Transgender

Transgender is an umbrella term for people whose gender identity differs from the sex they were assigned at birth. A transgender woman is a woman who was assigned male at birth, while a transgender man is a man who was assigned female at birth. Some nonbinary people also consider themselves transgender.^[1]

Being transgender does not describe one particular body, sexual orientation or way of having sex. A trans person may or may not use hormones, may or may not have surgery, and may have many different combinations of secondary sex characteristics and genital anatomy.

This section of Sex Guide focuses especially on transgender bodies, sexual anatomy, hormone-related changes, sexuality and adult terminology.

What does transgender mean?

Gender identity is a person's internal sense of gender. It is different from both anatomical sex characteristics and gender expression — the outward presentation of gender through clothing, hairstyle, voice, mannerisms and other features.^[1]

The word transgender is normally used as an adjective: transgender woman, transgender man or transgender person. The shorter word trans is also widely used.

A person does not need to undergo hormone therapy or surgery in order to be transgender. Medical transition is one possible part of a much broader process, and different people make different choices about their bodies.^[2]

The opposite term is cisgender, describing a person whose gender identity corresponds with the sex they were assigned at birth.^[2]

Trans women, trans men and nonbinary people

A trans woman is a woman who was assigned male at birth. She may have a feminine appearance, use a female name and pronouns, wear ordinary women's clothing and live socially as a woman. Some trans women prefer simply to be described as women rather than having trans emphasized.^[2]

A trans man is a man who was assigned female at birth. Testosterone, masculine presentation and surgery can change many visible characteristics of the body, but none of these is required for someone to be a trans man.

Nonbinary describes gender identities that do not fit completely into the categories of man or woman. Many nonbinary people consider themselves part of the transgender population, while others do not.^[2]

Gender expression should not be confused with gender identity. A feminine man, masculine woman or person who cross-dresses is not automatically transgender.

Transition

Transition describes changes a transgender person may make in order to live more comfortably as their gender. There is no single required sequence or endpoint.

Social transition can include changing a name, pronouns, clothing, hairstyle, grooming, voice or public gender presentation.^[1]

Medical transition can include hormone therapy, surgery or both. The World Professional Association for Transgender Health describes transgender healthcare as individualized and potentially involving primary care, reproductive care, voice therapy, mental-health services, hormones and surgical treatment.^[3]

Not every transgender person wants every available treatment. A trans woman can be comfortable retaining her penis, for example, while another may experience strong genital dysphoria and want vaginoplasty. Likewise, a trans man may retain his vagina and internal reproductive organs or may choose one or more genital or reproductive surgeries.

The presence or absence of surgery therefore does not determine whether someone is "really" transgender.

How hormones change the body

Gender-affirming hormones can substantially change the visible and sexual characteristics of the body.

For trans women, feminizing hormone therapy usually involves estrogen together with reduction of testosterone activity. Changes can include breast development, softer skin, reduced muscle mass, redistribution of body fat, reduced facial and body-hair growth, smaller testicles and fewer spontaneous erections.^[4]

These changes can produce a body with breasts and feminine contours while a penis and scrotum remain present. Hormones also affect sexual function: erections may become less frequent, libido can change, ejaculation can decrease and fertility may be reduced.^[4]

For a more detailed explanation, see What Hormones Do to a Trans Woman's Body.

For trans men, masculinizing hormone therapy is based primarily on testosterone. It can stop menstruation, deepen the voice, increase facial and body hair, redistribute fat, increase muscle mass and enlarge the clitoris.^[5]

Testosterone can also make vaginal tissues thinner and drier, and it can affect fertility and sexual function.^[5]

Hormonal changes occur gradually and vary between individuals. Hormones also cannot change every characteristic established during an earlier puberty.

Genitals and surgery

A transgender person's gender cannot be reliably determined from one particular genital anatomy.

A trans woman may have a penis and testicles. If she undergoes genital surgery, procedures can include removal of the testicles and creation of a vulva, clitoris and vagina. Not every trans woman chooses these procedures.^[6]

A trans man may retain a vulva, vagina, uterus and ovaries. Masculinizing genital surgery can instead include metoidioplasty, which uses the testosterone-enlarged clitoris to create a small penis, or phalloplasty, which constructs a penis using tissue from another part of the body. Other procedures can include scrotoplasty, vaginectomy, hysterectomy or removal of the ovaries.^[7]

Because transition is individualized, transgender bodies can therefore contain combinations of features that inexperienced readers may initially find unexpected: breasts together with a penis, a masculine chest together with a vulva, or surgically reconstructed genital anatomy.

A short visual introduction to one of these combinations is also included in Naked Female Body.

Sex and sexual orientation

Gender identity and sexual orientation are separate characteristics. A transgender person can be heterosexual, gay, lesbian, bisexual, asexual or use another description of sexual orientation.^[1]

For example, a trans woman attracted to men may describe herself as straight, while a trans woman attracted to women may describe herself as lesbian.

Sexual practices also cannot be predicted simply from gender identity. Two trans women with similar bodies may have completely different preferences about penetration, genital touching, oral sex or the sexual use of the penis.

A trans person's relationship with their genitals can range from positive to strongly uncomfortable. Some people incorporate their existing genitals into sex without difficulty, while others experience genital dysphoria and prefer that certain body parts are not touched, looked at or used sexually.

Hormones and surgery can also change sexual response. Feminizing hormones can affect erections, ejaculation and libido, while testosterone can enlarge the clitoris and alter vaginal tissues.^[4]^[5]

Practical communication is therefore more useful than making assumptions from appearance alone.

For receptive and insertive roles, anatomy after surgery and sexual response during anal activity, see Trans Anal Sex.

Transgender terminology in adult media

Pornography uses a mixture of current transgender terminology, older terminology and slang.

Trans woman and transgender woman are neutral descriptions. The older word transsexual is still used by some people and appears in older medical literature and pornography, but it is no longer the preferred general term; it is best used for a person who specifically uses it for herself.^[2]

Adult websites also historically used labels such as shemale, tranny and trap. These remain recognizable search or pornographic terms, but they are widely regarded as derogatory when applied to transgender people outside consensual self-description or discussion of the terminology itself.^[2]

Terms such as pre-op, post-op and non-op have also been used to classify trans people according to genital surgery. They can be useful when a particular anatomical distinction is genuinely relevant, but they reduce a person's description to surgical status and should not be assumed to be how that person describes herself or himself.

Porn categories can also blur concepts that are distinct in real life. A sissy is usually an erotic feminization or submissive role and is not another word for a trans woman. A person can enjoy sissy hypno, sissy captions or other feminization fantasies while continuing to identify as a man.

Likewise, cross-dressing describes clothing or presentation and does not by itself establish transgender identity or sexual orientation.^[1]

References

↑ ^1,1 ^1,2 ^1,3 ^1,4 ^1,5 American Psychological Association. Understanding transgender people, gender identity and gender expression. American Psychological Association
↑ ^2,1 ^2,2 ^2,3 ^2,4 ^2,5 ^2,6 GLAAD. Glossary of Terms: Transgender. GLAAD
↑ World Professional Association for Transgender Health. Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. WPATH
↑ ^4,1 ^4,2 ^4,3 Mayo Clinic. Feminizing hormone therapy. Mayo Clinic
↑ ^5,1 ^5,2 ^5,3 Mayo Clinic. Masculinizing hormone therapy. Mayo Clinic
↑ Mayo Clinic. Feminizing surgery. Mayo Clinic
↑ Mayo Clinic. Masculinizing surgery. Mayo Clinic