Go into any U.S. toy store. There are toys for boys, and toys for girls. Go to a clothing store, and there is a women’s and a men’s section. Go to a university, and there are fraternities for boys and sororities for girls. Our society is based on two genders, and since there are two biological sexes (see my prior post in which I clarify that this is a great simplification), that’s the way it is everywhere. Right?

In fact, there are numerous societies and cultures in which gender is not binary (male or female). On almost every continent there are examples of biological men taking on a feminine gender, or biological women taking on a masculine gender, or a class of people recognized as both genders, or something else completely different. This is a fascinating interactive map that takes us across the world looking at the way different societies interpret gender (the Bugi of Indonesia recognize five genders!) We’re not just talking small, isolated tribes; people have recognized more than two genders in Italian, Indian, and Native American societies.

My point is that the way things are in Western society, gender-wise, is not “natural”, “obvious”, or “right.” It’s just the way we do things.

So for us, someone who is transgender is somebody who is born a biological male or female, who wants to take on the gender expression normally associated with the opposite sex. Or perhaps they’re not satisfied with either a male or female gender expression. Sometimes they also want the body of the opposite sex, such as someone who has sex reassignment surgery, and sometimes they don’t, and sometimes it’s something in between.

If it sounds confusing, that’s because it is- or rather, because our society has simplified gender to the point where stretching our boundaries takes some work. We are looking at the complex issue of gender using a language, history, and worldview where gender is binary, and goes along with biological sex. So to start with, let’s look at some definitions.

A male-to-female (MTF) transgender person is a biological male who is driven to express a feminine gender. The masculine gender is not a gender that feels right or comfortable for them. MTF people may wear traditionally female clothes or makeup, talk or walk in a traditionally female way, and generally act in a feminine manner. Some MTF people feel very strongly that their male body is wrong for them. They may engage in hormonal or surgical interventions to bring their external selves in line with their internal selves. (We’ll discuss these interventions in more detail later.) MTFs are referred to as “she.”

A female-to-male (FTM) transgender person is a biological female who is driven to express a masculine gender. FTM people may dress, act, and behave in a traditionally masculine manner. Like MTFs, FTMs may feel that their body is not accurately expressing who they are, and they may seek hormonal or surgical intervention. FTMs are referred to as “he.”

A genderqueer person has a gender identity that is not masculine or feminine. They may feel they are both masculine and feminine, or neither, or that they move between the two, or that they have a distinct gender but it is a third gender that we do not apply a name to. It is kind of a catch-all phrase for people who do not ascribe to a masculine or feminine gender, regardless of biological sex.

Please note that there are a lot of names for people with gender differences; the ones above are the ones we most often use in our clinic.

In Part 3, we’ll talk about some myths and misperceptions about transgender people.