LGBTQ people express a broad array of sexual and gender minority identities. The alternative umbrella gender, sexual, and romantic minorities is sometimes used for this group.
Groups that blend into the larger LGBTQ population include:
LGBTQ culture varies widely by geography and the identity
of the participants. Elements common to cultures of gay, lesbian,
bisexual, transgender, and intersex people include:
LGBTQ-owned businesses, particularly those that cater specifically to the LGBTQ community
Not all LGBTQ people identify with LGBTQ culture; this may
be due to geographic distance, unawareness of the subculture's
existence, fear of social stigma or a preference for remaining unidentified with sexuality- or gender-based subcultures or communities. The Queercore and Gay Shame movements critique what they see as the commercialization and self-imposed "ghettoization" of LGBTQ culture.
The history of LGBTQ people dates back to the first
recorded instances of same-sex love and diverse gender identities and
sexualities in cultures around the world. In many cultures this history
has involved marginalization and persecution, such that these histories
have only in recent decades been pursued and interwoven into more
mainstream historical narratives.
In 1994, the annual observance of LGBT History Month
began in the United States, and it has since been picked up in other
countries. This observance involves highlighting the history of the
people, LGBTQ rights and related civil rights movements. It is observed during October in the United States, to include National Coming Out Day on October 11. In the United Kingdom it has been observed during February since 2005: Section 28,
which had prohibited local authorities from "promoting" homosexuality
was repealed in England and Wales in 2003, while the same legislation
(named Section 2a in the Scottish legislation) was repealed by the Scottish parliament in 2000.A celebrated achievement in LGBTQ history occurred when Queen Beatrix signed a law making Netherlands the first country to legalize same-sex marriage in 2001, and another when Ireland became the first country to legalise same-sex marriage by popular vote in 2015.
Opposition to LGBTQ rights
exists worldwide. While laws are "a necessary foundation to achieve
equality ... protections under the law are not sufficient to eliminate
prejudice", and "social equality is not synonymous with equality under
the law", according to Ilan Meyer. According to a study by the European Parliament's
internal policy body in 2012: "To resolve the vast majority of problems
faced by LGBTI people, individuals, society, organisations and
authorities must stop regarding their differences as factors which
require differential treatment. While this seems self evident, such
shifts in attitude cannot be achieved through one-off, short term
action, nor through legislation alone. ... in some areas a change of
views of some groups may simply not be possible."
Research on LGBTQ responses to discrimination has
highlighted both individual and collective forms of resilience. It has
been suggested that resilience should be treated as a core component of
how stigma affects sexual and gender minority health, and distinguished
between individual resilience (i.e., personal coping resources) and
community resilience (i.e., group-level resources such as supportive
institutions, role models, and shared identity), suggesting that the
latter is particularly significant because the source of minority stress
is itself collective in nature. A longitudinal study of 3,627 LGBTQ+ adults sampled across five waves
between 2017 and 2025 documented one such collective response, which the
authors termed identity vigilance: as perceptions of the possibility of
progressive social change declined, group identification, group-based self-definition and satisfaction, collective efficacy,
and the desire to preserve identity-related spaces and symbols all
increased significantly, and stronger identification buffered
respondents against the negative emotional consequences of perceived
social decline. Other scholars have urged caution about resilience as an analytic
frame, arguing that it can place the burden of navigating oppression on
individuals while leaving the institutions that produce discrimination
unchallenged.
LGBTQ movements are social movements
that advocate for the inclusion, recognition, and rights of LGBTQ
people. These movements work to secure legal rights, or enact broader
social changes aimed at advancing equality and inclusion. In addition, LGBTQ movements and communities work to advance LGBTQ culture.
LGBTQ people may face disparities in access to care,
targeted public health interventions, and the impact of stigma on
physical and mental well-being. The psychology of LGBTQ people covers aspects such as identity development including the coming out process, parenting and family practices and support for LGBTQ individuals.
A transgender (often shortened to trans) person has a gender identity different from that typically associated with the sex they were assigned at birth. The opposite of transgender is cisgender, which describes persons whose gender identity matches their assigned sex. Transgender does not have a universally accepted definition, including among researchers; it can function as an umbrella term. The definition given above includes binary trans men and trans women and may also include people who are non-binary or genderqueer.
Being transgender is distinct from sexual orientation, and transgender people may identify as heterosexual (straight), homosexual (gay or lesbian), bisexual, asexual, or otherwise, or may decline to label their sexual orientation. Accurate statistics on the number of transgender people vary widely, in part due to different definitions of what constitutes being transgender. Some countries collect census data on transgender people. Canada was the first country to introduce collection of census data on its transgender and non-binary population in 2021. Generally, less than 1% of the worldwide population is transgender, with figures ranging from <0.1% to 0.6%.
A display on gender identity in the Elmer L. Andersen Library at the University of Minnesota in Minneapolis, Minnesota
Before the mid-20th century, various terms were used within
and beyond Western medical and psychological sciences to identify
persons and identities labeled transsexual, and later transgender from mid-century onward. Imported from the German and ultimately modeled after German Transsexualismus (coined in 1923), the English term transsexual has enjoyed international acceptability, though transgender has been increasingly preferred over transsexual. The word transgender acquired its modern umbrella term meaning in the 1990s.
Health-practitioner manuals, professional journalistic
style guides, and LGBTQ advocacy groups advise the adoption by others of
the name and pronouns identified by the person in question, including
present references to the transgender person's past.
Transgender
Although the term transgenderism was once considered acceptable, it has come to be viewed as pejorative, according to GLAAD. Psychiatrist John F. Oliven of Columbia University used the term transgenderism in his 1965 reference work Sexual Hygiene and Pathology, writing that the term which had previously been used, transsexualism, "is misleading; actually, transgenderism is meant, because sexuality is not a major factor in primary transvestism". The term transgender was then popularized with varying definitions by transgender, transsexual, and transvestite people, including Christine Jorgensen and Virginia Prince, who used transgenderal in the December 1969 issue of Transvestia, a national magazine for cross-dressers she founded. By the mid-1970s both trans-gender and trans people were in use as umbrella terms, while transgenderist and transgenderal were used to refer to people who wanted to live their lives as cross-gendered individuals without gender-affirming surgery. Transgenderist was sometimes abbreviated as TG in educational and community resources; this abbreviation developed by the 1980s. In 2020, the International Journal of Transgenderism changed its name to the International Journal of Transgender Health "to reflect a change toward more appropriate and acceptable use of language in our field."
By 1984, the concept of a "transgender community" had developed, in which transgender was used as an umbrella term. In 1985, Richard Ekins established the "Trans-Gender Archive" at the University of Ulster. By 1992, the International Conference on Transgender Law and Employment Policy defined transgender as an expansive umbrella term including "transsexuals, transgenderists, cross dressers", and anyone transitioning. Leslie Feinberg's pamphlet, "Transgender Liberation: A Movement Whose Time has Come", circulated in 1992, identified transgender as a term to unify all forms of gender nonconformity; in this way transgender has become synonymous with queer. In 1994, gender theorist Susan Stryker defined transgender
as encompassing "all identities or practices that cross over, cut
across, move between, or otherwise queer socially constructed sex/gender
boundaries", including, but not limited to, "transsexuality,
heterosexual transvestism, gay drag, butch lesbianism, and such non-European identities as the Native American berdache or the Indian Hijra".
Transgender can also refer specifically to a person whose gender identity is opposite (rather than different from) the sex the person had or was identified as having at birth. In contrast, people whose sense of personal identity corresponds to the
sex and gender assigned to them at birth – that is, those who are
neither transgender nor non-binary or genderqueer – are called cisgender.
Inspired by Magnus Hirschfeld's 1923 term seelischer Transsexualismus, the term transsexual was introduced to English in 1949 by David Oliver Cauldwell and popularized by Harry Benjamin in 1966, around the same time transgender was coined and began to be popularized. Since the 1990s, transsexual has generally been used to refer to the subset of transgender people who desire to transition permanently to the gender with which they
identify and who seek medical assistance (for example, sex reassignment
surgery) with this.
Distinctions between the terms transgender and transsexual are commonly based on distinctions between gender and sex. Transsexuality may be said to deal more with physical aspects of one's
sex, while transgender considerations deal more with one's psychological
gender disposition or predisposition, as well as the related social
expectations that may accompany a given gender role. Many transgender people reject the term transsexual. Christine Jorgensen publicly rejected transsexual in 1979 and instead identified herself in newsprint as trans-gender, saying, "gender doesn't have to do with bed partners, it has to do with identity." Some have objected to the term transsexual on the basis that it describes a condition related to gender identity rather than sexuality.Some people who identify as transsexual people object to being included in the transgender umbrella.
In his 2007 book Imagining Transgender: An Ethnography of a Category, anthropologist David Valentine asserts that transgender
was coined and used by activists to include many people who do not
necessarily identify with the term and states that people who do not
identify with the term transgender should not be included in the transgender spectrum. Leslie Feinberg likewise asserts that transgender is not a self-identifier (for some people) but a category imposed by observers to understand other people. According to the Transgender Health Program (THP) at Fenway Health
in Boston, there are no universally-accepted definitions, and confusion
is common because terms that were popular at the turn of the 21st
century may have since been deemed offensive. The THP recommends that
clinicians ask clients what terminology they prefer, and avoid the term transsexual unless they are sure that a client is comfortable with it.
Harry Benjamin invented a classification system for transsexuals and transvestites, called the Sex Orientation Scale
(SOS), in which he assigned transsexuals and transvestites to one of
six categories based on their reasons for cross-dressing and the
relative urgency of their need (if any) for sex reassignment surgery. Contemporary views on gender identity and classification differ markedly from Harry Benjamin's original opinions. Sexual orientation is no longer regarded as a criterion for diagnosis,
or for distinction between transsexuality, transvestism and other forms
of gender-variant behavior and expression. Benjamin's scale was designed
for use with heterosexual trans women, and trans men's identities do
not align with its categories.
Other terms
Transfeminine (commonly abbreviated to both transfem and transfemme)
refers to a person, binary or non-binary, who was assigned male at
birth and has a predominantly feminine gender identity or presentation.
Transmasculine (commonly abbreviated to transmasc)
refers to a person, binary or non-binary, who was assigned female at
birth and has a predominantly masculine gender identity or presentation.
Transgendered is a common term in older literature. Many within the transgender community deprecate it on the basis that transgender is an adjective, not a verb. Organizations such as GLAAD and The Guardian also state that transgender should never be used as a noun in English (e.g., "Max is transgender" or "Max is a transgender man", not "Max is a transgender").Transgender is also a noun for the broader topic of transgender identity and experience.
Assigned Female At Birth (AFAB), Assigned Male At Birth (AMAB), Designated Female At Birth (DFAB), and Designated Male At Birth (DMAB)
are terms used to represent a person's sex assigned at birth; they are
considered to be more gender-inclusive than the related terms biological male or biological female.
The term trans* (with an asterisk) emerged in the 1990s as an inclusive term used to encompass a wide range of non-cisgender identities. First used in 1995 on an online Usenet
forum, it entered common use in the early 21st century within activist,
academic, and online communities. It was originally used to explicitly
include both transgender and transsexual, but in modern use it is usually used as a more inclusive version of "trans", explicitly including identities such as genderqueer, agender, and genderfluid. The asterisk represents a wildcard, indicating the inclusion of various identities, beyond just transgender and transsexual, such as gender-fluid or agender, within the transgender umbrella. The use of the asterisk in trans*
has been debated; some argue that it adds unnecessary complexity, while
others say that it enhances inclusivity by explicitly recognizing
non-normative gender identities. The term is incompatible with many common search engines such as Google because the "*" is interpreted as a wildcard character, yielding results with the "trans-" prefix instead of the literal trans*.
Shift in use of terms
Between the mid-1990s and the early 2000s, the primary
terms used under the transgender umbrella were "female to male" (FtM)
for men who transitioned from female to male, and "male to female" (MtF)
for women who transitioned from male to female. These terms have been
superseded by "trans man" and "trans woman",
respectively. This shift in preference from terms highlighting
biological sex ("transsexual", "FtM") to terms highlighting gender
identity and expression ("transgender", "trans man") reflects a broader
shift in the understanding of transgender people's sense of self and the
increasing recognition of those who decline medical reassignment as
part of the transgender community.
In place of transgenderism, terms such as transness, transgenderness, or transidentity, have been suggested, corresponding to their cisgender counterparts, such as cisness, cisgenderness and cisidentity.
Gender, gender identity, and being transgender are distinct concepts from sexual orientation. Sexual orientation is an individual's enduring pattern of attraction, or lack thereof, to others (being straight, lesbian, gay, bisexual, asexual,
etc.), whereas gender identity is a person's innate knowledge of their
own gender (being a man, woman, non-binary, etc.). Transgender people
can have any orientation, and generally use labels corresponding to
their gender, rather than assigned sex at birth. For example, trans
women who are exclusively attracted to other women commonly identify as
lesbians, and trans men exclusively attracted to women would identify as
straight. Many trans people describe their sexual orientation as queer, in addition to or instead of, other terms.
For much of the 20th century, transgender identity was conflated with homosexuality and transvestism. In earlier academic literature, sexologists used the labels homosexual and heterosexual transsexual to categorize transgender individuals' sexual orientation based on their birth sex. Critics consider these terms "heterosexist", "archaic", and demeaning. Newer literature often uses terms such as attracted to men (androphilic), attracted to women (gynephilic), attracted to both (bisexual), or attracted to neither (asexual) to describe a person's sexual orientation without reference to their gender identity. Therapists are coming to understand the necessity of using terms with
respect to their clients' gender identities and preferences.
The 2015 U.S. Transgender Survey reported that of the 27,715 transgender and non-binary respondents, 21% said queer best described their sexual orientation, 18% said pansexual, 16% said gay, lesbian, or same-gender-loving, 15% said straight, 14% said bisexual, and 10% said asexual. A 2019 Canadian survey of 2,873 trans and non-binary people found that
51% described their sexual orientation as queer, 13% as asexual, 28% as
bisexual, 13% as gay, 15% as lesbian, 31% as pansexual, 8% as straight
or heterosexual, 4% as two-spirit, and 9% as unsure or questioning. A 2009 study in Spain found that 90% of trans women patients reported
being androphilic and 94% of trans men patients reported being
gynephilic.
Some non-binary (or genderqueer) people identify as
transgender. These identities are not specifically male or female. They
can be agender, androgynous, bigender, pangender, or genderfluid, and exist outside of cisnormativity. Bigender and androgynous are overlapping categories; bigender
individuals may identify as moving between male and female roles
(genderfluid) or as being both masculine and feminine simultaneously
(androgynous), and androgynes may similarly identify as beyond gender or
genderless (agender), between genders (intergender), moving across
genders (genderfluid), or simultaneously exhibiting multiple genders (pangender). Non-binary gender identities are independent of sexual orientation.
A transvestite is a person who cross-dresses, or dresses
in clothes typically associated with the gender opposite the one they
were assigned at birth. The term transvestite is used as a synonym for the term cross-dresser, although cross-dresser is generally considered the preferred term. The term cross-dresser
is not exactly defined in the relevant literature. Michael A. Gilbert,
professor at the Department of Philosophy, York University, Toronto,
offers this definition: "[A cross-dresser] is a person who has an
apparent gender identification with one sex, and who has and certainly
has been birth-designated as belonging to [that] sex, but who wears the
clothing of the opposite sex because it is that of the opposite sex." This definition excludes people "who wear opposite sex clothing for other reasons", such as "those female impersonators
who look upon dressing as solely connected to their livelihood, actors
undertaking roles, individual males and females enjoying a masquerade,
and so on. These individuals are cross dressing but are not cross
dressers." Cross-dressers may not identify with, want to be, or adopt the
behaviors or practices of the opposite gender and generally do not want
to change their bodies medically or surgically. The majority of
cross-dressers identify as heterosexual.
The term transvestite and the associated outdated term transvestism are conceptually different from the term transvestic fetishism, as transvestic fetishist refers to those who intermittently use clothing of the opposite gender for fetishistic purposes.In medical terms, transvestic fetishism is differentiated from cross-dressing by use of the separate codes 302.3 in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and F65.1 in the ICD.
A drag queen performer. Drag performers are not inherently transgender.
Drag is clothing and makeup worn on special occasions for
performing or entertaining, unlike those who are transgender or who
cross-dress for other reasons. Drag performance includes overall presentation and behavior in addition
to clothing and makeup. Drag can be theatrical, comedic, or grotesque.
Drag queens have been considered caricatures of women by second-wave feminism. Drag artists have a long tradition in LGBTQ culture.
Generally the term drag queen covers men doing female drag, drag king covers women doing male drag, and faux queen covers women doing female drag. Nevertheless, there are drag artists of all genders and sexualities who
perform for various reasons. Drag performers are not inherently
considered transgender. However, for some trans people, drag communities
have been "a safe and fun arena for exploring gender identity". Some drag performers such as Carmen Carerra have later come out as transgender. Drag historian Devin Antheus stated there were overlaps in the past,
such as in the 1960s and 1970s: "for a lot of the girls, both queens who
currently now identify as trans and those who don't, back in the day,
there weren't such precise divisions when people were in internal spaces
… they all rolled together."
Some drag performers, transvestites, and people in the gay community have embraced the pornographically derived term tranny for drag queens or people who engage in transvestism or cross-dressing; this term is widely considered an offensive slur if applied to transgender people.
A precise history of the global occurrence of transgender
people is difficult to assess because the modern concept of being
transgender, and of gender in general in relation to transgender
identity, did not develop until the mid-1900s. Historical depictions,
records and understandings are inherently filtered through modern
principles, and were largely viewed through a medical and (often
outsider) anthropological lens until the late 1900s.
Some historians consider the Roman emperor Elagabalus
to have been transgender. Elagabalus was reported to have dressed in a
feminine manner, preferred to be called "Lady" instead of "Lord" and may
have even sought a primitive form of gender-affirming surgery.
Worldwide, a number of societies have had traditional third gender roles, some of which continue in some form into the present day. The Hippocratic Corpus (interpreting the writing of Herodotus) describes the "disease of the Scythians" (regarding the Enaree),
which it attributes to impotency due to riding on a horse without
stirrups. This reference was well discussed by medical writings of the
1500s–1700s. Pierre Petit
writing in 1596 viewed the "Scythian disease" as natural variation, but
by the 1700s writers viewed it as a "melancholy", or "hysterical"
psychiatric disease. By the early 1800s, being transgender separate from
Hippocrates' idea of it was claimed to be widely known, but remained
poorly documented. Both trans women and trans men were cited in European
insane asylums of the early 1800s. One of the earliest recorded gender
nonconforming people in America was Thomas(ine) Hall, a seventeenth century colonial servant. The most complete account of the time came from the life of the Chevalière d'Éon (1728–1810),
a French diplomat. As cross-dressing became more widespread in the late
1800s, discussion of transgender people increased greatly and writers
attempted to explain the origins of being transgender. Much study came
out of Germany, and was exported to other Western audiences.
Cross-dressing was seen in a pragmatic light until the late 1800s; it
had previously served a satirical or disguising purpose. But in the
latter half of the 1800s, cross-dressing and being transgender became
viewed as an increasing societal danger.
William A. Hammond wrote an 1882 account of transgender Pueblo "shamans"[sic] (mujerados), comparing them to the Scythian disease. Other writers of the late 1700s and 1800s (including Hammond's associates in the American Neurological Association)
had noted the widespread nature of transgender cultural practices among
native peoples. Explanations varied, but authors generally did not
ascribe native transgender practices to psychiatric causes, instead
condemning the practices in a religious and moral sense. Native groups
provided much study on the subject, and perhaps the majority of all
study until after WWII.
Critical studies first began to emerge in the late 1800s
in Germany, with the works of Magnus Hirschfeld. Hirschfeld coined the
term "Transvestit" in 1910, borrowed from 19th-century French word travesti with the same meaning, as the scope of transgender study grew, and it was translated to
English as "transvestite". His work would lead to the 1919 founding of
the Institut für Sexualwissenschaft
in Berlin. Though Hirscheld's legacy is disputed, he revolutionized the
field of study. The Institut was destroyed when the Nazis seized power
in 1933, and its research was infamously burned in the May 1933 Nazi
book burnings. Transgender issues went largely out of the public eye until after World War II. Even when they re-emerged, they reflected a forensic psychology approach, unlike the more sexological that had been employed in the lost German research.
1879 photograph of Edward de Lacy Evans, upon his admittance into Kew Lunatic Asylum. Evans identified as a man for the majority of his life, later becoming known in Melbourne as the "Wonderful Male Impersonator".
Mental healthcare
People who experience discord between their gender and the
expectations of others or whose gender identity conflicts with their
body may benefit by talking through their feelings in depth. While
individuals may find counseling or psychotherapy helpful, it is no
longer recommended as a prerequisite for further transition steps. Research on gender identity with regard to psychology, and scientific
understanding of the phenomenon and its related issues has existed for
decades. The term gender incongruence is listed in the ICD by the WHO. In the American Diagnostic and Statistical Manual of Mental Disorders (DSM), the term gender dysphoria is listed under code F64.0 for adolescents and adults, and F64.2 for children. (Further information: Causes of gender incongruence.)
France removed gender identity disorder as a diagnosis by decree in 2010, but according to French trans rights organizations, beyond the impact of the announcement itself, nothing changed. In 2017, the Danish parliament abolished the F64 Gender identity disorders. The DSM-5 refers to the topic as gender dysphoria (GD) while reinforcing the idea that being transgender is not considered a mental illness.
Transgender people may meet the criteria for a diagnosis
of gender dysphoria "only if [being transgender] causes distress or
disability." This distress may manifest as depression or inability to work and form
healthy relationships with others. This diagnosis is often
misinterpreted as implying that all transgender people suffer from GD,
which has confused transgender people and those who seek to either
criticize or affirm them. Transgender people who are comfortable with
their gender and whose gender is not directly causing inner frustration
or impairing their functioning do not suffer from GD. Moreover, GD is
not necessarily permanent and is often resolved through therapy or
transitioning. Feeling oppressed by the negative attitudes and
behaviours of such others as legal entities does not indicate GD. GD
does not imply an opinion of immorality; the psychological establishment
holds that people with any kind of mental or emotional problem should
not receive stigma. The solution for GD is whatever will alleviate
suffering and restore functionality; this solution often, but not
always, consists of undergoing a gender transition.
Clinical training lacks relevant information needed in
order to adequately help transgender clients, which results in a large
number of practitioners who are not prepared to sufficiently work with
this population of individuals. Many mental healthcare providers know little about transgender issues.
Those who seek help from these professionals often educate the
professional without receiving help. This solution usually is good for transsexual people but is not the
solution for other transgender people, particularly non-binary people
who lack an exclusively male or female identity. Instead, therapists can
support their clients in whatever steps they choose to take to
transition or can support their decision not to transition while also
addressing their clients' sense of congruence between gender identity
and appearance.
Research on the specific problems faced by the transgender
community in mental health has focused on diagnosis and clinicians'
experiences instead of transgender clients' experiences. Therapy was not always sought by transgender people due to mental health needs. Prior to the seventh version of the Standards of Care
(SOC), an individual had to be diagnosed with gender identity disorder
in order to proceed with hormone treatments or sexual reassignment
surgery. The new version decreased the focus on diagnosis and instead
emphasized the importance of flexibility in order to meet the diverse
health care needs of transsexual, transgender, and all
gender-nonconforming people.
The reasons for seeking mental health services vary
according to the individual. A transgender person seeking treatment does
not necessarily mean their gender identity is problematic. The
emotional strain of dealing with stigma and experiencing transphobia
pushes many transgender people to seek treatment to improve their
quality of life. As one trans woman reflected, "Transgendered
individuals are going to come to a therapist and most of their issues
have nothing to do, specifically, with being transgendered. It has to do
because they've had to hide, they've had to lie, and they've felt all
of this guilt and shame, unfortunately usually for years!" Many transgender people also seek mental health treatment for
depression and anxiety caused by the stigma attached to being
transgender, and some transgender people have stressed the importance of
acknowledging their gender identity with a therapist in order to
discuss other quality-of-life issues. Rarely, some choose to detransition.
Problems still remain surrounding misinformation about
transgender issues that hurt transgender people's mental health
experiences. One trans man who was enrolled as a student in a psychology
graduate program highlighted the main concerns with modern clinical
training: "Most people probably are familiar with the term transgender,
but maybe that's it. I don't think I've had any formal training just
going through [clinical] programs... I don't think most [therapists] know. Most therapists–Master's degree, PhD level–they've had...
one diversity class on GLBT issues. One class out of the huge diversity
training. One class. And it was probably mostly about gay lifestyle." Many health insurance policies do not cover treatment associated with
gender transition, and numerous people are under- or uninsured, which
raises concerns about the insufficient training most therapists receive
prior to working with transgender clients, potentially increasing
financial strain on clients without providing the treatment they need. Many clinicians who work with transgender clients only receive mediocre
training on gender identity, but introductory training on interacting
with transgender people has recently been made available to health care
professionals to help remove barriers and increase the level of service
for the transgender population. In May 2009, France became the first country in the world to remove transgender identity from the list of mental diseases.
A 2014 study carried out by the Williams Institute (a UCLA
think tank) found that 41% of transgender people had attempted suicide,
with the rate being higher among people who experienced discrimination
in access to housing or healthcare, harassment, physical or sexual
assault, or rejection by family. A 2019 follow-up study found that transgender people who wanted and
received gender-affirming medical care had significantly lower rates of
suicidal thoughts and attempts. Another study on the impact of parental support on trans youth found
that among trans children with supportive parents, only 4% attempted
suicide, a 93% decrease.
Suicidal thoughts and attempts by gender affirmation milestones
Intervention Category
Suicidal Thoughts (Past 12 Months)
Suicidal Attempts (Past 12 Months)
Lifetime Suicidal Thoughts
Lifetime Suicidal Attempts
Want hormones and have not had them
57.9
8.9
84.4
41.1
Want hormones and have had them
42.9
6.5
81.9
42.4
Want reassignment surgery, have not had
54.8
8.5
83.9
41.5
Want reassignment surgery, have had
38.2
5.1
79.0
39.5
Have not "de-transitioned"
44.2
6.7
81.6
41.8
Have "de-transitioned"
57.3
11.8
86.0
52.5
Autism is more common in people who are gender dysphoric.
It is not known whether there is a biological basis. This may be due to
the fact that people on the autism spectrum are less concerned with
societal disapproval, and feel less fear or inhibition about coming out
as trans than others.
Physical healthcare
Medical and surgical procedures exist for transsexual and
some transgender people, though most categories of transgender people as
described above are not known for seeking the following treatments. Hormone replacement therapy for trans men induces beard growth and masculinizes skin, hair, voice, and fat distribution. Hormone replacement therapy for trans women feminizes fat distribution and breasts, as well as diminishes muscle mass and strength. Laser hair removal or electrolysis removes excess hair for trans women. Surgical procedures for trans women feminize the voice, skin, face, Adam's apple, breasts, waist, buttocks, and genitals. Surgical procedures for trans men masculinize the chest and genitals and remove the womb, ovaries, and fallopian tubes. The acronyms "Gender-affirming surgery (GAS)"
and "sex reassignment surgery" (SRS) refer to genital surgery. The term
"sex reassignment therapy" (SRT) is used as an umbrella term for
physical procedures required for transition. Use of the term "sex
change" has been criticized for its emphasis on surgery, and the term
"transition" is preferred. Availability of these procedures depends on degree of gender dysphoria, presence or absence of gender identity disorder, and standards of care in the relevant jurisdiction.
Health risks among transgender people largely align with
those of cisgender people with the same hormonal makeup, and the same
routine cancer screenings are generally recommended as for cisgender
people with the same organs. It has been suggested that trans men who have not had a hysterectomy and who take testosterone may be at increased risk for endometrial cancer
due to the presence of external estrogen, but this theoretical risk has
not been proven in a clinical setting, and providers do not recommend
any additional preventive measures or routine screening.
Detransition refers to the cessation or reversal of a sex
reassignment surgery or gender transition. Formal studies of
detransition have been few in number, of disputed quality, and politically controversial. Estimates of the rate at which detransitioning occurs vary from less than 1% to as high as 13%. Those who undergo sex reassignment surgery have very low rates of detransition or regret.
The 2015 U.S. Transgender Survey, with responses from
27,715 individuals who identified as "transgender, trans, genderqueer,
[or] non-binary", found that 8% of respondents reported some kind of
detransition. "Most of those who de-transitioned did so only
temporarily: 62% of those who had de-transitioned reported that they
were currently living full time in a gender different than the gender
they were thought to be at birth." Detransition was associated with assigned male sex at birth, non-binary
gender identity, and bisexual orientation, among other cohorts. Only 5% of detransitioners (or 0.4% of total respondents) reported
doing so because gender transition was "not for them"; 82% cited
external reason(s), including pressure from others, the difficulties of
transition, and discrimination. "The most common reason cited for
de-transitioning was pressure from a parent (36%)."
Camille Cabral, a French transgender activist, at a Paris demonstration for transgender people in 2005
Legal procedures exist in some jurisdictions which allow
individuals to change their legal gender or name to reflect their gender
identity. Requirements for these procedures vary from an explicit
formal diagnosis of transsexualism,
to a diagnosis of gender identity disorder, to a letter from a
physician that attests the individual's gender transition or having
established a different gender role. In 1994, the DSM IV entry was changed from "Transsexual" to "Gender
Identity Disorder". In 2013, the DSM V removed "Gender Identity
Disorder" and published "Gender Dysphoria" in its place. In many places, transgender people are not legally protected from discrimination in the workplace or in public accommodations. A report released in February 2011 found that 90% of transgender
Americans faced discrimination at work and were unemployed at double the
rate of the general population, and over half had been harassed or
turned away when attempting to access public services. Members of the transgender community also encounter high levels of discrimination in health care.
As of 2017, 36 countries in Europe require a mental health diagnosis for legal gender recognition and 20 countries require sterilisation. In April 2017, the European Court of Human Rights ruled that requiring
sterilisation for legal gender recognition violates human rights.
Jurisdiction over legal classification of sex in Canada is
assigned to the provinces and territories. This includes legal change
of gender classification. On June 19, 2017, Bill C-16, having passed the legislative process in the House of Commons of Canada and the Senate of Canada, became law upon receiving Royal Assent, which put it into immediate force. The law updated the Canadian Human Rights Act and the Criminal Code to include "gender identity and gender expression" as protected grounds from discrimination, hate publications and advocating transgender genocide.
The bill also added "gender identity and expression" to the list of
aggravating factors in sentencing, where the accused commits a criminal
offence against an individual because of those personal characteristics.
Similar transgender laws also exist in all the provinces and
territories.
In the United States, transgender people are protected from employment discrimination by Title VII of the Civil Rights Act of 1964.
Exceptions apply to certain types of employers, for example, employers
with fewer than 15 employees and religious organizations. In 2020, the U.S. Supreme Court affirmed that Title VII prohibits discrimination against transgender people in the case R.G. & G.R. Harris Funeral Homes Inc. v. Equal Employment Opportunity Commission.
In 2016, the United States Department of Education and Department of Justice issued guidance directing public schools to allow transgender students to use bathrooms that match their gender identities. The same year, the United States Department of Defense removed the ban that prohibited transgender people from openly serving in the US military. After back-and-forth reversals by presidents Donald Trump, Joe Biden, and Trump again, and various stays and reversals in the federal courts, a ban is again in effect as of May2025.
The topic of trans rights in the United States has often been contentious and has become a deeply partisan wedge issue in recent years; hundreds of pieces of legislation have been passed, and thousands
proposed, that seek to limit the rights of transgender individuals,
especially the right of minors to seek gender affirming care.
Compared with data from 2022, by 2025, Americans had
become more supportive of restrictions for trans people and less
supportive of laws aimed at protecting them. Public opinion polling
conducted by the Pew Research Center
showed that in 2025, 66% of Americans believed trans athletes should
only be allowed to compete on teams that match their sex assigned at
birth, while 56% of Americans believed that health care professionals
should be banned from providing gender transition care to minors. There
is a wide partisan gap in views of trans issues, with Republicans much
more likely than Democrats to support policies that limit trans rights.
In April 2014, the Supreme Court of India declared transgender to be a 'third gender' in Indian law. The transgender community in India (made up of Hijras and others) has a long history in India and in Hindu mythology. Justice KS Radhakrishnan
noted in his decision that, "Seldom, our society realizes or cares to
realize the trauma, agony and pain which the members of Transgender
community undergo, nor appreciates the innate feelings of the members of
the Transgender community, especially of those whose mind and body
disown their biological sex". Hijras have faced structural discrimination including not being able to
obtain driving licenses, and being prohibited from accessing various
social benefits. It is also common for them to be banished from
communities.
Despite the distinction between sexual orientation and
gender, throughout history gay, lesbian and bisexual subcultures were
often the only places where gender-variant people were socially accepted
in the gender role they felt they belonged to;
especially during the time when legal or medical transitioning was
almost impossible. This acceptance has had a complex history. Like the
wider world, the gay community
in Western societies did not generally distinguish between sex and
gender identity until the 1970s, and the role of the transgender
community in the history of LGBTQ rights is often overlooked.
Transgender individuals have been part of various LGBTQ
movements throughout history, with significant contributions dating back
to the early days of the gay liberation movement.
The LGBTQ community is not a monolithic group, and there
are different modes of thought on who is a part of this diverse
community. The changes that came with the Gay Liberation Movement and Civil Rights movement
saw many gay, lesbian, and bisexual people making headway within the
public sphere, and gaining support from the wider public, throughout the
latter half of the twentieth century. The trans community only
experienced a similar surge in activism during the start of the
twenty-first century. Due to the many different groups that make up the broader LGBTQ
movement, there are those within the larger community who do not believe
that the trans community has a place within the LGBTQ space.
Feminist views on transgender women have changed over
time, but have generally become more positive. Second-wave feminism saw
numerous clashes opposed to transgender women, since they were not seen
as "true" women, and as invading women-only spaces. Though second-wave feminism argued for the sex and gender distinction,
some feminists believed there was a conflict between transgender
identity and the feminist cause; e.g., they believed that male-to-female
transition abandoned or devalued female identity and that transgender
people embraced traditional gender roles and stereotypes. By the emergence of third-wave feminism (around 1990), opinions had shifted to being more inclusive of both trans and gay identities. Fourth-wave feminism
(starting around 2012) has been widely trans-inclusive, but
trans-exclusive groups and ideas remain as a minority, though one that
is especially prominent in the UK. Feminists who do not accept that trans women are women have been labeled "trans-exclusionary radical feminists" (TERFs) or gender-critical feminists by opponents.
Transgender individuals experience significant rates of
employment discrimination. According to a 2011 aggregation of several
studies, approximately 90% of transgender Americans had encountered some
form of harassment or mistreatment in their workplace. 47% had
experienced some form of adverse employment outcome due to being
transgender; of this figure, 44% were passed over for a job, 23% were
denied a promotion, and 26% were terminated on the grounds that they
were transgender.
Studies in several cultures have found that cisgender women are more likely to be accepting of trans people than cisgender men.
The start of the twenty-first century saw the rise in transgender activism and with it an increase in support. Within the United States, groups such as the Trevor Project
have been serving the wider LGBT community including people who
identify with the term transgender. The group offers support in the form
of educational resources including research, advocacy, and crisis
services. The American Civil Liberties Unions (ACLU) also often represents members of the trans community.
Other groups within the United States specifically
advocate for transgender rights. One of these groups directly related to
transgender support is the National Center for Transgender Equality
(NCTE), which is committed to advocating for policy changes that protect
transgender people and promote equality. Through their research,
education, and advocacy efforts, the NCTE works to address issues such
as healthcare access, employment discrimination, and legal recognition
for transgender individuals. One prominent organization within Europe is Transgender Europe (TGEU), a
network of organizations and individuals committed to promoting
equality and human rights for transgender people within European
borders. TGEU works to challenge discrimination, improve transgender
healthcare access, advocate for legal recognition of gender identity,
and support the well-being of transgender communities.
Little is known about the prevalence of transgender people
in the general population and reported prevalence estimates are greatly
affected by variable
definitions of transgender. According to a recent systematic review, an estimated 9.2 out of every
100,000 people have received or requested gender affirmation surgery or
transgender hormone therapy; 6.8 out of every 100,000 people have
received a transgender-specific diagnosis; and 355 out of every 100,000
people self-identify as transgender. These findings underscore the value of using consistent terminology
related to studying the experience of transgender, as studies that
explore surgical or hormonal gender affirmation therapy may or may not
be connected with others that follow a diagnosis of "transsexualism",
"gender identity disorder", or "gender dysphoria", none of which may
relate with those that assess self-reported identity. Common terminology across studies does not yet exist, so population
numbers may be inconsistent, depending on how they are being counted.
A study in 2020 found that, since 1990, of those seeking
sex hormone therapy for gender dysphoria there has been a steady
increase in the percentage of trans men, such that they equal the number
of trans women seeking this treatment.
In Thailand and Laos, the term kathoey is used to refer to male-to-female transgender people and effeminate gay men. However, many transgender people in Thailand do not identify as kathoey.
In the Philippines, the umbrella term Bakla
is commonly used but not solely for transgender women, it also includes
effeminate gay men and non-binary people. Transgender people are
becoming relatively visible and common in the post-colonial Philippines
due to a mix of pre-colonial history, colonial influence, language,
media, and social roles.
The cultures of the Indian subcontinent include a third gender, referred to as hijra in Hindi. In India, the Supreme Court
on April 15, 2014, recognized a third gender that is neither male nor
female, stating "Recognition of transgenders as a third gender is not a
social or medical issue but a human rights issue." In 1998, Shabnam Mausi became the first transgender person to be elected in India, in the central Indian state of Madhya Pradesh.
Europe
According to Amnesty International, 1.5million transgender people lived in the European Unionas of 2017, making up 0.3% of the population. A 2011 survey conducted by the Equality and Human Rights Commission
in the UK found that of 10,026 respondents, 1.4% would be classified
into a gender minority group. The survey also showed that 1% had gone
through any part of a gender reassignment process (including thoughts or
actions).
North America
The 2021 Canadian census released by Statistics Canada found that 59,460 Canadians (0.19% of the population) identified as transgender. According to the Survey of Safety in Public and Private Spaces by Statistics Canada in 2018, 0.24% of the Canadian population identified as transgender men, women or non-binary individuals.
In the United States, over 2.8 million persons identify as transgender, as of 2025. It's the case for 1% of adults (about 2.1 million persons) and 3.3% of youth (about 724,000 persons aged 13 to 17). Among adults, 32.7% (698,500) are transgender women, 34.2% (730,500) transgender men, and 33.1% (707,100) non-binary.
The Social Security Administration has tracked the sex of US citizens since 1936. A 1968 estimate, by Ira B. Pauly, estimated that about 2,500
transsexual people were living in the United States, with four times as
many trans women as trans men. One effort to quantify the modern population in 2011 gave a "rough estimate" that 0.3% of adults in the US are transgender. In 2016, studies estimated the proportion of Americans who identify as transgender at 0.5 to 0.6%.
In Latin American cultures, a travesti
is an individual who has been assigned male at birth and who has a
feminine, transfeminine, or "femme" gender identity. Travestis generally
undergo hormonal treatment, use female gender expression including new
names and pronouns from the masculine ones they were given when assigned
a sex, and might use breast implants, but they are not offered or do
not desire sex-reassignment surgery. Travesti might be regarded as a
gender in itself (a "third gender"), a mix between man and woman
("intergender/androgynes"), or the presence of both masculine and
feminine identities in a single person ("bigender"); they are framed as
something entirely separate from transgender women.
Other transgender identities are becoming more widely known, as a result of contact with other cultures of the Western world. These newer identities, sometimes known under the umbrella use of the term "genderqueer", along with the older travesti
term, are known as non-binary and go along with binary transgender
identities (those traditionally diagnosed under the obsolete label of
"transsexualism") under the single umbrella of transgender,
but are distinguished from cross-dressers and drag queens and kings,
that are held as nonconforming gender expressions rather than
transgender gender identities when a distinction is made.
Oceania
The 2021 Australian Census released by the Australian Bureau of Statistics
estimated that 178,900 Australians (0.9% of the population) aged 16
years and over reported a gender that is different to their sex recorded
at birth. They estimated that 67,100 people reported are trans men,
52,500 are trans women and 58,500 are non-binary people. People aged
16–24 years were more likely than any other age group to be trans and
gender diverse (1.8%).
On the 2023 New Zealand Census, 26,097 people self-identified as transgender, defined by Stats NZ
as someone whose gender identity does not match their sex recorded at
birth. This is 0.7 percent of all census-takers who were 15 years of age
and older and usually residents of the country.
Coming out is the process of sharing one's identity with others, and can include sharing new pronouns and a new name. Individuals who have come out are known as out. The experience of coming out can change depending on whether the
transgender individual is perceived as the gender with which they
identify, which is known as passing. In certain environments, some passing transgender individuals can choose to be stealth,
which means to deliberately avoid coming out, often to avoid
transphobia; these individuals are often out in other environments. The decision for transgender people to come out to current or potential
romantic or sexual partners can be especially difficult.
The decision to come out is based on navigating others'
gender expectations, reactions, and the threat of violence. Coming out
is not a 'one-and-done' decision; rather, individuals make ongoing
strategic decisions about their gender enactment and identity disclosure
based on social contexts.
The age at which transgender people come out can vary;
some transgender individuals will know about and share their identities
at a young age, while for others, the process is longer or more
complicated. Different transgender individuals choose to come out at different times during the transition process and to different people. Some transgender individuals will choose to come out as bisexual,
lesbian, or gay before recognizing their gender identity or choosing to
come out as transgender. Although there are some similarities, coming out as transgender is
different than coming out as a sexual minority, such as lesbian, gay, or
bisexual. This is partly due to the relatively lower level of information that
people have about transgender people compared to people who are sexual
minorities. Some come out in an online identity
first, providing an opportunity to go through experiences virtually and
safely before risking social implications in the real world.
It may take time for people to understand and respond when a transgender person comes out. Most transgender people feel healthier and happier when they come out and their gender identity is validated by others.
Some transgender people choose not to come out at all. For some, this decision can be because of stigma, lack of knowledge, or fear of rejection by friends and family. Upon coming out, transgender people can face discrimination, rejection, and violence. These risks are heightened when transgender individuals are members of other marginalized communities.
In 2014, the United States reached a "transgender tipping point", according to Time. At this time, the media visibility of transgender people reached a
level higher than seen before. Since then, the number of transgender
portrayals across TV platforms has stayed elevated. Annual marches, protests or gatherings take place around the world for
transgender issues, often taking place during the time of local Pride parades for LGBTQ people. These events are frequently organised by trans communities to build community, address human rights struggles, and create visibility. International Transgender Day of Visibility is an annual holiday occurring on March 31 dedicated to celebrating transgender people and raising awareness of
discrimination faced by transgender people worldwide. The holiday was
founded by Michigan-based transgender activist Rachel Crandall Crocker in 2009.
A 2017 trans march called "Existrans"
Transgender Day of Remembrance
(TDOR) is held every year on November 20 in honor of Rita Hester, who
was killed on November 28, 1998. Her murder remains unsolved, but was
described in 2022 as "a result of transphobia and anti-trans violence"
by the Office of the Mayor of Boston, Michelle Wu. TDOR memorializes victims of hate crimes and prejudice and raises
awareness of hate crimes committed upon living transgender people. Transgender Awareness Week
is a one-week celebration leading up to TDOR, dedicated to educating
about transgender and gender non-conforming people and the issues
associated with their transition or identity. Several trans marches
occur in cities around the world, including Paris, San Francisco, and
Toronto, in order to raise awareness of the transgender community. There are also significant portrayals of transgender people in the media. Transgender literature
includes literature portraying transgender people, as well as memoirs
or novels by transgender people, who often discuss elements of the
transgender experience. Several films and television shows feature transgender characters in the storyline, and several fictional works also have notable transgender characters.
A common symbol for the transgender community is the Transgender Pride Flag, which was designed by the American transgender woman Monica Helms in 1999, and was first shown at a pride parade in Phoenix, Arizona, in 2000. The flag consists of five horizontal stripes: light blue, pink, white, pink, and light blue. Other transgender symbols include the butterfly (symbolizing transformation or metamorphosis) and a pink/light blue yin and yang symbol. Several gender symbols have been used to represent transgender people, including U+26A5⚥MALE AND FEMALE SIGN and U+26A7⚧MALE WITH STROKE AND MALE AND FEMALE SIGN.
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