QueerCME Transgender Medical Care Glossary

The language of gender, sex, sexuality, and romantic orientation is constantly shifting and evolving just as all language is. It can feel intimidating to stay current with the latest terms. If you’re just starting to explore gender and sexuality, the combination of slang, acronyms, and medical terminology can be overwhelming.  We have included a glossary of terms we use frequently at QueerCME. Updates will be tracked! 

 

At QueerCME, we strive to use language that upholds the principles of safety, dignity, respect, and autonomy. Some terms may be considered offensive in current use or in specific communities. When in doubt, ask your patient/friend/family member/the person you are communicating with what terms they use. Premium members have access to our sample intake paperwork that includes questionnaires around terminology! 

 

This is not a complete or comprehensive glossary. Some other glossary options include our favorite:

• Trans Language Primer (also, their Spanish language version) 
• Made by community for community and others
• Please consider donating to support their work

Additional medically-focused glossaries include WPATH SOC8 (See Appendix B for Glossary) and The National LGBTQIA+ Health Education Center.

Foundational Concepts

 

Queer -  adjective. Historically used as a slur. Segments of the LGBTQIA+ communities have reclaimed the term to describe a state of being, often interpreted as a statement of how an individual relates to themselves and to their community and how they move through the world. There is no singular meaning, and some still find “queer” to be a derogatory and hurtful term that causes stress. It is often used as an umbrella term to encompass large swaths of the LGBTQIA+ community. Consider reading
9 LGBTQ+ People Explain How They Love, Hate, and Understand the Word "Queer" from Them.us.

Our founder thinks of “queer” as an ideology and really appreciates bell hooks’ definition:

“Queer' not as being about who you're having sex with (that can be a dimension of it); but 'queer' as being about the self that is at odds with everything around it and that has to invent and create and find a place to speak and to thrive and to live.”

Gender - noun. A complex combination of roles and norms, expression, aesthetics, identities, performances, social interactions, and more that are assigned certain meanings by society. Gender is both self-defined and society-defined. How gender is embodied and defined varies from culture to culture and from person to person. (from TransLanguagePrimer.)

 

Gender Expression noun. How we share our gender with the world.

 

Gender Identity - noun. A person’s deeply felt internal and individual experience of gender, which may or may not seemingly correspond to the person’s physiology or designated sex at birth.

 

Sex - noun. The different biological and physiological characteristics of humans such as chromosomes, hormones, and reproductive organs.

 

Sexual orientation - noun. Who we are attracted to sexually. We often recommend the Gender Unicorn to learn more.

 

Sex Assigned at Birth - noun. The typically binary designation given to newborn infants by medical providers based on the appearance of the infants’ genitals compared to the Prader or Quigley scale. The appearance of genitals is determined by a complex arrangement of genetic material, chromosomal expression, hormonal exposure in utero, and phenotypic expression.

 

Gender Assigned at Birth - noun. Expected societal gender roles based on assigned or assumed sex at birth.

 

Femme/Feminine/Transfeminine - adjective. Feminine is a vague term that involves socially constructed stereotypes that mean different things to different people and thus is best avoided in clinical practice. Individual patients may use these terms to describe gender roles and expressions, or sexual orientations, roles, or expressions, but those should not be conflated with medical care or gender expression goals. It is generally acceptable to use the language a patient requests, and we recommend a deeper dive to understand what feminine means to each individual patient.

 

Masc/Masculine/Transmasculine - adjective. Masculine is a vague term that involves socially constructed stereotypes that mean different things to different people and thus is best avoided in clinical practice. Individual patients may use these terms to describe gender roles or expressions, or sexual orientations, roles, or expressions, but those should not be conflated with medical care or gender expression goals. It is generally acceptable to use the language a patient requests, and we recommend a deeper dive to understand what masculine means to each individual patient.

 

Feminizing hormone treatment - noun phrase. Historical term for medical treatments such as estradiol, progesterone, and anti-androgens. However because treatments don’t have a gender (only people do) we strive to use more objective language. Using gendered language for treatments may restrict care options and misgender patients.

 

Masculinizing hormone treatment - noun phrase. Historical term for medical treatments such as testosterone. However because treatments don’t have a gender (only people do) we strive to use more objective language. Using gendered language for treatments may restrict care options and misgender patients.

 

Nonbinary - adjective. If gender is thought of as a spectrum and not a binary, nonbinary is everything beyond a simplistic mapping of gender and sex as the two end-points on an either-or scale or two opposite ways of being.

 

Trans / Transgender - adjective. An umbrella term for people whose gender, gender identity, and/or gender expression expands beyond society’s binary social construct of gender.

 

Trans* - adjective. Historically used as an umbrella term to describe the many ways to be transgender. Has fallen out of favor in the community.

Common Acronyms

 

AMAB - Assigned Male At Birth; historically used to, often inaccurately, shorthand information needed to determine preventive care; we recommend doing an organ inventory and describing the endogenous and exogenous hormone histories. Originally used by intersex individuals and adopted by other communities.

 

AFAB - Assigned Female At Birth; historically used to, often inaccurately, shorthand information needed to determine preventive care; we recommend doing an organ inventory and describing the endogenous and exogenous hormone histories. Originally used by intersex individuals and adopted by other communities.

 

AGAB - Assigned Gender At Birth; often used by individuals to reference prior ways of moving through the world without needing to reference primary or secondary sex characteristics. Is not as often used in healthcare, as specificity is intentionally low. 

 

TGD - Trans and Gender Diverse; umbrella term to describe individuals who identify themselves as beyond a cisgender framework.

 

TCGNC - Trans and Gender Diverse or Nonconforming; umbrella term to describe individuals who identify themselves as beyond a cisgender framework.

 

2SLGBTIAQ+:

2S - Two Spirit. Definition from Paths(Re)membered.  Refers to someone who is Native and expresses their gender identity or spiritual identity in indigenous, non-Western ways. This term can only be applied to a person who is Native. A Two Spirit person has traditional roles and responsibilities within their tribe.  Not all Native LGBTQ people identify as Two Spirit. Another popular term within the indigenous community is indigiqueer. 

L - Lesbian

G - Gay

B - Bisexual

T - Transgender

I - Intersex

A - Asexual or Aromantic

Q - Queer or Questioning

+ - recognizing that there are other non-cis and non-heterosexual identities not fully captured by the acronym.

Now In Alphabetical Order

 

Androgens - noun. Steroid hormones which bind to androgen receptors in the body and contribute to anabolic processes (energy-using) in the body. Androgenic hormones include testosterone, dehydroepiandrosterone (DHEA,) and metabolites: dihydrotestosterone (DHT,) androstenedione, and dehydroepiandrosterone sulphate (DHEAS.)  Androgens are produced both by the gonads and the adrenal glands.

 

Anti-androgens - noun. Substances that alter the activity of androgen receptors or the production of androgens. Finasteride and dutasteride affect the production of DHT from testosterone, bicalutamide affects the ability of testosterone and DHT to bind to testosterone receptors and may raise blood testosterone levels. Spironolactone theoretically lowers testosterone levels and interferes with the production of testosterone, but the effect is clinically negligible when used in the presence of exogenous estradiol. 

 

Aro-ace - adjective. Pertaining to emotional and sexual attraction. Aro-ace is short for aromantic-asexual and describes a person who feels little to no romantic or sexual attraction.

 

Aromantic - adjective. Pertaining to emotional attraction orientation. An aromantic person experiences little to no romantic attraction and may have any sexual orientation. Aromantic may be shorted to “aro” and “aro-spec” for “aromantic spectrum.”  A separate glossary of terms used in the aromantic community can be found here.

 

Aromatase - noun. Not an aromatic taser. An enzyme used in the synthesis of estrogens in the body.  It converts testosterone to estradiol and androstenedione to estrone. Too much aromatase in the body can be caused by a genetic mutation and may result in precocious puberty, early closure of bone growth plates, and gynecomastia/gigantomastia. A mutation causing too much aromatase in the body results in primary amenorrhea and tallness.

 

Aromatase inhibitor - noun. Aromatase inhibitors stop the synthesis of androgens into estrogens in the body. Clinically, they are used in gender affirming care to stop menses and/or decrease breast development and to limit the synthesis of estrogen from testosterone. Common drug names are anastrozole and letrozole. Over the counter products that have aromatase inhibiting effects include nicotine, vitamin E, and zinc.

 

Asexual - adjective. Pertaining to sexual orientation. An asexual person experiences little to no sexual attraction. Asexual may be shortened to “ace” and “ace-spec” for “asexual spectrum”. Asexual people may or may not participate in sexual activity. Clinicians should not assume they do not have sex.

 

Back hole - community terminology. Refers to the anus/rectum.

 

Binary - adjective. Referring to a gradient that has two ends that are polar opposites.

 

Binder - noun. Garments with compression to minimize and flatten the appearance of the chest.

 

Bisexual - adjective.  A sexual orientation meaning “attracted to two.”  In current usage is often used broadly to mean a person who is attracted to more than one gender, gender expression, sexual orientation, or combination of primary and secondary sexual characteristics. May be shortened to “bi.”

 

Capacity - noun. Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment.) If they can demonstrate understanding of the situation, appreciation of the consequences of their decision, and reasoning in their thought process, and if they can communicate their wishes. Medical capacity is not competency, which is a legal construct.

 

Cisgender - adjective. A person whose gender, gender identity and/or gender expression is seemingly congruent with societal expectations of their sex assigned at birth is cisgender. May be shortened to “cis.” Not a slur.

 

Chosen name - noun. The name intentionally adopted by an individual compared to a given name. Recommended over “preferred” terminology. Names and pronouns are not preferences. 

 

Consent-driven - adjective. Consent in a medical visit cannot be assumed and should be checked at every step.

 

Dead name  - community terminology. A no longer used name. Often refers to a pre-transition legal name.

 

Demiromantic - adjective. Pertaining to romantic attraction.  A demiromantic person may not feel romantic attraction strongly, or only feel it after an emotional connection is formed.

 

Demisexual - adjective. Pertaining to sexual attraction/orientation. A demisexual person may not feel sexual attraction strongly, or only feel it after an emotional connection is formed.

 

Dysphoria - noun.  In psychiatry, dysphoria is a profound sense of ill-ease.  In gender affirming care, dysphoria is the sense that an aspect of gender or primary or secondary sexual characteristics does not match with the person’s sense of self. Dysphoria may be connected to physical items or bodily characteristics, or intangibles such as the gendered perceptions or expectations of other people.

 

Embodiment - noun. How a person wants their body to look or feel. The QueerCME founder often just refers to this as goals of care. Jen Hastings, MD was lead author on a paper with similar terminology.

 

Endocisheteronormativity - adjective. Harmful historical and present day practice on an individual level assuming that a person’s ideal gender embodiment most closely approximates that of an endosex cisgender heterosexual person and that a person’s gender identity determines their embodiment goals. Applies white supremacist, colonial, and, misogynistic standards to all bodies. Systemic and individual, as well as erases the visibility and experiences of intersex, trans, and queer people.

 

Endogenous - adjective. Made within the body. Endogenous hormones are those produced by glands within the body.

 

Exogenous -  adjective. Made outside of the body and added to the body.  A person taking testosterone, estrogen, or progesterone is using exogenous hormones.

 

Estrogen - noun.  Adjectival form estrogenic. Estrogen is a category of sex steroid hormones made in the body by the enzyme aromatase acting upon androgens (testosterone and androstenedione.)  There are four major forms of endogenous estrogen: estrone, estradiol, estriol, and estetrol, and many minor forms. To learn more about the changes driven by estrogen in bodies, visit the QueerDoc All the E page.

 

Evidence-informed - adjective. We like to call the informed decision making process in gender affirming care evidence-informed to honor both the value of community/lived experience and evidence-based medicine in making shared decisions with patients.

 

Front hole - community terminology. Refers to the vagina.

 

GAS - acronym. Short for Gender Affirming Surgery.

 

Gender - noun. A complex combination of roles and norms, expression, aesthetics, identities, performances, social interactions, and more that are assigned certain meanings by society. Gender is both self-defined and society-defined. How gender is embodied and defined varies from culture to culture and from person to person.

 

Gender Affirming Care - noun. The set of interventions that help an individual achieve their gender goals which can include medical, social, and legal interventions. Can also be referred to as “gender care” or “transgender care” or "transgender medical care."

 

Gender Assigned at Birth - noun. Expected societal gender roles based on assigned or assumed sex at birth.

 

Gender Diverse - adjective. An umbrella term for people who identify with or express a gender beyond societal expectations of cisgendered persons.

 

Gender Diversity - noun. The broad array of the ways in which humans experience and express gender.

 

Gender Expression - noun. How we share our gender with the world. 

 

Gender Expansive, Gender Nonconforming, Gender Queer - adjective. Describes a person whose experience of or expression of gender is not constrained by societal expectations of gender roles.

 

Gender Identity - noun. A person’s deeply felt internal and individual experience of gender, which may or may not seemingly correspond to the false binary social construct of their sex assigned at birth.

 

Gender Unicorn - noun. Visual depiction of gender, sex assigned at birth, and attraction identities using a unicorn and binary scales. Originally developed by Landyn Pan and Anna Moore, and visible at this website.  

 

Informed consent - noun phrase. An ethical and legal obligation of medical practitioners in the US and originates from the patient’s right to direct what happens to their body.  There are five required elements of an informed consent discussion:

1. The nature of the treatment
2. The risks and benefits of the treatment
3. Reasonable alternatives
4. Risks and benefits of the alternatives, and
5. Assessment of the patient’s understanding of elements 1 through 4.

The provider must make a recommendation and provide their reasoning for said recommendation.  The provider must make clear that the patient is participating in the decision making process.

 

Legal name - noun phrase. The name as recognized by governmental authorities.

 

Nonbinary - adjective. Outside of a binary scale.  Often refers to gender identity other than man or woman.  

 

Pansexual  - adjective. People who experience sexual attraction regardless of gender may identify as pansexual.

 

Pass/Passing - adverb, community terminology. “Passing” refers to a person “blending in” to cis expectations of gender expression and appearance. Passing may or may not be a transition goal. The concept of passing is complex and nuanced - it can be very important to the physical safety of patients and can cause significant harm as it is often rooted in “ideal standards of beauty”. 

 

SARM - acronym. Selective Androgen Receptor Modifier

 

SERM - acronym. Selective Estrogen Receptor Modifier

 

Sex - noun. The different biological and physiological characteristics of humans such as chromosomes, hormones, and reproductive organs.

 

Sex Assigned at Birth - noun phrase. The typically binary designation given to newborn infants by medical providers based on the appearance of the infants’ genitals compared to the Prader or Quigley scale. The appearance of genitals is determined by a complex arrangement of genetic material, chromosomal expression, hormonal exposure in utero, and phenotypic expression.

 

Sexual Orientation - noun phrase. Who we are attracted to. Sexual orientation labels can be ill-defined or contradictory to presumed or actual sexual activity, and may apply to body parts, to personal expression—gendered or otherwise— or to other characteristics. Each person gets to name their orientation as they see fit.  On a binary scale, heterosexual and homosexual are opposites, while bisexual can indicate varying degrees of attraction to (generally binary sexual characteristics.)  Many people use “bi” to indicate that they experience attraction beyond the binary rather than “attracted to two.”  Some people choose to use “pansexual” to indicate attraction beyond the binary.  There are, of course, many other words describing sexual orientations.

 

Testosterone - noun. Adjectival form testosteronic. One of the two primary sex steroid hormones. In the United States, testosterone in gender affirming care is available in injectable, oral, nasal, implantable, gel, and compounded forms. Testosterone is primarily available as testosterone enanthate and testosterone cypionate. Testosterone undecanoate is used in the FDA-approved oral preparation. To learn more about physical changes driven by testosterone visit QueerDoc's All the T page.