What Is Gender Identity?

Understanding of Ourselves as Male, Female, Non-Binary, etc.

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Gender identity is a person's understanding of themselves as male, female or another gender. Gender identity is separate from both sex and sexual orientation. Individuals whose gender identity is not what would be expected from their assigned sex at birth are transgender, whereas those whose gender identity is what would be expected from their assigned sex at birth are cisgender.

Male and female sex icons on wooden cubes on pink and blue background. Sex change, gender reassignment, transgender and sexual identity concept.
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Statistics

In general, data on the prevalence of diverse gender identities is not terribly reliable. This is because, despite the existence of many national surveys about population and health, researchers often only ask about sex and not gender.

Furthermore, even when they do ask about gender, they do not do so in a way that is consistent across studies. Because of this, there have been substantial differences in the estimates of the size of the transgender population.

One of the best estimates for the U.S. transgender population was published by the Williams Institute in 2016. It found that surveys suggested that between 0.3-0.8% of the population of any given state identify as transgender, with an overall estimate of 0.6% of the population.

That estimate would imply that there were around 1.4 million transgender adults in the U.S., but that number is likely to increase with time as transgender identities were more common in younger populations.

Medical Significance

Gender identity does not require medical or mental health treatment or indicate a need for such treatment. However, individuals whose gender identity is not concordant with their physical bodies may experience gender dysphoria.

For some people, gender dysphoria may require medical, and or surgical treatment. In addition, individuals suffering from gender dysphoria or exploring their gender identity may benefit from working with a supportive mental health professional.

It is important to understand that in cases of gender dysphoria, a person's gender identity is not in and of itself the problem. Indeed, this is why the diagnosis used to support medical and surgical gender transition shifted from gender identity disorder to gender dysphoria.

The identity is not a disorder, instead, the mismatch between body and identity is what causes the problem. Additionally, discrimination and stigma experienced by transgender individuals can also lead to physical and mental health disparities.

Relevant Terminology

Terminology around topics of gender identity tends to shift very quickly. Some common terms include:

  • Cisgender: A person whose gender identity is what would be expected to be associated with their assigned sex as birth (for example, a person with a female gender identity who was assigned female at birth is a cisgender woman)
  • Binary gender: A gender that is either male or female
  • Gender dysphoria: Discomfort associated with one's gender identity, often because of a mismatch between one's identity and one's physical self
  • Gender euphoria: Happiness or satisfaction associated with one's gender identity, or one's understanding of one's gender identity.
  • Gender expression: How individuals express themselves in a gendered way, such as through clothing choices and haircuts
  • Sexual orientation: A way to describe the gender of people to whom an individual is sexually attracted (this is separate from gender identity—common sexual orientations include heterosexual, homosexual, bisexual, pansexual, and asexual)
  • Transgender: A person whose gender identity is different from what would be expected to be associated with their assigned sex as birth (for example, a non-binary or agender person, regardless of their assigned sex at birth)

Health Care

As discussed above, gender identity is not something that needs treatment. In fact, treatments designed to change a person's gender identity are broadly considered to be unethical and are illegal in many places. However, some individuals with diverse gender identities may seek out medical or surgical care to address their gender dysphoria.

Medical treatment for gender dysphoria involves using hormones and/or hormone blockers to either keep a person from developing secondary sexual characteristics that are not congruent with their identity, or to help them develop characteristics that are congruent with their identity.

For example, a transgender man may be prescribed testosterone to lower his voice, increase facial hair growth, and cause other masculinizing changes. A transgender adolescent may be prescribed puberty blockers to give them time to fully understand their gender, without having to experience pubertal changes that could make their dysphoria worse.

Surgical treatments for gender dysphoria have the same purpose as medical ones, but are used to accomplish changes that can not be managed medically. For example, top surgery can be used to masculinize the chest of a transgender man who experienced breast growth before transition.

Vaginoplasty can be used to create a vagina for a transgender woman. Phalloplasty or metoidioplasty can be used to create a penis for a transgender man.

Not all transgender people, or even all those with gender dysphoria, are interested in medical or surgical transition. A number of factors affect whether these options are right for any given person. Someone is not any more or less transgender, or valid in their gender identity, based on whether they have undergone any particular type of medical or surgical care.

Discrimination

Under President Barack Obama, there was a move towards protecting individuals with diverse gender identities under laws that prohibited gender discrimination. Among other things, these changes expanded access to health care both federally and in many states.

Under the Trump administration, the Justice Department has attempted to remove gender identity as a protected category both inside and outside the medical domain.

In June 2020, the Supreme court ruled that civil rights legislation protects gay and transgender workers from workplace discrimination. Part of the majority opinion written by Justice Gorsuch stated "It is impossible to discriminate against a person for being homosexual or transgender without discriminating against that individual based on sex."

Therefore, it is possible laws that prohibit sex discrimination in other areas will be interpreted similarly as protecting transgender Americans.

A Word From Verywell

Although the term gender identity is most often discussed in reference to transgender people, everyone has a gender identity. Regardless of whether people are cisgender or transgender, gender is a component of identity.

Just as with other aspects of identity, how important gender identity is to any one person can vary quite a bit. People may think of themselves as Black first, or Jewish, or an academic, before they think of themselves as a man, a woman, agender, or non-binary. However, that doesn't mean that gender isn't still relevant to their lives.

That's as true for cisgender as for transgender people. Just because cisgender people may not spend a lot of time questioning their gender identity, doesn't mean it isn't relevant to how they see themselves and structure their interactions with others. People have a lot of expectations about gender and, right or wrong, those expectations play into how they move through the world.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  5. Delozier AM, Kamody RC, Rodgers S, Chen D. Health disparities in transgender and gender expansive adolescents: A topical review from a minority stress framework J Pediatr Psychol. 2020;jsaa040. doi:10.1093/jpepsy/jsaa040

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  7. Janssen, A., & Voss, R. (2020). Policies sanctioning discrimination against transgender patients flout scientific evidence and threaten health and safety. Transgender Health. 2020. doi:10.1089/trgh.2020.0078

  8. Supreme Court. Bostock v. Clayton County, No. 17-1618, 590 U.S. ___ (2020).

By Elizabeth Boskey, PhD
Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.