An A to Z of Sex and Gender

Sometimes the language our children use to describe their experiences can be confusing; whilst some words might be completely new to us, others we thought we understood are used to describe completely different concepts altogether. We have highlighted some commonly used terms and phrases, and their definitions as we understand them. It is best to have a shared understanding of the language your child uses, so don’t be afraid to ask them to define the terms they use in order to facilitate good communication.




ADHD is a condition characterised by three main difficulties – Hyperactivity (having lots of energy, needing to fidget and poor sleep); impulsivity (an inability to regulate thoughts, feelings and/or actions); and inattention (difficulties with concentration and memory). It is one of the conditions described under the term neurodiversity (others include Autism, ADHD, Tourette’s Syndrome, Dyslexia). Unlike the well-documented correlation between gender dysphoria and autism, there is far less research to show that ADHD is linked in the same way, although there is significant anecdotal evidence. For more on ADHD, take a look here.


This is the transitional stage of human development that takes place roughly between the ages of 10 and 19. It is a time in which the body and brain undergo huge changes, to prepare an individual physically, psychologically and socially for adulthood. Although the physical changes of adolescence start with the onset of puberty and finish with the completion of growth, the changes in the brain typically continue well into young adulthood. Experts often disagree about when this stage comes to an end, but many agree it is around the age of 25. There is a complex interaction of the development of these different processes, where social and emotional maturity influences the cognitive development of the individual and vice versa.


These acronyms stand for assigned female at birth and assigned male at birth. They were originally used to refer to individuals born with disorders of sexual development, where the sex of a child could not be reliably determined at birth. It is widely used in the transgender community to refer to the biological sex of an individual.


This term describes the approach to an individual who has declared a transgender identity, where the request of that person to change their name, pronouns and appearance, and to be treated as the sex with which they identify, is followed without question as to where these feelings and beliefs may have come from.


A term which refers to a range of conditions characterised by difficulties in social interaction and understanding, often with repetitive or restrictive behaviours. The conditions can also feature extreme anxiety, highly focused hobbies and interests and meltdowns or shutdowns as a response to overwhelming situations or feelings. For more information on autism, please click here. There is a large amount of evidence which points to a correlation between autism and gender dysphoria. Many gender clinics have published statistics showing that rates of autism in the populations seeking their help are much higher than in the general population.


A term coined by Dr Ray Blanchard, describing males who experience sexual arousal at the thought or appearance of themselves as women. They are typically attracted to women and are more likely to wish to transition later in life, having shown little deviation from a male identity before then.



The process by which natal females flatten the appearance of their breasts with tape, bandages or specialist items of clothing. It aims to give the appearance of a more masculine body, and it is promoted as a way to reduce feelings of dysphoria over breast development, but there is a risk of significant harm. There has been very little research carried out into this practice, despite the practice being recommended by most transgender websites and charities.


A sexual orientation whereby someone is attracted to both males and females.

Bottom Surgery

A euphemism for genital surgery, designed to give the genital appearance of the opposite sex. For males, this involves the removal of the penis and/or testes (orchidectomy), with or without the creation of a neovagina (vaginoplasty). For females, this can be the removal of the uterus (hysterectomy), ovaries (oophorectomy) and/or vagina (vaginectomy) with or without the fashioning of a false penis (phalloplasty or metoidioplasty). Results for this kind of surgery are highly variable, and many individuals are highly dissatisfied with the outcome. Indeed, although bottom surgery is often advertised as a solution to feelings of dysphoria or suicidal thoughts, research shows this may well not be the case. 



A term used to describe someone who is not transgender ie. is happy in the sex they were born. Many individuals find this term unacceptable, as it can imply that one is happy with the stereotypes enforced by society based on one’s natal sex.

Conversion Therapy

Originally used to describe therapy or treatment intended to correct a person’s sexual orientation to heterosexual. Many of these practices were actively harmful, and have been largely, but not universally, abandoned today. However, in legislating against these practices for correcting sexual orientation, some countries are also including the term gender identity. In the UK, the Memorandum of Understanding does just this. Many clinicians fear that exploring reasons for a cross-sex identity will be seen as conversion therapy, and will criminalise practitioners who wish to prevent vulnerable young people from making these decisions without careful exploring of the issues they may face.


Often interchangeable with the now less acceptable term transvestite, this is the term for someone who dresses in clothes typically associated with the opposite sex. The term does not necessarily describe someone who identifies as the opposite sex, although it is often included in wider definitions of the term transgender.

Cross-Sex Hormones

Although both males and females produce oestrogen and testosterone, when describing the treatment of individuals with cross-sex hormones, this refers to giving testosterone to females and oestrogen (and sometimes progesterone) to males. There is a move to refer to this practice as giving ‘gender-affirming’ hormones.



This refers to the name a person was known by before their transgender identity. In the trans community, deadnaming is seen as highly offensive, even traumatic. For many parents, the request to use a new name is hardest to navigate.

Desistance (reidentification)

The term used to describe individuals who have had a transgender identity, but have since returned to accepting their natal sex. It is most often used regarding those who have not undergone medical or surgical transition, ie. A purely social transition


A term usually reserved to describe those who have transitioned medically or surgically, have then returned to living as their natal sex. Absolute numbers of detransitioners are unknown for a variety of reasons.


Differences/Disorders of Sexual Development. A term used to describe the rare conditions where the development of the reproductive system doesn’t follow the usual path. The term intersex was used to describe these conditions, but this is falling out of use. There are many different types of DSD, but they all affect either males or females – there is no condition which describes a third category of sex. There is no evidence that individuals who have a transgender identity are more likely to have an intersex condition, and people with DSDs are becoming increasingly uncomfortable with being used to ‘prove’ or ‘disprove’ the arguments around transgender identities.

Dutch Protocol

This pathway for treating gender dysphoria involves the suppression of puberty with GnRHa (puberty blockers) at around 11 or 12, followed by cross-sex hormones at 15/16. Over 18s may then be offered surgical intervention. This video gives a very good overview of this approach to treating gender dysphoria.



Endocrinology is the medical discipline which is concerned with the hormone systems of the body. These systems control our temperature, mood, growth and sexual development. In the context of gender dysphoria, endocrinologists are involved in the prescription of hormone blockers and cross-sex hormones.

The Endocrine Society

This an international community of physicians and researchers who produce clinical guidelines for the treatment of endocrine disorders. They also produce guidelines for the treatment of gender dysphoria. They surprised many of their members by producing guidelines calling for the affirmative approach to gender dysphoria, based on very little evidence.



Belonging to the sex whose anatomy is organised in such a way as to produce large immobile gametes (eggs), or to give birth to young. Just because a body does not currently produce eggs, doesn’t mean it is no longer female.


The advocacy of women’s rights based on equality of the sexes. There are various sub-categories of feminism, each having different beliefs about gender identity. Broadly speaking, liberal feminists believe transwomen are included in feminism, and gender critical feminists believe the only shared characteristic women have is their biology; therefore transwomen are not included in the term ‘women’. For their belief in this definition of woman, they are often referred to as trans-exclusionary radical feminists (TERFs), though this is contested, as they include transmen in their feminism (due to shared biology). TERF has also become somewhat of a slur.


Female to Male. Describing a female who makes a social, medical or surgical transition to a male presentation



Defining gender is a bit of a Pandora’s box. When we refer to gender, we are describing the set of stereotypical appearances, attitudes and behaviours associated with a particular sex.

Gender affirming hormones

A euphemism for cross-sex hormones (see above)


A term used to describe those who believe gender is socially constructed, ie, has no basis in biology, and that biological sex is an immutable characteristic which cannot be identified into.

Gender dysphoria

This is a feeling of discomfort an individual may feel because their internal sense of what gender they should be (‘gender identity’) is at odds with their natal sex. It is a medical diagnosis with a set of criteria that need to be met to say someone has gender dysphoria.

Gender expression

This is how an individual presents to the world in a particular gender. It may include behaviour, mannerisms, clothing, interests and appearance. It relies heavily on the sex stereotypes in a given community.


A gender identity related description of someone who does not have a fixed gender. Their gender identity and expression can change over time. It can also be used to describe those who feel they experience different genders sequentially, simultaneously, or not at all.


An organisation founded by Dr Helen Webberley, a UK General Practitioner who was suspended from practice by the General Medical Council for running an unlicensed clinic. Gender GP is probably the most well known private clinic from which UK residents, including under 18s, can obtain private prescriptions for puberty blockers and cross-sex hormones.

Gender identity

A personal sense of being male or female or neither, or both. It can correlate with an individual’s natal sex, in which case they are described as cisgender, or not, in which case they are transgender. There is no empirical evidence for the existence of gender identity and, many people state that they do not have one.

Gender ideology

There is no concise definition of gender ideology, despite  having become part of general parlance. It is broadly understood to mean that sex and gender are both socially constructed and have no root in biology. It promotes the idea that everyone has a gender identity, an innate feeling of whether they are male, female, or one of a myriad other ‘genders’. If this gender identity does not match your biological anatomy, this may or may not cause gender dysphoria, but will necessitate the pursuit of gender transition – socially, medically or surgically. It is epitomised by the phrase “transwomen are women, transmen are men, non-binary identities are valid”.

Gender non-conforming

An individual whose appearance, likes and dislikes do not conform to the stereotypes associated with their sex. For example the classic image of a girl who likes trains and football, or the boy who enjoys ballet. 

Gender Reassignment

According to the Gender Recognition Act 2004, “a person has the protected characteristic of gender reassignment if the person is proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person’s sex by changing physiological or other attributes of sex.”

Gender reassignment surgery

Surgery to afford an individual the external appearance of their chosen gender. For females, this can include hip shaving, mastectomy, hysterectomy and phalloplasty. For males, this can include orchidectomy, vaginoplasty and facial feminisation surgery.

Gender Recognition Act 2004

This is the legislation that allows people who are pursuing transition to gain legal recognition in their acquired gender. It governs various aspects of the process, including setting down the criteria for legal recognition.

Gender recognition certificate

To obtain a gender recognition certificate (GRC) a person must a) have or have had gender dysphoria, b) have lived in the ‘acquired gender’ for two years and c) intend to live in their acquired gender for the rest of their lives. It allows a person to “be considered in the eyes of the law to be of [their] acquired gender.” This includes benefitting from the rights of those of the acquired gender, such as pension and retirement age, as well as the entitlement to a new birth certificate, stating your acquired gender. Read more here

GIC (Gender identity clinic)

The name by which most UK based clinics which provide medical services and assessment of gender identity issues to adults are known.

GIDS (Gender Identity Development Service)

This is the UK’s only child and adolescent gender clinic, based at the Tavistock Centre in London, with a satellite clinic in Leeds. It provides assessment of children distressed by their gender, and facilitates referrals to the paediatric endocrine clinic at UCL for puberty blockers and/or cross-sex hormones.


Gonadotrophin Releasing Hormone agonists, commonly known as puberty blockers



A sexual orientation where an individual is attracted to members of the same sex


Homosexual transsexual. A term used to describe adult males who transition to appear as female, who are attracted to other men. They were described by Ray Blanchard as being very gender non-conforming in their presentation from a very young age.



An alternative, and less used, term for Differences of Sexual Development (DSD). It also represents the I in LGBTQI, despite not describing a sexual orientation.


Legal Transition

In the UK, this describes the pathway by which an individual who has obtained a Gender Recognition Certificate



Belonging to the sex whose anatomy is organised in such a way as to produce small immobile gametes (sperm). Just because a body does not currently produce sperm, doesn’t mean it is no longer male.

Medical Transition

The use of medical interventions, such as puberty blockers and cross-sex hormones, to confer the external characteristics typical of the desired sex. It doesn’t include surgical alterations.


A surgical procedure used to create a neophallus (artificial penis). It involves testosterone-drive enlargement of the clitoris and detachment of the clitoral ligaments, with or without creating testes from the labia.


To refer to an individual by the pronouns that do not correlate with their gender identity, but often with their natal sex.


Male to Female. Describing a male who makes a social, medical or surgical transition to a female presentation



Natal Sex

Synonymous with biological sex, denoted by the anatomical structures which identify an individual as male or female.


A gender identity which is described as neither male nor female. Often associated with using the pronouns they and them.



Using padding or an artificial insert to give the appearance of male genitalia underneath trousers or underwear.


A sexual orientation where an individual is attracted to people of any sex or declared gender.


Where steps taken in transition or changes in gender expression and presentation result in an individual being recognised as the chosen rather than the natal sex.


In language, these are words that take the place of a noun. Concerning sex and gender, these are the words we use to communicate the sex of another person (he/him/she/her/they etc). Trans people may wish to be addressed by the pronouns of the sex to which they wish to transition. Many non-binary people choose to use they/them. Neo pronouns are newly created pronouns that are used to take the place of gender-neutral pronouns. Examples include ze/zir, xe/xem, fae/faer.

Puberty Blockers

Also known as GnRHa – gonadotrophin releasing hormone agonists. These drugs exert their effect on the brain to reduce the release of sex hormones by the ovaries and testes.

Originally developed to treat prostate cancer, they were found to be of use in halting precocious puberty (puberty which starts much younger than it should). A Dutch study from 2006 proposed their use as a puberty blocker in young people who had declared a trans identity, to prevent the progression of puberty and allow surgical intervention as adults to be more successful (the Dutch Protocol). The long term effects of using puberty blockers during adolescence, when the body needs hormones to grow and develop physically, socially and emotionally are unknown. There is evidence they may be harmful to brain development, bone growth and also fertility (if followed by cross-sex hormones). In 2020, The UK High Court deemed under 16s unlikely to be able to give consent to their use, due to child’s inability to comprehend the long term effects of their use on fertility and sexual function.


This is a surgical procedure to create a penis-like structure. Flaps of skin and muscle are used from donor sites such as the forearm or thigh. See also metoidioplasty.



Rapid Onset Gender Dysphoria. This is a term coined in a paper by Lisa Littmann, where she interviewed parents whose adolescents declared a transgender identity in their teens. The parents described groups of teens coming out as trans, immersion in online social media networks and withdrawal from family and non-trans friendships. She proposed the need to explore the roles of social influence, maladaptive coping mechanisms and family dynamics in the development of gender dysphoria in adolescents and young adults.



The process by which an individual is treated as a member of a sex class based on their self declared gender identity, or by which a person can obtain legal recognition of their gender identity, without the need for social, medical or surgical transition, or the declaration of a medical professional.


Either of the two main categories (male and female) into which humans and most other living things are divided based on their reproductive functions.

Social Transition

The non-medical, non-surgical steps an individual takes to present as their chosen sex. This can include changes to clothing, hairstyle, behaviour and mannerisms.

Surgical Transition

This describes the undergoing of surgical procedures to give an individual the external physical characteristics of the desired sex. For males who wish to look female, this can include facial feminisation, breast augmentation (breast implants), penectomy and orchidectomy (surgical removal of the penis and testes) and vaginoplasty (creation of a neo-vagina). For women wishing to appear male, this can include a double mastectomy (removal of both breasts), hip shaving, hysterectomy and oophorectomy (removal of uterus and ovaries), vaginectomy (removal of the vagina), phalloplasty or metoidioplasty (creation of a neo-penis).



A euphemism for testosterone.

TERF (Trans-Exclusionary Radical Feminist)

A term that was originally used to describe feminists those who believe that only biological women should be called women, along with the belief that transwomen should be excluded from spaces traditionally reserved for biological women such as changing rooms, bathrooms, women’s prisons and rape/domestic abuse shelters, as well as all-women shortlists and women’s sports.It is now used indescriminately against anyone who might question any aspect of transgender ideology. 

Tanner Stages

Clinicians separate the sequential stages of puberty into 5 stages, first described by  Professor James Tanner (hence Tanner stages). The stages start with Stage 1, the appearance of a child before the onset of puberty, to the end of Stage 5, by which time the child has fully completed the pubertal changes. Tanner stages are used to assess the earliest stage at which a child could be offered puberty blockers (Tanner stage 2).

The Tavistock Centre

The Tavistock and Portman NHS Trust is the smallest trust within the NHS and specialises in mental health. The Tavistock Centre has a long history of psychotherapeutic interventions and is home to the UK’s only child and adolescent gender clinic – the Gender Identity Development Service (GIDS). It also provides one of several adult clinics in the UK. 

Top Surgery

This phrase is used to describe a double mastectomy, with or without subsequent masculinising contouring of the chest.

Transman or Transwoman

A female who wishes to, or has, transitioned to appear male may be referred to as a transman. A transwoman may be used to describe a male who wishes to, or has, taken steps to appear as a female.


According to Stonewall, this is ‘An umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth.’


The proess which someone goes through to present as a member of the opposite sex, or as non-binary. This may include:

Legal Transition
Medical Transition
Social Transition
Surgical Transition


This term refers to the prejudice or dislike of a transwoman. It is seen by the trans community as a unique intersection of transphobia, misogyny and sexism, uniquely experienced by transwomen.


According to Stonewall, this is ‘The fear or dislike of someone based on the fact they are trans, including denying their gender identity or refusing to accept it. Transphobia may be targeted at people who are, or who are perceived to be, trans.’


This term was used to describe individuals who had undergone gender reassignment surgery. Some now find this term offensive, but many older trans-identified individuals still prefer it, especially to denote the steps they have taken to appear as the opposite sex.

Trans umbrella

The definition of transgender has expanded hugely in recent years. In the broadest sense, it now includes individuals who identify as non-binary, crossdressers, gender non-conformity, as well as androgyny, feminine men and even detransitioners. There are still some purists who argue that the umbrella still only includes transwomen, transmen, and non-binary individuals.




This is used as a derogatory term, synonymous with transmedicalist. It originated on social media platform Tumblr to describe ‘true transsexual scum’ – those who believe that you require gender dysphoria to identify as transgender and that there are ‘true’ trans and ‘fake’ trans.

This is used as a derogatory term to describe an individual as a ‘transtrender’, a ‘fake’ trans person, either because they do not have gender dysphoria, believe you do not need gender dysphoria to be transgender, or do not wish to alter their bodies in any way.


Watchful Waiting

The established pathway to treat children and young people with distress about their gender. Based on the understanding that the large majority of children would outgrow their feelings of dysphoria, it was thought best to take a supportive but watchful approach.


The World Professional Association for Transgender Health (WPATH), formerly known as the (Harry Benjamin International Gender Dysphoria Association (HBIGDA), is “an interdisciplinary professional and educational organization devoted to transgender health. Our professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally. We are funded primarily through the support of our membership, and through donations and grants sponsored by non-commercial sources.”