Some Quick Facts About Transgender People

Recently, the US government sued North Carolina over HB2, the restroom bill. I found that the section that describes transgender people remarkably enlightened, and included things that I hadn’t known until entirely too recently. Thus, I’ve included paragraphs 30-42 from the court filing here. (Link to original document.)

30. Individuals are typically assigned a sex on their birth certificate solely on the basis of the appearance of the external genitalia at birth. Additional aspects of sex (for example, chromosomal makeup) typically are not assessed and considered at the time of birth, except in cases of infants born with ambiguous genitalia.
31. An individual’s “sex” consists of multiple factors, which may not always be in alignment. Among those factors are hormones, external genitalia, internal reproductive organs, chromosomes, and gender identity, which is an individual’s internal sense of being male or female.
32. For individuals who have aspects of their sex that are not in alignment, the person’s gender identity is the primary factor in terms of establishing that person’s sex. External genitalia are, therefore, but one component of sex and not always determinative of a person’s sex.
33. Although there is not yet one definitive explanation for what determines gender identity, biological factors, most notably sexual differentiation in the brain, have a role in gender identity development.
34. Transgender individuals are individuals who have a gender identity that does not match the sex they were assigned at birth. A transgender man’s sex is male and a transgender woman’s sex is female.
35. A transgender individual may begin to assert a gender identity inconsistent with their sex assigned at birth at any time from early childhood through adulthood. The decision by transgender individuals to assert their gender identity publicly is a deeply personal one that is made by the individual, often in consultation with family, medical and health care providers, and others.
36. Gender identity is innate and external efforts to change a person’s gender identity can be harmful to a person’s health and well-being.
37. Gender identity and transgender status are inextricably linked to one’s sex and are sex-related characteristics.
38. Most states authorize changing the sex marker on one’s birth certificate, but the requirements for doing so vary and are often onerous. Specifically, many states require surgical procedures. At least one state does not allow persons to change the sex marker on their birth certificates.
39. Individuals born in North Carolina must have proof of certain surgeries, such as “sex reassignment surgery,” in order to change the sex marker on their birth certificates. N.C. Gen. Stat. § 130A-118(b)(4).
40. Surgery related to gender transitioning is generally unavailable to children under age 18.
41. In addition, the great majority of transgender individuals do not have surgery as part of their gender transition. Determinations about such surgery are decisions about medical care made by physicians and patients on an individual basis. For some, health-related conditions or other medical criteria counsel against invasive surgery. For others, the high cost of surgical procedures, which are often excluded from health insurance coverage, present an insurmountable barrier.
42. Standards of medical care for surgery related to gender transitioning generally advise that transgender individuals present consistent with their gender identity on a day-to-day basis across all settings of life, including in bathrooms and changing facilities at school and at work, for a significant time period prior to undergoing surgery.