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The word “transgender” is an umbrella term that describes those who have a gender that’s different from the sex assigned at birth: male, female, or intersex.

“Transsexual” is a more specific term that fits under the transgender umbrella. This word can be contentious and shouldn’t be used unless someone specifically asks to be referred to this way.

Read on to learn more about the difference between being transgender and being transsexual, why someone might choose one term over the other, and more.

The term transgender can mean different things to different people. There are a number of other labels individuals who are transgender use to describe their gender.

This can be confusing at first, particularly if you or someone you know think they might be transgender.

For example, a person who was assigned a female sex at birth and has a male sense of self could be categorized as transgender.

A person who was assigned male at birth and has a female sense of self could also be categorized as transgender.

Sometimes, those who are transgender use the abbreviated term “trans” to convey the idea that the sex they were assigned at birth doesn’t fully and accurately reflect their core sense of self or internal experience of gender.

Those who are transgender can identify as a woman, man, a combination of both, or something else altogether.

The word transgender can also be used in conjunction with other labels to indicate the gender or sex someone knows themselves to be.

For example, someone can identify as a transgender man, a transgender woman, or a transgender nonbinary person.

Nonbinary is an umbrella term that describes those who have a gender that can’t be exclusively categorized as male or female.

As a rule of thumb, the term transgender provides information about the extent to which someone identifies with the sex they were assigned at birth.
The following word often communicates important information about the way someone experiences and understands gender, as well as how they might want to be referred to.

For example, a transgender male is someone who doesn’t identify with the sex assigned at birth and has a sense of self that’s male.

Some transgender people change their appearance, body, name, or legal gender marker to convey and affirm their internal experience of gender. Others don’t feel the need to make these changes to express and validate this aspect of who they are. Either way is OK.

Historically and medically, the term transsexual was used to indicate a difference between one’s gender identity (their internal experience of gender) and sex assigned at birth (male, female, or intersex).

More specifically, the term is often (though not always) used to communicate that one’s experience of gender involves medical changes, such as hormones or surgery, that help alter their anatomy and appearance to more closely align with their gender identity.

Similar to the word transgender, the meaning of the word transsexual can vary from person to person, culture to culture, and across history.

Despite their similar definitions, many transgender people don’t identify as transsexual.

Transsexual isn’t an umbrella term. It should never be used to refer to the entire transgender community.

It’s important to remember that the term transsexual doesn’t include or reflect the experience of many who are a part of the transgender community. Therefore, it shouldn’t be used to refer to someone — unless they specifically assert that preference.

Further, some transgender people find the word transsexual to be offensive and stigmatizing. This is because of its history and roots in the professional fields of medicine and psychology, which used this term to incorrectly label all transgender people as mentally ill or sexually deviant.

Professionals in medicine and mental health now understand that having a transgender or transsexual gender identity isn’t a mental illness, and that transgender identities are a naturally occurring part of human gender diversity and gender experiences.

The main difference between the word transgender and the word transsexual has to do with the way it’s used and experienced.

Many transgender people report having negative associations with the word transsexual.

Current best practices in transgender health still use the word transsexual, but acknowledge that it’s no longer the most inclusive and affirming term to describe someone who has a gender that’s different from the sex assigned at birth.

Transgender or trans are now the generally accepted and promoted terms that Western societies use to describe those who have a gender that’s different from the sex assigned at birth.

Transgender tends to be more inclusive and affirming than transsexual because it includes the experience of those who pursue medical changes to affirm gender as well as those who do not.

While some transgender and transsexual advocates have argued that the word transsexual doesn’t always have to include medical changes, this notion hasn’t yet been widely accepted by the larger transgender community.

Generally, the word transgender recognizes the need to medically alter one’s body, hormonal makeup, or appearance isn’t required for everyone who identifies with a gender that’s different from the sex assigned at birth.

The decision to pursue physical and medical changes can vary from transgender person to transgender person.

The term transsexual can be contentious because it was historically used to categorize transgender people as mentally ill. It often served as justification for discrimination, harassment, and mistreatment.

This term is heavily debated both within the transgender community and outside of it.

Some people feel it’s necessary and important to have a medical diagnosis or surgery to validate one’s transgender experience.

Others feel a medical or mental health diagnosis and requirement for intervention only perpetuate the inaccurate assumption that transgender people have an inherent medical or mental health problem.

In the past, transsexualism, transvestism, and gender identity disorder were the labels used to medically and psychologically categorize someone who has a gender or appearance that differs from the sex assigned at birth.

Current medical and psychological guidelines have moved away from using these terms to convey the idea that being transgender or transsexual, in and of itself, isn’t a mental illness or medical problem.

More accurately, it’s the lack of access, acceptance, and understanding of gender diversity that contributes to the mental health issues many transgender people face.

Gender dysphoria is the current diagnosis used to describe the distress an individual may experience as a result of having a gender that’s different from the sex assigned at birth.

Despite this history, some in Western countries and other cultures across the globe continue to use the word transsexual to refer to themselves and the experience of having a gender that’s different from the sex assigned at birth.

Many who use the word transsexual to describe their gender see a medical diagnosis, medical transition using hormones, and gender confirmation surgery as important parts of their experience. They use the term to help communicate that viewpoint.

Remember that the negative connotations of the word transsexual vary from person to person and culture to culture.

If a particular culture, community, or individual experiences and uses the word transsexual as a respectful and authentic descriptor, then it can be used in that particular situation or context.

“Gender identity disorder,” “transvestite,” and “tranny” are other terms that were historically used to label transgender people as mentally ill, sexually deviant, or inferior.

These terms are also commonly associated with instances of discrimination, harassment, mistreatment, and misunderstanding. It’s best to avoid using them in both casual and professional conversations.

The best way to determine which term you should use to refer to someone is to ask them.

If you’re unsure, asking the person is always the best option.

The word someone uses to describe their gender can be a private and sensitive topic. Many people don’t share that information publicly or with strangers.

It isn’t always necessary to know or agree with how someone identifies their gender in order to interact with them respectfully.

If you’re in a situation where asking isn’t possible or doesn’t feel appropriate, the next best option is to ask someone else — who ideally knows the person — if they know how the person in question likes to be referred to.

If you need to refer to someone but don’t know their gender or pronoun, it’s best to avoid gendered language and use the person’s name instead.

If you want to learn more about gender labels such as transgender and transsexual, check out these articles:

And check out these resources:

Education about different gender labels can be an important part of exploration, self-discovery, and supporting loved ones. Each person deserves the right to determine the label that’s used to describe them.


Mere Abrams, MSW, ASW, is a gender specialist, researcher, educator, and consultant in the San Francisco Bay Area, providing gender affirming services to trans, nonbinary, and gender-expansive children, teens, and young adults. As a clinical researcher at the UCSF Child and Adolescent Gender Center, Mere works on the first NIH sponsored research, studying long-term medical and mental health outcomes for trans youth starting puberty blockers or cross-sex hormones. Mere was a contributor and editor of “The Transgender Teen: A Handbook for Parents and Professionals Supporting Transgender and Non-Binary Teens” and speaks publicly on the topics of ethical considerations for working with trans youth and their families, nonbinary experiences, and gender diversity and inclusion.