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Gender transition

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(Redirected fromGender transitioning)
"Gender change" redirects here. For sex change, seeSex change.
Street art that reads: "A Gender Transition is Divine — Protect Black Trans Life"
Street art that reads: "A gender transition is divine — Protect black trans life".
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Gender transitionis the process ofaffirmingandexpressingone'sinternal sense of gender,as opposed to the genderassigned to them at birth.There are two major facets of gender transitioning: a social transition, and a medical transition; almost all transgender people will socially transition, and most will undergo some degree of medical transition.

Asocial transitionmay entail coming out as transgender[a],using a new name and pronouns, and changing one's public gender expression.[1]This is usually the first step in a gender transition, and may occur at any age.[2][3]Socially transitioning does not involve medical intervention or gender affirming surgery, but it may be a prerequisite to access transgender healthcare in some regions.[4][5]

Amedical transition,on the other hand, may entail pursingcross-sex hormone replacement therapy(HRT) (which chemically develops cross-sexsecondary sex characteristics),transgender voice therapy,(training to masculinize or feminize one's voice) andgender affirming surgery(which surgically alters physical attributes). In many cases, medical transition is offered after a diagnosis ofgender dysphoria,the diagnosis being a form ofmedicalisation.[6]However, recently there has been a move towardsinformed consentmodel of treatment, wherein adults may not require a diagnosis to medically transition.[7]

The distinction between gender expression and identity is important to note, as while people who undergo gender transition often change their gender expression, people with non-normative gender expression (i.e.tomboys,cross-dressers,drag queens) do not, necessarily, wish to transition.

Transitioning is a process that can take anywhere from several months to several years. As a personal journey, there will never be a one-size-fits-all approach to transition.

Terminology

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This page may use topic-specific vocabulary that may be unclear to the layperson. Here are some definitions to help this page be more easily digestible:

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  • Assigned gender at birth(AGAB) is a term that refers to the sex or gender assigned to people when they are born. As people are assigned a gender at birth in regards to their physical characteristics, an assigned gender does not account for one's internal gender identity.
  • Gender expressionrefers to the external presentation of one's gender identity. Typically, a person's gender expression is thought of in terms ofmasculinity(atomboy,abutch lesbian,adrag king) orfemininity(aneffeminate male,a 'femboy', adrag queen), but an individual's gender expression may incorporateboth feminine and masculine traits,or neither. One may express their gender through clothing, behavior, hair styling, voice, etc.[8][9]It is not necessarily related to one's gender identity.
  • Gender identityrefers to the personal sense of one's owngender.It may correlate with the gender assigned at birth, or differ from it. In most individuals, gender identity is congruent with their assigned gender. Those who do not identify with their birth gender may identify astransgender.
  • Gender dysphoriarefers to the distress a person experiences from a mismatch between theirinternal gender identityand theirgender assigned at birth[10][11].People who suffer from gender dysphoria maytransitionin order to alleviate this distress.
  • Cisgenderis an adjective that refers to individuals who identify the gender assigned to them at birth. Cisgender people may have anysexual orientationorgender expression.
  • Transgenderis an adjective that refers to individuals who identify with a gender that differs from the one assigned to them at birth. For simplicity's sake, this article uses the termstransmasculineandtransfeminineto refer to transgender people assignedfemaleat birth and assignedmaleat birth, respectively. Transgender people may have any sexual orientation or gender expression.
  • Non-binaryis a term that refers to a gender identity described as neither entirely male nor female (not one of the two binary sexes). Non-binary people may suffer from gender dysphoria, and may consider themselves transgender. Non-binary people may have any sexual orientation or gender expression.
  • Transitioningrefers to the process ofaffirmingandexpressingone'sinternal sense of gender,as opposed to the genderassigned to them at birth.There are two major facets of gender transitioning: a social transition, and a medical transition; almost all transgender people will socially transition, and most will undergo some degree of medical transition. See the opening paragraphs for further information on social and medical transitioning.
  • Detransitioning(sometimes also known asre-transitioning) is the cessation of transgender identity and/or a transition to a different gender, often to one's natal sex.[12]
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It is important to note that most transgender individuals will receive few, if any surgeries throughout their lifetimes and some may never receive HRT. Barriers to accessing medical transitioning can include: a lack of financing, a lack of desire, or a lack of accessibility. There is no one way to transition, and while a medical transition or surgery can absolutely be medically necessary for some individuals' personal wellbeing, no two transitions are the same.

  • Puberty blockers / hormone blockersare terms that refer to medications used to block natal sex hormones. For transgender youth, hormone blockers may be offered at the onset of puberty to allow the exploration of their gender identity without the distress[13][14]ofirreversible pubertal changes.Puberty blockers are considered reversible[15]and their use is deemed safe and effective[16]as treatment for gender dysphoria in gender-diverse children[17]andprecocious pubertyincisgenderchildren[18];their use may be discontinued at any time if natal puberty-blocking is no longer desired.[15]For transgender adults, hormone blockers may be offered in a course with cross-sex hormone replacement therapy in order to treat gender dysphoria.
  • Hormone replacement therapy (HRT)is a medical treatment that replaces the primary sex hormones in one's body, in order to develop the secondary sex characteristics of the opposite sex. Individuals seeking masculinizing HRT are prescribed the male sex hormonetestosterone,while individuals seeking feminizing HRT are prescribed the female sex hormoneestrogen.
  • Voice therapy(or 'voice training') refers to anon-surgicalgender-affirming treatment for the masculinization or feminization of one's voice.Transfeminine peoplewill not experience any impact on voice pitch from feminizing hormone therapy (unless their natal puberty was sufficiently blocked), so voice training is very often underwent in order to learn how to speak in a higher and more feminine register.Transmasculine people,on the other hand, will experience a marked lowering in pitch from masculinizing HRT (testosterone) to an often cisgender male level, so vocal masculinization training is uncommon outside of those who have not underwent masculinizing HRT. Irrespectively, vocal masculinization training can help one learn to speak in a lower and more masculine register.
  • Voice surgeryrefers to asurgicaltreatment that allows for the masculinization or feminization of one's vocal pitch.Transfeminine peoplecan undergo voice surgery to surgically increase their pitch range. Transmasculine people very uncommonly undergo voice surgery, as masculinizing HRT (testosterone) often lowers voices to a cisgender male pitch. Irrespectively, vocal masculinization surgery can be underwent to surgically decrease their pitch range.
  • Facial surgeryrefers to any gender-affirming surgery underwent on the face. There existsfacial masculinizationandfacial feminization.
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  • Going 'full-time'refers to the act of living everyday life as one's identified gender.[19]People who go full-time may or may not pass, and may or may not keep their transgender identity a secret.
  • Passingrefers to the perception and recognition of trans people as their desired gender identity by outsiders who may not know they are transgender. For many trans people, passing is a very important aspect of their transition often seen as an 'end goal'. Passing can greatly alleviate gender dysphoria. Failure to pass can cause serious repercussions for trans people's psychological well-being and safety, including but not limited to:poor mental health,discrimination,increased barriers to medical care[citation needed],harassment, fetishization, ostracization, increased risk of homelessness, andtargeted violencedue to increased visibility of one's transgender status.[20]
  • Going 'stealth'refers to the act of living as one's identified gender without revealing oneself to be transgender.[21]In some countries, being stealth may be a safety necessity, due to health, safety, and wellbeing risks of being openly transgender.

Various aspects

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Transitioning is a complicated process that involves any or all of the gendered aspects of a person's life, which include aesthetics, social roles, legal status, and biological aspects of the body. People may choose elements based on their own gender identity, body image, personality, finances, and sometimes the attitudes of others. A degree of experimentation is used to know what changes best fit them. Transitioning also varies greatly between cultures and subcultures according to differences in the societies' views of gender.[22]

Social aspects

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"Social transitioning" redirects here. For social changes on a societal level, seeSocial change.

The social process of transitioning begins with'coming out', where others are told that one does not identify with theirbirth sex.The newly out trans person may adopt a new name, ask to be referred to with a new set of pronouns, and change their presentation to better reflect their identity.[23][24]Socially transitioning does not involve medical intervention or gender affirming surgery, but it may be a prerequisite to access transgender healthcare in some regions.[4][5]

People may socially transition at any age, with documented cases of children asyoung as 5[2][25][26],or adults asold as 75[3].While the majority of those who socially transition will pursue a medical transition[citation needed],not everyone can access gender affirming care, and not all may wish to pursue it.

Psychological aspects

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A person's ideas about gender in general may change as part of their transition, which may affect theirreligious,philosophical and/or political beliefs. In addition, personal relationships can take on different dynamics after coming out. For instance, what was originally a lesbian couple may become a heterosexual one as a partner comes out as a trans man - or parents of a boy may become parents of a girl after their child comes out as a trans woman.

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Main articles:Transgender rightsandLegal recognition of non-binary gender

Transgender people in many parts of the world can legallychange their nameto something consistent with their gender identity.[24]Some regions also allow one's legal sex marker changed on documents such asdriver licenses,birth certificates,andpassports.The exact requirements vary from jurisdiction to jurisdiction; some requiresex reassignment surgery,while many do not. In addition, some states that require sex reassignment surgery will only accept 'bottom surgery', or a genital reconstruction surgery, as a valid form of sex reassignment surgery, while other states allow other forms of gender confirmation surgery to qualify individuals for changing information on their birth certificates.[27]In some U.S. states, it is also possible for transgender individuals to legally change their gender on their drivers license without having had any form of qualifying gender confirmation surgery.[27]Also, some U.S. states are beginning to add the option of legally changing one's gender marker to X on legal documents, an option used by somenon-binarypeople.[28]

Physical aspects

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Main article:Sex reassignment therapy

Physical aspects of gender transition can go along with social aspects; as well as wearing gender affirming clothing, transgender people often hide features from their natal puberty, with many transgender menbinding their breastsand transgender women shaving. Other physical aspects of transitioning require medical intervention, such astransgender hormone therapyor surgeries.

Grieving gender identity

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Over the course of a gender transition, people who are close to the transitioning individual may experience a sense of loss, and work through agrievingprocess.[29]This type of loss is anambiguous loss,characterized by feelings of grief where the item of loss is obscure. Family members may grieve for the gendered expectations that their loved one will no longer follow, whereas the transgender person themself may feel rejected by their relatives' need to grieve.[30]Feelings that arise are described as a way of seeing the person who is transitioning as the same, but different, or both present and absent.[29]

See also

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References

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  1. ^Brown, M. L. & Rounsley, C. A. (1996)True Selves: Understanding Transsexualism – For Families, Friends, Coworkers, and Helping ProfessionalsJossey-Bass: San FranciscoISBN0-7879-6702-5
  2. ^abKennedy, Natacha; Hellen, Mark (2010)."Transgender Children: more than a theoretical challenge"(PDF).Graduate Journal of Social Science.
  3. ^abFabbre, Vanessa D. (2015).Gender Transitions in Later Life: The Significance of Time in Queer Aging.doi:10.4324/9781315731803-5/gender-transitions-later-life-significance-time-queer-aging-vanessa-fabbre(inactive 2024-07-22).ISBN9781315731803.{{cite book}}:CS1 maint: DOI inactive as of July 2024 (link)
  4. ^abEvans, Shelley; Crawley, Jamie; Kane, Debbie; Edmunds, Kathryn (December 2021)."The process of transitioning for the transgender individual and the nursing imperative: A narrative review".Journal of Advanced Nursing.77(12): 4646–4660.doi:10.1111/jan.14943.ISSN0309-2402.PMID34252206.
  5. ^abRachlin, Katherine."Medical Transition without Social Transition: Expanding Options for Privately Gendered Bodies".read.dukeupress.edu.Retrieved2024-07-21.
  6. ^Johnson, Austin H. (2019). "Rejecting, reframing, and reintroducing: trans people's strategic engagement with the medicalisation of gender dysphoria".Sociology of Health & Illness.41(3): 517–532.doi:10.1111/1467-9566.12829.ISSN0141-9889.
  7. ^Schulz, Sarah L. (2017-12-13). "The Informed Consent Model of Transgender Care: An Alternative to the Diagnosis of Gender Dysphoria".Journal of Humanistic Psychology.58(1). SAGE Publications: 72–92.doi:10.1177/0022167817745217.ISSN0022-1678.
  8. ^Edelman, Elijah Adiv (6 November 2019), Bosia, Michael J.; McEvoy, Sandra M.; Rahman, Momin (eds.),"Gender Identity and Transgender Rights in Global Perspective",The Oxford Handbook of Global LGBT and Sexual Diversity Politics,Oxford University Press, pp. 61–74,doi:10.1093/oxfordhb/9780190673741.013.24,ISBN978-0-19-067374-1,retrieved17 March2023
  9. ^Carabez, Rebecca; Pellegrini, Marion; Mankovitz, Andrea; Eliason, Mickey; Scott, Megan (12 August 2015)."Does your organization use gender inclusive forms? Nurses' confusion about trans* terminology".Journal of Clinical Nursing.24(21–22): 3306–3317.doi:10.1111/jocn.12942.ISSN0962-1067.PMID26263919.
  10. ^Human Rights Campaign."Sexual Orientation and Gender Identity Definitions".Archivedfrom the original on November 25, 2015.RetrievedJune 13,2021.
  11. ^Morrow DF, Messinger L, eds. (2006).Sexual Orientation and Gender Expression in Social Work Practice: working with gay, lesbian, bisexual, and transgender people.New York:Columbia University Press.p. 8.ISBN978-0-231-50186-6.Gender identity refers to an individual's personal sense of identity as masculine or feminine, or some combination thereof.
  12. ^"Transitioning Back To One's Assigned Sex At Birth".The TransAdvocate.7 August 2013. Archived fromthe originalon 2017-09-20.Retrieved1 September2017.
  13. ^Turban, MD, MHS, Jack L.; King, ALM, Dana; Carswell, MD, Jeremi M.; Keuroghlian, MD, MPH, Alex S. (1 February 2020)."Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation".publications.aap.org.PMID31974216.Retrieved2024-07-21.{{cite journal}}:CS1 maint: date and year (link) CS1 maint: multiple names: authors list (link)
  14. ^Lambrese, Jason (2010-08-01)."Suppression of Puberty in Transgender Children".AMA Journal of Ethics.12(8): 645–649.doi:10.1001/virtualmentor.2010.12.8.jdsc1-1008.ISSN2376-6980.PMID23186849.
  15. ^abRölver, Angela; Föcker, Manuel; Romer, Georg (2022)."Desisting from gender dysphoria after 1,5 years of puberty suppression: A case report".Department of Child and Adolescent Psychiatry.University Hospital Münster.1(2).doi:10.1016/j.psycr.2022.100049.
  16. ^Rew, Lynn; Young, Cara C.; Monge, Maria; Bogucka, Roxanne (February 2021)."Review: Puberty blockers for transgender and gender diverse youth—a critical review of the literature".Child and Adolescent Mental Health.26(1): 3–14.doi:10.1111/camh.12437.ISSN1475-357X.PMID33320999.
  17. ^Giordano, Simona; Holm, Søren (2020-04-02)."Is puberty delaying treatment 'experimental treatment'?".International Journal of Transgender Health.21(2): 113–121.doi:10.1080/26895269.2020.1747768.ISSN2689-5269.PMC7430465.PMID33015663.
  18. ^Eugster, Erica A (May 2019)."Treatment of Central Precocious Puberty".Journal of the Endocrine Society.3(5): 965–972.doi:10.1210/js.2019-00036.PMC6486823.PMID31041427.{{cite journal}}:CS1 maint: date and year (link)
  19. ^"TransWhat? • Social transition".transwhat.org.Archivedfrom the original on 2017-11-08.Retrieved2017-10-29.
  20. ^"Transgender-Specific Issues: Passing | Responding to Transgender Victims of Sexual Assault".ovc.gov.Archivedfrom the original on 2019-10-07.Retrieved2019-10-07.
  21. ^Urquhart, Evan (June 29, 2018)."For Many Trans Men in the South, Going" Stealth "Makes the Most Sense".Slate Magazine.Archivedfrom the original on February 25, 2022.RetrievedFebruary 25,2022.
  22. ^Elliot, Patricia (1 October 2008). "Book Review: Sally Hines, Transforming Gender: Transgender Practices of Identity, Intimacy and Care. Bristol: The Policy Press,2007.227 pp.ISBN 978-1-86134-9170 £24.99 (pbk).ISBN 978-1-86134-9163 £60.00 (hbk)".Sexualities.11(5): 646–648.doi:10.1177/13634607080110050603.S2CID145654831.
  23. ^Olson, PhD, Kristina R.; Durwood, PhD, Lily; Horton, BS, Rachel; Gallagher, PhD, Natalie M.; Devor, PhD, Aaron (13 July 2022)."Gender Identity 5 Years After Social Transition".publications.aap.org.Retrieved2024-07-21.{{cite web}}:CS1 maint: date and year (link)
  24. ^abJerry J. Bigner, Joseph L. Wetchler,Handbook of LGBT-affirmative Couple and Family Therapy(2012,ISBN0415883598), page 207: "gender transition can be achieved through the use of clothing, hairstyle, preferred name and pronouns,..."
  25. ^Olson, Kristina R.; Gülgöz, Selin (June 2018)."Early Findings From the TransYouth Project: Gender Development in Transgender Children".Child Development Perspectives.12(2): 93–97.doi:10.1111/cdep.12268.ISSN1750-8592.
  26. ^Olson, Kristina R.; Key, Aidan C.; Eaton, Nicholas R. (April 2015)."Gender Cognition in Transgender Children".Psychological Science.26(4): 467–474.doi:10.1177/0956797614568156.ISSN0956-7976.PMID25749700.
  27. ^ab"Movement Advancement Project | Snapshot: LGBT Equality by State".lgbtmap.org.Archivedfrom the original on 2019-04-22.Retrieved2019-10-07.
  28. ^"Gender Neutral Choice in Legal Documents - Love is a Rainbow Article".Love is a Rainbow.2018-04-14.Retrieved2019-10-07.[permanent dead link]
  29. ^abNorwood, Kristen (March 2013). "Grieving Gender: Trans-identities, Transition, and Ambiguous Loss".Communication Monographs.80(1): 24–45.doi:10.1080/03637751.2012.739705.ISSN0363-7751.S2CID35092546.
  30. ^McGuire, Jenifer K.; Catalpa, Jory M.; Lacey, Vanessa; Kuvalanka, Katherine A. (September 2016)."Ambiguous Loss as a Framework for Interpreting Gender Transitions in Families: Ambiguous Loss in Gender Transition".Journal of Family Theory & Review.8(3): 373–385.doi:10.1111/jftr.12159.Retrieved30 December2022.
  1. ^While the label Transgender is used here, people of diverse gender identities may socially or medically transition.

Further reading

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