Every person’s gender journey is different. Exploring gender helps people learn more about themselves and how they wish to engage with the world around them. Many people are comfortable with the gender assigned to them at birth. This is referred to as ‘cisgender’. Other people realize at some point that they are not cisgender. For some people, this may be a new self-understanding that does not involve major changes. For other people, this may mean there is a need to share about their genders, find support, and possibly make changes to live more comfortably in their authentic genders. There are many words TTNB people use to describe their genders, including (but not limited to) boy/man, girl/woman, non-binary, transgender, Two-Spirit and genderfluid.^3,4 Gender journeys take many forms and coming to an understanding about one’s gender is a personal process.

Many people are clear about their gender as young children. Others discover a new understanding about their genders as adults. The ways people understand or describe their genders can shift throughout their lives.^3–5 As we grow up and learn more about ourselves, it is common to explore gender and expand our personal gender awareness over time. Through this process, people may find that their gender stays the same across their lifespan, or they may come to a new understanding of their gender. People may explore and understand aspects of their gender at different points in their lives.^5–7

Social affirmation and transition refer to steps taken to live in the gender TTNB people feel is authentic for them. Support for these steps is important for  all children, youth, and adults. Social affirmation and transition can involve changes in names, pronouns, clothes, hairstyles, and other ways people express their genders. No matter how old someone is, using their name and pronouns shows care and respect.^8,9 When youth’s genders are affirmed at their home, school, workplace, doctor’s office and other places, they have better mental health and well-being.^7,9–14 For young people, parental and family support regarding their gender is connected to well-being later in life.¹⁵

Some youth and adults will need gender-affirming medical treatment at different times in their gender journeys. While not every youth who is TTNB will want or need puberty blockers or hormone therapy, it’s important that youth know what their options are and that this care is accessible for those who need medical treatment.¹⁶ Healthcare providers play an important role in ensuring youth are well-supported while learning about and accessing this care.⁸ Knowing about and considering gender-affirming medical treatments is an important part of a person’s gender journey.

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The only way to know a person’s gender is for them to tell you. It is impossible to tell someone’s gender from clothes, hair, or external appearance. The pronouns a person uses may connect to their gender, but pronouns do not necessarily reveal someone’s gender identity (for example, a nonbinary person might be most comfortable using he or she pronouns). We may not know someone’s gender, and that is ok. It is important to practice using inclusive language and to avoid assumptions about gender and pronouns.^9,17

Understanding one’s gender and sharing gender can happen at different times. Gender identity is sometimes considered ‘internal’ because people come to understand their gender by making sense of their experiences and reflecting on who they are. ^3–5 Gender exploration may include learning about gender and similar concepts within a person’s culture(s). Gender expression or sharing gender is often considered ‘external’ because these are the ways people share their gender(s); for example, through words, clothing, hair, accessories, and other signals that fit with our cultural understandings of gender. People often come to understand their gender sooner than they’re ready to share this with other people.^18,19

Children and youth may not yet have the language to share their understandings of their genders. While some have the language to describe their gender at a very young age, others may have a general sense that something is ‘different’ related to their gender but do not yet have the words to express this.¹⁸ Discovering that trans people exist and that gender diversity is a natural part of the human experience can be key in opening more space for this understanding and vocabulary.⁵

Some people wait a long time to share their gender. They may wait until they have safe and supportive people to talk to. Others may have shared their identity and received unsupportive or negative feedback, leading them to keep this to themselves until later in life.⁵