transgender essay conclusion

The Performance of Transgender Inclusion

The pronoun go-round and the new gender binary.

This essay was originally published on November 27 2018.

The first time someone asked me my pronoun was about a decade ago at a meeting of directors of LGBTQ centers from colleges and universities in the Northeast. Sitting around a table for our first session, we were invited to share our names, pronouns, and the school we represented. I immediately felt my heart beat faster. The room was a mixture of people I had known for many years and others I was just meeting for the first time. As one of the few, potentially the only, visibly gender nonconforming people at the table, this question seemed aimed at me. The people I had known a long time came to attention when it was my turn. They wanted to know… well, what exactly was it that they wanted to know?

There are numerous things to be discovered by finding out someone’s pronoun. At its most utilitarian, it is a literal question: tell me what pronoun to call you when I speak of you in the third person. Two intertwined forces inspire this question. Viewed pessimistically, the question seems to ask, how do I not offend you? Viewed optimistically, it asks instead, how do I refer to you respectfully? This question is deceptively simple, the possible answers vary ever so slightly — the difference between he and she is just one letter; they is simply “he” bracketed by “t” and “y.” But great conclusions are drawn from the answer. It is less about she, he or they than it is about the significance of the answer: an ability to determine whether the speaker is transgender or cisgender.

While the question was a narrow one about language, the answer had great implications. Was I trans? Given what I knew about transgender identity at the time and what I knew about myself, I did not identify as transgender. I was also very comfortable being referred to using the gendered pronoun she. I still am for two reasons: being referred to as such my whole life and a feeling that it has no bearing on my gender. My gender — a lifetime of non-conformity, masculinity, butchness, and transness — is neither validated nor undone by a one syllable word.

As a female-bodied masculine-presenting person, there was no good answer. Whatever I said would force me into a box — a new box. Though I successfully resisted the gender norms of family, church, and society for over 30 years, my chosen family — the LGBTQ community — was asking me to make an impossible decision. My pronoun was “she.” But saying it felt that I was consenting to a denial of my gender nonconformity and masculinity. My gender, something I then described as butch, was not legible as transgressive in this new gendered order. Saying “she” implied that I was cisgender and not trans, which I resented. Saying “she” implied that I was unaware, out of touch, or in denial of my gender. The exercise meant to create space and affirmation for transgender and gender-nonconforming people like me made me feel terrible and invisible.

The origins of this practice are important and noteworthy. Misgendering transgender people through pronouns is widespread and mean. People do it all the time — intentionally and inadvertently. People who are friends, allies, queer, and strangers use these one-syllable words to bully, invalidate, and erase transgender people. Making a big deal about affirming what we used to call preferred names and pronouns was a basic staple of transgender organizing and consciousness raising. Responding to the demands of transgender students and under the leadership of longtime LGBTQ professionals, higher education led the way in instituting systems and policies to enable gender affirming naming and pronouns. The rhetorical exercise of having everyone declare their gender pronouns — not just trans people — was a valuable exercise in visibility and solidarity.

The practicality of the gesture of compulsory pronoun reporting has run its course. This practice does more harm than good, on several fronts. For so many young people who might be questioning or discovering their gender, it requires them to make a declaration, whether or not they are ready, or want to. For people with clarity about their gender identities, certain situations may not feel comfortable or safe for any number of reasons. For transgender and gender nonconforming people like me who use pronouns that are consistent with our assigned sex, it serves to erase the significance of gender in our life, leading people to lump us into the “cisgender” pile. Some people are probably comfortable with this. I am not. When a young transgender student just out of high school called me cisgender, I was shocked. How could anyone — even just by looking at me — ever come to the conclusion that I was cisgender?

I have always been a gender warrior and a gender outlaw. The earliest evidence I have of this are a few pictures dating to when I was about five or six. Wearing a frilly white dress as a flower girl for my cousin’s wedding, I refused to smile for the camera. In all of the wedding pictures of me, I am making the worst face I possibly could to express my upset about the dress. Sometime that same year, I smiled a broad toothless smile while posing for a photo shoot for my dance recital. I joyfully showed off my matching satin vest and bow tie while clutching onto a top hat, knees slightly bent in comfortable white pants. I agreed to dance my part in the duet with my partner once I was allowed to be the boy.

I now have a deeper understanding of the category of transgender and am happy to identify or be identified as such. As a social constructionist, I understand this development as a process shaped by external forces around me and not as an expression of some inner truth that has been until this moment suppressed. With the social, cultural, and political rise of a new gendered binary — that of transgender and cisgender — it is clear that I am transgender. Many aspects of the transgender community and identity are wonderfully affirming and comfortable for me. I have found my place, even though the most common social ritual of transgender inclusion erases me. Most people overseeing such rituals are not trans themselves.

Rituals of transgender inclusion have amplified binary thinking unwittingly by centering on pronouns. This has given rise to two related developments. First, an increase in the invocation of “they” as a pronoun, in some cases seemingly so as to avoid being designated as cisgender. If people find comfort, joy, and recognition for themselves by claiming “they,” that is awesome. We are winning the battle in making space for those of us who live beyond the gender binary. The second development is the use of the category cisgender to describe broad swaths of people without knowledge of their self-identification. Cisgender advances the notion that gender for everyone else is fixed, knowable, and normative. By using cisgender as a normative category, we deny the permeability, temporality, and messiness of gender for everyone. Asserting the idea that only trans people are on a gender journey and only trans people face gender struggles is the implication of the category cisgender. It divorces our gender struggle from those of other gendered beings. By doing so, we are losing the war against the gender binary.

When someone tells you what pronoun to use in reference to them, there is only one response: use it. It does not matter whether or not you understand their gender or approve of this request. I have made this point hundreds of times over the years, often trying to convince faculty members to make their classes welcoming environments for transgender students. I argue endless battles with well-educated people who think their own grammar school lessons from 40 or 50 years ago preclude them from referring to individual students as “they.” I will fight this battle over gendered language and pronouns every day of the week for any and every transgender person.

That said, it is time that rituals of transgender inclusion move away from pronouns. First, the pronoun “issue” is anxiety-provoking for many people, including some trans people as well as our best friends and allies. I have seen this repeatedly in higher education. Students embrace an expansive vocabulary for describing their sexual and gender identities that can be illegible even to LGBTQ faculty and staff of a different generation. LGBTQ students experience a certain degree of acceptance, but many faculty and staff keep them at arm’s length because they are afraid they will say something wrong. While faculty need to be more proactive in learning about LGBTQ communities and our language, our classrooms should not be defined by “gotcha” moments that leave no room for learning from our mistakes, together.

I cannot even count how many people have expressed anxiety over misgendering me. They feel bad. I feel worse. All of this hinges on the use of a pronoun. People who I think of as friends and colleagues, who I talk to every week or month then suddenly say “Oh, I’m sorry, did I use the wrong pronoun?” This gesture is well-intended. They do not want to offend me. But it is such a vacuous, disheartening experience for me every time. In that moment, whatever trust, friendship, or intimacy I felt is thrown into doubt. Why do they not know that I would correct them if they spoke of me inaccurately? Why did I assume they were comfortable with me and my gender when they obviously are not? In times like these, I miss the rituals of an earlier era when polite people — especially in the workplace — did not talk of such things.

But the real reason we need to rethink the place of pronouns in public life is even more significant: the advancement of transgender rights. What a distraction the pronoun go-round has become. I have sat through countless meetings in all kinds of spaces facilitated by well-intended people, often gay, sometimes straight, seldom trans, who righteously assert compulsory pronoun identification on everyone in the room and then never speak another word about transgender issues, rights, or people. It is as if this achievement — making space for pronouns — is the beginning and the end of the needs of transgender people. College students report doing this in meetings of all kinds and not really understanding why they do it. No one is doing anything to educate themselves or each other about the widespread discrimination and violence faced by transgender people, but by golly, every person will have a chance to state their pronoun! Now, if only people actually listened when said pronoun is declared — and remembered it — and used it every time in reference to that person. Then we would be getting somewhere, but that never happens. People cannot hear what you said or they forget it or mix it up with someone else’s anyway. What a thoroughly misguided good intention.

Trans people are used to advocating for ourselves in the face of great misunderstanding and hostility. Telling people our pronoun — when needed — is nothing compared to navigating educational, carceral, government and public spaces that enforce outdated gender binaries. We fight for access to healthcare — an industry long a source of violence — and try to make it work for us. Anti-transgender violence, especially against transgender women of color, persists at alarming rates. Transgender people experience high rates of suicide, homelessness, and unemployment. These issues of accessing the basic necessities for human survival are the important issues of transgender justice.

The next time you start a meeting and are tempted to go around the room asking everyone to report their pronoun, consider a better use of that time. Create an opportunity for people to say something substantive about their lives, including but not limited to gender. Provide some information that will actually advance the cause of transgender justice. Stop contributing to a performance of transgender inclusion that makes you feel good while doing little to actually advance the cause of transgender rights.

Jen Manion is Associate Professor of History at Amherst College and author of the forthcoming  Born in the Wrong Time: Female Husbands and the Transgender Past  (Cambridge University Press, 2020)

Associate Professor of History, Amherst College

22 thoughts on “ The Performance of Transgender Inclusion ”

this perfectly articulates how I’ve felt about (what feels like) mandatory pronoun self designation in queer&trans circles – and the well-meaning others who have adopted it. Thanks so much!

thank you so much for this. no more mandatory pronoun pronouncement, please, folks! or trying to put us all in trans vs cis binary categories when, in fact, some of us don’t fit neatly in either (such as a lot of butch women)

This is SO SO good. Thank you.

I am never a he. I am often she. Sometimes I am they. But no matter what.I am called, I am always me.

thank you for writing this. it is about several difficult subjects that too many people write/speak as if they have a clear and obvious answers, when they just don’t.

Thank you for this essay, Jen. It is beautiful, generous and very helpful.

What an awesome article! My own comments on it outgrew the format of a facebook repost, so would definitely also be too much for a comments section. But I’m gonna workshop it with some folks locally and try to work it up into a follow-up blog post in its own right. If you’re interested, I’d be honored to have you weigh in on it at some point.

I totally disagree with this article on so many levels as a GQ/GNC person. Pronouns are important for us transgender folx, especially youth in the academic setting. Even more so for those who are nonbinary as we are often misgendered based on looks. Ones transness isn’t defined by pronouns but for many, it is important to be seen and affirmed by our pronouns. And if you don’t want to out yourself when pronouns are asked, you simple can just not respond or use your assigned at birth gender. We still live in a cisnormativity society so it is imperative we, as Gender Outlaws, still buck the norms by reminding folx that our pronouns are important for many of us. We are far from being at a place where we can say it is irrelevant. If it isn’t important to you, that is your perogative. But this isn’t the truth for all of us.

i think she says several times that pronouns are REALLY important. i think she’s arguing against *compulsory* pronoun go-arounds, and expressing a particular experience of disorientation that i think is important to hear. i’m not at ALL arguing with you…i’m just saying that i think she, too, (though i don’t know her) would agree with every single thing you said, and disagree with a reading of her piece that interpreted it as saying that pronouns aren’t important.

I agree. If pronouns are important, then discussing them is too. Relegating gender interrogations to only Trans/GQ/GNC people isn’t helpful — it’s isolating. And we’re isolated enough already.

As a gender-expansive/genderqueer student affairs graduate student who has been nothing but misgendered through the misuse of my pronouns throughout my entire program, I find this essay incredibly disturbing. We cannot say “we’re past pronouns” when folks cannot even get them right in the first place.

The acknowledgment of pronouns is important because we exist in a heteronormative/cisnormative environment. Our student exist in these heavily gendered environments and when we ask for pronouns and use them appropriately we create an environment that may be the ONLY validation they receive that day.

If you ask transgender and gender-expansive students what they need and want out of their academic and co-curricular spaces it is validation through pronouns and name policies.

I say all of this with the acknowledgement that every time I disclose my pronouns in a group setting it “outs” me. That in and of it self could be harmful for trans students. That is why it is imperative to apply pronouns to a group setting but allow space for folks to approach you individually if necessary. Also, you should acknowledge that people use different pronouns in different spaces.

I definitely did not choose my pronouns to prove my “lack of cisgenderism” or transness. After reading this essay I feel like you took my identity and erased it as a tool to unpack your own internalized sexism.What kind of “gender warrior” does that make you besides coming off as just another trans exclusionary feminist?

hey, sorry you are feeling erased here. my personal experience of reading this was that it resonated so strongly with me that it almost felt like my own words. so perhaps i’m having trouble getting distance from it and understanding your critique, but your characterization of the message of the piece as “we’re past pronouns” REALLY doesn’t match my reading. in fact, the author emphasizes the importance of pronouns several times. what she’s saying is that COMPULSORY pronoun go-arounds are painful and anxiety-inducing for people like her–and like me. i completely agree with pretty much everything you say aside from the difference in our readings… like, validation through pronouns and name policies is ESSENTIAL and non-negotiable in higher ed. i think the author would agree with all of that too–like, your point about using different pronouns in different spaces is kind of EXACTLY what i think is at the heart of her point: pronouns can be messy and are not this key to a precise understanding of someone’s lived experience. you (cis folks, not actual you) have to be able to move to the next level of support here, and embrace all that complexity, to do EXTRA work to understand and support trans/non-binary folks and their full experiences. that means shifting pronouns to accommodate someone’s shifting identity or to ensure their safety. it means using male pronouns for someone who asks for it even if they don’t conform to your sense of what someone using these pronouns should look like or do. it means prioritizing student safety and dignity in the face of the challenges of bureaucracy and technology. a lot of people of close to my age (i’m 37) are sharing this article, and i think there is a really generational particularity to it…i identified as ‘butch’ in high school, used terms like ‘bio-boy’ in college, drove across the country to join camp trans and protest the mich fest policy, argued passionately with the second-wave-era women’s studies professors who had ignited my activism and then disappointed me with their failure to be allies to trans people or understand the ways in which our work was continuing, not surrendering to, the battle for gender freedom. i’m trying to say that i feel on a real cusp with all this… i feel like the journey i’ve been on intellectually and politically has really mirrored my internal journey. “gender non-conforming” and “non-binary”–these are terms that feel comfortable for me, and the fact that they are now MAINSTREAM INTELLIGIBLE is frankly mind-blowing. but for 20-years-ago me, ‘butch’ was SUPER important. using female pronouns was really important in the face of the proscriptive narratives i was up against at the time–not because i actually felt like a woman, but because i didn’t believe there WAS one defined way to feel like a woman and insisting on the pronoun that didn’t match people’s reading of me felt like a way to register my objection–to require that THEY experience some of the dissonance that i felt. i don’t feel like my identity changed. i’ve always been gnc and non-binary–the rest of the world just didn’t have language for that. now they are starting to (thanks not only to my work but that of this AMAZING new generation taking the reins). but i spent so long insisting that the pronouns people used for me reflected absolutely nothing essential about me. the pronoun i use is not consistent with my gender. it never was. so what resonated with me was the experience of being framed as “cisgender” when i say i use “she” just because they read me as having a vagina. it’s a little mind-boggling. and i’ll throw in that in my experience, it’s not other trans/gnc folks who do this–mostly cis straight folks, sometimes cis gay folks. so i sometimes ask for “they” in these situations, not because it is organically important to me, but because i worry about how i’ll be interpreted, and it is always an incredibly anxious and fraught moment. these are the moments i think this person is speaking to. this is different from a claim that everyone who uses they does so for this reasons.

one more quick thing–in addition to generational particularities, there are surely regional particularities to these experiences. though i have never met the author, i was for several years a staff member at the institution where she teaches, and assume we live in the same region. there are some places where, i think, the pronoun go-around is still a deeply informative educational experience for some folks. but there, like in many liberal pockets of the northeast, there can be a sanctimonious performativity at play, especially when requests from trans/gnc folks for further steps to safeguard their dignity are blatantly ignored.

but across all generations and regions, using the right pronouns is mandatory, and “they” is a thoroughly valid and meaningful option. in my reading, this piece explicitly supports these tenets.

I agree. I think it’s clear the author is projecting their own fears, insecurities, and assumptions on others. It’s important to make a public effort to treat people respectfully. I transitioned 17 years ago, and getting people to change pronouns took time. They got it wrong, but I knew anyone making an effort was on my side, even though they screwed up.

It’s not a “gotcha” moment to tell someone your pronoun, even when they get it wrong. It’s something trans people have to deal with, as well as those around them. That wouldn’t change if you had a room full of people announce their preferences or not. At worst you’re giving other people the opportunity to address troublemakers without your direct involvement — a true victory in my book. I wish I had more people doing that when I transitioned.

And on top of that, it may seem uncomfortable for people to be asked their pronoun and to have to think about such things, but it’s also uncomfortable for trans people to be the one singled out for that question. By asking that question of everyone, you’re providing people with an experience they wouldn’t normally have to face, and you’re asking them something they may not have even asked themselves. Actually having to go through that can be as instructive as any lecture.

It’s also really easy to challenge the assumption that answering someone’s questions about your pronouns is compulsory — say something. Say you aren’t comfortable. Try to explain why if you want.

The over-focus on pronouns has contributed to erasing the fact that cis queer femmes are also gender transgressors and do not perform gender as proscribed by patriarchy. Every time I say “she” as a cisqueer woman, it feels diminishing. But I won’t shift to “they,” and erase myself further.

Thank you for this. As someone who used to identify as a butch/GNC woman and later came out as a trans man, I’ve been in so many situations (mostly in well-meaning and/or LGBT spaces) where I’ve felt very singled out or uncomfortable with mandatory stating of pronouns. I remember that when I was questioning my gender, saying “they” felt like outing myself before I was ready and saying “she” felt like erasing a part of myself I didn’t really understand yet but still didn’t want people to assume didn’t exist. Now when people ask for my pronouns it still bothers me because I doubt they would ask someone they aren’t reading as trans for whatever reason. I can’t agree more with the part about transgender and cisgender being a new kind of binary. There’s no way to know that every person using “she” who is assigned female at birth (or vice versa) is cisgender, and assuming you understand someone’s gender from the pronouns they use is not helping trans people or trans rights at all.

“I prefer not to answer.” Congrats, it’s not compulsory anymore, you have avoided having to say anything, and you’ve instantly made the point that the issue can be complex or at least very personal.

The real issue here is that the author is projecting their own insecurity on others when they discuss pronouns or ask for their pronouns. Making assumptions about other people’s feelings and motivations is a recipe for projection.

If you’re already presenting as visibly gender queer/non conforming, and someone asks you about your pronoun preference, are they really saying that they are not comfortable with you? Or is that your fear? They could just be wanting to treat you with respect. The same is true for asking in a group setting.

Is it reality the case that others discussing pronouns are doing so just to make themselves feel good? Or is that just what we may fear? While I would certainly agree more needs to be done than simply dealing with pronouns, it’s far better than nothing to have people who care enough to ask and respect the answer — especially in a world full of people intentionally misgendering transgender people or worse in order to deny their identity.

And I totally get that it can be difficult for someone to out themselves when they are just starting to question their identity or transition, but in group settings where that is going to be discussed (like a support group) it’s quite common for reporting to be voluntary — not compulsory. You tell people what you’re comfortable telling.

I think it has also escaped notice that asking everyone for their gender preferences does the opposite of singling transgender or non conforming people out. Everyone that was asked now has the experience of being asked, which they would not have otherwise had. And any transgender people in the group are now treated the same as everyone else. And quite frankly, we need more of that, not less. When we’re singled out, it can feel as if they’ve set us apart.

After we have been othered and mistreated for so long, it can be very difficult to tell what other people’s true intentions may be. It’s especially important that we are addressing our own fears and noticing our own tendencies to project them on others, especially since there are supportive people out there, and unless we trust their intentions, we’ll be stuck in a never ending cycle of questioning our allies rather than working on the real problems trans people face.

Wait, I’m confused. You denounce the author for making assumptions about other peoples’ feelings. And then your supposedly triumphant conclusion is that other people … share your feelings? That seems self-serving to me.

I feel she centered her own experiences and insecurities (however validly felt) and stretched to extrapolate those experiences to the trans community in general. And I think she missed the point of pgp go-arounds. I was talking to a teacher at a school I run workshops in the other day. I bring coloring pages to all my groups, and when I’m doing sexual health groups, I bring genital coloring pages. She said, at first she was really shocked and even embarrassed by the coloring pages, but after a few weeks of bringing those coloring pages, and decorating the classrooms with the finished pieces, genitals and body parts became a normal part of the communities periphery. PGP go-arounds are an intentional way of normalizing the idea that our assumptions of people are not reliable at best, and harmful at worst.

PGP go-arounds also give permission to people who may never have felt they had permission to assert themselves in a new light. When I run my groups, I always ask for peoples names, and whatever pronouns they want the group to use for the next hour (or however long I’m with them). That also explicitly asserts the idea that pronouns are not stagnant, they can change, and you have permission to try something new out. You are allowed to explore yourself in the space I am holding, and that ultimately is what pgp go-arounds are about.

In terms of the issue of safety, there are always going to be places where people who experience erasure feel unsafe. And trans/GNC/NB people may very well not feel safe enough to share the pronouns that feel good for them in a space where a pgp go-around is happening. That may never go away, and people always have the option to code switch for safety. It’s a skill we all know, and skill we all utilize when we need it. But entering a space where pgps aren’t even acknowledged feels far more detrimental, especially if you then have to out yourself as having different pronouns than the way people perceive you as. There is safety and solidarity in a common practice.

Jen’s experiences that she asserts as ubiquitous also deny the idea that gender is not something that be determined by your pronouns. Pronouns are how you want to be referred to as. Gender identity can be an entirely different experience. For some people those experiences are the same, and for some they are vastly different. Manion’s insistence that pronouns in fact alienate the cisgender community with discomfort is the very reason that pgp go-arounds are so vital. Working through the discomfort, normalizing mistakes that are then corrected with effort, is an imperative step to creating space where people’s full selves are welcome. The advancement of transgender rights does not rest on pgp go-arounds. But it is certainly buoyed by it. Especially for the work that we do, particularly with young kids. When you start normalizing the idea that gender does not exist necessarily through presentation, interest preferences, names, OR pronouns, but instead exists as an identity, both internally and externally, that everyone has the right to explore, you raise a generation to people who will question their assumptions, and glean deeper understanding of why those assumptions live within them in the first place.

SO. Needless to say, Dean Spade’s article resonated much more with me. http://www.deanspade.net/2018/12/01/we-still-need-pronoun-go-rounds/?fbclid=IwAR1H_KsX1fLzvNZOLNvNnfTi43BibWyhv_7PWRyB0t7qA7aKpD149RVTgsQ No, “It cannot take care of all of the complex problems of judgement, identity, and anxiety that exist around out complex lives and political movements. It is merely an attempt to create a practice of not assuming we what someone goes by just by looking at them.” He’s right when he says “it signals a culture of respect” because an effort is being made to acknowledge that erasure of a specific group of people happens, and this practice is actively working to combat that. No it’s not perfect, and no, that can’t be where it ends. But halting the practice all together gives permission to people to never think about their privilege, to never question their assumptions, and to move through the world in ways that continue to erase people, either intentionally, or inadvertently.

I’m late to the party but this article very much seems to come from my own head. I agree with all the points made by other commenters about the values in asking for pronouns, but the compulsory nature of this is not needed. What’s wrong with asking “And please share your preferred pronouns if you wish”? I participated in a workshop that seemingly required participation in this level of sharing in introductions. I say “seemingly” because the facilitator jumped in, after several people introduced themselves and chose not to provide this info, with a “reminder” to provide our preferred pronouns. “Seemingly required” too, because I don’t know what would have happened had I said I prefer not to answer. This was a group I was not comfortable sharing this with but a module of an expensive workshop so I couldn’t really walk out the virtual door. Having already heard the “reminder” given to others, I just gave my presenting pronoun and left feeling more uncomfortable and untrue to myself. I understand the idea behind putting that unease and discomfort in the room for conforming folk to get a sense of what other groups may feel; I understand opening the doors for people to feel comfortable sharing if they want to. But why inadvertently risk adding anxiety to a person’s day/life with the forced nature of this in go-arounds?

Thank you. This opens up a really helpful dialogue — in particular with those who are still questioning.

Some people really are born in the wrong body. Some people really are expressing an inner truth that has until now been repressed. And differentiating that from people who are responding to social constructs is crucial. You talk about erasure while making it implicit in your argument that your idea of “trans” is based in a reaction-based modality, without understanding that among the label OF “trans” there are many, many forms of PERSON, who may or may not have any common needs. Fact is, this specific erasure is why I am dialing back from calling myself trans, or identifying as trans, and praying that I can somehow end up reclassified as a cis man in the wrong body. Sorry, but as an actual born-that-way “trans man,” and believe me all of my experiences point to this, you ARE cisgendered and gender non conforming. Being conflated with butch lesbians responding to socialized gender is the bane of my existence. It is piling on so much misery and erasure and just hateful experiences that I can’t even be polite or patient about this anymore.

I agree that the way people are handling gender is bad for trans people, but so are you. I know I’ll probably get scolded for saying this, and that’s part of why I’m thoroughly done with the LGBT community. It’s just a second and more insidious misgendering at this point.

At this point so much damage has been done that I’m honestly not sure it can ever be repaired. I’m not even a human being anymore. I don’t believe in compassion or inclusion, and I get more antisocial with each passing day. I didn’t used to be like this. But nobody believes me and they only care about skin-deep reactionary gendered culture, to such a point where it’s more convenient to pretend I don’t exist at all.

This entire planet is a miserable pile of failure, anyway. There are bigger problems on this earth, and it never ends. I’d rather focus on compulsory slavery in palm oil farming (massive chunk of our consumed western food is derived from this) but instead I’ve been turned into a dancing monkey used to make cis people feel better about themselves, and not even for reasons that have anything to do with ME. Garbage and exhausting. Y’all should know how bad you’re messing this up, but you won’t care because I’m Mean and Not Inclusive and Don’t Care About Butch Feelings.

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• v.19(3Suppl 2); 2016

Transgender social inclusion and equality: a pivotal path to development

Vivek divan.

1 United Nations Development Programme Consultant, Delhi, India

Clifton Cortez

2 United Nations Development Programme, HIV, Health, and Development Group, New York, NY, USA

Marina Smelyanskaya

3 United Nations Development Programme Consultant, New York, NY, USA

JoAnne Keatley

4 University of California, San Francisco, Center of Excellence for Transgender Health, San Francisco, CA, USA

Introduction

The rights of trans people are protected by a range of international and regional mechanisms. Yet, punitive national laws, policies and practices targeting transgender people, including complex procedures for changing identification documents, strip transgender people of their rights and limit access to justice. This results in gross violations of human rights on the part of state perpetrators and society at large. Transgender people's experience globally is that of extreme social exclusion that translates into increased vulnerability to HIV, other diseases, including mental health conditions, limited access to education and employment, and loss of opportunities for economic and social advancement. In addition, hatred and aggression towards a group of individuals who do not conform to social norms around gender manifest in frequent episodes of extreme violence towards transgender people. This violence often goes unpunished.

The United Nations Development Programme (UNDP) views its work in the area of HIV through the lens of human rights and advances a range of development solutions such as poverty reduction, improved governance, active citizenship, and access to justice. This work directly relates to advancing the rights of transgender people. This manuscript lays out the various aspects of health, human rights, and development that frame transgender people's issues and outlines best practice solutions from transgender communities and governments around the globe on how to address these complex concerns. The examples provided in the manuscript can help guide UN agencies, governments, and transgender activists in achieving better standards of health, access to justice, and social inclusion for transgender communities everywhere.

Conclusions

The manuscript provides a call to action for countries to urgently address the violations of human rights of transgender people in order to honour international obligations, stem HIV epidemics, promote gender equality, strengthen social and economic development, and put a stop to untrammelled violence.

Those who have traditionally been marginalized by society and who face extreme vulnerability to HIV find that it is their marginalization – social, legal, and economic – which needs to be addressed as the highest priority if a response to HIV is to be meaningful and effective. Trans people's experiences suggest that although HIV is a serious concern for those who acquire it, the suffering it causes is compounded by the routine indignity, inequity, discrimination, and violence that they encounter. Trans people, and particularly trans women, have articulated this often in the context of HIV [ 1 ].

For a reader who is not trans, imagine a world in which the core of your being goes unrecognized – within the family, if and when you step into school, when you seek employment, or when you need social services such as health and housing. You have no way to easily access any of the institutions and services that others take for granted because of this denial of your existence, worsened by the absence of identity documents required to participate in society. Additionally, because of your outward appearance, you may be subject to discrimination, violence, or the fear of it. In such circumstances, how could you possibly partake in social and economic development? How could your dignity and wellbeing – physical, mental, and emotional – be ensured? And how could you access crucial and appropriate information and services for HIV and other health needs?

Trans people experience these realities every day of their lives. Yet, like all other human beings, trans people have fundamental rights – to life, liberty, equality, health, privacy, speech, and expression [ 2 ], but constantly face denial of these fundamental rights because of the rejection of the trans person's right to their gender identity. In these circumstances, there can be no attainment of the goal of universal equitable development as set out in the 2030 Agenda for Sustainable Development [ 3 ], and no effort to stem the tide of the HIV epidemic among trans people can succeed if their identity and human rights are denied.

The human rights gap – stigma, discrimination, violence

The ways in which marginalization impacts a trans person's life are interconnected; stigma and transphobia drive isolation, poverty, violence, lack of social and economic support systems, and compromised health outcomes. Each circumstance relates to and often exacerbates the other [ 4 ].

Trans people who express their gender identity from an early age are often rejected by their families [ 5 ]. If not cast out from their homes, they are shunned within households resulting in lack of opportunities for education and with no attempts to ensure attention to their mental and physical health needs. Those who express their gender identities later in life often face rejection by mainstream society and social service institutions, as they go about undoing gender socialization [ 6 ]. Hostile environments that fail to understand trans people's needs threaten their safety and are ill-equipped to offer sensitive health and social services.

Such discriminatory and exclusionary environments fuel social vulnerability over a lifetime; trans people have few opportunities to pursue education, and greater odds of being unemployed, thereby experiencing inordinately high levels of homelessness [ 6 ] and poverty [ 7 ]. Trans students experience resentment, prejudice, and threatening environments in schools [ 8 ], which leads to significant drop-out rates, with few trans people advancing to higher education [ 9 ].

Workplace-related research on lesbian, gay, bisexual, and trans (LGBT) individuals reveals that trans workers are the most marginalized and are excluded from gainful employment, with discrimination occurring at all phases of the employment process, including recruitment, training opportunities, employee benefits, and access to job advancement [ 10 ]. This environment inculcates pessimism and internalized transphobia in trans people, discouraging them from applying for jobs [ 11 ]. These extreme limitations in employment can push trans people towards jobs that have limited potential for growth and development, such as beauticians, entertainers or sex workers [ 12 ]. Unemployment and low-paying or high risk and unstable jobs feed into the cycle of poverty and homelessness. When homeless trans people seek shelter, they are housed as per their sex at birth and not their experienced gender, and are subject to abuse and humiliation by staff and residents [ 13 ]. In these environments, many trans people choose not to take shelter [ 14 ].

Legal systems often entrench this marginalization, feed inequality, and perpetuate violence against trans people. All people are entitled to their basic human rights, and nations are obligated to provide for these under international law, including guarantees of non-discrimination and the right to health [ 2 ]; however, trans people are rarely assured of such protection under these State obligations.

Instead, trans people often live in criminalized contexts – under legislation that punishes so-called unnatural sex, sodomy, buggery, homosexual propaganda, and cross-dressing [ 12 ] – making them subject to extortion, abuse, and violence. Laws that criminalize sex work lead to violence and blackmail from the police, impacting trans women involved in this occupation [ 15 ]. Being criminalized, trans people are discouraged from complaining to the police, or seeking justice when facing violence and abuse, and perpetrators are rarely punished. When picked up for any of the aforementioned alleged crimes or under vague “public nuisance” or “vagrancy” laws, their abuse can continue at the hands of the police [ 16 ] or inmates in criminal justice systems that fail to appropriately respond to trans identities.

The transphobia that surrounds trans people's lives fuels violence against them. Documentation over the last decade reveals the disproportionate extent to which trans people are murdered, and the extreme forms of torture and inhuman treatment they are subject to [ 16 – 18 ]. When such atrocities are perpetrated against trans people, governments turn a blind eye. Trans sex workers are particularly vulnerable to brutal police conduct including rape, sometimes being sexually exploited by those who are meant to be protectors of the law [ 15 ]. In these circumstances, options to file complaints are limited and, when legally available channels do exist, trans complainants are often ignored [ 19 ].

These experiences of severe stigma, marginalization, and violence by families, communities, and State actors lead to immense health risks for trans people, including heightened risk for HIV, mental health disparities, and substance abuse [ 20 , 21 ]. However, most health systems struggle to function outside the traditional female/male binary framework, thereby excluding trans people [ 22 ]. Health personnel are often untrained to provide appropriate services on HIV prevention, care, and treatment or information on sexual and reproductive health to trans people [ 20 , 23 ]. HIV voluntary counselling and testing facilities and antiretroviral therapy (ART) sites intimidate trans people due to prior negative experiences with medical staff [ 21 , 24 , 25 ]. Additionally, when trans women test HIV positive, they are wrongly reported as men who have sex with men [ 4 ]. Consequently, testing rates in trans communities are low [ 26 ], which serves to disguise the serious burden of HIV among trans people and perpetuates the lack of investment in developing trans-sensitive health systems. The economic hardships that trans people face due to their inability to participate in the workforce further complicate access to HIV, mental health, and gender-affirming health services. In short, hostile social and legal environments contribute to health gaps, and public health systems that are unresponsive to the needs of trans people.

In addition, understanding of trans people's concerns around stigma, discrimination, and violence, related as they are to gender identity, is often limited due to their being combined with lesbian, gay, and bisexual sexual orientation issues. However, trans people's human rights concerns, grounded in their gender identity, are inherently different and necessitate their own set of approaches.

Imperatives for trans social inclusion

In order to overcome the human rights barriers trans people confront, certain measures are imperative and should be self-evident, given the standards that States are obliged to provide under international law to all human beings. Paying attention to these is key to effectively addressing the systemic marginalization that trans people experience. Such action can have immeasurable benefits, including the full participation of trans people in human development processes as well as positive health and HIV outcomes. For trans people, the change must begin with the most fundamental element – acknowledgement of their gender identity.

The right to gender recognition

For trans people, their very recognition as human beings requires a guarantee of a composite of entitlements that others take for granted – core rights that recognize their legal personhood. As the Global Commission on HIV and the Law pointed out, “In many countries from Mexico to Malaysia, by law or by practice, transgender persons are denied acknowledgment as legal persons. A basic part of their identity – gender – is unrecognized” [ 19 ]. This recognition of their gender is core to having their inherent dignity respected and, among other rights, their right to health including protection from HIV. When denied, trans people face severe impediments in accessing appropriate health information and care.

Recognizing a trans person's gender requires respecting the right of that person to identify – irrespective of the sex assigned to them at birth – as male, female, or a gender that does not fit within the male–female binary, a “third” gender as it were, as has been expressed by many traditionally existing trans communities such as hijras in India [ 27 ]. This is an essential requirement for trans people to attain full personhood and citizenship. The guarantee of gender recognition in official government-issued documents – passports and other identification cards that are required to open bank accounts, apply to educational institutions, enter into housing or other contracts or for jobs, to vote, travel, or receive health services or state subsidies – provides access to a slew of activities that are otherwise denied while being taken for granted by cisgender people. 1 Such recognition results in fuller civic participation of and by trans people. It is a concrete step in ensuring their social integration, economic advancement, and a formal acceptance of their legal equality. It can immeasurably support their empowerment and act as an acknowledgement of their dignity and human worth, changing the way they are perceived by their families, by society in general, and by police, government actors, and healthcare personnel whom they encounter in daily life. UN treaty bodies have acknowledged this vital right of trans people to be recognized. The UN High Commissioner for Human Rights has recommended that States “facilitate legal recognition of the preferred gender of transgender persons and establish arrangements to permit relevant identity documents to be reissued reflecting preferred gender and name, without infringements of other human rights” [ 28 ].

Freedom from violence & discrimination

Systemic strategies to reduce the violence against trans people need to occur at multiple levels, including making perpetrators accountable, facilitating legal and policy reform that removes criminality, and general advocacy to sensitize the ill-informed about trans issues and concerns. Strengthening the capacity of trans collectives and organizations to claim their rights can also act as a counter to the impunity of violence. When trans people are provided legal aid and access to judicial processes, accountability can be enforced against perpetrators. Sensitizing the police to make them partners in this work can be crucial. When political will is absent to support such attempts in highly adverse settings, trans organizations and allies can consider using international human rights mechanisms, such as shadow reports made to UN human rights processes like the Universal Periodic Review, to bring focus to issues of anti-trans violence and other human rights violations against trans people.

Providing equal access to housing, education, public facilities and employment opportunities, and developing and implementing anti-discrimination laws and policies that protect trans people in these contexts, including guaranteeing their safety and security, are essential to ensure that trans individuals are treated as equal human beings.

The right to health

For trans people, their right to health can only be assured if services are provided in a non-stigmatizing, non-discriminatory, and informed environment. This requires working to educate the healthcare sector about gender identity and expression, and zero tolerance for conduct that excludes trans people. Derogatory comments, breaches of confidentiality from providers, and denial of services on the basis of gender identity or HIV status are some of the manifestations of prejudice. The right to non-discrimination that is guaranteed to all human beings under international law must be enforced against actions that violate this principle in the healthcare system. Yet, a multi-pronged approach that supports this affirmation of trans equality together with a sensitized workforce that is capable of delivering gender-affirming surgical and HIV health services is necessary.

Building on the commitments made by the UN General Assembly in response to the HIV epidemic [ 29 ], the World Health Organization (WHO) developed good practice recommendations in relation to stigma and discrimination faced by key populations, including trans people [ 30 ]. These recommendations urge countries to introduce rights-based laws and policies and advise that, “Monitoring and oversight are important to ensure that standards are implemented and maintained.” Additionally, mechanisms should be made available “to anonymously report occurrences of stigma and/or discrimination when [trans people] try to obtain health services” [ 30 ].

Fostering stigma-free environments has been successfully demonstrated – where partnerships between trans individuals and community health nurses have improved HIV-related health outcomes [ 31 ], or where clinical sites welcome trans people and conduct thorough and appropriate physical exams, manage hormones with particular attention to ART, and engage trans individuals in HIV education [ 32 ].

Advancing trans human rights and health

For all the challenges faced by trans people in the context of their human rights and health, promising interventions and policy progress have shown that positive change is possible, although this must be implemented at scale to have significant impact. Change has occurred due to the efforts of trans advocates and human rights champions, often in critical alliances with civil society supporters as well as sensitized judiciaries, legislatures, bureaucrats, and health sector functionaries.

Key strides have been made in the context of gender recognition in some parts of the world. In the legislatures, this trend began in 2012 with Argentina passing the Gender Identity and Health Comprehensive Care for Transgender People Act , which provided gender recognition to trans people without psychiatric, medical, or judicial evaluation, and the right to access free and voluntary transitional healthcare [ 33 , 34 ]. In 2015, Malta passed the Gender Identity, Gender Expression and Sex Characteristics Act , which provides a self-determined, speedy, and accessible gender recognition process. The law protects against discrimination in the government and private sectors. It also de-pathologizes gender identity by stating that people “shall not be required to provide proof of a surgical procedure for total or partial genital reassignment, hormonal therapies or any other psychiatric, psychological or medical treatment.” It presumes the capacity of minors to exercise choice in opting for gender reassignment, while recognizing parental participation and the minor's best interests. It stipulates the establishment of a working group on trans healthcare to research international best practices [ 35 ]. Pursuant to its passing the Maltese Ministry of Education working with activists also developed policy guidelines to accommodate trans, gender variant, and intersex children in the educational system [ 36 ]. Other countries, such as the Republic of Ireland and Poland, have also passed gender identity and gender expression laws, albeit of varying substance but intended to recognize the right of trans people to personhood [ 37 , 38 ]. Denmark passed legislation that eliminated the coercive requirement for sterilization or surgery as a prerequisite to change legal gender identity [ 39 ].

Trans activists and allies have also used the judicial process to claim the right to gender recognition. In South Asia, claims to recognition of a gender beyond the male–female binary have been upheld – in 2007, the Supreme Court of Nepal directed the government to recognize a third gender in citizenship documents in order to vest rights that accrue from citizenship to metis [ 40 ]; in Pakistan, the Supreme Court directed the government to provide a third gender option in national identity cards for trans people to be able to vote [ 41 ]; in 2014, the Indian Supreme Court passed a judgement directing the government to officially recognize trans people as a third gender and to formulate special programmes to support their needs [ 42 ]. These developments in law, while hopeful, are too recent to yet discern any resultant trends in improvements in trans peoples’ lives, more broadly.

More localized innovative efforts have also been made by trans organizations to counter violence, stigma, and discrimination. For instance in South Africa, Gender DynamiX, a non-governmental organization worked with the police to change the South African Police Services’ standard operating procedures in 2013. The procedures are intended to ensure the safety, dignity, and respect of trans people who are in conflict with the law, and prescribe several trans-friendly safeguards – the search of trans people as per the sex on their identity documents, irrespective of genital surgery, and detention of trans people in separate facilities with the ability to report abuse, including removal of wigs and other gender-affirming prosthetics. Provision is made for implementation of the procedures through sensitization workshops with the police [ 43 ]. In Australia, the Transgender Anti-Violence Project was started as a collaboration between the Gender Centre in Sydney and the New South Wales Police Force, the City of Sydney and Inner City Legal Centre in 2011. It provides education, referrals, and advocacy in relation to violence based on gender identity, and support for trans people when reporting violence, assistance in organizing legal aid and appearances in court [ 44 ].

Measures have also been taken to tackle discrimination faced by trans people, in recognition of their human rights – in 2015, Japan's Ministry of Education ordered schools to accept trans students according to their preferred gender identity [ 45 ]; in 2014 in Quezon City, the Philippines the municipal council passed the “Gender Fair City” ordinance to ensure non-discrimination of LGBT people in education, the workplace, media depictions, and political life. This law prohibits bullying and requires gender-neutral bathrooms in public spaces and at work [ 46 ]; in Ecuador, Alfil Association worked on making healthcare accessible to trans people, including training and sensitization meetings for health workers and setting up a provincial health clinic for trans people in collaboration with the Ministry of Health, staffed by government physicians who had undergone the training; and Transbantu Zambia set up a small community house providing temporary shelter for trans people, assisting them in difficult times or while undergoing hormone therapy. Similar housing support has been provided by community organizations with limited resources in Jamaica and Indonesia. 2

Towards sustainable development: time for change

Although there are other examples of human rights progress for trans people, much of this change is isolated, non-systemic, and insufficient. Trans people continue to live in extremely hostile contexts. What is required is change and progress at scale. The international community's recent commitment towards Sustainable Development Goals (SDGs) presents an opportunity to catalyze and expand positive interventions [ 3 ].

Preventing human rights violations and social exclusion is key to sustainable and equitable development. This is true for trans people as much as other human beings, just as the achievement of all 17 SDGs is of paramount importance to all people, including trans people. Of these SDGs, the underpinning support for trans people's health and human rights is contained in SDG 3 –“Ensure healthy lives and promote well-being for all at all ages,” SDG 10 – “Reduce inequality within and among countries,” and SDG 16 – “Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels.”

The SDGs are guided by the UN Charter and grounded in the Universal Declaration of Human Rights. They envisage processes that are “people-centered, gender-sensitive, respect human rights and have a particular focus on the poorest, most vulnerable and those furthest behind” and a “just, equitable, tolerant, open and socially inclusive world in which the needs of the most vulnerable are met” [ 3 ]. They reiterate universal respect for human rights and dignity, justice and non-discrimination, and a world of equal opportunity permitting the full realization of human potential for all irrespective of race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth, disability, or other status . The relationship between the SDGs and trans people's concerns has been robustly articulated in the context of inclusive development [ 47 ].

UN Member States have unequivocally agreed to this new common agenda for the immediate future. The SDGs demand an unambiguous, farsighted, and inclusive demonstration of political will. Their language clearly reflects the most urgent needs of trans people, for whom freedom from violence and discrimination, the right to health and legal gender recognition are inextricably linked.

Specifically in regard to trans people, the SDGs are a call to immediate action on several fronts: governments need to engage with trans people to understand their concerns, unequivocally support the right of trans people to legal gender recognition, support the documentation of human rights violations against them, provide efficient and accountable processes whereby violations can be safely reported and action taken, guarantee the prevention of such violations, and ensure that the whole gamut of robust health and HIV services are made available to trans people. Only then can trans people begin to imagine a world that respects their core personhood, and a world in which dignity, equality, and wellbeing become realities in their lives.

Acknowledgements and funding

The authors are grateful for the work of courageous trans activists around the world who have overcome tremendous challenges and continue to battle disparities as they bring about positive change. Many encouraging examples cited in this manuscript would be impossible without their contribution. The authors also thank Jack Byrne, an expert on trans health and human rights, whose work on the UNDP Discussion Paper on Transgender Health and Human Rights (2013) served as an inspiration for this piece, and JoAnne Keatley's effort to provide writing, editorial comment, and oversight. UNDP staff and consultants, who contributed time to this manuscript, were supported by UNDP.

1 Cisgender people identify and present in a way that is congruent with their birth-assigned sex. Cisgender males are birth-assigned males who identify and present themselves as male.

2 These illustrations are based on information gathered in the process of developing a tool to operationalize the Consolidated Guidelines on HIV prevention, diagnosis, treatment and care for key populations (WHO, 2014), through interviews with and questionnaires sent to trans activists. See also reference 31.

Competing interests

The authors have declared that no competing interests exist.

Authors' contributions

The concept for this manuscript was a result of collaborative work between all four authors. VD provided key ideas for content and led the writing for the manuscript. CC provided thought leadership and contributed writing, particularly on the SDGs, while MS provided writing and editorial input, as well as other support. JK advised on content and provided writing and editorial input and guidance. All authors have read and approved the final version.

Transgender - Free Essay Samples And Topic Ideas

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Culture Heritage – LGBT+ Community

One thing, many people pride themselves on is their culture heritage. Culture can be described as the attitudes, beliefs, and behaviors of indigenous or social groups that have been passed down through generations. U.S. Census Bureau has recorded that 11 % of people in America were not native born, which has created America to become a multicultural society (Black, 2017). All culture are different when it comes to their beliefs and values. One culture that is rapidly building its members […]

Navigating the Complex Terrain: Transgender Athletes in Competitive Sports

The global athletic community has always been a crucible for talent, determination, and human potential. However, it has also often served as a battleground for cultural, societal, and political issues. One of the most contemporary and heated debates in this arena revolves around the participation of transgender individuals in competitive sports. This discourse raises intricate questions about fairness, biology, and the very essence of what constitutes a level playing field. Historically, sports competitions have been segregated primarily based on gender, […]

Essay on Transgender Persons

The Human Rights Campaign defines transgender as “an umbrella term that describes people whose gender identity and/or gender expression differs from the sex they were assigned at birth” (HRC, 2018). Susan Stryker further explains stating that transgender refers “to people who move away from the gender they were assigned at birth, people who cross over (trans-) the boundaries constructed by their culture to define and contain that gender” (Stryker, 2017, p. 1); the meanings of trans, according to Stryker are […]

Gender Dysphoria & Identity: Teens

Have you ever wondered what harsh cruelties that some teens have to face, because of their gender identity? Gender fluidity is the belief that you feel male one day but feel like a female another day regardless of what sex you were born. Teens that discover they are gender fluid can experience bullying from peers and family. There are many cases of injustices against gender fluid teens experience. The older generations are usually unaccepting of the younger generations gender identity. […]

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Yet despite the scientific uncertainty, drastic interventions are prescribed and delivered to patients identifying, or identified, as transgender. This is especially troubling when the patients receiving these interventions are children. We read popular reports about plans for medical and surgical interventions for many prepubescent children, some as young as six, and other therapeutic approaches undertaken for children as young as two. We suggest that no one can determine the gender identity of a two-year-old. We have reservations about how well scientists understand what it even means for a child to have a developed sense of his or her gender, but notwithstanding that issue, we are deeply alarmed that these therapies, treatments, and surgeries seem disproportionate to the severity of the distress being experienced by these young people, and are at any rate premature since the majority of children who identify as the gender opposite their biological sex will not continue to do so as adults. Moreover, there is a lack of reliable studies on the long-term effects of these interventions. We strongly urge caution in this regard.

We have sought in this report to present a complex body of research in a way that will be intelligible to a wide audience of both experts and lay readers alike. Everyone — scientists and physicians, parents and teachers, lawmakers and activists — deserves access to accurate information about sexual orientation and gender identity. While there is much controversy surrounding how our society treats its LGBT members, no political or cultural views should discourage us from understanding the related clinical and public health issues and helping people suffering from mental health problems that may be connected to their sexuality.

Our work suggests some avenues for future research in the biological, psychological, and social sciences. More research is needed to uncover the causes of the increased rates of mental health problems in the LGBT subpopulations. The social stress model that dominates research on this issue requires improvement, and most likely needs to be supplemented by other hypotheses. Additionally, the ways in which sexual desires develop and change across one’s lifespan remain, for the most part, inadequately understood. Empirical research may help us to better understand relationships, sexual health, and mental health.

Critiquing and challenging both parts of the “born that way” paradigm — both the notion that sexual orientation is biologically determined and fixed, and the related notion that there is a fixed gender independent of biological sex — enables us to ask important questions about sexuality, sexual behaviors, gender, and individual and social goods in a different light. Some of these questions lie outside the scope of this work, but those that we have examined suggest that there is a great chasm between much of the public discourse and what science has shown.

Thoughtful scientific research and careful, circumspect interpretation of its results can advance our understanding of sexual orientation and gender identity. There is still much work to be done and many unanswered questions. We have attempted to synthesize and describe a complex body of scientific research related to some of these themes. We hope that this report contributes to the ongoing public conversation regarding human sexuality and identity. We anticipate that this report may elicit spirited responses, and we welcome them.

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Transgender identities: a series of invited essays

As discussion about gender self-identification becomes heated, the economist seeks to uphold the liberal value of open debate.

By H.J. | LONDON

This is the introduction to a two-week, ten-part series of essays on transgender identities. Click here for the essays .

FROM the transgender bathroom debate in America to the argument in Britain over who can stand for election on women-only shortlists, a row about transgender identities is generating more heat than light. On one hand are some transgender people and activists, who advocate for “gender self-identification”: the belief that the world should take at face value a person’s declaration of their own gender identity. On the other are people who assert the primacy of biological sex; who fear the erosion of protections for women, including from male violence; or who see gender as a pernicious class system that maintains male supremacy and would like it done away entirely.

The row pits one historically oppressed group against another. It strikes at some very modern dilemmas: the usefulness of identity politics; the accommodations that should be made for small subgroups; how to work towards inclusion without triggering a backlash.

Further heightening tensions, many countries are considering changing the way someone can legally change gender from a process mediated by medical professionals to one of gender self-identification, and a few have already done so. On July 3rd Britain launched a public consultation on this issue: under government proposals, a simple statutory declaration would suffice to change your legal gender, and enable you to change the sex stated on your birth certificate and other official records.

To coincide with the consultation, The Economist is hosting a series of essays from a range of people with interesting and varied viewpoints, insights and arguments on transgender identities. The series will run over two weeks, with two or three essays published each day in the first week, and further comments and discussion between our participants published next week. On July 13th I will wrap up the event, drawing out the points that most struck me from the essays, and from readers’ comments.

This online event is part of The Economist ’s Open Future project, which aims to remake the case for liberalism today. One of the liberal values we seek to uphold is open debate. When it comes to transgender issues, and gender self-identification in particular, positions have become entrenched. Debate has become polarised, toxic and unilluminating. We hope our event will help to change that.

In the interests of fostering open debate we have set ground rules, both for essays and reader comments: use the pronouns people want you to use, and avoid all slurs, including TERF (trans-exclusionary radical feminist), which may have started as a descriptive term but is now used to try to silence a vast swathe of opinions on trans issues, and sometimes to incite violence against women. Comments will be open but closely moderated.

We are grateful to our contributors, who have agreed with grace and good humour to step onto this contested ground. We hope they will all find the fortnight interesting and perhaps even illuminating. We have enormously enjoyed reading their thoughts, and have already learned a great deal.

Essays published so far:

Vic Valentine: “ Self-declaration would bring Britain into line with international best practice ”

Debbie Hayton: “ Gender identity needs to be based on objective evidence rather than feelings ”

Kristina Harrison: “ A system of gender self-identification would put women at risk ”

Charlie Kiss: “ The idea that trans men are “lesbians in denial” is demeaning and wrong ”

Pippa Fleming: “ The gender-identity movement undermines lesbians ”

Sarah Ditum: “ Trans rights should not come at the cost of women’s fragile gains ”

Emily Brothers: “ Making transitioning simpler would not usurp the rights of women ”

James Kirkup: “ I am neither trans nor a woman. Can I write about the issues they face? ”

Kathleen Stock: “ Changing the concept of “woman” will cause unintended harms ”

Adam Smith: “ The struggle for trans rights has parallels to that for gay rights ”

Adam Smith: “ The online debate over transgender identity needs more speech, not less ”

Debbie Hayton: “ Society needs to dismantle sexism before revising legal definitions of sex ”

Sarah Dittum: “ Transgender issues are not yet a schism between conservatives and liberals in Britain ”

Dig deeper:

“ Making sense of the culture war over transgender identity ,” The Economist , November 16th 2017.

“ Children are victims in the latest identity-driven culture war ,” The Economist , Leader, November 16th 2017

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The Experiences, Challenges and Hopes of Transgender and Nonbinary U.S. Adults

Findings from pew research center focus groups, table of contents, identity and the gender journey, navigating gender day-to-day, seeking medical care for gender transitions , connections with the broader lgbtq+ community, policy and social change.

• Focus groups
• The American Trends Panel survey methodology
• Panel recruitment
• Sample design
• Questionnaire development and testing
• Data collection protocol
• Data quality checks
• Acknowledgments

Introduction

Transgender and nonbinary people have gained visibility in the U.S. in recent years as celebrities from  Laverne Cox  to  Caitlyn Jenner  to  Elliot Page  have spoken openly about their gender transitions. On March 30, 2022, the White House issued a proclamation  recognizing Transgender Day of Visibility , the first time a U.S. president has done so.  

More recently, singer and actor Janelle Monáe  came out as nonbinary , while the U.S. State Department and Social Security Administration announced that Americans  will be allowed to select “X” rather than “male” or “female” for their sex  marker on their passport and Social Security applications. 

At the same time, several states have enacted or are considering legislation that would  limit the rights of transgender and nonbinary people . These include bills requiring people to use public bathrooms that correspond with the sex they were assigned at birth, prohibiting trans athletes from competing on teams that match their gender identity, and restricting the availability of health care to trans youth seeking to medically transition. 

A new Pew Research Center survey finds that 1.6% of U.S. adults are transgender or nonbinary – that is, their gender is different from the sex they were assigned at birth. This includes people who describe themselves as a man, a woman or nonbinary, or who use terms such as gender fluid or agender to describe their gender. While relatively few U.S. adults are transgender, a growing share say they know someone who is (44% today vs.  37% in 2017 ). One-in-five say they know someone who doesn’t identify as a man or woman. 

In order to better understand the experiences of transgender and nonbinary adults at a time when gender identity is at the center of many national debates, Pew Research Center conducted a series of focus groups with trans men, trans women and nonbinary adults on issues ranging from their gender journey, to how they navigate issues of gender in their day-to-day life, to what they see as the most pressing policy issues facing people who are trans or nonbinary. This is part of a larger study that includes a survey of the general public on their attitudes about gender identity and issues related to people who are transgender or nonbinary.

The terms  transgender  and  trans  are used interchangeably throughout this essay to refer to people whose gender is different from the sex they were assigned at birth. This includes, but is not limited to, transgender men (that is, men who were assigned female at birth) and transgender women (women who were assigned male at birth). 

Nonbinary adults  are defined here as those who are neither a man nor a woman or who aren’t strictly one or the other. While some nonbinary focus group participants sometimes use different terms to describe themselves, such as “gender queer,” “gender fluid” or “genderless,” all said the term “nonbinary” describes their gender in the screening questionnaire. Some, but not all, nonbinary participants also consider themselves to be transgender.

References to  gender transitions  relate to the process through which trans and nonbinary people express their gender as different from social expectations associated with the sex they were assigned at birth. This may include social, legal and medical transitions. The social aspect of a gender transition may include going by a new name or using different pronouns, or expressing their gender through their dress, mannerisms, gender roles or other ways. The legal aspect may include legally changing their name or changing their sex or gender designation on legal documents or identification.  Medical care  may include treatments such as hormone therapy, laser hair removal and/or surgery. 

References to  femme  indicate feminine gender expression. This is often in contrast to “masc,” meaning masculine gender expression.

Cisgender  is used to describe people whose gender matches the sex they were assigned at birth and who do not identify as transgender or nonbinary. 

Misgendering  is defined as referring to or addressing a person in ways that do not align with their gender identity, including using incorrect pronouns, titles (such as “sir” or “ma’am”), and other terms (such as “son” or “daughter”) that do not match their gender. 

References to  dysphoria  may include feelings of distress due to the mismatch of one’s gender and sex assigned at birth, as well as a  diagnosis of gender dysphoria , which is sometimes a prerequisite for access to health care and medical transitions.

The acronym  LGBTQ+  refers to lesbian, gay, bisexual, transgender, queer (or, in some cases, questioning), and other sexual orientations or gender identities that are not straight or cisgender, such as intersex, asexual or pansexual. 

Pew Research Center conducted this research to better understand the experiences and views of transgender and nonbinary U.S. adults. Because transgender and nonbinary people make up only about 1.6% of the adult U.S. population, this is a difficult population to reach with a probability-based, nationally representative survey. As an alternative, we conducted a series of focus groups with trans and nonbinary adults covering a variety of topics related to the trans and nonbinary experience. This allows us to go more in-depth on some of these topics than a survey would typically allow, and to share these experiences in the participants’ own words.

For this project, we conducted six online focus groups, with a total of 27 participants (four to five participants in each group), from March 8-10, 2022. Participants were recruited by targeted email outreach among a panel of adults who had previously said on a survey that they were transgender or nonbinary, as well as via connections through professional networks and LGBTQ+ organizations, followed by a screening call. Candidates were eligible if they met the technology requirements to participate in an online focus group and if they either said they consider themselves to be transgender or if they said their gender was nonbinary or another identity other than man or woman (regardless of whether or not they also said they were transgender). For more details, see the  Methodology . 

Participants who qualified were placed in groups as follows: one group of nonbinary adults only (with a nonbinary moderator); one group of trans women only (with a trans woman moderator); one group of trans men only (with a trans man moderator); and three groups with a mix of trans and nonbinary adults (with either a nonbinary moderator or a trans man moderator). All of the moderators had extensive experience facilitating groups, including with transgender and nonbinary participants. 

The participants were a mix of ages, races/ethnicities, and were from all corners of the country. For a detailed breakdown of the participants’ demographic characteristics, see the  Methodology .

The findings are not statistically representative and cannot be extrapolated to wider populations.

Some quotes have been lightly edited for clarity or to remove identifying details. In this essay, participants are identified as trans men, trans women, or nonbinary adults based on their answers to the screening questionnaire. These words don’t necessarily encompass all of the ways in which participants described their gender. Participants’ ages are grouped into the following categories:  late teens; early/mid/late 20s, 30s and 40s; and 50s and 60s (those ages 50 to 69 were grouped into bigger “buckets” to better preserve their anonymity).

These focus groups were not designed to be representative of the entire population of trans and nonbinary U.S. adults, but the participants’ stories provide a glimpse into some of the experiences of people who are transgender and/or nonbinary. The groups included a total of 27 transgender and nonbinary adults from around the U.S. and ranging in age from late teens to mid-60s. Most currently live in an urban area, but about half said they grew up in a suburb. The groups included a mix of White, Black, Hispanic, Asian and multiracial American participants. See  Methodology  for more details.

Most focus group participants said they knew from an early age – many as young as preschool or elementary school – that there was something different about them, even if they didn’t have the words to describe what it was. Some described feeling like they didn’t fit in with other children of their sex but didn’t know exactly why. Others said they felt like they were in the wrong body. 

“I remember preschool, [where] the boys were playing on one side and the girls were playing on the other, and I just had a moment where I realized what side I was supposed to be on and what side people thought I was supposed to be on. … Yeah, I always knew that I was male, since my earliest memories.” – Trans man, late 30s

“As a small child, like around kindergarten [or] first grade … I just was [fascinated] by how some people were small girls, and some people were small boys, and it was on my mind constantly. And I started to feel very uncomfortable, just existing as a young girl.” – Trans man, early 30s

“I was 9 and I was at day camp and I was changing with all the other 9-year-old girls … and I remember looking at everybody’s body around me and at my own body, and even though I was visually seeing the exact shapeless nine-year-old form, I literally thought to myself, ‘oh, maybe I was supposed to be a boy,’ even though I know I wasn’t seeing anything different. … And I remember being so unbothered by the thought, like not a panic, not like, ‘oh man, I’m so different, like everybody here I’m so different and this is terrible,’ I was like, ‘oh, maybe I was supposed to be a boy,’ and for some reason that exact quote really stuck in my memory.” – Nonbinary person, late 30s

“Since I was little, I felt as though I was a man who, when they were passing out bodies, someone made a goof and I got a female body instead of the male body that I should have had. But I was forced by society, especially at that time growing up, to just make my peace with having a female body.” – Nonbinary person, 50s

“I’ve known ever since I was little. I’m not really sure the age, but I just always knew when I put on boy clothes, I just felt so uncomfortable.” – Trans woman, late 30s

“It was probably as early as I can remember that I wasn’t like my brother or my father [and] not exactly like my girl cousins but I was something else, but I didn’t know what it was.” – Nonbinary person, 60s

Many participants were well into adulthood before they found the words to describe their gender. For those focus group participants, the path to self-discovery varied. Some described meeting someone who was transgender and relating to their experience; others described learning about people who are trans or nonbinary in college classes or by doing their own research.  

“I read a Time magazine article … called ‘Homosexuality in America’ … in 1969. … Of course, we didn’t have language like we do now or people were not willing to use it … [but] it was kind of the first word that I had ever heard that resonated with me at all. So, I went to school and I took the magazine, we were doing show-and-tell, and I stood up in front of the class and said, ‘I am a homosexual.’ So that began my journey to figure this stuff out.” – Nonbinary person, 60s

“It wasn’t until maybe I was 20 or so when my friend started his transition where I was like, ‘Wow, that sounds very similar to the emotions and challenges I am going through with my own identity.’ … My whole life from a very young age I was confused, but I didn’t really put a name on it until I was about 20.” – Nonbinary person, late 20s

“I knew about drag queens, but I didn’t know what trans was until I got to college and was exposed to new things, and that was when I had a word for myself for the first time.” – Trans man, early 40s

“I thought that by figuring out that I was interested in women, identifying as lesbian, I thought [my anxiety and sadness] would dissipate in time, and that was me cracking the code. But then, when I got older, I left home for the first time. I started to meet other trans people in the world. That’s when I started to become equipped with the vocabulary. The understanding that this is a concept, and this makes sense. And that’s when I started to understand that I wasn’t cisgender.” – Trans man, early 30s

“When I took a human sexuality class in undergrad and I started learning about gender and different sexualities and things like that, I was like, ‘oh my god. I feel seen.’ So, that’s where I learned about it for the first time and started understanding how I identify.” – Nonbinary person, mid-20s

Focus group participants used a wide range of words to describe how they see their gender. For many nonbinary participants, the term “nonbinary” is more of an umbrella term, but when it comes to how they describe themselves, they tend to use words like “gender queer” or “gender fluid.” The word “queer” came up many times across different groups, often to describe anyone who is not straight or cisgender. Some trans men and women preferred just the terms “man” or “woman,” while some identified strongly with the term “transgender.” The graphic below shows just some of the words the participants used to describe their gender.

The way nonbinary people conceptualize their gender varies. Some said they feel like they’re both a man and a woman – and how much they feel like they are one or the other may change depending on the day or the circumstance. Others said they don’t feel like they are either a man or a woman, or that they don’t have a gender at all. Some, but not all, also identified with the term transgender. 

“I had days where I would go out and just play with the boys and be one of the boys, and then there would be times that I would play with the girls and be one of the girls. And then I just never really knew what I was. I just knew that I would go back and forth.” – Nonbinary person, mid-20s

“Growing up with more of a masculine side or a feminine side, I just never was a fan of the labelling in terms of, ‘oh, this is a bit too masculine, you don’t wear jewelry, you don’t wear makeup, oh you’re not feminine enough.’ … I used to alternate just based on who I felt I was. So, on a certain day if I felt like wearing a dress, or a skirt versus on a different day, I felt like wearing what was considered men’s pants. … So, for me it’s always been both.” – Nonbinary person, mid-30s

“I feel like my gender is so amorphous and hard to hold and describe even. It’s been important to find words for it, to find the outlines of it, to see the shape of it, but it’s not something that I think about as who I am, because I’m more than just that.” – Nonbinary person, early 30s

“What words would I use to describe me? Genderless, if gender wasn’t a thing. … I guess if pronouns didn’t exist and you just called me [by my name]. That’s what my gender is. … And I do use nonbinary also, just because it feels easier, I guess.” – Nonbinary person, late 20s

Some participants said their gender is one of the most important parts of their identity, while others described it as one of many important parts or a small piece of how they see themselves. For some, the focus on gender can get tiring. Those who said gender isn’t a central – or at least not the most central – part of their identity mentioned race, ethnicity, religion and socioeconomic class as important aspects that shape their identity and experiences.

“It is tough because [gender] does affect every factor of your life. If you are doing medical transitioning then you have appointments, you have to pay for the appointments, you have to be working in a job that supports you to pay for those appointments. So, it is definitely integral, and it has a lot of branches. And it deals with how you act, how you relate to friends, you know, I am sure some of us can relate to having to come out multiple times in our lives. That is why sexuality and gender are very integral and I would definitely say I am proud of it. And I think being able to say that I am proud of it, and my gender, I guess is a very important part of my identity.” – Nonbinary person, late 20s

“Sometimes I get tired of thinking about my gender because I am actively [undergoing my medical transition]. So, it is a lot of things on my mind right now, constantly, and it sometimes gets very tiring. I just want to not have to think about it some days. So, I would say it’s, it’s probably in my top three [most important parts of my identity] – parent, Black, queer nonbinary.” – Nonbinary person, mid-40s

“I live in a town with a large queer and trans population and I don’t have to think about my gender most of the time other than having to come out as trans. But I’m poor and that colors everything. It’s not a chosen part of my identity but that part of my identity is a lot more influential than my gender.” – Trans man, early 40s

“My gender is very important to my identity because I feel that they go hand in hand. Now my identity is also broken down into other factors [like] character, personality and other stuff that make up the recipe for my identity. But my gender plays a big part of it. … It is important because it’s how I live my life every day. When I wake up in the morning, I do things as a woman.” – Trans woman, mid-40s

“I feel more strongly connected to my other identities outside of my gender, and I feel like parts of it’s just a more universal thing, like there’s a lot more people in my socioeconomic class and we have much more shared experiences.” – Trans man, late 30s

Some participants spoke about how their gender interacted with other aspects of their identity, such as their race, culture and religion. For some, being transgender or nonbinary can be at odds with other parts of their identity or background. 

“Culturally I’m Dominican and Puerto Rican, a little bit of the macho machismo culture, in my family, and even now, if I’m going to be a man, I’ve got to be a certain type of man. So, I cannot just be who I’m meant to be or who I want myself to be, the human being that I am.” – Trans man, mid-30s

“[Judaism] is a very binary religion. There is a lot of things like for men to do and a lot of things for women to do. … So, it is hard for me now as a gender queer person, right, to connect on some levels with [my] religion … I have just now been exposed to a bunch of trans Jewish spaces online which is amazing.” – Nonbinary person, mid-40s

“Just being Indian American, I identify and love aspects of my culture and ethnicity, and I find them amazing and I identify with that, but it’s kind of separated. So, I identify with the culture, then I identify here in terms of gender and being who I am, but I kind of feel the necessity to separate the two, unfortunately.” – Nonbinary person, mid-30s

“I think it’s really me being a Black woman or a Black man that can sometimes be difficult. And also, my ethnic background too. It’s really rough for me with my family back home and things of that nature.” – Nonbinary person, mid-20s

For some, deciding how open to be about their gender identity can be a constant calculation. Some participants reported that they choose whether or not to disclose that they are trans or nonbinary in a given situation based on how safe or comfortable they feel and whether it’s necessary for other people to know. This also varies depending on whether the participant can easily pass as a cisgender man or woman (that is, they can blend in so that others assume them to be cisgender and don’t recognize that they are trans or nonbinary).

“It just depends on whether I feel like I have the energy to bring it up, or if it feels worth it to me like with doctors and stuff like that. I always bring it up with my therapists, my primary [care doctor], I feel like she would get it. I guess it does vary on the situation and my capacity level.” – Nonbinary person, late 20s

“I decide based on the person and based on the context, like if I feel comfortable enough to share that piece of myself with them, because I do have the privilege of being able to move through the world and be identified as cis[gender] if I want to. But then it is important to me – if you’re important to me, then you will know who I am and how I identify. Otherwise, if I don’t feel comfortable or safe then I might not.” – Nonbinary person, early 30s

“The expression of my gender doesn’t vary. Who I let in to know that I was formerly female – or formerly perceived as female – is kind of on a need to know basis.” – Trans man, 60s

“It’s important to me that people not see me as cis[gender], so I have to come out a lot when I’m around new people, and sometimes that’s challenging. … It’s not information that comes out in a normal conversation. You have to force it and that’s difficult sometimes.” – Trans man, early 40s

Work is one realm where many participants said they choose not to share that they are trans or nonbinary. In some cases, this is because they want to be recognized for their work rather than the fact that they are trans or nonbinary; in others, especially for nonbinary participants, they fear it will be perceived as unprofessional.

“It’s gotten a lot better recently, but I feel like when you’re nonbinary and you use they/them pronouns, it’s just seen as really unprofessional and has been for a lot of my life.” – Nonbinary person, early 30s

“Whether it’s LinkedIn or profiles [that] have been updated, I’ve noticed people’s resumes have their pronouns now. I don’t go that far because I just feel like it’s a professional environment, it’s nobody’s business.” – Nonbinary person, mid-30s

“I don’t necessarily volunteer the information just to make it public; I want to be recognized for my character, my skill set, in my work in other ways.” – Trans man, early 30s

Some focus group participants said they don’t mind answering questions about what it’s like to be trans or nonbinary but were wary of being seen as the token trans or nonbinary person in their workplace or among acquaintances. Whether or not they are comfortable answering these types of questions sometimes depends on who’s asking, why they want to know, and how personal the questions get.

“I’ve talked to [my cousin about being trans] a lot because she has a daughter, and her daughter wants to transition. So, she always will come to me asking questions.” – Trans woman, early 40s

“It is tough being considered the only resource for these topics, right? In my job, I would hate to call myself the token nonbinary, but I was the first nonbinary person that they hired and they were like, ‘Oh, my gosh, let me ask you all the questions as you are obviously the authority on the subject.’ And it is like, ‘No, that is a part of me, but there are so many other great resources.’” – Nonbinary person, late 20s

“I don’t want to be the token. I’m not going to be no spokesperson. If you have questions, I’m the first person you can ask. Absolutely. I don’t mind discussing. Ask me some of the hardest questions, because if you ask somebody else you might get you know your clock cleaned. So, ask me now … so you can be educated properly. Otherwise, I don’t believe it’s anybody’s business.” – Trans woman, early 40s

Most nonbinary participants said they use “they/them” as their pronouns, but some prefer alternatives. These alternatives include a combination of gendered and gender-neutral pronouns (like she/they) or simply preferring that others use one’s names rather than pronouns. 

“If I could, I would just say my name is my pronoun, which I do in some spaces, but it just is not like a larger view. It feels like I’d rather have less labor on me in that regard, so I just say they/them.” – Nonbinary person, late 20s

“For me personally, I don’t get mad if someone calls me ‘he’ because I see what they’re looking at. They look and they see a guy. So, I don’t get upset. I know a few people who do … and they correct you. Me, I’m a little more fluid. So, that’s how it works for me.” – Nonbinary person, mid-30s

“I use they/she pronouns and I put ‘they’ first because that is what I think is most comfortable and it’s what I want to draw people’s attention to, because I’m 5 feet tall and 100 pounds so it’s not like I scream masculine at first sight, so I like putting ‘they’ first because otherwise people always default to ‘she.’ But I have ‘she’ in there, and I don’t know if I’d have ‘she’ in there if I had not had kids.” – Nonbinary person, late 30s

“Why is it so hard for people to think of me as nonbinary? I choose not to use only they/them pronouns because I do sometimes identify with ‘she.’ But I’m like, ‘Do I need to use they/them pronouns to be respected as nonbinary?’ Sometimes I feel like I should do that. But I don’t want to feel like I should do anything. I just want to be myself and have that be accepted and respected.” – Nonbinary person, early 30s

“I have a lot of patience for people, but [once someone in public used] they/them pronouns and I thanked them and they were like, ‘Yeah, I just figure I’d do it when I don’t know [someone’s] pronouns.’ And I’m like, ‘I love it, thank you.’” – Nonbinary person, early 30s

Transgender and nonbinary participants find affirmation of their gender identity and support in various places. Many cited their friends, chosen families (and, less commonly, their relatives), therapists or other health care providers, religion, or LGBTQ+ spaces as sources of support.

“I’m just not close with my family [of origin], but I have a huge chosen family that I love and that fully respects my identity.” – Nonbinary person, early 30s

“Before the pandemic I used to go out to bars a lot; there’s a queer bar in my town and it was a really nice place just being friends with everybody who went and everybody who worked there, it felt really nice you know, and just hearing everybody use the right pronouns for me it just felt really good.” – Nonbinary person, early 30s

“I don’t necessarily go to a lot of dedicated support groups, but I found that there’s kind of a good amount of support in areas or groups or fandoms for things that have a large LGBT population within them. Like certain shows or video games, where it’s just kind of a joke that all the gay people flock to this.”  – Trans woman, late teens

“Being able to practice my religion in a location with a congregation that is just completely chill about it, or so far has been completely chill about it, has been really amazing.” – Nonbinary person, late 30s

Many participants shared specific moments they said were small in the grand scheme of things but made them feel accepted and affirmed. Examples included going on dates, gestures of acceptance by a friend or social group, or simply participating in everyday activities.

“I went on a date with a really good-looking, handsome guy. And he didn’t know that I was trans. But I told him, and we kept talking and hanging out. … That’s not the first time that I felt affirmed or felt like somebody is treating me as I present myself. But … he made me feel wanted and beautiful.” – Trans woman, late 30s

“I play [on a men’s rec league] hockey [team]. … I joined the league like right when I first transitioned and I showed up and I was … nervous with locker rooms and stuff, and they just accepted me as male right away.” – Trans man, late 30s

“I ended up going into a barbershop. … The barber was very welcoming, and talked to me as if I was just a casual customer and there was something that clicked within that moment where, figuring out my gender identity, I just wanted to exist in the world to do these natural things like other boys and men would do. So, there was just something exciting about that. It wasn’t a super macho masculine moment, … he just made me feel like I blended in.” – Trans man, early 30s

Participants also talked about negative experiences, such as being misgendered, either intentionally or unintentionally. For example, some shared instances where they were treated or addressed as a gender other than the gender that they identify as, such as people referring to them as “he” when they go by “she,” or where they were deadnamed, meaning they were called by the name they had before they transitioned. 

“I get misgendered on the phone a lot and that’s really annoying. And then, even after I correct them, they keep doing it, sometimes on purpose and sometimes I think they’re just reading a script or something.” – Trans man, late 30s

“The times that I have been out, presenting femme, there is this very subconscious misgendering that people do and it can be very frustrating. [Once, at a restaurant,] I was dressed in makeup and nails and shoes and everything and still everyone was like, ‘Sir, what would you like?’ … Those little things – those microaggressions – they can really eat away at people.” – Nonbinary person, mid-40s

“People not calling me by the right name. My family is a big problem, they just won’t call me by my name, you know? Except for my nephew, who is of the Millennial generation, so at least he gets it.” – Nonbinary person, 60s

“I’m constantly misgendered when I go out places. I accept this – because of the way I look, people are going to perceive me as a woman and it doesn’t cause me huge dysphoria or anything, it’s just nice that the company that I keep does use the right pronouns.” – Nonbinary person, early 30s

Some participants also shared stories of discrimination, bias, humiliation, and even violence. These experiences ranged from employment discrimination to being outed (that is, someone else disclosing the fact that they are transgender or nonbinary without their permission) without their permission to physical attacks.

“I was on a date with this girl and I had to use the bathroom … and the janitor … wouldn’t let me use the men’s room, and he kept refusing to let me use the men’s room, so essentially, I ended up having to use the same bathroom as my date.” – Trans man, late 30s

“I’ve been denied employment due to my gender identity. I walked into a supermarket looking for jobs. … And they flat out didn’t let me apply. They didn’t even let me apply.” – Trans man, mid-30s

“[In high school,] this group of guys said, ‘[name] is gay.’ I ignored them but they literally threw me and tore my shirt from my back and pushed me to the ground and tried to strip me naked. And I had to fight for myself and use my bag to hit him in the face.” – Trans woman, late 20s

“I took a college course [after] I had my name changed legally and the instructor called me out in front of the class and called me a liar and outed me.” – Trans man, late 30s 

Many, but not all, participants said they have received  medical care , such as surgery or hormone therapy, as part of their gender transition. For those who haven’t undergone a medical transition, the reasons ranged from financial barriers to being nervous about medical procedures in general to simply not feeling that it was the right thing for them.

“For me to really to live my truth and live my identity, I had to have the surgery, which is why I went through it. It doesn’t mean [that others] have to, or that it will make you more or less of a woman because you have it. But for me to be comfortable, … that was a big part of it. And so, that’s why I felt I had to get it.” – Trans woman, early 40s

“I’m older and it’s an operation. … I’m just kind of scared, I guess. I’ve never had an operation. I mean, like any kind of operation. I’ve never been to the hospital or anything like that. So, it [is] just kind of scary. But I mean, I want to. I think about all the time. I guess have got to get the courage up to do it.” – Trans woman, early 40s

“I’ve decided that the dysphoria of a second puberty … would just be too much for me and I’m gender fluid enough where I’m happy, I guess.” – Nonbinary person, early 30s

“I’m too old to change anything, I mean I am what I am. [laughs]” – Nonbinary person, 60s

Many focus group participants who have sought medical treatment for their gender transition faced barriers, although some had positive experiences. For those who said there were barriers, the cost and the struggle to find sympathetic doctors were often cited as challenges. 

“I was flat out turned down by the primary care physician who had to give the go-ahead to give me a referral to an endocrinologist; I was just shut down. That was it, end of story.” – Nonbinary person, 50s

“I have not had surgery, because I can’t access surgery. So unless I get breast cancer and have a double mastectomy, surgery is just not going to happen … because my health insurance wouldn’t cover something like that. … It would be an out-of-pocket plastic surgery expense and I can’t afford that at this time.” – Nonbinary person, 50s

“Why do I need the permission of a therapist to say, ‘This person’s identity is valid,’ before I can get the health care that I need to be me, that is vital for myself and for my way of life?” – Nonbinary person, mid-40s

“[My doctor] is basically the first person that actually embraced me and made me accept [who I am].” – Trans woman, late 20s

Many people who transitioned in previous decades described how access has gotten much easier in recent years. Some described relying on underground networks to learn which doctors would help them obtain medical care or where to obtain hormones illegally. 

“It was hard financially because I started so long ago, just didn’t have access like that. Sometimes you have to try to go to Mexico or learn about someone in Mexico that was a pharmacist, I can remember that. That was a big thing, going through the border to Mexico, that was wild. So, it was just hard financially because they would charge so much for testosterone. And there was the whole bodybuilding community. If you were transitioning, you went to bodybuilders, and they would charge you five times what they got it [for], so it was kind of tough.” – Trans man, early 40s

“It was a lot harder to get a surgeon when I started transitioning; insurance was out of the question, there wasn’t really a national discussion around trans people and their particular medical needs. So, it was challenging having to pay everything out of pocket at a young age.” – Trans man, early 30s

“I guess it was hard for me to access hormones initially just because you had to jump through so many hoops, get letters, and then you had to find a provider that was willing to write it. And now it’s like people are getting it from their primary care doctor, which is great, but a very different experience than I had.” – Trans man, early 40s

The discussions also touched on whether the participants feel a connection with a broader lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community or with other people who are LGBTQ+. Views varied, with some saying they feel an immediate connection with other people who are LGBTQ+, even with those who aren’t trans or nonbinary, and others saying they don’t necessarily feel this way. 

“It’s kind of a recurring joke where you can meet another LGBT person and it is like there is an immediate understanding, and you are basically talking and giving each other emotional support, like you have been friends for 10-plus years.” – Trans woman, late teens 

“I don’t think it’s automatic friendship between queer people, there’s like a kinship, but I don’t think there’s automatic friendship or anything. I think it’s just normal, like, how normal people make friends, just based on common interests.” – Nonbinary person, early 30s 

“I do think of myself as part of the LGBT [community] … I use the resources that are put in place for these communities, whether that’s different health care programs, support groups, they have the community centers. … So, I do consider myself to be part of this community, and I’m able to hopefully take when needed, as well as give back.” – Trans man, mid-30s

“I feel like that’s such an important part of being a part of the [LGBTQ+] alphabet soup community, that process of constantly learning and listening to each other and … growing and developing language together … I love that aspect of creating who we are together, learning and unlearning together, and I feel like that’s a part of at least the queer community spaces that I want to be in. That’s something that’s core to me.” – Nonbinary person, early 30s

“I identify as queer. I feel like I’m a part of the LGBT community. That’s more of a part of my identity than being trans. … Before I came out as trans, I identified as a lesbian. That was also a big part of my identity. So, that may be too why I feel like I’m more part of the LGB community.” – Trans man, early 40s

While many trans and nonbinary participants said they felt accepted by others in the LGBTQ+ community, some participants described their gender identity as a barrier to full acceptance. There was a sense among some participants that cisgender people who are lesbian, gay or bisexual don’t always accept people who are transgender or nonbinary.  

“I would really like to be included in the [LGBTQ+] community. But I have seen some people try to separate the T from LGB … I’ve run into a few situations throughout my time navigating the [LGBTQ+] community where I’ve been perceived – and I just want to say that there’s nothing wrong with this – I’ve been perceived as like a more feminine or gay man in a social setting, even though I’m heterosexual. … But the minute that that person found out that I wasn’t a gay man … and that I was actually a transgender person, they became cold and just distancing themselves. And I’ve been in a lot of those types of circumstances where there’s that divide between the rest of the community.” – Trans man, early 30s

“There are some lesbians who see trans men as being traitors to womanhood. Those are not people that I really identify with or want to be close to.” – Trans man, early 40s 

“It’s only in the past maybe dozen or so years, that an identity like gender fluid or gender queer was acceptable even within the LGBTQ+ community. … I tried to go to certain LGBTQ+ events as a trans man and, you know, I was not allowed in because I looked too female. The gay men would not allow me to participate.” – Nonbinary person, 50s 

“Technically based on the letters [in the acronym LGBTQ+] I am part of that community, but I’ve felt discrimination, it’s very heavily exclusive to people who are either gay or lesbian and I think that’s true … for queer or bisexual or asexual, intersex … anybody who’s not like exclusively hardcore gay or lesbian. It’s very exclusive, like excluding to those people. … I feel like the BTQ is a separate group of people…. So, I identify with the second half of the letters as a separate subset.” – Trans man, late 30s

When asked to name the most important policy or political issues facing transgender and nonbinary people in the United States today, many participants named basic needs such as housing, employment, and health care. Others cited recent legislation or policies related to people who are transgender that have made national news.

“Housing is a huge issue. Health care might be good in New York, it might be good in California, but … it’s not a national equality for trans folks. Health care is not equal across the states. Housing is not equal across the states. So, I think that the issues right now that we’re all facing is health care and housing. That’s the top, the most important things.” – Trans woman, early 40s 

“Definitely education. I think that’s very important … Whether you identify as trans or not as a young child, it’s good to understand and know the different things under the umbrella, the queer umbrella. And it is also just a respect thing. And also, the violence that happens against trans and nonbinary people. I feel like educating them very young, that kind of helps – well, it is going to help because once you understand what’s going on and you see somebody that doesn’t identify the same as you, you’ll have that respect, or you’ll have that understanding and you’re less likely to be very violent towards them.” – Nonbinary person, mid-20s 

“Employment is a big one. And I know that some areas, more metropolitan progressive-leaning areas, are really on top of this, but they’re trans people everywhere that are still being discriminated against. I think it’s a personal thing for me that goes back to my military service, but still, it’s just unfortunate. It’s an unfortunate reality.” – Trans man, early 30s

“I think just the strong intersectionality of trans people with mental health issues, or even physical health issues. … So in that way, accessing good health care or having good mental health.” – Trans man, late 30s

“I honestly think that the situation in Texas is the most pressing political and policy situation because it is a direct attack on the trans community. … And it is so insidious because it doesn’t just target bathrooms. This is saying that if you provide medical care to trans youth it is tantamount to child abuse. And it is so enraging because it is a known proven fact that access to gender affirming medical care saves lives. It saves the lives of trans youth. And trans youth have the highest suicide rate in the country.” – Nonbinary person, mid-40s 

Participants had different takes on what gets in the way of progress on issues facing transgender and nonbinary people. Some pointed to the lack of knowledge surrounding the history of these issues or not knowing someone who is transgender or nonbinary. Others mentioned misconceptions people might have about transgender and nonbinary people that influence their political and policy perspectives. 

“People who don’t know trans people, honestly … that’s the only barrier I can understand because people fear what they don’t know and then react to it a lot of the time.” – Nonbinary person, early 30s

“Sometimes even if they know someone, they still don’t consider them to be a human being, they are an ‘other,’ they are an ‘it,’ they are a ‘not like me,’ ‘not like my family,’ person and so they are put into a place socially where they can be treated badly.” – Nonbinary person, 50s

“Just the ignorance and misinformation and this quick fake social media fodder, where it encourages people who should not be part of the conversation to spread things that are not true.” – Trans man, late 30s

“Also, the political issues that face nonbinary people, it’s that people think nonbinary is some made-up thing to feel cool. It’s not to feel cool. And if someone does do it to feel cool, maybe they’re just doing that because they don’t feel comfortable within themselves.” – Nonbinary person, mid-30s

“There’s so much fear around it, and misunderstanding, and people thinking that if you’re talking to kids about gender and sexuality, that it’s sexual. And it’s like, we really need to break down that our bodies are not inherently sexual. We need to be able to talk with students and children about their bodies so that they can then feel empowered to understand themselves, advocate for themselves.” – Nonbinary person, early 30s

When asked what makes them hopeful for the future for trans and nonbinary people, some participants pointed to the way things in society have already changed and progress that has been made. For example, some mentioned greater representation and visibility of transgender and nonbinary people in entertainment and other industries, while others focused on changing societal views as things that give them hope for the future. 

“I am hopeful about the future because I see so many of us coming out and being visible and representing and showing folks that we are not to stereotype.” – Trans woman, early 40s

“Also, even though celebrity is annoying, it’s still cool when people like Willow [Smith] or Billie Eilish or all these popstars that the kids really love are like, ‘I’m nonbinary, I’m queer,’ like a lot more progressive. … Even just more visibility in TV shows and movies, the more and more that happens the more it’s like, ‘Oh yeah, we are really here, you can’t not see us.’” – Nonbinary person, late 20s

“We shouldn’t have to look to the entertainment industry for role models, we shouldn’t have to, we should be able to look to our leaders, our political leaders, but I think, that’s what gives me hope. Soon, it’s going to become a nonissue, maybe in my lifetime.” – Trans man, 60s

“I have gotten a little bit into stand-up comedy in the last few weeks, and it is like the jokes that people made ten years ago are resurfacing online and people are enraged about it. They are saying like, ‘Oh, this is totally inappropriate.’ But that comes with the recognition that things have changed, and language has changed, and people are becoming more intolerant of allowing these things to occur. So that is why I am hopeful, is being able to see that progression and hopeful continued improvement on that front.” – Nonbinary person, late 20s

“I think because of the shift of what’s happening, how everything has become so normal, and people are being more open, and within the umbrella of queerness so many different things are happening, I think as we get more comfortable and we progress as a society, it’s just going to be better. So, people don’t have to hide who they are. So, that gives me hope.” – Nonbinary person, mid-20s

For many, young people are a source of hope. Several participants talked about younger generations being more accepting of those who are transgender or nonbinary and also being more accepted by their families if they themselves are trans or nonbinary. 

“And then the other portion that gives me hope are the kids, because I work now with so many kids who are coming out as trans earlier and their families are embracing them and everything. … So I really am trusting in the young generation.” – Nonbinary person, 60s

“I mean kids don’t judge you the same way as adults do about gender, and they’re so expansive and have so much creativity. … So it’s just the kids, Gen Z, and it just makes me feel really, really hopeful.” – Nonbinary person, early 30s

“The youth, the youth. They understand almost intrinsically so much more about these things than I feel like my generation did. They give me so much hope for the future.” – Nonbinary person, early 30s

“I think future generations, just seeing this growing amount of support that they have, that it’s just going to keep improving … there’s an increase in visibility but there’s also an increase in support … like resources for parents where they can see that they don’t have to punish their kids. Their kids can grow up feeling like, ‘This is okay to be this way.’ And I feel like that’s not something that can be stopped.” – Trans man, late 30s

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Home — Essay Samples — Sociology — Sociology of Gender — Transgender

Essays on Transgender

Brief description of transgender.

Transgender refers to individuals whose gender identity differs from the sex they were assigned at birth. It is a crucial and often misunderstood aspect of human diversity, and writing essays on transgender topics can help increase understanding and awareness of this community.

Importance of Writing Essays on This ... Read More Brief Description of Transgender

Importance of writing essays on this topic.

Essays on transgender topics are important for both academic and personal exploration. They can help challenge societal norms, promote empathy and understanding, and contribute to the ongoing conversation about gender identity and equality.

Tips on Choosing a Good Topic

• Consider current issues and controversies within the transgender community, such as access to healthcare or discrimination in the workplace.
• Explore personal narratives and experiences of transgender individuals to gain insight into their lived experiences.
• Research the history and cultural significance of transgender identities in different societies and time periods.

Essay Topics

• Argumentative Essay: The impact of transgender-inclusive policies in schools and workplaces.
• Reflective Essay: My journey of understanding and supporting transgender rights.
• Expository Essay: Exploring the history of transgender representation in media and popular culture.
• Research Essay: The mental health challenges faced by transgender individuals and the need for better support systems.
• Persuasive Essay: The importance of transgender representation in politics and leadership roles.
• Comparison Essay: Contrasting the experiences of transgender individuals in different countries or regions.
• Cause and Effect Essay: The consequences of societal discrimination on the mental health of transgender youth.
• Definition Essay: Defining the spectrum of gender identity beyond the binary understanding of male and female.
• Narrative Essay: Sharing the personal story of a transgender individual navigating their identity and relationships.
• Analytical Essay: Examining the portrayal of transgender characters in literature and film.

Concluding Thought

Writing essays on transgender topics can be a powerful way to engage with and understand the complexities of gender identity. By exploring these issues through writing, we can contribute to a more inclusive and empathetic society.

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Nine Conclusions: (re)theorising transgender

• Published: September 2007
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This chapter consolidates points of discussion from the previous chapters and relates back to the theoretical premise mapped out in the first chapter. It suggests that a theoretical model which fuses social and cultural theories of identity is relevant for understanding the emergence and the experiences of contemporary transgender practices. The intersections of transgender studies and queer theory offer a theoretical space in which to conceptualise a queer sociological approach to transgender. The themes of this book indicate the diversity of transgender identities and point to both the similarities and differences between categories of transgender experience. The book argues for the importance of theorising gender diversity in relation to social structures, discursive formations, subjective understandings, embodied corporalities, and cultural (and subcultural) practices.

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Understanding the Transgender Community

Transgender people come from all walks of life, and HRC Foundation has estimated that there are more than 2 million of us across the United States. We are parents, siblings, and kids. We are your coworkers, your neighbors, and your friends. We are 7-year-old children and 70-year-old grandparents. We are a diverse community, representing all racial and ethnic backgrounds, as well as all faith traditions.

The word “transgender” – or trans – is an umbrella term for people whose gender identity is different from the sex assigned to us at birth. Although the word “transgender” and our modern definition of it only came into use in the late 20th century, people who would fit under this definition have existed in every culture throughout recorded history.

Alongside the increased visibility of trans celebrities like Laverne Cox, Jazz Jennings or the stars of the hit Netflix series “Pose,” three out of every ten adults in the U.S. personally knows someone who is trans. As trans people become more visible, we aim to increase understanding of our community among our friends, families, and society.

What does it mean to be trans?

The trans community is incredibly diverse. Some trans people identify as trans men or trans women, while others may describe themselves as non-binary, genderqueer, gender non-conforming, agender, bigender or other identities that reflect their personal experience. Some of us take hormones or have surgery as part of our transition, while others may change our pronouns or appearance. Roughly three-quarters of trans youth that responded to an HRC Foundation and University of Connecticut survey identified with terms other than strictly “boy” or “girl.” This suggests that a larger portion of this generation’s youth are identifying somewhere on the broad trans spectrum.

What challenges do trans people face?

While trans people are increasingly visible in both popular culture and in daily life, we still face severe discrimination, stigma and systemic inequality. Some of the specific issues facing the trans community are:

• Lack of legal protection – Trans people face a legal system that often does not protect us from discrimination based on our gender identity. Despite a recent U.S. Supreme Court Decision that makes it clear that trans people are legally protected from discrimination in the workplace, there is still no comprehensive federal non-discrimination law that includes gender identity - which means trans people may still lack recourse if we face discrimination when we’re seeking housing or dining in a restaurant. Moreover, state legislatures across the country are debating – and in some cases passing – legislation specifically designed to prohibit trans people from accessing public bathrooms that correspond with our gender identity, or creating exemptions based on religious beliefs that would allow discrimination against LGBTQ+ people.
• Poverty – Trans people live in poverty at elevated rates, and for trans people of color, these rates are even higher. Around 29% of trans adults live in poverty , as well 39% of Black trans adults, 48% of Latine trans adults and 35% of Alaska Native, Asian, Native Americans and Native Hawaiian or Pacific Islander trans adults.
• Stigma, Harassment and Discrimination – About half a decade ago, only one-quarter of people in the United States supported trans rights, and support increased to 62% by the year 2019. Despite this progress, the trans community still faces considerable stigma due to more than a century of being characterized as mentally ill, socially deviant and sexually predatory. While these intolerant views have faded in recent years for lesbians and gay men, trans people are often still ridiculed by a society that does not understand us. This stigma plays out in a variety of contexts – from lawmakers who leverage anti-trans stigma to score cheap political points; to family, friends or coworkers who reject trans people upon learning about our trans identities; and to people who harass, bully and commit serious violence against trans people. This includes stigma that prevents them from accessing necessary services for their survival and well-being. Only 30% of women’s shelters are willing to house trans women. While recent legal progress has been made, 27% of trans people have been fired, not hired or denied a promotion due to their trans identity. Too often, harassment has led trans people to avoid exercising their most basic rights to vote. HRC Foundation’s research shows that 49% of trans adults, and 55% of trans adults of color said they were unable to vote in at least one election in their life because of fear of or experiencing discrimination at the polls.
• Violence Against Trans People – Trans people experience violence at rates far greater than the average person. Over a majority ( 54% ) of trans people have experienced some form of intimate partner violence, 47% have been sexually assaulted in their lifetime and nearly one in ten were physically assaulted in between 2014 and 2015. This type of violence can be fatal. At least 27 trans and gender non-conforming people have been violently killed in 2020 thus far, the same number of fatalities observed in 2019.
• Lack of Healthcare Coverage – An HRC Foundation analysis found that 22% of trans people and 32% of trans people of color have no health insurance coverage. More than one-quarter ( 29% ) of trans adults have been refused health care by a doctor or provider because of their gender identity. This sobering data reveals a healthcare system that fails to meet the needs of the trans community.
• Identity Documents – The widespread lack of accurate identity documents among trans people can have an impact on every aspect of their lives, including access to emergency housing or other public services. Without identification, one cannot travel, register for school or access many services that are essential to function in society. Many states do not allow trans people to update their identification documents to match their gender identity. Others require evidence of medical transition – which can be prohibitively expensive and is not something that all trans people want – as well as fees for processing new identity documents, which may make them unaffordable for some members of the trans community.

While advocates continue working to remedy these disparities, change cannot come too soon for trans people. Visibility – especially positive images of trans people in the media and society – continues to make a critical difference for us; but visibility is not enough and can come with real risks to our safety, especially for those of us who are part of other marginalized communities. That is why the Human Rights Campaign is committed to continuing to support and advocate for the trans community, so that the trans Americans who are and will become your friends, neighbors, coworkers and family members have an equal chance to succeed and thrive.

Related Resources

Transgender

HRC’s Brief Guide to Reporting on Transgender Individuals

Transgender, Health & Aging, Workplace

Debunking the Myths: Transgender Health and Well-Being

Bisexual, Allies, Coming Out, Transgender

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113 Gender Roles Essay Topics & Examples

Looking for gender roles essay topics? This field is hot, controversial, and really worth exploring!

• 🔝 Top 10 Gender Topics
• 📝 Gender Essay: Writing Tips
• 🏆 Gender Essay Examples & Topic Ideas

✍️ Gender Argumentative Essay Topics

❓ research questions about gender roles.

In your gender role essay, you might want to focus on the issues of gender equality in the workplace. Another exciting option is to write about gender stereotypes in education. Finally, you can elaborate on how traditional gender roles are changing.

In this article, you’ll find a list of gender argumentative essay topics, ideas for papers on gender and society, as well as top gender roles essay examples.

🔝 Top 10 Gender Roles Topics

• Gender stereotypes and the way they affect people
• Fighting gender stereotypes and sexism
• Gender equality in the workplace
• Gender stereotypes in education
• Gender schema theory
• Is gender socially constructed?
• Social learning theory and gender
• Gender roles and sexual orientation
• Body image and gender
• Social gender construction in the media

📝 Gender Roles Essay: Writing Tips

Essays on gender roles present students’ understanding of the similarities, differences, and aspects of gender roles in society.

Writing gender roles essays helps learners to understand the significance of topics related to gender roles and the changes in societal norms. Students should be highly aware of the problems associated with traditional gender roles. For example, there are many periods in world history, in which people did not have equal rights.

Moreover, some aspects of gender roles may be associated with discrimination. To make an essay on this problem outstanding, you should discuss the problem in detail and present your points clearly. A useful tip is to develop a good structure for your paper.

Before starting to work on the paper, you should select the problem that is most interesting or relevant to you.

Gender roles essay topics and titles may include:

• The history of gender roles and their shifts throughout the time
• Male and female roles in society
• Gender roles in literature and media
• How a man and a woman is perceived in current society
• The causes and outcomes of gender discrimination
• The problem of ‘glass ceiling’
• The problem of social stratification and its outcomes
• The revolution in the concept of gender

After selecting the issue for discussion, you can start working on the essay’s structure. Here are some useful tips on how to structure your paper:

• Select the topic you want to discuss (you can choose one from the list above). Remember to pay attention to the type of essay you should write. If it is an argumentative essay, reflect on what problem you would want to analyze from opposing perspectives.
• Gender roles essay titles are important because they can help you to get the reader’s attention. Think of something simple but self-explanatory.
• An introductory paragraph is necessary, as it will present the questions you want to discuss in the paper. Remember to state the thesis of your essay in this section.
• Think of your gender roles essay prompts. Which aspects of the selected problem do you want to focus on? Dedicate a separate section for each of the problems.
• Remember to include a refutation section if you are writing an argumentative essay. In this section, you should discuss an alternative perspective on the topic in 1-2 paragraphs. Do not forget to outline why your opinion is more credible than the alternative one.
• Avoid making the paragraphs and sentences too long. You can stick to a 190 words maximum limit for one paragraph. At the same time, make sure that the paragraphs are longer than 65 words. Try to make all sections of the body paragraphs of similar length.
• Check out examples online to see how you can structure your paper and organize the information. Pay attention to the number of paragraphs other students include.
• Remember to include a gender roles essay conclusion. In this paragraph, you will discuss the most important claims of your paper.
• Do not forget to add a reference page in which you will include the sources used in the paper. Ask your professor in advance about the types of literature you can utilize for the essay.

Do not forget that there are free samples on our website that can help you to get the best ideas for your essay!

🏆 Gender Roles Essay Examples & Topic Ideas

• Gender Roles in Antigone Essay This will be seen through an analysis of the other characters in the play and the values of ancient Greeks. Indeed this central character appears to be at odds with the inclinations of the other […]
• Gender Roles in “The Glass Menagerie” by Tennessee Williams In the play The Glass Menagerie, Tennessee Williams has written the story of the Wingfield family that lived in St Louis during the 1940s.
• Gender roles in the Wind in the Willows For instance, in the case where both the mole and the rat make comments to the toad that are full of women critics.
• Gender Roles in “Bridge to Terabithia” by Paterson The theme of gender roles is consistently present in the novel, starting with character origins and becoming the central concept as they mature to defy archetypal perceptions of feminine and masculine expectations in order to […]
• Gender Roles in the 19th Century Society: Charlotte Gilman’s The Yellow Wallpaper However, the narrator’s developing madness can also act as the symbolical depiction of the effects of the men’s dominance on women and the female suppression in the 19th-century society.”The Yellow Wallpaper” was first published in […]
• Changing Gender Roles Between Boys and Girls In the twenty-first Century, girls have greatly stepped up and assumed some of the roles that were considered to be boy’s while boys have done the same leading to an interchange of roles.
• The Concepts of Gender Roles and Sexuality by John Money and Judith Butler These categories of feminists are united in the belief of existence of many children and little sex. This paper explains the concepts and ideologies relating to gender roles and sexuality.as advocated by John Money and […]
• Gender Roles Set in Stone: Prehistoric and Ancient Work of Arts In the prehistoric and ancient works of art, the representation of women and men reveals a massive imbalance in gender equity that favors men over women.
• Athena and Gender Roles in Greek Mythology According to Eicher and Roach-Higgins, the elements of her dress were important because they immediately communicated specific ideas about her character that was as contradictory as the physical gender of the birthing parent.”In appropriating the […]
• Conflict of Gender Roles in Munro’s “Boys and Girls” Munro’s “Boys and Girls” is a story about a puzzled girl who struggles to find the balance between the battles of her inner female-housewife side, like her mother, and a boyish character who likes to […]
• Discussing Gender Roles in the Interaction Perspective It is the purpose of this issue to discuss the concept of gender roles using the sociological perspective of symbolic interaction.
• Gender Roles Inversion: The Madonna Phenomenon At the same time partial narrowing of the gender gap in the context of economic participation did not lead to the equality of men and women in the field of their occupations.
• Nomadic Society’s Gender Roles and Warrior Culture On the one hand, it was clear that the 1100s and the 1200s included the period of male power. It was wrong to assume that all women were similar and treat them in the same […]
• Gender Roles in Society One might think that a child is born with the idea of how to behave in relation to gender while in the real sense; it is the cultivation of the society that moulds people to […]
• Gender Roles and Stereotyping in Education Teachers should be trained to give clear and useful instruction to students on the issue of gender roles in modern society.
• Ideology of Gender Roles In the world of literature, ideology has played a vital role in depicting the condition of the society. In this scenario, Kingston reveals that the men out-live their roles in the society, and they are […]
• Women’s Gender Roles in American Literature The stories written by Constance Woolson Fenimore, Mary Wilkins Freeman, and Jaqueline Bishop highlight the harmful gender roles and discrimination that still remains a major topic for disputes and illustrate the fate of oppressed women.
• Culture and History: Gender Roles Over the Past 50 or So Years It is not that there were no women in the workforce; it was just that she had to choose one over the other, juggling the two was quite rare and unheard of.
• Biology and Gender Roles in Society Thus, it may be more convenient for society to justify the imposition of certain gender roles on men and women using biology-related arguments, which, in reality, are more related to culture and social development.
• Gender Roles in South Korean Laws and Society At the same time, all custody is traditionally granted to husbands and fathers in a case of a divorce” though the anxiety about the high divorce rate and the nasty endings of relationships is more […]
• Gender Roles in Brady’s and Theroux’s Works In the satire “Being a Man” by Paul Theroux, the author demonstrates to readers the essence of how a particular manifestation of masculinity is extolled in American society.
• Aspects of Gender Roles and Identity The breadth of her practice in transgender issues suggests that every choice Bowers makes is ethical, requiring her to be respectful and highly responsible.
• Changing Gender Roles in Families Over Time The division of labor and traditional gender roles in the family usually consists of men doing the work while women take care of the children, other relatives, and housekeeping.
• Gender Roles, Expectations, and Discrimination Despite Isaac being the calmest boy in the school, he had a crush on Grace, a beautiful girl in the school who was from a wealthy family.
• Gender Roles in Social Constructionism The reality, in the view of sociologists, is a social attitude in connection with which a personality is formed that adapts to the requirements of the world.
• Gender Roles and Stereotypes in Straightlaced Film One might conclude that gender neutrality and abstraction in offices are only a cover to maintain the basis of gender injustice.
• Children’s Views of Gender Roles Today, both parents and teachers see the positive impact of the attempts to integrate anti-biased gender-related education on young children as they get more freedom to express themselves and grow up less aggressive.
• The Construction of Gender Roles However, it is wrong to consider women exposed to the domestic work powerless, as they have the opportunity to informally or implicitly influence men and the decisions they make.
• Sociology of the Family: Gender Roles Thus, the societal predisposition and notion that women are lesser in the community should be abandoned, and greater emphasis should be placed on the critical functions they perform in the household. These assertions, equivocations, and […]
• Femininity and Masculinity: Understanding Gender Roles The understanding of how gender roles are portrayed in the media and the general perception of the expected behavior for men and women communicated non-verbally in the society is the basis on which children build […]
• Injustice Within Strict Gender Roles There is still no clear answer to how a person can find his or her destiny and place in the world, and understand the opportunities and prospects, considering the opinion of the dominant number of […]
• Gender Roles and Body Image in Disney Movies In this research, attention will be paid to gender roles and body images of Disney princesses to understand the popularity of the franchise and its impact on child development.
• Gender Roles and How People Perceive Them However, all of the survey participants indicated that their families would be inclined to differentiate between the toys for a child based on the latter’s sex and the corresponding perceived gender role.
• Gender Roles: From Prehistoric Era to Modern Society Since each gender was assigned a particular role in the past due to the differences in the biological makeup between a man and a woman in the prehistoric era, the modern process of communication between […]
• Gender Roles in TV Commercials and Values in the Society Each of them will watch, code, and analyze the TV commercials separately; at the end of the procedure, their results will be compared in order to ensure the inter-observer reliability of the chosen research method.
• Gender Roles in Contemporary Society The conditions of life are tough and it is presumed that only men are able to carry out such hardships and limitations of a soldier life.
• Gender Roles in ‘Mr. Green’ by Robert Olen Butler Green Butler uses the character of the grandfather to develop the theme of gender roles within the culture. The character of the grandfather is extremely sound for the cultural beliefs the author conveyed through all […]
• Gender Roles and Sexuality in Media: Cosmopolitan & Maxim The woman portrayed in these sites is supposed to look ‘hot’ and sexy in order to be attractive to a man.
• Gender Roles: Changes From the Late 1800’s to Today The definition of who is a male or a female depends on the types of gender roles one was exposed to during the early ages. In today’s society, we have a greater number of women […]
• Social Element in Gender Roles I learned of the origins of gay and lesbian studies, as well that of the confining of such studies in earlier times to specific institutions.
• Equality: The Use of TV to Develop Our Gender Roles In this sense, when it is the men who predominantly work outside of the home, they will usually see the home as a place of leisure and so use the TV as a source of […]
• Gender Roles in Brady’s “Why I Want a Wife” and Sacks’ “Stay-at-Home Dads” Yet, there are some distinctions Judy Brady believes that women are often viewed as unpaid house servants who have to take care of husbands’ needs, whereas Glenn Sacks argues that gender roles begin to transform […]
• Gender Roles and Family Systems in Hispanic Culture In the Hispanic culture, amarianismo’ and amachismo’ are the terms used to determine the various behavioral expectations among the family members.
• Family Unit and Gender Roles in Society and Market The role of molding the infant into an adult belonged to the family in the ancient society. In the past, the father was expected to be the breadwinner of the family.
• China’s Gender Roles in Mo Yan’s and Shen Fu’s Works Six Records of a Floating Life is a multi-faceted chronicle which helps to comprehend the difficulties and the features of Shen Fu’s life and the romance between him and his beloved Chen Yun.
• “Beside Oneself” by Judith Butler: Gender Roles Following the views of the author, who states that choice in the formation of gender and sexuality is not transparent, and a key role is still played by others in the form of expectations and […]
• Gender Roles in Couples and Sex Stereotypes Altogether, the last reconsiderations of the nature of relations promoted the appearance of numerous debates related to the role of partners and their right to be the leader.
• Understanding the Social Element in Gender Roles When saying that gender is a binary construction, one implies that there are two genders, namely, the masculine and the feminine one, and two corresponding types of social behaviour, which are predetermined by the existing […]
• Gender Roles in Tango: Cultural Aspects However, one should not assume that the role of women in tango is inferior because they create the most aesthetic aspects of this dance.
• Gender Roles in Toy Stores According to Fisher-Thompson et al, two of the major differentiating factors in toys for girls and boys are color and nature.
• Women in Hip-Hop Music: A Provocative and Objectified Gender Roles It is one thing that men want women to be in music videos and play a particular role, but women are willing to participate in the videos.
• Content Analysis of Gender Roles in Media In the critical analysis of the article, the point of disagreement is that of under-representation of women in the media. How do the media subordinate and relegate roles of women in society?
• Effects of Media Messages about Gender Roles Media articles, such as the Maxim Magazine and the Cosmopolitan Magazine, socialize individuals to believe that women are very different from men as regards to dressing, behaving, and eating.
• The Change of Gender Roles This similarity is one of the most important to focus on the structure of the narrative. In both plays, the main actions of the characters are not directly described by the authors.
• Gender Equality: Male Dominance The simple reason is that gender inequality exists in affluent societies wherein women are free to do what they want, have access to education, and have the capacity to create wealth.
• “The Odd Women” and “Women in Love”: Evolving Views of Gender Roles An effort is also made to track the changes of the roles of women in the social fabric in the Victorian era by considering The Odd Women by George Gissing written in 1893.
• Gender Roles: Constructing Gender Identity In the course of the twentieth century and at the threshold of the twenty-first century, the images and roles of gender have constantly been changing.
• Analysis of the Peculiarities of Gender Roles Within Education, Families and Student Communities Peculiarities of gender aspect within the education system and labour market Attitude for marriage of men and women as one of the major aspects within the analysis of gender roles Family relations as a significant […]
• Concepts of Gender Roles As a result of these, the war on gender inequality and sexism has failed, because of the failure of these agents of change to promote gender equality and eliminate discriminative notions held by the society.
• Cohabitation and Division of Gender Roles in a Couple Cohabitation is perceived in the society as the form of relationships which is an effective alternative to the traditional marriage because of focusing on the principles of flexibility, freedom, and equality, but few couples can […]
• Gender Roles in the United States Over the Last Century The men’s perception towards this idea was negative, and this consequently resulted to a conflict with the men claiming that the roles of the women were in the kitchen.
• Fashions, gender roles and social views of the 1950s and 1960s Fashion was highly valued and this can be seen in the way the clothes worn by the wives of the presidential candidates in America hit the headlines. In the 1950s, the role of housekeeping and […]
• Gender Roles by Margaret Mead Once the a rift defining men and women develops this way, it goes further and defines the positions, which men and women occupy in the society, basing on these physical and biological differences, which form […]
• Cheating, Gender Roles, and the Nineteenth-Century Croquet Craze The author’s main thesis is, “Yet was this, in fact, how the game was played on the croquet lawns of the nineteenth century?” Whereas authors of croquet manuals and magazines emphasize so much on the […]
• Gender Roles in Cartoons Though the males are portrayed to be logical, but it is shown that the females are more successful because of simple blunders or miscalculations which males fail to understand, females are able to beat males […]
• The Industrial Revolution Impact on the Gender Roles The population growth combined with the increased productivity of small parts of the country and the migration of the now landless people in search of work opportunities led to the phenomena of urbanization.
• Gender Roles in The Yellow Wallpaper & Trifles The two texts; the short story ‘The Yellow Wallpaper’ by Charlotte Perkins and the play ‘Trifles’ by Susan Glaspell strategically illustrate this claim since they both aim at attracting the reader’s attention to the poor […]
• How Does Aristophanes Represent Gender Roles in Lysistrata?
• Are Gender Roles and Relationships More Equal in Modern Family Life?
• How Do Children Develop Gender Roles?
• Does Men’s Fashion Reflect Changes in Male Gender Roles?
• How Did Colonialism Resonate With Gender Roles and Oppression?
• Are Gender Roles Damaging Society?
• How Did Revolutions Affect Gender Roles?
• Are Gender Roles Defined by Society or by Genetics?
• How Have Family Structure and Gender Roles Changed?
• Are Gender Roles Fluid When Dealing With Death and Tragedy?
• How Do Gender Roles Affect Communication?
• Are Gender Roles Natural?
• How Do Gender Roles Affect Immigrants?
• Are Gender Stereotyped Roles Correct?
• How Do Gender Roles Affect the Physical and Emotional Health?
• Have Gender Roles Played a Big Part in the History?
• How Do Gender Roles and Extroversion Effects How Much People Talk?
• What Are Gender Roles? How Are They Defined?
• How Are Gender Roles Predetermined by the Environment?
• What Drives the Gender Wage Gap?
• How Has Gender Roles Changed Over the Last Centuries?
• What Factors Influence Gender Roles?
• How Have Gender Roles in Japanese Theatre Influenced and Affected Societal View on Homosexuality and Masculinity?
• What Society Norms for Gender Roles Should Be Conceived?
• How Have Traditional Gender Roles Been Stressful?
• What Was Distinctive About Gender Roles in the Nineteenth Century?
• How Has Hegemonic Masculinity Set Ideas of Gender Roles?
• How Do Media and Politics Influence Gender Roles?
• Where Does the Truth on Gender Roles Lie in Nahua and Mayan Civilizations?
• How Radical Are the Changes to the Gender Roles in Carter’s “The Company of Wolves”?
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Integrating transgender care into mainstream medicine—an essay by Guy T’Sjoen and Joz Motmans

• Related content
• Peer review
• Guy T Sjoen , head of department of endocrinology ,
• Joz Motmans , professor of gender studies
• 1 Ghent University Hospital, Belgium
• 2 Ghent University, Belgium
• Correspondence to: G T’Sjoen Guy.TSjoen{at}ugent.be

All healthcare professionals will find themselves supporting care for a transgender or gender diverse person at some point, and education and research need to be widened, write Guy T’Sjoen and Joz Motmans

Population estimates show that transgender and gender diverse identities or experiences can no longer be considered a rarity. The prevalence of transgender identities is cited as 0.3% to 0.5% among adults and 1.2% to 2.7% among children and adolescents 1 ; data from the 2021 Canadian census, to pick one example, showed 0.33% of the 30.5 million citizens identifying as transgender or non-binary ( box 1 ). 2 3 These numbers can be understood through the evolving awareness of gender diversity in societies, the improved legal framework in many regions around the world, access to information over the internet and through social media, and the existing possibilities for gender affirming care. 4 5

Gender diverse terminology

Transgender or trans are umbrella terms used to describe people whose gender identities or gender expressions are not what is typically expected for the sex to which they were assigned at birth.

Transgender women, trans women, or women of trans experience are people who were assigned male at birth and who have gender identities as women. They may, or may not have undergone any transition.

Transgender men, trans men, or men of trans experience are people who were assigned female at birth and who have gender identities as men. They may or may not, have undergone any transition.

Gender diverse is a term used to describe people with gender identities or expressions that are different from social and cultural expectations attributed to their sex assigned at birth. This includes people who identify as non-binary, gender expansive, gender non-conforming, and others who do not identify as cisgender.

As more people feel comfortable in outing themselves, more transgender and gender diverse people are seeking psychological or medical care, with rising referrals reported by gender clinics. 6 Moreover, it is almost inevitable that anyone working in healthcare will sooner or later have at least one transgender patient under their care. Emergency staff may be confronted with a trans person brought in after a car crash; a general practitioner may be puzzled with gender reversed lab results; a radiologist may see unexpected organs on magnetic resonance imaging. All healthcare professionals therefore need at least some knowledge on the composition of diverse bodies, and on the health needs of this patient population so that even simple care is not delayed.

Moreover, healthcare professionals have an important role in supporting gender diverse people to care for themselves through provision of reliable information or access to medication, self-testing, and other self-care practices. This can help to improve health outcomes and support their mental health, among other benefits. But the lack of access to supportive quality care inhibits people’s ability to effectively self-care. Feeding into this is the poor knowledge and education of healthcare professionals that can affect clinical judgement and communications with transgender and gender diverse people.

The first commitment of all healthcare workers is to quality of care with compassion, with the goal of improving lives. Inappropriate curiosity, such as asking about their genitals or surgery history when this is not relevant for the specific medical issue being treated—often cited as the most common experience of transgender and gender diverse people seeking healthcare—should be avoided. 7 A non-judgmental and open approach is important, and attention to sensitivities in language can contribute to building trust with patients. 8 9 A single patient should never be the only source of information, and healthcare professionals need to be as well informed about transgender and gender diverse health issues as their patients. As such, knowledge and education around transgender care should no longer be managed by the few specialised interdisciplinary gender care facilities.

Getting started

Many healthcare professionals have not received any training on transgender health as it is not systematically included in curriculums. Results from an online survey among European healthcare professionals showed that only 52.7% reported some form of training on transgender health and that training led to increased confidence. 10 GPs had significantly lower confidence than nurses, psychosocial care providers, and other medical specialists. Ninety per cent of healthcare professionals believed that training would raise their competence, and this belief was significantly higher among professionals who had received some training. 10

Healthcare professionals who are more specialised in transgender care often start working in this field through personal interest or after meeting a transgender and gender diverse patient. They rarely get a chance to dedicate more than a few hours a week to train in aspects that may help. This is why most gender clinics are made up of part time and largely self-taught “gender specialists.”

Transgender healthcare is a relatively new field, so healthcare professionals need to spend more time offering not just good quality care but dealing with policy makers and administration, not to mention the time and effort it takes to argue for space, time, specialist staff, and recognition for transgender and gender diverse patients within existing healthcare frameworks.

Outdated guidelines on frequency of outpatient visits for patients receiving hormone treatment also create an unnecessary workload. 11 12 Three monthly follow-up sessions on starting treatment have often in reality been reduced to only two visits in the first year, at three and 12 months, as few problems are raised at follow-up and treatment strategies rarely need adjustment. These decisions have been partly determined by the long waiting lists. In some countries the waiting times for specialised gender clinics are now up to three to five years, 13 14 15 making it necessary to rethink the organisation of care. 15 Our centre in Ghent, Belgium, for example, saw 487 patients for an initial appointment in 2021. But a further 863 people contacted our service (an increase of 170% compared with 2016) and had to be put on the waiting list. At the same time, in many regions of the world no care is available at all or clinics are few, apply restrictive criteria, or require long travel times. 7

A lack of available care and barriers to accessing it may add to a higher prevalence of mental health problems such as suicide and depression among trans and gender diverse people, 16 and may lead some to self-manage with unprescribed gender affirming hormone treatment. 17 Care professionals see substantial numbers of patients who self-medicate, especially trans women taking contraceptive pills. 18 This is largely because of waiting lists, unavailability of care, or distrust in healthcare professionals. 7 Health professionals may get irritated with patients or turn them away if they declare self-administration (or self-initiation) because they do not meet the requirement of being without hormone treatment at presentation for mental health evaluation. Patients may then have to start again at the bottom of a waiting list for another centre or to turn to private (and more expensive) practices. Although it is understandable that doctors will not accept responsibility for treatments not started through the health system, respect and dignity for all is crucial. These patients need reassurance about the effectiveness and safety of their treatment and may want professional guidance and adaptation of their treatment. Nevertheless, to minimise health risks, it is crucial to motivate patients to adhere to prescription drugs and to avoid the risks of inappropriate dosing and counterfeit medicines on the black market. 19

The increased visibility of transgender and gender diverse people, and especially the increase in referrals of children, has resulted in a more critical approach to transgender care and severely polarised opinions. This may partly explain why many healthcare professionals hesitate to get involved. Members of specialised gender teams need to build a network with colleagues in other disciplines, including primary care, so that continuation of care is not hindered and established gender clinics can stop being the bottleneck of care. International networking among other trans care providers is also needed to share new insights, fresh ideas, and learn from one another’s experience.

Mainstream educational programmes

Research shows that healthcare professionals working in transgender care services have mostly sought knowledge from less reliable sources on the internet 20 or from more specialised conferences, published papers, or guidelines. 10 This implies that postgraduate training is much needed for healthcare professionals licensed some years ago.

A recent review of transgender health content in medical education found that most current training consisted of single session interventions facilitated by instructors with a range of professional experience; half covered more general LGBT+ content, and half was trans health specific. 21 The authors detected several facilitators (such as scaffolding learning throughout the curriculum, drawing on expertise of transgender people, and engaging learners in skills based training) as well as barriers (lack of educational materials, lack of faculty expertise, time or cost constraints, and challenges in recruiting and compensating transgender guest speakers).

The original guidelines and care protocols for transgender care were written in the late 1960s and have been regularly rewritten since. 11 The shift from experience based approaches to more evidence based approaches is notable over the past decade. An update of the World Professional Association for Transgender Health’s standards of care 22 is due to be published in autumn 2022. Based on a strong peer reviewed process, it will provide information on current knowledge and practices. As a result, many aspects from current training programmes will need further debate and update. Topics that are heavily debated focus on the one-size-fits-all gender affirming hormonal therapy, and the need for specific protocols for treating non-binary people. Other topics include the time required for different stages of transitioning, such as length of mental health counselling, the requirement for hormonal therapy before irreversible surgical interventions, and the age restrictions in adolescent care.

Quality care is rapidly evolving in this field and needs to move beyond purely medical knowledge and content. The broader social and psychological wellbeing and quality of life aspects determine health as well, hence the need to work interdisciplinarily in trans care facilities. For example, many restrictive concerns about the safety and effectiveness of gender affirming hormonal therapy need to be revised. One example is the monitoring of liver function tests, which were once described as mandatory but are not necessary if there is no other medical indication. 23 Hormonal therapy in fact has few serious side effects, although you will still find long lists of (relative and absolute) contraindications and safety measures in current guidelines.

With the aim of mainstreaming transgender care, GPs need to be trained and educated about the necessary (and often) lifelong follow-up of transgender patients taking gender affirming hormonal therapy. A recent study found just 50% of surveyed GPs are willing to take on such care, with willingness related to religious identity and perceived capability of providing routine care. 24 Training of healthcare professionals is also important for supporting self-care of people taking hormonal therapy.

Research and funding support

Transgender healthcare is a relatively new specialty, as are many of its interventions. Thus, work with transgender and gender diverse patients also means engaging in clinical research. Gender clinics have to divide their attention between seeing many patients and setting up research efforts, well aware that time spent in research will only increase the ever expanding waiting list. Research is, however, needed so that gender clinics obtain the scientific information to train and support their colleagues.

Funding agencies have been slow to adapt their frameworks to accommodate research into transgender healthcare, making it difficult. Nevertheless, more progressive examples such as the National Institutes of Health’s sexual and gender minority research office exist. 1 The reason so many clinical research questions remain today is because the right questions haven’t been asked or questionnaires were not adapted to the studied population and clinical researchers did not find access to substantial funding.

To keep our finger on the pulse and to avoid mistakes from the past, new holistic population health surveys should include questions on gender identity to discover a detailed and realistic sample. Equally important, medical research is too often blind to part of a reality that includes a socioeconomic context, stigma, and minority stress, among other issues. Insights from broader general health surveys should ideally inform healthcare professionals about new developments, including concerns that have not yet entered the consultation room. For example, the medical world has been blind too long to the specific health needs of people with non-binary identities. The life stories of transgender and gender diverse people and real life data collected with a scientific approach may hopefully influence those opposing trans related care, and may trump the many ill-advised opinions out there.

Current transgender research is mostly confined to people who are receiving clinical care. A challenge will be to also reach people unknown to or outside the healthcare system. Access to online communities and recruitment through collaboration with peer recruiters will open these doors. Research on trans health also needs to apply specific ethical considerations. 25 26

Doing better

It is unacceptable to ignore the needs of the growing number of transgender and gender diverse people who wish to access gender services. This requires reorganisation of transgender care so that it is not only available in overloaded specialty services. We call on governments to invest more in training programmes for healthcare professionals, both as a structural component in the curriculum and in lifelong learning programmes. Research shows clearly that education increases confidence and competence, and well informed healthcare providers will lower many obstacles transgender and gender diverse people experience in accessing care. Putting care into the mainstream is the only way to cope with the increases in demand we witness, and to decrease self-medication and the terrible effects that long waiting lists have on the mental health of transgender and gender diverse people.

At the same time, more long term follow-up research is needed. Studies have often excluded participants who had started hormone treatment before their first visit. This is no longer tenable given the high percentage of new patients who already self-administer hormones. The inclusion and exclusion criteria for (expensive) endocrine research have been strict. Including people who self-administer would be a leap forward in breaking down these research walls, by including a broader spectrum of people taking gender affirming hormonal therapy and thus creating larger databases. Comparing their data on first encounter to those of study participants with similar duration of prescribed hormone treatment within a provided context (such as the European Network for the Investigation of Gender Incongruence 27 ) will elucidate differences in safety and effectiveness. Psychosocial variables must also be included in this type of research.

The need for more education and more research puts an important responsibility on educational committees and research funding agencies to push this long ignored field forward.

Biographies

Guy T’Sjoen is a clinical researcher and principal investigator for the endocrine part of the multicenter ENIGI (European Network for the Investigation of Gender Incongruence) study. He is as past-president of EPATH their representative at the WPATH board (European and World Professional Associations for Transgender Health).

Joz Motmans is the president of EPATH and the coordinator of the Transgender Infopunt, the Flemish expertise centre on transgender topics.

Competing interests:We have read and understood BMJ policy on declaration of interests and declare the following interests: GT has received scientific grants from Ipsen, Bayer Shering and Sandoz. He is associate editor for the International Journal of Transgender Health and the Journal of Sexual Medicine .

Provenance and peer review: Commissioned; externally peer reviewed.

This article is part of a series proposed by the UNDP/UNFPA/Unicef/WHO/World Bank Special Programme for Human Reproduction (HRP) and commissioned by The BMJ. The BMJ retained full editorial control over external peer review, editing, and publication of these articles. Open access fees are funded by HRP.

This is an Open Access article distributed under the terms of the Creative Commons Attribution IGO License (https://creativecommons.org/licenses/by-nc/3.0/igo/), which permits use, distribution, and reproduction for non-commercial purposes in any medium, provided the original work is properly cited.

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Guest Essay

Who Should Be Allowed to Transition?

By Alex Marzano-Lesnevich

Mx. Marzano-Lesnevich writes extensively on transgender issues and is the author of a forthcoming memoir about nonbinary identities.

Two and a half years ago, I sat in a medical waiting room nervously rehearsing my reason for seeing the nurse practitioner. The words I needed to say to her — that I was transgender and wanted her help medically transitioning — I had once promised myself not to say to anyone. I thought I’d keep this part of my identity my deepest secret, one I’d known since childhood but would never reveal.

Back then, I wouldn’t have even known how to reveal it, what words to use — I only sensed that I wasn’t the girl everyone assumed me to be and that I wasn’t quite a boy like my twin brother, either. I had vivid dreams in which I could change the shape of my body, dreams from which I woke up heartbroken. I didn’t know how to articulate who I was or imagine a world in which others could truly see me. I only knew who I wasn’t .

As the decades went by, I found language that helped me articulate my nonbinary identity, language that led me to a community. I became more secure, more certain, more comfortable. I noticed a pattern: The more out I was, the more openly myself and recognized as such, the happier I became. I started to believe that a different life might be possible, one in which my body and my experience in the world more closely aligned with my self-knowledge. I decided I wanted to begin hormone replacement therapy, or HRT, which is how I had come to be in that waiting room, whose taupe walls were lined with photographs of the medical providers, smiling with stethoscopes slung around their necks.

Recently, conservative politicians have whipped up fears that doctors are agreeing too readily to treat people, particularly young people, for gender dysphoria. On Feb. 21, Attorney General Ken Paxton of Texas released a formal opinion declaring that under state law, gender-affirming medical care for transgender children — including nonpermanent options like puberty blockers — is considered child abuse. The next day, Gov. Greg Abbott issued a letter calling on teachers, doctors and other professionals to report parents who provide their transgender children with gender-affirming care. One investigation has already begun. Hundreds of new bills introduced nationally in the past few years seek to criminalize care for transgender children, and based on a January report by the Human Rights Campaign, hundreds more appear to be coming.

How best to support transgender kids is an important question, but there is no good evidence that they are being rushed into treatment. In fact, in many parts of the country, it is difficult even for adults to locate and get good care.

Where I lived in Maine made doing so possible. The clinic I chose operated under what’s known as the self-ID or informed consent model, which emphasizes trust in a trans person’s self-knowledge. Medical providers offer assistance and expertise, but they begin by listening. As a result, my own attestation that I was transgender turned out to be all I needed to get HRT. I was, to put it simply, believed.

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5 Powerful Essays Advocating for Gender Equality

Gender equality – which becomes reality when all genders are treated fairly and allowed equal opportunities –  is a complicated human rights issue for every country in the world. Recent statistics are sobering. According to the World Economic Forum, it will take 108 years to achieve gender parity . The biggest gaps are found in political empowerment and economics. Also, there are currently just six countries that give women and men equal legal work rights. Generally, women are only given ¾ of the rights given to men. To learn more about how gender equality is measured, how it affects both women and men, and what can be done, here are five essays making a fair point.

Take a free course on Gender Equality offered by top universities!

“Countries With Less Gender Equity Have More Women In STEM — Huh?” – Adam Mastroianni and Dakota McCoy

This essay from two Harvard PhD candidates (Mastroianni in psychology and McCoy in biology) takes a closer look at a recent study that showed that in countries with lower gender equity, more women are in STEM. The study’s researchers suggested that this is because women are actually especially interested in STEM fields, and because they are given more choice in Western countries, they go with different careers. Mastroianni and McCoy disagree.

They argue the research actually shows that cultural attitudes and discrimination are impacting women’s interests, and that bias and discrimination is present even in countries with better gender equality. The problem may lie in the Gender Gap Index (GGI), which tracks factors like wage disparity and government representation. To learn why there’s more women in STEM from countries with less gender equality, a more nuanced and complex approach is needed.

“Men’s health is better, too, in countries with more gender equality” – Liz Plank

When it comes to discussions about gender equality, it isn’t uncommon for someone in the room to say, “What about the men?” Achieving gender equality has been difficult because of the underlying belief that giving women more rights and freedom somehow takes rights away from men. The reality, however, is that gender equality is good for everyone. In Liz Plank’s essay, which is an adaption from her book For the Love of Men: A Vision for Mindful Masculinity, she explores how in Iceland, the #1 ranked country for gender equality, men live longer. Plank lays out the research for why this is, revealing that men who hold “traditional” ideas about masculinity are more likely to die by suicide and suffer worse health. Anxiety about being the only financial provider plays a big role in this, so in countries where women are allowed education and equal earning power, men don’t shoulder the burden alone.

Liz Plank is an author and award-winning journalist with Vox, where she works as a senior producer and political correspondent. In 2015, Forbes named her one of their “30 Under 30” in the Media category. She’s focused on feminist issues throughout her career.

“China’s #MeToo Moment” –  Jiayang Fan

Some of the most visible examples of gender inequality and discrimination comes from “Me Too” stories. Women are coming forward in huge numbers relating how they’ve been harassed and abused by men who have power over them. Most of the time, established systems protect these men from accountability. In this article from Jiayang Fan, a New Yorker staff writer, we get a look at what’s happening in China.

The essay opens with a story from a PhD student inspired by the United States’ Me Too movement to open up about her experience with an academic adviser. Her story led to more accusations against the adviser, and he was eventually dismissed. This is a rare victory, because as Fan says, China employs a more rigid system of patriarchy and hierarchy. There aren’t clear definitions or laws surrounding sexual harassment. Activists are charting unfamiliar territory, which this essay explores.

“Men built this system. No wonder gender equality remains as far off as ever.” – Ellie Mae O’Hagan

Freelance journalist Ellie Mae O’Hagan (whose book The New Normal is scheduled for a May 2020 release) is discouraged that gender equality is so many years away. She argues that it’s because the global system of power at its core is broken.  Even when women are in power, which is proportionally rare on a global scale, they deal with a system built by the patriarchy. O’Hagan’s essay lays out ideas for how to fix what’s fundamentally flawed, so gender equality can become a reality.

Ideas include investing in welfare; reducing gender-based violence (which is mostly men committing violence against women); and strengthening trade unions and improving work conditions. With a system that’s not designed to put women down, the world can finally achieve gender equality.

“Invisibility of Race in Gender Pay Gap Discussions” – Bonnie Chu

The gender pay gap has been a pressing issue for many years in the United States, but most discussions miss the factor of race. In this concise essay, Senior Contributor Bonnie Chu examines the reality, writing that within the gender pay gap, there’s other gaps when it comes to black, Native American, and Latina women. Asian-American women, on the other hand, are paid 85 cents for every dollar. This data is extremely important and should be present in discussions about the gender pay gap. It reminds us that when it comes to gender equality, there’s other factors at play, like racism.

Bonnie Chu is a gender equality advocate and a Forbes 30 Under 30 social entrepreneur. She’s the founder and CEO of Lensational, which empowers women through photography, and the Managing Director of The Social Investment Consultancy.

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About the author, emmaline soken-huberty.

Emmaline Soken-Huberty is a freelance writer based in Portland, Oregon. She started to become interested in human rights while attending college, eventually getting a concentration in human rights and humanitarianism. LGBTQ+ rights, women’s rights, and climate change are of special concern to her. In her spare time, she can be found reading or enjoying Oregon’s natural beauty with her husband and dog.

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