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Transgender people: 10 common myths

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Transgender people: 10 common myths

As transgender issues get more attention, pernicious myths remain. Here’s what you should know.

Myth #1: Transgender people are confused or tricking others

The most pervasive myth about transgender people — and the one myth that underpins much of the discrimination they face — is that they’re somehow confused or actively misleading others by identifying with a gender different from the one assigned to them at birth.

This misconception is “baffling to a lot of trans people,” Mara Keisling, a trans woman and executive director of the National Center for Transgender Equality, said. “We realize we’re among the few people who are really approaching things with full integrity and full transparency. We’re saying, ‘This is who I really am.’”

To understand why this is wrong, it’s first important to understand the concepts of gender identity and expression. Gender identity is someone’s personal identification as a man, woman, or a gender outside of societal norms. Gender expression refers to characteristics and behaviors a person identifies with that can be viewed as masculine, feminine, a mix of both, or neither.

The vast majority of Americans are cisgender, meaning they identify with the sex they were assigned at birth. Perhaps because of this — and because people who are not cisgender have been visible in the mainstream media only relatively recently — there’s an exposure gap for many Americans. For them, it can be difficult to understand how, for instance, a person born with a vagina and raised as a woman might identify as a man.

What pronoun do you use for a transgender person? Whatever they use for themselves.

Lily Carollo, a trans writer, said she helps cisgender people expand their views on gender identity through a thought exercise that, if successful, conveys the feeling of being identified by others as the wrong gender. She begins by asking people if a huge sum of money would get them to physically transition to the opposite gender. Most people say no, she said, because they’d rather continue presenting themselves as the gender they were born as and identify with. “If you go into why they’re answering no, they’ll usually say that it wouldn’t feel right,” Carollo said. “That’s what you lock into. Take that sense and imagine if you had been born in the opposite body.”

Studies also support the concept of gender identity. Researchers at Boston University School of Medicine conducted a review of the current studies. They concluded that the available data suggests there’s a biological link to a person’s gender identity, indicating that trans people are essentially assigned genders at birth that don’t match their inherent, biologically set identity.

This evidence suggests that trans people aren’t trying to trick anyone or confused. They’re simply trying to be the people they’ve long felt they are.

If trans people were confused, one would expect a lot of regret among people who medically transition. But the research doesn’t show this happening: As Brynn Tannehill, director of advocacy at the LGBTQ group SPARTA, wrote in the Huffington Post, multiple studies show almost no trans people — at most 1 or 2 percent — report regret after they medically transition.

Despite the evidence, most trans advocates will almost always mention this myth — of trans people being confused or tricking others — as the biggest problem trans people face. “It’s creating a phobia,” said Angelica Ross, CEO of TransTech Social, a company that actively trains and hires trans people to provide them with job opportunities.

So this myth is a problem not just because trans people’s testimonies and available scientific evidence show it’s wrong, but because it also feeds into some of the discrimination trans people face.

Myth #2: Sexual orientation is linked to gender identity

Equal rights battles and advocacy efforts have brought together gay, lesbian, bisexual, transgender, questioning, and genderqueer people over the past several decades. But that doesn’t mean that the basis for these identities is the same — in fact, sexual orientation and gender identity are very different.

Sexual orientation is who someone is sexually attracted to. Gender identity is who someone is. They are, as trans woman and former Olympian athlete Caitlyn Jenner explained to ABC News’s Diane Sawyer, “apples and oranges.”

Still, this remains a very common misconception. But a transgender person can identify as a woman, even though she was assigned male at birth, and be gay (attracted to other women), straight (attracted to men), bisexual, asexual (sexually attracted to no one), or attracted to a traditionally undefined gender. Trans men, gender nonconforming people, and genderqueer people can also be sexually attracted to men, women, both, no one, or another preference.

Mara Keisling, a trans woman and executive director of the National Center for Transgender Equality, acknowledged that this concept can be difficult to explain. “If somebody was living as a man dating women, and now they’re living as a woman dating women, what does that mean? They were straight; now they’re gay,” Keisling said. “But did their sexual orientation change, or were they always attracted to women?”

This infographic, put together by Trans Student Educational Resources, helps break through some of that confusion by showing how a person’s gender identity and expression fall outside characteristics like sexual orientation and sex assigned at birth:

The gender unicorn explains the difference between gender identity, gender expression and presentation, sex assigned at birth, and sexual and romantic attractions.

Myth #3: Letting trans people use the bathroom or locker room matching their gender identity is dangerous

Transgender people generally prefer using the bathroom or locker room that matches their gender identity, not the one that corresponds with the gender they were assigned at birth. But conservative critics argue that this could expose others to sexual voyeurism and assault in bathrooms or locker rooms — even though there’s no evidence to support this claim.

Former Arkansas Gov. Mike Huckabee perpetuated this myth at a 2015 convention, stating, “Now I wish that someone told me that when I was in high school that I could have felt like a woman when it came time to take showers in PE. I’m pretty sure that I would have found my feminine side and said, ‘Coach, I think I’d rather shower with the girls today.’”

But as Media Matters pointed out, experts from 12 states that protect trans rights have thoroughly refuted this talking point. In the US, there’s not a single reported instance of this kind of voyeurism occurring in states with legal protections for trans people.

Experts say LGBTQ nondiscrimination laws do not lead to sexual crimes in bathrooms.

In another investigation, Media Matters also found that 17 school districts around the country with protections for trans people, which collectively cover more than 600,000 students, had no problems with harassment in bathrooms or locker rooms after implementing their policies.

Conservatives usually counter that there are examples of men sneaking into women’s bathrooms to attack women. But as PolitiFact reported, none of the examples cited in the US happened after a city or state passed a nondiscrimination law or otherwise let trans people use the bathroom or locker room for their gender identity. Instead, these seem to be examples of men doing awful things regardless of the law — which has, unfortunately, happened since the beginning of civilization.

One example is a case in Toronto, Canada, which now has a nondiscrimination law, in which a man disguised himself as a woman and attacked women in shelters. But the attacks happened months before Ontario (Toronto’s province) protected trans people in a nondiscrimination law. So the law couldn’t have been the cause.

While the issue is now being used primarily against trans people, historically bathroom fears have been regularly deployed against civil rights causes. It was used against black people to justify segregation — by invoking fears that black men would attack white women in bathrooms. And it was used to stop the Equal Rights Amendment, which tried to establish legal equality between men and women, because opponents claimed it would lead to the abolition of bathrooms for different genders, potentially putting women in danger.

Some people are also, frankly, just bothered by the idea that someone in the same bathroom or locker room won’t share the same genitalia as them. 

This gets to the heart of the issue: Bathrooms are places where really private things happen, and that makes people feel vulnerable in all sorts of ways. “People are afraid because they’re exposed,” Kathryn Anthony, author of Designing for Diversity: Gender, Race and Ethnicity in the Architectural Profession, told the Guardian. “There’s a vulnerability we feel in public restrooms we don’t feel in other places.”

But a lot of things happen in public bathrooms that people aren’t comfortable with — and people have managed to deal with it to accommodate others’ rights and needs. 

So if it’s not harming anyone, perhaps it’s best, LGBTQ advocates argue, to let trans people use the facility for their gender identity without making them feel ostracized and discriminated against. (Discrimination is a huge contributor to gender dysphoria, a medical condition that some trans people experience that can cause depression, anxiety, and even suicidal ideation.)

But conservative lawmakers have latched on to the insecurity over bathrooms to propagate myths about the power of discriminatory laws to stop horrible attacks in bathrooms and protect people’s privacy. And although these are plainly myths with no evidence behind them, they’ve been used in attempts to perpetuate discrimination since the Jim Crow era.

Myth #4: Transitioning is as simple as one surgery

Transitioning is a long, complicated process that involves far more than medical procedures. Trans people also have to go through personal, legal, and social changes — and some may go through some of these changes but forgo medical procedures entirely.

Trans people individually decide how they’ll express their gender identity in different public and private settings. They may decide to be fully open with some people but cautious with others. Some trans people will also undertake legal changes, such as changing a name or switching a gender marker on a driver’s license. And those who are willing and can afford it will go through medical procedures, including hormone therapies, gender-affirming surgeries, or only some of the medical options.

Kortney Ziegler, a trans man in Oakland, California, described his transition as a journey. “I use that word — journey — because it contrasts from a definitive time stamp,” he said. “It’s not that simple for a lot of people.”

Depending on geography, the legal transition can be particularly tricky for some trans people. States have all sorts of requirements and rules for allowing people to, for example, change the gender marker on their birth certificates and driver’s licenses. Some require a court order, verification from a medical professional, or certain surgeries, while others don’t allow a change at all on some documents. (For a breakdown of states’ laws for identification documents, check out the databases at the National Center for Transgender Equality and Lambda Legal.)

The legal difficulties are just one of many examples that demonstrate trans people can’t just go through a simple medical procedure to reach the status they want in society. For some people, going through the social, legal, and medical hurdles is a years-long process — and local, state, and federal laws can make it difficult for trans people to fully complete their journeys.

Myth #5: All trans people medically transition

Not everyone who is transgender prioritizes or desires procedures, such as hormone therapy and gender-affirming surgeries, required for a full medical transition. While some undergo medical transitions for cosmetic, psychological, or health reasons, many won’t because they can’t afford it, face some other obstacle, or simply don’t want to.

The 2011 National Transgender Discrimination Survey found 61 percent of trans and gender nonconforming respondents reported having medically transitioned, and 33 percent said they had surgically transitioned. About 14 percent of trans women and 72 percent of trans men said they don’t ever want full genital construction surgery.

Some but not all trans people require but can’t access medical care. They may, for instance, suffer from severe gender dysphoria, a state of emotional distress caused by how someone’s body or the gender they were assigned at birth conflicts with their gender identity. This condition, the American Medical Association noted in a 2008 resolution, can lead to “distress, dysfunction, debilitating depression and, for some people without access to appropriate medical care and treatment, suicidality and death.” But the AMA and American Psychiatric Association say it can be treated by letting someone transition without significant barriers and social stigma.

But trans people very often face discrimination in medical settings that prevents them from getting this type of care. In a national survey published by various LGBTQ groups in 2010, 19 percent of trans and gender nonconforming people said they were refused care because of their gender identity or expression, 28 percent of trans and gender nonconforming respondents said they were subjected to harassment in medical settings, and 2 percent said they experienced violence. This led to delays in care for many people: 28 percent said they postponed medical care when sick or injured due to discrimination.

In 2016, the Obama administration clarified that Obamacare regulations explicitly prohibit anti-transgender discrimination from medical providers and insurers. So the type of discrimination trans people faced in the past is now illegal.

Still, access to health care remains a major issue for LGBTQ groups. For organizations like the National Center for Transgender Equality, getting all trans people into life-saving health care — whether it’s by overcoming financial hurdles or discrimination — remains a major goal. But if the public and policymakers aren’t aware of the kinds of issues trans people face in health care, it makes it much more difficult to communicate why this is part of a serious problem.

Myth #6: Transgender-inclusive health care is expensive

The cost of health plans doesn’t increase much, if at all, if they include transgender-inclusive health benefits.

The Human Rights Campaign, an LGBTQ advocacy group, estimates that trans-specific treatments can cost between $25,000 and $75,000, which is minimal compared with other health-care needs. And very few patients require these treatments, since trans people make up less than 1 percent of the population, making the cost relatively small for major health providers.

These treatments can also save health insurers money in other areas — since trans people who receive care are less likely to struggle with gender dysphoria, a state of emotional distress caused by how someone’s body or the gender they were assigned at birth conflicts with their gender identity, and with the mental health issues that can arise from untreated dysphoria, according to medical organizations like the American Medical Association and American Psychiatric Association.

When San Francisco began to offer trans-inclusive health coverage to its employees in 2001, the city applied a small surcharge to all employees enrolled in its health plan. But the city ended up using just $386,000 of the $5.6 million raised by the policy — a cost so low that it eventually dropped the additional charge altogether.

”[D]espite actuarial fears of over-utilization and a potentially expensive benefit,” San Francisco’s Human Rights Commission noted, “the Transgender Health Benefit Program has proven to be appropriately accessed and undeniably more affordable than other, often routinely covered, procedures.”

San Francisco’s experience shows that health plans, many of which don’t provide fully trans-inclusive care, can adopt these benefits at a minimal cost. For LGBTQ advocates, getting this point across is crucial as they lobby federal, state, and local lawmakers to stop discrimination against trans people in health-care plans — since, for a lot of trans people, an insurer’s exclusion can be the biggest obstacle to dealing with severe, even life-threatening gender dysphoria.

Myth #7: Children aren’t old enough to know their gender identity

Some children genuinely identify with a gender different from the one assigned to them at birth at a very early age. And some others won’t conform to gender norms — but won’t necessarily grow up to identify as transgender.

A study from the TransYouth Project found that trans children as young as 5 years old respond to psychological gender-association tests, which evaluate how people view themselves within gender roles, as quickly and consistently as those who don’t identify as trans.

”I always knew,” Jordan Geddes, a trans man in Columbia, Maryland, said. “But I grew up and had the whole world telling me I’m wrong. At that point [as a child in the 1990s], there was no visibility whatsoever about trans issues. My parents just assumed I’m a very butch lesbian.”

For medical professionals who consult with parents on gender, the goal is to gauge whether a child’s behavior indicates gender dysphoria, gender nonconformity, or early experimentation. Diane Ehrensaft, director of mental health at UCSF Benioff Children’s Hospital’s Child and Adolescent Gender Center, said parents and doctors should watch for consistence, persistence, insistence, and history of gender nonconformity, which can be evaluated early on to tell if a child is trans. But, above all, she said parents should foster a supportive environment that lets kids drive the process of establishing their own identity.

”We can’t say with 100 percent accuracy, but we can get a good picture very early on,” Ehrensaft said. “In my training as a developmental psychologist, the very theory is that by age 6 you should know your gender or there’s something wrong with you.”

She added, “When kids whose gender matches the sex on their birth certificates say, ‘I know my gender,’ nobody questions that. They say, ‘Oh, of course. You should.’ But if a kid says, ‘I know my gender,’ but it’s not the sex on their birth certificate, people ask, ‘Oh, how could you possibly know that?’ How can we have both at the same time?”

Fostering a supportive environment can be crucial to preventing some of the worst socioeconomic and health outcomes linked to gender dysphoria. The 2011 National Transgender Discrimination Survey found trans and gender nonconforming people who are rejected by their families are nearly three times as likely to experience homelessness, 73 percent more likely to be incarcerated, and 59 percent more likely to attempt suicide.

And that’s among a population that already reports many grave outcomes:

So creating a supportive, flexible environment for kids — regardless of whether they grow up to be trans, gender nonconforming, or another identity — can be very important in making sure gender dysphoria and any related problems don’t lead to horrible socioeconomic and health outcomes later in life.

Myth #8: Transgender people are mentally ill

Major medical organizations, like the American Medical Association and American Psychiatric Association, say being transgender is not a mental disorder.

The APA explained this in explicit terms when it stopped using the term “gender identity disorder” in favor of “gender dysphoria”: “Part of removing stigma is about choosing the right words. Replacing ‘disorder’ with ‘dysphoria’ in the diagnostic label is not only more appropriate and consistent with familiar clinical sexology terminology, it also removes the connotation that the patient is ‘disordered.’”

Gender dysphoria — a state of emotional distress caused by how someone’s body or the gender they were assigned at birth conflicts with their gender identity — is a widely recognized medical condition. If untreated, it can lead to severe mental health issues, including debilitating depression, anxiety, and suicidal ideation.

But the AMA, APA, and other medical experts agree that letting someone transition, which can entail medical treatments like hormone therapy and gender-affirming surgeries, without social stigma is the main treatment for gender dysphoria. In this way, being trans isn’t the medical condition; living as trans is in fact the treatment to the medical condition.

And not all trans people deal with severe dysphoria. It’s barely or not present for some trans people, while it’s mentally excruciating for others.

These facts show that psychological distress and disability aren’t inherent to being trans, so being trans doesn’t meet the definition of a mental disorder (a psychological state that causes significant distress and disability).

Myth #9: Transgender people make up a third gender

Most transgender people explicitly identify as male or female. They aren’t part of a third gender — they are, by all intents and purposes, men and women.

Emily Prince, a trans woman in Alexandria, Virginia, recently struggled with this misconception about trans people’s gender identity while signing up for a therapy program. “The first line of the form asked for sex with three options: male, female, and transgender,” she said. “Right there, we already have an issue. I’m a woman. I’m not some third sex. There are some non-binary people who don’t fit into male or female, but you don’t describe all trans people in that way.”

As Prince alluded, some people — such as gender nonconforming, genderqueer, and nonbinary communities — may identify outside the traditional boundaries of male or female. Although these forms of identity and expression are often associated with sexual orientation — think stereotypes of flamboyant gay men or butch lesbians — they’re not intertwined.

Gender nonconforming people don’t express their gender in a way society expects them to. Some gender nonconforming people might be androgynous, meaning they don’t readily exhibit traits that can easily identify them as men or women. Men who exhibit feminine traits and women who express masculine characteristics may also identify as gender nonconforming.

Genderqueer and nonbinary people generally don’t identify or express as men or women, sometimes borrowing gender roles and traits outside society’s typical expectations and other times taking elements from both masculinity and femininity. Androgynous people can also fall into this category if they identify their gender as neither male nor female. (There are nuanced differences between the terms genderqueer and nonbinary, although they’re fairly similar and often used interchangeably.)

”Some people just don’t think the term ‘male’ or ‘female’ fits for them,” Mara Keisling, a trans woman and executive director of the National Center for Transgender Equality, said.

Sometimes there is an overlap between transgender, gender nonconforming, genderqueer, and nonbinary communities. People might identify with all, some, or none of these concepts, even if they exhibit traits attributed to these three forms of identity and expression. There are dozens of ways people identify and express themselves, so these three concepts fall far short of the full realm of possibilities.

Myth #10: Drag queens and kings are transgender

Although commonly intermixed as part of LGBTQ communities, transgender people and drag queens or kings aren’t necessarily related.

LGBTQ group GLAAD explained: “Transgender women are not cross-dressers or drag queens. Drag queens are men, typically gay men, who dress like women for the purpose of entertainment. Be aware of the differences between transgender women, cross-dressers, and drag queens. Use the term preferred by the individual.”

This distinction is very important to LGBTQ and trans advocates because it helps show the permanence of someone’s trans identity.

Being trans isn’t a matter of dressing up in different clothes. It’s a permanent identity that follows people throughout their entire lives. And while some trans people enjoy dressing up in exotic outfits to entertain others, the act of dressing up in clothes that match one’s gender identity reflects only one part of what it means to be trans.

Similarly, being a cross-dresser or drag queen or king doesn’t mean that people identify with a gender different from the one they were assigned at birth. Some drag queens or kings may even be straight and cisgender — meaning they identify with the gender assigned to them at birth — and are only dressing up for entertainment. What cross-dressing means can vary a lot from individual to individual.

Getting this right is crucial to understanding the nuance of gender identity and expression, which are deeply ingrained and follow nearly all aspects of trans people’s lives. For many trans people, picking out gender-affirming clothes is only one small part of the social transition — the act of coming out as trans to family, friends, and society as a whole. The other steps — from medical procedures to dealing with how society as a whole reacts — often play a much bigger role in a trans person’s life.

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