All About Transgender

What does it mean to describe a person as “transgender”? In recent years, trans people have been a major focus for the news and media, if not always covered in the most favourable light. That, combined with the fact that more trans people than ever have been rejecting the idea of living “in stealth” and are out and in the public eye, makes it tempting to believe that “we all understand trans now”.

Tempting: but that is the problem of familiarity: when you think you know a thing, it is too easy to stop asking questions; and judging by common misconceptions that trans folk keep encountering, at work, while socialising, or on the news, it is clear that many people still know less about trans folk than they think they do.

Trans Folk: the theory

It starts with gender

Until recently it was common for people to talk about what “sex” they were: but notions of “gender” are a more recent addition. It does not help that when people talk of gender they frequently use it in two very different ways. (Or three, if you count the fact that some people prefer to say “gender” because the word just feels that bit more polite than “sex”).

Performative gender

In 1990, feminist writer Judith Butler introduced the idea of gender as something we perform1. According to this view, gender is “performative”: a set of behaviours that most individuals adopt to send out signals about who we are. Typical female-gendered behaviours include wearing skirts, or shopping with friends, whereas male-gendered behaviours might include drinking beer or going to a football match. It should be instantly obvious that while some behaviours are viewed by society at large as more essentially feminine or masculine than others,  no single behaviour can be considered definitional: women support football teams, and play football. Men like to shop.

In addition, the degree to which we consider any given behaviour “gendered” can change over time. So, behaviours once considered strong markers of one gender, such as wearing make-up, may become less gender-specific. In the 60s and 70s, wearing make-up was a means by which certain men marked themselves out as different and perhaps challenged gender norms. In recent years, however, wearing basic make-up has become far more acceptable for men in all walks of life.

Other behaviours can reverse entirely. Wearing pink is today viewed as quintessentially feminine. However, for a very long time, the convention throughout much of Europe was that men wore red (to signify blood and a readiness for combat) and boys wore pink (a watered down version of red). This started to change in the 1920’s and from the 1940’s onward, pink became firmly associated with femininity.

Gender as inner sense: gender dysphoria

Gender may also refer to the internal sense that most of us have of being male, female or somewhere in between. Again, there appears to be no absolute rule. Some individuals believe they could live comfortably in bodies configured differently from the one they are now occupying. Others, though would find this troubling: impossible, even. In effect, they would be suffering from dysphoria.

Current consensus among experts is that this internal sense of gender develops between the ages of about three and five2 and in most cases it then remains consistent and stable for the rest of an individual’s life.

For transgender people, it is this second experience of gender that is key: because trans people, by definition, possess a deep-rooted sense of gender at variance with the gender we would expect them to claim, based on their anatomy at birth. In common parlance,  we speak of people being “born a boy” or “born a girl”. Trans people are more likely to talk of being “assigned male at birth” (AMAB) or “assigned female at birth” (AFAB).

‘Gender incongruence’ is the fact of gender identity not being stereotypically aligned with sex characteristics (genital appearance at birth particularly): where that incongruence gives rise to (significant) discomfort/unease the individual is described as suffering from gender dysphoria. This, in turn, may manifest as mild, manageable through only minor changes to lifestyle: or severe, at which point, those with dysphoria are likely to seek more major interventions involving hormones, surgery or both.

‘Changing gender’

These two divergent views of gender have frequently led non-trans people to advocate what seem to them to be “logical” responses. For instance many assume that more widespread acceptance of “cross-dressing” or androgynous behaviour would fix trans people’s problems. This though is to mix up external presentation with inner gender sense, and while it may help a little at the edges, it does next to nothing for individuals with acute dysphoria.

In some cases, it can have the opposite effect, forcing trans men and women into straitjacketed roles and modes of presentation that they reject in the mistaken belief it will sort out the deeper issue. Thus, in the early days of trans medicine, many doctors and psychiatrists would deny trans women treatment if they failed to fit their vision of how a “proper woman” should act.

These behaviours don’t determine who they are inside, any more than they do for anybody else.

This has had a number of negative consequences. To begin, it set therapists and patients on a collision course.  Trans women may prefer wearing jeans, playing ‘masculine’ sports or even working in ‘masculine’ jobs, in much the same way as non-trans women. Trans men may wear pink and enjoy romantic comedies, again, in much the same way as non-trans men.

By demanding that trans men and women fit stereotypes – in many cases set up according to a middle-aged male view of the “correct” way to perform male or female genders – these therapists became a form of gender police. Fine, if the trans man or trans woman did see their gender in traditional terms: less fine if they did not. In some cases, trans individuals were rejected for treatment if they failed to live up to such stereotypes. In others, they feigned conformity.

Still, there were a number of toxic consequences of this approach:

    • many individuals, especially trans women were rejected for treatment for reasons they could do nothing about, such as being too tall or having broad shoulders. Others were forced to divorce before treatment would be permitted (because, presumably, no “normal” woman would be lesbian);
    • trans folk as a whole – but especially trans women – were accused of upholding gender stereotypes: ironic, since this is something that most trans people reject. Yet they were forced into an outward conformity in order to receive treatment;
    • this was the beginning of a long term hostility between the medical profession and many trans people, who saw gender specialists not as people there to help or treat them as individuals, but as gatekeepers to be by-passed.

In the end, many trans people reject language that suggests they wish to “change gender”, because that is exactly what they are NOT looking to do. Treatment, is about aligning bodies more closely with the gender that the trans person – man or woman – has always experienced themselves as: and this world view is more and more supported by the science of gender development .

This problem with an essentially binary view of the world – one is either gender A or gender B – is further compounded both by the emergence of non-binary identities, according to which people own to NOT identifying at either end of the spectrum, and a growing body of research demonstrating that contrary to the populist view of science, research shows that sex itself is anything but binary3.

We are only at the beginnings of our understanding of this topic right now, but increasingly, evidence is stacking up that people experience both sex and gender to varying degrees: that for some, this is a matter of indifference; and that for others this is very important indeed. The degree to which this is important to an individual will then determine whether they are trans or non-trans (“cisgender”), binary or non-binary and ltimately, whether they need any medical or social intervention.

For further information, check out our sections on

Thanks to Jennie Kermode whose up and coming book on supporting Trans and non-binary people with disabilities4 was a major resource in putting together this page.


1 – Gender Trouble: Feminism and the Subversion of Identity, by Judith Butler, Routledge, 1990

2 – The role of gender constancy in early gender development, Ruble, D N, Taylor, L J, Cyphers, L, Greulich, F K, Lurye, L E and Shrout, P E   Child Development 78, 4, 1121–1136 (2007)

3 –Stop Using Phony Science to Justify Transphobia, Simón(e) D Sun, Scientific American Blog, June 2019

4 – Supporting Transgender and Non-binary People with Disabilities or Illnesses: a Good Practice Guide for Health and Care Provision, Kermode J, Jessica Kingsley Publishers, August 2019