Topic Overview

Gender identity is your internal and psychological sense of yourself as a woman, a man, both, in between or neither. Only you can determine your gender identity.

You may express gender in a way that differs from how you feel on the inside. This expression includes the name and pronoun you use, your style of dress, voice or hairstyle. Gender expression may be referred to as masculine, feminine or androgynous. You may change how you express yourself depending on the situation you are in; such as at school or work, home alone, out with friends.  

When you are transgender, also known as trans, your gender identity doesn't match the sex that you were assigned at birth (usually male or female). 

The realization that you are trans can happen in an instant or unfold over many years. Some people know from a young age that the gender they have been assigned doesn’t fit with who they really are. Other people come to this realization as adults. 

Sometimes a person experiences so much discomfort or distress because their gender identity and the sex they were assigned at birth are different; they decide to explore medical options like hormone therapy or gender-affirming surgeries. These medical options often provide significant comfort.

Sexual orientation and gender identity aren't the same thing. Everyone has both a gender identity and a sexual orientation. Like anybody, trans people may identify as straight, pansexual, queer, asexual, bisexual, lesbian, gay or something else. 

Remember: You're not alone

The pressure and stress caused by feeling alone and sad can lead to depression. Depression can be mild or severe. In its most severe form, depression can lead to suicide. For more information about depression, see Depression or Depression in Children and Teens.

If you are trans, it's important to realize that there are lots of people like you. They have the same problems, emotions, and questions that you have, whether your trans identity is known or not known to others or you have a friend or family member who is trans.

It can be very comforting and helpful to talk to people who know what you're going through. You can find such people through local or online groups. If you don't know where to find support, ask:

    • Your health care provider.
    • Your school counsellor or trusted teacher.
    • A therapist or other counsellor.
    • Your parent or caregiver, if you feel comfortable.
    • Websites and online organizations.

Why is it important to understand stress and know how to cope with it?

Stress is a fact of life. Most of us have periods of stress at various times in our lives. But extra stress can have a serious effect on your health, especially if it lasts for a long time.

If your trans identity is known to others, you may be under a lot of extra stress because of discrimination in the community.  If your trans identity is not known to others you may feel shame, guilt or other negative emotions when you consider the possibility that you might be trans.  Rejection, discrimination, fear, and confusion cause long-term stress in many trans people.

Constant stress can be linked to headaches, an upset stomach, back pain, and trouble sleeping. It can weaken your immune system, so that you have a harder time fighting off disease. If you already have a health problem, stress may make it worse. It can make you moody, tense, or depressed. Your relationships may suffer, and you may not do well at work or school.

People who are under long-term stress are also more likely to smoke tobacco, drink alcohol heavily, and use other drugs. These habits can lead to serious health problems.

It's important to recognize the effects that stress can have on your life and to learn how to cope with stress to stay healthy. For more information, see the topic Stress Management.

How can you support someone who is transgender or transsexual?

    • Learn all you can about trans issues.
    • Learn to use the right pronouns ("he," "she," "they," "him," "her," 'them"). Don't be afraid to ask the person what they prefer.
    • If the person is changing his or her name (from Dennis to Sarah, for example), use that new name when talking to or about the person.
    • Make sure you get support and information. Supporting someone who is trans may be a new experience for you and it might not be easy at first.

For more information, see the topics:

Other Places To Get Help


Action Canada for Sexual Health an Rights: Love Your Parts (Canada)


Other Works Consulted

  • American Psychological Association (2008). Answers to Your Questions: For a Better Understanding of Sexual Orientation and Homosexuality. Washington, DC: American Psychological Association. Available online:
  • APA Committee on Lesbian, Gay, Bisexual, and Transgender Concerns (2011). Answers to Your Questions About Transgender Individuals and Gender Identity. Washington, DC: American Psychological Association. Available online:
  • Biggs WS (2011). Medical human sexuality. In RE Rakel, DP Rakel, eds., Textbook of Family Medicine, 8th ed., pp. 1000–1012. Philadelphia: Saunders.
  • Eliason MJ, et al. (2009). LGBTQ Cultures: What Health Care Professionals Need to Know About Sexual and Gender Diversity. Philadelphia: Lippincott Williams and Wilkins. Available online:
  • Hillman JB, Spigarelli MG (2009). Sexuality: Its development and direction. In WB Carey et al., eds., Developmental-Behavioral Pediatrics, 4th ed., pp. 415–425. Philadelphia: Saunders Elsevier.
  • Kaufman M, et al. (2008, reaffirmed 2012). Adolescent sexual orientation. Paediatrics and Child Health, 13(7): 619–623. Also available online:
  • Sadock VA (2009). Normal human sexuality and sexual and gender identity disorders. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 1, pp. 2027–2060. Philadelphia: Lippincott Williams and Wilkins.
  • Zucker KJ (2011). Gender identity and sexual behavior. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 346–348. New York: McGraw-Hill.


Adaptation Date: 7/8/2016

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC

Adaptation Date: 7/8/2016

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC