Glossary

 

This glossary is the cumulative work of detrans and desisted people and professionals in the mental health field. It comes from our knowledge and experiences in trans and detrans culture. This glossary is our attempt to categorise and make available the words and phrases associated with transition and detransition. Not all the definitions in this glossary will be universally used or understood  in the same way.  Meanings can vary from group to group and person to person within trans and detrans culture. We will do our best to update any words in this glossary that may evolve in meaning as time goes on. We will also add words or phrases that may come to our attention.  This glossary is a living document. 

 

AFAB: Acronym for “assigned female at birth,” a descriptive term which is preferred by some people over the term “born female.”

AMAB: Acronym for “assigned male at birth,” a descriptive term which is preferred by some people over the term “born male.”

Autogynepilia (AGP): Autogynephilia is a sexual fixation experienced by some men, in which they are sexually aroused by imagining themselves as female, or as dressing or acting in a feminine way.  While autogynephilia has historically been stigmatized, it is accepted and a common topic in men’s crossdressing and “crossdreaming” communities.

Body Dysmorphia: Body dysmorphic disorder (BDD) is a mental health disorder in which a person becomes preoccupied or fixated with a perceived flaw with their body or appearance. The person believes that some part of their body is “ugly” or “deformed” when in fact it is not. The person may avoid social situations because of their belief that they have this “ugly” or “deformed” body part. People who struggle with BDD often seek out plastic surgery or other “corrective” means to fix the perceived flaw with their body part. It is believed that BDD shares some similarities with eating disorders and Obsessive-Compulsive Disorder. People who struggle with eating disorders often also struggle with body dysmorphic disorder. BDD is one of many mental health issues whose symptoms are sometimes misinterpreted as being caused by gender dysphoria.  This may cause a person with these symptoms to self-diagnose with gender dysphoria, or to be diagnosed with gender dysphoria by a therapist, despite the symptoms having a different root cause.

Cisgender: Often abbreviated as “cis”. Used to distinguish between a transgender person and a person who is not transgender. Commonly used by trans identified people to refer to people who do not identify as transgender. It can also carry an implication that a person is uninformed or “out of the loop” in relation to complex concepts of gender identity, that their relationship to gender is simple and easy for them to manage in their daily life, and that they do not experience distress related to gender, gender roles, and the sex characteristics of their body.  Depending on context, it can also be used to imply that a person is traditional or conformist in their adherence to social roles stereotypically associated with their sex.  Some people who are not trans do not identify with the term cisgender and prefer to not be referred to as cisgender.

Cross-Sex Hormone Therapy: Also called “hormone replacement therapy” (HRT). A medical intervention used in female-to-male and male-to-female gender/sex transition.  Females are given testosterone to masculinize their features and bodies, and males are given estradiol (synthetic estrogen) to feminize. Cross-sex hormone therapy can only change a person’s secondary sex characteristics, and cannot change a person’s biological sex.

DBT: DBT stands for Dialectical Behavior Therapy. This therapy was developed by Behaviorist and Psychologist Dr. Marsha Linehan specifically to help people who have difficulty regulating distressing emotions and presenting with significant suicidality, symptoms characteristic of Borderline Personality Disorder. A full DBT program entails weekly group sessions to learn and review behavioral skills (mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation), phone check-ins, and weekly individual therapy. The DBT program and skills have been adapted to help people with a variety of difficult emotional and behavioral issues, including people with eating disorders.

Depersonalization/Derealization: Depersonalization and derealization are types of dissociative symptoms. Depersonalization is an experience of feeling detached from one’s body or self: for example, feeling like one’s body is not one’s own, feeling like one’s actions are out of one’s control or are robotic, or not recognizing one’s self in the mirror. Derealization is the experience of the world being unreal, feeling that some aspects of the world (like certain people or objects) are unreal, or feeling as though one is in a dream. Derealization can be accompanied by side effects such as changes in vision (either blurriness or heightened/sharpened vision), changes in physical perspective (reduced or increased sense of depth perception), and a distorted sense of the passage of time. During episodes of depersonalization/derealization, the person remains in contact with reality and can typically respond to events in their environment as normal.  Depersonalization and derealization are two of the many mental health issues whose symptoms are sometimes misinterpreted as being caused by gender dysphoria.  This may cause a person with these symptoms to self-diagnose with gender dysphoria, or to be diagnosed with gender dysphoria by a therapist, despite the symptoms having a different root cause.

Desistance from transgender identity: Desistance can be a return to previous identity, reidentifying with one’s birth sex, or simply ceasing to identify as transgender. It does not necessarily require any physical change, such as medical detransition or change in presentation. Desistance is more an internal process based on one’s sense of self then an external process or physical change.

Desister/desist: See: desistance.  A desister is a person who identified as transgender (or nonbinary) for a period of time, and who no longer does, but who did not take medical steps to transition.  The difference between a detransitioner and a desister is that a detransitioner took medical steps to transition (such as taking hormones or undergoing surgery), and a desister did not.

Detrans: See: detransition

Detransition: The act of returning to living as one’s biological sex after a period of medical transition to the opposite sex/gender. Although many aspects of medical transition are not reversible, such as mastectomies or the removal of reproductive organs, some aspects are reversible. The most common way in which people detransition is stopping hormone replacement therapy (hrt) and returning to the hormones of their biological sex. If gonads (ovaries or testes) remain intact, simply stopping continued use of hrt will allow the body to continue normal hormone production. If reproductive organs have been removed, then the individual will be required to use synthetic hormones of their biological sex for the remainder of their lives. Medical detransition does not necessarily mean the person does not still identify as trans or wishes to return to living as their birth sex. Some people must stop medical transition for health reasons or other complications. Like many trans related terms, detransition can have other meanings depending on location and individual experiences. Some people will use ‘detransitioner’ to mean anyone who no longer identifies as transgender, regardless of medical transition. 

Differential diagnosis: The process of differentiating between two or more conditions which share similar signs, symptoms, or presentation.  This is done to avoid putting a person through medical or psychiatric treatment for a condition that is not actually the root cause of their symptoms.  In the context of trans medicine, differential diagnosis could involve screening a patient for conditions such as body dysmorphic disorder, PTSD, dissociative disorders, and OCD, to determine whether their symptoms of dysphoria could be rooted in one or more of these conditions, and offer treatment appropriate to the disorder(s).  Differential diagnosis is a controversial topic in trans medicine.  Many detransitioners believe that they could have avoided transition if they had been offered a differential diagnosis rather than having medical transition presented as the only option for relief from their symptoms.  Some transgender activists believe that differential diagnosis should not be offered to dysphoric patients, because it is seen as invalidating to the patient’s identity.

Dissociation: The feeling of being separated from yourself, either physically or mentally. Common symptoms include feeling disconnected from your body, feeling like you are living in a dream, and loss of memory. There are three types of dissociative disorders: Dissociative Amnesia, Dissociative Identity Disorder, and Depersonalization/Derealization Disorder. Trauma is the most common cause of dissociation and dissociative disorders. Dissociation is one of many mental health issues whose symptoms are sometimes misinterpreted as being caused by gender dysphoria.  This may cause a person with dissociative symptoms to self-diagnose with gender dysphoria, or to be diagnosed with gender dysphoria by a therapist, despite the symptoms having a different root cause.

Eating disorders: People with eating disorders experience disturbances in their eating behaviors and related thoughts and emotions. They typically become preoccupied with food and their body weight. The most common of these disorders include anorexia (restricting food intake), bulimia (overeating/bingeing followed by purging), and binge eating disorder (episodes of eating large amounts of food while feeling out of control). Eating disorders may result from using food and eating as a means to regulate difficult emotions, inlcuding as a means of disconnecting from one’s body to avoid feeling difficult emotions. Some people recognize that their disordered eating is a way to maintain power and control over their bodies and experience. This is one of several mental health issues whose symptoms are sometimes misinterpreted as being caused by gender dysphoria.  This may cause a person with disordered eating to self-diagnose with gender dysphoria, or to be diagnosed with gender dysphoria by a therapist, despite the symptoms having a different root cause.

Estrogen: The primary female sex hormone and largely produced by the ovaries. Estrogen contributes to women’s overall health, including bone growth and density, as well as regulating the reproductive system. It promotes growth and development of breast tissue in female puberty. Estrogen is also produced by males, but at significantly lower levels than that of females.  Estrogen in its synthetic form is called Estradiol, and is considered identical in its chemical form to estrogen produced by the ovaries. Estradiol is most often prescribed to women to ease the symptoms of menopause and retain bone density. It is also prescribed to males as a part of feminizing hormone therapy. It can be given in pill, gel, patch or injectable forms.  

FTM: Female-to-Male transgender/transsexual.

Gatekeeping: Any process within the medical system or mental health system that determines which patients are offered medical interventions for gender dysphoria, i.e. medical transition.  Within the transgender community, the term “gatekeeping” often has a negative connotation, and implies an antagonistic relationship between two groups: the patients, who seek medical transition, and the medical professionals who are responsible for choosing whether or not to administer the desired medications and surgeries.

Gatekeeping covers a broad range of screening processes, including:

– An assessment by a therapist to ensure that a patient is mentally sound and capable of understanding the consequences of their actions and decisions.

– A health screening to determine whether a patient has pre-existing medical conditions that could increase the health risks associated with cross-sex hormones or sex reassignment surgeries.

– A mental health screening to determine whether a patient has pre-existing mental health conditions that could be the root cause of their dysphoric symptoms, in which case treating the root cause may be more effective in reducing distress than medical transition.

In the past, it was common for gatekeeping to include an analysis by a therapist to ensure that a person would live a “normal” lifestyle for their desired gender, including enjoying clothing and social roles typical for their desired gender, and requiring that they be attracted to the gender opposite the one they intend to transition to (so that they would be “heterosexual” after transitioning).  This is now considered regressive by most people and is generally not supported within trans or detrans communities.

Gender:The term “gender” has several different meanings:

– In mainstream terminology, gender is synonymous with sex.

– In queer theory, gender is defined as the cultural associations attached to people of a specific sex or gender identity.  This definition has made its way into mainstream use in recent years.

– In the transgender community, it is used to encompass a number of different concepts: an innate neurological “sense of gender”, gender identity, gender expression, any feelings a person has related to the cultural expectations imposed on them based on their sex, and a person’s overall relationship to the concept of gender and how they engage with it in their daily life.  The term “gender” is often used in a way that does not differentiate between these things.

Gender/Sex dysphoria: Feeling emotional distress with regard to one’s sex/gender. People describe gender/sex dysphoria as a feeling of wrongness with their bodies, specifically their biological sex and/or genitalia, feeling uncomfortable with being perceived by others as their biological sex, or feeling disconnected from the gender/sex roles associated with their biological sex.  Some people, but not all, make a distinction between sex dysphoria, which relates to feelings about one’s body, and gender dyshoria, which relates to personal identity and how someone wants to be perceived by others. In addition to this, there are many broad categories of mental health issues and neurological differences whose symptoms are sometimes seen as being evidence that a person has gender dysphoria.  These include: body dysmorphia, dissociative disorders (especially depersonalization and derealization), obsessive-compulsive disorder (OCD), PTSD, attention deficit disorder (ADD), sensory processing differences, and cognitive differences related to autism.  People with these issues and cognitive differences sometimes report being diagnosed with gender dysphoria by a therapist (or self-diagnosing with gender dysphoria) as a result of their symptoms, despite their symptoms having a root cause unrelated to gender dysphoria.

Informed consent: A common legal/medical practice in which the patient agrees to a medical procedure after receiving all information relevant to the procedure, such as expected benefits and potential risks.  The patient is also assessed by the physician to ensure that they are able to make informed decisions about their health. The legal process of informed consent for transition treatments (HRT and surgery) is the same as for other medical procedures.  However, there is a difference in that transgender medicine has not received the rigorous research that most medical procedures have had before being offered as a treatment to patients. For example, testosterone, commonly used by FTM individuals, has no long-term studies regarding its effects on the female body.  Many side effects of testosterone are not well understood, and the effects of long-term use are not known. The biggest criticism of informed consent within transgender medicine is that the physician does not have sufficient information on the effects and possible dangers of the medical procedure, and thus cannot provide this information to the patient. Some patients also report not being properly informed by their doctor of the most common effects of HRT or sex reassignment surgeries.

Informed consent model of transgender care: Within the informed consent model of transgender care, a person who desires medical transition (hormones or surgery) receives these treatments at their own request, without being diagnosed with gender dysphoria, undergoing a mental health evaluation, or obtaining a referral from a physician.  This differs from the diagnostic model of medical care, in which a physician is responsible for diagnosing a patient based on their existing symptoms and referring them to treatments that are likely to improve their physical or mental health.  The informed consent model reduces the legal liability of the physicians involved, since they are not required to act in the patient’s best interest, only to administer medications and surgeries requested by the patient. This model is often used by gender clinics in the United States.

Internalized homophobia: The negative beliefs and stereotypes about same-sex attraction that a person who is lesbian, gay or bisexual may believe about themselves and other same-sex attracted people. It can manifest as a feeling of repulsion towards same-sex attraction, a feeling of disgust with one’s own sexuality or gender presentation, feelings of dislike for other same-sex attracted people, or embarrassment around one’s sexuality and/or gender presentation. People who struggle with internalized homophobia are often unaware that they have it, since it is mostly turned inward on the self. Feelings of self-loathing and disgust with one’s own sexuality, biological sex, and gender presentation are common.  Some desisters and detransitioners report that their feelings of gender dysphoria were caused in part by internalized homophobia.  This can happen in several ways. A person who is same-sex attracted may feel a sense of relief at distancing themselves from the social categories of “lesbian”, “gay man”, “homosexual”, etc, and feel more comfortable with the social category of “transgender”.  Or, a person who is same-sex attracted may feel more comfortable perceiving themselves as the opposite sex, allowing them to perceive their attractions as “heterosexual”.  Internalized homophobia can also cause a person to feel disgusted with their own body, especially with the sexual characteristics of their body, and some people interpret those feelings as sex dysphoria.

Legal gender/sex detransition: As a part of detransition, people may opt to legally change their gender/sex marker and/or their legal name — either back to their original name and gender/sex marker or to something new. As with legal gender/sex transition, this can be an expensive process, including court fees, passport and state identification card application fees, and administrative fees. Some transgender advocacy organizations provide microgrants to people in need of financial support for such changes, but it is unclear if these are available to people who are detransitioning. Many times, legal detransition involves the same steps as legally transitioning the first time. In some states and countries, detransitioners may find it difficult to change their legal gender/sex marker back to their birth sex on documents such as their birth certificate or passport. This may require more steps and supporting documentation than were required when changing the legal gender/sex marker the first time. Detransitioners may decide that legally changing their name and gender/sex marker a second time is too burdensome and opt to not legally detransition. A detransitioner may also simply view this kind of change as unimportant.

Legal gender/sex transition: In general, a legal gender/sex transition is the act of changing all legal documentation to the opposite sex/gender from the person’s birth sex. This usually entails a name change as well as the sex/gender marker on driver’s license, birth certificate, and government ID. Depending on local laws, a letter or legal form from a doctor or surgeon stating that the individual has undergone some form of sex/gender change may be required, but this is not always the case.

LGBT: An acronym which stands for “lesbian, gay, bisexual, transgender.” Lesbian, gay, bisexual, and transgender people have been grouped together under this acronym since the 1990s. Advocates for gay and transgender rights have formed coalitions together to promote shared political interests.

Medical gender/sex detransition: Typically includes the process of stopping cross-sex hormone therapy and/or beginning sex-congruent hormone therapy. If no surgeries on reproductive organs/gonads have been performed (orchiectomy, vaginoplasty, oophorectomy, phalloplasty), the body may regain its ability to produce its own natural sex hormones. Detransitioners may or may not pursue procedures to reverse permanent effects of medical transition. Reversal procedures include facial hair removal and vocal training for detransitioning females, transgender surgery reversals (reconstructive surgeries) for both detransitioning males and females, and gynecomastia surgery/mastectomy for detransitioning males.

Medical gender/sex transition: Transitioning from one’s birth gender/sex to the opposite gender/sex through the use of cross-sex hormones (also called hormone replacement therapy, or HRT) and surgical interventions. Surgeries for female-to-male (FTM) trans-identified people include “top surgery” (mastectomy with chest reconstruction to provide the appearance of a male chest), metoidioplasty (surgery to enlarge and straighten the clitoris, giving it a penis-like appearance), and phalloplasty (transplanting tissue from elsewhere in the body to construct a penis). Surgeries for male-to-female (MTF) trans-identified people include orchiectomy (removal of the testes and scrotum), penectomy (removal of the penis), vaginoplasty, breast augmentation, and facial feminization surgery.  Medical transition can include only HRT and does not necessarily require any surgical intervention.

MTF: Male-to-Female transgender/transsexual.

Nonbinary: An identity or label that is used to express that a person does not identify fully as a man or a woman, or does not feel fully aligned with a masculine or feminine gender expression. Not all people who feel this way identify as nonbinary, and for those who use the term, it may have different meanings for different people.

Progesterone: A hormone that is primarily responsible for regulating menstruation and supporting pregnancy in females.  It is also found in males, although at significantly lower levels then in females. It is believed that progesterone in males assists in the development of sperm. Progesterone in its synthetic form is called Progestin and is primarily used in birth control and to alleviate menopausal symptoms in women. Although it has not been studied for use in males, and there is little scientific evidence that taking Progestin aids in feminization, many male-bodied transgender people use it along with synthetic estrogen to feminize their bodies.

Puberty Blockers: A class of medications called gonadotropin-releasing hormone (GnRH) agonists. These medications have been primarily used to treat symptoms associated with prostate cancer in men, endometriosis in women, and central precocious puberty in children. Central precocious puberty is a condition where children begin puberty too young, usually between the ages of 5 and 9, causing faster then normal bone growth. The two most commonly used GnRH medications are histrelin acetate and leuprolide acetate.  Leuprolide acetate is commonly known as Lupron and is the most widely used in this class of medications. In recent years, GnRH medications have been used to halt the normal puberty of children considered to be transgender, the idea being that this will give the children and their family more time to make the decision as to whether to proceed with medical transition or not. Medical transition includes cross sex hormone replacement therapy (HRT) and sex reassignment surgeries (SRS).

Although the use of puberty blockers is a common practice in pediatric transgender medicine, some concerns have been raised in recent years as to the safety of these medications. Lupron, the most widely used medication in this class, is a powerful medication known for its long list of side effects, many of which are severe. There have been concerns that many adults who received Lupron as children to halt puberty suffered significant bone density loss, which in adulthood led to repeated bone fractures and crippling. Lupron and other GnRH agonists have not been approved by the FDA for use in children, and have not been extensively tested for safety in children. However, they are commonly prescribed to children as an off-label drug, a process which does not require FDA approval or proof of safety or effectiveness.

Rapid-Onset Gender Dysphoria (ROGD): This term was coined by public health researcher Dr. Lisa Littman. The term descibes a phenomenon of adolescents and young adults appearing to develop symptoms of gender dysphoria after encountering social influence through social media, peer groups, and/or learning about transgender topics, including medical gender transition. This is similar to the ways that the development of eating disorders have been observed in peer groups of adolescent females. In ROGD, gender dysphoria (significant distress related to gender/sex) is not experienced in childhood, only developed in adolescence or young adulthood. Additionally, there is a rapid onset of symptoms, meaning that once the young person’s distress has been self-labeled as gender dysphoria and the young person begins to self-identify as transgender, symptoms of distress related to gender/sex and gender identity intensify.

Reconciling: In relation to detransition, people who detransition or desist feel the need to reconcile or attempt to live harmoniously with the parts of their bodies and lives they previously tried to change. Many detrans people undergo a personal process of reflection and self-examination to reconcile with their birth sex and their experiences living as that sex.

Reidentified: When used by detransitioning/detransitioned and desisted people, to “reidentify” is to identify again with one’s biological sex, or with the gender identity associated with their sex.

Social gender/sex detransition :The act of socially reidentifying as one’s birth gender/sex after a time of identifying as the opposite gender. Social detransition may include: reidentifying as one’s birth gender/sex to family, friends and others within one’s social circle, requesting that others use the pronouns that align with their birth gender/sex, and sometimes (but not always) returning to a previous way of dressing or presenting. Social detransition is the interpersonal social part of detransition, and does not necessarily include medical detransition. It’s important to note that some detranstioned people do not attempt to change their presentation or way of dressing in an attempt to look like their birth gender/sex, and some may not be easily recognized by others as their birth sex due to medical transition.

Social gender/sex transition: The act of socially identifying as transgender, or as the opposite gender to that of one’s birth sex/gender. Social transition may include identifying as transgender to family, friends and anyone within the person’s social circle, requesting that others use the pronouns that correspond with their gender identity, dressing or presenting as the opposite gender, and attempting to live one’s life according to the desired gender. Social transition does not necessarily include medical transition, but instead is the interpersonal social part of gender transition.

“T,” Testosterone: Slang for testosterone. Testosterone is the primary male sex hormone and plays a key role in the development of the testes and prostate in men. Testosterone promotes the development of male secondary sexual characteristics, such as male-patterned distribution of body fat, increased muscle mass, deepening of the voice, male-pattern baldness, and development of coarse facial and body hair. Testosterone is also produced naturally by females, but at significantly lower levels than that of males. Testosterone is prescribed to females as part of masculinizing hormone therapy, and is administered most commonly as subcutaneous or intermuscular (IM) injection or topical gel.

Testosterone Blockers: Medications that prevent the production of testosterone in males. There are three commonly used medications: Spironolactone, Finasteride, and Dutasteride. These medications target a specific form of testosterone called dihydrotestostrerone, which affects hair, skin, and the prostate. Spironolactone is known to have a high number of negative side effects and is often not tolerated well. Finasteride or Dutasteride are often used in place of Spironolactone. These two medications are a weaker testosterone blocker then Spironolactone, but are considered to be safer.

Transgender: A person who does not identify with the sex/gender they were born as. People who identify as transgender often feel that they have an innate gender identity which is in conflict with their birth sex.  This gender identity may manifest as a desire to be perceived as a member of the opposite sex, or a desire to have a body of the opposite sex.   Many describe a feeling of incongruence between their body and mind. Some transgender people experience psychological discomfort with their genitalia, feeling as though they should have the genitalia of the opposite sex. Transgender people often seek medical intervention to change their bodies to resemble that of the opposite sex. More recently, “transgender” has sometimes been used as an umbrella term for anyone who does not adhere to the social roles or stereotypes associated with their birth sex, even though this encompasses many people who do not identify as transgender.

Transman/Transsexual man: A person born biologically female who identifies as a man, or who medically transitions to appear more male. Also referred to as a transsexual man, although this is an older term and no longer widely used.

Transphobia: In the most general sense, transphobia is prejudice, dislike, or discrimination against transgender people.  It is sometimes used broadly to apply to any belief or behavior that does not conform to beliefs commonly held in the transgender community.  This usage is especially common online.  The question of whether a given belief or behavior is transphobic is often a subject of debate in online spaces.

Transwoman/Transsexual woman: A person born biologically male who identifies as a woman, or who medically transitions to appear more female. Also referred to as a transsexual woman, although this is an older term and no longer widely used.