The term “transgender” refers to individuals whose gender identity differs from the sex they were assigned at birth. Gender identity is a person’s internal sense of being male, female, both, or neither, which may or may not align with their biological sex. Transgender people may experience gender dysphoria, which is distress caused by a mismatch between their gender identity and their assigned sex.
Transgender people come from all walks of life, and their experiences vary widely. Some may choose to transition, which can involve social, medical, or legal steps to align their lives with their gender identity. This might include changing their name and pronouns, hormone therapy, or gender-affirming surgeries. However, not all transgender individuals desire or are able to transition medically.
The transgender community faces numerous challenges, including discrimination, prejudice, and violence. Many transgender people struggle with issues like employment, housing, healthcare, and social acceptance. However, there has been increasing awareness and advocacy for transgender rights in recent years, leading to greater visibility and legal protections in some places.
It’s important to treat transgender individuals with respect and understanding. Using their correct pronouns and names, and being open to learning about their experiences, are crucial steps in fostering inclusivity and acceptance. The journey of each transgender person is unique, and recognizing and respecting their individuality is essential.
It is impossible to identify a transgender person at birth, because gender identity is a person’s internal sense of self, not something that can be determined by a doctor’s examination of their external anatomy. A transgender person is someone whose gender identity differs from the sex they were assigned at birth, which is a determination based on observable characteristics at birth. Gender identity is an internal feeling that is not visible at birth.
Sex assigned at birth vs. gender identity: Sex assigned at birth is a physical categorization, typically based on genitalia, that is recorded on a birth certificate. Gender identity is a person’s internal sense of being a man, woman, both, or neither.
Timing: Many transgender people know their gender identity from a very young age, sometimes as early as age 2, but others may not realize it until later in life.
Signs: There is no simple test for identifying a transgender baby, as there is no way to know a person’s internal identity at birth. Instead, caregivers should be attentive to a child’s consistent and persistent expressions of gender identity over time.
Distinction from intersex: It’s important to distinguish between being transgender and being intersex. Intersex individuals have reproductive or sexual anatomy that doesn’t fit typical definitions of male or female, which can sometimes be discovered at birth. A transgender person is usually born with anatomy that fits typical male or female categories, but their gender identity differs from the one assigned to them.
Treatment;
For transgender individuals
Hormone therapy: Gender-affirming hormone therapy (GAHT) uses hormones to help secondary sexual characteristics develop in alignment with a person’s gender identity.
Feminizing therapy: Involves estrogens, sometimes with antiandrogens.
Masculinizing therapy: Involves androgens, sometimes with antiestrogens.
Surgeries: Procedures are available to alter physical characteristics.
Genital reconstruction: Reshaping of genitals to be more aligned with gender identity.
Chest surgery: May include breast augmentation for trans feminine people or mastectomy for trans masculine people.
Facial surgeries: Procedures like facial plastic reconstruction or hair removal through electrolysis can be options.
Other procedures: Treatments can also include hair growth or removal therapies.
For intersex individuals
Hormone-related care:
Providers can offer a wide range of hormone options, including puberty suppressants to give children more time to explore their gender identity before developing a puberty that does not align with their assigned sex at birth.
Hormonal treatment can be provided to those who need it, with choices presented based on the individual’s needs and gender identity.
Surgeries:
Medical consensus and patient advocates have increasingly raised concerns about non-medically necessary surgeries performed on intersex infants to “normalize” their appearance, noting that these can lead to lifelong harm like scarring, loss of sexual sensation, and chronic pain.
The focus is shifting toward giving intersex people autonomy in their care and to only perform surgery when it is medically necessary for conditions like hormone-related issues, as noted by the National Institutes of Health.
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