1 Daisho

Words With Xual Reassignment

It seems for every letter and every color in the LGBTQI rainbow, there is a specialized language known only to members of that community and some of its allies. Navigating across the spectrum of lesbian, gay, bisexual, and transgender people, as well as those questioning, queer, and intersex, can be like stepping into a minefield if you don’t know the jargon. 

And when it comes to a group as outspoken — and as persecuted — as transgender people, there are many words which carry a negative connotation, or are used to describe actions or events that can be demeaning, condescending, and also triggering.

So, here are 10 of the terrible words used by and about those trans folks assigned male at birth (AMAB) and assigned female at birth (AFAB) as well as the gender-nonconforming — often referred to as GNC, just so you know. For those of us who are trans, perhaps you'll want to send a link to family and friends, to help them better understand you.

"Doxxing" isn't one of the offending words so much as it represents the act of doing something offensive. It's a word used so rarely that it may have escaped your attention. In March 2014, the Economistsought to explain the term, following a report by Newsweek revealing the identity of the man it said was the inventor of the Bitcoin.

"Doxxing" is short for “dropping documents,” a practice begun by hackers more than a decade ago. These hackers would collect and then reveal “personal and private information, including home addresses and national identity numbers," according to The Economist. "The data are often released publicly against a person’s wishes. It is a practice frowned upon by users of Reddit, a popular online forum, and many others.” 

Its most trans-related usage was in a lawsuit filed by lawyer and radical feminist activist Cathy Brennan last year against a journalist and the company that owns the AfterEllen website. Brennan claimed to have been defamed by the report, which said she harasses, outs, and “doxxes” transgender women. 

"TERF" is an acronym for Trans Exclusionary Radical Feminist, and is used to describe those radical feminists, like Brennan, who oppose inclusion of transgender women in spaces they reserve exclusively for women assigned female at birth. 

Brennan has refuted claims that this term applies to her and those who actively wage online campaigns against transgender women.

“People socially transition and decide to live as the opposite sex or how they think the opposite sex is. Good for you!” Brennan told The Advocate in July 2015. She continued:

“I think people should live their lives and be happy. The problem is when this conflicts with laws that are in place to protect women and girls.

“I have no interest in telling people what they should or shouldn’t do, and I’m especially not interested in telling women what they should or should not do because we are told what we should or shouldn’t do all the time, and I’m not contributing to that. Do I believe transition makes a female person male? Of course not.”

In her lawsuit against AfterEllen, Brennan claims that she does not support “irrational discrimination” against transgender people, but she made it clear in a July interview with The Advocate that she is strongly opposed to legislation to “afford biological males protection at the expense of the rights of women and girls,” as also stated in the lawsuit.  

Read more about the origin of "TERF" as explained by journalist and trans historian Cristan Williams on her website, The TERFs. 

"Deadnaming" someone who is transgender is a form of "doxxing," and is the practice of uttering or publishing the name that a trans person used prior to transition. Cisgender (nontrans) people often refer to this as a trans person’s “real” name, as if the name a trans person either uses or have legally had changed is somehow less real than the one given them at birth, when they were assigned male or female. It is seen as a verbally violent offense that attempts to invalidate a person’s authentic gender identity. 

A common practice among trans people on social media to avoid deadnaming is to use punctuation and a stand-in word to reflect a reference to a name they’d just as soon forget, such as <boyname> or using a single initial of the former first name. In some cases, a creative trans person might rely upon artistic license by referring to their former identity as “my twin.”

The most famous transgender woman in the world, Caitlyn Jenner, is perhaps also the most deadnamed person in the world. Why some news media keep doing it raises the question: is there anyone who doesn’t know she used to go by another name beginning with the letter “B?” 

But it’s not just conservative critics and religious right forces who aim to discredit Jenner’s transition and all trans people by using her former first name. Even The New York Times and the website for NBC’s Today show deadnamed her last week. NBC is owned by the same company that owns E!, home to Jenner's docu-series I Am Cait, and the show featuring her famous ex-wife and daughters, Keeping Up With The Kardashians.

Jenner legally changed her name in 2015 to Caitlyn Marie Jenner, and held a naming ceremony with friends that was featured in the season one finale of I Am Cait.

“Clocking” is insider lingo that got its start on the outside. To the rest of the English-speaking universe, it is colloquially used to define the measurement of time or speed, as when a police officer says “I clocked you at 75 in a 35 mile per hour zone, ma’am. License and registration, please.” For decades, it has also been used in boxing to describe the act of punching someone in the face violently. Boxing fans have long been heard uttering phrases like “He really cleaned his clock,” or “Wow, did he get clocked!” The Word Detective website says “clock” has been slang for the human face since the mid-19th century. 

But for those of us in the trans world, the term “clocked” is used to reflect that someone transgender has been recognized as trans, usually when that person is trying to blend in with cisgender people, and not intending to be seen as anything other than the gender they present.

"Clocking" is typically used by presentation-focused trans men and women to explain the crushing disappointment they feel, usually when cisgender people clock them, but also when someone trans does it. Another word is "read," as in "She read me," or "I got read as trans."

It should be noted not all trans people can or want to “blend in” or "pass" (more on that word later) to avoid being “clocked,” and many make peace with their gender presentation being at odds with what society dictates a man or woman "should" look like. 

Reddit and a multitude of Facebook groups also serve as good resources to read more about “clocking,” and why it is never, ever a good thing. 

Similar to outing someone against their will, this word is best defined as the outcome of the act of “clocking” someone trans. "Misgendering" someone is to label that person as a gender different from the one with which they identify.

When someone “misgenders” a trans person, it means they have said words to someone within earshot that erases the trans person's gender presentation. This can trigger any reaction, from anger, to panic, to "so what?" The key issue in misgendering is that the word spoken, broadcast, or published does not match that trans person's authentic gender presentation. 

All too often, trans women of color are misgendered by police or local media, who rely on legal identification and irrelevant prior arrests to report on the ongoing epidemic of murders of transgender women. Last year, at least 21 trans women were killed as a result of transphobic violence — nearly double the number killed in 2014.

It can be a huge blow when a trans man is called “miss” or a trans woman is addressed as “sir,” as seen in the Season 2 premiere episode of Transparent. The lead character, Maura Pfefferman, played by Jeffrey Tambor, is called “sir” by a wedding photographer, and opts to just walk away rather than call out the lensman for misgendering her.

“Passing” is among the most controversial of the 10 Terrible Trans Words, in that it represents two contrary perspectives on the transgender experience. 

To those whose aim is to be accepted as the gender with which they identify, “passing” is considered a worthy goal, and at the same time a very arbitrary determinant. “Passing” is to “blend-in,” and like beauty, can vary depending on the eye of the beholder. For many trans people, the pursuit of "passing" is rooted in a desire for safety — as being "clocked" as visibly trans can have deadly consequences, depending on who is doing the clocking. 

Detractors of trans women tend to focus on what they say are telltale signs of binary gender, such as above-average height, the size of hands and feet, facial hair or five o’clock shadow, Adam’s apple and broad shoulders. But they are ignoring the fact that with the exception of the Adam’s apple and five o’clock shadow, plenty of cisgender women are tall, broad-shouldered, battle unruly facial hair, and are stuck with the dreaded “man hands” and size 13 feet. These same transphobes might choose to say “passing is to be "mistaken for,” which is a perpetuation of the myth that trans women are by nature deceivers of cisgender men. 

While “passing” as male is equally important to many trans men, there is no apparent equivalent to the deception myth. However, many a trans man benefits from the effects of hormone therapy that allow him to “pass” in ways trans women can only wish would work in their favor. Where estrogen prompts the redistribution of fat and can help trans women develop breasts, testosterone has arguably more pronounced effects that are outwardly visible early in transition for many trans men. Testosterone deepens a trans man’s voice, allows him to grow facial and body hair equal to that of a cis male, and gives him the ability to pack on muscle mass that even those assigned male at birth would be lucky to acquire. 

But, as for trans women, there are certain characteristics that will not be impacted by hormone therapy for trans men, including several stereotypical aspects of being assigned female at birth. Trans men may have a smaller head, shorter-than-average height for males, and many feel the need for chest compression, binding, or “top surgery” to conceal or remove breasts, and wider than male-standard hips. These are all roadblocks for trans men who want to “pass” as men.

That, however, is not a priority for every trans man, or trans woman for that matter. Individuals not interested in passing may be so secure in their own identity and expression that binary-based societal judgments don’t concern them, or may recognize that their own physical, financial, or health conditions prevent them from even attempting to pass. These individuals — and others who openly embrace a nonbinary identity like many genderqueer, intersex, or gender-fluid people — don’t need help “passing;” they need society to broaden its concept of gender and expression and allow non-conformity to be an acceptable alternative to the male or female binary.

Much like those who still refer to gay people exclusively as "homosexuals," the majority of the people who use the word “transgenderism” are either biased against the community, such as the discredited anti-trans "expert"Dr. Paul McHugh, or harbor hatred toward the trans community, like the right-wing organization classified as a hate group by the Southern Poverty Law Center, the Family Research Council.

TERFs like Sheila Jeffreys use the word to dismiss trans identity as nothing more than an expression of cultural stereotypes. Jeffreys is quoted in pieces such as The New Yorker, claiming those who de-transition serve as “evidence that transgenderism isn’t immutable and thus doesn’t warrant radical medical intervention.” (She considers gender-reassignment surgery a form of mutilation.)

GLAAD calls the term “problematic” and includes it in its media reference guide as one of the “terms to avoid:” 

“This is not a term commonly used by transgender people. This is a term used by anti-transgender activists to dehumanize transgender people and reduce who they are to 'a condition.' Refer to 'being transgender' instead, or refer to 'the transgender community.' You can also refer to 'the movement for transgender equality.'"

The word “sex change” dates back to when Christine Jorgensen made headlines in 1952, as the Caitlyn Jenner of her day. Most dictionaries still have the words “sex change” in them, to define “a change in a person's physical sexual characteristics, typically by surgery and hormone treatment.” So what’s so terrible about the term?

It’s not the worst of the bunch but it’s far from accurate. It’s also not a preferred term, and to many in the trans community, it’s insulting. 

To those looking in from the outside, "sex change" seems to be the perfect description: one day you’re a woman, now you’re a man. You changed your sex. 

Well, not really. To understand why “sex change” is a terrible thing to say, understand that “sex” is a stand-in for the word “gender.” Gender doesn’t really change when someone undergoes an operation that for decades was commonly called a “sex change,” or more recently, “sexual reassignment surgery.” Someone who identifies as female — regardless of their sex assigned at birth — doesn’t change, so much as work to align their physical appearance and anatomy with the gender they know themselves to be. 

That’s why the term “gender reassignment” came about, to better explain that a person assigned male at birth was given a treatment or surgery to live as a female. But that, too, raised heckles, and that is where we get the terms “gender-confirmation surgery” and “gender-affirming surgery,” two more accepted terms that emphasize the treatment and surgery not so much as a transformation but as an acknowledgement that the mind and body needed realignment. 

It should also be noted these kinds of surgeries vary from person to person, and not every trans person wants, needs, or has access to any surgical intervention as part of their transition. Surgery is not "the end" of transition for many trans people, and asking "have you had 'the surgery'?" is just about the rudest question imaginable, as Katie Couric learned the hard way.

“Oh ignore that beyotch. She’s so Triple T.”

“Triple T” stands for "Trannier Than Thou," and that first word is most definitely a slur. So, make no mistake, this is a put-down; an expression meant to criticize someone transgender who has either taken the position or exhibited behavior that indicates their transition was (or is) somehow better than another trans person’s. Such a proclamation more often than not carries with it a lot of attitude and swagger, sometimes unjustified to others. 

"Triple T" can involve many factors, most typically “passing” and “stealth mode,” which is the act of not being detected as anything other than the gender being presented. Transgender people who never come out to their coworkers or friends or partners are described as being “stealth.”

Number 10 on the list of Terrible Trans Words also includes that ugly slur, and will not be repeated here for that reason — although it is a word used by many within the community and sometimes by outsiders, but almost always derisively. 

Combined with “chaser,” this term describes a suitor, usually a man, whose sexual yearnings are to hook up with the object of his desire: a transsexual or transgender woman. The term often refers to those who seek out trans people solely because of their trans identity, rather than those who happen to be attracted to someone who is transgender. It can also appl to a predator, and/or a fetishist. 

As for the words “transgender” and “transsexual,” some people in the community use them interchangeably, while others prefer “transsexual” to mean only those have either undergone or are intending to have gender-affirming surgery. Transgender is typically a more broad, “umbrella” term used to describe anyone whose gender assignment at birth does not match their gender identity. 

Bottom line on these “chasers:” it’s not meant to be flattering. Some have derided men attracted to trans women as "gay," as if that were a bad thing. But it's worth noting that the term does not typically apply to a heterosexual man who is attracted to a woman who is trans. 

In simpler language, that is what is called a “man” who is turned on by a “woman.” Also known as a heterosexual.  

Sex assignment (sometimes known as gender assignment) is the determination of an infant's sex at birth.[1] In the majority of births, a relative, midwife, nurse or physician inspects the genitalia when the baby is delivered, and sex and gender are assigned, without the expectation of ambiguity.[2] Assignment may also be done prior to birth through prenatal sex discernment.

In the majority of cases, the gender of the child matches the child's gender identity. The act of assignment carries the implicit expectation that future gender identity will develop in alignment with the physical anatomy, assignment, and rearing.[3]

In some cases, sex or gender assignment does not align with future gender identity, and the assignment can be problematic. People who have a gender identity or gender expression that differs from that associated with their assigned sex may identify themselves as transgender or gender non-conforming (GNC).[4][5][6] In the case of intersex individuals born with sex characteristics, such as chromosomes, gonads, hormones or genitals, that do not fit typical notions of female or male bodies,[7] there may be complications in making a sex assignment[8] and that assignment may not be consistent with the child's future gender identity.[9] Reinforcing sex assignments through surgical and hormonal means may violate the individual's rights.[10][11][12][13]


Sex assignment is the determination of an infant's sex at birth. Terms that may be related to sex assignment are:

Assigned male at birth (AMAB): a person of any age and irrespective of current gender whose sex assignment at birth resulted in a declaration of "male". For example, when an attending midwife or physician announces, "It's a boy!" Synonyms: male assigned at birth (MAAB) and designated male at birth (DMAB).[14][15]

Assigned female at birth (AFAB): a person of any age and irrespective of current gender whose sex assignment at birth resulted in a declaration of "female". For example, when an attending midwife or physician announces, "It's a girl!" Synonyms: female assigned at birth (FAAB) and designated female at birth (DFAB).[14][15]

Intersex, in humans and other animals, describes variations in sex characteristics including chromosomes, gonads, sex hormones, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies".[7] These may complicate the sex assignment of an infant at birth or lead to an erroneous assignment.[8][9]

Transgender people have a gender identity, or gender expression, that differs from their assigned sex.[4][5][6] Transgender people are sometimes called transsexual if they desire medical assistance to transition from one sex to another.

Sex reassignment : a treatment program consisting of a combination of psychological, medical, and surgical methods intended to physically change a person's sex to match their gender identity.


The discernment of an infant's sex is almost universally considered an observation or recognition of an inherent aspect of a baby.[1] The rationales for sex assignment and consequential registration appear to have been little questioned. A Dutch report on gender registration states that sex registration was introduced in 1811 as an intrinsic component in population registration, due to gender-specific rights and responsibilities, such as military conscription.[16] Many discriminatory provisions in legislation no longer exist, but the provisions remain for rationales that include "speed of identification procedures".[16]

Assignment in cases of infants with intersex traits, or cases of trauma[edit]

Main articles: Intersex medical interventions and History of intersex surgery

Observation or recognition of an infant's sex may be complicated in the case of intersex infants and children, and in cases of early trauma. In such cases, sex assignment is generally taken to require medical treatment to confirm that assignment, but this is disputed in part due to the human rights implications of such treatment.[7][17]

Intersex is a broadly defined term that usually denotes the presence of atypical sex characteristics: at least some aspect of the genitalia, internal organs, secondary sex characteristics, gonadal tissue, or chromosomes is more typical of the other sex. When the external genitalia appear to be in between, they are described as ambiguous.[18] The intersex population is one that is not necessarily large. In the U.S., about 1 in 2000 babies born are intersex. Due to nonconsensual reassignment surgery many intersex people go about their lives in the gender that was chosen for them in a lot of cases. Not having the choice to choose their own gender can lead to depression and anxiety due to confusion and possible isolation.[19]

Cases of trauma include the famous John/Joan case, where sexologist John Money claimed successful reassignment from male to female at age 17 months of a boy whose penis was destroyed during circumcision. However, this claim was later shown to be largely false. The subject, David Reimer, later identified as a man.

In approximately 1 in 2,000 infants, there is enough variation in the appearance of the external genitalia to merit hesitation about appropriate assignment by the physician involved.[20] Typical examples would be an unusually prominent clitoris in an otherwise apparently typical girl, or complete cryptorchidism in an otherwise apparently typical boy. In most of these cases, a sex is tentatively assigned and the parents told that tests will be performed to confirm the apparent sex. Typical tests in this situation might include a pelvic ultrasound to determine the presence of a uterus, a testosterone or 17α-hydroxyprogesterone level, and/or a karyotype. In some of these cases a pediatric endocrinologist is consulted to confirm the tentative sex assignment. The expected assignment is usually confirmed within hours to a few days in these cases.

In a much smaller proportion of cases, the process of assignment is more complex, and involves both determining what the biological aspects of sex may be and choosing the best sex assignment for the purposes of rearing the child. Approximately 1 in 20,000[citation needed] infants is born with enough ambiguity that assignment becomes a more drawn-out process of multiple tests and intensive education of the parents about sexual differentiation. In some of these cases, it is clear that the child will face physical difficulties or social stigma as he or she grows up, and deciding upon the sex of assignment involves weighing the advantages and disadvantages of either assignment.


Nothing currently appears to be known about sex discernment prior to the medicalization of intersex. However, in European societies, Roman law, post-classical Canon law, and later Common law, referred to a person's sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant. Under Roman law, a hermaphrodite had to be classed as either male or female.[21] The 12th-century Decretum Gratiani states that "Whether an hermaphrodite may witness a testament, depends on which sex prevails".[22][23][24] The foundation of common law, the 16th Century Institutes of the Lawes of England described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile."[25][26] Legal cases where sex assignment was placed in doubt have been described over the centuries.

With the medicalization of intersex, criteria for assignment have evolved over the decades, as clinical understanding of biological factors and diagnostic tests have improved, as surgical techniques have changed and potential complications have become clearer, and in response to the outcomes and opinions of adults who have grown up with various intersex conditions.

Before the 1950s, assignment was based almost entirely on the appearance of the external genitalia. Although physicians recognized that there were conditions in which the apparent secondary sexual characteristics could develop contrary to the person's sex, and conditions in which the gonadal sex did not match that of the external genitalia, their ability to understand and diagnose such conditions in infancy was too poor to attempt to predict future development in most cases.

In the 1950s, endocrinologists developed a basic understanding of the major intersex conditions such as congenital adrenal hyperplasia (CAH), androgen insensitivity syndrome, and mixed gonadal dysgenesis. The discovery of cortisone allowed survival of infants with severe CAH for the first time. New hormone tests and karyotypes allowed more confident diagnosis in infancy and prediction of future development.

Sex assignment became more than choosing a sex of rearing, but also began to include surgical treatment. Undescended testes could be retrieved. A greatly enlarged clitoris could be amputated to the usual size, but attempts to create a penis were unsuccessful. John Money and others controversially believed that children were more likely to develop a gender identity that matched sex of rearing than might be determined by chromosomes, gonads, or hormones. The resulting medical model was termed the "Optimal gender model."[27]

The view of gender as a purely social construction, and gender identity as a result of nurture rather than nature reached near-universal acceptance, especially among liberal, progressive, and academic portions of Western society. The primary goal of assignment was to choose the sex that would lead to the least inconsistency between external anatomy and assigned psyche (gender identity). This led to the recommendation that any child without a penis or with a penis too small to penetrate a vagina could be raised as a girl, taught to be a girl, and would develop a female gender identity, and that this would be the best way to minimize future discrepancy between psyche and external anatomy in those infants determined to be biologically male but without a penis that meets medical norms (e.g., cloacal exstrophy), and also in those like in the John/Joan case who lost it to accidental trauma in early infancy.

From the 1960s, pediatric surgeons attempted and claimed success with reconstruction of infant genitalia, especially enlargement or construction of vaginas. The recommended rules of assignment and surgery from the late 1960s until the 1990s were roughly:

  • Any XX infant, no matter how virilized, should be raised as a girl to preserve the chance of future fertility. A large, protruding clitoris should be reduced in size with a nerve-sparing recession or reduction rather than simple amputation.
  • Any undervirilized XY infant should be raised as a boy if the penis could be expected to be large enough to stand to urinate and to insert into a vagina for coitus. If it was too small or atypically formed (e.g., cloacal exstrophy) for these functions, it was recommended that the baby be assigned as female, any gonads removed, a vaginal opening surgically constructed, and estrogen provided at puberty.
  • An infant with mixed chromosomes (e.g., mixed gonadal dysgenesis or true hermaphroditism) could be raised either way depending on appearance of genitalia and size of phallus.
  • Gender identity is set by 2 years of age and reassignment after that age should not be attempted unless requested by the patient.[citation needed]
  • Non-disclosure of the intersex condition to the individual on whom sex assignment treatment was conducted.[28][29]

Since the 1990s, a number of factors have led to changes in the recommended criteria for assignment and surgery. These factors have included:

  • Public disclosure by intersex individuals and organizations about unsatisfactory sexual function or incongruent gender identity, and criticism of infant surgery for "psychosocial rationales".
  • In 1997, the rest of David Reimer's story, referred to above as John Money's John/Joan case, was made public. He was the boy who had lost his penis to a botched circumcision at 8 months in 1966, was reassigned from boy to girl at 18 months with further surgery to remove testes and estrogen treatment beginning at age 12. Although John Money had described the reassignment as a success in the 1970s, Reimer went public with his account of continuing to have a male gender identity despite the reassignment to a female sex of rearing. At age 15, Reimer reverted to living as a male. At age 38, he committed suicide.
  • A large proportion of XY infants born with cloacal exstrophy and raised as female from early infancy have requested reassignment to male gender in late childhood and adolescence.

Clinical recommendations in the 2000s for assignment changed as a result:

  • Raise nearly all XX infants with functional ovaries as female. The only rare exception would be completely and unambiguously virilized XX infants with CAH, who might be raised as male with genital surgery deferred.
  • Raise most ambiguous XY infants with testes as male unless the external genitalia are more female than male, marked androgen insensitivity is present, and testes are absent or non-functional. Raise as male any XY infant with unambiguous micropenis. Raise as male any XY infant with functional testes and normal androgen sensitivity but atypically formed or absent penis.
  • Raise infants with mixed gonadal tissue, true hermaphroditism, or other chromosome anomalies as the sex most consistent with external genitalia, since gonads are usually nonfunctional.
  • Gender identity is set by 1–2 years of age and reassignment after that age should not be attempted unless requested by the patient.

These recommendations do not explicitly necessitate surgical or hormonal interventions to reinforce sex assignments, but such medical management persists worldwide, utilizing rationales such as the mitigation of parental distress and trauma, reducing the likelihood of stigma, making a child feel more "normal", and improving marriage prospects.[30]


Further information: Intersex human rights

Controversies over surgical aspects of intersex management, have often focused on controversies regarding indications for surgery and optimal timing. However, intersex and human rights organizations have criticized medical models as they are not based on the consent of the individuals on whom such irreversible medical treatments are conducted, and outcomes may be inappropriate or poor.[30][31]Anne Tamar-Mattis, for example, states that, "The true choice is not between early and late [surgery], but early surgery versus patient autonomy.[31] Human rights institutions now refer to such practices as "harmful practices".[10]

However, while surgical interventions remain experimental, and clinical confidence in constructing "normal" genital anatomies has not been borne out, medically credible pathways other than surgery do not yet exist.[32] Changes to clinical recommendations in the current millennium do not yet address human rights concerns about consent, and the child's right to identity, privacy, freedom from torture and inhuman treatment, and physical integrity.[9][11][12]

In 2011, Christiane Völling won the first successful case brought against a surgeon for non-consensual surgical intervention. The Regional Court of Cologne, Germany, awarded her €100,000.[33]

In 2015, the Council of Europe recognized, for the first time, a right for intersex persons to not undergo sex assignment treatment, identifying issues with the pathologization of intersex bodies as inherently disordered.[9] In April 2015, Malta became the first country to recognize a right to bodily integrity and physical autonomy, and outlaw non-consensual modifications to sex characteristics. The Act was widely welcomed by civil society organizations.[34][35][36][37][38]

Reassignment of sex or gender[edit]

Main articles: Sex reassignment therapy and Sex reassignment surgery

Sex reassignment is to a change in gender role or identity after an original and presumably incorrect sex assignment in infancy. This may occur in several types of circumstances.

  • An early reassignment may be made to correct a clear error. The most common example of this is when a newborn is assumed to be a boy and assigned as such despite absent testes. If at 1–4 weeks of age it is discovered because of newborn screening, a salt-wasting crisis, or investigation of the cryptorchidism that he has ovaries, uterus, an XX karyotype, and CAH, the child is likely to be reassigned as female. When virilization is complete and unambiguous, reassignment may be declined or deferred. Any reassignment after the first month or two is no longer considered an "early reassignment".
  • There have been cases where a male infant has been reassigned to female at several days, weeks, or months of age because of an irreparable birth defect of the genitalia or loss of the penis to trauma or other accident. This is no longer recommended by most experts in the field because of the publicity surrounding similar failed reassignments which became public in the 1990s, such as that of David Reimer.
  • There have been cases where a child with an intersex condition has rejected a sex of rearing, asserted an opposite gender identity, and requested reassignment. Examples of this have occurred in adolescents with several forms of CAH and 5-alpha-reductase deficiency.
  • The most common type of reassignment occurs when a child or adult with no detectable intersex condition assumes a different gender identity, and either requests or asserts the recognition of their new asserted gender. Such a person, and the general spectra of identities incongruous with gender assignment, is described as transgender. Therapy and/or surgery may be performed in adulthood and, since the 2000s, adolescence to align their body with their gender identity. People who seek these processes often form a subset identity among transgender people known as transsexual, albeit not all may identify as such.

Challenges to requirements for sex assignment[edit]

In recent years, the perceived need to legally assign sex is increasingly being challenged.[16][39] A report for the Dutch Ministry of Security and Justice states "Gender increasingly seems to be perceived as a ‘sensitive’ identity feature, but so far is not regarded, nor protected as such in privacy regulations".[16] Australian government guidelines state that "departments and agencies that collect sex and/or gender information must not collect information unless it is necessary for, or directly related to, one or more of the agency’s functions or activities"[40]

See also[edit]


  1. ^ abReiner WG (October 1997). "Sex assignment in the neonate with intersex or inadequate genitalia". Arch Pediatr Adolesc Med. 151: 1044–5. doi:10.1001/archpedi.1997.02170470078014. PMID 9343017. 
  2. ^Reiner WG (2002). "Gender identity and sex assignment: a reappraisal for the 21st century". Adv. Exp. Med. Biol. 511: 175–89; discussion 189–97. doi:10.1007/978-1-4615-0621-8_11. PMID 12575762. 
  3. ^Shaw, Alison; Ardener, Shirley (2005). Changing sex and bending gender, p. 21. Berghahn Books, ISBN 978-1-84545-099-1
  4. ^ abTerry Altilio, Shirley Otis-Green (2011). Oxford Textbook of Palliative Social Work. Oxford University Press. p. 380. ISBN 0199838275. Archived from the original on December 1, 2016. Retrieved April 12, 2016.  
  5. ^ abCraig J. Forsyth, Heith Copes (2014). Encyclopedia of Social Deviance. Sage Publications. p. 740. ISBN 1483364690. Archived from the original on December 1, 2016. Retrieved April 12, 2016.  
  6. ^ abMarla Berg-Weger (2016). Social Work and Social Welfare: An Invitation. Routledge. p. 229. ISBN 1317592026. Archived from the original on December 1, 2016. Retrieved April 12, 2016.  
  7. ^ abcUnited Nations; Office of the High Commissioner for Human Rights (2015). Free & Equal Campaign Fact Sheet: Intersex(PDF). Archived(PDF) from the original on 2016-03-04. 
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