You know you are trans when the gender on your birth certificate does not fit who you are and that feeling will not go away. There is no test, and you are allowed to be unsure, to change your mind and to try different identities until one fits.
Is there a way to tell if I am trans?
You do not get a label with it. Nobody is born with a note attached saying "this baby is going to be transgender". What every baby does get is a birth certificate, filled in by somebody else, saying male or female. That decision is usually made from a quick look at the body, and nobody ever asks the person what their brain, their heart or their sense of self has to say about it.
Most of the time the label turns out to be right. Sometimes it is wrong. Someone is marked male because of what the midwife saw, and it does not suit them at all. They do not feel like the other males seem to feel. They do not belong in that category. They feel much closer to being a woman, and that category fits them better. The same is true the other way round, and for people who fit neither category and are non-binary.
So the nearest thing to a test is this. Does the gender you were given fit you? Have you carried a label your whole life that never quite sat right, and has that feeling stayed with you rather than passed? If so, you may well be trans, or gender diverse, or gender incongruent, whichever word feels like yours.
Can I be trans even if I am not sure?
Yes. Coming to this realisation can take time, and it is difficult. Maybe you do not want it. Maybe you do not want to be different, or it frightens you, or you can see that some trans people are getting a rough time at the moment and you would rather not join them. Those are all understandable reactions.
But if your gender identity is different from the one on your birth certificate, there is nothing you can do to make it otherwise. You can hide it, argue with it or wish it away, and it will still be there. What you can choose is how and when you act on it.
What if I feel different about it tomorrow?
The number of people who have told me that one day they feel one way, and the next day they are certain they will live in their birth gender, is huge. Then the day after, they cannot possibly live in their birth gender because male or female simply does not work for them. Then they decide they are transgender and are going to love it. Then they decide they do not want to be transgender at all, because their mum does not like it and their dad does not like it.
The journey to acceptance can be a very rocky one. I do not think I have met many people who realised their gender was different and then moved smoothly to living as themselves without any ups and downs. So feel differently if you do. Try out your birth gender as many times as you want to. Try living as non-binary. Try any gender identity you like and see how it fits. That is a perfectly acceptable way to find out, because it is your journey and you are the one taking it.
A change of direction is part of the process, not a failure of it. Finding that something does not fit tells you something useful about what does.
How old do you have to be to know?
This is the million dollar question, isn't it? How old is old enough to understand your own gender identity?
If you listen to trans adults, they will tell you that from a very young age they knew something was different. They probably did not announce at two years old that they were transgender. They may not have had the vocabulary, and how much they understood varies enormously from person to person. But when you speak to trans adults, they describe something being up from the early years.
Look at trans children today who are allowed to express themselves freely, and you hear it directly. "You can call me a girl all you like, but actually I'm a boy." Or "Why do you keep telling me I'm a boy? I don't want short hair. I don't want to play with the boys. I'm a girl, let me live my childhood as a girl." When children are listened to, believed and permitted to speak, they tend to tell you early. Where the subject is uncomfortable and there is no open door to talk about it, children are very good at hiding it. So a child saying nothing is not the same as a child having nothing to say.
Is it too late to find out I am trans?
No, though I understand why people ask, and it is not simple. Testosterone puberty does not start at nine or ten and finish at fifteen. Testosterone keeps acting on the body year after year. Muscles, skeleton, body hair, beard, greying and hairline all carry on evolving in that direction as part of natural ageing. So someone who reaches fifty and realises they are a woman has been through a lot of years of it, and may well wonder how they will blend in with other women. Society has expectations of us all, and that worry is real.
But the yearning to live authentically, to correct the mistake on the birth certificate, is very strong, and living as your true self matters. I have watched people reach the decision that they are not going to live as a man any longer because they are not a man, and that society, friends, family and workplace will have to support them through it. Once they have made that decision and gone for it, I do not think I have seen people happier.
If you decide you want to explore the medical side, GenderGP can help with access to affirming medical care, including hormones, blockers, prescribing and monitoring.
What is gender dysphoria?
Dysphoria means a deep discomfort or unhappiness. It is the opposite of euphoria, that elation and joy where you cannot help but smile. Dysphoria sits on a spectrum. At one end it can be a grumbling, mild annoyance, and at the other a profound feeling of hurt, distaste and unhappiness.
Gender dysphoria is that unhappiness, that sense that something is not right, when your body or the way you are living does not match your true gender identity. Your body might look to you and to everyone else like a man's body, for example, while everything inside you is saying you are a woman and should not have this body, this chest, this beard, this voice. Carrying that every day, with no way of doing anything about it, can be very distressing.
Not all trans people have that deep sadness about their body. Some feel it very profoundly and some do not, and you can be trans either way. Dysphoria is one way people recognise it. It is not a requirement.
Could autism, depression or past experiences be the reason?
People ask me this a great deal, and many raise it with Sammy here. Did I cause this? Did my parents do something? Is it because of something in my past, or because I have depression, or I am autistic, or I have ADHD? Often the real question underneath is whether there is a reason that would make the feeling go away.
Being trans is not a mental illness, and none of those things makes your gender less real. I cannot point you to a specific paper for this, so take it as my general understanding rather than a citation. Many autistic people are trans, many people with ADHD are trans, and plenty of trans people have also lived through depression or hard experiences. When distress shows up alongside being trans, it is very often linked to rejection, hostility and the difficulty of getting care, not to the fact of being trans. Having something else going on does not mean your gender is a symptom of it.
What can I do next?
You can try things in small ways. Use a different name with a friend you trust. Try different clothes, a different haircut, a different pronoun, and see how each one feels. Notice whether it brings a sense of relief or euphoria, or whether it simply feels wrong. Take it at whatever pace feels right, while remembering that living a life that does not fit takes its own toll every day.
If you want somewhere to think out loud, Sammy is here for exactly that. You can work out what you feel, plan what to say to somebody, rehearse a difficult conversation, or come back to it later when something has changed. You do not need to have an answer before you start.
Most of all, look after yourself.
If there is a topic that you would like me to cover, just let Sammy know.
Dr Helen Webberley, Gender Specialist and Medical Educator
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