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Most of us grew up thinking there were only two genders—male and female. But there is a growing recognition that this is not the case, and that gender is not so simply defined.
Wherever you are in your journey to understand gender, thanks for being here. Conversations around gender can be uncomfortable for those who struggle to understand its nuances — and even more uncomfortable for those who constantly have to justify their identity to others.
To get you started, here are a few must-know gender facts.
What is gender?
To understand gender, it’s important first to understand the difference between gender and sex.
Typically, someone’s sex is based on their physical attributes such as their genitals, their body type and features, and whether they have an X or Y sex chromosome. Usually, if someone is born with a vagina and reproductive organs like a uterus, they’re assigned female at birth. The same concept goes for someone born with a penis and a scrotum — they’re usually assigned male at birth.
There are also many intersex variations that exist. Intersex people are those born with both male and female biological traits.
Gender involves the different psychology and behaviors society has traditionally associated with each sex. For example, some common gender stereotypes include ideas like how men shouldn’t cry or show emotion or how only women should wear dresses or makeup.
We tend to assume a person’s sex and gender are the same because, let’s face it — that’s how we’ve been socialized. A man, by definition, has a penis, and a woman, a vagina. Men are expected to be masculine, and women, feminine. But in reality, many people don’t feel they fit the gender role society has assigned them.
“Gender identity has always existed on a spectrum,” says Dr. Corinne Heinen, the physician lead at the UW Transgender & Gender Non-Binary Health. Even biological sex can be on a spectrum, she explains, with some individuals being biologically intersex.
“There are many different variations,” she says, “This is all part of the human experience.”
And you might ask — what exactly are these variations? Here are some definitions to get you started.
Understanding gender terms
Cisgender means someone who identifies as their gender assigned at birth. For example, a person who is a biological male and who thinks of himself as a male, is a cisgender man.
Transgender typically means someone identifies as a gender that was not what was assigned to them at birth. For example, someone who was assigned female at birth might be a transgender man, and someone who was assigned male at birth might be a transgender woman.
Non-binary means the person identifies as neither strictly male nor strictly female but somewhere in between along a gender spectrum.
Gender non-conforming is a generic term for those who don’t follow any typical gender stereotypes.
Gender-fluid people don’t have a fixed gender identity or gender expression. The fluidity in their gender expression or identity can change from day to day.
Sexual orientation is independent of the individual’s own gender identity and refers to the gender a person feels attracted to romantically and sexually. A transgender woman, for example, could be homosexual (gay or lesbian), heterosexual (straight), bisexual, or another orientation.
And finally, it’s important to support people — or yourself — wherever you may land. This means using the terms someone asks you to use when referring to them.
Gender dysphoria
Gender dysphoria is the state of unease and dissatisfaction a person may feel when their gender identity isn’t the same as their biological sex. “These feelings can cause significant distress at work and in social interactions,” says Heinen. “Imagine if others, even those closest to you, had a fundamental misunderstanding of who you are as a person. Or, if looking in the mirror, you felt your face didn’t reflect the person you are.”
Many people experience gender dysphoria as a disagreement between their body features and how they’re treated in society.
There are a lot of ways this disconnect can be experienced.
“Gender diversity has been a stable pattern in human populations for thousands of years,” says Heinen. “In some societies, gender-diverse people were accorded special roles, including spiritual ones.”
Gender-affirming care
Gender-affirming care is one way to combat feelings of gender dysphoria, which is why access to this kind of care is crucial to the lives of gender-diverse people.
The term “gender-affirming care” is typically for transgender people and non-binary individuals. However, cisgender people have received gender-affirming care for decades.
“The option for cis women who have had a mastectomy to have a reconstruction of their breasts is readily recognized as medically necessary for cisgender people,” says Heinen. “If a cisgender man has significant trauma to his penis, reconstruction would always be covered. Some cisgender women have a variation in sexual development where they don’t have a vagina, and in these cases, a surgical procedure called vaginoplasty has been offered since the late 1800s.”
Heinen explains that most surgeries offered by surgeons providing care for transgender patients are adaptations of surgeries originally developed for cisgender people.
“A vaginoplasty was first done for a transfeminine individual in 1931. This is well-established medical care, with national guidelines first published in 1979,” says Heinen. “It is only due to discrimination that this care hasn’t been consistently offered or paid for over time, something that needs to change.”
So, what does gender-affirming care look like for gender-diverse people?
It can start with a healthcare professional listening to a person’s needs and experiences and treating them respectfully — like using someone’s current name and pronouns.
“Sex hormones — estradiol and testosterone — are the backbone of medical therapy, but there are other medications that can relieve other types of incongruence people experience as well, such as balding,” says Heinen.
This might involve using plastic surgery to construct a penis (phalloplasty), or a vagina (vaginoplasty), or to have a breast reduction or construction. Facial surgery can be performed to feminize or masculinize a person’s features.
Why do transgender and non-binary people need gender-affirming care?
Receiving gender-affirming care can significantly improve the quality of life for a transgender or nonbinary person.
“For many people, having body features that are consistent with their sex assigned at birth causes true anguish,” says Heinen.
There could be many reasons for those feelings of despair, including being repeatedly treated as the gender they do not identify with, which is called being “misgendered.”
“Many trans or nonbinary people feel more at ease with their body when their new features fit with their self-conception, such as a lower voice or different body contours, but not everyone needs medication or surgery to feel more at ease,” says Heinen. “They just ask to be treated in a way that is aligned with their gender identity. There is a great deal of variation in what gender-diverse people need for support,” she adds, “There is no one right way.”
How does gender identity affect mental health?
In general, people feel the best when they can be themselves. Gender-diverse people face more social stigma when it comes to living an authentic life, which can result in feelings of isolation and depression.
One study showed that 82% of transgender individuals have considered suicide, and 40% have attempted suicide — the highest rates being among transgender youth. In another study with transgender youth, after receiving gender-affirming care services, their odds of suicidality decreased by 73%.
“These numbers don’t even capture everything I have seen in my personal professional experience, which includes people reaching their full potential, taking much better care of themselves and experiencing relief from the intense discomfort they previously experienced. Gender-affirming care is undoubtedly lifesaving care,” says Heinen.
Is there anything else to know?
Of course, someone’s gender is unique to them, so always work to be open to learning, growing and understanding more about other genders and your own. It can also help all of us become better advocates for those in the trans and non-binary community (or help you become a better advocate for yourself).
There’s a wealth of terms to use and to avoid, information on how to be a better ally to your transgender friends and how to advocate for yourself as a trans or non-binary person.
Doing the work to better understand gender is a good place to start, but most importantly, check in with the gender-diverse people in your life — or with yourself, if that’s you — to understand how you can be a support and always keep learning.
