Transgender is the current umbrella adjective for people whose gender identity does not match the sex they were assigned at birth. Transsexual is an older, narrower, medical-origin word for people who have changed or want to change their body medically. Transgender is now standard. Transsexual is still used, mostly by people who claim it for themselves.
What does transgender mean?
Transgender is an adjective describing a person whose gender identity does not align with the sex assigned to them at birth. It requires no surgery, no hormones and no diagnosis. It covers trans men, trans women and, for many people, non-binary identities as well. The full entry is at transgender.
The important grammatical point: transgender is an adjective, not a noun and not a verb. "A transgender person" and "trans people" are correct. "A transgender", "transgendered" and "transgenders" are not, and read as dated or hostile.
What does transsexual mean, and where does the word come from?
Transsexual came out of twentieth-century medicine and originally described people who sought to change their physical sex characteristics. Its history is often reported wrongly, including in earlier versions of this page, so here it is carefully:
- 1923. Magnus Hirschfeld used the German phrase seelischer Transsexualismus, roughly "psychological transsexualism", in a lecture published in the Jahrbuch für sexuelle Zwischenstufen. He used it once, in passing, and never defined it. This is a real first appearance of the root, but it is not the coinage of the English word.
- 1949. The American physician David Oliver Cauldwell published "Psychopathia Transexualis" in the magazine Sexology, spelling it with one s. This is the first use of the English noun in something like its later sense. Cauldwell was hostile to surgery and treated the condition as a mental disorder.
- 1966. Harry Benjamin published The Transsexual Phenomenon, which put the word into general clinical use and, unlike Cauldwell, argued that medical transition was the appropriate response.
- 1990s. Transgender displaced transsexual as the umbrella term, largely because trans communities wanted a word that did not centre surgery or require a doctor's approval.
Transgender vs transsexual: side by side
| Transgender | Transsexual | |
|---|---|---|
| Scope | Umbrella: any gender identity that differs from sex assigned at birth | Narrower: historically tied to medical transition |
| Origin | Community and activist usage; standard umbrella from the 1990s | Clinical: Cauldwell 1949, popularised by Benjamin 1966 |
| Requires medical transition? | No | Historically implied it; in current self-description, varies |
| Includes non-binary people? | Generally yes, though some non-binary people do not use trans for themselves | Generally no, by historical definition |
| Current status | Standard in media, medicine, law and community use | Largely retired as a general term; retained by some individuals |
| Safe to apply to someone else? | Yes, if it is accurate | Only if they use it about themselves |
| Grammatical form | Adjective. Never "transgendered", never a noun | Adjective or noun historically; "transsexual person" if used at all |
Is transsexual an offensive word?
It depends entirely on who is using it and about whom.
Used by someone about themselves, it is not offensive at all. A number of trans people, particularly people who transitioned before the 1990s, use transsexual deliberately and prefer it. For some it names the specific medical experience they had. For others it is a refusal to have their history renamed by a younger vocabulary.
Used by an outsider about someone who has not claimed it, it usually lands badly. It carries the assumption that a person's genitals and surgical history are the relevant facts about them, which is the assumption most trans people spend their lives dealing with. The noun form, "a transsexual", is worse again.
The related word "transsexualism" is a diagnostic category, and it is being retired: the WHO's ICD-11, in force since 2022, replaced it with "gender incongruence" and moved it out of the mental and behavioural disorders chapter entirely.
Which word should I use?
For general writing and for talking about people in the abstract, transgender or trans. It is the current standard, it is the broadest, and it does not make claims about anybody's body.
For a specific person, use what they use. If someone says transsexual about themselves, use transsexual about them. If someone says trans woman, do not upgrade it to transsexual because you think it is more precise. This is the whole rule and it does not have exceptions.
If you are the person deciding what to call yourself: both words are available to you, neither is more legitimate, and you can use one word with your doctor and a different word with your friends. Some people also prefer other framings entirely, including simply "man" or "woman" with no modifier, or a word specific to their language and country rather than an English one.
Questions people ask
Are all transsexual people transgender?
In current usage, yes: transgender is the umbrella and transsexual sits inside it. Some people who use transsexual about themselves reject the umbrella, though, and prefer to be described only as transsexual. That is theirs to decide.
Does being transgender require surgery or hormones?
No. Transgender describes gender identity, not medical history. Many trans people have no medical transition at all, for reasons ranging from cost and waiting lists to simply not wanting it. None of that affects whether they are trans.
What is the correct term in Dutch, French and German?
In Dutch, transgender is standard, often as transgender persoon; transseksueel is dated in the same way as the English. In French, personne trans or transgenre is standard and transsexuel is dated. In German, trans Person or transgeschlechtlich is standard and transsexuell survives mainly in legal and medical texts, including the name of the old Transsexuellengesetz.
Why did the umbrella term change?
Because the old one built a medical requirement into the definition. Under the transsexual framing, whether you counted depended on what a clinician had agreed to do to your body. Transgender removed that gate, which mattered enormously to people who could not access care, did not want it, or were refused it.
Is "transgenderism" a word I should use?
No. It is not a neutral noun. It is used almost exclusively by people arguing that trans identity is an ideology rather than a fact about people, and it reads that way regardless of intent.
See also
This entry is never complete. If something here is wrong, out of date or missing, tell us and we will fix it.