Glossary

• “Gender-Affirming Care” (GAC)+
  A misleading term for so-called medical care that encourages children with gender confusion to socially, medically and surgically impersonate or “transition” to the opposite sex. It is based on the dangerous premise that any child with distress should automatically be treated with social transition to the sex of their choice, followed by hormonal interventions and then surgery to remove healthy body parts. Unfortunately, underlying mental health problems are usually not addressed.
• Gender Dysphoria+
  The experience of “disconnect” between the objective reality of the child’s body and the child’s subjective self-perception that is accompanied by emotional distress.
• Gender Identity+
  A subjective claim, unrelated to the individual’s actual sex, to identify as a male, female, both, or neither; it is completely based in feelings and may change over time.
• Transgender+
  An individual who feels he or she is the opposite sex; a term that refers to people who wish to determine their identity based on their feelings instead of their actual sex.
• Sex+
  The objective, binary biological reality of being male or female. It is determined by the presence of XX (female) chromosomes or XY (male) chromosomes and the presence of male or female external genitalia.
• Transition+
  The process by which an individual attempts to look like the opposite sex. Transition can involve different steps. This may begin with a “social transition,” which includes changing one’s preferred pronouns, wearing clothes associated with the opposite sex, or using specific clothing or devices to conceal one’s actual sex. Examples of this include a female using a “chest binder” to conceal her breasts. “Medical transition” involves the use of puberty blockers and/or cross-sex hormones. Puberty blockers delay the onset of normal puberty. This is often followed by cross-sex hormones, which are used to cause the individual to develop secondary sex characteristics of the opposite sex. For example, a male might take estrogen to develop breasts, and a female might take testosterone to develop more body hair and muscle mass and lower her voice.
• Puberty Blockers+
  Synthetic hormones which are used to postpone puberty in children. These synthetic hormones, called gonadotropin-releasing hormone agonists (GnRH), work by regulating the production of sex hormones (estrogen and testosterone). They are approved for use in precocious puberty (the onset of puberty at an unusually early age) in children. GnRH agonists are also used to treat endometriosis, some types of breast cancer, and prostate cancer. In both cases, it is considered safe and effective to use GnRH agonists. However, disrupting normal puberty is harmful, and may cause bone loss, mood problems, seizures, cognitive changes, and sterility.
• Cross-sex Hormones/Hormone Therapy+
  Also called hormone therapy, these are synthetic hormones used to make one appear either more masculine or more feminine. For example, a male would take synthetic estrogen to develop breasts, and a female would take synthetic testosterone to develop more body hair and greater muscle mass. The goal of hormone therapy is to induce the development of secondary sex characteristics commonly associated with the opposite sex.
• Sex Reassignment Surgery/Body Modification Surgery/Gender Confirmation Surgery+
  A cosmetic medical procedure meant to alter a person’s appearance to look like or mimic the opposite sex; these procedures cannot change a person’s sex. Types of sex reassignment surgeries include procedures such as “top surgery,” “bottom surgery,” and facial masculinization/feminization surgeries.
• “Top Surgery”+
  Chest masculinization: Typically involves a bilateral mastectomy (removal of both breasts), followed by contouring of the remaining chest tissue to appear like a male chest. Breast augmentation: Enlargement of breasts using breast implants; done to create a female-appearing chest.
• "Bottom Surgery"+
  Vaginal construction (vaginoplasty): A surgery where a healthy penis and testes are removed, and remaining tissue from the penis is used to construct an artificial (pseudo) vagina, clitoris, and labia. Metoidioplasty: A surgery that uses existing genital tissue, such as an enlarged clitoris following the use of testosterone, to form an artificial/pseudo penis. Penile construction (phalloplasty): The construction of an artificial penis from donor skin, usually from the patient’s own thigh, and an artificial scrotum using tissue from the labia. This surgery also requires lengthening of the urethra to pass through the artificially created penis, so the patient can urinate normally. A penile implant is also inserted to allow for erection.
• Facial Feminization Surgery+
  Plastic surgery that reshapes the face to appear more feminine. This might include reshaping the nose, chin, and cheeks; a brow or forehead lift; reduction of the Adam’s apple; lip augmentation; hairline restoration; and earlobe reduction.
• Facial Masculinization Surgery+
  Plastic surgery that reshapes the face to appear more masculine. This includes forehead lengthening and augmentation; cheek augmentation; reshaping the nose and chin; jaw augmentation; and thyroid cartilage enhancement to construct an Adam’s apple.
• Voice Therapy+
  Treatment used to alter someone’s voice characteristics to sound more feminine or more masculine.