Sex usually refers to the way a person is classified as either male or female, based on the appearance of external anatomy at birth, as recorded on one’s birth certificate. 

Gender Identity is a persons innate, deeply held sense of gender, not necessarily visible to others.

Besides the binary male or female, some people identify as non-binary or gender queer. And many cultures have a history of a third, or fluid gender. 

Gender Expression is how a person presents their gender identity externally, through choice of proper names, pronouns (he/she/they etc.)  or personal style (hair, clothes, makeup) or behaviors, conscious or subconscious.

Sexual Orientation describes a person’s attraction to another person on a physical, romantic, or emotional level. Sexual orientation, is different from gender identity. Gender identity is who you are, sexual orientation -- lesbian, gay, bisexual, queer, or straight – is about who you’re attracted to.  

A transgender woman who is only attracted to other women will usually identify as a lesbian.

Transgender is the broad term to describe people whose gender identities and/or gender expressions differ from those associated with their assigned sex. Someone who is transgender may be prescribed hormones to help align their bodies with their gender identity. Surgery is also an option, but those decisions differ for each person. Someone may be transgender without altering their appearance or undergoing medical procedures. Trans is the shortened form as in trans woman, trans man or trans person. 

Transsexual was the term first used in medical and psychological communities for people who made permanent changes, or sought to make permanent changes to their bodies through medical treatment. Someone can be transgender without being transsexual, while someone may specifically describe themselves as a transsexual woman or man. 

Cross-dresser may refer to anyone who regularly wears clothes associated with another sex. Cross-dressing is a non-permanent form of gender expression. Cross-dressers don’t look to medically alter their physical appearance nor do they usually feel at odds with their gender. Male cross-dressers often identify as straight. 

A cross-dresser is not the same as a drag queen. Drag queens are men, usually gay, who perform dressed as women for entertainment or satire. 

The process of transitioning from assigned sex to a more actualized sense of gender identity varies in personal, medical and legal choices from deciding whether to tell friends family or coworkers, to changing names socially or legally, to using new pronouns, discovering a new look, discussing if hormone therapy is the right choice, and whether to have surgery.

Gender Confirmation Surgery (GCS) or Sex Reassignment Surgery (SRS) is supervised by a doctor and may play a part in the larger picture of a person’s transition. These terms are preferred over “sex change operation.” Referring to people as “pre-op” or “post-op” should be avoided as it implies that all transgender people should choose to, or can afford to have medical procedures. 

Gender Dysphoria formerly known as Gender Identity Disorder (GID) describes the feeling of emotional and psychological discord that one experiences when their assigned sex and gender identity are at odds. Individualized treatment through hormones or surgery may be recommended by a psychiatrist or other medical authority. 

In 2013 the American Psychiatric Association released new guidelines, replacing GID with Gender Dysphoria. Trans healthcare advocates maintain that because Gender Dysphoria is a condition listed within the APA’s Diagnostic and Statistical Manual of Mental Disorders (DSM), that health insurance should cover any medically necessary treatments.

Cisgender describes someone who is not transgender. Cis is a Latin prefix meaning “on the same side as” versus trans meaning “across, beyond, or through.”

Gender Non-Conforming describes some people whose gender expression is different from cultural expectations of masculine and feminine, but it is not interchangeable with transgender. While a person’s gender expression may step outside of traditional male and female norms, this alone doesn’t make them transgender. Just as many transgender men and women may express themselves in conventionally masculine or feminine ways.

Non-binary and/or genderqueer refers to people whose gender identity and/or expression falls outside of the traditional male or female roles. They may find their experience falls somewhere in between, or is something separate entirely. Not to be confused with transgender or transsexual.