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Opinion Lydia Polgreen

Born This Way? Born Which Way?

Credit... Illustration by Najeebah Al-Ghadban. Photographs, via Getty Images/Room Rf

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By Lydia Polgreen

Opinion Columnist

• Dec. 1, 2023

When I was in sixth grade, I made a decision that changed the course of my life. I decided not to try out for the middle school swim team. I know that might not sound like a big deal, but it was. As a grade schooler I was a standout swimmer — strong shoulders and back, and well-muscled legs that powered me through the water with ease and speed. I was disciplined, obsessive. My form was excellent. My coach saw potential.

Had I stuck with it, my life might have turned out pretty different. I might have been a popular jock rather than a lonely weirdo. I might have become a varsity athlete who won admission to a top college rather than a barely graduated teenager who had to take remedial math at a community college to scrape my way into a not-very-competitive school.

I have been thinking about this decision a lot lately, because many of us have been forced, regardless of whether we want to, to think about children and the decisions we allow them to make, and what it might mean for them to regret those decisions. I am speaking, of course, about the ongoing war over transgender and gender-nonconforming children.

For people on the right who oppose gender transition at any age, the argument is simple: There are two genders, and people who think they are a different sex or gender than the one they were assigned at birth are delusional; indulging that delusion is wrong. Biological reality requires all people to simply live with the gender associated with their birth sex. (Unless they are intersex, in which case it is evidently OK for parents and doctors to decide and surgically alter a child’s body to conform with that decision without the child’s consent or even knowledge.)

For those liberals and progressives who fret about the rapidly changing gender landscape, the agonized argument over gender-affirming care for children is different. As this thinking goes, there is a small category of people who were born in the wrong bodies, and those individuals are entitled to express their identities. But when children say they are one of these people, we must be extremely careful and rigorous in being absolutely certain that their gender identities have been unearthed and verified through a lengthy medical and psychiatric inquiry before they are validated by social, legal and medical interventions. We must be sure that this is the pure expression of an immutable self, not simply the adoption of a fad or the byproduct of autism or bipolar disorder. The possibility that children might make irreversible decisions on this particular question that they later regret is, for many people, simply intolerable. Transition, to borrow a phrase, should be safe, legal and rare.

We allow children to make irreversible decisions about their lives all the time, ideally with the guidance and support of the communities that care for them. Sometimes they regret those decisions. The stakes vary, but they are real. So what are we saying, really, when we worry that a child will regret this particular decision, the decision to transition? And how is it different, really, from the decision I made to quit competitive swimming? To many people — I am guessing most — this question is absurd. How could you possibly compare something as fundamental and consequential to one’s life as gender to something that seems comparatively trivial, competitive sport?

Most Americans believe there is a clear and absolute binary between genders. In May, the last time Gallup polled on the issue , 55 percent of Americans said they believed changing one’s gender is “morally wrong.” It’s not hard to understand why. Man and woman make a dyad as old as time, written in our chromosomes, our religious texts, our myths and legends.

Many major identity categories, like race, gender and ethnicity, seem absolute and immovable. But dig a little deeper and quickly you realize how malleable and mutable they are. Indeed, the freedom to participate in the way you are viewed through these identities is a basic part of being a modern human. So is the right to change your mind about them over time.

For a binary identity that is supposedly so fixed and powerful, gender eludes and confounds us constantly. Efforts to define the terms “man” and “woman,” so popular on the campaign trail as gender identity has become a white hot issue in our politics, inevitably end in unsatisfying tautologies. Merriam-Webster unhelpfully defines a woman as “an adult female person.” Look up “female” and it says “relating to, or being the sex that typically has the capacity to bear young or produce eggs,” a description that is both imprecise (“typically”) and incomplete (what of women born without these capacities?).

Personally, I have never had much use for binaries. I was born to a Black African mother and a white American father, the beginning of a life that has included many identities and many hyphens, and doubtless will include more with the passage of time and the ever-gathering tumbleweeds of experience. I am Black but also mixed race; I am a woman but the way I look and dress means I’m constantly taken for a man; I’m American but also African, but not African American in the sense that that term is usually used; I am a lesbian but had happy (and unhappy) romantic relationships with boys and men in my youth.

Sorting humans into immutable identities has always been a fraught business. In South Africa, the apartheid state was so committed to its racial classification hierarchy that it employed bizarre tests to sort people into categories. The most absurd of these was the pencil test: If a pencil placed in a person’s hair fell out, they were not Black but some other, interstitial category. If their curls were tight enough to hold the pencil in place, they were Black, a designation with life-determining consequences.

In polite society, we don’t do this kind of sorting and ranking of identities anymore. But the last frontier in binary sorting is the first binary known to humankind, the one all of us experience in some form or another. The gender binary is the cornerstone of human existence. Troubling it in the way that young people are today is no small thing. To most people, changing genders is a big deal. The way to make sure you don’t regret it is to be really sure you know what your gender is. But that isn’t quite as simple as it sounds.

How do we know who we are? This may seem like a profound, philosophical question. The exhortation to know yourself is, after all, one of the most famous and ancient utterances in Western civilization. But it is also an interesting question to ask yourself in a more literal sense. Because what we discover, if we are really honest with ourselves, is that most of the time we know who we are because someone told us.

I discovered this when I was made aware of an immutable fact about my identity at the rather belated age of 10. It happened during gym class, in the heat of a game of dodge ball. My family had recently moved from Kenya to Minnesota, my dad’s home state. A boy shoved me and called me a racial slur. Our horrified teacher leaped into action, consoling me and sending the boy, who I now understand is white, to the principal’s office.

But I wasn’t upset. I was confused. What was this word that caused all this tumult, and what did it have to do with me? Growing up in Kenya, I was of course aware that my parents had different skin tones and that my light brown skin was a result of that mixture. I had many friends who also had mixed parentage, but the identity categories and hierarchies that held meaning for us were the countries or tribes our parents came from or what languages we spoke at home. So I knew nothing of the American binary between white and Black, the core identity concept of race.

To put it plainly, I did not know I was Black. This central identity, plain as day to any American who looked at me, was completely invisible to the 10-year-old classmate who apparently possessed it innately and inescapably. I assimilated this news into my consciousness with no rancor, just some confusion and bemusement. There was nothing wrong with being Black, I knew, whatever the white boy might have been trying to tell me. It sent me down a rabbit hole of belated discovery, reading books like “The Autobiography of Malcolm X” and “Invisible Man,” “The Color Purple” and “The Bluest Eye,” to try to understand this new identity that I now inhabited.

Much later in life, I learned that concern that just such a moment might happen was a preoccupation in the white, Midwestern milieu my father came from. This makes sense; my parents married less than a decade after the Supreme Court declared bans on mixed-race marriage unconstitutional. Mixed-race children — “tragic mulattos,” as they were known — were a common trope in American literature and film, portrayed as a byproduct of doomed love or evidence of the crime of rape. They were seen as something that, in an ideal world, should not exist, in the same way some see transgender children now.

In 1973, the year my parents married, just 29 percent of Americans approved of interracial marriage, according to Gallup . By 2021, 94 percent of Americans said they approved of interracial marriage. This transformation, which has taken place over just two generations, is a very good thing.

Race is not an exact parallel for gender identity, but as categories, we experience them in large part through the perceptions that others have of us, based largely on our outward appearances. Gender identity, many will argue, is fundamentally different, and medically or surgically altering your body to better align with your gender identity is a drastic intervention, especially for a child. But is it so different?

Lately I have been asking people this question: Do you remember the first time someone informed you of your gender? It’s a nonsense question, of course. No one remembers. Mine was first declared to me, and everyone else involved, in the birthing room. Nowadays, for many people, gender is given to them well before they are born, and perhaps even heralded with cannons of pink or blue confetti at a gender reveal party. Maybe that’s what makes it seem so immutable? It’s an early, definitive declaration.

As children, we are given many things — some are biologically inherited, like hair and eye color, while other things, like names, religion and folkways, are bestowed upon us by our families and communities. Some people find these things they were given regrettable, and some, even children, change those characteristics.

According to the American Society of Plastic Surgeons, in 2020 , more than 44,000 people between the ages of 13 and 19 got a rhinoplasty, the most common surgical cosmetic procedure performed on teenagers. Thousands of kids went under the knife for chest surgery — 3,200 girls got breast augmentations and 1,800 girls got breast reductions, while 2,800 boys had surgery to remove breast tissue from their chests, presumably to help them conform better to their gender identities. Indeed, many if not most of these often irreversible interventions on children’s bodies are designed, in one way or another, to help children feel better about their appearances in a way that is inescapably bound up with gender.

In all, roughly 230,000 cosmetic procedures were performed on teenagers in 2020, 15 percent fewer than the year before, presumably owing to the pandemic. That drop was smaller than I expected. It underscores just how desperate these children were to change their bodies that even in the first, terrifying year of a deadly pandemic, when most of us were avoiding medical settings like the literal plague engulfing us, teenagers had, with their parents’ permission, hundreds of thousands of mostly elective medical treatments. Many of these were adolescent girls seeking the small, cute noses that fill our television screens and fashion magazines, chasing an ideal of feminine beauty that feels forever out of reach.

More than 90 percent of cosmetic procedures are performed on women and girls, but there has been a notable boom in several kinds of cosmetic procedures for adult men. Expensive and complex leg-lengthening surgeries that can add a few inches to a patient’s height are rising in popularity. ProPublica and The New Yorker recently published a long investigation into the boom in implants that can increase the size of a man’s penis but also can come with significant complications and side effects.

Cosmetic procedures can produce regret, sometimes famously so. The actress Jennifer Grey had a career-imploding rhinoplasty, which prompted years of cruel punchlines. Some famous young people who have these procedures later spoke of regretting them — Kylie Jenner has spoken of regretting a breast augmentation surgery performed when she was 19, and Bella Hadid of regretting a nose job at 14.

These are covered in the media as the ordinary stuff of human regret: A person made a choice and had complicated feelings about that choice in the aftermath. You live and learn. There has been no stampede to ban such treatments for children. Some might disapprove of these decisions, as some do of all cosmetic surgeries, but we rightly understand them as freely made choices of human beings who have the right to decide what they do to their own bodies. In the case of children, these decisions are made in a context of community, in consultation with parents and doctors. These procedures usually affirm the gender the child was assigned at birth, the one that, in most cases, matches the child’s sex at birth.

People who express regret about a gender transition are seen in a very different light. A handful of such people have appeared over and over again in news stories across the world, portrayed as the harbingers of a tsunami of regret that is always about to arrive because countless children are being carelessly affirmed by an ideologically driven activist community in their mistaken beliefs that they are transgender. In this telling, impressionable children, especially those assigned as female when they were born, are falling into a fad or being manipulated by the so-called gender ideology that taught them to reject womanhood. Most chilling to some is a mistaken belief that medical transition routinely causes permanent sterility, foreclosing any chance at parenthood. (Some treatments, including cross-sex hormones, can hamper fertility in a patient, but the effects are often reversible — plenty of transgender people, men, women and nonbinary people become biological parents.)

Statistics on gender transition medical care for children in the United States are not easy to find, but last year Reuters performed an analysis of insurance data to try to quantify the number of children receiving medication or surgery as a treatment for gender dysphoria. It found that the number of children starting puberty blockers had risen, from 633 in 2017 to 1,390 in 2021. The number of children starting hormone therapy had more than doubled in the same period, to 4,231. The analysis found evidence of 56 genital surgeries between 2017 and 2021. The number of children who underwent mastectomies as treatment for gender dysphoria in 2021 was 282, up from 238 in 2019.

Even if these numbers are significantly undercounted — the data do not include treatment paid for out of pocket — medical transition for children, an issue that has received a huge amount of attention from the news media and politicians, is very uncommon. You would not know that from the 590 bills targeting transgender people that have been introduced in 49 states as of the end of November. So far, 85 have passed.

The discrepancy between the number of children who medically transition and the attention paid to them in our politics is striking. But transgender children are just a subset of all children struggling with gender.

As the frenzy of medical treatment for people who think of themselves as cisgender demonstrates, and indeed the entire $430 billion beauty industry shows, most of us feel at least a little bit weird about our gender — how we wear it, how we show it, how we transmit it to those around us. As the scholar Kathryn Bond Stockton has said, gender is queer, even when we play it straight.

Girls and boys, women and men are enthusiastic and active participants in the construction of their gender identities, making small tweaks or wholesale changes to make the way they feel match the way they look. Maybe the way transgender and nonbinary people feel about their genders is no different from anyone else. It is confusing and contradictory. It feels deeply personal and yet built on the images and influences of our culture. It sets unreachable ideals and is subject to unpredictable variations that spread like wildfire. What is gender if not contagious? We catch it in the form of fads all the time, from the Beatles mop-top craze to Bama Rush .

Transgender and nonbinary people can have complicated feelings about their medical treatment, and may act on them, up to and including transitioning again. They may either go back to the genders they were assigned at birth or reject the binary entirely, and describe themselves as nonbinary, genderqueer or simply queer. It’s a mistake to dismiss these feelings as simply regret.

When the media fixates on the hypothetical regret of children who do transition — and when that fixation blocks treatment paths for others — are we actually debasing the kind of regret that might be felt by a child who wishes to transition but cannot? To borrow another phrase: A single mistaken transition is a tragedy. A million children denied care? That’s just a statistic.

The right claims that transgender people want to impose gender ideology on the world. But as the saying goes, every accusation is also a confession. We are already living under a gender ideology: It is called the gender binary, and transgender people are hardly the only ones suffering from its crushing weight.

Jules Gill-Peterson, a historian at Johns Hopkins University and the author of “Histories of the Transgender Child,” suggested to me that we might be thinking of the gender experiences of transgender people all wrong.

“It might be comforting and reassuring to imagine that trans people are fundamentally different,” she said. “But I think the real startling possibility is that they are not, and that we all depend on the generosity of strangers to give us our genders every single day.”

Maybe we should all learn to wear our genders, indeed, all of our identities, a bit more lightly. I have come to think of the institution of gender as something a bit like an arranged marriage. It is something your family does for you, usually with loving intention and in the interest of your community, that may or may not work out, or may work for a time but then break down. For most of human history, all marriages were arranged marriages, but in much of the world we’ve come to accept that most people want to choose their own life partners, even at the price of family and community cohesion. Why should gender be any different?

The notion that transgender and nonbinary people experience gender in the same way as everyone else is a surprisingly controversial one, not least among the queer community itself. The history of queer activism in the United States is marked by the same tensions as every other identity-based movement: Securing legal rights and protections almost always requires drawing a clearly defined circle around an identity group and the central trait as one that is innate rather than a choice.

For queer people, this notion has been especially fraught, because for much of the last two centuries, queerness was thought to be a disease. It wasn’t until 1973 that the gay rights movement was able to push the American Psychiatric Association to cease referring to homosexuality as a disorder. Queer people, like Black people had been for much of their history in this country, were thought to be defective compared with what was assumed to be the norm.

For gays and lesbians, social acceptance and legal protection came as Americans learned to see sexual orientation as an innate and immutable characteristic. When Gallup first polled on the topic in 1977, just 13 percent of Americans thought gay and lesbian people were born that way. Now roughly half do, and in many ways it hardly seems to matter anymore. The frenzied search for a “gay gene,” a very 1990s preoccupation, has petered out. Believing gay people had no choice but to be gay was a critical way station on the road to accepting homosexuality as just another way of being in the world, and no one talks much about it anymore.

I know plenty of gay and lesbian people who were aware from a very young age of their sexual orientation and who would describe themselves as always having known they were queer. I am not among them. I had a wonderful gay role model in my uncle Tom, who has been out his whole adult life and modeled what a happy queer life without shame and hiding could be. But like many queer people, I had many different romantic entanglements in my youth, and had I not met my wife in college it is not impossible to imagine that I might have ended up on another path. I certainly did not experience myself as being born any particular way.

Among people of my generation and younger, it isn’t all that uncommon for women who were once married to men to later in life end up in partnerships with women, and I certainly have known men in gay relationships who wound up in straight ones and vice versa. These people seldom describe themselves as having “lived a lie” in their previous relationships. I think most of us know intuitively that sexual orientation is not binary, and is subject to change over the course of our lives.

The notion that people who diverge from social norms under existing hierarchies deserve basic human dignity only if they have no choice about that divergence is fundamentally degrading. Undergirding it is the unspoken but clear judgment that this identity is regrettable but in a civilized country must be tolerated. I’m glad it has faded as a justification for rights for gay and lesbian people.

Given the astonishing ferocity of the legislative assault on transgender people right now, and the need to secure even the most basic protections, much of the activism around transgender issues has understandably focused on survival over liberation. The born-this-way narrative prevails in most mainstream organizations and institutions and dominates much of the discourse.

And yet. To many queer people, myself very much included, it feels like an incomplete account of their experiences, a simplification that shortchanges their lives. The writer and academic Grace Lavery, who has written with great clarity and wit about what she calls her “sex change,” describes this problem in her memoir, “Please Miss”:

“‘I always knew’ is an especially unreasonable standard by which to rank the legitimacy of various transitions, because it implies two things — (1) that it was always true; (2) that we have consistent access to truths about ourselves.”

Indeed, in the more radical corners of queer thought, a different conversation is unfolding. I came across one of the most striking examples of this thinking in a slim book published this summer called “Gender Without Identity.” It was written by a pair of queer psychoanalysts, Avgi Saketopoulou and Ann Pellegrini, and in it they argue that the born-this-way model of treating gender of trans and nonbinary patients ignores the vital role life experiences, including traumatic ones, play in shaping gender in all people. Pretending it is otherwise “sets the stage” for regret, Saketopoulou told me.

“To imagine that there was a way to live a life without regret is to sign on to a very particular understanding of human life as being interior, as being sovereign to itself, as having nothing to do with the social world, with the political world, with relationships with each other,” she told me. When it comes to gender, “there’s no way to make a mistake, and there’s no way to get it right. Meaning that you get it right enough. That’s what we’re all aiming for.”

We ended up with the born-this-way model because of the tension between the seeking of rights for an embattled minority and the broader search for liberation. But this tension is ultimately dialectical — it contains the seeds of its own destruction.

I still love to swim, and will jump into just about any swimmable body of water, in just about any weather. The strokes I worked so hard to perfect four decades ago remain embedded in my muscle memory, sending me gliding through pond, stream and sea.

There are times in my life when I’ve wished I hadn’t given up competitive swimming. You can’t step into the same river twice, as the ancient fragment from Heraclitus tells us. Neither you nor the river is the same. I guess that’s how I feel about the champion swimmer I could have been. It would have been another life. It does not impoverish the value of the wonderful life I’ve led to imagine what pleasure and pain might have come from living a different one, or foreclose another, future transition, whatever that might bring. I’m lucky that I got to choose. The gift is the choice, even if I haven’t always been sure I made the right one.

I understand the impulse to protect children from regret. The fantasy of limitless possibility is alluring — who wouldn’t want that for their child? To forestall, for as long as possible, throwing the switches that will determine your destination in life, is tempting. But a life without choosing is not a human life.

Transitions are hard, even when we know that they are coming. We all struggle to see ourselves clearly, and the notion that who we are depends on where and when we are feels deeply destabilizing. This is why the riddle of the sphinx, that ancient tale of Greek myth, stumped so many until Oedipus came along. The sphinx asked: What has one voice but goes on four legs in the morning, two legs in the day and three in the evening? The answer, of course, is us.

We all know what awaits us with age, and yet it is all but impossible for any of us to fathom the transitions our selves will undergo over time. Each of those transitions is a kind of little death — the end of one way of being and the birth of another. It is no surprise that the more unexpected the transition, the more deeply unsettling it is.

We are all hurtling, inevitably, toward that one last transition, across the one true binary, the one between life and death. And that binary is the true source of all our regrets, and our joy, too. Regret exists because we all get just one life.

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Lydia Polgreen is an Opinion columnist and a co-host of the “ Matter of Opinion ” podcast for The Times.

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85 Transgender Essay Topic Ideas & Examples

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102 Transgender Essay Topics & Research Paper Titles

Are you looking for the best transgender essay topics? On this page, you’ll find a perfect title for your essay or research paper about gender identity, LGBT rights, and other transgender-related issues. Read on to get inspired by research topics on transgender prepared by StudyCorgi!

🏆 Best Transgender Research Paper Topics

🎓 interesting transgender essay topics, 👍 good transgender research topics & essay examples, 🌶️ hot research topics about transgender, 📝 transgender argumentative essay topics, ✒️ more transgender topics for essay.

• Transgender Women in Sports
• Transgender People and Healthcare Barriers
• Transgender Issues in Cis- and Trans-Made Movies
• Challenges of Transgender Patients
• Transgender Offenders in the Criminal Justice System
• Transgender Women Athletes in Professional Sports
• Transgender Prisoners and How They Are Treated
• Transgender Support Group Meeting and Its Importance The transgender support groups allow people to connect and talk about issues that they have faced in their lives.
• Critical Thinking and Transgender Ethics Sexual orientation and preference is a debated and complex topic involving biological aspects, including hormones, which can alter and change people’s behavior and feelings.
• Transgender Children’s Issues in Society The topic of transgender children in society proves to be divisive and is widely discussed by parents, teachers, clinicians, and politicians.
• Viviane Namaste and Julia Serano’ Views on Transgenders First of all, it is important to note that both authors consider the theme of representation of transsexuals and transvestites.
• The Fight for $15 Movement vs. the Transgender Law Center For an examination of non-profit organizations, it will be convenient to use case studies. The Fight for $15 movement and the Transgender Law Center will be used as comparisons.
• Health Disparities of Transgender Population The problem is centered around the healthcare inequality experienced by members of the transgender community, where the barriers include financial factors and discrimination.
• Clinically and Culturally Competent Care for Transgender and Non-Binary People The analyzed review can be considered an essential step toward a better understanding of how to work with such groups.
• Transgender People in the Olympic Games The new guidelines state that transgender athletes may be permitted to compete in the Olympics without undergoing sex reassignment surgery.
• Transgender People in Prisons: Rights Violations There are many instances of how transgender rights are violated in jails: from misgendering from the staff and other prisoners to isolation and refusal to provide healthcare.
• Transgender People: Prejudice and Discrimination Transgender remains a stereotyped sexual identity, and these individuals face prejudice from critics, religious leaders, and the vast majority of society.
• Transgender Health Disparities and Solutions People who identify as transgender, intersex, gender non-conforming, or gender diverse have exacerbated health disparities compared to other people.
• Mental Healthcare Services for Transgender Individuals This research paper suggests a range of options to treat mental health and related illnesses among the non-binary populations.
• Media Coverage of Transgender Policy in Military This paper aims to provide an annotated bibliography for the ten articles related to the topic of media coverage of transgender policy in the military.
• Transgender Movement: Overview and Importance Ultimately, policies, guidelines, or steps ensure that the social change that the transgender movement is yearning for can be realized.
• Transgender Health Care in the USA: Then and Now The change of physical appearance or function through clothing, medical, surgical, or other means often becomes part of the personal gender experience of a transgender person.
• Why We Shouldn’t Compare Transracial and Transgender Identities To compare transracial identity with transgender identity is to reduce both to a set of immutable rules, be it rules of biology or society – and this is a very wrong approach.
• Conflict Between Transgender Theory, Ethics, and Scientific Community This essay aims to give answers to questions of ethics within the transgender topic and research fraud based on scholarly articles and presentations by Dr. Q Van Meter.
• The Problem of Lesbian, Gay, Bisexual and Transgender Youth Suicidality Recently, there was a sharp increase in cases of suicides committed by lesbian, gay, bisexual, transgender, and queer youth.
• Lesbian, Gay, Bisexual, Transgender Activism This paper aims at exploring the background of LGBTQ activism, the oppression that its members experience, the measures they take, and the opposition that hinders their progress.
• Transgender Care: Challenges, Implications In a healthcare setting not putting effort into ensuring diverse patient groups are treated with professional finesse with no regard for their differences is a timely issue.
• Trump Administration and Transgender Discrimination The paper reviews one of the recent issues that caught the public eye and media attention is the Trump administration’s treatment of transgender people’s healthcare rights.
• Gender Non-Conforming or Transgender Children Care The purpose of this paper is to discuss the challenges to be aware of when working with gender non-conforming or transgender children and adolescents.
• Transgender People’s Challenges Within Healthcare This paper aims to discuss the challenges in healthcare that the transgender community faces and how the challenges affect their overall health outcome.
• Transgender Care by Healthcare Professionals Transgender patients require healthcare professionals who are conversant with their experiences and who can treat them with utmost respect and dignity.
• Transgender Bias in News Coverage In the context of increasing LGBTQ activism and recognition, transgenderism faces the greatest controversy and public backlash.
• The Issue of Transgender Discrimination Despite numerous attempts to eliminate biased attitude, transgender people still face different challenges that deteriorate results of treatment.
• Transgender Community and Heterosexism in Language The term “transgender” became commonly used only by the end of the 20th century. Not all transgenders commenced using this and preferred to pass as a different gender.
• Healthcare System: Transgender Patients Discrimination According to the statistics, almost 1 million Americans identifies themselves as transgender, making it a numerous population subgroup that is likely to expand in the future.
• Transgender Patients Problem and the Consequences of Discrimination Transgender patients come across different forms of harassment and do not have the same access to services as other people do.
• Transgender and Gender Non-Conforming Children This paper discusses the issues a psychiatric mental health nurse practitioner should be aware of when interacting with transgender and gender non-conforming children and adolescents.
• Transgender Patients and Health Care Challenges One of the challenges encountered by transgender patients refers to the lack of adequate access to healthcare services.
• Transgender Care and Health Care Professionals Despite the adoption of policies aimed at limiting discrimination, transgender people still face daily challenges in the aspects of employment, education, and healthcare access.
• Transgender Healthcare Barriers in the United States This paper examines central barriers to high-quality health care and includes practices employed to address the issue and some recommendations.
• Transgender Patients: Challenges & Discrimination in Healthcare It is worth noting that the concept of transgenderism implies a state of internal imbalance between the real and desired gender of an individual.
• Healthcare Challenges of Transgender Patients Transgender individuals have health problems common for the whole population and frequently face challenges in healthcare settings related to inadequate healthcare.
• Transgender Patients and Challenges in Health Care The community remains predominantly marginalized, with policies and laws denying them recognition of their gender, making accessing health care very challenging.
• Lesbian, Gay, Bisexual, Transgender Patients’ Therapy The current quality of managing the needs of the representatives of the LGBT community needs a significant improvement.
• Transgender Patients and Nursing Health Management There is a growing recognition today among health care providers and researchers that patients’ transgenderism may become a factor in their care.
• Lesbian, Gay, Bisexual, Transgender in Hospital The paper discusses the cultural competency concept since it appears to be of critical importance for the profound understanding of the problems of the LGBT community.
• Challenges to Transgender Patients Despite the recent attention to the issues of transgender people, the level of discrimination against them is still incredibly high.
• Discrimination Faced by Transgender Patients Contemporary hospitals are not designed for transgender people, therefore, they can have many troubles there ranging from the unfriendly environment of a hospital and doctors.
• Transgender-Associated Stigma in Healthcare Transgender individuals are people who assume a gender definition of identity that differs from gender assigned to them at birth.
• Transgender Disorders and Homosexuality There is a lot of evidence of both the genetic mechanisms’ and surroundings’ influence on people’s sexual preferences. However, the environment is more responsible for such choice.
• Transgender and Problems with Healthcare Services Transgender individuals find it difficult to approach physicians because it is difficult for them to reach needed treatment.
• Transgender People in Healthcare Facilities Gender nonconforming and transgender people face discrimination in almost every sphere of human activity. It has a negative impact on the access of these groups to primary care.
• Transgenders Discrimination from Healthcare Providers The transgender community reports that at the moment, it faces numerous barriers to care because of health workers` inability to consider their specific needs.
• Transgender, Its History and Development Transgender is not a new concept and people have discussed the issues associated with it since the 19th century.
• Problems of Transgender Patients in Health Care A number of transgender patients admit cases of discrimination from the health care workers. From 30% to 60% of the representatives of this group face biased attitude.
• Transgender Discrimination in Health Care This paper investigates the discrimination that transgender persons are subjected to in the health care setting in more detail.
• Transgender Community’s Treatment in Healthcare This paper discusses the transgender community and the discrimination that affects them every day, especially in healthcare, and how we can help stop it.
• Principles of Healthcare for Transgender Patients
• Characteristics of Interpersonal Relationships and the Transgender Community
• Improving Correctional Healthcare Providers’ Ability to Care For Transgender Patient
• Analyzing Transgender Communities Rights
• General Information About Gay, Lesbian, and Transgender Rights Movement
• Transgender Equality and the Progression of the Employment Non-Discriminate
• Beyond Depression and Suicide: The Mental Health of Transgender College Students
• Violence Against Lesbians, Gays, Bisexuals, and Transgender
• Transgender Men and Women Have Been Around for Centuries
• Quality Healthcare for Transgender People
• Role of African American Gay, Bisexual and Transgender Men in Contemporary Society
• Public Bathroom Controversies Due to Transgender Issue in America
• Hate Crimes Against Lesbian, Gay, Bisexual and Transgender
• Empowering and Educating About the Transgender Sodality Through Social Media and Laws
• Transgender Youth Homelessness: Understanding Programmatic Barriers Through the Lens of Cisgenderism
• Policies and Best Practices for Transgender Hiring Organizations in India
• Transgender Rage: The Compton’s Cafeteria Riot of 1966
• The Pros and Cons of Transgender and Gender Nonconforming
• Proper Communication With the Transgender Community
• Gender Dysphoria and the Persecution of Transgender People
• Lesbian, Gay, Bisexual, and Transgender U.S. Legal Questions
• Informal Mentoring for Lesbian, Gay, Bisexual, and Transgender Students
• Transgender Rights Under Bigotry and Ignorance
• Differences Between Gender Feminism and Transgender Activism
• Transgender Rights and Surviving Hate Crimes in the Case of Cece McDonald
• Should transgender adolescents have access to gender-affirming treatments?
• Is transgender representation in media crucial for promoting transgender rights?
• Transgender athletes in competitive sports: equality or unfair advantage?
• Is religious freedom incompatible with protecting transgender rights?
• Transgender parenting rights: why do they deserve equal protection and recognition?
• Transgender people in prisons: how should they be placed and protected?
• Should puberty blockers be banned?
• Should transgender people be disqualified from military service?
• Is it ethical for homeless shelters to discriminate against transgender individuals?
• Should non-binary gender be legally recognized?
• The importance of inclusive terminology for protecting transgender rights.
• Mental health challenges faced by transgender youth.
• The role of transgender activists in driving social change.
• How can religious beliefs help and hinder transgender rights promotion?
• Challenges faced by transgender parents.
• Ways to support transgender youth in schools.
• The relationship between transgender identity and body positivity.
• Comparing transgender rights in different countries.
• Transgender identity and aging: unique challenges.
• The impact of corporate policies on transgender workplace inclusion.

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These essay examples and topics on Transgender were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

This essay topic collection was updated on January 9, 2024 .

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Recognizing the Rights of Transgender People

It's time to create a world that recognizes the rights of transgender people

NeelaGhoshal

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The process is as universal as it gets: when a baby is born, a doctor, parent, or birth attendant announces the arrival of a “girl” or “boy.” That split-second assignment dictates multiple aspects of our lives. It is also something that most of us never question.

But some people’s gender evolves differently, and might not fit rigid traditional notions of female or male.

That should have no bearing on whether someone can enjoy fundamental rights. But for transgender people it does—to a humiliating, violent, and sometimes lethal degree.

As researchers on lesbian, gay, bisexual and transgender (LGBT) rights, we document countess cases of violence and discrimination against transgender people, whose very existence is outlawed in parts of the world.  In Malaysia, state religious officials arrest trans people for the simple act of walking down the street wearing clothing deemed inappropriate to their assigned sex. Similar arrests have been made in Indonesia, Nigeria, Kuwait, the United Arab Emirates, and Saudi Arabia. Police have arrested trans people in Malawi, Uganda, Tanzania and Zambia under laws that criminalize same-sex conduct.

Trans people are murdered at shockingly high rates, most notably in Latin America and the United States.  Systematic marginalization contributes to high rates of suicide and HIV.

Despite this litany of rights violations, trans people have made tremendous strides in recent years toward achieving legal gender recognition—a crucial step toward curbing abuses.

The concept of a right to legal gender recognition—in other words, that everyone should be able to have documents marked with the gender with which they identify—has only recently gained traction. Many countries don’t allow people to change the gender designation on their documents at all. Others set stringent conditions for those who wish to do so.

Absent legal recognition in the gender with which they identify, every juncture of daily life when documents are requested or appearance is scrutinized becomes fraught with potential for violence and humiliation.

A trans woman in Malaysia told us that because she must present a male ID card at job interviews, the interviews inevitably dissolve into interrogations about her breasts. In Uganda, a trans man reported that a doctor threatened to call the police after realizing his appearance did not match his legal gender.

A trans man in Kazakhstan described his routine treatment by airport security:  “First, the guard looks at my documents and is confused; next he looks at me and asks what’s going on; then I tell him I’m transgender; then I show him my medical certificates; then he gathers his colleagues around, everyone he can find, and they all look and point and laugh at me and then eventually let me go.”

Even in countries that consider themselves beacons on LGBT rights,  including some European and Latin American countries and the US, transgender people are still forced to undergo demeaning procedures to change their documents, including gender reassignment surgery, forced sterilization, psychiatric evaluation, lengthy waiting periods, and divorce.

Achieving the right to legal gender recognition is crucial to the ability of trans people to leave behind a life of marginalization and enjoy a life of dignity. ​A simple shift toward allowing people autonomy to determine how their gender is expressed and recorded is gaining momentum. It is long overdue.

But some governments are beginning to realize they should no longer serve as gender gatekeepers.

Argentina broke ground in 2012 with a law that is considered the gold standard for legal gender recognition. Anyone over 18 can choose their legal gender and revise official documents without judicial or medical approval. Children can do so with the consent of their legal representatives or through summary proceedings before a judge.

In the next three years, Colombia, Denmark, Ireland, and Malta eliminated significant barriers to legal gender recognition.                                               

In parts of South Asia, activists have fought for recognition of a third gender category. A Nepal’s Supreme Court ruled in 2007 that the government must recognize a third gender based on an individual’s “self-feeling.” Similar developments followed in Pakistan, Bangladesh, and India.

Elsewhere, the very purpose of gender markers has been interrogated. New Zealand and Australia now offer the option of listing “unspecified” gender on official documents. The Dutch parliament has begun considering whether the government should record gender on identification documents at all.  

In places where trans people’s very identities are criminalized, a future in which they may be legally recognized seems far off.

Yet it is precisely the persecution they face that lends urgency to the struggle for legal gender recognition. It highlights that states should not be in the business of regulating gender identities. Recognizing people’s self-identified gender does not require governments to acknowledge any new or special rights; instead, it is a commitment to the core idea that the state will not decide for people who they are.

To make this shift will require societies to recognize gender for what it is: a social construct.

Gender is deeply-felt by individuals; governments should not be in the businesss of adjudicating this identity through abusive protocols and bureaucratic snags. To alleviate this nightmare, governments should take some basic steps to separate legal and medical processes related to gender transition. That is to say, allow people to change their legal gender as an administrative process; and provide quality transition-related healthcare as a separate matter.

After making this procedural change, governments should adjust all relevant systems—including the multiple documents we carry in our daily lives, national databases such as the census, and any other gendered space ranging from restrooms to prisons. Dignity on paper must be ensured in practice as well.

Transgender activists have made great strides in making this vision a reality in some parts of the word, but too often, their struggle has been a lonely one. Mainstream human rights organizations and donors should recognize that legal gender recognition is a fundamental human right, and should throw their weight, and their resources, into its realization.

Achieving the right to legal gender recognition is crucial to the ability of trans people to leave behind a life of marginalization and enjoy a life of dignity. A simple shift toward allowing people autonomy to determine how their gender is expressed and recorded is gaining momentum. It is long overdue.

Neela Ghoshal is a senior researcher and Kyle Knight a researcher in the LGBT rights program at Human Rights Watch. 

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We Need to Change the Terms of the Debate on Trans Kids

By Masha Gessen

Every night, when I walk my dog, several strangers, similarly tethered, will ask me the same two questions: “Boy or girl?” and “How old?” The pragmatic meaning of these questions escapes me. The answers do not inform the interactions between our dogs, nor do they tell a story. Wouldn’t it be more interesting to learn whether the dog was a longtime family member or a pandemic puppy, whether it lived with other pets, how much exercise it got or desired, how it tolerated last summer’s orgy of fireworks, or to learn at least the dog’s name? These are the questions I usually ask other dog owners as our pets sniff each other, but in response I am still asked—hundreds of times a year—about my dog’s age and gender. These categories, it seems, are so central to the way we organize the world around us that we apply them to everything, including random dogs in the night.

No wonder, then, that attempts to subvert these two categories make people uncomfortable and, often, scared and angry. This happens when children act with particular independence; when people challenge the norms of gender; and, especially, when both of these things happen at once, as in the case of trans children. In December, the British High Court of Justice ruled on the question of whether young people under the age of eighteen are capable of giving informed consent to treatments that forestall puberty. Such treatments can be prescribed to children given a diagnosis of gender dysphoria, both to alleviate discomfort that can stem from the physical changes brought on by puberty and to pave the way for later medical gender transition. The court ruled that children under sixteen cannot consent to such treatment because they are unable to grasp its long-term consequences, and cast doubt on the ability of young people between the ages of sixteen and eighteen to give informed consent. The decision effectively bars British children and adolescents from transitioning medically.

British media coverage of the High Court’s decision was generally positive. “Other countries should learn from a transgender verdict in England” the Economist wrote . “The court was correct to curb a disturbing trend,” the Observer wrote . Later in the month, the BBC’s media editor, Amol Rajan, published his list of the five best essays of the year, among them J. K. Rowling’s piece explaining her position “on sex and gender issues.” Rowling, who presents herself as a defender of bathrooms, dressing rooms, and other “single-sex spaces” against trans women, wrote that she was “concerned about the huge explosion in young women wishing to transition and also about the increasing numbers who seem to be detransitioning.” She cited the controversial hypothesis that some adolescent transitions may stem from a kind of social contagion. Had transition been an option during her own adolescence, Rowling wrote, she might have chosen it as a way to deal with her own mental-health challenges: “The allure of escaping womanhood would have been huge.”

In the United States, this line of argument has been advanced by Abigail Shrier, a writer for the Wall Street Journal who published a book last year titled “ Irreversible Damage: The Transgender Craze Seducing Our Daughters .” The cover art is a drawing of a prepubescent girl with a giant round cutout where her abdomen should be. The book is currently ranked “#1 Bestseller in Transgender Studies” on Amazon. Bills that would ban trans care for young people have already been prefiled for this year’s legislative sessions in Alabama, Texas, and Missouri; last year, a similar bill was defeated in South Dakota, thanks to opposition from the pharmaceutical industry. When such bills contain language explaining their rationale, they make similar arguments to those of Rowling, Shrier, and the British High Court: that the effects of trans care are irreversible and that many people who want to transition when they are adolescents will ultimately choose to identify with the gender they were assigned at birth.

The state bills tend to lump all kinds of trans care—puberty blockers, cross-sex hormones, and surgeries—together. As a narrative, this is not unreasonable: the vast majority of people who receive puberty blockers do go on to take cross-sex hormones, and many choose surgery. But the short- and long-term effects of the medical interventions are markedly different. Agonists of gonadotropin-releasing hormone, originally developed to treat prostate cancer and endometriosis in adults, can have the effect of preventing puberty-related changes: genital growth, breasts, body and facial hair, and voice changes. Estrogen promotes breast growth, and testosterone will likely lead to a lower voice and more body and facial hair; both kinds of hormones affect fat and muscle distribution. The effects of hormones are not as predictable—and the line between reversible and irreversible effects of hormone treatments isn’t as clear—as their opponents seem to think, but a person whose puberty is effectively prevented and who later receives cross-sex hormones is unlikely to preserve their fertility. Some European researchers are experimenting with reserving gonad tissue that may be used to create biological progeny later (similar efforts are made with children undergoing cancer treatment that is likely to render them infertile). Natal males and females who transition during adolescence forfeit their fertility equally, but Rowling, Shirer, and other opponents of pediatric trans care seem particularly concerned with people they see as girls clamoring to escape womanhood. (The lead plaintiff in the British case, Keira Bell, who was assigned female at birth, began taking puberty blockers at sixteen and testosterone at seventeen and had a double mastectomy at twenty. Bell later transitioned back to being female.)

“Women and children are always mentioned in the same breath,” the visionary feminist activist Shulamith Firestone observed in the book “ The Dialectic of Sex: The Case for Feminist Revolution ,” from 1970. “I submit . . . that the nature of this bond is no more than shared oppression. And that moreover this oppression is intertwined and mutually reinforcing in such complex ways that we will be unable to speak of the liberation of women without also discussing the liberation of children, and vice versa.” Firestone noted that women and children were inextricably linked not only by the women’s duty of childbearing and child rearing but by the obligation, for both groups, to maintain innocence, fragility, immaturity, and dependence on others. She saw the path to liberation in divorcing the reproductive function from women’s biology, and in abolishing childhood. One might argue that young people who seek trans care are pursuing both of these projects, and that is why they inspire such panicked opposition.

Yet the arguments in favor of trans care for young people are usually not so much liberationist as they are determinist. Advocates generally claim that trans children are innately, immutably different from cis children and that access to medical transition is essential for staving off depression and even suicide. “The fear that puberty per se can be a threat to life for transgender children permeates pediatric trans care,” Sahar Sadjadi wrote in an essay in Transgender Studies Quarterly last year. (Sadjadi is a medical anthropologist who has studied clinical practices for transitioning and other non-gender-conforming children for a decade.) This type of advocacy, she argues, builds on two long-standing tendencies: the habit of thinking of gender transition as primarily a medical process, and the habit of grounding L.G.B.T. civil-rights claims in “born this way” rhetoric. These habits make for a compelling, easily digestible argument: transness is an immutable characteristic, and denying young people access to medical transition can be tantamount to killing them. This argument is grounded in the lived experience of some advocates, whose own medical transition relieved extreme anguish. But an argument rooted in despair cannot and should not represent all young trans people.

When we are not talking about children and adolescents, trans people talk about a much broader range of options than medical transition—a spectrum of gender expression more varied than the linear path of puberty blockers followed by cross-sex hormones. Some adult trans people consider themselves binary, and some don’t; some use hormones and have surgeries, some choose one or the other, some try different approaches, and some eschew medical interventions altogether. Medical intervention requires a diagnosis of gender dysphoria, even if the person is paying for surgery and hormones out of pocket. In general, though, adults are not required to prove that they have always felt like they were in the wrong body (although some have).

If we hold to the premise that transness is an immutable, inborn trait, it follows that every young person who chooses to detransition will undermine the case any other young person may have for seeking trans care. “The main debate has become whether these young people will ‘persevere,’ ” Sadjadi told me by Zoom from Montreal, where she is on the faculty at McGill University’s Department of Social Studies of Medicine. “I think this is the wrong question. Gender changes with age. The gender of a fifty-year-old woman is not the same as of a five-year-old girl. Nothing terrible happens if a person transitions again, which is how I think we should think about it.”

The British High Court’s decision makes a point that appears compelling and compassionate. A child, the panel decided, cannot fully comprehend the meaning of infertility and possible loss of sexual function that come with transitioning at a young age. (One concern is that puberty blockers prevent genital growth, making gender-affirming bottom surgery more complicated.) But this argument rests not only on a narrow definition of sexual pleasure but on an impossible ideal of comprehension: we can never fully imagine loss, especially the loss of something we’ve never had. Keira Bell testified, “It is only until recently that I have started to think about having children and if that is ever a possibility, I have to live with the fact that I will not be able to breastfeed my children. I still do not believe that I have fully processed the surgical procedure that I had to remove my breasts and how major it really was.” As heartbreaking as that admission is, all available data indicate that such regrets are exceedingly rare. That one person’s testimony convinced the court to make a decision that will affect untold thousands tells us more about the pull that human reproduction has on the imagination than it does about gender transition.

“People change their minds about all kinds of decisions,” Sadjadi added. Hers is not an argument against thinking of transition as a serious, consequential decision, but rather an argument for viewing gender transition as one of the many important choices some people face. People—including young people, acting legally, with their parents’ support—choose to have babies, move continents, subject themselves to extreme physical risk by engaging in certain sports, make what often amounts to commitments to lifelong medical intervention with S.S.R.I.s for depression or stimulants for attention deficit hyperactivity disorder, join the R.O.T.C. or the National Guard. None of these decisions is just like the decision to transition. But are they really so much lighter, so much less consequential, that the possibility of one person reversing course shouldn’t prevent others from making the same choices?

In her 1970 book, Firestone discussed the arbitrary historical boundaries of childhood. In other eras, boys would be expected to abandon toys and take up adult vocations at the age of seven; girls were historically married off as soon as they went through puberty. Firestone’s point was that childhood was a relatively new category, and an unstable one. Our own ideas of maturity are no less arbitrary than our ancestors’. We know that a fifteen-year-old is probably better equipped to make life decisions than is a nine-year-old, who is still vastly more experienced and informed than a four-year-old. But for the purposes of the law, we lump them in the same category. An eighteen-year-old, on the other hand, is deemed capable of making the full range of life choices—except for whether to ingest alcohol. There is little doubt, however, that the experience, wisdom, and skill for assessing risk and making decisions continue to accumulate well past middle age. If you think about it, a fifty-year-old who has experienced life in a particular gender is in a much better position to make a decision about transition than is a twenty-year-old. But at that point, it’s too late to decide to be a young person in the other gender, and this, too, is irreversible. I began my own transition at fifty, long after experiencing the misery of pregnancy and the incomparable joy of breastfeeding. I have no regrets. Had I had the option of transitioning as a teen-ager, I would have chosen to do so—and I am almost certain that I would have had no regrets then, either, because I would have had a different life.

Sadjadi, who was a physician before she became an anthropologist, has written that puberty blockers are not as medically inconsequential as they are often portrayed. Although they appear to have no long-term physical effects if they are used for a short time (a year or less), some studies suggest that they can have long-term detrimental effects for the musculoskeletal system if they are used for three or four years. (Long-term data comes from the use of puberty blockers to forestall what is deemed “precocious” puberty, occurring in children under the age of nine.) The manufacturer of Lupron, the drug most commonly used as a puberty blocker, warns of depression as a possible side effect. Sadjadi suggested freeing gender transition in young people from the assumption that they will necessarily take puberty blockers. For some kids, she said, it may be worth considering social transition as the first or even only step. Social transition is often conspicuously absent from the menu offered to adolescents. For others, cross-sex hormones may be preferable to puberty blockers, which are supposed to “buy time” before a child is deemed old enough to make the commitment to transitioning. There is not enough data to say whether and when these may be the better care options.

To be able to talk about a range of transition options, at different times in life, we would need to change the terms of the debate. We would need to view both age and gender on a continuum, not as binary states. None of us has ever been as innocent and ignorant as the children of our imagination, and none of us will ever be as wise and competent as the adults we make ourselves out to be. What if we saw ourselves as always changing, always uncertain, but always capable of making choices? What if we accepted that some losses are desirable and some are regrettable, and that we can’t always know the difference? What if we knew that we are always changing not only as individuals but as societies, and the categories we use to sort ourselves mutate faster than we realize? Then maybe we could have a real conversation about trans care for young people.

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By Rebecca Mead

By Jessica Winter