Māhū ('in the middle') in Kanaka Maoli (Hawaiian) and Maohi (Tahitian) cultures are third gender persons with traditional spiritual and social roles within the culture, similar to Tongan fakaleiti and Samoan fa'afafine,[1] Kāne (men) who have sexual relationships with men are Aikāne.

According to present-day māhū kumu hula Kaua'i Iki:

Māhū were particularly respected as teachers, usually of hula dance and chant. In pre-contact times māhū performed the roles of goddesses in hula dances that took place in temples which were off-limits to women. Māhū were also valued as the keepers of cultural traditions, such as the passing down of genealogies. Traditionally parents would ask māhū to name their children.[2]


In the pre-colonial history of Hawai'i, Māhū were notable priests and healers, although much of this history was elided through the intervention of missionaries. The first published description of māhū occurs in Captain William Bligh's logbook of the Bounty, which stopped in Tahiti where he was introduced to a member of a "class of people very common in Otaheitie called Mahoo... who although I was certain was a man, had great marks of effeminacy about him."[3]

A surviving monument to this history are the "Wizard Stones" of Kapaemāhū on Waikiki Beach, which commemorate four important māhū who first brought the healing arts from Tahiti to Hawaiʻi.[4] These are referred to by Hawaiian historian Mary Kawena Pukui as pae māhū, or literally a row of māhū.[5] The term māhū is misleadingly defined in Pukui and Ebert's Hawaiian dictionary as "n. Homosexual, of either sex; hermaphrodite."[6] The assumption of same-sex behavior reflects the conflation of gender and sexuality that was common at that time.[note 1] The idea that māhū are biological mosaics appears to be a misunderstanding of the term hermaphrodite, which in early publications by white sexologists and anthropologists was used generally used to mean "an individual which has the attributes of both male and female," including social and behavioral attributes, not necessarily a biological hybrid or intersex individual. This led to homosexual, bisexual, and gender nonconforming individuals being mislabeled as "hermaphrodites" in the medical literature.[7]

In 1891, when painter Paul Gauguin first came to Tahiti, he was thought to be a māhū by the indigenous people, due to his flamboyant manner of dress during that time.[8] His 1893 painting Papa Moe (Mysterious Water) depicts a māhū drinking from a small waterfall.[8][9]

Missionaries to Hawai'i introduced homophobic and transphobic biblical laws to the islands in the 1820s; under their influence Hawai'i's first anti-sodomy law was passed in 1850. These laws led to the social stigmatization of the māhū in Hawai'i. Beginning in the mid-1960s the Honolulu City Council required trans women to wear a badge identifying themselves as male.[10]

In American artist George Biddle's Tahitian Journal (1920–1922) he writes about several māhū friends in Tahiti, of their role in native Tahitian society, and of the persecution of a māhū friend Naipu, who fled Tahiti due to colonial French laws that sent māhū and homosexuals to hard labor in prison in New Caledonia.[11] Rae rae is a social category of māhū that came into use in Tahiti in the 1960s, although it is criticized by some māhū as an abject reference to sex work.

During World War II, māhū and gender variant peoples of the South Pacific were encountered by American men and women in the U.S. military and helped influence the beginnings of gay liberation.

In contemporary cultures

In 1980s, Māhū and fa'afafine of Samoa and other queer cultures of the Pacific began organizing, as māhū and queer Pacific Islanders were beginning to receive international recognition in various fields.[12]

In 2003,[12] the term mahuwahine was coined within Hawaii's queer community: māhū (in the middle) + wahine (woman), the structure of the word is similar to Samoan fa'a (the way of) + fafine (woman/wife). The term mahuwahine resembles a transgender identity that coincide with Hawaiian cultural renaissance.[13]

Notable contemporary māhū, or mahuwahine, include activist and kumu hula Hinaleimoana Kwai Kong Wong-Kalu,[14] kumu hula Kaumakaiwa Kanaka'ole, and kumu hula Kaua'i Iki; and within the wider māhū LGBT community, historian Noenoe Silva, activist Ku‘u-mealoha Gomes, singer and painter Bobby Holcomb, and singer Kealii Reichel.

In many traditional communities, Māhū play an important role in carrying on Polynesian culture, and teaching "the balance of female and male throughout creation".[15] Modern Māhū carry on traditions of connection to the land, language preservation, and the preservation and revival of cultural activities including traditional dances, songs, and the methods of playing culturally-specific musical instruments. Symbolic tattooing is also a popular practice. Modern Māhū do not alter their bodies through what others would consider gender reassignment surgery, but just as any person in Hawaiian/Tahitian society dress differently for work, home, and nights out.[16]

Strong familial relationships are important in Māhū culture,[17] as kinship bonds within all of Hawaiian/Tahitian cultures are essential to family survival. When possible, the Māhū maintain solid relationships with their families of origin, often by becoming foster parents to nieces and nephews, and have been noted for being especially "compassionate, and creative".[15] This ability to bring up children is considered a special skill specific to Māhū people.[18] Māhū also contribute to their extended families and communities through the gathering and maintaining of knowledge, and the practicing and teaching of hula traditions, which are traditionally handed down through women.[15]

In situations where they have been rejected by their families of origin, due to homophobia and colonization, Māhū have formed their own communities, supporting one another, and preserving and teaching cultural traditions to the next generations. In the documentary Kumu Hina, Hinaleimoana Wong-Kalu visits one of these communities of elders up in the mountains, and meets with some of the Māhū who were her teachers and chosen family when she was young.

See also


  1. ^ The term "transgender" was not in use yet during the time the earliest sources were written, and has undergone significant changes in definition over time. While technically coined in the 1960s, the term transgender was rarely published until the 1990s and did not see wide usage until the 2000's.

References and sources

  1. ^ Perkins, Robert (October 2013). "Like a Lady in Polynesia: The Māhū of Tahiti, the Fa'a Fafine in Samoa, the Fakaleiti in Tonga and More". GenderCentre.org.au. Petersham, NSW, Australia: The Gender Centre. Archived from the original on 24 September 2015. Retrieved 30 September 2015.
  2. ^ Kaua'i Iki, quoted by Andrew Matzner in 'Transgender, queens, mahu, whatever': An Oral History from Hawai'i. Intersections: Gender, History and Culture in the Asian Context Issue 6, August 2001
  3. ^ William Bligh. Bounty Logbook. Thursday, January 15, 1789.
  4. ^ James Boyd. Traditions of the Wizard Stones Ka-Pae-Mahu. 1907. Hawaiian Almanac and Annual.
  5. ^ Mary Kawena Pukui. Place Names of Hawaii, 2nd Ed. 1974. University of Hawaii Press.
  6. ^ Mary Kawena Pukui, Samuael H Ebert. Hawaiian Dictionary. 1986. University of Hawaii Press.
  7. ^ Websters International Dictionary of the English Language. 1890. Merriam Company.
  8. ^ a b Llosa, Mario Vargas. "The men-women of the Pacific". Tate.org.uk. Tate Britain. Archived from the original on 6 March 2015.
  9. ^ Stephen F. Eisenman. Gauguin's Skirt. 1997.
  10. ^ Zanghellini, Aleardo (2013). "Sodomy Laws and Gender Variance in Tahiti and Hawai'i". Laws. 2 (2): 51–68. doi:10.3390/laws2020051.
  11. ^ Biddle, George (1999). Tahitian Journal. ISBN 9780816604968.
  12. ^ a b Kleiber, Eleanor (10 September 2019). "Gender Identity and Sexual Identity in the Pacific and Hawai'i: Introduction". University of Hawai'i at Mānoa Library. Retrieved 19 September 2019.
  13. ^ Ellingson, Lyndall; Odo, Carol (December 2008). "HIV Risk Behaviors Among Mahuwahine (Native Hawaiian Transgender Women)". AIDS Education and Prevention. 20 (6): 558–569. doi:10.1521/aeap.2008.20.6.558. ISSN 0899-9546.
  14. ^ Borofsky, Amelia Rachel Hokule’a (2012-10-29). "'Gender Identity Disorder' to Go the Way of Homosexuality". The Atlantic. Retrieved 2019-01-18.
  15. ^ a b c Robertson, Carol E. (1989). "The Māhū of Hawai'i". Feminist Studies. 15 (2): 318. doi:10.2307/3177791. ISSN 0046-3663. JSTOR 3177791.
  16. ^ Gender on the edge : transgender, gay, and other Pacific islanders. Besnier, Niko,, Alexeyeff, Kalissa. Honolulu. 2014. p. 95. ISBN 9780824840198. OCLC 875894847.CS1 maint: others (link)
  17. ^ "Gender on the Edge". Gender on the Edge: Transgender, Gay, and Other Pacific Islanders. University of Hawai'i Press. 2014. p. 95. ISBN 9780824838829. JSTOR j.ctt6wqhsc.
  18. ^ "Gender on the Edge". Gender on the Edge: Transgender, Gay, and Other Pacific Islanders. University of Hawai'i Press. 2014. p. 108. ISBN 9780824838829. JSTOR j.ctt6wqhsc.
  • Eisenman, Stephen F., (1999). Gauguin's Skirt. London: Thames and Hudson. ISBN 978-0500280386.
  • Matzner, Andrew (2001). O Au No Keia: Voices from Hawai'i's Mahu and Transgender Communities

External links


Akava'ine is a Cook Islands Māori word which has come, since the 2000s, to refer to transgender people of Māori descent from the Cook Islands.

It may be an old custom but has a contemporary identity influenced by other Polynesians, through cross-cultural interaction of Polynesians living in New Zealand, especially the Samoan "Fa'afafine", transgender people who hold a special place in Sāmoan society.


Bigender, bi-gender or dual gender is a gender identity that includes any two gender identities and behaviors. Some bigender individuals express two distinct personas, which may be feminine, masculine, agender, androgyne, or other gender identities; others find that they identify as two genders simultaneously. A 1999 survey conducted by the San Francisco Department of Public Health observed that, among the transgender community, 3% of those who were assigned male at birth and 8% of those who were assigned female at birth identified as either "a transvestite, cross-dresser, drag queen, or a bigendered person".


Cisgender (sometimes cissexual, often abbreviated to simply cis) is a term for people whose gender identity matches the sex that they were assigned at birth. For example, someone who identifies as a woman and was assigned female at birth is a cisgender woman. The term cisgender is the opposite of the word transgender.Related terms include cissexism and cisnormativity.

Dual-role transvestism

Dual-role transvestism is the formal diagnosis used by psychologists and physicians to describe people who wear clothes of the opposite sex to experience being the opposite sex temporarily, but don't have a sexual motive or want gender reassignment surgery. The International Classification of Diseases (ICD-10) list three diagnostic criteria for "Dual-role transvestism" (F64.1).A person who is diagnosed with dual-role transvestism should not receive a diagnosis of transvestic fetishism (F65.1).


Fa'afafine are people who identify themselves as having a third-gender or non-binary role in Samoa, American Samoa and the Samoan diaspora. A recognized gender identity/gender role in traditional Samoan society, and an integral part of Samoan culture, fa'afafine are assigned male at birth, and explicitly embody both masculine and feminine gender traits in a way unique to Polynesia. Their behaviour typically ranges from extravagantly feminine to conventionally masculine.A prominent Western theory, among the many anthropological theories about Samoans, was that if a family had more boys than girls or not enough girls to help with women's duties about the house, male children would be chosen to be raised as fa'afafine; although this theory has been refuted by studies.It has been estimated that 1–5% of Samoans identify as fa'afafine. Te Ara: The Encyclopedia of New Zealand estimates that there are 500 fa’afafine in Samoa, and the same number in the Samoan diaspora in New Zealand; while according to SBS news, there are up to 3000 fa'afafine currently living in Samoa.

Hinaleimoana Wong-Kalu

Hinaleimoana Kwai Kong Wong-Kalu, also known as Kumu Hina, is a Native Hawaiian māhū - a traditional third gender person who occupies "a place in the middle" between male and female - as well as a modern transgender woman. She is known for her work as a kumu hula ("hula teacher"), as a filmmaker, and as a community leader in the field of Kanaka Maoli language and cultural preservation. She teaches Kanaka Maoli philosophy and traditions and promotes cross-cultural alliances throughout the Pacific Islands. Described as a "powerful performer with a clear, strong voice", she has been hailed as "a cultural icon".Wong-Kalu was born in the Nuuanu district of Oʻahu. She attended Kamehameha School (1990) and the University of Hawaiʻi at Manoa (1996–2004) where she began her activism. She was a founder of the Kulia Na Mamo transgender health project, cultural director of a Hawaiian public charter school, and candidate for the Office of Hawaiian Affairs, one of the first transgender candidates for statewide political office in the United States. She also served as the Chair of the O'ahu Island Burial Council, which oversees the management of Native Hawaiian burial sites and ancestral remains. She is a recipient of the National Education Association Ellison Onizuka Human and Civil Rights Award, Native Hawaiian Community Educator of the year, and a White House Champion of Change.Wong-Kalu was the subject of the feature documentary film Kumu Hina, directed by Dean Hamer and Joe Wilson. Kumu Hina premiered as the closing night film in the Hawaii International Film Festival in 2014 and won several awards including best documentary at the Frameline Film Festival and the GLAAD Media Award for Outstanding Documentary. It was nationally broadcast on PBS in 2015 where it won the Independent Lens Audience Award. Wong-Kalu wrote an educational children's version of the film, A Place in the Middle, which premiered at the Berlin International Film Festival and Toronto International Film Festival for Kids and is featured on PBS learning media. Switching to the other side of the lens, Wong Kalu co-directed and produced the short film, Lady Eva and feature documentary Leitis in Waiting about the struggle of the Indigenous transgender community in the South Pacific Kingdom of Tonga. Her films on this subject screened and won awards at AFI Docs and the LA, Margaret Mead, FIFO and Commonwealth film festivals and are being broadcast on PBS/Pacific Heartbeat, ARTE, Maori TV, TV France and NITV.


Kapaemāhū refers to four stones on Waikiki Beach that were placed there as tribute to four legendary māhū (third-gender individuals) who brought the healing arts from Tahiti to Hawaiʻi centuries ago. It is also the name of the leader of the healers, who according to tradition transferred their spiritual power to the stones before they vanished.. The stones are currently located inside a City and County of Honolulu monument in Honolulu at the western end of Kuhio Beach Park, close to their original home in the section of Waikiki known as Ulukou.Kapaemāhū is considered significant as an historical landmark in Waikiki, an example of sacred stones in Hawaiʻi, an insight into indigenous healing methods, and a topic of academic interest.


Khanith (also spelled Khaneeth or Xanith; Arabic: خنيث‎; khanīth) is a vernacular Arabic term used in Oman and parts of the Arabian Peninsula to denote the gender role ascribed to males who function sexually, and in some ways socially, as women. The word is closely related to Arabic: مخنث‎, romanized: mukhannath, "effeminate".John Money summarizes material presented by Unni Wikan in an article titled Man becomes woman: Transsexualism in Oman as a key to gender roles. According to this account, the mukhannath is the "bottom" in a male same-sex relationship. Because of this, khanith are considered men by Omani standards and are often considered an "alternative gender role" – and sometimes considered as being transgender or transvestites – even though the khanith are still referred to by masculine names and are treated as male by the law. Because of this confusion in terminology, many people refer to the khanith as khanith alone.The khanith are considered a specific third gender category in the Arabian Peninsula. And although they behave like women and have same-sex relationships with other men, at some stage they may one day "become a man" and give up their lifestyle for marriage and children.

Kumu Hina

Kumu Hina is a 2014 documentary film by Dean Hamer and Joe Wilson and is the story of Hina Wong-Kalu. It premiered at the Hawaii International Film Festival and aired on Independent Lens, a PBS program, in May 2015.

LGBT rights in Hawaii

Lesbian, gay, bisexual, and transgender (LGBT) persons in the U.S. state of Hawaii enjoy all of the same rights as non-LGBT people. Same-sex sexual activity has been legal since 1973; Hawaii being one the first six states to legalize it. Following the approval of the Hawaii Marriage Equality Act in November 2013, same-sex couples have been allowed to marry on the islands. Additionally, Hawaiian laws prohibit discrimination on the basis of both sexual orientation and gender identity. The use of conversion therapy on minors has been banned since July 2018. Gay and lesbian couples enjoy the same rights, benefits and treatment as opposite-sex couples, including the right to marry and adopt.Same-sex relationships have been part of Hawaiian culture for centuries. The term aikāne refers to homosexual or bisexual relationships, which were widely accepted in pre-colonial Hawaiian society, and the term māhū refers to a "third gender" alongside male and female. The Christian missionaries, who arrived in the 19th century, were adept in converting the local population to Christianity. As a result, the first ever anti-gay law was enacted in 1850, prohibiting sodomy with 20 years hard labor. During the 1960s and onwards, LGBT rights entered into the public eye, which was followed by multiple pro-LGBT rights reforms, including the repeal of the sodomy law.

In modern times, Hawaii is notable for its LGBT-friendliness, with several establishments, accommodations, and festivals catering especially for gay tourists and couples. Recent opinion polls have found that same-sex marriage enjoys very high levels of support.

List of transgender-related topics

The term "transgender" is multi-faceted and complex, especially where consensual and precise definitions have not yet been reached. While often the best way to find out how people identify themselves is to ask them, not all persons who might be thought of as falling under the transgender 'umbrella' identify as such. Transgender can also be distinguished from intersex, a term for people born with physical sex characteristics "that do not fit typical binary notions of male or female bodies".Books and articles written about transgender people or culture are often outdated by the time they are published, if not already outdated at the time of composition, due to inappropriate and/or outdated questions or premises.Psychology, medicine, and social sciences research, aid, or otherwise interact with or study about transgender people. Each field starts from a different point of view, offers different perspectives, and uses different nomenclature. This difference is mirrored by the attitude of transgender people as regards transgender issues, which can be seen in the articles listed below.

List of transgender-rights organizations

Transgender organizations seek to promote understanding and acceptance, both legally and socially, of transgender persons.

Moe aikāne

Moe aikāne relationships were sexual relationships in pre-colonial Hawai'i between aliʻi nui and the male and female kaukaualiʻi performing a hana lawelawe or expected service with no stigma attached. While the cultural tradition is one of the best examples of a nominally heterosexual community also accepting homosexual and bisexual relationships, author Kanalu G. Terry Young states in his book; "Rethinking the Native Hawaiian Past" that these relationships were not bisexual in a social sense. These were relationships from the ʻōiwi wale times that held no stigmatism to the persons ʻano (one's nature or character). To call it a bisexual relationship is liking saying the children of multiple husbands from one Hawaiian mother were out of wedlock. For the time, the comparison is impossible. These relationships are accepted as part of the history of ancient Hawaiian culture. Among men, the sexual relationships usually begin when the partners are teens and continue throughout their lives, even though they also maintain heterosexual partners. The Hawaiian aikane relationship is well known to have been a part of life for Hawaiian nobility, including Kamehameha. While more examples of male relationships exist, some stories refer to women's desires, supporting the theory that some women may have been involved in aikāne relationships as well.In regard to the aikāne relationship, Lieutenant James King stated that "all the chiefs had them". He recounts a tale that Captain Cook was actually asked by one chief to leave King behind, considering such an offer a great honor. A number of Cook's crew related tales of the tradition with great disdain. American adventurer and sailor, John Ledyard commented in detail about the tradition as he perceived it. The relationships were official and in no way hidden. The sexual relationship was considered natural by the Hawaiians of that time.The word and social category of aikāne refers to: ai or intimate sexual relationship; and kāne or male/husband. In traditional mo'olelo or chants, women and goddesses (as well as ali'i chiefs) referred to their male lovers as aikāne, as when the goddess Hi'iaka refers to her male lover Hopoe as her aikāne. During the late 19th and early 20th century, the word aikāne was "purified" of its sexual meaning by colonialism, and in print meant simply "friend", although in Hawaiian language publications its metaphorical meaning could mean either "friend" or "lover" without stigmatization.Although their roles are often conflated with aikāne in contemporary LGBT culture, the Māhū are in a social category of liminal gender. Māhū (in the middle) live in a space between the genders, and many live in the opposite gender to their birth.

Non-binary gender

Non-binary is a spectrum of gender identities that are not exclusively masculine or feminine‍—‌identities that are outside the gender binary. Genderqueer is an earlier term with the same meaning, originating from queer zines of the 1980s. Non-binary identities can fall under the transgender umbrella, since many non-binary people identify with a gender that is different from their assigned sex.Non-binary people may identify as having two or more genders (being bigender or trigender); having no gender (agender, nongendered, genderless, genderfree or neutrois); moving between genders or having a fluctuating gender identity (genderfluid); being third gender or other-gendered (a category that includes those who do not place a name to their gender).Gender identity is separate from sexual or romantic orientation, and non-binary people have a variety of sexual orientations, just as cisgender people do.A non-binary gender is not associated with a specific gender expression, such as androgyny. Non-binary people as a group have a wide variety of gender expressions, and some may reject gender "identities" altogether.


Rae-rae are male-to-female trans women in Tahitian culture, a contemporary distinction originating in the 1960s from Māhū (meaning "in the middle"), which is the more traditional social category of gender liminal people of Polynesia. Petea is a disparaging term for cis-male homosexuality (suggesting "men who sexually desire each other") used in French Polynesia, in contrast to traditional social category aikane used in Hawaii.

Whereas mahu are regarded as an integral part of Maori tradition, history, and culture, rae-rae are generally less accepted in Tahitian society. They are regarded as the more modern equivalent to drag queens of the western world, and carry a negative connotation with ties to poverty and sex work. Rae-rae may be more likely than mahu to undergo male-to-female gender reassignment surgery or other cosmetic surgeries. Additionally, the identity of rae-rae has closer ties to homosexuality, in contrast to mahu, which identify more with femininity and "sweetness" and may take a vow of chastity. Rae-rae is seen by some as an influence from western (i.e. French) culture, whereas the concept and history of mahu are purely Polynesian and untouched by western ideals. Rae-rae is also a controversial term in Tahiti because it is seen by some as incompatible with two Polynesian cultural ideas: firstly, that one's gender identity is defined before and thus determines one's sexuality; and secondly, that one's gender is constant throughout one's life instead of being fluid. However, some scholars suggest that the objections to rae-rae may be due to Christian influence and morality of sexual modesty.

The idea of a third gender or third sex is common in many cultures. Rae-rae in Tahiti is similar to Kathoey in Thailand, Kothi and Hijra in India, Femminiello in Italy, Muxe in Mexico, and Travesti in South America.

Sex reassignment surgery (female-to-male)

Sex reassignment surgery for female-to-male transgender people includes a variety of surgical procedures that alter anatomical traits to provide physical traits more comfortable to the trans man's male identity and functioning. Non-binary people assigned female at birth may also have these surgeries.

Often used to refer to phalloplasty, metoidoplasty, or vaginectomy, sex reassignment surgery can also more broadly refer to many procedures an individual may have, such as male chest reconstruction, hysterectomy, or oophorectomy,

Sex reassignment surgery is usually preceded by beginning hormone treatment with testosterone.

Third gender

Third gender or third sex is a concept in which individuals are categorized, either by themselves or by society, as neither man nor woman. It is also a social category present in societies that recognize three or more genders. The term third is usually understood to mean "other"; some anthropologists and sociologists have described fourth, fifth, and "some" genders.

Biology determines whether a human's chromosomal and anatomical sex is male, female, or one of the uncommon variations on this sexual dimorphism that can create a degree of ambiguity known as intersex. However, the state of personally identifying as, or being identified by society as, a man, a woman, or other, is usually also defined by the individual's gender identity and gender role in the particular culture in which they live. Not all cultures have strictly defined gender roles.In different cultures, a third or fourth gender may represent very different things. To Native Hawaiians and Tahitians, Māhū is an intermediate state between man and woman, or a "person of indeterminate gender". Some traditional Diné Native Americans of the Southwestern US acknowledge a spectrum of four genders: feminine woman, masculine woman, feminine man, and masculine man. The term "third gender" has also been used to describe the hijras of India who have gained legal identity, fa'afafine of Polynesia, and sworn virgins.While found in a number of non-Western cultures, concepts of "third", "fourth", and "some" gender roles are still somewhat new to mainstream western culture and conceptual thought. The concept is most likely to be embraced in the modern LGBT or queer subcultures. While mainstream western scholars - notably anthropologists who have tried to write about the South Asian hijras or the Native American "gender variant" and two-spirit people - have often sought to understand the term "third gender" solely in the language of the modern LGBT community, other scholars – especially Indigenous scholars – stress that mainstream scholars' lack of cultural understanding and context has led to widespread misrepresentation of third gender people, as well as misrepresentations of the cultures in question, including whether or not this concept actually applies to these cultures at all.

Transgender pregnancy

Transgender pregnancy is the incubation of one or more embryos or fetuses by transgender people.

Transitioning (transgender)

Transitioning is the process of changing one's gender presentation and/or sex characteristics to accord with one's internal sense of gender identity – the idea of what it means to be a man or a woman, or to be non-binary or genderqueer. (Non-binary people's internal sense of gender identity is neither solely female nor male.) For transgender and transsexual people, this process commonly involves reassignment therapy (which may include hormone replacement therapy and sex reassignment surgery), with their gender identity being opposite that of their birth-assigned sex and gender. Transitioning might involve medical treatment, but it does not always involve it. Cross-dressers, drag queens, and drag kings tend not to transition, since their variant gender presentations are (usually) only adopted temporarily.

Transition must begin with a personal decision to transition, prompted by the feeling that one's gender identity does not match the sex that one was assigned at birth. One of the most significant parts of transitioning for many transgender people is coming out for the first time. Transitioning is a process, not an event, that can take anywhere between several months and several years. Some people, especially non-binary or genderqueer people, may spend their whole life transitioning and may redefine and re-interpret their gender as time passes. Transitioning generally begins where the person feels comfortable: for some, this begins with their family with whom they are intimate and reaches to friends later or may begin with friends first and family later. Sometimes transitioning is at different levels between different spheres of life. For example, someone may transition far with family and friends before even coming out at work.

Gender and sexual identities
See also


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