgender. What feels right for one trans person might not feel right for another.

Transgender people often face stigma, harassment, and discrimination in their everyday lives, which can be a major source of psychological stress. Many deal with bullying, rejection by their families, homelessness, or have trouble finding work. 

Minority stress theory can help explain how this type of discrimination and social stigma can cause constant stress for marginalized groups. It shows that both outside challenges, like discriminatory policies and violence, and internal struggles, such as feeling ashamed or fearing rejection, can harm mental and physical health. 

For trans people, these combined stresses often lead to higher levels of anxiety, depression, and even suicide attempts. Trans people with cross-sectional identities – for example, those who are part of a racial minority or disabled – have an even higher risk.

Trans youths are especially vulnerable. According to the National Center for Transgender Equality, 40% of them attempt suicide in their lifetime – which is nine times higher than the national average.

In the United States, trans people are also more than 2.5 times likely to experience violence, and the risk is even higher in other parts of the world. Trans people who are part of minority groups, are migrants, or are sex workers face the greatest risk of violence, including assaults, rape, and even murder.

This discrimination extends to health care settings, where trans people often endure forced psychiatric evaluations, unwanted surgeries, and sterilizations.

Advocates point out that few U.S. states and cities protect transgender people from discrimination based on their gender identity, making them vulnerable to unfair treatment when they look for a place to live, a job, or medical treatment. In some states, access to medical treatment has been banned or severely restricted, making it even harder for transgender people to live as themselves. In 2023, more bills targeting gender-affirming health care were introduced in the U.S. than in the previous five years combined. 

If you’re facing discrimination

If you’re dealing with discrimination as a trans person in the U.S., there are things you can do to protect yourself and seek support. Start by documenting what happened, including dates, times, locations, and any witnesses. This can be helpful if you decide to file a formal complaint. Consider reaching out to organizations like the American Civil Liberties Union (ACLU) or the National Center for Transgender Equality, many of which offer resources, legal assistance, and other support. If the discrimination happens at work, you can also file a complaint with the Equal Employment Opportunity Commission. Local LGBTQ+ organizations can also provide a safe space to share your experiences and offer support.

It’s normal for children to show interests or behaviors that are normally associated with the opposite genders, like girls playing with trucks or boys wanting to wear dresses. This doesn’t mean your child is transgender. If, on the other hand, they consistently insist they are a different gender than the one they were assigned at birth, then they may be trans. Since kids express themselves in many different ways, the best approach if you think your child is trans is to talk to a gender therapist.

You should never try to force your child to change their gender identity. Not only is it ineffective, but it can also harm your child’s mental health over the long run. Conversion or reparative therapies in particular, which attempt to “fix” a person’s gender identity through emotional and behavioral treatment, are considered dangerous by mental health experts. Supporting and accepting your child for who they are is the best way to help them thrive. 

You can do this in many ways. Always use the name and pronouns your child has chosen, and make sure others do the same. Take time to learn about the challenges trans people face, and find out how schools can support your child. Encourage your child to speak up for themselves when it’s safe and to set boundaries when they need to. Most importantly, let them know you love and support them no matter what.

Being an ally to the trans community involves learning, respect, and support. Start by educating yourself about what it means to be transgender and the challenges that come with it. Keep in mind that everyone’s journey is different, and there’s no “one way” to be trans. Always use the name and pronouns a trans person prefers, and if you're unsure, ask politely. Be mindful not to ask personal or intrusive questions about a trans person’s medical history or body. If you ever witness discrimination against a trans person, say something. You can also support trans people in your community by advocating for inclusive policies, like gender-neutral bathrooms and anti-discrimination laws.

There are still a lot of misconceptions about what it means to be transgender, but understanding gender identity is a good place to start. Gender isn’t always the same as the sex someone was assigned at birth – it’s about how a person feels and sees themselves on the inside. While there’s been progress in visibility and rights, transgender people continue to face discrimination, stigma, and barriers to accessing gender-affirming health care, both in the U.S. and globally. If you’re trans and looking for support, connecting with affirming communities, finding trusted allies, and seeking care from a gender-affirming health care specialist or therapist can make a big difference. For parents of transgender children, showing unconditional love and getting guidance from gender specialists can help you navigate the journey together. And to be an ally, the most important steps are to listen to, learn from, and support the trans community.

What is the full meaning of transgender?

Transgender is a term used to describe a person whose gender is different from the one they were assigned when they were born. 

What is the meaning of transgender woman?

A transgender woman is someone who was born with the biological traits of a male, but who identifies and lives as a woman. 

How does a woman transition to a man?

Transitioning looks different for everyone. Many trans men change how they express their gender to match their male gender identity. This could include changing their name, dressing in more masculine clothing, or even pursuing medical treatments like hormone therapy or surgery. 

Are transgender and hijra the same?

No, transgender and hijra are not the same. In South Asia, hijra refers to a third gender for people who don’t fit into the traditional male or female categories, and they often live together as a community. Transgender, on the other hand, is a broader term used around the world to describe people whose gender identity doesn’t match the sex they were assigned at birth.