THE BLOG

What Does It Mean to Be Transgender?

02/18/2015 04:26 pm ET | Updated Feb 02, 2016

Whether the rumors about Bruce Jenner are true or not, the story has definitely stimulated a national conversation about what it means to actually be transgender.

Ryan Sallans, who is a transgender man and author of the book Second Son, is an activist and international speaker on this topic. Ryan has agreed to answer my questions regarding some of the most-talked-about questions about what it means to be transgender. Here's our full interview; it sheds more insight into this often-misunderstood identity.

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Dr. Robi: What does it mean to be Transgender?

Ryan: To be transgender may mean something different, depending on who you ask, because it is used either as an umbrella term for people in the community, or as an individual identifier. Something I do when speaking to audiences, to help them better understand what transgender means, is to break it down into two parts. First, "trans" in Latin means "to cross," so when we say someone is "transgender" we are saying that they are "crossing gender."

Second, when we talk about gender we may be describing one of three things, a person's gender identity, a person's gender expression or a combination of both. Gender identity refers to our brain; it is our psychological identification of gender. Gender expression is the way we communicate our gender, for example the way we walk, our voice infliction and tone, the way we dress, and our body language. We define gender expression as masculine, feminine or androgynous traits. To be transgender means a person's gender identity is different from the sex they were assigned at birth, or a person's gender expression is outside of traditional societal norms.

Dr. Robi: Is being transgender the same as being transsexual?

Ryan: Transgender is the umbrella term that transsexual falls under, so not everyone who is transgender is transsexual. If we look at the root of the term, transsexual, "trans" means to cross, so here we are crossing "sexes." For example, I was born assigned female, but at the age of 25 I began my transition to align my body with my mind and male identity, so I could be categorized as transsexual, although I more frequently use the term transgender to describe myself. As our language continues to evolve, we are seeing more people adopt the umbrella term, transgender, over using the term transsexual to describe their identity.

Dr. Robi: Is there an age when people start to realize they might have a conflict with the gender they have been born with? Or can this vary widely?

Ryan: First, we need to remember to recognize that a person's biological sex and their gender are two different things. Our biological sex is what we are assigned at birth when the doctor looks between a newborn's legs and proclaims they are a "boy" or a "girl." This is flawed because we know that biological sex goes beyond "boy" and "girl" as our biological sex is a composition of our internal and external anatomy, our hormones and our chromosomes.

So recognizing boys and girls completely ignores people who are intersex, meaning they have a different composition of either anatomy, chromosomes or hormones outside of what we define as male and female. Our gender, as I mentioned above, is composed of our gender identity and gender expression, which develop overtime and can align with or be different than our biological sex.

Different researchers, educators and psychologist have looked at the development of gender identity overtime and have determined a range of when we first begin to sense our gender identity, stabilize our gender identity and then concretized our gender identity. In the book The Transgender Child by Stephanie Brill and Rachel Pepper, it is stated that we have a sense of our gender identity as early as 18 months, and that we become more concretized by ages nine to twelve. What this means is that when we see children who are expressing a transgender identity at a young age and they continue to be consistent, persistent and insistent about their identity through adolescents, we are most likely seeing a child that will move on to be a transgender adult. Having said that, I didn't realize I was transgender until the age of 25, and I know other people that do not come out until their 50s or 60s, so the gender identity development timeline cannot be predicted for each individual.

Dr. Robi: What does being transgender mean about one's sexuality, and being gay or straight?

Ryan: Sexual orientation and gender identity are a part of a person's sexuality, but they are two different parts. Oftentimes, people try to put these two together, or we assume that one is correlated to the other, but that is just not the case. When we talk about transgender identities we are talking about gender identity and expression, when we talk about sexual orientation we are talking about romantic, affectionate and erotic orientations toward other people. I am a transgender man who is in a monogamous relationship with a woman, on the outside people would define us as a heterosexual couple, however I define my sexual orientation as queer because although I am partnered with a woman, I experience different levels of attraction to people outside of a female identity.

Dr. Robi: Is it easier to transition from one sex over another? For example, is it easier to transition from being a man to a woman, or a woman to a man? Or does this make no difference at all?

Ryan: Any transition isn't easy, period. I don't care who you are, how much money you have or don't have or what family you come from. The emotional and physical toll that a transition can take, along with the worry about how family, friends, co-workers, etc. will handle the news, and the potential harassment and discrimination that a person faces when they transition, is overwhelming and at times can feel defeating.

Dr. Robi: I've heard there are more than two gender identities and that the term transgender is a broad term for people who don't identify with the gender they were assigned at birth?

Ryan: As I mentioned earlier, gender identity is our psychological identification of gender. Gender identity can go beyond identifying as a man or a woman. For example, some people are gender fluid, meaning they move between genders. Bi-gender is a term used to describe a person that has a sense of being both a man and a woman; in the Native American culture, a bi-gender person would be referred to as two-spirited.

For people that identify their gender outside of a man or woman, they may use the term genderqueer to define themselves. This term is often used as an umbrella term for people who do not identify within the binary (being a man or a woman). Agender is a term used to describe a person who identifies as genderless, while others may use this term to define their gender as being neutral. It is important to recognize that how a person defines their identity may be different than some of the ways these terms have been defined above. To not assume anything, ask people what their gender identity means to them individually.

Dr. Robi: How does someone know if they are transgender? Are there a list of questions they should consider asking themselves to get more insight into this question?

Ryan: Every person's journey and self-discovery is different. Usually it begins with a feeling, a feeling of not fitting in, desiring something different from what you are told you should want, longing to be a different gender or feeling like you don't really belong in any specific gender. The key at this time is to remain open, to explore feelings through artwork, music, journaling, talking, research and/or therapy, and to be patient. Knowing who you are doesn't happen overnight, and it not necessarily a linear process.

In a way, we are all constantly exploring who we are throughout our lifespan. While providers may use different tools and assessments when working with folks who are exploring their identity, the best questions an individual can ask themselves are: What am I feeling? Why am I feeling this? What does my future self look like and feel like? What am I scared of? What excites me? What, deep down inside, feels right for me?

Dr. Robi: Would it make sense to work with a gender therapist to explore the question if they are transgender? And if so, how does a person find this type of therapist?

Ryan: I am a huge advocate for therapy. I think EVERYONE should undergo therapy at some point in their life. If someone desires to explore their gender identity or expression with a therapist, finding one that is knowledgeable about transgender identities and issues is ideal. The one catch to this is that there isn't a specific, certification program that trains people to be gender therapist, so anyone can say they specialize in this topic. For example, many people use Psychology Today to find mental health providers for specific issues; any provider can click a box and say they work with clients that are transgender, but not really know what they are doing.

Transgender people often become the educators and advocates for their own health, not only with therapist, but also with medical providers. When looking for a provider, some helpful tips include asking other people (who are exploring their gender) who they went to and how they felt about their sessions; a person can also research online to see a provider's experiences in the field. Attending conferences where both transgender people and professionals may be attending or presenting can also be a way to connect with providers. I wrote a blog on this topic that may also be helpful: found here.

Dr. Robi: Are there books, workbooks, blogs people who want to learn more about what it means to be transgender should explore?

Ryan: Doing an internet search will pull up hundreds of different resources and books that may be helpful. In order not to get overwhelmed, first think about a specific area that you are interested in exploring, are you interested in personal stories, medical and mental health care, media coverage, family and friend support, politics and legalities or movies and documentaries?

It is helpful to put in further identifiers in your search to help you find more specific information. If you begin with professional organizations, some helpful resources, include: the World Professional Association for Transgender Healthcare, National Center for Transgender Equality, National LGBTQ Task Force, Lambda Legal, Center for Transgender Excellence, TransActive, Trans Youth Family Allies, Gender Spectrum and PFLAG.

Dr. Robi: How can one be a supportive friend, co-worker or family member to a person who is transgender or thinks they might be?

Ryan: The first thing one can do is to sit down and listen to the person who has chosen to share this very private part of their life and their identity with them. The second thing is to support the person who has come out as transgender, and to not ask invasive questions. The third thing is to respect the person who has come out and to not share anything about this person's identity with other people (this is something the media really needs to work on).

The fourth is to be flexible. Some people need to try out different names, pronouns or identities; it is a time for exploration and to find what fits right, what feels right and what affirms who they are.

Lastly, if you hear people talking about it, or you hear jokes that are attacking the transgender community, use your voice and stand up for the community. Begin to ask questions and challenge old ways of thinking.