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Everything you've always wanted to know about trans issues (but were afraid to ask)

Writing for NS Trans Issues Week, Jennie Kermode outlines the facts about trans issues and language - an area where prejudice and confusion so often get in the way.

A person holds a placard reading "I am the one who decide how I dress and not your standards" as he takes part in the 16th Existrans in France. Photograph: Getty Images

1. What is the difference between a transvestite and a transsexual person?

A transsexual person needs a permanent change of gender role, often accompanied by bodily changes, in order to feel comfortable. A transvestite, also called a cross dresser, is a man who dresses in a way usually associated with women, or vice versa. For some transvestites this is just a bit of fun or a way of challenging gender norms; for others it reflects a deep seated need. Some people go through a stage of cross dressing on the way to coming out as transsexual.

2. I've seen people talking about trans* issues. What is the asterisk for?

The asterisk shows that "trans" is being used as an umbrella term, covering not just transsexual people but also transvestites and people who don't identify as male or female.

3. Why do some people in the trans* community find "tranny" problematic?

It's a word that has strong associations wth pornography and it's often shouted at people in the street in an abusive way. This can be accompanied by a threat of violence — sadly not uncommon — so people are reminded of that fear when they encounter the word elsewhere.

4. What happens when a person transitions from one gender to another - what's the process?

There's no one-size-fits-all procedure. The primary process is psychological and social — learning to fit into a different social role and hoping loved ones can adjust to that. Most people take hormones, which can make them feel more mentally relaxed even before starting to change their bodies. Many go on to have surgery.

5. Do all trans people have surgery?

No. Some people are not able to, for medical reasons. For others, intimate changes don't feel necessary as long as their gender is generally accepted — after all, when we meet strangers, we don't usually need to see their genitals to decide what gender we think they are. Many trans men have breasts removed but don't have genital surgery because it carries a risk of urological problems. This means that the notion of "pre-op" and "post-op" trans people is misleading. For many, changing social role is a much bigger deal anyway.

6. What does being genderqueer mean?

This is one of several terms that people use to describe not feeling either male or female. This is different from just not having much sense of gender. For some people, it's a very strong feeling and may lead to them seeking medical assistance to align their bodies with their identities. For others, it's about creating a space in which to escape from the usual expectations of gendered behaviour.

7. I've seen some people call themselves "queer". Is that an OK word for straight people to use?

Because it has a history of being used as a term of abuse, it's best to avoid it in generral discourse. In smaller social circles you may find that people don't mind, but it never hurts to ask.

8. What inaccurate clichés about trans people do you see in the media?

Most transsexual people don't think of themselves as changing sex — they have a consistent sense of gender identity. Rather, they feel that bodily changes are about feeling more comfortable in their own skins and having their gender more easily recognised by others, confirming their existing identities. By and large, they are no more concerned about being manly men or beautiful women than the average person. Some know they will never "pass" very well but passing isn't the point — they hope people will respect the clear signals that they're sending about their gender. The media tends to find these concepts difficult. Likewise, it tends to present people without male or female gender identities as confused (much like the clichés that exist about bisexual people) whereas most have a very clear sense of their gender, it just isn't one that onforms with society's expectations. Finally, there's the notion that all trans people are attention-seekers. In fact, most just want to get on with their lives.

9. Are there more M2F transgendered people than F2M? And if so, why?

We used to think so but gender clinics now tell us they have about equal numbers coming forward to seek help. It's sometimes easier for trans men to stay in the closet because masculine behaviour in women is more socially acceptable than feminine behaviour in men.

10. What does "cis" mean?

It's simply a catch-all term referring to people who are not trans.

11. What kind of problems and challenges do trans people face in everyday life, and in getting treatment?

They are often rejected by family and friends, they can find it difficult to secure employment (especially before getting medical support) and they face high rates of stress-related mental health problems. It is estimated that around 45 per cent of trans people attempt suicide at least once — nine times the rate for the wider population. Trans people are often subjected to verbal abuse and threats from strangers and face a higher than average risk of being assaulted, with this being worse in some areas than others. Getting medical support is a bit of a lottery. There's a new system in Scotland which is very good, but not enough specialist doctors yet to make it work. In England, many people struggle to get taken seriously, face obnoxious treatment from medical profesionals (as exemplified in the recent #transdocfail Twitter thread) and face long waiting lists, while genderqueer people have to pretend to be transsexual if they want to get any treatment at all. This is particularly tough for people who can't afford to go private.

12. What proportion of the population is transgender?

This really depends on how widely you want to cast your net. Around one in five people try cross dressing, even if it's just for fun, and lots of people feel uncomfortable with the roles set out for them as men or women. The number of people who feel a strong need to change roles is much smaller, probably around 0.8 per cent of the population. Of course, that's still a lot of people overall, and the problems they face also affect their friends and families.

If you need to talk to somebody because you think you might be trans, The Gender Trust can help. For young trans people and their parents, Mermaids provides excellent support.

Jennie Kermode is Chair of Trans Media Watch and writes at Eye For Film