Terms of Identity
Assigned sex at birth: The sex (male or female) assigned to a child at birth, most often based on the child’s external anatomy. Also referred to as birth sex, natal sex, biological sex or sex.
Cisgender: A term for people whose gender identity generally matches the gender assigned for their physical sex. In other words, someone who does not identify as transgender. The word is derived from the Latin root “cis” meaning “on this side.”
Genderqueer and/or nonbinary: People whose gender identity and/or gender expression falls outside the binary categories of man and woman. They may define their gender as falling somewhere in between man and woman, or they may define it as wholly different from these terms.
Gender affirming: Adjective used to refer to behaviors or interventions that affirm a transgender person’s gender identity (e.g., a treatment using cross-sex hormones for a transgender patient may be called gender affirming, as can the use of a correctly gendered pronoun.)
Transgender: An umbrella term for people whose gender identity does not match the sex they were assigned at birth. Transgender people may identify as straight, gay, bisexual or another sexual orientation.
Transition: An individualized process in which transgender people move from living aligned with the sex they were assigned at birth to living aligned with their gender identity. There are three general aspects to transitioning: social (e.g., presentation, relationships, employment, names/pronouns); medical (e.g., hormones, surgery, mental health) and legal (e.g., changing gender marker and name on legal documents and identification). Each person’s transition path is unique.
Gender Affirming Medical Interventions
Bottom surgery: Colloquial phrase to describe gender affirming genital surgery.
Breast augmentation: Enlarging the breasts using breast implants.
Chest masculinization: A bilateral mastectomy that removes most of the breast tissue, shapes a contoured male chest, and refines the nipples and areolas.
Facial feminization surgery: Includes such procedures as reshaping the nose; brow or forehead lift; reshaping the chin, cheek and jaw; Adam’s apple reduction; lip augmentation; hairline restoration and earlobe reduction.
Facial masculinization surgery: Includes forehead lengthening and augmentation; cheek augmentation; reshaping the nose and chin; jaw augmentation; thyroid cartilage enhancement to construct an Adam’s apple.
Hormone replacement therapy (HRT): The process in which transgender people choose to take a prescription of synthetic hormones. For transgender women, that may include estrogen as well as testosterone blockers. For transgender men, testosterone.
Metoidioplasty: A surgical procedure that works with existing genital tissue to form a phallus, or new penis. It can be performed on anyone with significant clitoral growth caused by using testosterone.
Penile construction/phalloplasty: The construction of a penis generally includes several procedures that are often performed in tandem. They may include the following: a hysterectomy to remove the uterus, an oophorectomy to remove the ovaries, a vaginectomy to remove the vagina, a phalloplasty to turn a flap of donor skin into a phallus, a scrotectomy to turn the labia majora into a scrotum, a urethroplasty to lengthen and hook up the urethra inside the new phallus, a glansplasty to sculpt the appearance of an uncircumcised penis tip, and a penile implant to allow for erection.
Top surgery: Colloquial phrase to describe gender affirming surgery of the chest — either bilateral mastectomy or breast augmentation.
Vaginal construction/vaginoplasty: A procedure in which surgeons may remove the penis and testes, if still present, and use tissues from the penis to construct the vagina, clitoris and labia.
Sources: The Johns Hopkins University’s LGBTQ Life, Johns Hopkins Medicine, and Healthline
Updated March 2024