If you are a guy, you usually don't think about it much. It feels normal to be male. And, for most girls, it feels very natural to be female. But that's not true for everyone. Transgender people who were born male feel they should be female, and transgender people who were born female feel they should be male.

People who are transgender feel like they're living inside a body that's all wrong for them. They often say they feel "trapped in someone else's body."

What Does It Mean to Be Transgender?

When you think of yourself as male or female, it's called gender identity. Everyone has a gender identity — the inborn sense of ourselves as being male or female.

Most people's gender identity matches their anatomy. But people who are transgender feel different from their physical appearances.

What society expects of us as men, women, boys, and girls also affects what we feel about ourselves. Every culture has "rules" about what is expected for men and what is expected for women. These expectations can include things like hairstyles, clothing, and jobs — and how people should act or behave.

These "rules" are mostly unspoken. We know them because we see them all over. So most people grow up believing men should act a certain way and women should act a certain way without thinking about it much. Transgender people, though, have a very different sense of themselves.

Some transgender people know they feel "different" from the time they're young kids. Others start sensing it around puberty or even later. When people who are transgender become aware that they feel mismatched with their bodies, they may feel confused and emotionally conflicted.

Some people decide to physically change their bodies — through surgery or taking hormones — to match the gender they feel they really are. Physically becoming the opposite gender can be a long, complicated, and expensive process.

Not everyone decides to get surgery or hormones, though. Some transgender people are most comfortable keeping their physical anatomy but dressing as the opposite gender. Some aren't completely sure what they want yet, but may start by asking to be called a new name and use the pronouns that go with that name (such as "Amanda" instead of "Anthony" and "she" instead of "he").

When transgender people start living their lives as the opposite gender, many issues may come up — like how to fill out forms that require checking "female" or "male," and even which public bathrooms to use.

As with any group, not all transgender people think or want the same things. It all depends on what that particular person needs to feel most comfortable in both body and mind.

What's in a Name?

The word transgender doesn't only mean that a person identifies with the opposite gender. It also can be used by people who don't feel like they're either completely male or completely female.

In addition to transgender, people use other words to describe feeling different from the gender they were born with. These words can include gender variant, MTF (for male to female), or FTM (for female to male). Some people don't want to be called by any of the terms that are typically used to describe people who are questioning their gender. They just want to be known as who they are, unique in their own special way.

Are Transgender People Gay?

Being transgender is not the same thing as being gay.

Being transgender is about gender identity — the way you see yourself and the gender you identify with. Being gay or lesbian is about sexual orientation — the gender you are attracted to.

Many gay and lesbian people are comfortable with their gender. They don't want to be a different gender from what they are. They're just attracted to people of the same sex they are.

Because sexual orientation is a different thing from gender identity, a transgender teen can be straight, gay, or bisexual — just like other teens can.

Are People Who Dress as the Opposite Sex Transgender?

People who dress in clothes that are usually associated with a different gender are sometimes called cross-dressers (or transvestites). Not all people who dress as the opposite sex are transgender. Lots of people who cross-dress are making a clothing choice for fun, comfort, or as a way to express their personal style — not because they see themselves as the other gender.

What Causes People to Be Transgender?

Many health experts believe that being transgender isn't caused by one single thing. They believe it's the result of a complex mixture of biology, psychology, and environmental factors — and not simply a matter of choice.

Experts don't know what makes a person comfortable or not comfortable with his or her anatomy. After all, no one knows why most males are comfortable with being male and most females are comfortable being female.

What Does the Future Hold for Transgender Teens?

The idea that people can feel that they are in the wrong gender bodies is something that many people have never heard of — or don't understand. Being transgender is something some people feel uncomfortable thinking or talking about.

For people who are transgender, the realization that they feel different from others can be very difficult. They may face rejection, discrimination, and even anger from people who don't understand transgender identity. It can be a challenge to deal with others' reactions. Not everyone is tolerant or accepting, and transgender teens can face situations that can feel hostile and be unfair. This may lead to feelings of depression and isolation.

Advocacy groups and a growing number of health professionals are committed to helping transgender people find acceptance, support, rights, and care. Many expert medical centers are available to help transgender people address the complex physical and emotional issues they might face.

Like everyone, transgender people want to feel accepted, understood, and supported.

Reviewed by: Linda A. Hawkins, EdD, and Nadia Dowshen, MD
Date reviewed: December 2010