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Coalition for Family Harmony: Nonprofit Offers LGBTQ+ Counseling Programs

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Our efforts are possible because of caring, compassionate individuals and organizations who believe victims deserve better and brighter futures, without violence and abuse. Thank you for choosing to support The Coalition and the families and communities we serve.

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Coalition For Family Harmony | LGBTQ+ Counseling Program

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Our efforts are possible because of caring, compassionate individuals and organizations who believe victims deserve better and brighter futures, without violence and abuse. Thank you for choosing to support The Coalition and the families and communities we serve.

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Advocating for LGBTQ Equality | Human Rights Campaign

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The Human Rights Campaign is America's largest civil rights organization working to achieve lesbian, gay, bisexual, transgender and queer equality.

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first person gender queer sexuality transgender bisexuality gay lgbtq

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Welcome to First Person! First Person is an exploration of gender identity and sexuality, and a weekly forum for covering LGBTQ-related news and issues. With...

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First Person: Real LGBTQ+ Stories on Twitter

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First Person: Real LGBTQ+ Stories on Twitter

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Out Magazine - Gay & Lesbian Travel, Fashion, Culture & Politics

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Gay and lesbian perspectives on style, entertainment, travel, fashion, arts, politics, culture, music, film, celebrities and the world at large.

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Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Pride Month is currently celebrated each year in the month of June to honor the 1969 Stonewall Uprising in Manhattan. The Stonewall Uprising was a tipping point for the Gay Liberation Movement in the United States. In the United States the last Sunday in June was initially celebrated as "Gay Pride Day," but the actual day was flexible. In major cities across the nation the "day" soon grew to encompass a month-long series of events. Today, celebrations include pride parades, picnics, parties, workshops, symposia and concerts, and LGBTQ Pride Month events attract millions of participants around the world. Memorials are held during this month for those members of the community who have been lost to hate crimes or HIV/AIDS. The purpose of the commemorative month is to recognize the impact that lesbian, gay, bisexual and transgender individuals have had on history locally, nationally, and internationally.

In 1994, a coalition of education-based organizations in the United States designated October as LGBT History Month. In 1995, a resolution passed by the General Assembly of the National Education Association included LGBT History Month within a list of commemorative months. National Coming Out Day (October 11), as well as the first "March on Washington" in 1979, are commemorated in the LGBTQ community during LGBT History Month.

Annual LGBTQ+ Pride Traditions

The first Pride march in New York City was held on June 28, 1970, on the one-year anniversary of the Stonewall Uprising. Primary sources available at the Library of Congress provide detailed information about how this first Pride march was planned and the reasons why activists felt so strongly that it should exist. Looking through the Lili Vincenz and Frank Kameny Papers in the Library's Manuscript Division, researchers can find planning documents, correspondence, flyers, ephemera and more from the first Pride marches in 1970. This, the first U.S. Gay Pride Week and March, was meant to give the community a chance to gather together to "...commemorate the Christopher Street Uprisings of last summer in which thousands of homosexuals went to the streets to demonstrate against centuries of abuse ... from government hostility to employment and housing discrimination, Mafia control of Gay bars, and anti-Homosexual laws" (Christopher Street Liberation Day Committee Fliers, Franklin Kameny Papers). The concept behind the initial Pride march came from members of the Eastern Regional Conference of Homophile Organizations (ERCHO), who had been organizing an annual July 4th demonstration (1965-1969) known as the " Reminder Day Pickets," at Independence Hall in Philadelphia. At the ERCHO Conference in November 1969, the 13 homophile organizations in attendance voted to pass a resolution to organize a national annual demonstration, to be called Christopher Street Liberation Day.

As members of the Mattachine Society of Washington, Frank Kameny and Lilli Vincenz participated in the discussion, planning, and promotion of the first Pride along with activists in New York City and other homophile groups belonging to ERCHO.

By all estimates, there were three to five thousand marchers at the inaugural Pride in New York City, and today marchers in New York City number in the millions. Since 1970, LGBTQ+ people have continued to gather together in June to march with Pride and demonstrate for equal rights.

Watch documentary footage of the first Pride march, "Gay and Proud," a documentary by activist Lilli Vincenz:

Gay and Proud

Footage of one of the earliest Gay Pride demonstration marches, the first Christopher Street Liberation Day Parade, held in New York City, New York, on June 28, 1970, to commemorate the first anniversary of the Stonewall Riots.

Executive and Legislative Documents

The Law Library of Congress has compiled guides to commemorative observations, including a comprehensive inventory of the Public Laws, Presidential Proclamations and congressional resolutions related to Lesbian, Gay, Bisexual Transgender and Queer Pride Month.

Images Used on this Site

[Arthur Laurents, director La Cage aux Folles]

Walt Whitman
1819-1892

Lilli Vincenz
(The Ladder), January 1966, Lilli Vincenz Papers, Manuscript Division, Library of Congress

Frank Kameny (in suit), June 1948, Box 137, Folder 10, Frank Kameny Papers, Manuscript Division, Library of Congress

Pauli Murray of New York, winner of a 1946 Mademoiselle Merit Award for signal achievement in law

Bayard Rustin
1912 - 1987

Librarian of Congress Carla Hayden announces the Library's acquisition of the AIDS Memorial Quilt Archive during a ceremony in the Great Hall, November 20, 2019. Photo by Shawn Miller/Library of Congress External .

The cast of Queer Eye discuss LGBTQ+ youth issues during a conversation with moderator Jonathan Capehart, April 3, 2019. Photo by Shawn Miller.

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About | Lesbian, Gay, Bisexual, Transgender and Queer Pride Month | Library of Congress

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Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Pride Month is currently celebrated each year in the month of June to honor the 1969 Stonewall Uprising in Manhattan. The Stonewall Uprising was a tipping point for the Gay Liberation Movement in the United States.

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California Pride Festivals, Parades and Events

FRESNO: Bowling for Pride April 8, 2018
fresnorainbowpride.com

LAGUNA BEACH: West Street BeachSpring Break at America's Favorite Gay Beach April 22, 2018, 11 a.m.
1 Camel Point Drive
Laguna Beach, CA
facebook.com/WestStreetBeach
There will be food, games, giveaways, and more. Mark your calendar and get ready for your favorite Gay Beach! Hosted once again by Frankie Ciccone.

LONG BEACH Pride FestivalMay 19-20, 2018 Marina Green Park
386 E Shoreline Dr - Intersection Pine Ave and Shoreline Dr, Long Beach, CA, 90802
$22 festival, longbeachpride.com
Free to see Parade, Route - Ocean Blvd.; from Lindero to Alamitos Blvd.
Parade Step off Begins at 10:30 a.m.
Festival - Marina Green Park, & Rainbow Lagoon, Long Beach, California
Festival Hours: Saturday and Sunday 11 a.m.-10 p.m. -- may change
Festival Headliner is Sheila E.

FRESNO: Rainbow Pride Parade & Festival June 2, 2018, 10 a.m.-3 p.m.
Parade: 10 a.m., Festival: 11 a.m. to 3 p.m. Free to attend parade. Festival $5 approx. Fresno, Tower District (Olive & Wishon Avenues)
fresnorainbowpride.com

Come join Fresno's Gay, Lesbian, Bisexual and Transgender + (GLBT+) Community, as well as visitors from all over the Central Valley. This is perhaps the single biggest event in the GLBT+ Community annually, as well as the most elaborate in its organization and preparation, for Fresno and its surrounding communities.

SACRAMENTO: June 10, 2018, 11 a.m. at Capitol Mall$10 festival, sacramentopride.org
Sacramento Pride consists of a parade and festival. The parade is free and starts at 11:00 am on 3rd and N
Street and ends on 10th and N Street.
Sacramento Pride consists of a parade and festival. The parade is free and starts at 11 a.m. traveling towards the Capital along N Street between 3rd and 10th. The festival costs $10 per person (children five and under are free) and is located on Capitol Mall between 3rd and 7th streets and goes from 11am-5pm.

SANTA CRUZ: Kresge presents PRIDE Sunday May 12, 2018, 12 Noonevents.ucsc.edu/event/3978
Celebrate the LGBTQIA communities and their many allies with a campus wide parade that starts at the Quarry Plaza at noon. March through the campus, meeting up with community members as we go, on our way to our final destination Kresge Lower Street. Festival includes entertainment, speakers, food, crafts and more. All are welcome to this inclusive and upbeat event. Location details: Quarry Plaza is in front of the Bay Tree Bookstore, central campus. Kresge College Lower Street is in the middle of the residential college on the west side of campus Admission: Free Admission. Parade 12 - 2 p.m. Festival 2 - 5 p.m. Started in 1971, Kresge College is one of 10 residential colleges in the University of California, Santa Cruz. Known for its all-apartment housing style, Kresge also houses a Food Co-op, Music Co-op, Photo Co-op, and Garden Co-op.

DAVIS: Davis Pride May 20, 2018, 8 a.m. -11 p.m. davispride.org
Free community festival in Central Park, includes Run/ Walk and two stages of live entertainment and more.

SANTA CRUZ: Pride Parade, Festival June 3, 2018, Parade at 11 a.m. diversitycenter.org | santacruzpride.org
Annual Santa Cruz Pride PARADE and FESTIVAL
Parade: kicks off at 11 a.m., starts at Pacific Avenue and Church Street in downtown Santa Cruz. Ends at Cathart & Center
Festival: 11a.m.-4 p.m., Cathart & Cedar - Lincoln

SAN MATEO: Pride San Mateo County Without Borders June 16, 2018, 11 a.m. - 5 p.m.facebook.com/PRIDEInitiativeSMC
smchealth.org/pride
Celebrate the annual San Mateo County Pride Festival at San Mateo Central Park with a fun-filled day of live music, family friendly activities, local art and merchandise, entertainment, and local resources. This is a family friendly, free event and everyone is welcome! Last year's theme was Pride without Borders: Embracing Culture and Diversity, which emphasizes the importance of recognizing how culture, race, marginalized sexual orientation, and gender identity overlap and affect our community. Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, and Two-Spirited (LGBTQQI2S) Pride Celebration provides an opportunity for all communities to come together, learn from each other, and share a common experience.

WEST HOLLYWOOD: L.A. Pride June 9-10, 2018, 11 a.m.-1 a.m. (Christopher Street Production)
PRIDE Parade June 10, 2018, 11 a.m.$25-35, VIP $250-400, lapride.org
Route: Santa Monica Boulevard West Hollywood, Crescent Heights Blvd. to Robertson Blvd.
Festival acts include Kehlani | Tove Lo | Eve | Kim Petras | Icona Pop | Keri Hilson | Natalia Jimenez
Parade: with over 400,000 participants, spectators and marchers, this emotionally charged experience, gathers together a colorful and diverse look at our creative community showcasing all that is great about the TLGB community. Attendees should plan to arrive early. Traffic will be closed on Santa Monica Blvd. between Fairfax Ave. and Doheny Dr. starting at 6:00 a.m. on Sunday. Santa Monica Blvd. will re-open immediately at the end of the end of the Parade, which may be as late as 4 p.m.

SAN FRANCISCO: Pride June 23-24, 2018
Parade is June 24, 2018, 10: 30 a.m.
The Parade kicks off at 10:30 a.m. at Market & Beale and ends at Market & 8th Street in downtown San Francisco
Celebration at Civic Center Plaza
Saturday, June 23, 2018, 12-6 p.m.
Sunday, June 24, 2018, 11 a.m.-6 p.m.
Multiple stages offer varied entertainment from Hip Hop and DJ to Leather, Tantra & Dance or Women's Stage.

CENTRAL COAST SLO Pride July TBAslopride.com

SAN DIEGO Pride July 14-15, 2018
Parade July 14, 2018, 11 a.m.
sdpride.org
Location: The parade begins at the Hillcrest Pride Flag at University Avenue and Normal Street, proceeds west on University Avenue to 6th Avenue, turns south on 6th Avenue, ending at Balboa Drive and Upas Street.
Route Length: 1.1 miles
Cost: This is a free community event.
The annual San Diego LGBT Pride Parade is the 4th largest in the United States attracting over 300,000 cheering spectators, supportive organizations, businesses, and significant media participation. Held in Balboa Park, the festival includes over 90 acts across four stages, including breakthrough LGBTQ acts from international and local artists.

SANTA ANA: OC Pride Festival & Parade June 23, 2018 Noon - prideoc.com
OC Pride will return to the streets of Downtown Santa Ana

VENTURA COUNTY - Ventura County Beachside Pride Festival August 17-19, 2018
vcpride.org | diversitycollectivevc.org/pride.html
The festival includes AIDS Walk Ventura | Ventura Pride | Diversity Gala. Sponsorship opportunities.

SANTA BARBARA: Pacific Pride Festival August 25, 2018, 11:30 a.m.-7 p.m.
Chase Palm Park
Free and open to all ages, pacificpridefoundation.org
The festival features a full day of live entertainment, vendors, food booths, activities and community member support. The mission of the Pacific Pride Festival is to build community, foster visibility, and celebrate sexuality & gender diversity, all while raising funds for Pacific Pride Foundation's LGBTQ+ programs and services in Santa Barbara County.

CHULA VISTA: South Bay Pride Art & Music Festival September 8, 2018, 12-7 p.m.
Bayside Park
Chula Vista, CA
southbaypride.org

OAKLAND: Oakland Pride September 9, 2018
$10 festival, oaklandpride.org
It's a parade, festival and celebration all in one! Parade starts and finishes on Broadway St.

EUREKA: Humboldt Pride September 16, 2018 is likely date - needs confirmation
humboldtpride.org The Pride Parade travels through Old Town Eureka and ending at Halvorsen Park to kick off the annual Pride Festival. Parade begins at 1st & C Streets, Eureka Parade route Old Town Eureka, Specific Route below, subject to change

REDDING: Redding LGBTQ + Pride Festival 2018 TBA
September 23, 2017, 12-5 p.m. Pride March 12 Noon from City Hall to Cypress Street Bridge & back
The Sculpture Park
777 Cypress Ave
Redding, CA
reddingpride.org
We Stand Strong Together for our LGBTQ+ community, loved ones, and allies.

PALM SPRINGS Pride November 2-4, 2018
Parade November 4, 2018, 10 a.m. Route: Travels along Palm Canyon Drive in Downtown Palm Springs
pspride.org
Palm Springs LGBT Pride

OCEANSIDE: Pride by the Beach October 13, 2018, 11 a.m.-5 p.m.
Oceanside Civic CenterThis annual event features L.G.B.T. pride festivities, music, food and entertainment. Sponsored by North County LGBTQ Resource Center. When: Saturday, Where: Pier View Way & Ditmar, Oceanside, CA. northcountypride.com

ANAHEIM: Gay Days Anaheim 2018 TBA
October 6-8, 2017gaydaysanaheiminfo.com
Disneyland discounts

SAN FRANCISCO: Castro Street FairOctober 7, 2018, 11 a.m. - 6 p.m.Held on 1st Sunday in OctoberCastro District
Market & Castro Streets and surrounding area
San Francisco, CA
castrostreetfair.org
Suggest donation $10
Between Market and 19th Streets, and on 18th Street between Noe and Diamond Streets multiple stages of entertainment; along with food and beverage vendors and hundreds of arts & crafts and community organization exhibitors.

PASADENA: San Gabriel Valley Pride 2018 TBA
October 14, 2017, 11 a.m.-6 p.m.Central Park
275 S. Raymond
Pasadena, CA
sgvpride.org
San Gabriel Valley Pride, A Different Kind of Pride features: Author's Forum | Children's Area | Classic Car Show | Community Art Project | Cultural Entertainment | Pet Area & Adoption | Health Fair | Wine Tasting (21+)

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California LGBT Gay Pride Festivals and Parades

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FRESNO: Bowling for Pride April 8, 2018fresnorainbowpride.com LAGUNA BEACH: West Street BeachSpring Break at America's Favorite Gay Beach April 22, 2018, 11 a.m. 1 Camel Point Drive Laguna Beach, CA facebook.com/WestStreetBeach There will be food, games, giveaways, and more. Mark your calendar and get ready for your favorite Gay Beach!

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Diversity Collective Ventura County (DCVC) is the proud parent organization of Ventura County PRIDE, Diversity Gala and AIDS Walk Ventura. It is our mission to advocate for diversity, education, mental and physical health via community outreach to the lesbian, gay, bisexual and transgender population as well as the general public.

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Together We Rise: Free All-Day LGBTQ Youth Conference @ USC

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Together We Rise: Free All-Day LGBTQ Youth Conference @ USC

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Planned Parenthood is offering Models of Pride attendees 14- to 19-years-old incentives for participation in an LGBTQ relationships & sexual health study taking place on Saturday, Nov. 11, 2017.

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TSER: Trans Student Educational Resources

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TSER: Trans Student Educational Resources

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GLAAD | GLAAD rewrites the script for LGBTQ acceptance.

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Political Equality Federation Human Rights Campaign (HRC) National LGBTQ Task Force Victory Fund Bisexual BIENESTAR BiNetUSA Bisexual.org Bisexual Resource Center Youth Gay, Lesbian & Straight Education Network (GLSEN) GSA Network LGBTQ Student Resources & Support Point Foundation Safe Schools Coalition The Trevor Project Military The American Military Partner Association (AMDA) American Veterans for Equal Rights

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Cite this

American Psychological Association. (2014, December 1). Answers to your questions about transgender people, gender identity, and gender expression. https://www.apa.org/topics/lgbtq/transgender

What does transgender mean?

This pamphlet also is available in the following languages:

According to the APA Style guide, the term "transsexual" is largely outdated, but some people identify with it; this term should be used only for an individual who specifically claims it. While the term "transsexual" appears multiple times throughout this document, APA's Committee on Sexual Orientation and Gender Diversity is undertaking a systematic review of its use along with other terms. In the meantime, please refer to the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (PDF, 472KB) for more up-to-date language regarding transgender and gender nonconforming people.

Transgender is an umbrella term for persons whose gender identity, gender expression or behavior does not conform to that typically associated with the sex to which they were assigned at birth. Gender identity refers to a person's internal sense of being male, female or something else; gender expression refers to the way a person communicates gender identity to others through behavior, clothing, hairstyles, voice or body characteristics. "Trans" is sometimes used as shorthand for "transgender." While transgender is generally a good term to use, not everyone whose appearance or behavior is gender-nonconforming will identify as a transgender person. The ways that transgender people are talked about in popular culture, academia and science are constantly changing, particularly as individuals' awareness, knowledge and openness about transgender people and their experiences grow.

This pamphlet also is available in the following languages:

What is the difference between sex and gender?

Sex is assigned at birth, refers to one's biological status as either male or female, and is associated primarily with physical attributes such as chromosomes, hormone prevalence, and external and internal anatomy. Gender refers to the socially constructed roles, behaviors, activities, and attributes that a given society considers appropriate for boys and men or girls and women. These influence the ways that people act, interact, and feel about themselves. While aspects of biological sex are similar across different cultures, aspects of gender may differ.

Various conditions that lead to atypical development of physical sex characteristics are collectively referred to as intersex conditions.

Have transgender people always existed?

Transgender persons have been documented in many indigenous, Western, and Eastern cultures and societies from antiquity until the present day. However, the meaning of gender nonconformity may vary from culture to culture.

What are some categories or types of transgender people?

Many identities fall under the transgender umbrella. The term transsexual refers to people whose gender identity is different from their assigned sex. Often, transsexual people alter or wish to alter their bodies through hormones, surgery, and other means to make their bodies as congruent as possible with their gender identities. This process of transition through medical intervention is often referred to as sex or gender reassignment, but more recently is also referred to as gender affirmation. People who were assigned female, but identify and live as male and alter or wish to alter their bodies through medical intervention to more closely resemble their gender identity are known as transsexual men or transmen (also known as female-to-male or FTM). Conversely, people who were assigned male, but identify and live as female and alter or wish to alter their bodies through medical intervention to more closely resemble their gender identity are known as transsexual women or transwomen (also known as male-to-female or MTF). Some individuals who transition from one gender to another prefer to be referred to as a man or a woman, rather than as transgender.

People who cross-dress wear clothing that is traditionally or stereotypically worn by another gender in their culture. They vary in how completely they cross-dress, from one article of clothing to fully cross-dressing. Those who cross-dress are usually comfortable with their assigned sex and do not wish to change it. Cross-dressing is a form of gender expression and is not necessarily tied to erotic activity. Cross-dressing is not indicative of sexual orientation. (See Answers to Your Questions: For a Better Understanding of Sexual Orientation and Homosexuality for more information on sexual orientation.) The degree of societal acceptance for cross-dressing varies for males and females. In some cultures, one gender may be given more latitude than another for wearing clothing associated with a different gender.

The term drag queens generally refers to men who dress as women for the purpose of entertaining others at bars, clubs, or other events. The term drag kings refers to women who dress as men for the purpose of entertaining others at bars, clubs, or other events.

Genderqueer is a term that some people use who identify their gender as falling outside the binary constructs of "male" and "female." They may define their gender as falling somewhere on a continuum between male and female, or they may define it as wholly different from these terms. They may also request that pronouns be used to refer to them that are neither masculine nor feminine, such as "zie" instead of "he" or "she," or "hir" instead of "his" or "her." Some genderqueer people do not identify as transgender.

Other categories of transgender people include androgynous, multigendered, gender nonconforming, third gender, and two-spirit people. Exact definitions of these terms vary from person to person and may change over time, but often include a sense of blending or alternating genders. Some people who use these terms to describe themselves see traditional, binary concepts of gender as restrictive.

Why are some people transgender?

There is no single explanation for why some people are transgender. The diversity of transgender expression and experiences argues against any simple or unitary explanation. Many experts believe that biological factors such as genetic influences and prenatal hormone levels, early experiences, and experiences later in adolescence or adulthood may all contribute to the development of transgender identities.

How prevalent are transgender people?

It is difficult to accurately estimate the number of transgender people, mostly because there are no population studies that accurately and completely account for the range of gender identity and gender expression.

What is the relationship between gender identity and sexual orientation?

Gender identity and sexual orientation are not the same. Sexual orientation refers to an individual's enduring physical, romantic, and/or emotional attraction to another person, whereas gender identity refers to one's internal sense of being male, female, or something else. Transgender people may be straight, lesbian, gay, bisexual, or asexual, just as nontransgender people can be. Some recent research has shown that a change or a new exploration period in partner attraction may occur during the process of transition. However, transgender people usually remain as attached to loved ones after transition as they were before transition. Transgender people usually label their sexual orientation using their gender as a reference. For example, a transgender woman, or a person who is assigned male at birth and transitions to female, who is attracted to other women would be identified as a lesbian or gay woman. Likewise, a transgender man, or a person who is assigned female at birth and transitions to male, who is attracted to other men would be identified as a gay man.

How does someone know that they are transgender?

Transgender people experience their transgender identity in a variety of ways and may become aware of their transgender identity at any age. Some can trace their transgender identities and feelings back to their earliest memories. They may have vague feelings of "not fitting in" with people of their assigned sex or specific wishes to be something other than their assigned sex. Others become aware of their transgender identities or begin to explore and experience gender-nonconforming attitudes and behaviors during adolescence or much later in life. Some embrace their transgender feelings, while others struggle with feelings of shame or confusion. Those who transition later in life may have struggled to fit in adequately as their assigned sex only to later face dissatisfaction with their lives. Some transgender people, transsexuals in particular, experience intense dissatisfaction with their sex assigned at birth, physical sex characteristics, or the gender role associated with that sex. These individuals often seek gender-affirming treatments.

What should parents do if their child appears to be transgender or gender nonconforming?

Parents may be concerned about a child who appears to be gender-nonconforming for a variety of reasons. Some children express a great deal of distress about their assigned sex at birth or the gender roles they are expected to follow. Some children experience difficult social interactions with peers and adults because of their gender expression. Parents may become concerned when what they believed to be a "phase" does not pass. Parents of gender-nonconforming children may need to work with schools and other institutions to address their children's particular needs and ensure their children's safety. It is helpful to consult with mental health and medical professionals familiar with gender issues in children to decide how to best address these concerns. It is not helpful to force the child to act in a more gender-conforming way. Peer support from other parents of gender-nonconforming children may also be helpful.

How do transgender individuals make a gender transition?

Transitioning from one gender to another is a complex process and may involve transition to a gender that is neither traditionally male nor female. People who transition often start by expressing their preferred gender in situations where they feel safe. They typically work up to living full time as members of their preferred gender by making many changes a little at a time. While there is no "right" way to transition genders, there are some common social changes transgender people experience that may involve one or more of the following: adopting the appearance of the desired sex through changes in clothing and grooming, adopting a new name, changing sex designation on identity documents (if possible), using hormone therapy treatment, and/or undergoing medical procedures that modify their body to conform with their gender identity.

Every transgender person's process or transition differs. Because of this, many factors may determine how the individual wishes to live and express their gender identity. Finding a qualified mental health professional who is experienced in providing affirmative care for transgender people is an important first step. A qualified professional can provide guidance and referrals to other helping professionals. Connecting with other transgender people through peer support groups and transgender community organizations is also helpful.

The World Professional Association for Transgender Health (WPATH), a professional organization devoted to the treatment of transgender people, publishes The Standards of Care for Gender Identity Disorders, which offers recommendations for the provision of gender affirmation procedures and services.

Is being transgender a mental disorder?

A psychological state is considered a mental disorder only if it causes significant distress or disability. Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder. For these individuals, the significant problem is finding affordable resources, such as counseling, hormone therapy, medical procedures and the social support necessary to freely express their gender identity and minimize discrimination. Many other obstacles may lead to distress, including a lack of acceptance within society, direct or indirect experiences with discrimination, or assault. These experiences may lead many transgender people to suffer with anxiety, depression or related disorders at higher rates than nontransgender persons.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people who experience intense, persistent gender incongruence can be given the diagnosis of "gender dysphoria." Some contend that the diagnosis inappropriately pathologizes gender noncongruence and should be eliminated. Others argue that it is essential to retain the diagnosis to ensure access to care. The International Classification of Diseases (ICD) is under revision and there may be changes to its current classification of intense persistent gender incongruence as "gender identity disorder."

What kinds of discrimination do transgender people face?

Anti-discrimination laws in most U.S. cities and states do not protect transgender people from discrimination based on gender identity or gender expression. Consequently, transgender people in most cities and states face discrimination in nearly every aspect of their lives. The National Center for Transgender Equality and the National Gay and Lesbian Task Force released a report in 2011 entitled Injustice at Every Turn, which confirmed the pervasive and severe discrimination faced by transgender people. Out of a sample of nearly 6,500 transgender people, the report found that transgender people experience high levels of discrimination in employment, housing, health care, education, legal systems, and even in their families.

Transgender people may also have additional identities that may affect the types of discrimination they experience. Groups with such additional identities include transgender people of racial, ethnic, or religious minority backgrounds; transgender people of lower socioeconomic statuses; transgender people with disabilities; transgender youth; transgender elderly; and others. Experiencing discrimination may cause significant amounts of psychological stress, often leaving transgender individuals to wonder whether they were discriminated against because of their gender identity or gender expression, another sociocultural identity, or some combination of all of these.

According to the study, while discrimination is pervasive for the majority of transgender people, the intersection of anti-transgender bias and persistent, structural racism is especially severe. People of color in general fare worse than White transgender people, with African American transgender individuals faring far worse than all other transgender populations examined.

Many transgender people are the targets of hate crimes. They are also the victims of subtle discrimination-which includes everything from glances or glares of disapproval or discomfort to invasive questions about their body parts.

How can I be supportive of transgender family members, friends, or significant others?

Educate yourself about transgender issues by reading books, attending conferences, and consulting with transgender experts. Be aware of your attitudes concerning people with gender-nonconforming appearance or behavior.

Know that transgender people have membership in various sociocultural identity groups (e.g., race, social class, religion, age, disability, etc.) and there is not one universal way to look or be transgender.

Use names and pronouns that are appropriate to the person's gender presentation and identity; if in doubt, ask.

Don't make assumptions about transgender people's sexual orientation, desire for hormonal or medical treatment, or other aspects of their identity or transition plans. If you have a reason to know (e.g., you are a physician conducting a necessary physical exam or you are a person who is interested in dating someone that you've learned is transgender), ask.

Don't confuse gender nonconformity with being transgender. Not all people who appear androgynous or gender nonconforming identify as transgender or desire gender affirmation treatment.

Keep the lines of communication open with the transgender person in your life.

Get support in processing your own reactions. It can take some time to adjust to seeing someone you know well transitioning. Having someone close to you transition will be an adjustment and can be challenging, especially for partners, parents, and children.

Seek support in dealing with your feelings. You are not alone. Mental health professionals and support groups for family, friends, and significant others of transgender people can be useful resources.

Advocate for transgender rights, including social and economic justice and appropriate psychological care.Familiarize yourself with the local and state or provincial laws that protect transgender people from discrimination.

Where can I find more information about transgender health, advocacy and human rights?

American Psychological Association
Office on Sexual Orientation and Gender Diversity
Programs and Projects
750 First Street, NE
Washington, DC 20002
Email

Children's National Medical Center
Gender and Sexuality Advocacy and Education
111 Michigan Avenue, NW
Washington, DC 20010
(202) 476-4172

Family Acceptance Project
San Francisco State University
3004 16th Street, #301
San Francisco, CA 94103
Email

FTMInternational
(FTM means Female-to-Male)
601 Van Ness Ave., Suite E327
San Francisco, CA 94102
(877) 267-1440
Email

Gender Spectrum
(510) 788-4412
Email

National Center for Transgender Equality
1325 Massachusetts Ave., Suite 700
Washington, DC 20005
(202) 903-0112
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Parents, Families, and Friends of Lesbians and Gays (PFLAG) Transgender Network (TNET)
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Sylvia Rivera Law Project
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Email

TransYouth Family Allies
P.O. Box1471
Holland, MI 49422-1471
(888) 462-8932

World Professional Association for Transgender Health
Email

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, D.C.: Author.

American Psychological Association. (2006). Answers to your questions about individuals with intersex conditions(PDF, 1MB). Washington, D.C.: Author.

American Psychological Association. (2008). Answers to questions: For a better understanding of sexual orientation and homosexuality. Washington, D.C.: Author.

Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., ... Zucker, K. (2012). Standards of care for the health of transsexual, transgender, and gender nonconforming people (7th version). International Journal of Transgenderism, 13, 165-232. doi:10.1080/15532739.2011.700873

National Center for Transgender Equality and the National Gay and Lesbian Task Force. (2011). Injustice at every turn.

World Health Organization. (1990). ICD-10: International classification of diseases and related health problems (10th ed).

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Answers to your questions about transgender people, gender identity, and gender expression

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Transgender is an umbrella term used to describe people whose gender identity (sense of themselves as male or female) or gender expression differs from socially constructed norms associated with their birth sex. This includes androgynous, bigendered and gender queer people, who tend to see traditional concepts of gender as restrictive.

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Answers to Your Questions For a Better Understanding of Sexual Orientation and Homosexuality

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This pamphlet is designed to provide accurate information for those who want to better understand sexual orientation and the impact of prejudice and discrimination on those who identify as lesbian, gay or bisexual. The brochure is also available in Russian and Spanish.

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Be True and Be You: A Basic Guide for LGBTQ+ Youth

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A basic mental health guide for LGBTQ+ young adults.

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Wondering how to come out? Whether coming out to friends, family or coworkers, you should always be in the driver's seat. Read HRC's coming out report for advice and resources.

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During the last 12 months, School Library Journal has reviewed a wide range of titles with LBGTQAI+ characters or themes in a variety of genres, from realistic fiction to fantasy, and including nonfiction and graphic novels, too. The 25 books here have received glowing reviews from SLJ-several landed on our Best Books 2017 list. All will enhance elementary, middle grade, and YA collections, whether in June for national Pride celebrations or throughout the year.

Middle Grade Fiction

BELL, Eric. Alan Cole Is Not a Coward. 272p. HarperCollins/Katherine Tegen Bks. Sept. 2017. Tr $16.99. ISBN 9780062567024.
Gr 4-6-All Alan Cole has ever wanted is to blend in. He takes care not to let his cafeteria tablemates, Zack and Madison, become his friends. Alan stays quiet at the dinner table so as not to upset his irascible father, and tries to avoid his brother, Nathan, who relentlessly bullies him. One day Nathan forces Alan to play a round of Cole vs. Cole, in which each brother must attempt to accomplish as many of Nathan's proposed seven assignments as possible within a week. The tasks are tough and include learning how to swim, retrieving a slip of paper from inside a broken vending machine, and receiving a first kiss. If Alan loses, Nathan will reveal his biggest secret to the whole school: Alan is gay and has a crush on one of his male classmates. With its well-developed characters, juxtaposition of supportive adult educators and aggressive parents, and message of hope, this novel feels like a contemporary version of Gary D. Schmidt's The Wednesday Wars and Okay for Now. Many of the book's most memorable scenes involve its lovable supporting characters, including Zack, a sweet kid who brings new meaning to the phrase free spirit, and Madison, who is named after three U.S. presidents and feels that his name comes with a responsibility to speak as eloquently as possible at all times. VERDICT A strong debut; recommend to tweens who enjoy realistic fiction, particularly readers looking for stories about LGBTQ kids.- Shira Pilarski, Charles E. Smith Jewish Day School, Washington, DC

Gr 4-6-A sweet story of a first crush and being stuck in the middle. In the aftermath of a tornado, Ivy and her family find themselves without a home and dependent upon the kindness of others. Already often overlooked as the middle child, Ivy feels even more invisible now that her family of six shares a small hotel room. What's worse, Ivy is developing feelings for another girl at school; but after hearing the way her older sister reacted when her best friend came out, Ivy doesn't know who to talk to. Filling a much-needed gap in middle grade literature, this story addresses not just the topic of a first crush, but also the invisibility frequently felt by middle children. The protagonist struggles with the disappearance of a beloved journal after a tornado and a lack of privacy while sharing one room with her entire family. She is too young to help care for her twin brothers but old enough that she is often forgotten about. Ivy doesn't feel comfortable discussing her blossoming romantic feelings with her family but is able to find a trusted adult in whom to confide. Young readers will find Ivy's challenges very real and will sympathize with her choices, both good and bad. Give to fans of Tim Federle's Better Nate than Ever or Barbara Dee's Star-Crossed. VERDICT Relatable and engaging. A first purchase for public and school libraries.-Jenni Frencham, Columbus Public Library, WI

POP KARIM, Sheba. Mariam Sharma Hits the Road. 320p. HarperCollins/HarperTeen. Jun. 2018. Tr $17.99. ISBN 9780062445735. Gr 9 Up-The past year has brought its share of woes for Mariam Sharma and her best friends, Ghaz and Umar. The remedy? A summer road trip. After their freshman year of college, Mariam, reeling from a recent breakup and in search of answers about her absent father, and Ghaz, who leaves behind a family apoplectic about her foray into modeling, join recent high school grad Umar on his cross-country trip to New Orleans for the Islamic Association of North America convention. High jinks involving pot brownies, mechanical bulls, and karaoke ensue. Ghaz and Umar ooze drama, keeping up witheringly sarcastic, at times raunchy commentary, while introspective Mariam takes it all in. However, like its characters, this breezy, irreverent romp has a deeply thoughtful side. Though devoted to his religion, Umar contends with the knowledge that there are Muslims who see him as a sinner because he is gay, while Ghaz expresses frustration with Islam and anger at her repressive family. Karim offers a nuanced perspective on the road trip novel, centering the experiences of three South Asian American teens who also encounter racism and Islamophobia on their journey of self-discovery. VERDICT This joyously exuberant tale will speak to readers who enjoy a blend of barbed humor and poignant reflection. An excellent choice for all YA shelves.
-Mahnaz Dar, School Library Journal

LAUREN, Christina. Autoboyography. 416p. S. & S. Sept. 2017. Tr $17.99. ISBN 9781481481687.
Gr 10 Up-Tanner's family moved from California to Provo, Utah, almost two years ago. They are one of the very few non-Mormon families in town, with a mother who left the Mormon church in college and a nonpracticing Jewish father. Although Tanner's family is exuberantly supportive of his bisexuality, they all agree it's safest to keep it to himself in the ultra-conservative town. With only one semester until graduation, Tanner plans to keep his head down and escape unscathed. Then Sebastian Brothers walks into his life. Sebastian is mentoring the school's legendary novel writing seminar, after having his own class novel bought for publication. Tanner is in lust at first sight, but Sebastian is the son of the Mormon bishop. As Sebastian begins to return Tanner's flirtation, questions arise about how far he's willing to push his faith and how satisfied Tanner can be in the shadows. The duo writing team (Christina Hobbs & Lauren Billings) brings an impressively balanced approach to writing about the conflict between sexuality and strict religion. Members of the Mormon church are not painted as one-dimensional villains, but as multifaceted individuals with merits and faults. Sebastian is a devoted Mormon even as he struggles to justify his attraction to the same sex. Occasionally, the major characters are too effortlessly talented and popular, with their flaws only emerging when narratively convenient. Regardless, the teenagers are modern and relatable and the plot is emotionally engaging without becoming dark. VERDICT A thoughtful variation on the traditional high school LGBTQ+ romance that will enhance public library collections.- Amy Diegelman, formerly at Vineyard Haven Public Library, MA

LENO, Katrina. Summer of Salt. 272p. HarperCollins/HarperTeen. Jun. 2018. Tr $17.99. ISBN 9780062493620.
Gr 8 Up -The Fernweh family has lived on the island of By-the-Sea-where the two smells you can always be sure of are "salt and magic"-for generations. Almost 18-year-old twins Georgina and Mary are the latest in a long line of Fernweh women with magical gifts ranging from teleportation to potion-making (the sisters' mother Penelope can brew a mean hangover cure). Every summer, By-the-Sea also hosts 300-year-old Annabella, an Eastern Seaborn Flicker bird who may be a Fernweh herself, and the influx of tourists who come to see her. But when Annabella is found violently murdered, suddenly the island doesn't seem so magical, and more than one dark secret must be uncovered. A magical realist YA book is still a relatively rare sight, and Leno expertly crafts this example of the genre with atmospheric prose and subtle feminism. The real heart of the novel is the exceptionally well-written female characters and relationships. Leno's way of writing Georgina's blossoming first love with island visitor Prue Lowry is so sweet and purely devoid of the "problem novel" overtones that accompany so many LGBTQ+ relationships in fiction. Her examination of the trauma of sexual assault and the "imperfect victim" is sophisticated and complex. VERDICT A necessary novel that is, at the same time, so enjoyable to read that teens will have to fight the urge to crawl into the pages. Buy multiple copies.-Ann Santori, Cook Memorial Public Library, Libertyville, IL

MITCHELL, Saundra, ed. All Out: The No-Longer-Secret Stories of Queer Teens Throughout the Ages. 384p. Harlequin Teen. Feb. 2018. Tr $18.99. ISBN 9781335470454.
Gr 9 Up-From witch trials to Y2K, this short story anthology tells fictional tales of LGBTQ teens throughout history. Though most entries are realistic, there are a few magical tales based on legends scattered throughout. The diversity is refreshing: it's not just white history being told and there is a deaf character fighting alongside Robin Hood. However, the queerness trends toward lesbian and gay teens. There are a few asexual characters, showing a variety of people on the ace spectrum, and a few trans boys, but no trans girls or nonbinary characters. The short stories are well written, as can be expected from the well-known contributors such as Anne-Marie McLemore and Shaun David Hutchinson. One standout piece is "And They Don't Kiss at the End" by Nilah Magruder, which tells Dee's story as a black, roller disco-loving teen coming to terms with her asexuality. Malinda Lo's "New Year" really captures the slow discovery by young Lily on Lunar New Year of an underground of queer folk like her. Fans who are loyal to these authors will be pleased by the entries. Some teen voices feel more authentic than others, and at times, the more modern settings felt a bit heavy-handed. VERDICT Give to those teens who don't read full novels but still long for LGBTQ representation. A strong choice for most collections.- Kathryn Kania, Pelham Public Library, NH

Gr 9 Up-Everyone who is going to die on a given day gets a call to let them know; not the when, or the how, or the why, but just notification that they will die on that day. Mateo and Rufus each get that call and are facing their last day without a loved one. But there's an app for that. Combining a well-realized alternative present with a lovely romance, Silvera's latest delivers what readers want in a book about dying teens. There's no avoiding the cliches that go along with the idea that an impending end makes life more meaningful, but recasting a Lurlene McDaniel-style doomed teen romance with Latinx queer boys and having the societal changes wink at those clichés softens them and makes a better storytelling device. The overarching structure of meaningful coincidences making a magical day in New York has its predecessors-Rachel Cohn and David Levithan's Nick and Norah's Infinite Playlist and Nicola Yoon's The Sun Is Also a Star being prime examples-but this title is a deft exploration of that trope. Silvera continues to masterfully integrate diversity, disability, and young queer voices into an appealing story with a lot of heart. VERDICT While most of the elements and themes of this work are not new, they are combined, realized, and diversified expertly in this title. A must-have for YA shelves.-L. Lee Butler, Hart Middle School, Washington, DC

WILDE, Jen. The Brightsiders. 304p. Feiwel & Friends. May 2018. Tr $16.99. ISBN 9781250189714. POP
Gr 9 Up-Set in the fast pace of Hollywood, rockstar drummer Emmy King, 17, just can't seem to get it right. Always caught up in drama with her parents and friends, the paparazzi have a field day when Emmy ends up in the hospital after a hard night of underage drinking. A few months later she is on stage and coming out as a bisexual. She eventually falls for Alfie, her irresistible, genderfluid band mate, which leads to a relationship that is physically mature. Emma is a complex, multifaceted character who doesn't always make the right decisions, but she proves that relationships can be complicated regardless of one's sexuality. The author adeptly captures the essence and confusion that young people may go through when trying to figure out their identities. This inclusive romance features multiple LGBTQ+ protagonists, including a nonbinary character who uses the pronouns they/them. The frankness and details of Emmy's sexual experiences make this a better choice for older readers. VERDICT Perfect for collections seeking high drama and romance.- Karen Alexander, Lake Fenton High School, Linden, MI

Nonfiction

KAYE, Julia. Super Late Bloomer: My Early Days in Transition. illus. by Julia Kaye. 160p. Andrews McMeel. May 2018. pap. $14.99. ISBN 9781449489625.
Gr 8 Up-Cartoonist Kaye, who is transgender, reveals the many ups and downs of starting hormone replacement in this collection of strips from her webcomic Up and Out. In a "Before" section, she writes about her life before fully understanding her identity and transitioning, which helps ground the short, disconnected comics. The strips begin four months into Kaye's decision to take hormones, and express her joy and excitement along with her impatience, frustration, dysphoria, and internalized transphobia. She describes moving home, changing her name, and coming out and explores self-image, reactions from others, misgendering, and more. Kaye shares many affirming experiences such as her parents using the right pronouns, her forays into trying out different clothes and makeup, and her reminders that she is valid no matter how she looks or is perceived, but never shies away from moments of frustration or self-loathing. The strips are like reading a diary-raw, honest, emotional, and not always uplifting. While Kaye's feelings are complicated, she is ultimately hopeful. The simple line drawings add warmth and whimsy to the small snippets of text. Though Kaye focuses on her experiences as an adult, teens will relate to her reflections on identity and acceptance. VERDICT An important and accessible work, especially given that relatively few books tackle the process of transitioning.- Amanda MacGregor, Parkview Elementary School, Rosemount, MN

SANDERS, Rob. Pride: The Story of Harvey Milk and the Rainbow Flag. illus. by Steven Salerno. 40p. chron. photos. websites. Random. Apr. 2018. Tr $17.99. ISBN 9780399555312.
Gr 1-3-Written in direct, accessible language, this book opens with a quote from Harvey Milk about hope, the connecting theme of this uplifting introduction to the symbol of the Rainbow Flag. The text starts with Milk's choice to enter politics and Gilbert Baker's design of the first flag and connects that to the flag's modern appearances as a symbol of equality and pride and the use of it on June 26, 2015 across the White House. The illustrations are vibrant and lively, taking inspiration from 1970s fashions and styles while emphasizing the effectiveness of symbols. The narrative includes references to opposition to Milk's dream of equality and the assassination of Milk and George Moscone, but moves decisively on to tell of enduring hope, with an illustration of the candlelight vigil and the persistence of the rainbow flag as an icon. Biographical notes include more information on the flag, Milk, Baker, and the significance of the June 16, 2014 rainbow lights across the White House. The back matter also includes two time lines, a few suggested books and websites, and assorted photographs related to the story. VERDICT With its emphasis on pride and hope, this title will make a strong addition to classroom and school library collections to support discussions of character and equality. Recommended for all collections.- Amanda Foulk, Sacramento Public Library, CA

SLATER, Dashka. The 57 Bus. 320p. Farrar. Oct. 2017. Tr $17.99. ISBN 9780374303235.

SMITH-GONZALEZ, Matthew & Maya Gonzalez. They She He Me. illus. by Maya Gonzalez. 40p. Reflection Pr. Oct. 2017. Tr $19.95. ISBN 9781945289064.

Adult Books 4 Teens

WHITE, Nick. How To Survive a Summer. 352p. Penguin/Blue Rider. Jun. 2017. Tr $26. ISBN 9780399573682.
Will Dillard is working on his film theory dissertation when he learns about Proud Flesh, a slasher movie about a group of straight teens who try to rebuild a dilapidated gay conversion therapy camp only to be stalked and killed by a former attendee. Will is transported to his adolescence, when he was sent to Camp Levi, the inspiration for the film's setting. There, he and four other boys were subjected to a month of torture. Meanwhile, the movie is causing rifts in the LGBTQ community yet also garnering a following. White's stark but beautiful debut is about rebuilding one's past and having the strength to accept oneself. Will's journey, told through flashbacks from when he first discovered that he was gay up through his days at Camp Levi, is searing. Funny and anxious, Will is likable, and the portrayal of the LGBTQ community is free of stereotypes. VERDICT For those looking for a cathartic novel or an exploration of the obstacles that many gay teens face.- Tyler Hixson, Brooklyn Public Library

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25 LGBTQAI+ Titles for Pride Month-and Onward

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During the last 12 months, School Library Journal has reviewed a wide range of titles with LBGTQAI+ characters or themes in a variety of genres, from realistic fiction to fantasy, and including nonfiction and graphic novels, too. The 25 books here have received glowing reviews from SLJ-several landed on our Best Books 2017 list.

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A Champion of LGBTQ+ issues in K-12 Education

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1-800-273-TALK (8255)

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National Suicide Prevention Lifeline - Wikipedia

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In July 2004, SAMHSA released a notice of funding availability (NOFA) as part of its National Suicide Prevention Initiative (NSPI). In keeping with SAMHSA's duty to advance the goals of the National Strategy for Suicide Prevention, the NOFA called for proposals from nonprofit organizations to expand, enhance, and sustain a network of certified crisis centers providing suicide prevention and intervention services to those in need using a toll-free number and website.

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Trevor Project: LGBTQ+ Suicide Prevention

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Trevor Project: LGBTQ+ Suicide Prevention

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1-866-488-7386

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The Trevor Project - Saving Young LGBTQ Lives

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A national 24-hour, toll free confidential suicide hotline for LGBTQ youth.

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Definitions:
Gender Identity: Gender Identity: One's internal sense of being male, female, neither of these, both, or another gender(s). Everyone has a gender identity, including you. For transgender people, their sex assigned at birth and their own internal sense of gender identity are not the same. Female, woman, and girl and male, man, and boy are also NOT necessarily linked to each other but are just six common gender identities.
Gender Expression/Presentation: The physical manifestation of one's gender identity through clothing, hairstyle, voice, body shape, etc. Most transgender people seek to make their gender expression (how they look) match their gender identity (who they are), rather than their sex assigned at birth.
Sex Assigned at Birth: The assignment and classification of people as male, female, intersex, or another sex based on a combination of anatomy, hormones, chromosomes. It is important we don't simply use "sex" because of the vagueness of the definition of sex and its place in transphobia. Chromosomes are frequently used to determine sex from prenatal karyotyping (although not as often as genitalia). Chromosomes do not determine genitalia.
Sexually Attracted To: Sexual Orientation. It is important to note that sexual and romantic/emotional attraction can be from a variety of factors including but not limited to gender identity, gender expression/presentation, and sex assigned at birth.
Romantically/Emotionally Attracted To: Romantic/emotional orientation. It is important to note that sexual and romantic/emotional attraction can be from a variety of factors including but not limited to gender identity, gender expression/presentation, and sex assigned at birth.
Example of how to fill out your own Gender Unicorn:
Here are some fundamental issues with the graphic:
Many people were curious if agender and asexual people were included in this graphic. In short, they are. For example, identifying on the left of the sexuality spectra would indicate no attraction.

Changes from The Genderbread Person
You may recognize this graphic as similar to The Genderbread Person
by itspronouncedmetrosexual. We created a similar graphic with significant changes to more accurately portray the distinction between gender, sex assigned at birth, and sexuality.

1. The itspronouncedmetrosexual Genderbread Person is plagiarized.
2. We wanted to create a gender graphic that shows how queer and trans people view gender instead of one straight, cisgender man.

Here are some structural issues with the graphic:
1. Nongendered isn't the only identity that may fall on the "left" of the Gender Identity Spectrum. Most people prefer the term "agender".
2. Agender is typically used as a gender identity, not a gender expression
3. Biological sex is an ambiguous word that has no scale and no meaning besides that it is related to some sex characteristics.
It is also harmful to trans people.
Instead, we prefer "sex assigned at birth" which provides a more accurate description of what biological sex may be trying to communicate.
4. Asex isn't a word, everyone has some sex characteristics prescribed to them.
5. There are other genders besides male and female and not all cultures operate on a male/female binary ( which is mostly a European construct).
We included "other genders" to indicate the many genders that other people might identify as, express themselves as, and be attracted to.
6. Sex, whether referencing an array of sex characteristics or sex assigned at birth is not exclusively determined through genitals as insinuated by the image.

Sources:
Queer and trans organizers have been making the distinction between gender identity, gender presentation/expression, sex, and attraction for decades. No one person or organization has created the concept. However "Genderbread" itself has two main sources:

1. textualharassment.tumblr.com (http://www.reddit.com/r/transgender/
comments/ipgod/oversimplified_diagram_
but_still_a_good_way_to/)

2. http://cisnormativity.tumblr.com/post/
9652156368/gingerbread-person-this-is-an-anthropomorphic

Illustrations by Anna Moore. Design by Landyn Pan, Eli Erlick, and many others.

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Definitions: Gender Identity: Gender Identity: One's internal sense of being male, female, neither of these, both, or another gender(s). Everyone has a gender identity, including you. For transgender people, their sex assigned at birth and their own internal sense of gender identity are not the same.

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Trans 101: A Gender Diversity Crash Course

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Trans 101 is a starter pack designed to help support trans people around you.

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Without LGBTQ history, there is no American history. From Learning for Justice and hosts Leila Rupp and John D’Emilio, Queer America takes listeners on a journey that spans from Harlem to the Frontier West, revealing stories of LGBTQ life we should have learned in school.

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im gay