What Is the Difference Between Transgender and Transsexual?

Medically Reviewed on 9/30/2021
Transgender people have a gender expression or gender identity that differs from their sex assigned at birth.

Transgender is a general term for individuals whose perceived gender differs from their sex assigned at birth. This means that they identify themselves as male despite having female sexual characteristics (transgender males) and vice versa (transgender females).

Sometimes, they may prefer terms such as “gender fluid” or “nonbinary,” meaning they do not identify with either gender. People under the transgender umbrella describe themselves using many terms. They may prefer to be addressed as “he,” “she” or “they.” Many transgender people choose to undergo sexual transformation by medications and gender reassignment surgeries so that their bodies are more aligned with their opposite sex. Some transgender people choose not to do so since their gender expression is not dependent on physical appearance or medical procedures.

The term “transsexual” comes under the umbrella term—transgender. Many transgender people do not identify as transsexual, which is an older term that has its origins in medical and psychological terminology. It is particularly preferred by individuals who have permanently changed or seek to change their bodies through medical interventions (medications or surgeries). The specific meaning of transsexual, however, may vary across different people, cultures, and ideologies.

It is best to ask which term a person prefers and address them accordingly.

How is a transgender identity different from sexual orientation?

It is important to remember that gender identity and sexual orientation are distinct and independent of each other.

Being transgender does not mean being lesbian, gay, or bisexual. Your sexual orientation describes who you’re attracted to, who you want to be with, or who you feel drawn to romantically, emotionally, and sexually. Gender identity is about who you feel you are inside (female, male, both, or none of these) regardless of your sexual characteristics. It specifies who you are.

A transgender or transexual individual can be gay, lesbian, straight, or bisexual.

What is gender reassignment surgery?

Gender or sex reassignment surgery is commonly referred to as sex change procedure or sex change surgery. Gender reassignment involves a combination of counseling, medications, and surgical procedures that are meant to help an individual align their body with their perceived gender identity.

These components are collectively called gender reassignment therapy. The procedure is often prolonged, costly, and painful. The earlier the changes are made, the lesser the incidences of complications. The therapy is often commenced after the person reaches 18 years of age.

The following protocol and treatment modalities are included in the therapy:

  • Sessions with a counselor: A psychiatrist, psychologist, and social worker will talk to you and help you understand your gender identity. You may be put in touch with other transgender people so that you can talk to someone who shares your issues and mindset. This step mentally prepares you for the path that lies ahead. Your body will change with hormone treatment and surgery (if you choose these).
  • Social transition: It means living as per your gender identity at home and in public, wearing clothes or hairstyles associated with your gender identity, and using a name and pronoun (such as “he,” “she” or “they”).
  • Hormone therapy: Individuals will be given both sex hormones and medicines that block their inherent sex hormones. These may be taken as pills, injections (shots), or gels that you rub on your skin. The process can cause severe distress in many individuals.
  • Surgery: “Gender confirmation surgeries” or “gender-affirming surgeries” are of various types. Many transgender people choose not to have these surgeries. 

For transgender women, surgeries include:

  • Surgeries on the face and neck to create a more feminine appearance
  • Breast reconstruction and augmentation
  • Vaginoplasty (genital surgery), in which the surgeon uses the penile skin to reconstruct a new vagina and clitoris

For transgender men, surgeries include:

  • Surgical breast removal
  • Surgeries to remove the uterus and/or ovaries
  • Phalloplasty or genital surgery to create a penis, lengthen the urethra (allowing the person to urinate standing up if they want to), and reshape the labia into the scrotum with prosthetics for testes

You must discuss the pros and cons, risks, and recovery time with your doctor before you undergo surgical procedures.


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Medically Reviewed on 9/30/2021