With so much misinformation around, it is important to get to the facts and logic behind sex and gender. Understanding transgender requires briefly exploring the biology of sex and how that is different to the gender representation constructs so that we can understand why gender identity may not align with biological sex. Mental illness is often co-occurring with trans gender identity for both societal and biological reasons. Trans affirming care addresses both of these aspects and decreases trans people’s mortality.

Biological Sex is not Gender

We need to differentiate between biological sex and gender.

Biological sex is what category you fall into so far as far as your biology is concerned if there is a condition that has a sex driven component. For example, some conditions exist for people who are intersex (not XX or XY chromosomed, such as XXX chromosome) and not for people who are classically XX or XY.

The chromosomes that a person has does not define their sex either. While most people who have XX chromosomes will be biologically female, with the expected female features of soft skin, breasts, vagina and uterus, there are people who are born with XX chromosomes and do not have some or any of those features. The same applies for XY chromosomed people.

While determining what is a biological man and what is a biological woman is quite easy for most of the population, there is no single biology definition that always works. The major problem here is a category error. We have been raised with the simple idea that animals come in two sexes, male and female, and that there is a simple way to tell what that is. Both of these statements are literally wrong. There are more than two biological sexes in most species of animal, including humans, and no simple way to determine what that biological sex is for all members of each species.

Now let us look at gender.

Gender is a construct. Your society constructed what it means to be “man” or “woman”, and what actions indicate that you belong or don’t belong to those labels. In my society, here in Western Australia, if you care for your children, you are considered to be doing “women’s work” and that is not “manly”. To be fair, that has been changing over the last few decades. It is still rare for father’s to be considered nurturing, or for mother’s to be considered stern and stoic.

Think about it “what does it mean to be placed in a category of people called man?” People asked this almost always go to discussing biological bits, rather than behaviours. So let us replace that with “what does it mean to be manly?” How many people with those man biology bits are actually manly? I suspect an honest answer is going have fewer people fulfill “manly” than “man”.

We tend to think of manly people as Masculine, and womanly people as Feminine. When we try to picture who Manly people look like, they often are imagined as grizzly adults. Picturing Femininity, we often think of young ladies, often teenagers. This seems a bit odd. A mature and functional woman is not really fitting the aesthetic of feminine, rather seeming more matronly. Hopefully you can see that the societal ideal female (the construct) does not actually represent the majority of women – the gender trait is not representative of the biological grouping.

Transgender is an Umbrella Term

Transgender is an umbrella term for a variety of ways in which people become aware of themselves not fitting the construct of the gender they are assigned due to the biological features they appear to have. This can include those who wish to change their sex assignment to match the person that they feel they are, people who feel that they are not represented by the general genre of gender, those who transition fluidly through multiple feels of gender and other nonclassical identifications of self vs construct and biology.

Trans and Mental Health

Any time that your identity is at odds with how society categorises and treats you can cause mental harm. Additionally, there are a number of co-occurring (comorbid) biological conditions that have a large overlap with being trans that can affect our mental health.

When your identity is at odds to how you feel and are treated by others, this can cause quite a lot of psychological harm. That harm can manifest as anxiety, depression, self-harm, suicidal ideation and suicide. The majority of people experiencing gender dysphoria have these symptoms, and the risk to the trans person is high. Many studies have found that trans affirming care is the key to significantly decreasing mortality. This can be as little as a single family member, friend or professional taking your experiences and feelings seriously and allowing that how you feel about your identity is true.

There is a strong correlation between Transgender and Autism. Autism has strong co-occurrence of various conditions such as anxiety, ADHD, depression and risk of Self-Harm and Suicide.

It can be difficult to separate out whether the trans mental health of a person is due to conflicts with society or a co-occurring biological mental health issue.

Good trans affirming care considers both identity conflict and co-occurring conditions in medication, medical intervention and mental health therapy.

Trans Myths

Any time that the status quo of society is challenged, we find that there are those conservative people who resist changing that society and who will attack the people who they think are causing the society upset. Many myths, lies and misrepresentations are made to justify why they don’t want the system to change.