Unifying Concepts

Definition of Transgender Persons

Gender identity is the term used to describe a person’s sense of being male, female, neither, or some combination of both. The terms “transgender,” “transsexual,” “trans,” “gender nonbinary,” “gender incongruent,” and “genderqueer” are adjectives for persons with gender identities that are not aligned with the sex recorded at birth. “Cisgender” is the term for persons who are not transgender – that is, persons whose sex recorded at birth aligns with their gender identity.

Sex and gender
Umbrella terms used to reference biologic characteristics, gender identification, and stereotypical behaviors considered male, female, or variation thereof

Gender identity
Internal sense of being male or female or identifying with both or neither

Transgender, transsexual, trans, gender nonbinary, gender incongruent, genderqueer
Adjectives for persons with gender identity not aligned with sex recorded at birth

Cisgender, nontransgender
Adjectives for persons with gender identity aligned with sex recorded at birth

Gender expression
Ways in which a person communicates gender identity to others

Gender-affirming or gender-confirming hormone treatment and surgery
Medical and surgical interventions for transgender persons performed to align appearance with gender identity

Gender dysphoria
Mental health term that refers to discomfort felt by some persons owing
to lack of alignment between gender identity and sex recorded at birth

Sexual orientation
Term that characterizes pattern of romantic or sexual attraction to other
people, independent of gender identity

Term for conditions in which a person is born with reproductive or sexual anatomy that does not fit typical definitions of female or male. Also known as DSD (differences of sexual differentiation).

Principles of treatment
There are several criteria for the prescription of hormone therapy. These include persistent gender incongruence, capacity to make informed treatment decisions, and reasonable control of associated mental health conditions.



  1. Collin L, Reisner SL, Tangpricha V, Goodman M. Prevalence of Transgender Depends on the “Case” Definition: A Systematic Review. J Sex Med. 2016;13(4):613–626. [Medline]
  2. Safer JD, Tangpricha V. Care of Transgender Persons. N Engl J Med. 2019;381(25):2451–2460. [Medline]


Created Jan 03, 2020.

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