Transgender Starting Points

Gender Dysphoria

The term “transgender” refers to a person whose sex assigned at birth (i.e. the sex assigned at birth, usually based on external genitalia) does not align their gender identity (i.e., one’s psychological sense of their gender). Some people who are transgender will experience “gender dysphoria,” which refers to psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity. Though gender dysphoria often begins in childhood, some people may not experience it until after puberty or much later. more…


  • Cisgender: Describes a person whose gender identity aligns in a traditional sense with the sex assigned to them at birth.
  • Gender diverse: An umbrella term describing individuals with gender identities and/or expressions and includes people who identify as multiple genders or with no gender at all.
  • Gender dysphoria: A concept designated in the DSM-5-TR as clinically significant distress or impairment related to gender incongruence, which may include desire to change primary and/or secondary sex characteristics. Not all transgender or gender diverse people experience gender dysphoria.
  • Gender expression: The outward manifestation of a person’s gender, which may or may not reflect their inner gender identity based on traditional expectations. Gender expression incorporates how a person carries themselves, their dress, accessories, grooming, voice/speech patterns and conversational mannerisms, and physical characteristics.
  • Gender identity: A person’s inner sense of being a girl/woman, boy/man, some combination of both, or something else, including having no gender at all. This may or may not correspond to one’s sex assigned at birth.
  • Nonbinary: A term used by some individuals whose gender identity is neither girl/woman nor boy/man.
  • Sex/gender assigned at birth: Traditional designation of a person as “female,” “male,” or “intersex” based on anatomy (e.g., external genitalia and/ or internal reproductive organs) and/or other biological factors (e.g., sex chromosomes). “Sex” and “gender” are often used interchangeably, but they are distinct entities. It is best to distinguish between sex, gender identity, and gender expression and to avoid making assumptions about a person regarding one of these characteristics based on knowledge of the others. This is sometimes abbreviated as AFAB (assigned female at birth) or AMAB (assigned male at birth).
  • Sexual orientation: Describes the types of individuals toward whom a person has emotional, physical, and/or romantic attraction.
  • Transgender: An umbrella term describing individuals whose gender identity does not align in a traditional sense with the gender they were assigned at birth. It may also be used to refer to a person whose gender identity is binary and not traditionally associated with that assigned at birth.

Pronouns (He & Them & Hers)

Using a person’s preferred pronouns demonstrates respect and insight to the person’s identity and preferences in how they wish to be addressed. Though changing a mentally assigned pronoun is not always easy it is important to have an open mindset that affirms the person’s identity is more important than your frustration by apologizing when appropriate, practicing, and correcting self. People who do this have been shown to be protective factors to psychological distress including severity of suicidal thoughts. For more on chosen names and pronoun affirmations affects on mental health please read the University of Texas’ article.

How to change your name in Massachusetts

What is binding?

Binding is a cosmetic modification to the body’s silhouette through the use of fabric, tape, and other materials. It is a practice that has been shown to reduce suicidal thoughts in those with dysphoria, and should be practiced no more than roughly 8 to 10 hours a day on a regular basis. For a comprehensive article on the medical risks associated with binding please go here.

What are Puberty Blockers?

Puberty blockers is a common term used for histrelin acetate and leuprolide acetate. A gender expansive adolescent should be granted a space to talk about whether or not there is a need for arresting the development of their secondary sex characteristics in order to have space and time to decide on whether or not they need to transition their body to cope with symptoms of Dysphoria. For more of an introduction to the benefits and risks of puberty blockers please read the Mayo Clinic’s article.

What does Hormone Therapy mean?

Hormone treatment refers to the use of supplementing the body with testosterone or estrogen; the effect of which maintains or affirms binary secondary sex characteristics. Target goals of the effects of hormone therapy should be well understood before treatment begins and reasoning should show insight on all aspects of effect it will have on the body, mind, and life of the person.

“Many transgender individuals seek cross-sex hormone therapy for treatment of gender dysphoria. Hormone therapy plays an integral role in the transition process for patients. Guidelines exist to help providers prescribe and monitor therapy. Hormone therapy has been shown to be associated with positive outcomes for patients, but there are important metabolic implications of therapy that must be carefully considered when treating patients.” – National Institute of Health

What is Gender Affirming Surgery?

Also known as Sexual Reassignment Surgery (SRS), is a surgery that modifies the genitals in order to reduce severe gender dysphoria symptoms associated with a person’s structure. For more on this topic please consult the following links: National Institute of Health, American Society of Plastic Surgeons, Cleveland Clinic, John Hopkins, Denver Health, and Michigan Medicine.

Finding a Medical Provider

Medical providers are often regionally clumped, but continued expansion of networks are forming to help navigate options for clients seeking gender affirming care. Recommendations of where to start include:

Edward M. Kennedy Community Health Center

Gender Multispeciality Service (GeMS)

Fenway Health

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