What Is a Trans Woman?

A trans woman is someone who identifies as female despite their assigned male sex and gender at birth. This can include feminizing hormone treatment, changing legal documents to reflect a new identity, and wearing feminine clothing.

Often, media depictions of trans women are sexualized. But this fetishization only devalues the importance of true femininity and femaleness in the lives of real trans women.

How do I know if I’m a trans woman?

People can be confused about terminology, especially when trying to determine if they are transgender. “Transgender” is the community term for people who have a social and personal gender identity that differs from the gender assigned to them at birth. Some trans women, for example, were born male but grew up feeling like they were girls. This is called “transitioning,” and it may or may not involve having surgery or medical treatments such as feminizing hormones.

Other signs that you are transgender include a strong desire to dress in feminine clothes or to act in female ways, even if it’s just for fun. It’s important to note that this doesn’t necessarily mean you’re sexually attracted to other girls/women. Many trans women, for instance, have a sissy kink that can be just as intense as the fetishes of their cisgender friends. The only way to know for sure is to speak with your doctor about how you feel and what options are available to you.

What are my options?

Health care providers should discuss gender-affirming hormone therapy and surgery options with their patients. This includes discussion of sperm freezing and fertility options if the patient is considering those treatments.

Many trans women need feminizing hormones to produce physical changes that match their gender identity. This can include a more feminine body shape and facial features, a less masculine voice and reduction of male pattern hair growth.

Some trans women will continue hormone therapy after their transition is complete to help them maintain their new appearance and to avoid hormonal aging. Others will continue their hormone therapy for life.

The Gender Recognition Act currently requires people to have a medical diagnosis of ‘gender dysphoria’ before they can be recognised as a woman by the government. This is a difficult, traumatic and stressful process that lots of trans people struggle with. Some countries have reformed the process and now allow people to change their gender by legal declaration, rather than by going through a clinic.

How do I get the medical care I need?

Transgender people have unique health needs, but they also need routine medical care. This includes things like annual checkups, STI screening and meningitis vaccines.

All people have the right to access quality, respectful health care that meets their gender identity and needs. Unfortunately, transgender people are often excluded from this basic health care.

A huge part of this problem is rooted in anti-trans stigma that persists in our society. It shows up in a variety of ways, from politicians who use it to score cheap political points, to family, friends and coworkers who reject us, even to the violence that kills many transgender people.

Fortunately, the medical community now recognizes that transition-related treatments are “medically necessary.” That means that it is illegal for private insurance companies to deny coverage for these treatments. You can find more information about how to navigate this process on NCTE’s Health Coverage Guide.

How do I get surgery?

For many transgender women, surgery helps them feel more in line with their self-identified gender. Gender-affirmation surgeries can involve operations on the face, chest or genitalia. In some cases, health care professionals recommend that transgender people first begin hormone treatment before having surgery.

Feminizing surgery may include procedures such as orchiectomy (removal of the testicles) or scrotectomy (removal of the scrotum), construction of a vulva and vagina (vaginoplasty) and removal of the ovaries and uterus (oophorectomy and hysterectomy). Health insurance coverage for these procedures varies.

Talk to transgender people who have had surgery and read articles on the Internet to learn more about what you can expect during your transition. It also can be helpful to use a health savings account or flexible spending account, both of which allow you to stash pre-tax money for medical expenses, including gender affirmation surgery. This could save you a lot of money in the long run. There are also grants available for people who need help affording their surgery, including the Point of Pride annual Transgender Surgery Fund and the Krysallis Anne Hembrough Legacy Fund through The Loft LGBTQ+ Community Center.