When a baby is born, someone (usually a doctor or midwife) looks at its external sex organs and says, “It’s a boy,” or “It’s a girl.” This is the baby’s sex assigned at birth. Transgender is a term for someone whose gender identity does not match the sex assigned at birth.
Gender identity is an individual’s perception of themselves as male, female, a blend of both, or neither. Non-binary people identify as neither male nor female. They may define themselves as on the spectrum between male and female, or even entirely outside of the gender spectrum.
It may take years before a person knows their gender identity does not match their sex assigned at birth. Sometimes children know from a very young age, as young as 4 years old. Gender identity is not the same as sexual orientation, which describes which gender(s) you are attracted to romantically and sexually.
Gender dysphoria is the distress a person feels when their physical or assigned sex is in conflict with their gender identity. Often they are very uncomfortable with their body, especially the changes that happen during puberty. If you identify as male but your body begins to grow breasts and you have a period, or if you identify as female but you begin to have erections and your voice deepens, you may feel deeply unhappy and depressed. Many transgender young people fear rejection by their family and friends, as well as bias and discrimination.
Being transgender is not something that you can change. What you can do is try to get the validation and support you need while you decide how to express your true self.
Social transitioning is changing the way you present yourself to the world so that your gender expression matches your gender identity. That can include changing your hair or clothes, using a new name, and being called by the correct pronouns for your gender identity. Some people find that social transition is enough to make them feel happier, especially before puberty. You may decide to transition just with family and friends, or you may want to come out at school or in your community. The support of your family, school and community is key to transitioning safely and avoiding bullying or discrimination.
If you are transgender, you may be able to find a support group in your community. Finding other people who understand what you’re going through is a real source of comfort. Talking to a sympathetic school counselor or a mental health professional can help you deal with the changes in your life and any emotions you feel.
There are several stages to medical transitioning. Some trans people don’t do medical transition, while others may use hormones and surgery in transitioning. Each person has to decide the right course for their life.
If a young person is approaching puberty, puberty blockers like Lupron can stop anatomical puberty. Puberty blockers are hormone-blocking agents which keep a person from developing the sexual characteristics of their assigned sex. These are physical attributes such as breast development and menstrual periods for someone assigned female at birth, or broader shoulders, an Adams apple, and a deeper voice if you are assigned male at birth. If you decide not to transition, you can stop taking puberty blockers at any time, and you will then go through puberty. Stopping puberty eases the transition if transgender young people later go on to use cross-gender hormones.
Cross-gender hormones are the next stage, which allow you to take on some of the secondary sex characteristics of your true gender. Usually young people don’t start cross-gender hormones until age 16, although they may start at a younger age.
Most people wait until they are 18 to 21 to start surgical procedures. You may decide you don’t want to have surgery, or you only want to have certain procedures.
Transgender Program at Mount Sinai Adolescent Health Center
At Mount Sinai Adolescent Health Center, we tailor our transgender health program’s services to fit the individual needs of young people and their families. We provide comprehensive, patient-centered care that is free of obstacles. All patients ages 10-24 are welcome, regardless of income, ability to pay, or immigration status. Our team provides services at the Center or will work with outside providers such as community based therapists to provide comprehensive evaluation and treatment for transgender young people.
In addition to primary care including reproductive needs, STI evaluations and treatment, and urgent medical needs, our comprehensive care provides:
- Evaluations for gender dysphoria
- Evaluations for hormone readiness
- Short and long term individual counseling
- Family therapy
- Support groups for youth and parents
- Puberty blocking prescriptions
- Feminizing and masculinizing hormone treatments
- Preparation for future surgical interventions and referrals to the Center for Transgender Medicine and Surgery at Mount Sinai
Transgender patients have access to all other services at the Center such as free primary care, optical, legal, health education, and nutritional services, as well as social work and psychological testing. Call 212-423-3000 to make an appointment.
This information is not intended to provide medical advice, professional diagnosis, opinion, treatment or services, only general information for education purposes only.