When we’re speaking with, talking about, or making policies, procedures, guidance, or laws that impact the lives of transgender-spectrum people, it’s important to have our questions answered using evidence-based information.
Public awareness of transgender people dates back to the early 1950’s, so it’s not uncommon for people to have questions about gender diversity.
Curiosity, and the objective desire to learn is only natural, just like gender diversity.
“Assigned Gender Role” is often misidentified as “sex assigned at birth” because administrative systems (and people)
confuse “sex” (an exclusively biological process) with “gender”, which is a combination of
biological development and social constructs of gender.
It describes the culturally and socially determined sets of stereotypes (‘boxes’) regarding how
individuals are expected to behave, think, and interact based on their assigned gender role at birth.
These roles are often associated with stereotypical (aka “traditional” concepts of masculinity and femininity,
influencing various aspects of life, including family dynamics, career choices, and personal relationships.
The arrogance, and hubris of pre/post-natally assigning an infant a lifelong, binary gender-only social identity
(and the masculine/feminine stereotypes that go with it) will traumatically impact
the remaining three cornerstones of gender experience.
“Gender identity” is something everyone experiences as an internal, deeply held sense of who they are within any socially or culturally constructed gender framework.
This may correspond to their sex biology and gender role assigned at birth (cisgender), but it may not (transgender, nonbinary, etc.)
A person’s gender identity is separate from their sexuality (heterosexual/gay/bisexual, etc.)
“Gender Expression” refers to how a person chooses to communicate their gender identity to the world through appearance,
mannerisms, behavior, and clothing. Gender expression is not necessarily an indicator of, or reflection of, gender identity.
There are, essentially, two categories of public gender performance, and no one has to perform in the same category all the time!
Most people perform gender in this category (most of the time).
It’s the most convenient way to blend in with your culture.
Most (not all) people feel comfortable conforming to cultural gender stereotypes; it’s a common characterisic of being cisgender.
Some people (cisgender and transgender), feel deeply constrained and uncomfortable with gender conformity, but are (justifiably) afraid
to ‘transgress’ gender stereotypes because of where they live, who they live with, or other factors they may not even feel safe talking about with their closest friends, or family.
What is considered “gender conforming” changes over time.
The Williams Institute at the UCLA School of Law shared data in 2022 that showed 25.6% of 1.35 million transgender people surveyed described their gender expression as ‘gender non-conforming’.
The data comes from the 2017 Centers for Disease Control (CDC) Behavior Risk Factor Surveillance System (BRFSS).
You might think, “Well, yeah. They’re trans, they want to stand out.”
It would be a mistake to jump to that conclusion.
For many trans-spectrum people, ‘blending in’ with gender
stereotypes is a goal. It may even be a matter of survival.
And, brace yourself…you don’t even need to be transgender, or nonbinary, or gay to be gender non-conforming.
The vast majority of gender non-conforming people on planet Earth are (wait for it), CISGENDER.
Let’s do some math…
Since 93% of people on Earth are, essentially cisgender, then even if only 5% of them were gender
non-conforming, they would outnumber LGBTQI2S gender non-conforming people by more than
7.5 BILLION
Gender attribution is the process by which someone perceives and categorizes another person’s gender, often based on
observable characteristics like mannerisms, voice pitch, hairstyle, clothing, height, body type, and clothing.
This perception may, or may not align with the person’s self-identified gender.
It’s a social process that can be influenced by stereotypical cultural norms, expectations, and habits about gender.
Anyone can be subjected to incorrect gender attribution, which is why sharing
your name and pronouns and giving space for others to do the same is so important.
A gender roles, often referred to as an “assigned gender role” is the second designation related to your existence. The first, is some variation of ‘human fetus/baby’.
Gender identity is perhaps the most important aspect of individual autonomy, and importantly, having a sense of your own gender identity is not dependent on either your sexual biology, assigned gender role, or parental/societal expectations.
Gender expression is how someone chooses to outwardly express their gender in public. Gender expression is external manifestations of gender, while gender identity is internal. Expression includes a person’s name, pronouns, body characteristics, voice, behavior, and aesthetic choices such as hair, clothing, and cosmetics. Various forms of expression are regarded as “masculine” or “feminine” within different cultures. Some transgender people seek to align their gender expression with their gender identity, rather than the cues associated with the sex they were assigned at birth.
Gender expression is how someone chooses to outwardly express their gender in public. Gender expression is external manifestations of gender, while gender identity is internal. Expression includes a person’s…Various forms of expression are regarded as “masculine” or “feminine” within different cultures. Some transgender people seek to align their gender expression with their gender identity, rather than the cues associated with the sex they were assigned at birth.
Most people (approx. 93%) who were labeled male at birth identify as boys and eventually grow up to be men, and most people who were labeled female at birth identify as girls and eventually grow up to be women. These people are part of a population group called cisgender. It is (by far) the largest category of population groups established by gender identity.
Some cisgender people believe that the majority group of people is superior to the minority group of people.
Most cisgender people do not believe that.
Learn more here!
Transgender people are people whose gender identity is different from the gender they were thought to be at birth. “Trans” is often used as shorthand for transgender. Most people who were labeled male at birth turn out to actually identify as men, and most people who were labeled female at birth grow up to be women. But some people’s gender identity – their innate knowledge of who they are – is different from what was initially expected when they were born. Most of these people describe themselves as transgender.
Some Trans+ people believe that being transgender is inferior to being cisgender, and that Trans+ people should defer to policies, procedures, rules, and laws the prioritize the needs of cisgender people over those of Trans+ people.
Learn more here!
Let’s begin by defining what the word “binary” means, according to the Merriam-Webster dictionary:
By extension, “non-binary” (aka “NB” or “Enby”) means someone not defined or limited by an unrealistic binary-only definition of gender as their lived experience.
There have always been trans people who felt their gender identity didn’t fall neatly into the two binary categories of “boy/man” or “girl/woman.” In the past, trans people who felt that way used the words genderqueer and genderfluid to describe that experience. While those words are still used today, it’s now more common for people to call themselves non-binary if they feel their gender identity is something other than boy/man or girl/woman.
Some non-binary people may also identify as transgender. The terms are not mutually exclusive.
Learn more here!
The concept of Two-Spirit folks existed well before the arrival of European settlers on Turtle Island in the 15th century. Indigenous individuals who identified as Two-Spirit folks were seen as gifted and honored in their community because they carried two spirits with them, both male and female. 2S folks were often the healers, medicine people, and visionaries within their given community and they were foundational members of their culture. Much of this can be attributed to the “double vision” 2S people are thought to be gifted with, being able to see both through the masculine and feminine lens.
Two-Spirit people, as well as all Indigenous peoples on Turtle Island, were deeply impacted and harmed by the genocidal actions Christian European colonization. One major impact was the introduction of residential schools which forced extremely heteronormative roles onto Indigenous children. Colonization resulted in Two-Spirit folks losing their way of life and culture, and the effects of that are still very real today and should be brought to light.
It is important to remember that notions, ideas, and identities should not be generalized to all Indigenous peoples and cultures. Due to the diverse and culturally specific nature of these traditions and understandings, it is crucial to recognize that the concept of 2S folks is not universal to all Indigenous worldviews. Additionally, when discussing the concept of Two-Spirit individuals and identity, it is necessary to remember that it is not an identity that non-Indigenous people can appropriate or claim.
Learn more here!
Being “agender” means the individual doesn’t experience a gender, feels genderless, or has a null gender. Some agender people may also identify as gender-neutral or have an undefinable gender. Being agender can fall under the broader category of non-binary identities, but not all agender people align with that. Some agender individuals may also identify as trans, while others may not.
Learn more here!
That is a great question, and I’ll start by posing another question;
Can a child be cisgender?
The answer to both questions is, of course, yes. That is because gender identity is an individualized, natural variation in human development. It is not dependent on, or derived from one’s physiology (penis/scrotum/testicles, vulva/vagina/ovaries). While between 93-94.5% of U.S. youth will identify as cisgender (corresponding to the gender role they were assigned at birth), at least 5.5% and as high as 7% of youth will identify as something other than cisgender.
The existence of transgender or nonbinary children is often dismissed through transmisiac (see above definition of “transmisia”) arguments/postulations that “a child is too young to know their gender”, or as Buck Angel, semi-famous trans man who exploits the trans population and profits from promoting anti-trans ideologies on YouTube puts it, “there is no such thing as trans kids”. (YouTube/June 23, 2025).
If, indeed, a child, any/every child, is “too young to know their gender”, then we must ask the rhetorical question, “why does anyone affirm, or reinforce a cisgender child’s confidence in their identity as a boy, or a girl?”
What if the cisgender child is wrong about that? What if they’re ‘confused’? What if they change their mind later? What if they’re being ‘groomed’, or ‘indoctrinated’ by influential religious, governmental, social media, and almost exclusively cisheteronormative historical narratives?
The answer, of course, is that most patriarchal societies and cultures have been groomed by the influences listed above to believe that assigned binary gender at birth (defined by observable genitalia) is the final word; there is no allowance for individual identity that transcends a male/man, female/woman binary. Acknowledging natural variations in human gender identity that does transcend essentialist binary constructs would be too inconvenient, transgressive, or difficult to explain to others.
After all, there was already a “party” to reveal the child’s genitalia, oops…, gender to family, friends, and neighbors.
Learn more here!
The experience of “gender dysphoria” (not to be confused with “dysmorphia” or “Body Integrity Identity Disorder“) may be felt by a person whose sex or gender (for both Intersex and non-Intersex individuals) assigned at birth does not align with their individual experience of biology or gender identity.
Dysphoria is the antonym (opposite) of “euphoria”, which according to the Cambridge Dictionary means “extreme happiness”. That same dictionary defines “dysphoria” as “severe unhappiness, especially a person’s feeling of being very uncomfortable in their body or of being in the wrong body.”
The diagnosis of “Gender Dysphoria” in the American Psychiatric Association’s (APA) DSM-5-TR is deeply problematic. It describes Gender Dysphoria as, “the psychological distress that results from an incongruence [mismatch] between one’s sex assigned at birth and one’s gender identity.” Transgender rights activist and advocate, Dr. Kelley Winters, Ph.D., has written an excellent critique of this APA diagnosis, which you can read here.
The eleventh revision to the International Classification of Diseases and Related Health Problems (ICD-11), released in 2019, defines gender identity-related health as “gender incongruence of adolescence and adulthood”, and “gender incongruence of childhood”. Further, gender incongruence has been moved out of the “Mental and Behavioral Disorders” chapter and into the new “Conditions Related to Sexual Health” chapter. This reflects current knowledge that trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma.
For more information about ICD-11, and why the United States hasn’t adopted it, click here!
“Gender non-conforming” refers to individuals whose behavior, mannerisms, and/or appearance do not align with traditional masculine or feminine gender stereptypes. This term encompasses a range of expressions and identities, meaning that a person can be gender nonconforming regardless of their gender identity, such as being transgender, non-binary, or cisgender. Essentially, it describes those who do not adhere to societal expectations for their gender expression, which can include variations in interests, behaviors, and self-concept.
Learn more here!
“Sex” and “Gender” are terms that are often used interchangeably in everyday conversation, but they carry distinct meanings with significant implications in various aspects of society, law, politics, and culture. The distinction between sex and gender is not merely an academic or semantic exercise; it holds profound significance in understanding human identity, societal dynamics, and the pursuit of social justice.
This is even more significant in the lives of people who do not conform to the traditional perceptions of sex and gender, such as trans or intersex individuals, whose experiences are almost always defined by this distinction.
“Sexuality” is all about who someone is romantically (and/or sexually) attracted to.
Learn more here!
People can have awareness of gender differences (in physical anatomy) and communicate gender expression as early as 18 months of age. The can communicate their gender identity as early as 3 years old. Some people can trace their awareness back to their earliest memories – they just knew. Others may need more time to find words, or descriptions that resonate with what they’re experiencing. Others spend years feeling like they don’t fit in without really understanding why, and they may try to avoid thinking or talking about their gender out of fear, shame, or confusion.
Trying to repress or change one’s gender identity (often called “Gender Identity Change Efforts”) doesn’t work; in fact, it can be very painful and damaging to one’s emotional and mental health. As Trans+ people become more visible in the media and in community life across the country, more children, youth, and adults are able to name and understand their own experiences and may feel safer and more comfortable sharing it with others.
If you want to have some fun (don’t expect 100% accuracy, and for Pete’s sake, don’t make any decisions as a result of this) take this “What’s My Gender Identity” quiz!
“Transmisia” (formerly, and erroneously called ‘transphobia’) refers to a prejudice and aversion towards transgender and gender non-conforming individuals, including those whose gender expression differs from stereotypical norms. The “misia” in transmisia means “hatred”. It encompasses a disbelief in the validity of transgender identities and can manifest as discrimination and marginalization.
Trasmisia can involve elements of metaphysical skepticism.
The brilliant, talented, and very entertaining Abigail Thorn explores this wonderfully in this Philosophy Tube video.
Learn more here!
For people who follow one of the three major Abrahamic (Judaism, Christianity, Islam) monotheistic religious mythologies, references to a supreme being (“God”) have traditionally utilized a male pronoun (He, Him, His). Correspondingly, artistic depictions of “God the Father” has most frequently been visualized as a bearded old man. Feminist influenced Wiccan mythology embraces the concept of both goddesses and gods, who represent the feminine and masculine essences of the Earth.
Let’s look at (in chronological order, based on earliest historical appearance) how three major Abrahamic religions, Judaism, Christianity, and Islam, conceive of, and intentionally (or unintentionally), promote the idea of a male “God”.
Rabbinic texts recognize that there are more than two sexes in their use of terms such as androgynous and tumtum, but the Tanakh (Bible) never does, assuming instead a dichotomous world of males and females.
The use of masculine Hebrew inflections and pronouns for God does not necessarily mean that the supreme being was construed as manly (although that would be the default inference). Torah’s use of masculine God-language means only that God was not thought of as a solely womanly being.
Although Conservative Christians and Evangelical theologians attempt to reframe patriarchy as complementarianism, it matters what metaphors, analogies, and symbols are used for God and God’s gender. Because Genesis 1:26-27 affirms that humans are made in the image and likeness of God, if only male language is used for God, then the patriarchal assumption that males are more god-like than females scaffolds “male headship/female submission”, and energizes religion-based misogyny.
Many Christian denominations however, affirm that God is beyond gender, opening the way for acceptance of all people, whatever their gender identity—be it cisgender, transgender, or anywhere on the gender spectrum—as equally made in God’s image and likeness.
Allah’s attributes encompass both “masculine” and “feminine” qualities: Islamic theology utilizes 99 names to describe Allah’s attributes, categorized as either jamali (feminine) or jalali (masculine). This highlights a comprehensive and inclusive nature of God’s attributes, transcending human gender distinction. Some Muslim women have begun to refer to Allah with feminine or gender-neutral pronouns.
Aisha Chaudhry, a Gender and Islamic Studies professor at the University of British Columbia shared this in an interview on NPR in 2023:
“I do remember, like, a particular class where, you know, I just referred to God as she. And I just remember this male student – he had a physical reaction to me doing that.”
“Our language forces God to be constantly misgendered in order to be spoken about,” Chaudhry explains.
Dr. amina wadud, PhD (who spells her name with lowercase letters), professor of Arabic and Islamic Studies writes:
“While discussing pronouns for God, the men in the class told her that they could relate to God when God was referred to as “He,” but not when God was referred to as “She.” In that moment, wadud decided to start using female pronouns for Allah, who, according to traditional Muslim teachings, transcends gender, yet has historically been described with male pronouns.”
In Islamic theology, a central approach to understanding God is through Allah’s 99 names – such as “The loving,” “The merciful,” and “The guide.” These names are categorised as either jamali (feminine) or jalali (masculine) attributes.
The International Classification of Diseases 11th Revision (ICD-11) is a globally recognized standard for diagnostic health information. Developed and issued by the World Health Organization (WHO), and adopted by the United Nations, ICD-11 is a modern and comprehensive standard for classifying and coding diseases and health problems. It “went live” globally on January 1, 2022.
Since the 1980’s, the United States (and other global nations) have linked the ICD codes to reimbursement for health care services…however, the USA has not yet adopted ICD-11, continuing to use the antiquated ICD-10 coding system.
Why?
According to a July 2023 article in the Journal of the American Medical Association (JAMA), “implementation in the United States would at minimum require 4 to 5 years.”
Learn more here!
In April, 2025, Dr. Kelley Winters, Ph.D., authored an (unpublished) brief summary of where things currently stand in the United States and its Territories with regard to the diagnostic healthcare policies currently in use.
With Dr. Winter’s permission, Burleton Education is providing verbatim excerpts, in context, from that summary.
Burleton Education has added Oxford English Dictionary links to definitions of words that may not be familiar to every reader, and occasionally additional comments contained within [brackets] that do not alter the context of the summary.
***
“Diagnostic nomenclature has long played an important role in private and public health care
systems, alike. When used ethically, diagnostic systems, including mental health nosology, can
define the medical necessity of specific treatments and facilitate access to care. However, these
systems can also be subject to cultural and social bias. They carry a dark history of punitive,
political psychopathologization that discards scientific and ethical standards and delegitimizes
entire marginalized communities. For example, women of my grandmothers’ generation who
demanded the right to vote were imprisoned, without due process, in mental institutions under a
diagnosis of “hysteria” (Mayer, 1974). In the very first edition of the Diagnostic and Statistical
Manual of Mental Disorders (DSM-I), the American Psychiatric Association (1952) emphasized
diagnosis of cisgender Gay, Lesbian, and Bisexual people as well as Transgender and Gender
Diverse (TGD) people of all sexual orientations with the code, “52.2 Sexual Deviation,” [pg. 38, 85] in a
category of “Sociopathic Personality Disturbance.” Thus, an entire industry of unconscionable
sexual orientation and gender identity conversion psychotherapy practices were legitimized.”
Nearly five decades have passed since same-sex orientation was declassified as mental disorder in
the DSM-III-R by the American Psychiatric Association (APA, 1987). Yet, United States diagnostic
and medical coding policy relating to TGD health remains uniquely prejudiced and untethered to
evidence and reason. TGD individuals who experience a need for endocrine or surgical care, to live
their authentic and congruent lives, are still classified as mentally disordered—not once, but twice,
in two separate coding systems from the American Psychiatric Association (APA) and the federal
Department of Health and Human Services (HHS). The diagnostic code “302.85 (F64.0) Gender
Dysphoria in Adolescents and Adults” (GDAA) appears in the current DSM Fifth Edition, Text
Revision (DSM-5-TR), published by the APA (2022). “Dysphoria” is from a Greek root for distress,
and GDAA is the most common diagnostic coding related to TGD endocrine and surgical care.
However, like all categories in the APA’s “Manual of Mental Disorders,” GDAA is indeed a label
of mental disorder. There is no scientific basis for the disparate practice of coding TGD patients as
mentally ill because of their physical, medical needs, while patients of cisgender privilege,
receiving equivalent endocrine or surgical care, are coded with non-psychiatric, somatic medical
diagnoses.
Learn more here!
