|Part of a series on|
|Part of a series on|
|lesbian ∙ gay ∙ bisexual ∙ transgender|
Gender variance, or gender nonconformity, is behavior or gender expression by an individual that does not match masculine or feminine gender norms. People who exhibit gender variance may be called gender-variant, gender-non-conforming, gender-diverse, gender-atypical  or non-binary, and may be transgender or otherwise variant in their gender identity. In the case of transgender people, they may be perceived, or perceive themselves as, gender-nonconforming before transitioning, but might not be perceived as such after transitioning. Some intersex people may also exhibit gender variance.
The terms gender variance and gender-variant are used by scholars of psychology, psychiatry, anthropology, and gender studies, as well as advocacy groups of gender-variant people themselves. The term gender-variant is deliberately broad, encompassing such specific terms as transsexual, butch and femme, queen, sissy, tomboy, travesti, or hijra.
The word transgender usually has a narrower meaning and different connotations, including an identification that differs from the gender assigned at birth. GLAAD (formerly the Gay and Lesbian Alliance Against Defamation)'s Media Reference Guide defines transgender as an "umbrella term for people whose gender identity or gender expression differs from the sex they were assigned at birth." Not all gender-variant people identify as transgender, and not all transgender people identify as gender-variant – many identify simply as men or women. Gender identity is one's internal sense of their own gender; while most people have a gender identity of a boy or a man, or a girl or a woman, gender identity for other people is a more complex experience.
Furthermore, gender expression is the external manifestation of one's gender identity, usually through "masculine", "feminine", or gender-variant presentation or behavior.
In some countries, such as Australia, the term gender diverse or, historically, sex and/or gender diverse, may be used in place of, or as well as, transgender. Culturally-specific gender diverse terms include sistergirls and brotherboys. Ambiguities about the inclusion or exclusion of intersex people in terminology, such as sex and/or gender diverse, led to a decline in use of the terms sex and/or gender diverse and Diverse Sexes and Genders (DSG). Current regulations providing for the recognition of trans and other gender identities use terms such as gender diverse and transgender. In July 2013, the Australian National LGBTI Health Alliance produced a guide entitled "Inclusive Language Guide: Respecting people of intersex, trans and gender diverse experience" which clearly distinguishes between different bodily and identity groups.
Multiple studies have suggested a correlation between children who express gender nonconformity and their eventually coming out as gay, bisexual, or transgender. In multiple studies, a majority of those who identify as gay or lesbian self-report gender nonconformity as children. However, the accuracy of some of these studies have been questioned. The therapeutic community is currently divided on the proper response to childhood gender nonconformity.
One study suggested that childhood gender nonconformity is heritable. Studies have also been conducted about adults' attitudes towards nonconforming children. There are reportedly no significant generalized effects (with the exception of few outliers) on attitudes towards children who vary in gender traits, interests, and behavior.
Children who are gender-variant may struggle to conform later in life. As children get older and are not treated for the mismatch between their minds and bodily appearance, this leads to discomfort, and negative self-image and eventually may lead to depression, suicide, or self-doubt. If a child is nonconforming at a very young age, it is important to provide family support for positive impact to family and the child. Children who do not conform prior to age 11 tend to have an increased risk for depression, anxiety, and suicidal ideation as a young adult. A 2012 study found that both children who will be heterosexual and children who will have a minority sexual orientation who expressed gender nonconformity before the age of 11 were more likely to experience abuse physically, sexually, and psychologically.
Roberts et al. (2013) found that of participants in their study aged between 23 and 30, 26% of those who were gender nonconforming experienced some sort of depressive symptoms, versus 18% of those were gender-conforming. Treatment for gender identity disorders (GID) such as gender variance have been a topic of controversy for three decades. In the works of Hill, Carfagnini and Willoughby (2007), Bryant (2004), "suggests that treatment protocols for these children and adolescents, especially those based on converting the child back to a stereotypically gendered youth, make matters worse, causing them to internalize their distress." Treatment for GID in children and adolescents may have negative consequences. Studies suggest that treatment should focus more on helping children and adolescents feel comfortable living with GID. There is a feeling of distress that overwhelms a child or adolescent with GID that gets expressed through gender. Hill et al. (2007) states, "if these youth are distressed by having a condition deemed by society as unwanted, is this evidence of a disorder?" Bartlett and colleagues (2000) note that the problem determining distress is aggravated in GID cases because usually, it is not clear whether distress in the child is due to gender variance or secondary effects (e.g., due to ostracization or stigmatization). Hill et al. (2007) suggests, "a less controversial approach, respectful of increasing gender freedom in our culture and sympathetic to a child's struggle with gender, would be more humane."
Social status for men vs. women
Gender nonconformity among people assigned male at birth is usually more strictly, and sometimes violently, policed in the West than is gender nonconformity among people assigned female at birth. However, a spectrum of types of gender nonconformity exists among boys and men. Some types of gender nonconformity, such as being a stay-at-home father, may pass without comment whereas others, such as wearing lipstick and skirts, may attract stares, criticism, or questioning. Some geographical regions are more tolerant than others of such differences.
This is a comparatively recent development in historical terms, because the dress and careers of women used to be policed, and still are in countries like Iran and Saudi Arabia (where they are regulated by the law). The success of second-wave feminism is the chief reason for the freedom of women in the West to wear traditionally-male clothing such as trousers, or to take up traditionally-male occupations such as being a medical doctor, etc. At the other extreme, some Communist regimes such as the Soviet Union made a point of pushing women into traditionally male occupations in order to advance the feminist ideology of the state — for example, 58% of Soviet engineers were women in 1980 — but this trend went into reverse after the collapse of the Soviet Union, a reversal that some attribute to women becoming more free to follow their own interests.
Gender nonconforming transgender people in the United States have been demonstrated to have worse overall health outcomes than transgender individuals who identify as men or women.
Association with sexual orientation
Gender norms vary by country and by culture, as well as across historical time periods within cultures. For example, in Pashtun tribes in Afghanistan, adult men frequently hold hands, without being perceived as gay, whereas in the West this behavior would, in most circumstances, be seen as proof of a homosexual relationship. However, in many cultures, behaviors such as crying, an inclination toward caring for and nurturing others in an emotionally open way, an interest in domestic chores other than cooking, and self-grooming can all be seen as aspects of male gender nonconformity. Men who exhibit such tendencies are often stereotyped as gay. Studies found a high incidence of gay males self-reporting gender-atypical behaviors in childhood, such as having little interest in athletics and a preference for playing with dolls. The same study found that mothers of gay males recalled such atypical behavior in their sons with much greater frequency than mothers of heterosexual males.
For women, adult gender nonconformity is often associated with lesbianism due to the limited identities women are faced with at adulthood. Notions of heterosexual womanhood often require a rejection of physically demanding activities, social submission to a male figure (husband or boyfriend), an interest in reproduction and homemaking, and an interest in making oneself look more attractive for men with appropriate clothing, make-up, hairstyles and body shape. A rejection of any of these factors may lead to a woman being called a lesbian regardless of her actual sexual orientation, or indeed to a man "crossing her off the list" as a potential romantic or sexual partner regardless of whether he actually believes she is a lesbian. Therefore, attracting a male romantic or sexual partner can be a strong factor for an adult woman to suppress or reject her own desire to be gender-variant.
Lesbian and bisexual women, being less concerned with attracting men, may find it easier to reject traditional ideas of womanhood because social punishment for such transgression is not effective, or at least no more effective than the consequences of being openly gay or bisexual in a heteronormative society (which they already experience). This may help account for high levels of gender nonconformity self-reported by lesbians.
Gender theorist Judith Butler, in her essay Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory, states: "Discrete genders are part of what humanizes individuals within contemporary culture; indeed, those who fail to do their gender right are regularly punished. Because there is neither an 'essence' that gender expresses or externalizes nor an objective ideal to which gender aspires." Butler argues that gender is not an inherent aspect of identity, further stating, "...One might try to reconcile the gendered body as the legacy of sedimented acts rather than a predetermined or foreclosed structure, essence or fact, whether natural, cultural, or linguistic".
Among adults, the wearing of women's clothing by men is often socially stigmatized and fetishised, or viewed as sexually abnormal. However, cross-dressing may be a form of gender expression and is not necessarily related to erotic activity, nor is it indicative of sexual orientation. Other gender-nonconforming men prefer to simply modify and stylise men's clothing as an expression of their interest in appearance and fashion.
Gender-affirmative practices recognize and support an individual's unique gender self-identification and expression. Gender-affirmative practices are becoming more widely adopted in the mental and physical health fields in response to research showing that clinical practices that encourage individuals to accept a certain gender identity can cause psychological harm. In 2015, the American Psychological Association published gender-affirmative practice guidelines for clinicians working with transgender and gender-nonconforming people. Preliminary research on gender-affirmative practices in the medical and psychological settings has primarily shown positive treatment outcomes. As these practices become more widely used, longer-term studies and studies with larger sample sizes are needed to continue to evaluate these practices.
Research has shown that youth who receive gender-affirming support from their parents have better mental health outcomes than their peers who do not.
Gender-affirmative practices emphasize gender health. Gender health is an individual's ability to identify as and express the gender(s) that feels most comfortable without fear of rejection. Gender-affirmative practices are informed by the following premises:
- gender variance is not a psychological disorder or mental illness
- gender expressions vary across cultures
- gender expressions are diverse and may not be binary
- gender development is affected by biological, developmental, and cultural factors
- if pathology occurs, it is more often from cultural reactions rather than from within the individual
Mental health practitioners have begun integrating the gender-affirmative model into cognitive behavioral therapy, person-centered therapy, and acceptance and commitment therapy. While taking different approaches, each therapeutic modality may prove beneficial to gender-variant people looking to self-actualize, cope with minority stress, or navigate personal, social, and occupational issues across the lifespan.
Atypical gender roles
Gender expectations, like other social norms, can vary widely by culture. A person may be seen as expressing an atypical gender role when their gender expression and activities differ from those usually expected in that culture. What is "typical" for one culture may be "atypical" for another. People from cultures who conceptualize gender as polar opposites on a binary, or having only two options, may see cultures with third gender people, or fluid gender expressions, and the people who live in these gender roles, as "atypical". Gender expressions that some cultures might consider "atypical" could include:
- Househusbands: men from patriarchal cultures who stay at home to raise children and take care of the home while their partner goes to work. National Public Radio reported that by 2015 this had risen to 38%. This would only be "atypical" in a culture where it is the norm for women to stay home.
- Androgynous people: having a gender presentation that is either mixed or neutral in a culture that prizes highly binary presentations.
- Crossdresser: a person who dresses in the clothing of, and otherwise assumes, "the appearance, manner, or roles traditionally associated with members of the opposite sex". Crossdressers may be cisgender, or they may be trans people who have not yet transitioned.
- Hijra: a traditional third-gender person who is occasionally intersex, but most often considered male at birth. Many of the Hijra are eunuchs who have chosen to be ritually castrated in a dedication ceremony. They have a ceremonial role in several traditional South Asian cultures, often performing naming ceremonies and blessings. They dress in what is considered "women's" garments for that culture, but are seen as neither men nor women, but hijra.
- Khanith: an effeminate gay male in Omani culture who is allowed to associate with women. The clothing of these individuals must be intermediate between that of a male and a female.
- Two-Spirit: a modern, pan-Indian, umbrella term used by some Indigenous North Americans to describe Native people in their communities who fulfill a traditional third-gender (or other gender-variant) social and ceremonial role in their cultures. The term two-spirit was created in 1990 at the Indigenous lesbian and gay international gathering in Winnipeg, and "specifically chosen to distinguish and distance Native American/First Nations people from non-Native peoples."
- Male spirit mediums in Myanmar: Biological men that are spirit mediums (nat kadaw) wear women's attire and wear makeup during religious ceremonies. The majority of male spirit mediums live their lives permanently as women.
- Haldeman, Douglas C. (2000-01-01). "Gender Atypical Youth: Clinical and Social Issues". School Psychology Review. 29 (2): 192–200. doi:10.1080/02796015.2000.12086007. S2CID 142509837.
- Carroll, Lynne; Gilroy, Paula J.; Ryan, Jo (2002). "Counseling Transgendered, Transsexual, and Gender-Variant Clients". Journal of Counseling & Development. 80 (2): 131–139. doi:10.1002/j.1556-6678.2002.tb00175.x. ISSN 0748-9633.
- Lev, Arlene Istar (2004). Transgender Emergence: Therapeutic Guidelines for Working with Gender-Variant People and their Families. New York: The Haworth Clinical Practice Press. ISBN 978-0789007087. OCLC 51342468.
- Stitt, Alex (2020). ACT For Gender Identity: The Comprehensive Guide. London: Jessica Kingsley Publishers. ISBN 978-1785927997. OCLC 1089850112.
- Karasic, Dan; Drescher, Jack, eds. (2005). Sexual and gender diagnoses of the Diagnostic and Statistical Manual (DSM) : a reevaluation. New York: Haworth Press. pp. 125–134. ISBN 978-0789032133. OCLC 61859826.
- Nanda, Serena (2000). Gender diversity: crosscultural variations. Prospect Heights, Ill.: Waveland Press, Inc. ISBN 978-1577660743. OCLC 43190536.
- "Gender Education and Advocacy (GEA) is a national [US] organization focused on the needs, issues and concerns of gender-variant people in human society." Mission statement, available on the front page of the group's website: www.gender.org
- Gay and Lesbian Alliance Against Defamation. GLAAD Media Reference Guide, 8th Edition. Transgender Glossary of Terms", GLAAD, USA, May 2010. Retrieved on 2011-03-02.
- Department of Health, Victoria, Australia (9 October 2014). "Transgender and gender diverse health and wellbeing". Retrieved 2014-12-30.CS1 maint: multiple names: authors list (link)
- National LGBTI Health Alliance (2013). "National LGBTI Health Alliance statement". National LGBTI Health Alliance. Retrieved 2014-12-31.
- Australian Human Rights Commission (1 August 2013). "New Protection". Retrieved 2014-12-30.
- Winter, Sarah (2009). "Are human rights capable of liberation? The case of sex and gender diversity" (PDF). Australian Journal of Human Rights. 15 (1): 151–174. doi:10.1080/1323238X.2009.11910865. S2CID 158873691. Retrieved 23 December 2011.
- National LGBTI Health Alliance (July 2013). "Inclusive Language Guide: Respecting people of intersex, trans and gender diverse experience" (PDF). National LGBTI Health Alliance. Retrieved 2014-12-31.
- Organisation Intersex International Australia (9 January 2013). ""Sex and Gender Diverse" discussion paper on terminology". Organisation Intersex International Australia. Retrieved 2014-12-31.
- Family Planning Victoria, February 2013, "ABS review of the sex standard / potential new gender standard, A submission by Family Planning Victoria in collaboration with Gay and Lesbian Health Victoria, Transgender Victoria, Y Gender and the Zoe Belle Gender Centre"
- Transgendervictoria.com Archived 2018-12-26 at the Wayback Machine, Transgender Victoria, February 2013, "Review of ABS Standard Welcome"
- Attorney-General's Department (Australia) (June 2013). "Australian Government Guidelines on the Recognition of Sex and Gender". Attorney-General's Department (Australia). Retrieved 2014-12-31.]
- Friedman, RC (2008). Sexual Orientation and Psychodynamic Psychotherapy Sexual Science and Clinical Practice. Columbia University Press. pp. 53–7. ISBN 978-0-231-12057-9.
- Baumeister, Roy F. (2001). Social Psychology and Human Sexuality: Essential Readings. Psychology Press. pp. 201–2. ISBN 978-1-84169-018-6.
- Brookley, Robert (2002). Reinventing the Male Homosexual: The Rhetoric and Power of the Gay Gene. Indiana University Press. pp. 60–65. ISBN 978-0-253-34057-3.
- Thomas, Rachel N.; Blakemore, Judith E. Owen (2013). "Adults' Attitudes About Gender Nonconformity in Childhood". Archives of Sexual Behavior. 42 (3): 399–412. doi:10.1007/s10508-012-0023-7. PMID 23150102. S2CID 22230241.
- Crawford, Nicole (2003). "Understanding children's atypical gender behavior". American Psychological Association.
- Peate, I. (January 01, 2008). Understanding key issues in gender-variant children and young people. British Journal of Nursing (mark Allen Publishing), 17, 17, 25
- Roberts, A., Rosario, M., Slopen, N., et al. (2013). Childhood gender nonconformity, bullying victimization, and depressive symptoms across adolescence and early adulthood: an 11-year longitudinal study. J Am Acad Child Adolesc Psychiatry, 52(2): 143-152
- Roberts, 1Andrea L.; Rosario, Margaret; Corliss, Heather L.; Koenen, Karestan C.; Austin, S. Bryn (March 2012). "Childhood Gender Nonconformity: A Risk Indicator for Child Abuse and Posttraumatic Stress in Youth". Pediatrics. 129 (3): 410–7. doi:10.1542/peds.2011-1804. PMC 3289524. PMID 22351893.
- Hill, D., Rozanski, C., Carfagnini, J., & Willoughby, B. (January 01, 2007). Gender identity disorders (GID) in childhood and adolescence. International Journal of Sexual Health, 19, 1, 57-75
- "Working women in the 1930s". Retrieved 21 Jan 2017.
- "Seven things women in Saudi Arabia cannot do". The Week UK. 27 Sep 2016. Retrieved 21 Jan 2017.
- "Iran travel advice". UK government. Retrieved 21 Jan 2017.
- Barabanova, Svetlana; Sanger, Phillip; Ziyatdinova, Julia; Sokolova, Anastasia; Ivanov, Vasiliy (2013). The Decline of Women in Russian Engineering Education. ASEE Annual Conference & Exposition.
- Lagos, D. (2018). "Hearing Gender: Voice-Based Gender Classification Processes and Transgender Health Inequality". Demography. 55 (6): 2097–2117. doi:10.1007/s13524-018-0714-3. PMID 30255426. S2CID 52822267.
- J. Michael Bailey, Joseph S. Miller, Lee Willerman; Maternally Rated Childhood Gender Nonconformity in Homosexuals and Heterosexuals, Archives of Sexual Behavior, Vol. 22, 1993.
- Butler, Judith (1988-01-01). "Performative Acts and Gender Constitution: An Essay in Phenomenology and Feminist Theory". Theatre Journal. 40 (4): 519–531. doi:10.2307/3207893. JSTOR 3207893.
- Gay and Lesbian Alliance Against Defamation. GLAAD Media Reference Guide, 8th Edition. Transgender Glossary of Terms", GLAAD, USA, May 2010. Retrieved on 2011-03-01.
- Bryant, Karl (September 2006). "Making gender identity disorder of childhood: Historical lessons for contemporary debates". Sexuality Research and Social Policy. 3 (3): 23–39. doi:10.1525/srsp.2006.3.3.23. S2CID 144613679.
- American Psychological Association (2015). "Guidelines for psychological practice with transgender and gender-nonconforming people". American Psychologist. 70 (9): 832–864. doi:10.1037/a0039906. PMID 26653312. S2CID 1751773.
- Ryan, Caitlin; Russell, Stephen T.; Huebner, David; Diaz, Rafael; Sanchez, Jorge (November 2010). "Family Acceptance in Adolescence and the Health of LGBT Young Adults". Journal of Child and Adolescent Psychiatric Nursing. 23 (4): 205–213. doi:10.1111/j.1744-6171.2010.00246.x. PMID 21073595.
- Hidalgo, Marco A.; Ehrensaft, Diane; Tishelman, Amy C.; Clark, Leslie F.; Garofalo, Robert; Rosenthal, Stephen M.; Spack, Norman P.; Olson, Johanna (2013). "The Gender Affirmative Model: What We Know and What We Aim to Learn". Human Development. 56 (5): 285–290. doi:10.1159/000355235.
- Austin, Ashley; Craig, Shelley L. (2015). "Transgender Affirmative Cognitive Behavioral Therapy: Clinical Considerations and Applications". Professional Psychology: Research and Practice. 46 (1): 21–29. doi:10.1037/a.0038642 (inactive 2021-01-14).CS1 maint: DOI inactive as of January 2021 (link)
- Hope, Sam (2020). Person-Centered Counselling for Trans and Gender Diverse People. London: Jessica Kingsley Publishers. ISBN 978-1785925429.
- "What Happens When Wives Earn More Than Husbands". National Public Radio. February 8, 2015. Retrieved April 25, 2016.
- "Dual-role transvestism". TheFreeDictionary.com. Retrieved 2019-05-18.
- Murray, Stephen O. (2002). Homosexualities. University of Chicago Press. p. 278. ISBN 0-226-55194-6.
- de Vries, Kylan Mattias (2009). "Berdache (Two-Spirit)". In O'Brien, Jodi (ed.). Encyclopedia of gender and society. Los Angeles: SAGE. p. 64. ISBN 9781412909167. Retrieved 6 March 2015.
- Pember, Mary Annette (Oct 13, 2016). "'Two Spirit' Tradition Far From Ubiquitous Among Tribes". Rewire. Retrieved October 17, 2016.
- Coleman, Eli; Allen, Mariette Pathy; Ford, Jessie V. (2018-05-01). "Gender Variance and Sexual Orientation Among Male Spirit Mediums in Myanmar". Archives of Sexual Behavior. 47 (4): 987–998. doi:10.1007/s10508-018-1172-0. ISSN 1573-2800. PMID 29497915. S2CID 4730569.