CISCENTRIC: the concept was established only in relation to the cis world. Something can be Ciscentric without being transphobic.

CISSEXIST: the concept is sexist in regards to trans people in relation to Cis people. Something can be transphobic and cissexist, or just cissexist.

CISNORMATIVE: a norm which applies only to the cis population, but is often pushed at trans people. Most cisnormative concepts are applied in a transphobic way, but are not transphobic themselves, merely Ciscentric.

TRANSCENTRIC: a concept which centers trans lives as normative.

TRANSPHOBIC: a concept which involves aversion, anxiety, and/or animus, singly or in any combination, to teams people or Transness. 

CISNESS (Cis): Cisness is the state of awareness or condition in society of someone who does conform in a majority of aspects to the way their society or culture sees them as behaving and living in relation to their culture’s social construction of physiological sex, usually due to an absence of variance between their physical sex and one or both of their social sex identity and/or internal sex identity. It exists at the same level as awareness of self, and it is, itself, an awareness, but because it is not at variance, is often unnoticed and unremarked.

TRANSNESS (Trans): Transness is the state of awareness or condition in society of someone who does not conform in a majority of aspects to the way their society or culture sees them as behaving and living in relation to their culture’s social construction of physiological sex, usually due to a variance between their physical sex and one or both of their social sex identity and/or internal sex identity. It exists at the same level as awareness of self, and it is, itself, an awareness.

WPATH: The World Professional Association for Transgender Health. The WPATH is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, advocacy, public policy, and respect for transgender health. The vision of WPATH is to bring together diverse professionals dedicated to developing best practices and supportive policies worldwide that promote health, research, education, respect, dignity, and equality for transsexual, transgender, and gender nonconforming people in all cultural settings.

The Standards of Care (SoC): The international Standards of treatment for Trans people. The minimums level of treatment considered ethical, moral, and standard.

Gender Dysphoria:  refers to discomfort or distress (disgust at their own genitalia, social isolation from their peers, anxiety, loneliness, and depression) that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics).

GENDER: Gender refers to the socially constructed roles, behavior, and expressions that a particular society considers appropriate for men and women. Gender is always social – that is, it only comes into play in relation to other people. Things, objects, parts, language all are involved in gendering things. When one says “that is male” one is gendering it.

GENDER ROLES: What we call Femininity and Masculinity. They deal in how we expect persons of a particular sex to behave or act within our culture. The three billion ways to be a man, and the three billion ways to be a woman, and all the stuff related to sexism lies here. Social sex roles are a set of social and behavioral norms that are structurally designated as appropriate for either a man or a woman in a social or interpersonal relationship based on their social sex.

GENDER EXPRESSIONS: how people present themselves to the wider world, not always in line with their Social Sex role. It has to do with primarily “superficial” stuff — dress and body decoration — that affect things like attraction and courtship. Expressions are the tools by which we convey to others, who cannot see our physical anatomy, that we fit into this particular box for a given physical sex.

GENDER BEHAVIORS: all the little things that social sex influences that are outside the realm of the usual and the commonplace – the indirect effects, so to speak. Inheritance is part of this, kinship is part of this, lineage is part of this, even names are part of this. These behaviors are basic elements, often focused around interpersonal relationships and the interplay between Social Sex Roles and Social Sex Expressions. Male privilege is an excellent example of a Social Sex Behavior.

Selections from the WPATH Standards of Care:

Official Title:

Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People

On Gender nonconformity not being the same as gender dysphoria:

Gender Nonconformity Is Not the Same as Gender Dysphoria 
Gender nonconformity refers to the extent to which a person’s gender identity, role, or expression differs from the cultural norms prescribed for people of a particular sex (Institute of Medicine, 2011). Gender dysphoria refers to discomfort or distress that is caused by a discrepancy between a person’s gender identity and that person’s sex assigned at birth (and the associated gender role and/or primary and secondary sex characteristics) (Fisk, 1974; Knudson, De Cuypere, & Bockting, 2010b). Only some gender nonconforming people experience gender dysphoria at some point in their lives.

On Surgery & Hormones being required to be trans

Indeed, hormone therapy and surgery have been found to be medically necessary to alleviate gender dysphoria in many people (American Medical Association, 2008; Anton, 2009; The World Professional Association for Transgender Health, 2008).

While many individuals need both hormone therapy and surgery to alleviate their gender dysphoria, others need only one of these treatment options and some need neither (Bockting and Goldberg, 2006; Bockting, 2008; Lev, 2004).

Often with the help of psychotherapy, some individuals integrate their trans- or cross-gender feelings into the gender role they were assigned at birth and do not feel the need to feminize or masculinize their body. For others, changes in gender role and expression are sufficient to alleviate gender dysphoria. Some patients may need hormones, a possible change in gender role, but not surgery; others may need a change in gender role along with surgery, but not hormones.

On nonbinary individuals

Some individuals describe themselves not as gender nonconforming but as unambiguously cross-sexed (i.e., as a member of the other sex; Bockting, 2008).

Other individuals affirm their unique gender identity and no longer consider themselves either male or female (Bornstein, 1994; Kimberly, 1997; Stone, 1991; Warren, 1993). Instead, they may describe their gender identity in specific terms such as transgender, bigender, or genderqueer, affirming their unique experience that may transcend a male/female binary understanding of gender (Bockting, 2008; Ekins and King, 2006; Nestle, Wilchins, and Howell, 2002).

They may not experience their process of identity affirmation as a “transition,” because they never fully embraced the gender role they were assigned at birth or because they actualize their gender identity, role, and expression in a way that does not involve a change from one gender role to another.

For example, some youth identifying as genderqueer have always experienced their gender identity and role as such (genderqueer). 

On Dysphoria being required to be Trans 

Only some gender nonconforming people experience gender dysphoria at some point in their lives.

What helps one person alleviate gender dysphoria might be very different from what helps another person. This process may or may not involve a change in gender expression or body modifications.

Gender identities and expressions are diverse, and hormones and surgery are just two of many options available to assist people with achieving comfort with self and identity.

On Regrets after surgery

Although Harry Benjamin already acknowledged a spectrum of gender nonconformity (Benjamin, 1966), the initial clinical approach largely focused on identifying who was an appropriate candidate for sex reassignment to facilitate a physical change from male to female or female to male as completely as possible (e.g., Green & Fleming, 1990; Hastings,1974).

This approach was extensively evaluated and proved to be highly effective.

Satisfaction rates across studies ranged from 87% of MtF patients to 97% of FtM patients (Green and Fleming, 1990), and regrets were extremely rare (1-1.5% of MtF patients and less than 1% of FtM patients; Pfafflin,1993).

On Transgender Children

When it comes to the persistence of cross gender behaviors from childhood, newer studies, also including girls, showed a 12 – 27% persistence rate of gender dysphoria into adulthood (Drummond, Bradley, Peterson-Badali, & Zucker, 2008; Wallien & Cohen-Kettenis, 2008).

In contrast, the persistence of gender dysphoria into adulthood appears to be much higher for adolescents. In a follow-up study of 70 adolescents who were diagnosed with gender dysphoria and given puberty suppressing hormones, all continued with the actual sex reassignment, beginning with feminizing/masculinizing hormone therapy (deVries, Steensma, Doreleijers, & Cohen-Kettenis, 2010).

Another difference between gender dysphoric children and adolescents is in the sex ratios for each age group. In clinically referred, gender dysphoric children under age 12, the male/female ratio ranges from 6:1 to 3:1 (Zucker, 2004). In clinically referred, gender dysphoric adolescents older than age 12, the male/female ratio is close to 1:1 (Cohen-Kettenis & Pfäfflin, 2003).

Treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success (Gelder & Marks, 1969; Greenson, 1964), particularly in the long term (Cohen-Kettenis & Kuiper, 1984; Pauly,1965)Such treatment is no longer considered ethical.

On Diagnoses

Some people experience gender dysphoria at such a level that the distress meets criteria for a formal diagnosis that might be classified as a mental disorder. Such a diagnosis is not a license for stigmatization or for the deprivation of civil and human rights. Existing classification systems such as the Diagnostic Statistical Manual of Mental Disorders (DSM) (American Psychiatric Association, 2000) and the International Classification of Diseases (ICD) (World Health Organization, 2007) define hundreds of mental disorders that vary in onset, duration, pathogenesis, functional disability, and treatability. All of these systems attempt to classify clusters of symptoms and conditions, not the individuals themselves. A disorder is a description of something with which a person might struggle, not a description of the person or the person’s identity. 

Thus, transsexual, transgender, and gender nonconforming individuals are not inherently disordered. Rather, the distress of gender dysphoria, when present, is the concern that might be diagnosable and for which various treatment options are available. The existence of a diagnosis for such dysphoria often facilitates access to health care and can guide further research into effective treatments.

Research is leading to new diagnostic nomenclatures, and terms are changing in both the DSM (Cohen-Kettenis & Pfäfflin, 2010; Knudson, De Cuypere, & Bockting, 2010b; Meyer-Bahlburg, 2010; Zucker, 2010) and the ICD. For this reason, familiar terms are employed in the SOC and definitions are provided for terms that may be emerging. Health professionals should refer to the most current diagnostic criteria and appropriate codes to apply in their practice areas.

On additional studies relating to broader prevalence needed:

  • (i) Previously unrecognized gender dysphoria is occasionally diagnosed when patients are seen with anxiety, depression, conduct disorder, substance abuse, dissociative identity disorders, borderline personality disorder, sexual disorders, and disorders of sex development (Cole, O’Boyle, Emory, & Meyer III, 1997).
  • (ii) Some crossdressers, drag queens/ kings or female/male impersonators, and gay and lesbian individuals may be experiencing gender dysphoria (Bullough & Bullough, 1993).
  • (iii) The intensity of some people’s gender dysphoria fluctuates below and above a clinical threshold (Docter, 1988).
  • (iv) Gender nonconformity among FtM individuals tends to be relatively invisible in many cultures, particularly to Western health professionals and researchers who have conducted most of the studies on which the current estimates of prevalence and incidence are based (Winter, 2009).

On Options for Psychological and Medical Treatment of Gender Dysphoria

For individuals seeking care for gender dysphoria, a variety of therapeutic options can be considered. The number and type of interventions applied and the order in which these take place may differ from person to person (e.g., Bockting, Knudson, & Goldberg, 2006; Bolin, 1994; Rachlin, 1999; Rachlin, Green, & Lombardi, 2008; Rachlin, Hansbury, & Pardo, 2010). Treatments options include the following:

  • Changes in gender expression and role (which may involve living part time or full time in another gender role, consistent with one’s gender identity);
  • Hormone therapy to feminize or masculinize the body;
  • Surgery to change primary and/or secondary sex characteristics (e.g., breasts/chest, external and/or internal genitalia, facial features, body contouring);
  • Psychotherapy (individual, couple, family, or group) for purposes such as exploring gender identity, role, and expression; addressing the negative impact of gender dysphoria and stigma on mental health; alleviating internalized transphobia; enhancing social and peer support; improving body image; or promoting resilience.

On withholding treatment for adolescents

Refusing timely medical interventions for adolescents might prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization. As the level of gender-related abuse is strongly associated with the degree of psychiatric distress during adolescence (Nuttbrock et al., 2010), withholding puberty suppression and subsequent feminizing or masculinizing hormone therapy is not a neutral option for adolescents. 

On informed consent

Feminizing/masculinizing hormone therapy may lead to irreversible physical changes. Thus, hormone therapy should be provided only to those who are legally able to provide informed consent. This includes people who have been declared by a court to be emancipated minors, incarcerated people, and cognitively impaired people who are considered competent to participate in their medical decisions (see also Bockting et al., 2006). Providers should document in the medical record that comprehensive information has been provided and understood about all relevant aspects of the hormone therapy, including both possible benefits and risks and the impact on reproductive capacity.

On the broad needs for health

WPATH recognizes that health is dependent upon not only good clinical care but also social and political climates that provide and ensure social tolerance, equality, and the full rights of citizenship. Health is promoted through public policies and legal reforms that promote tolerance and equity for gender and sexual diversity and that eliminate prejudice, discrimination, and stigma. WPATH is committed to advocacy for these changes in public policies and legal reforms.

On Trans People In Other Cultures

In applying these standards to other cultural contexts, health professionals must be sensitive to these differences and adapt the SOC according to local realities. For example, in a number of cultures, gender nonconforming people are found in such numbers and living in such ways as to make them highly socially visible (Peletz, 2006).

In settings such as these, it is common for people to initiate a change in their gender expression and physical characteristics while in their teens, or even earlier. Many grow up and live in a social, cultural, and even linguistic context quite unlike that of Western cultures. Yet almost all experience prejudice (Peletz, 2006; Winter, 2009).

In many cultures, social stigma towards gender nonconformity is widespread and gender roles are highly prescriptive (Winter et al., 2009). Gender nonconforming people in these settings are forced to be hidden, and therefore may lack opportunities for adequate health care (Winter, 2009).

The Standards of Care, Version 7 represents a significant departure from previous versions. Changes in this version are based upon significant cultural shifts, advances in clinical knowledge, and appreciation of the many health care issues that can arise for transsexual, transgender, and gender nonconforming people beyond hormone therapy and surgery (Coleman, 2009a, b, c, d).

Public Policies of the WPATH

On Identity Documents and Surgery Requirements

No person should have to undergo surgery or accept sterilization as a condition of identity recognition. If a sex marker is required on an identity document, that marker could recognize the person’s lived gender, regardless of reproductive capacity. The WPATH Board of Directors urges governments and other authoritative bodies to move to eliminate requirements for identity recognition that require surgical procedures.

On being trans being a Medical Condition (Mental Illness, Etc.)

The expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon which should not be judged as inherently pathological or negative. The psychopathologlisation of gender characteristics and identities reinforces or can prompt stigma, making prejudice and discrimination more likely, rendering transgender and transsexual people more vulnerable to social and legal marginalisation and exclusion, and increasing risks to mental and physical well-being. WPATH urges governmental and medical professional organizations to review their policies and practices to eliminate stigma toward gender-variant people


  • involving, caused by, or of the nature of a physical or mental disease.
  • caused by or involving disease; morbid.
  • caused by or evidencing a mentally disturbed condition
  • dealing with diseases

1680s, “pertaining to disease,” formed in English from pathology.

Synonyms: morbid, diseased, sick, ill, unhealthy, aberrant, medicalmedical condition

The very document that lays out the treatment for Trans people, and the very organization that is responsible for setting the standards and operating on the research and scientific evidence, state, in veryclear terms, that being Trans is not a medical condition, and in addition to that, they state that calling it a medical condition has been proven to be harmful to the health and well being of Trans people.

This is why professionals involved in the care and well being of Trans people who are culturally competent and knowledgeable, do not engage with it on those terms.

Trans people are gender noncomforming.  The standards of care applies to them, so long as they are trans people, and that includes all treatments.

Transness — being trans — does not come from dysphoria. It comes from the conflict between social sex, internal sex, and physical sex. That conflict is not dysphoria. Dysphoria is separate from that. That is the standard that the science shows.

Dysphoria does not make someone a trans person. Being a trans person is what makes someone have dysphoria. 

Not because they are trans. But because the world they live in is not designed for, considerate of, or permissible for, trans people.

Transphobia is aversion, anxiety, or animus, singly or in any combination, regarding trans people, transness, or trans related issues.

  • Aversion is things like being disgusted, in opposition to, identifying something as repugnant, and exhibiting strong feelings about this. Aversion is the desire to avoid, the act of arguing to avoid or reduce encounters. It includes being unwilling to listen or accept factual,statements made by trans people. It also includes not wanting trans people in the restroom. It also includes saying things like you need dysphoria to be trans.
  • Anxiety is distress, worry, concern, and overt anxiousness about something or someone that is strongly expressed in physical, literal, or metaphorical terms. Anxiety is worry, concern, or anticipatory ideation relating to trans people or Transness. It includes prejudice against trans people, such as worrying about what they do in the restroom. It also includes things like saying that transness is a medical condition.
  • Animus is a strong and intense dislike. It involves devaluing the lives of people, erasing their dignity, opposing their civil and human rights, denying them the ability to mark themselves,and outright harm to them. Animus is intense dislike, easily distinguished by overly concerned and reactionary language and violence, in any form. It includes agitating in the interest of preventing trans people from being In the restroom by law or policy.It also includes things like telling other trans people they aren’t trans enough.

So any of those thing, either individually or in combination, is what makes up transphobia.

Examples of Transphobic Statements

  • People who mutilate themselves like transgendered (Animus)
  • Transness is a mental illness. (Animus)
  • Transness is a medical condition (Anxiety)
  • I do not feel safe having male socialized trans women in my space. (Aversion, Anxiety)
  • Cis assigns a gender to someone. (Anxiety)
  • Trans women are biologically male. (Animus)
  • Trans women are men (Animus)
  • Trans men are traitors (Animus)
  • Dysphoria is needed to be trans (Aversion)
  • trans politics enforces gender and gender roles by reducing womanhood to a stereotype made up by males. (Animus, Anxiety)
  • If we include gender identity protections in this bill, it will be harder to pass (Aversion, Anxiety)
  • The second you become pregnant you are a woman.(Animus, Aversion)

There are many other examples, readily found in pretty much any attack on trans people and their lives or in any post that deals in trans issues coming from someone who proclaims themselves “trans critical” or “gender critical”. 

Some Facts Often ignored by TERFS, Trans Critical People, and related anti-LGBT people:

  • Biology does not determine what a person’s social sex is.
  • Gender is a complex system of inter-related parts that vary according to culture and social influence and is not a fixed system.
  • Gender Dysphoria is not a mental illness.
  • It is a core violation of human rights to deny trans people necessary medical care, regardless of their age. Agitating against that medical treatment is engaging in a willfully, intentional act of violence and trying to deny human rights to other people.
  • According to the SPLC and the ADL, the actions and speech of Cathy Brennan constitute hate speech. According to the World Health Organization, that classifies them as acts of violence.

On Trans Women’s Girlhood

Some folks think that Trans women do not experience girlhood, and argue that trans women do not grow up with the mythical idea of “sex-based oppression” (which doesn’t exist, as the oppression is gender based, since sex in social situations *is* gender).

These people often like to try and distance themselves from the more violent, dishonest, extremist elements in Radical feminism — generally referred to as TERFs — by disavowing some of the key aspects that informed the ideas of these terfs, even when making that “sex based oppression” argument, that is, itself, part of those dishonest, transphobic, extremist viewpoints.

They like to describe the ways in which physiology is used to oppress women, often ignoring the fact that physiology is presumed (social sex) in social systems and that the norm they are arguing is part of the very system they claim to be opposing.

Among those things they argue are the following:

  • That trans women do not grow up being shamed and feeling grossed out and insecure about their periods. This ignores the fact that trans women grow up being shamed and feeling grossed out and insecure because they don’t get periods, and that is used against them both internally and externally in order to further the idea of their being “wrong”.
  • That trans women are taught that masturbation is a healthy thing, when, in fact, trans women are taught that masturbation is shameful, that if they they masturbate they are perverts and horrible, and that the discussion of trans women masturbating is a really sick and disgusting thing.
  • That trans women are not subject to the cultural and social stigmas of having body hair being taught to them, when, in fact, they recieve these messages and in a state of pretty hard core crisis as their bodies do the very things they thought they wouldn’t do, often forcing many trans women to begin the ritualistic habit of shaving off all their body hair and creating a sense of horror about body hair that endures throughout their lives, ultimately leading to the most expensive process in transition.
  • That trans women did not face gender based bullying of the same sort as cis women, where they are treated very cruelly  for things boys would not be, which ignores that trans women are bullied and told that being themselves is a bad thing, while still recieving all the messages that they have to act and look a certain way as girls, and then being punished when they try to do those things by everyone around them, which is, itself, gender based bullying (and gender based oppression).
  • That trans women are not subjected to constant threats and deeds of sexual violence and harassment, when, in fact, transphobic and ciscentri ideas are based on such, and it starts at essentially the same age, and is constantly given in the form of mixed messages that amount to consistent abuse and neglect.
  • That trans women do not have the Whore/Madonna complex drilled into them despite this being one of the most common attacks used against trans women, especially by other women, and the way that often these abused and neglected children who grow up trying their damndest to fit in turn to that when they first transition, and sadly are sucked into it seeking the validation and affirmation they have been denied their whole lives because that was the message that they received loud and clear as children.

Keep in mind, all of these things apply to young trans girls — who are often told they are not allowed to be girls, that they are not girls, which is a direct and perpetuating form of violence against them recognized as such by all leading medical organizations in the US

Trans women — including young trans women — are seen as objects of desire and told they need to be objects of desire, which they usually strive for in a manner of overcompensating because of the messages they are told they are being fake that are internalized in the same way cis women internalize them.

So the harm from female socialization is still felt and the fact remains that trans women are female socialized, but they are punished for that socialization, even long after it has supposedly ended, and that socialization itself is combined with the violence, neglect and abuse done to them through additional axes of oppression to force them into some dark places that they are then blamed for being forced into.

All of this is done to girls because they are girls. It is done to women because they are women.

The act of saying that it happens to them because they have vaginas is part of the very system of oppression that also oppresses trans women: the patriarchy, which is what made that call and reinforces that idea.

When trans people say they have always felt like x or y, what they are trying to express in colloquial and layman’s terms is the concept of gender identity, now more commonly referred to as either social sex identity and physical sex identity, which is two concepts, each distinct.

Roughly translated, the whole thing means that a Trans person is aware that they are a woman, man, both, or neither, at the same core level as they are aware of themselves as a person that is distinct from other people.

Some people would prefer to argue that what this is suggesting is that there is a “brain sex”. That is not what this is describing. It is describing a sense of self-awareness — which, while decidedly part of the brain’s physiology, is more authentically part of the existential notion that one exists, and therefore is not part of that argument, nor even related directly to biological systems.

What that means, as well, is that this description has nothing whatsoever to do with biology, and, therefore arguments about biology aren’t valid when contradicting it. It would be akin to saying that the United States army shouldn’t exist because of broccoli.

This all comes together in the core aspect here: like sexual orientation, this is part of what creates the sense of self in people, and it therefore is part of how they know that they exist as an individual human being, and is a part of that.

So the same question of how you know can be answered in as many different ways as there are people, and it is the still same way that those asking the question know what their social sex identity is.

This effectively makes it the trans version of the question “how do you know you are gay?”, with the same accurate answer “I just do, because I know I exist.”

The answer may not satisfy those seeking some sort of concrete answer, but it is inevitable that they themselves, will discount any answer because for them the same question remains unanswered in a way they would accept from a trans person, usually due to cis privilege.

In the end, it does not matter if biology claims trans women are males.

Biology is not concerned with the violence done to people.

Biology is not a shield to do violence to people, and indeed, the admittedly flawed models of colloquial biology often cited against trans women have also been used to justify and make excuses for violence against minority populations in oppressive systems.

And they are not scientific and they are outright lies.

Violence is still violence. It is still immoral, still unethical, and defending it is immoral and unethical.

Psychology, sociology, anthropology, physiology, medicine — these sciences have all proven that calling a trans woman a man is violence.

Violence is not limited to broken bones and bruised flesh and physical damage visible to the seeing.

It is also words. Ask those fleeing persecution, read history, talk to survivors of child abuse and domestic violence and prison violence.

Words are just as physically damaging – and according to many measures more so, since the brain treats those words no differently than it treats the body blows. The science is there to demonstrate this, and it is well known.

Calling trans women men is violence. It has physical, measurable consequences, and it endures and we know that this applies even when it is strangers.

The science establishes it.

This is fact. Not opinion.

Calling a trans woman a man is an act of violence, an assault, and those who do so are being violent, are being immoral, are being unethical, are cruel and callous and pathetic.

Silence in the face of violence is complicity, especially when that violence is social. Defense of calling a trans woman a man is defending violence.

Liking it, re blogging it without calling it out, these are forms of complicity.

Name it what it is. Don’t dress it up, don’t reduce it, it is violence. It is unethical. It is immoral.

Shame those who do it, teach them it is wrong.

Because not doing so means you are complicit, means you are supporting, means you are not trying to stop violence against gay, lesbian, bisexual, and even straight people.

It means you are not trying to stop violence against people of color, against immigrants, against the disabled, against the poor.

It means you are standing by watching as someone does violence to another person.

And that is immoral, unethical, and shameful.