Articles & Resources

Society for Health Psychology

Key Terms in Understanding Adolescent and Young Adult (AYA) Gender Diversity

Adolescent/Young Adult, Diversity & Multiculturalism

Download a PDF of this fact sheet here!

Biological Sex: Is assigned at birth and typically falls within the binary category of male or female. This assignment is done on the basis of external genital anatomy, but can also be assigned based on chromosomes, and sex hormone levels [1].

Intersex, Intersexuality, and Disorder of Sex Development (DSD): Refers to congenital conditions that contribute to atypical development of chromosomal, gonadal, or anatomic sex [2]. Gender Identity is the deep internal sense of who one is and is not limited to binary categorization. This can include the internal sense of being a woman/female, a man/male, a combination of both, somewhere in between, or neither [1].

Gender Identity: Is the result of multifaceted intersections between environmental conditions, biological traits, and cultural expectations. Gender identity also develops over time and ranges on a spectrum, and for some is fluid.

Transgender: Umbrella term referring to those whose assigned sex at birth doesn’t align with their gender identity.

Cisgender: Those whose gender identity aligns with their sex assigned at birth.

Gender Expression: The way an individual displays their gender outwardly towards others [1]. This outward display of gender can be through clothing and hair style, social roles, and/or mannerisms expressed by an individual.

Gender Transition: Is an umbrella term for the steps a transgender AYA and their family take to affirm their gender identity [5]. Depending on the age, needs, and desires of the AYA, transitioning may include any combination of the following:

  • Social Transition: Modifying social appearance, ways of referring to oneself, and interactions to align with gender identity (i.e. clothing, hair styles, make up, name/pronouns, playing on gendered sports teams, bathroom use, etc.).
  • Legal Transition: Having one’s gender marker and/or name changed on legal documents such as ID, passport, birth certificate, etc.
  • Puberty Blockers: Preventing secondary sex characteristics from developing or continuing development (i.e. voice deepening, hair growth, menstrual cycle). Gonadotropin-releasing hormone analogs such as leuprolide and histrelin allow for this to happen.
  • Gender-affirming Hormone Therapy: Being prescribed and taking hormones that align with identified gender.
    • Testosterone for those assigned female at birth.
    • Estrogen + androgen inhibitor for those assigned male at birth.
  • Surgery: Having surgical procedures to alter the body to align with one’s gender identity.
  • Voice Training: Training one’s voice to be deeper or higher pitched to be more aligned with gender identity

For a more robust list of Key Terms, please see APA’s informational guide and The World Professional Association for Transgender Health (WPATH) Standards of CareThe Genderbread Person can also be used as a teaching and therapeutic tool to educate folx on gender diversity.


Rafferty, J. (2018). Ensuring comprehensive care and support for transgender and gender-diverse children and adolescents. Pediatrics, 142(4).

American Psychological Association. (2015). Key terms and concepts in understanding gender diversity and sexual orientation among students.

Coleman, E., Bockting, W., Botzer, M., Cohen-Kettenis, P., DeCuypere, G., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., Monstrey, S., Adler, R. K., Brown, G. R., Devor, A. H., Ehrbar, R., Ettner, R., Eyler, E., Garofalo, R., Karasic, D. H., . . . Zucker, K. (2012). Standards of care for the health of transsexual, transgender, and gender-nonconforming people, version 7. International Journal of Transgenderism, 13(4), 165–232.

Killermann S. (2020). It’s Pronounced Metrosexual.

Human Rights Campaign Foundation, American Academy of Pediatrics, & American College of Osteopathic Pediatricians (2016). Supporting and caring for transgender children. e=20200713125239&focal=none