There can be a strong adherence to the old way of thinking when it comes to gender being binary, and the social trend of transgender people expressing their gender through hormone replacement therapy (HRT), surgeries, living as their preferred gender, and use of pronouns that more accurately fit their gender. Not only do we see this in transgender people, but also non-binary, gender-queer, and intersex people. What are all these terms? Is it relevant that we allow, or encourage, someone to follow their preference? The short answer is “yes.” And maybe it would sway you to know that it is much more complicated than binary gender and preference.
Gender is not sexuality. When it comes to discussing any of these gender issues, I want to be clear that we are not simultaneously discussing sexuality. Any person of any gender can be any sexuality, so these are two separate issues. This article will not address sexuality as to help keep the issue clear.
What is a transgender person? Did I say that right? A person who is transgender is a person who was born into a body that is not the one that feels right and true to them. (If you are a person who is not transgender, you are cisgender.) Some people take action to make their body conform to the one that they feel they should have gotten. This can be done through HRT (hormones that change the endocrine system’s response), surgery, or dressing differently. They may also use different pronouns than those they were assigned. These people are either assigned male at birth (AMAB) and feel that is incorrect, or assigned female at birth (AFAB) and feel that is incorrect. If they desire to change their gender, modern technology and science allows that to happen to varying extents depending on when they start hormonal treatments. Starting treatment before puberty can help a person to “pass,” or look more like, their chosen gender by not having gone through the puberty of the body they were assigned. This matter is currently being hotly debated and voted on in politics by people who often don’t even bother to read the bills they are voting on. Some people who are transgender do not go on HRT because of medical conditions, an adverse reaction once starting them, fear of the physical ramifications (for instance, going on testosterone can increase the odds of certain cancers), fear of having to stop them once started (due to the political climate and little research into what will happen in those cases), or other more personal reasons. Some people who do or do not go on HRT choose not to have some or all of the gender-affirming surgeries as they are averse to the risks of elective surgery, are okay with some parts of their body remaining as they are, or for other more personal reasons. It is absolutely relevant that we allow transgender people to have the sorts of treatments they desire in order to stave off body dysmorphia – a feeling that the body, or parts of the body, are not a fit – as this is a source of depression, a reason for many suicide attempts, and just a terrible way to feel about one’s self.
Okay, so that’s transgender. What about non-binary and gender-queer? I thought that was a slur? A person who feels they are sometimes more masculine or more feminine, and changes things about themselves (their clothing, walk, style, etc.) on the fly can be considered to be gender-queer, meaning changeable from time to time – as frequently as several times a day and as infrequently as several times per month. Even cisgender people will say they may feel more masculine or feminine at times, although it is not as culturally acceptable for cisgender men to assert this in public due to toxic masculinity. Yes, queer can be a slur, when it refers to someone’s sexuality, and you should not assume that label of someone else, but if they say it of themselves, assume it means “flexible” or “fluid.” You may also hear the term “gender fluid” used interchangeably with “gender-queer.” However, a person who is non-binary considers themselves to be neither feminine nor masculine, but somewhere in between They may be more androgynous in nature, but not necessarily outwardly so, as it may be how they define themselves, while conforming to a more typical presentation.
Okay, that was a lot. I’m afraid to ask what intersex is. Ah, but ask, because asking is how we learn! “Intersex is an umbrella term used to describe a wide range of natural variations that affect genitals, gonads, hormones, chromosomes, or reproductive organs. Sometimes these characteristics are visible at birth, sometimes they appear at puberty, and sometimes they are not physically apparent at all.” Its intersex awareness day – here are 5 myths we need to shatter. Amnesty International. (2022, November 28). Retrieved March 28, 2023, from https://www.amnesty.org/en/latest/news/2018/10/its-intersex-awareness-day-here-are-5-myths-we-need-to-shatter/
It used to be, and likely still remains, that intersex children had their gender chosen by the doctor who delivered them and surgeries were recommended to the parents to make the body conform to what the doctor thought was most probable or most aesthetically pleasing. But it’s so much more complicated than that! Take for example, Persistent Mullerian Duct Syndrome (PMDS), a rare disease that occurs in cisgender men who have normal-looking and functioning genitalia, but also develop ovaries, and are only diagnosed when something goes wrong, requiring a scan. U.S. National Library of Medicine. (n.d.). Persistent müllerian duct syndrome: Medlineplus Genetics. MedlinePlus. Retrieved March 28, 2023, from https://medlineplus.gov/genetics/condition/persistent-mullerian-duct-syndrome/ Learn more about intersex by viewing the video Intersexion.
ALL of those variations fall under the transgender label or umbrella in the LGBTQIA+ community (it’s the T part).
How much of a person’s preference that isn’t mine applies to me? You can be an ally by: using a person’s preferred pronouns – that’s a small ask – “I prefer to called she/her,” but putting your own pronouns on work/school documents like next to your name on an email signature or on Zoom. By the way, a person who is non-binary or gender-queer might go by “they/them, so you don’t have to ask their designation on a particular day, just call them by their name or refer to them as they. The use of the singular “they” is not grammatically incorrect, as stated by the APA style guidelines, it simply fell out of fashion for awhile, but language is living, and always changing and evolving.
But it’s a choice, right? Probably not. More and more research is showing that there are distinct differences between the physical brains of transgender people and the bodies they were assigned, so the brains of a person’s preferred gender more closely aligns with those of their cisgendered counterparts. Here is a study from 2008, another from 2018, another from 2013, and I’m certain more will be forthcoming as technology continues to progress and there are more transgender people of all ages to study. There seems to be something about physiology that leads to the brain being in the wrong body; that’s not a choice!
But I’m unlikely to ever meet a transgender person, right? You probably have. Have you ever met a redhead? Intersex people are more common than redheads, you just don’t see it like you do hair color. This study from 2016 discusses the prevalence of transgender populations, and this one from 2002 discusses the prevalence of intersex populations.
Short-Term Therapy 