August 26, 2021

Why are Trans People Trans?

What makes trans people trans? A lot of theories have been presented, and few of them survive the test of time. Currently the dominant model is what I have called the Rainbow Model, where a transgender identity is seen as the end product of a complex interplay of factors, some of them biological. In this three parter, I look at several approaches to explaining what makes trans people trans.

Tailcalled, who has been taken active part in the "autogynhephilia" debate over at reddit, has invited me to an online debate about what makes trans people trans. I can do that. We have agreed that we will both publish a blog post giving some pointers as to how see the "etiology" (cause) of transgender identities, as starting points for our discussion.

This is my blog post. Tailcalled's one can be found here.

So the question is: What makes trans people trans?

Sounds easy, doesn't it? All we have to do is to find some relevant scientific papers and take it from there. But it is not that easy. Not that I am dismissing the role of science in such a debate. I have been writing about this kind of research since 2009. 

The problem is that science is not a kind of platform where you can look at transgender lives with purely objective and disinterested eyes. Scientists are as human as the rest of us, and their preconceptions and prejudices directs their research questions and the way they conceptualize what makes trans people trans. 

Even the terms we use are fluid and ambiguous, because they have to be as we move through a cultural shift where traditional ideas about sexuality and gender are being questioned along a wide front. That is, as I see it, a very good thing, but it makes it harder for people to discuss this topic, as people from different communities have different life experiences and understand the relevant words in different ways.

To give one example: When I started this site back in 2008, the dominant model for discussing trans people was still the classical two type model of "transvestites" vs. "real transsexuals". These days we are facing what I will call a Rainbow Model, where both sexuality and gender identities are seen as continuums containing a wide variety of identities and experiences. 

Back in 2009 the discussion was dominated by male to female/transfeminine people, while we now has a very visible female to male/transmasculine participation in the debate.

Some basic terms

So let me briefly discuss the terms I am using when thinking about trans lives today. Don't worry! Most of them are used by others as well.

I use the term biological sex to refer to how the medical community classify people on the basis of physical differences like genes and chromosomes, genitals and sex characteristics, gonads and hormones. People are normally categorized as male, female or intersex.

I use the term gender to refer to the way a culture may assigned people different categories, most often based on that culture's understanding of biological sex. The most common model is male vs. female, but cultures with more genders do exist (as reflected in concepts like "two spirit", "third gender" and "nonbinary" attest to). Gender is likely to determine expected behaviors, status and gender roles.

Gender identity is a persons experience of belonging to one or more gender categories.

I use the word transgender in the way it has been used since the 1990s, as an umbrella term for gender variance. This means that it encompasses both gender identity and various gender expressions. You do not have to feel a need to transition to call yourself trans.

I use nonbinary as subcategory under transgender. Nonbinary people are people who do not feel at home in an exclusively male or female identity. I know that some nonbinary people do not call themselves trans and respect that, but in our context it makes sense to see them as part of the transgender category.

Gender incongruence

The word transsexual is no longer in use, which leaves us with no term to describe those transgender people who might benefit from transitioning or who have transitioned. We have other terms that can be used to approach the same phenomenon, though:

Gender incongruence is defined by the international health manual, the ICD-11, in this way:

Gender Incongruence of Adolescence and Adulthood is characterised by a marked and persistent incongruence between an individual's experienced gender and the assigned sex, which often leads to a desire to ‘transition’, in order to live and be accepted as a person of the experienced gender, through hormonal treatment, surgery or other health care services to make the individual's body align, as much as desired and to the extent possible, with the experienced gender.

I probably see gender incongruence as a bit more fluid phenomena, as there are clearly grades of such a dissonance. That means that you can feel some kind of gender incongruence even if you do not want to transition. Indeed, the definition given by WHO and the ICD-11 allows for this.  

The term "assigned sex" is a bit misleading, though. "Assigned gender" would be better.

Gender incongruence, or the mismatch between the gender one was assigned at birth and ones experienced gender, may express itself in a wide variety of ways, the most important ones being, as I see it, the following two: Gender dysphoria and crossdreaming.

Gender dysphoria

Gender dysphoria is sometimes understood as the same as gender incongruence, which is understandable, as the American psychiatric manual, the DSM-5, refers to gender dysphoria  as "a general descriptive term refers to an individual's affective/cognitive discontent with the assigned gender..."

However, what makes the term gender dysphoria especially useful when debating what makes trans people trans is that the DSM-5 predominantly uses the term to refer to the distress that may accompany the incongruence between one's experienced or expressed gender and one's assigned gender. 

It says:

Although not all individuals will experience distress as result of such incongruence, many are distressed if the desired physical interventions by means of hormones and/or surgery are not available. 

So it makes sense to me to say that gender dysphoria is a way gender incongruence expresses itself. Common expressions are depression, anxiety, body dysphoria and depersonalization.

Note that the term gender identity disorder is no longer in use. Gender incongruence or gender dysphoria are no longer seen as mental illnesses.

Note also that the diagnosis gender dysphoria does not require a complete identification with one of the two genders as traditionally defined. Non-binary identities are accepted.


Gender incongruence may also express itself through crossdreaming (also referred to as cross-gender fantasies, expressions and behaviors). Crossdreaming is a term coined by me to describe various ways transgender people (in the wide umbrella sense of the term) can explore and express their gender. Among these we find fantasies and dreams, crossdressing and role playing, artistic expressions and more. 

Erotic crossdreaming represents cross-gender fantasies and expressions with some sexual content or representation.

You might say that gender dysphoria is the negative expression of gender incongruence, while crossdreaming is a positive one (which may even lead to a feeling of "gender euphoria").

The divide between transgender and non-transgender ("cisgender") is not a clear and unambiguous one. The experience of gender incongruence and the feeling of gender dysphoria varies a lot from person to person. Some of the people who crossdream may, for instance, identify as their assigned gender, not only because they have been conditioned to do so, but because it feels right for them to do so. I respect that, even if they according to the definition mentioned above can be classified as transgender.

Note also that the process of self-understanding may take time, as trans people free themselves from all the transphobic and homophobic attitudes their  social environment have instilled in them. 

So this is what we know

All of these terms have been developed by researchers, health experts and trans people to describe real phenomena. Gender incongruence is real. Many trans people do experience gender dysphoria. Many of them also explore and express their true nature through various forms of crossdreaming.

When anti-trans activists insist that gender does not exist, and biological sex is all there is, that is an ideological and political statement aimed at erasing transgender lives and identities. It is not based on science. It is not based on facts. The very existence of trans people proves that gender and biological sex is not the same thing.

In a perfect world we would leave it at this. Trans people exist. Let them live their lives to the best of their ability, with the respect and help all people deserve. People do not need to know why they identify as they do in order to accept them, no more than they need to know why cisgender (i.e. non-transgender) people feel the way they do.

Yet, for various reasons nearly all the dominant cultures existing today have made the gender binary an essential part of their idea of social and cultural "normalcy" and perceived stability. 

Most of them accept a certain amount of gender variance as far as gender expression goes, and many  increasingly accept more flexible (and even equal) gender roles. As far as gender identity is concerned, however, there are still obstacles.

Conservative extremists to the left (like TERFs) and to the right (like fascists and religious fundamentalists) are using transgender people as scapegoats in an attempt to protect cultural systems anchored in fixed gender roles. They therefore actively try to invalidate transgender identities. 

Trans people who are raised in such environments have to defend themselves against such narratives. Moreover, these trans people also often internalize the transphobia and homophobia of these cultures. Their transgender journey is therefore often one where they have to make the implicit assumptions of these belief systems explicit, so that they may relate to them in a more constructive way. That is the main reason we need to discuss what it is that makes trans people trans.

In Part 2 of this article I discuss some of the most influential models trying to explain why trans people are trans.

Part 2 also includes a list of relevant articles and books for reference.


Relevant articles found at this site


See also Books on Crossdreaming, Sex, Gender and Transgender Lives

Top photo of trans woman: FG Trade. Second photo of transgender man with daughter: Dean Mitchell


  1. So many terms, names, phrases, and ways to say the wrong thing to someone, offending them on accident. It boggles the mind. How do you keep up with every current discription? It's a full time job keeping it all, (for lack of a better word), strait.

  2. You don't have to do anything other than trust someone to identify themselves and mean it. It's not a job, it's not hard. As long as you're trying to do right by someone and respect them, there will be little offense taken.

  3. Jack, this is such a tour de force! Thank you very much for this article. Can't wait for Part II.

  4. "It's a full time job keeping it all, (for lack of a better word), strait."

    Yepp, it is. But I guess a complex reality needs a complex vocabulary. And keep in mind that this is a very popularized and simplified presentation.

  5. "Jack, this is such a tour de force!"

    I am glad you liked it. Part 2 is out today!

  6. "Some trans ppm still use transsexual. Especially young ppl. Its not a dirty word just use it

  7. great work as usual Jack. The reason that trans people are so offensive is that if the binary is put into question then so much of the rest of the dogma does as well. We live in a world of greys but the black and white is too tempting especially for anti-science conservatives who prefer things simple. Like you say:

    "In a perfect world we would leave it at this. Trans people exist. Let them live their lives to the best of their ability, with the respect and help all people deserve. People do not need to know why they identify as they do in order to accept them, no more than they need to know why cisgender (i.e. non-transgender) people feel the way they do"

    But this cannot be allowed to stand and hence efforts continue to delegitimize people who have always existed and who always will. As someone who has seen a significant improvement in my lifetime I think we are moving in the right direction even if still painfully slowly.

  8. "But this cannot be allowed to stand and hence efforts continue to delegitimize people who have always existed and who always will."

    Which is why we have to continue to fight for trans rights.

  9. The word "transsexual" seems to make a come back. However many transgender people have a hard time allowing and accepting others to use such a term they deem "loaded".
    "Transsexual" like "Queer" imo should be taken back by the community and fully embraced as for me and many others it is the perfect term to describe our experience


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