Transgender

Transgender, often shortened to trans, is an umbrella term that describes an individual whose gender identity differs from their assigned gender at birth (AGAB). Infants are assigned a sex that is recorded on their birth certificate, which is usually based only on the appearance of external genitalia. The birth assignment—generally defaulting to assigned male at birth (AMAB) or assigned female at birth (AFAB)—assumes that the individual's gender identity will correspond to their assigned sex. A person's gender identity—their sense of gender—usually develops when they are very young. The realization that their gender is different from what they were assigned can occur as early as three years old or in childhood prior to the onset of puberty. It may also happen later in life.

Transgender people can be binary or non-binary. Some transgender individuals may experience at least one form of gender dysphoria during their life, usually manifesting as an intense distress with their assigned gender. However, not all transgender people experience gender dysphoria. Conversely, some transgender individuals may experience what is known as gender euphoria, a term used to describe a "positive and exciting feeling of one's gendered self".Transgender people might transition socially and/or physically from their assigned gender to their actual gender identity.

The term transgender was first mentioned in 1965 as a synonym for transsexual in Sexual Hygiene and Pathology to make a distinction between sexuality and gender identity. It became an umbrella term during 1971. Transgender is a combination of the prefix trans—meaning "across, beyond, through, to change"—and the noun gender, creating an adjective that highlights the journey and/or change with one's gender identity. The use of "transgender" rather than previous terminology increased in the early 1990s to emphasize gender rather than sex and to reject describing all trans people based on medical and psychological criteria.

The terms transmasculine (often shortened to transmasc), transfeminine(often shortened to transfem or transfemme), and transneutral were in use as early as 2000. These terms do not correspond with any particular identity except for transgender.

History
Gender is perceived and expressed differently depending on culture, so experiences with gender similar to being transgender exist under many different names. Even though the use of the term transgender is recent, there have always been individuals expressing their gender differently from their sex.

Mary Jones is one of the first recorded transfeminine people in the United States. She was a sex worker who was charged with grand larceny in 1836. When she was subjected to a strip search, it was discovered she was assigned male at birth. She arrived at court wearing feminine attire and a wig, boldly explaining before a courtroom—which vilified her for her skin color and gender presentation—that she always presented that way and would not change.

We'wha was a Lhamana individual who lived from 1849 to 1896. In Zuni culture, Lhamana individuals were assigned male at birth but often presented femininely and took on the same responsibilities as women. We'wha studied crafts associated with women, such as pottery for ceremonial purposes and skills associated with men, such as weaving. Their skills as a craftsperson were renowned and they became a Cultural Ambassador for the Zuni people.

Hijra individuals are recognized as a third gender in Hindu society and were recorded in the holy texts of the Ramayana and the Mahabharata, which date back to as early as 4th and 5th century. Hijra individuals are assigned either male or intersex at birth and dress traditionally feminine. They leave home young to join a Hijra community to learn how to perform blessings for births and weddings.Before British colonization, Hijra individuals held powerful political positions in Sultanate and Mughal courts with responsibilities such as collecting taxes.

Flag
Monica Helms designed the transgender pride flag in August 1999, and debuted it in 2000 at a Phoenix, Arizona, USA Pride parade. It consists of five horizontal stripes: two stripes are blue with each at the top and bottom, two pink stripes directly follow the blue, and there is one white stripe in the center. The stripes are ordered this way so that the flag can be flown correctly in any direction, metaphoric for trans individuals finding correctness in themselves. The colors encompass the spectrum of trans experiences, as the blue represents masculinity, the pink represents femininity, and the white represents those who are transitioning, gender neutral, gender non-conforming, or non-binary.

Non-binary

 * Main article: Non-binary

Non-binary identities are included under the transgender umbrella as they are people whose gender differs from what they were assigned at birth. However, the two identities are distinct, and individuals do not need to identify as one term to be another. A binary transgender person differs from their birth assignment by identifying as a man or a woman rather than female or male. A non-binary individual might never identify with either binary term, or they might partially identify with either or both terms, which may or may not include their birth assignment. A trans non-binary individual is an individual who does not identify with their birth assignment (trans) and has a gender identity that is neither exclusively within the gender binary (non-binary). As stated before, one does not need to identify as one of the term to be the other one.

Intersex

 * Main article: Intersex

Intersex is an umbrella term for various people who are born with or develop sex characteristics that differ from binary notions of a "male" or "female" body. These differences are called variations, and may involve one's hormones, chromosomes, external and internal reproductive organs, or secondary sex characteristics.

Intersex people are not inherently transgender, as they may identify with their assigned gender just as non-intersex people might. However, a person who is intersex may identify as transgender alongside intersex if they identify differently from what they have been assigned. One cannot "transition" to being intersex as intersex traits come from a variation that already exists within the individual.

Controversy
''If there has been a specific variety of this identity-phobic discourse that has led to discrediting it, please detail that here. If there have been similar -phobic discourses around popular flags, it can also be documented in this section.''

Puberty blockers
Studies were developed by Finland and Sweden to look into the long-term effects of Lupron, a hormonal therapy known broadly as "puberty blockers". Lupron was discovered in the 1980s and was used by pediatric endocrinologists, among others in its class of GnRH agnoists. It was used to stop toddler, preschool, and kindergarten-age girls from entering puberty by shutting down estrogen flow in the brain to halt the body's progress toward puberty. Once the injections cease, the process of puberty resumes. The drug and its class of drugs, have dozens of off-label uses. Lupron specifically was given to cancer patients as an injectable chemotherapy drug, but became used in an off-label setting for hormonal therapy in pre-pubescent children to delay the start of their assigned gender puberty.

In 2017, more than 10,000 young women in the US who took the drug as children either to stop puberty or grow taller, whether related to gender identity or not, reported adverse events later in life. They were diagnosed with brittle bones, bone disorders, chronic pain, degenerative disks and spines, and other conditions that typically being in late adulthood. The FDA began a specific review of nervous system and psychiatric events in association with the class of drugs in which Lupron falls into, GnRH agnoists. The study focused entirely on pediatric patients. While there are several similar drugs to Lupron, it is a leader in the market, despite thousands of women's claims of its harmful long-term side effects. The spokesman for the company claimed that anything beyond the drug's label, including delaying sex characteristics, are considered unapproved use. The long term side effects of drugs in that class were put under scrutiny, due to the confirmation that the drug does cause bone disorders and disease-caused fractures. The impact of the class of drugs on children's bones is an unanswered question.

Research was conducted by Sweden and Finland was done not only to research the effects of the drug in transgender people, but also the effects of the drug as a whole. They found that the effects of the drug outweighed the potential benefits and banned the dispersal, an act that is also prevalent in many European countries.

Sweden's Health and Technology Assessment (SBU) conducted an evidence review in 2019, which found a lack of evidence for medical treatments, and a lack of explanation for the sharp increase in the numbers of adolescents presenting with gender dysphoria in recent years. They found the risk/benefits analysis of hormonal intervention to be uncertain.

In December 2020, Bell v. Tavistock was presented in the High Court of Justice for England and Wales, where they found it "highly unlikely" that children under the age of 12 could give full informed consent to receiving puberty blockers. They were also "doubtful" that children ages 14 and 15 could give full consent. The 2020 UK judicial review highlighted ethical dilemmas surrounding the medical "affirmation" of minors. The High Court judgement also allowed the NHS to suspend the initiation of hormonal interventions to minors under 16. Children between the ages of 16 and 18 were only allowed to do so clinical trial settings approved by an institutional review board.

Sweden effectively banned the use of the drug on children under the age of 18, and those who wanted to use the drug after turning 18 were only allowed to do so in a research setting. The policy states that careful assessment of the patient's maturity level must be conducted to determine if the patient is capable of providing meaningful informed consent. There is also an added clause that both patients and guardians must be informed of the potential risks and permeances of the drug.

Several European countries found the evidence base to be insufficient in justifying routine early medical interventions for gender-dysphoric minors. Final revised its treatment guidelines in 2020, prioritizing psychological interventions over medical interventions, particularly for minors.

In North America, the debate around the drug Lupron and its class of drugs is highly politicized. Several US states used laws to ban the use of hormonal interventions in dysphoric minors, while other states introduced a wide range of gender-"affirming" medical and surgical interventions for "gender incongruence", regardless of the patient's age or mental health status. The Canadian bill "Bill C-6" seeks to criminalize psychological treatments of gender dysphoric minors. While this effort criminalizes conversion therapies, it also removes the non-invasive medical options.

Only one type of Lupron is no longer distributed in America due to a national shortage caused by a routine manufacturing compliance review. Six other types are still on the market.

Perceptions and discrimination
Many transgender people medically transition through hormone replacement therapy (HRT) and/or surgeries to bring their bodies into alignment with their gender identity. However, not all people wish to, choose to, or have access to resources to be able to medically transition. Medical transitioning is often emphasized by cisgender people, and is a core belief of transmedicalism, but a trans person's identity is self-determined and not dependent upon procedures or appearance. In a 2018 survey, 52% of transgender people sought HRT or other medical care to help transition to their correct gender.

For some, the desire to transition stems from gender dysphoria, referring to the experience of intense distress with the lack of alignment between assigned gender at birth and gender identity. Dysphoria is not experienced by every trans person, and it is not necessary to be trans. However, because medical transitioning involves medical professionals, it often requires a diagnosis of gender dysphoria. Dysphoria often begins in childhood, but some people first experience it after puberty.

In the 21st century, being transgender has been incorrectly viewed as a trend or a fad that will pass. However, transgender people have always existed. This belief sometimes has been attributed to Western colonialism. Western colonialism began around the 15th century at a time when European countries sought to increase their power through conquering and exploiting other nations and indigenous peoples. One of the many tactics of colonialism is enforcing a place's culture and language onto another place. Western colonialism was so widespread that by 1914, most nations in the world had been colonized by European forces at some point. Western colonialism impacted other cultures' abilities to define genders in culturally specific ways through enforced assimilation versus annihilation, which caused the erasure of transgender people in history. Transgender people have had many different names and histories in various cultures around the world, some of which have involved sacred and/or important positions in their societies.

Gender essentialist beliefs and the gender binary impact the way transgender individuals are stigmatized as defiant or deviant. The stigma denies equal opportunity to prosperity as it impacts every aspect of life, such as economic and housing aspects, familial or social support systems, and mental health.