What Does Transgender Mean? A Plain-Language Guide for Families

TransHealthHub | Reviewed as of August 2026

KEY TAKEAWAYS

• Transgender is an umbrella term for people whose gender identity differs from the sex they were assigned at birth.

• Gender identity is a person's internal sense of being male, female, both, or neither. It is distinct from sexual orientation, which is about who a person is attracted to.

• Being transgender is not a mental illness, and it does not require any medical step to be valid.

• Not all transgender people experience gender dysphoria, and not all pursue medical care.

• About 2.8 million people aged 13 and older in the United States identify as transgender, roughly 1% of that age group, per 2025 estimates.

THE SHORT ANSWER

Transgender describes a person whose gender identity does not match the sex marked on their birth certificate. At TransHealthHub, we think the clearest way to hold the term is as an umbrella: it covers a wide range of people and experiences, and it says nothing by itself about whether someone has changed their name, taken any medication, or had any surgery. A person is transgender because of who they know themselves to be, not because of any step they have or have not taken.

BREAKING THE DEFINITION INTO PARTS

The American Psychological Association describes transgender as an umbrella term for people whose gender identity, expression, or behavior differs from what is typically associated with their sex assigned at birth. Three ideas do most of the work in that sentence.

• Sex assigned at birth is the male or female designation a clinician records at birth, usually based on external anatomy.

• Gender identity is a person's own internal sense of their gender. The CDC notes this applies to everyone, not only transgender people.

• Gender expression is how a person outwardly communicates gender, through clothing, hair, voice, or behavior.

When a person's gender identity lines up with their assigned sex, they are described as cisgender. When it differs, transgender may apply.

TRANSGENDER = NOT THE SAME AS SEXUAL ORIENTATION

This is one of the most common points of confusion, so it is worth stating plainly. Gender identity is about who you are; sexual orientation is about who you are drawn to. The two are separate. A transgender person can be straight, gay, lesbian, bisexual, or anything else. As the APA puts it, a transgender man attracted to women and a transgender woman attracted to women describe their orientation using their gender, just as anyone else would.

COMMON TERMS, BRIEFLY DEFINED

Term	Meaning
Transgender (or trans)	Gender identity differs from sex assigned at birth
Cisgender	Gender identity matches sex assigned at birth
Transgender woman	Assigned male at birth, identifies as a woman
Transgender man	Assigned female at birth, identifies as a man
Nonbinary	Gender identity outside the man/woman binary
Gender-nonconforming	Appearance or behavior outside gender expectations

A note on language: the Johns Hopkins Medicine glossary and APA both point out that terms evolve. "Trans" is common shorthand, while the older term "transsexual" is now largely out of use, though some individuals still identify with it.

IS BEING TRANSGENDER A MENTAL ILLNESS?

No. Major U.S. medical and psychological bodies are clear that being transgender is not a disorder. What can be diagnosed is gender dysphoria, the clinically significant distress that some, though not all, transgender people feel when their identity and body or social role do not match. We cover that distinction in depth in our explainer on gender dysphoria. The key point for families is that a person can be transgender without any distress and without any diagnosis.

Being transgender also does not require medical care to be real. Some people take social steps such as a new name or pronouns; some pursue medical care as adults or older adolescents; many do neither. What that care can involve is covered in our guide to gender-affirming care.

HOW MANY PEOPLE ARE TRANSGENDER?

The best current U.S. estimate comes from the Williams Institute at UCLA, which in 2025 found that about 2.8 million people aged 13 and older identify as transgender, roughly 1% of that age group. That figure includes an estimated 724,000 youth aged 13 to 17 and 2.1 million adults. Among transgender adults, the population splits roughly into thirds: trans women, trans men, and nonbinary adults.

Two things are worth noting for accuracy. The share of adults identifying as transgender has stayed fairly steady across the Institute's estimates since 2016, while youth estimates have risen, which the researchers attribute in part to better data collection and a greater willingness among younger people to disclose their identity on surveys. We present that as their stated interpretation rather than a settled explanation.

FREQUENTLY ASKED QUESTIONS

Does someone have to have surgery to be transgender? No. Being transgender is about identity, not about any medical or surgical step.

What is the difference between transgender and nonbinary? Nonbinary people have a gender identity outside the man/woman binary. Many, though not all, consider themselves under the transgender umbrella.

Is transgender a sexual orientation? No. It describes gender identity. Sexual orientation is separate.

FURTHER READING AND RESOURCES

• American Psychological Association, transgender people and gender identity: overview

• CDC, terminology for gender and sexual identity: reference

• Johns Hopkins Medicine, glossary of terms: glossary

• Williams Institute, U.S. transgender population estimates (2025): report

This page reflects widely used clinical and research definitions as of August 2026. It is not medical advice. Questions about a specific young person belong with them, their family, and their clinicians.