Sex – Sex refers to biological development—the male/female phenotype. Sex is judged on the genital appearance at birth. Other phenotypic factors are seldom investigated unless a genital anomaly is present.
Gender Identity – A person’s internal psychological identification as man/ woman, boy/ girl or neither. For Trans* people, their birth-assigned sex and internal sense of gender identity do not correspond.
Gender Expression / Role – Outward manifestation of one’s gender identity, usually expressed through ‘masculine’, ‘feminine’ or gender-variant behaviours. Trans* people typically seek to make their gender expression match their gender identity, rather than their birth-assigned sex.
Sexual Orientation – Sexual orientation is separate from gender identity. Trans* people may be gay, straight, bisexual or asexual. For example, a natal female who transitions from female to male and is attracted to other men would be identified as gay, or as a gay man.
Transgender/ Trans* – An umbrella term for people whose gender identity and/or gender expression differs from the sex assigned to them at birth. This term can include many gender identities such as: transsexual, transgender, androgynous, genderqueer, gender variant or differently gendered people. Trans* people may or may not decide to alter their bodies hormonally and/or surgically.
Transsexual – A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex.
Transman – A natal female who identifies as male.
Transwoman – A natal male who identifies as female.
Transition – A process through which a permanent change of gender role is undertaken and the individual starts to live as the gender with which they identify. Transition includes social, physical or legal changes such as coming out to family, friends, co-workers and others; changing one’s appearance; changing one’s name, pronoun and sex designation on legal documents (e.g. driving licence or passport); and medical intervention (e.g. through hormones or surgery).
Sex Reassignment Surgery (SRS) – The surgical procedures by which a person’s physical function and appearance of their existing sexual characteristics are altered to resemble that of the other sex. This is preferred to ‘sex-change operation’ that some Trans* people find offensive. Not all transgender people choose to have SRS.
Gender Identity Disorder (GID) / Gender Dysphoria – A desire to live and be accepted as a member of the opposite sex, usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex, and a wish to have surgery and hormonal treatment to make one’s body as congruent as possible with one’s preferred sex. (1)
Intersex – A person whose biological sex cannot be clearly classified as male or female. An intersex person may have the biological attributes of both sexes or lack some of the biological attributes considered necessary to be defined as one or the other sex. Intersex conditions can originate from genetic, chromosomal or hormonal variations. In some cases an intersex condition may not be identified until the onset of puberty, until the individual discovers they are infertile, or even during autopsy. Some people live and die with intersex anatomy without anyone (including themselves) ever knowing.
Cross Dressing – In the Trans* community “cross-dressing” is seen as a pejorative term and is not used. However, some patients may present with difficulties relating to their gender but not be gender dysphoric or have gender incongruity and referral to a specialist service may still be appropriate. Likely alternative diagnoses include the following:
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- Dual-role transvestism – The wearing of clothes of the opposite sex for part of the individual’s existence in order to enjoy the temporary experience of membership of the opposite sex, but without any desire for a more permanent sex change or associated surgical reassignment, and without sexual excitement accompanying the cross-dressing.
- Fetishistic transvestism – The wearing of clothes of the opposite sex principally to obtain sexual excitement and to create the appearance of a person of the opposite sex. Fetishistic transvestism is distinguished from transsexual transvestism by its clear association with sexual arousal and the strong desire to remove the clothing once orgasm occurs and sexual arousal declines. It can occur as an earlier phase in the development of transsexualism.
For more information contact:
Brackenburn Clinic
Shimna House, Knockbracken Healthcare Park
Saintfield Road, Belfast, BT8 8BH
Tel. 028 9504 1471
Email: BrackenburnClinic@belfasttrust.hscni.net