Understanding and supporting transgender people


Maybe you have a family member who’s transgender, a friend who’s nonbinary, or a child who’s discovering their gender identity. You want to support them but aren’t sure how.

For starters, one of the most powerful ways to show support is to use their chosen name and pronouns. While this may seem like a small thing, it means a lot to people who are transgender. When friends and loved ones use their chosen name and pronouns, it can improve their overall well-being and reduce the chance of mental health concerns and suicide.

But using the correct name and pronouns is just the start – there are other things you can do, too. Below, we answer questions about gender and share ways you can show support to your transgender friends, family and acquaintances.

What’s gender identity?

Your gender identity is your own personal sense of your gender and who you are. A person may identify as cisgender (cis for short) if their gender identity is the same as the sex they were assigned at birth. A person whose gender identity doesn’t match the male or female sex they were assigned at birth, may identify as transgender (trans for short).

What is binary sex?

To understand all forms of gender, you first need to understand binary sex and the gender binary. For starters, binary means “having two parts.”

The gender binary is the idea that there are only two genders – male and female – one of which is assigned to a person at birth, based on physical sex characteristics. While most people’s physical sex at birth is clear, there are exceptions. Some estimates suggest that up to 1.7% of people are intersex at birth, which means they have both male and female sex characteristics.

Gender binarism assumes that a person’s gender identity matches the sex they were assigned at birth. But the reality is we are all on a continuum, or range, of how we identify our gender and who we know ourselves to be. Some people identify as more masculine, others identify as more feminine, others are somewhere in between, and still others don’t identify with a gender at all.

What does it mean to be transgender?

So, when someone says that they’re transgender, what does that mean? The truth is that it can mean many different things. The term transgender is an umbrella term for people whose gender identity or gender expression are different from the cultural and social expectations of the binary sex they were assigned at birth. Examples of transgender identities:

  • Trans man (or boy) – A person who was assigned female at birth and identifies as a man or more masculine.
  • Trans woman (or girl) – A person who was assigned male at birth and identifies as a woman or more feminine.
  • Nonbinary – A person who doesn’t describe their gender identity exclusively as a man or a woman.

What’s the difference between gender identity and sexual orientation?

Everyone has a sexual orientation. Your sexual orientation relates to who you’re romantically or physically attracted to. Maybe you wonder if gender identity is related to sexual orientation. The answer is no – they’re completely separate parts of a person’s identity.

What is gender expression?

How you show yourself to the world is known as gender expression. Every society and culture has a defined set of expectations and rules for how gender should be expressed based on the sex assigned at birth. How other people see your gender expression and interpret your gender is known as gender perception.

People who identify as transgender may change their appearance, through clothing, hairstyle or changing their body, to align with their gender identity. This can be one way in which they can affirm their gender and feel more comfortable in their body. It is also a way in which they can adapt to the society and culture to be more accepted for who they are.

But to be clear, you can’t know someone’s gender identity just by looking at them and the way they dress, the pitch of their voice or their name. Your gender identity is related to your inner sense of self and who you know yourself to be – not the physical sex characteristics of the sex you were assigned at birth.

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What is gender transitioning or affirmation?

Some people choose to take steps to affirm who they are and align their life – and sometimes their body – with their gender identity. The affirmation process, which usually takes a few years, is unique to each person and includes one or more of the following:

  • Social affirmation – When people are ready, they may tell family, friends and coworkers, and begin to use a new chosen name and pronouns. They may also make changes to their physical appearance to align their gender expression with their gender identity. For example, they may change the clothes they wear, how they style their hair, and begin or stop using makeup.
  • Legal affirmation – This is the process of legally changing their sex or name on legal documents and accounts such as their driver’s license, passport and bank accounts.
  • Medical affirmation – People may use hormone replacement therapy or have surgery to affirm their gender. But it’s important to remember that a person who is transgender may not go through medical affirmation. Every person is different and the steps they may or may not choose to take are unique.

What transgender terms should we know?

Transgender and trans are widely accepted terms for implying all forms of trans identity. That is, when they are used as adjectives. You should never refer to someone as “a transgender” or “transgendered.”

But using the correct terms isn’t always easy – the language and terms people use to describe their gender identity continue to evolve and change. For example, people often ask about using the word transgender vs. transexual. The answer is that the term transgender has replaced the word transexual. Both refer to a person who has a gender identity that is different than the sex they were assigned at birth. But many trans people are offended by the term transexual and find it outdated. So, don’t use the term transexual unless a person who is transgender uses it to describe themselves.

The Gay & Lesbian Alliance Against Defamation (GLAAD) provides a list of transgender terms, including different identities and their definitions. The list also includes terms that should not be used. Don’t assume, though – it’s thoughtful to ask what people prefer.

How can I support someone who’s transgender?

Supporting someone who’s transgender really comes down to being a good friend and showing that you’re on their side. Here are a few things to keep in mind:

1. Respect their truth

Listen to them and respect their gender identity and expression – even if you don’t understand it.

2. Use the correct name and pronouns

The importance of using a person’s correct pronouns cannot be overstated, especially for transgender youth. In a national survey of LGBTQ youth, trans youth whose pronouns were respected were half as likely to attempt suicide compared to those whose pronouns weren’t respected. If you’re not sure which names or pronouns to use, ask, “What’s your name?” or “What pronouns do you use?”

If you accidentally use the wrong pronoun or name, apologize so the person knows it wasn’t intentional. But keep your apology brief. Usually, it’s enough to say something along the lines of, “Sorry, I meant to say she.”

Don’t dwell or try to explain why you got their name or pronoun wrong. They don’t need to be reminded that they had the different name or gender in the years that you’ve known them. The most important thing is to keep trying to get it right.

3. Let them take the lead

Remember, it’s up to them if they want to share that they’re transgender with others. Even if they’ve told you, it doesn’t mean they want everyone else to know. It’s not okay to “out” a person in front of other people.

4. Keep in mind that being transgender is not their entire identity

Ask the questions that you would ask anyone else, like, “How are you doing?” Or if they are in distress, ask, “How can I help?” You would never pry into the details of intimate procedures like colonoscopies or Pap tests. In the same way, don’t ask trans people about their affirmation care or surgery.

5. Visibly support transgender people

If someone uses the wrong name or pronoun to refer to a trans person, politely correct them. If you witness hurtful language or behavior, speak out. Better yet, get involved in an organization like the National Center for Transgender Equality which works to make things better for trans people.

6. Keep learning

There are countless resources that can help you better understand the issues faced by people who are transgender. Take time to learn how to support your friends and family who are trans.

7. Help them get therapy if they have mental health challenges

Mental health in the transgender community is a significant concern – people who are trans are 3-4 times more likely to have anxiety and depression than the rest of the population. But a trusted therapist can help people who are transgender understand how they’re feeling and help them see the way forward. Look for one that offers gender-affirming care or has experience supporting people through gender identity issues – you should be able to find this information by looking at a therapist’s bio on their website.

8. Encourage them to get their routine health care

If trans friends and family avoid seeing a doctor because they’ve had a bad experience in the past, let them know there are places that provide gender-affirming care.

We care for everybody at HealthPartners

At HealthPartners, we welcome everyone, and we work hard to ensure that people of all gender identities and expressions get the care they need in an affirmative environment.

Our gender medicine experts provide a complete range of health services to people who are trans, nonbinary or in the process of figuring it out. If you or a loved one needs routine health screenings, mental health services or help with gender affirmation, we’re here for you.

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