Transgender emerged as a popular term in the 1990s, although earlier references exist. The specific meaning of transgender varies across time, culture, and individual interpretation. Today, transgender is frequently used as an umbrella term for people who identify outside of socially prescribed male and female norms. It is sometimes more specifically defined as an individual whose gender identity does not match the sex assigned at birth.

Gender-expansive is a broad term referring to aspects of gender expression, identity, and interests that go beyond cultural binary prescriptions of behaviors and interests associated primarily with boys or girls. Gender-expansive includes young people who do not identify with the sex they were assigned at birth as well as those who do, but may nonetheless find themselves barraged with questions based on their dress, appearance, or interests, such as, “Are you a boy or a girl?” or “Why do you play with that? It’s a boy/girl toy!” Other words with similar meetings include gender diverse and gender creative.

These are just some of the many terms used by people for whom the gender binary—where everyone fits into neat categories of male or female—is not adequate to describe their experiences. People who identify outside of binary categories may feel both male and female or neither.

Language about gender is evolving every day. Within this shifting landscape, it is critical to respect how members of the school community self-identify. In some circumstances it can be helpful to respectfully ask questions, such as, “I know that word can mean different things to different people. What does it mean to you?” and “What pronouns do you prefer to use in reference to yourself?”
For a list of definitions related to gender and youth, see Gender Spectrum’s The Language of Gender (PDF) and the resources attached to the 2014 APA & NASP resolution on Gender and Sexual Orientation Diversity in Schools.

To learn more about nonbinary identities, see the Frontline article “I Like to Exist as a Person”: What It Means to Live Beyond Gender”.

The word transsexual has its origins in the work of German doctor Magnus Hirschfeld, who in the 1920s advocated for acceptance of diverse gender and sexual orientation identities. He was part of a team that oversaw early genital reassignment surgeries. Over time, transsexual came to be accepted as a term for someone who medically and/or socially transitions from one gender to another. It is not a word that is commonly used by young people, and is also increasingly less commonly used by adults.

In 2015, the word cisgender was added to the Oxford English Dictionary, defined as “denoting or relating to a person whose self-identity conforms with the gender that corresponds to their biological sex; not transgender.” It is built on the Latin-derived prefix cis, meaning “on this side of” and is the opposite of the Latin-derived prefix trans, which means "on the other side of."

Individuals whose biological sex and gender identity match may not think about the alignment of biology and gender identity because they have the privilege of majority status. Cisgender is an important word because it names the dominant experience rather than simply seeing it as the default norm.

Biological/anatomical sex is traditionally assigned at birth, based on a newborn’s genitals. It is also associated with chromosomes, hormones, and reproductive structures. While it is commonly assumed that these biological factors align as either male or female, in fact there is much variation in humans as well as other species. Intersex is a word used to describe people who show variation outside of the male/female binary in one or more of the physiological components we associate with sex. Given this potential variation, biological sex is most accurately seen as a spectrum or range of possibilities rather than a binary set of two options.

Gender identity is a person’s innermost concept of self as male, female, neither, or a blend of two or more gender identifications. It is the deeply held internal knowledge of identity—who a person is and how they want to be perceived. A person’s gender identity can be the same or different than the sex assigned at birth.

Gender expression refers to the ways in which people externally communicate their gender identity to others through behavior, clothing, haircut, voice, and other forms of presentation. Many of the qualities associated with traditional gender expression are socially constructed and vary across cultures and time. For example, high heels were originally the province of men and were worn by Persian soldiers in the 10th century and by European royals, including Louis XIV, in the 17th century.

We all have a gender identity and a sexual orientation/identity. Gender identity is a deeply held, personal understanding of our gender; it is who we are and how we want to be seen as individuals and in the cultural and social contexts in which we live. Sexual orientation is a deeply held understanding of the nature of our physical, emotional, spiritual, and/or romantic attractions to others. As with gender identity, sexual orientation is nonbinary, and encompasses people who have the capacity to be attracted to more than one sex or gender or not to feel sexual attraction at all.

The two concepts are related while distinctly different. A man who is attracted to women may consider himself heterosexual whether or not he is transgender or cisgender. A person who is gender fluid may find concepts such as gay and straight irrelevant, identifying their sexual orientation with less rigidly defining language, including bisexual, pansexual, or queer.

For a visual representation and downloadable poster detailing components of gender and sexual orientation, click here.

Gender dysphoria is a clinical term that has replaced gender identity disorder in the most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). Current research confirms that feeling a mismatch between one’s biological sex and gender identity is not psychopathology, though persons may experience clinical levels of anxiety, depression, and stress due to genetic predisposition or environmental factors related to acceptance.

Some, but not all, people who are transgender may have gender dysphoria; likewise, some but not all people with gender dysphoria identify as transgender. The DSM-5 indicates that:

For a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least [6] months. In children, the desire to be of the other gender must be present and verbalized. This condition causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
It is important to note that the DSM-5 reclassified variations in gender presentation to be a dysphoria rather than a disorder, reducing stigma and psychopathology related to nonconformity.

Transgender students whose families, schools, and communities accept and support their gender identity and expression are less likely to experience mental health issues or distress as described in the DSM-5 definition of gender dysphoria (Ryan, Huebner, Diaz, & Sanchez, 2009).

There will be times when a diagnosis is necessary to receive insurance reimbursement for treatment. A specifier code is available for those who are living full-time as a different gender than their assigned sex at birth (American Psychiatric Association, 2013).