He/She/They: How We Talk About Gender and Why It Matters

by Schuyler Bailar

Today, I am just who I am. I am Schuyler. My eyes well with tears. More than nineteen years of stumbling to get here. Just a few months ago, I was ready to quit swimming. A year ago, I was ready to quit the world and life altogether. But today, I am standing tall, a proud Korean American queer transgender swimmer on Harvard Men’s Swim and Dive—the first openly transgender athlete to compete for any D1 men’s team in the NCAA.

How could I connect with them? Because, in the end, the inability to connect is what breeds hatred and bigotry. That is, connection is the essence of our humanity itself.

Transgender is an adjective that describes people whose gender identity differs from the gender they were assigned at birth.

I was not “born a girl,” nor was my body “wrong.” No, I was born myself—a boy—and was assigned female at birth. My body is not “wrong”; my body followed the instructions it was given quite well! And still, at one point, my body did not fit me completely. Parts of my body felt foreign and misaligned. But I did not change my gender when I came out. I did not wake up one day and become a man or decide to be who I am. No, I decided to tell people about it.

Gender affirmation is an umbrella term that is more likely to be accurate and inclusive, in that it encompasses exactly what it is: a vague and therefore individualized process of affirming one’s gender—an identity that existed before any affirmation processes began.

Gender identity is an arrow pointing inward: it is who I am. Sexuality is an arrow pointing outward: to whom I am attracted.

Second, biological sex is not binary and cannot be reduced to one single factor. There are five main components of biological sex!

Chromosomes

Most people know of two variations of sex chromosomes: XX and XY, but several other variations also exist: XXY, XXX, XYY, and X.

Hormones

You’ve also likely been taught that testosterone is the “male” hormone and estrogen is the “female” hormone. But most people actually have both, just in differing concentrations.

Testosterone and estrogen are also not the only sex hormones—there are many types! Androgens include testosterone, androstenedione, and dehydroepiandrosterone, and estrogens include estrone, estradiol, estriol, and estetrol.

Hormonal Expression

This refers to the effects of hormones, sometimes called secondary sex characteristics, such as voice deepening or increased body hair with testosterone exposure.

Distinguishing between internal and external genitalia is crucial because these do not always develop in tandem; they do not always “match.” Some people born with testes also have a vagina and clitoris. While most bodies develop in neat categories labeled “male” and “female,” not all bodies do! The folks whose bodies do not fit these categories are called intersex, which literally means “between sex.”

Recognizing the complexity of biological sex does not negate or erase biology. Quite the opposite is true: defining sex by absolute categories of “male” and “female” erases biology.

Instead of a false binary, biological sex can be described by a bimodal distribution, with most bodies resembling two prototypes commonly labeled male and female. But these labels and prototypes are neither comprehensive nor absolute: diversity exists within and beyond them. Denying so is denying biology.

Scientists estimate that about 2 percent of the population is intersex.

But even if we consider only the lower estimate, 2 percent of the world population is still roughly 160 million people (in the 2020s), which is larger than the population of Russia. Just because Russians make up only 2 percent of the population does not mean they don’t exist. In similar statistical comparisons: about 2 percent of the world population has red hair, about 2 percent has green eyes. No one is claiming red hair or green eyes don’t exist.

According to the Merriam-Webster dictionary, a social construct is “an idea that has been created and accepted by the people in a society.”4 A social construct exists because humans agree that it does.5 Social constructs depend on people engaging with each other, and, without this interaction, they would be meaningless. However, because humans do interact with each other, social constructs are not, in fact, meaningless.

Because of the socially constructed importance money holds, most humans cannot exist without it. Simultaneously, if we collectively agreed one day that our rectangular green paper and circles of shiny metal alloy no longer carried any value, the dollar would become meaningless.

What made me this way? Did something happen in my brain’s biochemistry that made me this way? Are my chromosomes different? Is there a transgender gene? Finding nothing to support a biological reason for my transness, I had attempted to discard it.

Today, non-binary is largely regarded as an umbrella term. For some folks being non-binary means identifying somewhere between the binary “ends” (male and female) of gender, for some it means identifying as a combination of genders, and for others it means feeling a complete lack of gender altogether. For many folks, being non-binary entails liberation from the stereotypes and gender roles attached to the gender they were assigned at birth.

Hormone replacement therapy, often abbreviated as HRT, or sometimes as GAHT (Gender-Affirming Hormone Therapy), entails administering a cross hormone—one that is not produced at high concentrations during an individual’s puberty.

“But what about people using ‘they’? I just find it so hard. It’s not grammatically correct and I’m from a different generation than you are. So it’s hard for me.”

Consider the following scenario: You’re walking down the street and you see a wallet on the ground. What will you say? I bet you will exclaim, “Someone lost their wallet!” using they/them pronouns without hesitation.

Yes, change is hard, and yes, you can call someone they/them pronouns.

But at the heart of free speech rhetoric is one’s own agency—they argue that they should be allowed to use the words they want to describe others—isn’t that “free speech” after all? No, not exactly—telling someone else who they are through using incorrect pronouns is not about your self-expression, your own identity, or your beliefs. It’s about disregarding, demeaning, and controlling another person. In reality, respecting someone else’s identity and calling them the pronouns they’ve requested centers on recognizing another person’s self-determination and the ability to self-express—and costs you nothing.

While some trans people feel that coming out is discovering a completely new part of themselves, for a majority of trans people, “coming out” is less a process of becoming something new than an unearthing of a part of ourselves we’ve buried, finally finding the words to express who we’ve always been.

No one asks cis people, “Why are you cisgender?” Meanwhile, trans people are almost never granted the space to know ourselves simply by knowing. Instead, we are repeatedly demanded to explain, prove, and validate something we simply know to be true in our hearts.

Lastly, receiving treatment for gender dysphoria requires that an individual experiences gender dysphoria. It does not require being transgender—one does not get diagnosed as transgender; one gets diagnosed with gender dysphoria. Being transgender is not a medical condition.

While the DSM-5 has left some with hopes for more, the official depathologizing of trans identity aligns with what many trans activists have fought for—and what research has shown is effective: gender affirmation. The DSM-5, along with subsequent guidelines, has encouraged medical and mental health professionals to affirm gender identity instead of attempting to “correct” it.

I did not know any openly gay students at the time. Even when one of the girls at school came out a few years later in eighth grade, my mom would exclaim, “How would she know that? She’s so young!” I had known even younger. There must be something wrong with me, I’d concluded.

In a study by True Colors United, some 40 percent of youth experiencing homelessness are LGBTQ+, with the most commonly cited reason being familial rejection due to sexual orientation or gender identity. Fifty percent of LGBTQ+ teens receive a negative reaction from parents and more than a fourth of them are thrown out of their home and family.

A month or so later I went to a workshop called “A Gender Continuum.” It was held at a wonderful little LGBTQ+ education center called the YES Institute. My therapist had gently nudged me to go several weeks before I’d finally agreed. It wasn’t that I didn’t think attending would be a good idea—I knew it would be—it was that I was terrified of what it would elicit in me. What truths it would force me to confront. And wow, were my fears confirmed.

“When your child is crying and obviously in pain, what do you do?” He always pauses to allow the audience a moment to consider. “You hug them. You hold them. You be there. It’s that simple.”

Even with this privilege, my journey with my parents was not always easy. We did not always see eye to eye. I could always depend on their love, but not always their understanding.

This moment was about realizing that love is so much more important than understanding. My parents spent so much time trying to understand—or preoccupied with the fact that they did not understand—that they were forgetting to actually love me. To trust me. To let me be myself.

Most of us hold a deeply fallible unconscious belief: if we don’t understand something, it can’t be true/real/valid. But the world is filled with truths that I don’t understand. I do not quite understand how planes fly—and yet, they still do. And I trust that science so much, I fly in them all the time.

I don’t think being transgender is as complex as the physics of aeronautics, but if you do, that’s okay. You still don’t have to understand everything about transgender identity or a trans person’s experience to love and accept them. Using failure to “get it” as a reason to deny someone their truth, humanity, or autonomy is unkind and invalid.

Everyone is capable of committing negative actions that stem from systemic oppression because everyone has been steeped in and raised by these systems. Doing good doesn’t mean we are void of bias. Doing good means working to become aware of, unpack, and then act in opposition to the bias.

Trans people do not exist to exhibit shocking transformations. We are not girl-then-boy, or boy-then-girl. Again, most of us do not characterize our transitions as having changed genders, and asking for photos further legitimizes the gender binary and unnecessarily underscores the importance of our appearance. We are people with rich histories and nuanced stories. We are not a before and after. We are all a during and during.

Such legislation is bolstered through claiming that providing kids with gender-affirming healthcare hurts or damages the child. In reality, the exact opposite is true: denying care is abuse; denying care contributes to a number of negative mental health outcomes for children, including self-harm, depression, and suicide. This is backed up by peer-reviewed research, as well as by leading medical authorities.

Despite the fact that every major medical, psychological, and psychiatric association agrees gender-affirming healthcare is necessary, appropriate, and can be lifesaving, these state officials have arrogantly decided they know better.

Kids are absolutely capable of knowing their gender identity; this is supported by a few key facts: First, according to major medical associations like the Mayo Clinic, gender identity forms as early as three to five years old.21 Gender identity is usually established long before sexual orientation, but because many people confuse these, they assume that gender cannot be known prior to adolescence or adulthood. This is false. As soon as a child is able to verbalize their identity, they are capable of knowing it.

Invalidating a child’s understanding of themselves not only indicates to the child that they cannot trust you with declarations of self, but that the child should also learn to doubt themselves. This disruption of learning to trust oneself can become deeply rooted, disturbing the child’s very sense of self. Numerous studies have shown that invalidating childhood environments are hotbeds for the production of serious mental illness such as depression, eating disorders, and even personality disorders like borderline personality disorder and dissociative identity disorder.

As with adults, gender-affirming care can differ from child to child. Most gender affirmation before puberty includes no medical interventions at all. If a five-year-old child declares he is transgender—“Mom, I’m actually a boy!”—he might get a different haircut, new clothes, and perhaps use a new name and pronouns. No gender-affirming surgery is performed on a five-year-old. No hormones are provided at that age.

We don’t want to turn cis kids into trans kids. We want to make sure trans kids can grow into healthy, happy, and alive trans adults. The fear that providing accessible gender-affirming healthcare is going to make everyone transgender is not only unfounded, but also divisive and manipulative.

Myth: We have no research on puberty blockers and hormones; they’re not safe! Truth: This is false on both accounts. Puberty blockers are safe, and research supports that. Decreases in gender dysphoria, improvements in body image, reductions in depression and suicidality, and decreases in overall psychological distress are associated with not only access to puberty blockers, but also the timing of access to puberty blockers. Those who have access to puberty blockers earlier in puberty (as opposed to later when more effects of puberty have occurred) are even more likely to experience positive outcomes, including lower rates of suicidality.