What Transgender Means
Transgender describes a person whose gender identity does not match the sex they were assigned at birth. Gender identity is a person’s inner sense of their own gender. The American Psychiatric Association uses the word for a person whose sex assigned at birth “does not align with their gender identity.” Sex at birth is “usually based on the appearance of external genitalia,” the APA notes (American Psychiatric Association). A person whose gender identity matches the sex assigned at birth is cisgender.
Key facts
- The American Psychiatric Association says the term transgender “is not a psychiatric diagnosis” (APA).
- The World Health Organization moved gender incongruence out of its mental disorders chapter in ICD-11 (WHO).
- Over 2.8 million Americans 13 and older, 1.0%, are transgender (Williams Institute).
- Under Title VII, employers cannot fire someone for being transgender. The Supreme Court ruled 6-3 in Bostock v. Clayton County (2020) (Supreme Court).
Being transgender is not a mental illness, according to the American Psychiatric Association and the WHO. The WHO moved gender incongruence into a new chapter on sexual health because, in its words, “trans-related and gender diverse identities are not conditions of mental ill-health, and that classifying them as such can cause enormous stigma” (WHO). Some transgender people experience gender dysphoria, the distress that can come from the mismatch, and that distress is a diagnosis. Our gender dysphoria guide covers the diagnosis, and our gender-affirming care guide covers treatment and the laws around it.
What LGBTQ Stands For
LGBTQ stands for lesbian, gay, bisexual, transgender and queer. The Human Rights Campaign, an LGBTQ advocacy group, adds a ”+” to recognize other sexual orientations and gender identities (Human Rights Campaign). The letters describe two different things. L, G and B describe sexual orientation, meaning who a person is attracted to. T describes gender identity. Q is used both ways.
Gallup found that 9% of U.S. adults identified as LGBTQ+ in 2025, and 12% of those adults identified as transgender. Among adults under 30, the LGBTQ+ share was 23% (Gallup, February 2026).
Gender and Identity Terms Defined
Medical groups separate sex assigned at birth, gender identity, gender expression and sexual orientation. A person’s place on one does not predict the others. The table uses the American Psychiatric Association’s and the WHO’s definitions in plain words.
Gender and identity terms in medical definitions
How Many Americans Are Transgender
Over 2.8 million Americans 13 and older are transgender, or 1.0% of that population. That includes over 2.1 million adults (0.8%) and about 724,000 teens ages 13 to 17 (3.3%), according to the Williams Institute at UCLA School of Law, which analyzed federal health surveys from 2021 to 2023 (Williams Institute, August 2025).
- 2.8M
- Transgender Americans 13 and older
- 1.0%
- Share of people 13 and older
- 3.3%
- Share of teens 13 to 17
- 12%
- Share of LGBTQ+ adults who are transgender (Gallup)
Younger people identify as transgender at higher rates. In the Williams estimate, 76% of transgender people 13 and older are under 35. People 65 and older make up 20.8% of the population 13 and older but 5.4% of transgender people, and teens make up 25.3%.
| Category | Value |
|---|---|
| 13 to 17 | 3.3% |
| 18 to 24 | 2.7% |
| 25 to 34 | 1.4% |
| 35 to 64 | 0.4% |
| 65 and older | 0.3% |
Source: Williams Institute, UCLA School of Law, August 2025, Table 1. Adults from the 2021-2023 Behavioral Risk Factor Surveillance System; teens from the 2023 Youth Risk Behavior Survey.
Transgender adults divide almost evenly among three groups. The Williams Institute estimates that 34.2% are transgender men, 32.7% are transgender women and 33.1% are nonbinary. The adult figures count people who answered yes to the survey question “Do you consider yourself to be transgender?” (Williams Institute).
Gender Identity and Sexual Orientation Are Separate
Gender identity is about who a person is, and sexual orientation is about who they are attracted to. The American Psychiatric Association defines the two separately (APA). A transgender person, like a cisgender person, can be straight, gay, bisexual or another orientation. That is why transgender rights and same-sex marriage are different legal questions, even though both fall under LGBTQ rights.
Where Transgender Rights Stand in 2026
Federal job protection holds, while federal policy on sex markers, medical care and military service has moved against transgender people. In Bostock v. Clayton County, decided June 15, 2020 by a 6-3 vote, the Supreme Court ruled that “an employer who fires an individual merely for being gay or transgender defies the law” (Supreme Court). Since January 2025, an executive order has set the federal meaning of sex. Executive Order 14168 tells agencies that “sex” means “an individual’s immutable biological classification as either male or female” (Federal Register). The Supreme Court has upheld Tennessee’s ban on some medical treatments for transgender minors. In a later case, it held that states “may maintain women’s and girls’ sports for biological females” (West Virginia v. B. P. J.). Our anti-LGBTQ movement guide and transphobia guide track the wider fight.
Federal Rules and Court Cases Affecting Transgender People
As of October 14, 2026
- Federal definition of sex Agency action
Executive Order 14168, signed January 20, 2025, makes it federal policy "to recognize two sexes, male and female," defined by the sex a person belongs to "at conception." (source)
- Passports marked by sex at birth In litigation, policy in effect
The Supreme Court let the policy take effect on November 6, 2025, while the case continues. (source)
- Executive Order 14187 funding cutoff Blocked by a court, funding provisions
A nationwide injunction in PFLAG v. Trump, and one covering Washington, Oregon, Minnesota, and Colorado, still block it. The Fourth Circuit denied a stay on April 16, 2026, refused full-court review of that denial on May 21, and the appeal continues. (source)
- Gender-affirming care bans for minors Final ruling, bans upheld
United States v. Skrmetti upheld Tennessee's ban 6-3 on June 18, 2025. Chief Justice Roberts wrote that the law does not "violate the equal protection guarantee of the Fourteenth Amendment." (source)
- Transgender girls in school sports Final ruling, ruled for the states
On June 30, 2026, in West Virginia v. B. P. J. and Little v. Hecox, the Court held 6-3 that the Equal Protection Clause allows both states' laws, and reversed rulings for both students. The three dissenters agreed B. P. J.'s Title IX claim fails and would have dismissed Hecox's case as moot. (source)
- Military service ban In litigation, policy in effect
On May 6, 2025, the Supreme Court let the ban take effect while the Ninth Circuit appeal goes forward. On June 1, 2026, a divided D.C. Circuit panel kept an injunction for the named plaintiffs already serving and lifted it for those seeking to enlist. (source)
Source: Supreme Court dockets and opinions; D.C. Circuit; Federal Register; Lambda Legal
Common Questions About Transgender People
What does transgender mean?
Transgender describes a person whose gender identity, their inner sense of their own gender, does not match the sex they were assigned at birth. The American Psychiatric Association notes that transgender is not a psychiatric diagnosis. A person whose gender identity matches their sex assigned at birth is cisgender.
What does LGBTQ stand for?
Lesbian, gay, bisexual, transgender and queer, in the Human Rights Campaign’s definition, with a “+” to recognize other sexual orientations and gender identities. L, G and B describe sexual orientation, meaning who a person is attracted to. T describes gender identity.
How many people are transgender in the U.S.?
The Williams Institute at UCLA estimates that over 2.8 million people 13 and older, 1.0% of that population, identify as transgender, including over 2.1 million adults (0.8%) and 724,000 teens ages 13 to 17 (3.3%). Gallup found that 12% of LGBTQ+ adults identify as transgender.
Is being transgender a mental illness?
No. The American Psychiatric Association says transgender is not a psychiatric diagnosis, and the World Health Organization moved gender incongruence out of its chapter on mental disorders in ICD-11. Some transgender people experience gender dysphoria, the distress that can come from the mismatch, which is a diagnosis.
What is the difference between gender identity and sexual orientation?
Gender identity is a person’s sense of their own gender. Sexual orientation is who they are attracted to. They are separate: transgender people, like cisgender people, can be straight, gay, bisexual or another orientation.
What does nonbinary mean?
Nonbinary describes a person who does not identify only as a man or a woman, in the Human Rights Campaign’s definition. The Williams Institute estimates that about a third of transgender adults are nonbinary.
What You Can Do
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Learn the rules where you live. State laws on medical care, school sports and ID documents differ. Our gender-affirming care guide has a state map.
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Use the medical definitions when the words are in dispute. The American Psychiatric Association’s and the WHO’s own words, linked above, settle what the terms mean in medicine.
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Know the crisis lines. The Trevor Project (1-866-488-7386, text START to 678-678) serves LGBTQ young people, and Trans Lifeline (877-565-8860) serves transgender people.
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Tell your members of Congress where you stand on federal rules that define sex or limit care, and ask for a clear answer.