Transgender and Intersex Identity Developement
Options for gender expression, gender expansiveness, and gender creative youth are explored in this chapter, along with definition of terms. (Not all who are gender expansive wish to transition, so some issues will be introduced here, and followed up in Chapter Seven on questioning youth.) Transphobia and internalized transphobia can complicate healthy gender identity development and/or transition, and are therefore explored here. The Gray Gender Spectrum integrates complexities about gender identity, expression, and bodies, while other practices assist professionals and youth in assessing the persistence, insistence, and consistency of gender dysphoria. Names, pronouns, body confidence, positivity, and self-love are explored in this chapter, too.
Gender Spectrum is an organization in Northern California providing support and educational programming for gender expansive youth and their families. Schools and other organizations turn to Gender Spectrum for professional development and other trainings. With appreciation for their leadership, creativity, and ability to serve the needs of gender creative individuals, two of their documents are referred to in this chapter, and located in Appendix F.
THE RAINBOW OF GENDER
LEARN
Gender is a social construct that extends way beyond the binary of male and female. Science tells us that gender may not even be a linear spectrum (Wu, 2016). Like other aspects of identity, it exists on a number of dimensions simultaneously, and seems to lie outside the scope of current systems of classification. Moreover, gender may not be as stable and unchanging over time as we assume.
PRACTICE
Since you probably already know most of this stuff, take this moment to practice sharing and educate the adult who gave this sheet to you. It’s possible that this stuff may be newer to them than to you. By practicing sharing and educating with a trusted adult, you’ll become better at it when you need to do it out in the world.
Explain the following terms to your adult caregiver:
• AFAB: Assigned Female At Birth
• AMAB: Assigned Male At Birth
• Cisgender: personal gender identity corresponds with gender identity assigned at birth
• Non-Binary (NB): neither male nor female, or maybe even both, or simply no association with gender. They can be AFAB or AMAB. Also known as genderqueer and gender expansive youth
• Transgender:
• Transfemale (MtF)
• Transmale (FtM)
• Transition: the process of medical and social transition from one gender to another. Binary transpeople go through a process ranging from name change, clothing and hair choices, hormone replacement therapy, surgery, and voice coaching in order to present as their authentic selves
• HRT: Hormone Replacement Therapy
• Surgeries
• Presenting differently
• Legal name change
• Passing: not read/seen as trans, or passing as cisgender, including physical gender cues, behavioral attributes, and mannerisms
If you feel open and comfortable, discuss any of the terms on the previous page as they pertain to you.
REFLECT
• It may seem unnecessary to practice reviewing the terms and concepts with your trusted adult. Unfortunately, there are many people who just don’t know this stuff. You may find yourself faced with explaining basic concepts to people. Doing so with grace and kindness represents you, and the community, really well.
GENDER FLUIDITY
LEARN
Early theories and ideas about gender suggest it was tied to genitals, chromosomes, and either male or female. With progress, growth, and awareness, we now accept a wide range of genders, beyond the traditional binary of female and male. Gender identity refers to an internal psychological experience. For some people, labels don’t apply.
For others, the gender assigned at birth does not apply. In the case of intersex individuals, there are 140 chromosomal conditions that lead to ambiguity in assumed gender. For these reasons, and so many more, youth today benefit from freedom to creatively explore gender. The practice below invites you and your trusted adult caregiver to explore the full range and fluidity that is gender.
PRACTICE
Explore the terms below. Define and explain whatever you know about them. If any are new to you, look them up on the internet and discover new things with your trusted adult.
• Male/masculine
• Female/feminine
• Androgynous/Androgyne
• Pangender
• Bigender
• Agender
• Two-spirit
• Third gender
• Fa’afafine
• Non-binary
• Gender expansive
• Transfemale/trans/MtF
• Transmale/trans/FtM
• Misogyny/transmisogyny/misogynoir
REFLECT
• Find the answer key with definitions to the words above in Chapter One, Activity #2.
• Some terms may be obvious and others perhaps new and unfamiliar.
• Try to remain open to learning something new, even about terms that you’ve known about your whole life or feel expert about.
THE GRAY GENDER SPECTRUM
LEARN
As established earlier, gender identity seems to fall on a spectrum. Look below to see the different shades of gray, I mean gender, that fall between the black and white of the gender binary. Keep in mind that gender is expressed in a variety of ways, for example: the body, identity, and even the style, names, pronouns, and mannerisms used to present publicly (Brill & Kenney, 2016).
Use the grid below to explore your gender “identity” and “expression,” as well as your “body.” You can place a check mark in the box that corresponds to the category under “gender” – if any fit. Alternatively, you can write a little in the boxes that feel relevant to you – or not. Remember to explore the bottom rows of the grid to see if there are any differences between your “past,” “present,” and/or “ideal” gender “identity,” “expression,” and/or “body.”
PRACTICE
| Gender | Body | Identity | Expression |
| Totally female/feminine | |||
| Mostly female/feminine | |||
| A mix of female/feminine & male/masculine | |||
| Mostly male/masculine | |||
| Totally male/masculine | |||
| Neither female/feminine nor male/masculine | |||
| Past | Present | Ideal | |
REFLECT
• Explore the gray areas of gender. Where do you fall on the Gray Gender Spectrum?
• How is it for you to identify most authentically? Does it come easily?
• How might you embrace your authentic nature and express your gender identity in a way that most represents your true heart?
GENDER DYSPHORIA
LEARN
Gender dysphoria happens to some people early in life, to others later in life, and to some not at all. It’s the experience of feeling very unhappy, as if born in the body of the wrong gender, and/or assigned the wrong gender at birth regardless of body parts.
Gender dysphoria comes with a clear knowing about one’s gender and a strong misalignment with their body. This misalignment is so strong as to cause great depression and self-loathing. Coupled with society’s lack of acceptance of gender expansive people, it’s downright hard to resolve gender dysphoria.
There are three aspects of gender dysphoria that are assessed to determine if a person is ready and eligible to transition:
• Insistence
• Persistence
• Consistency
PRACTICE
The following questionnaire is intended to assess how insistent, persistent, and consistent your gender dysphoria is.
REFLECT
• Please share the results of this short questionnaire with a trusted adult.
• You deserve all the support in being your true Self. Keep going for that and finding people who help you along the way.
GENDER DYSPHORIA SCALE
Rate the following statements on a scale of 1-7:
I feel terrible when I look at my genitals. _____
I wish my parents let me wear clothes of another gender. _____
When I think about the gender I was assigned at birth, I get so hopeless. _____
I wish everyone knew my true gender. _____
I would be so much happier if I was another gender. _____
I would take measures (hormones, legal name change, surgery) to change myself/my body to better align with my gender. _____
Sometimes I feel like I am not even in my body, but rather outside looking in. _____
Life feels like a dream; this “reality” doesn’t feel real at all. _____
Changing my body to affirm my authentic gender would make me much happier. _____
I avoid going out because I can’t be seen as my true self. _____
My life is worse off because of the gender I was assigned at birth. _____
I think about killing myself because my body and the gender I was assigned at birth don’t match my sense of Self. _____
I’ve felt this way for a little while. _____
This way of life has been with me for so long I can’t remember a time it wasn’t like this. _____
My gender is clear to me. Why can’t others get it? _____
IS IT A BODY IMAGE PROBLEM OR THE GENDER?
LEARN
There are a few different ways to look at gender and/or body image concerns. One way to look at this dilemma is that a person was assigned the wrong gender at birth and feels like they are in the wrong body. This often leads to negative experiences. In another case, a person could feel like they were assigned the right gender at birth, but that their body isn’t quite right or pleasing. How do you know which it is? Here’s how to figure it out.
PRACTICE
| Gender Dysphoria | Body Dysmorphic | |
| Body concerns | Related to gender | May be stereotyped along gender lines, but are not related to gender |
| Internal sense of gender | Misalignment between body and assigned gender at birth | Alignment between body and gender assignment at birth |
| Desired outcome | Name, body, and gender change | Improved physical appearance along cultural norms and standards |
| Insight | May be present and clear | May be good/fair/poor or absent and delusional |
REFLECT
• There’s a big difference between body dysmorphic disorder and gender dysphoria. For transyouth, transitioning improves lives, health, well-being, and functioning. For those with body dysmorphic disorder, bodily improvements aren’t commonly associated with improved functioning.
• Knowing this difference may help you advocate for yourself.
NAMES AND PRONOUNS
LEARN
Your name and the pronouns used to talk with you, and about you, are important to your identity! It can be rough when you need to correct people and let them know they’ve made a mistake in assuming your gender. The following practice is intended to help you find the words when you need to advocate for yourself.
PRACTICE
Write your chosen name:
Write your preferred pronouns:
Create a few sample statements you might use to inform someone about your chosen name and preferred pronouns. Just put some words down, even if they don’t seem to make sense. Getting the imperfect words out is one way to discover what you want to say and what you don’t want to say.
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REFLECT
• It’s ok if at first the phrases you come up with don’t work. It’s expected.
• Keep trying to find new ways of saying whatever works for you.
• Invite assistance from a trusted friend or adult, if you can.
BEAUTY IN NON-BINARY BODIES
LEARN
Beautiful bodies come in all shapes and sizes and extend way beyond societal norms. For young people with gender non-conforming bodies, it’s important to find ways to love the skin you’re in and the body that carries your soul.
PRACTICE
In the lines below, list all the things you could love about yourself. You don’t have to be perfect, nor fit social norms. Just list a few things you like about your body even if it isn’t perfect.
REFLECT
• Loving non-binary bodies is an act of self-preservation and also a civil rights statement.
• When you find just one thing to cherish in your body that may not conform to your authentic gender, you’re practicing self-kindness and self-compassion. Combined together, they lead people to finding more ways of enjoying themselves and the lives they live-even when life is hard.
TRANSPHOBIA, INTERNALIZED TRANSPHOBIA, AND SELF-ACCEPTANCE
LEARN
Transphobia is a spectrum of negative attitudes toward transpeople. It can include disgust, fear, violence, and/or anger towards people who do not conform to gender norms. This manifests in several ways:
• Subtle and/or overt discrimination and oppression
• Emphasis on cisnormativity, cisgenderism, and/or cissexuality
When transpeople align with transphobic values-even in subtle or unconscious ways-it can be called internalized transphobia. It’s challenging to track internalized transphobia because it looks like insidious self-loathing, which many people have. When it relates specifically to being trans or their transbody, then it may be internalized transphobia.
Ultimately, self-love and self-acceptance are the best remedies for anything transphobic, and they can arise through self-compassion practices, such as the one offered below.
PRACTICE
When any kind of hatred flows your way, whether from the outside in, or simmering within, try the Along With Me meditation (Gray, 2016).
When settled, silently look at the people around the room, or picture people in your mind, and for each person, say:
“Along with me, ______ wants to be happy.” (Fill in the blank with the name of the person you are looking at, or imagining in your mind’s eye.)
“Along with me ______ wants to be free of harm.”
“Along with me, ______ wishes to be happy and safe.”
• It is also beneficial to focus on just one person, and to repeat the phrases several times.
• Ideally, this activity would be introduced and practiced during moments of calm centeredness, to be called on during moments when internal or external loathing arises.
REFLECT
• Along With Me meditation is one way to be compassionate, and strengthen and center yourself in the face of hatred.
INTERSEX IDENTITY DEVELOPMENT
LEARN
According to Alice Dreger (2016), intersex infants were historically mistreated by the medical community. Born with ambiguous genitalia, intersex infants challenged physicians who assigned gender based on external characteristics. One strategy used decades ago was for surgeons to modify intersex infant genitalia so that gender could be assigned.
Unfortunately, this didn’t turn out to be such a great solution. You probably already know this by now; gender isn’t tied to genitals, so the surgery didn’t necessarily align gender and body. For some intersex people who were treated this way, they grew up feeling like transpeople born in the wrong body/assigned the wrong gender at birth.
PRACTICE
• If you feel awkward about your gender and body, and have some questions-ask!
• It can be super hard to do so; however, opening the discussion may reveal things you need to know.
• Less than 2 percent of people are born with ambiguous genitalia (Fausto-Sterling, 2000), so this condition is rare.
• If infants have had surgeries to address the ambiguousness, sometimes intersex individuals disappear in the gender binary.
• Asking questions about your body, gender, and any previous surgeries could lead to new discoveries in a few rare situations.
REFLECT
• Since being born intersex is really rare, it’s unlikely to be the cause of gender expansiveness and transness.
• On the other hand, intersex is a real gender issue that is often ignored and surgically erased.
• Being aware of this element of gender and body enriches our collective sense of what gender really is.