The terms “transgender” and “transsexual” are similar in the word trans can be used as a shorthand for either term. But “transgender” and “transsexual” are not synonymous, though they are not mutually exclusive either. “Transsexual” is considered dated, and many — but not all — find it offensive.

OK, so what do these terms mean?
The GLAAD Media Reference Guide defines “transgender” as:

An umbrella term for people whose gender identity and/or gender expression differs from what is typically associated with the sex they were assigned at birth. People under the transgender umbrella may describe themselves using one or more of a wide variety of terms – including transgender… Use the descriptive term preferred by the person. Many transgender people are prescribed hormones by their doctors to bring their bodies into alignment with their gender identity. Some undergo surgery as well. But not all transgender people can or will take those steps, and a transgender identity is not dependent upon physical appearance or medical procedures.

The same GLAAD Media Reference Guide defines “transsexual” to mean:

An older term that originated in the medical and psychological communities. Still preferred by some people who have permanently changed – or seek to change – their bodies through medical interventions, including but not limited to hormones and/or surgeries. Unlike transgender, transsexual is not an umbrella term. Many transgender people do not identify as transsexual and prefer the word transgender. It is best to ask which term a person prefers. If preferred, use as an adjective: transsexual woman or transsexual man.

OK, so what do those definitions mean in a more basic sense?
Someone who is transgender might have a gender identity that differs from the gender associated with the sex they were assigned at birth. This includes men who were assigned female at birth and women who were assigned male at birth. This also includes non-binary people. It includes a whole range of people under the transgender umbrella.

And not all of those people will be considered transsexual?
Correct. Some transgender people will have surgeries, hormone treatments, or other medical procedures. Some won’t have any medical procedures, but that won’t make them any less transgender than people who do have medical procedures.

But anyone who is transgender who does have medical procedures like surgery or hormones will be considered transsexual?
Some people will use “transsexual” to refer to any transgender person who has hormone treatments or surgeries. But not everyone will use the term that way, and certainly not all transgender people will appreciate having that term applied to them.

Because historically, the term “transsexual” hasn’t always been used in a positive or even neutral way. As the GLAAD primer explained, it’s an older term that has clinical and medical connotations. Fenway Health, a non-profit healthcare organization in Boston, explains the history of the connotations of “transsexual” in a glossary on the organization’s website:

Use of the term “transsexual” remains strong in the medical community because of the DSM’s prior use of the diagnosis “Transsexualism” (changed to “Gender Identity Disorder” in DSMIV).

Some people suggest that “transsexual” includes only those people who are in the process of changing, or who have changed, their anatomical sex to align with their gender identity. In older writings, such people were referred to as “true transsexuals” when they had moderate to high intensity gender dysphoria. Some people use “primary transsexual” or “early transitioner” to refer to people who have not had a significant adult life in their birth gender because they started or completed their gender affirmations during their teen years (or earlier) or at the latest in young adulthood. These people also use “secondary transsexual” or “late transitioner” for those people who start their transitions after the age of 30. The distinctions mentioned in this paragraph have resulted in some very heated discussions and are considered offensive to many people. It is highly recommended that clinicians not use these terms unless their clients bring them up in discussions.

The term “transsexual” is hotly debated, and it is not certain whether people will use or reject this term. For some, it is disliked in the same way “homosexual” has become disfavored. Many people find both transsexual and homosexual pejorative. “Transsexual” is considered by some to be a misnomer inasmuch as the underlying medical condition is related to gender identity and not sexuality.

So in the history of the term “transsexual,” its connotations have changed over time?
That’s a fair assessment. Writer and historian Cristan Williams has documented the transgender community quite exhaustively on her website. Williams explained that when Harry Benjamin, an endocrinologist, popularized the term “transsexual” in the middle of the 20th century, “he meant it as a taxonomy for all part/full-time cross-sex living people whether or not they took hormones and/or undertook any surgical intervention.” Over time, “trans” or “transgender” became the umbrella term and “transsexual” was seen as more clinical.

“More clinical” in a bad way?
Over time, people’s understanding of transgender people evolved and became more sophisticated. At the time, Benjamin was considered an expert on the topic, but reading his 1986 obituary in The New York Times, one sees just how dated the language, phrasing, and framing of the issue is. In a 2014 article for Slate, Hugh Ryan said the term “transsexual” was no longer the term to use “in part because it focused attention narrowly on physical sex.”

OK, so should I not use “transsexual”?
Well, as Fenway Health’s glossary suggested, it’s hotly debated. Not everyone opposes it. Some people will self-identify as “transsexual,” as Riki Wilchins explained in a 2017 piece for The Advocate. Wilchins, a transgender man who sometimes referred to himself as “transsexual,” wrote about how he had used the term “transsexual” in a group setting and it did not go over well:

I was giving my Gender 101 presentation to an important corporate client in the Bay Area recently when I got to terms and definitions. It was then I learned I am no longer a transsexual. I tried to define the difference between “transgender” and “transsexual” but was stopped by three young people — two of whom identified themselves as nonbinary — who took strong exception to the word “transsexual.”

“We don’t use that anymore,” they said. This was backed up by a young cisgender man, a UCLA queer studies major, who declared that the term was objectionable because it “medicalizes” trans people and inappropriately ties recognition of someone’s genital status — which is private — to their gender identity. So it was not only archaic but offensive.

So even a transgender person isn’t allowed to use the word?
Wilchins then made it a point to tell the room that he himself was transgender, and that allowed him a little more leeway, he explained:

So I explained that — ahem — I started my own transition in 1976 and that “transsexual” was indeed the term of art. We used it. Those around us used it. The book many of us read was titled The Transsexual Phenomenon. I cofounded a nationwide protest group called Transexual Menace. (No mistake, one s by intention.) And oh, yes, I had my own surgery before any of you were born.

The atmosphere in the room became instantly warmer. The straight white oppressive male had morphed into … an oppressed marginalized transgender person. So who is politically incorrect now? The sex change was on the other foot.

We are at an interesting place in queer discourse when it comes to the politics of trans self-description. There are now rules for what we can call ourselves. I love that trans people are now considered legit enough that we can finally enjoy the luxury of telling people how we’d like to be referred to.

How will I know whether to use “transsexual” or “transgender”?
As the GLAAD entry states, “transgender” is an umbrella term while “transsexual” is not. With these terms — and with most terms in the LGBTQ+ lexicon — it’s best not to apply a term to someone unless you know they would use that term. Some people will feel comfortable with “transsexual,” and others will not. If someone does want you to use “transsexual” to refer to them, they will probably let you know. But it’s best to not use it unless you know it’s what someone wants.

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