Book summary “Transgender voices”: summary

Introduction

You live in a society that demands a strict choice between being male or female, leaving little room for those who do not fit either category. This rigid gender binary creates profound isolation, confusion, and distress when your internal sense of self contradicts the sex assigned to you at birth.

Lori Girshick challenges the rigid gender binary through the lived experiences of 150 sex- and gender-diverse individuals, proposing a parallel continuums framework for human identity.

The book explores the biological foundations of sex, the social pressures of gender socialization, and the complex realities of personal transitions. You will discover how family dynamics, workplace hurdles, and systemic gatekeeping shape the lives of transgender people.

Consider these questions as you read:

• How do biological sex and social gender differ?
• What pressures do families and children face during gender non-conformity?
• How do individuals navigate medical, legal, and social transitions?

1. Theoretical Foundations and Population Realities

Gender and sex are distinct concepts that should not be used interchangeably, and biological variations frequently deviate from the strict male-female binary.

Sex refers to biological characteristics such as genitals, reproductive organs, gonads, hormones, and chromosomes. Gender is a conceptual cultural category assigned to various phenomena, operating as a binary system that expects your gender designation to correlate with your biological sex.

Perceptions of gender normalcy are socially constructed to maintain hierarchical political and economic structures rather than resting on absolute biological facts. Drawing on William I. and Dorothy Thomas's 1928 sociological dictum, what you perceive as real has real consequences. The cultural insistence on a strict gender binary penalizes anyone who falls outside of it.

Sex Versus Gender

Grounded theory methodology was employed to derive conceptual categories directly from the lived experiences of participants rather than through logical deduction. Outreach involved mailing fliers asking if participants considered themselves a gender transgressor, distributing them via LGBT centers, Tri-Ess groups, conferences, and websites, which yielded 150 respondents. The research began with fundamental questions about gender feelings, using data gathered from a focus group of 5 participants and 150 diverse trans-identified participants.

The study sample demonstrated broad diversity in age, region, class, and gender identity despite being largely white and highly educated. Participants lived in thirty-two states, the District of Columbia, and four foreign countries. While highly educated, approximately one-third reported low incomes under nineteen thousand nine hundred ninety-nine dollars, illustrating economic challenges after transition.

Biological Variations

Intersex conditions involving nonstandard reproductive, chromosomal, or sexual anatomies affect a measurable percentage of newborns. Medical records show that various intersex traits occur across populations at specific frequencies:

• One in 100,000 newborns is a true hermaphrodite.
• One in 10,000 males is born with hypospadias.
• One in 1,666 births involves a child with neither an XX nor an XY chromosomal pattern.
• One in 500 to one in 1,000 males is born with Klinefelter syndrome.
• Androgen Insensitivity Syndrome occurs in one in 20,000 individuals.
• One in 100 births deviates from expected male and female bodies.

Estimates regarding the prevalence of transsexual individuals and cross-dressers indicate they are not rare occurrences. Lynn Conway estimated the number of male-to-female sex reassignment surgeries performed over forty years by United States doctors. Research points to 40,000 male-to-female sex reassignment surgeries performed over forty years in the United States, with one in 2,000 males being post-operative male-to-female transsexuals. One in 500 people is estimated as a transsexual male-to-female including pre- and non-operative individuals. The International Foundation for Gender Education estimated 6 percent of the population as cross-dressers and 1 percent as transsexuals.

Transgender individuals have created a lexicon from scratch to articulate experiences that traditional English and historical scientific language fail to capture. Language around gender variance has evolved from pejorative and clinical terms like inversion and transvestite toward self-defined terms like transgender, genderqueer, two-spirit, and androgynous. Gary Bowen noted how the Native American concept of spirit embraces an entire rainbow of possibilities rather than strict dichotomies.

2. Biological Sex Construction and Socialization

Biological sex traits are socially constructed and medicalized to fit a two-sex model, while society enforces binary gender roles through continuous socialization.

Biological sex involves chromosomes, genitalia, internal organs, hormones, and gonads. Doctors frequently interpret these traits to conform to cultural notions of male and female. From 1 to 2 out of every 1,000 infants born in the United States undergo surgery for intersex conditions. Medical professionals routinely perform non-consensual normalizing surgeries on intersex infants based on cultural discomfort rather than medical necessity.

Raven, a transgender FtM intersexual, described being born with congenital adrenal hyperplasia and experiencing severe complications after doctors placed him on estrogen to stop masculine secondary sex characteristics.

Roughgarden's research shows that sperm are small and eggs are large. This gamete binary does not dictate overall body type, behavior, or life history. Many animal species exhibit simultaneous or sequential hermaphroditism and overlapping traits.

All female spotted hyenas in Tanzania possess a clitoris that functions like a penis and fused labia forming a scrotum, giving birth through the penile canal.

From 10 to 20 percent of female grizzly bears, brown bears, American black bears, and polar bears mate and give birth through the tip of a clitoris. 99.9 percent of the DNA between considered women and considered men is exactly the same.

Intersex Realities

Prenatal hormone exposure during gestation plays a primary role in organizing the fetal hypothalamus and shaping gender identity and neural networks. During the sixteenth week of gestation, hormone presence or absence influences the developing brain's neural networks. These later manifest as behavioral traits and cognitive processing differences.

Audrey, a transwoman, suspected she was exposed to the synthetic estrogen DES during her mother's pregnancy to prevent miscarriage.

From 1941 to 1971, 3 million to 5 million women in the United States used DES. External chemicals, synthetic hormones, and environmental pollutants can disrupt the endocrine system and alter physical sex differentiation, gender identity, and sexual orientation. A 2003 Canadian study found that 2.5 older brothers doubles the likelihood of a boy being gay, and 4 older brothers triples it.

Institutional Enforcement

Cultural gender attribution is heavily weighted toward male markers. The presence of a penis exerts a much stronger influence on categorization than a vagina. Kessler and McKenna's study showed that more than two-thirds of study participants saw maleness in figures with non-specific pants even when they possessed an equal number of male and female traits.

• 96 different combinations of stick drawings were shown to 5 adult males and 5 adult females in Kessler and McKenna's study.
• 69 percent of figures without genital clues were seen as male.

Society enforces the gender binary through a continuous socialization cycle driven by the media, religion, medicine, and legal identification systems. Media messages police acceptable behaviors and portray non-conformity as a joke or pathology. Religious institutions and medical providers reinforce traditional dichotomies and penalize transgressions.

Glen recounted visiting a bank in full feminine presentation where a customer became immediately angry and disgusted upon learning he had never undergone gender confirmation surgery.

Cultural confusion between gender identity and sexual orientation leads to the misperception that transgender individuals are automatically gay or lesbian. Early sexologists conflated internal gender identity with same-sex desire. This created a persistent social link that leads families, peers, and institutions to associate gender non-conformity with aberrant sexuality.

Lydia recalled her early confusion where media sources like Playboy magazine explicitly linked men wearing feminine attire with homosexuality through captions and cartoons.

The binary gender system functions as an oppressive control mechanism that protects male privilege and punishes any perceived threat to patriarchal dominance. Because male characteristics are culturally valued and femininity is viewed as weak, male-bodied individuals who cross gender lines threaten male status and face harsher social penalties, sissyphobia, and violence than masculine women.

KT, a butch lesbian and transgender individual, noted that a man accompanying her in women's clothes in public is far more likely to be stared at or harassed than she is.

3. Childhood Self-Definition and Family Pressures

Children whose gender identity does not match their assigned sex experience profound distress, school harassment, and family pressure to conform.

Society uses biological determinism as a core cognitive schema, forcing gender onto newborns and training children to categorize everything into male or female. Infants are immediately dressed in pinks or blues, establishing gender before the child can proclaim their own identity. Children learn to map gender onto behaviors, objects, and people to understand the social world and communicate effectively.

Families act as primary agents of gender socialization through reinforced binary roles, toys, clothes, and chores, while covertly passing down male dominance. Parents model traditional husband, wife, father, and mother roles. Children observe these dynamics and learn what behaviors are acceptable.

Glen recounted that when he was about eight years old, his uncle constantly hammered the message that he needed to make a man out of him, and beat Glen up when Glen said he did not want to be a man.

Schools enforce strict gender binaries and punish non-conformity, forcing LGBT youth to expend immense energy to remain invisible and avoid abuse. Teachers and administrators frequently reinforce stereotypes, ignore or participate in harassment, and blame students for provoking attacks by flaunting their identity.

Aristotle recalled that elementary school teachers reinforced strict gender divisions by telling students that girls like music, art, and cats, while boys prefer sports and dogs.

Children whose gender identity does not match their assigned sex frequently experience profound distress, isolation, and a deep-seated feeling of being fundamentally wrong or alien. Unlike general social awkwardness, struggling with gender assignment creates continuous feelings of weirdness and inadequacy. Many trans individuals report feeling like an alien creature trapped in an alien body.

Tina described the constant message from every angle that she was bad and wrong, leading her to pray at night that God would turn her into a girl so she would no longer be a freak.

Childhood Schemas

Fear of rejection and the vital need for parental and peer approval compel gender-variant children to suppress their true feelings, hide cross-gender desires, and conform. Children quickly learn that love and validation are tied to successful role-playing. To avoid harassment, humiliation, or losing parental affection, many hide their desires or enter deep denial.

Beth stated that love from her parents was directly proportionate to her effectiveness in male role-playing, noting that a shotgun and sports gear were put in her hands while articles about Christine Jorgensen were taken away.

Awareness of gender variance often emerges at a very young age, frequently surfacing through painful experiences, humiliation, or distress over bodily changes like puberty. Children often feel a mismatch between their internal gender and their body long before they have the vocabulary to explain it.

AJ described hating the onset of menstruation at age nine, stating it felt horrible to have a brain of one gender and a body of another, like being cheated by nature out of a normal life.

Early Discovery

Some individuals experience a permanent or long-term mixed gender state, feeling neither fully male nor fully female rather than experiencing standard gender dysphoria. Not all gender-variant people believe they belong in the opposite binary category. Some identify as butch, stone butch, or ungendered, viewing their unique status as natural rather than wrong once they reject societal constraints.

Casey, a butch lesbian, noted that growing up she thought there were boys, girls, and people like her, never feeling isolated but wondering why people insisted on calling her a girl.

Cross-dressing is often one of the earliest and most accessible gender transgressions for children, though it is heavily stigmatized and frequently conflated solely with sexual fetishes. Many male cross-dressers begin exploring feminine clothing by kindergarten or puberty using available items. While mainstream culture often pathologizes this behavior as purely sexual or fetishistic, cross-dressing can also serve non-sexual functions like relaxation, comfort, or expressing an internal identity.

Asia admitted that as an 11 or 12-year-old, he and another kid took so many underwear, stockings, and girdles from their mothers that his mother feared a break-in, prompting him to confess out of guilt based on the 1990 census covering more than two million school-age children in the United States who are gay or lesbian.

4. Personal Transitions and Hormonal Changes

Navigating a gender journey involves aligning internal self-images with external presentation through hormones, voice training, and bodily changes.

Gender operates as both being and doing. You perform internal visualization where mental self-images stabilize into an identity. Living in a heavily gendered culture means people treat you based on social gender. Internal and external alignment becomes vital for authentic interaction.

Transition is not just moving from one endpoint to another. You often possess your true identity already. The actual transition involves society shifting its understanding of gender cues.

Internal and External Consistency

Joney, an MtF participant, explained to her visitation supervisor that feeling stressed out wearing men's clothes is comparable to how a feminine woman would feel forced to dress only in a crew cut, t-shirt, and jeans.

You navigate a complex set of milestones during this time:

• Identify the point of questioning assigned gender and feelings of not fitting the binary
• Record blood family responses to challenging gender roles
• Examine external appearance consistency and needs for physical changes
• Note experiences with incorrect pronoun usage and misattributed orientation
• Assess coping strategies including alcohol, drugs, and other methods
• Describe hormonal changes experienced

Hormonal Impacts

Testosterone replacement therapy produces profound physical and emotional changes in female-to-male individuals. You experience voice deepening, fat redistribution, and increased muscle mass. Transmen report rapid masculinization from testosterone, often experiencing increased appetite, acne, clitoral enlargement, and mood changes.

Jon, an intersex individual, experienced increased aggression and a heightened sex drive that made him feel like a raving lunatic while on testosterone, leading him to stop taking it to restore family peace.

Estrogen therapy for male-to-female individuals induces emotional peace and physical softening. It does not lower the voice, requiring testosterone suppression to be fully effective. You experience softer skin, breast development, weight redistribution to the hips, decreased body hair, reduced muscle mass, and diminished sex drive.

Karlette reported that after one year on hormones, her aggression dropped in half, hair loss stopped, breast growth occurred, beard growth diminished, and her need for sex decreased.

5. Coming Out, Community, and Workplace Struggles

Coming out as transgender carries profound personal risks and differs significantly from coming out as gay or lesbian because it involves dramatic changes in appearance, body, and gender role. While sexual orientation disclosures require explanation, gender variance directly challenges society's deeply held concepts of gender and human nature. You often feel exposed and stripped of privacy during this process.

Coming out as transgender triggers complex pronoun dilemmas, family rejections, and workplace discrimination despite growing legal protections.

Kand noted that coming out as gay twenty years earlier was much easier because people immediately understood the terms. Gender variance requires extensive explanation and processing.

The standard English binary pronoun framework ties birth sex and gender expression together. Traditional pronouns fail nonbinary people, while proposed gender-neutral alternatives remain largely unfamiliar outside of specific queer communities. You experience frequent misgendering and social discomfort.

Robert described how being called she around queer friends feels incorrect. Grocery store clerks calling him sir creates awkward corrections and public discomfort.

Transitioning forces an unavoidable reassessment of sexual orientation. Medical gatekeepers and society historically conflate gender identity with sexual desire. You demonstrate that sexual orientation depends on object choice, sexual behavior, and your own authentic gender identity rather than physical birth parts.

Raven explained why he identifies as pansexual rather than bisexual. Sex and attraction are driven by gender ambiguity rather than a strict binary. Seventeen study participants stated they were polyamorous, four said they were pansexual, and thirteen people defined their sexual orientation as queer.

Coming Out Challenges

Modern psychological theories that label transgender longing as autogynephilia reduce a complex identity to mere sexual fetishism. Critics argue that medicalizing trans identity through autogynephilia ignores the spiritual and psychological dimensions of gender identity that often precede adolescence and sexual feelings.

Andrea criticized the term autogynephilia as reductive. Identification with women begins long before adolescence when sexual feelings are central.

Passing as a man or woman is pursued by many trans people for safety and social acceptance. It often requires hiding your trans history and maintaining secrecy. Some view passing and going stealth as essential for living normally and avoiding discrimination. Others argue that hiding perpetuates invisibility and abandons visible activism.

Patricia expressed concern that transitioning individuals who go completely stealth fail to contribute to the broader fight for trans community advancement.

The integration of trans-identified individuals into the lesbian community has caused intense ideological debates regarding womanhood, boundaries, and sexual orientation. Female-to-male transitions challenge traditional feminist spaces built around shared female oppression. Partners of transitioning individuals often struggle with unwanted shifts in their own sexual identity.

Nathan described how his relationships with lesbian friends grew increasingly strained from confusion to shock as his masculine transition progressed.

Family members and spouses frequently experience severe stress, guilt, and religious conflict upon learning of a loved one's gender transition. This dynamic often results in rejection or divorce. Parents often internalize blame for a child's transition, while spouses may feel betrayed or unwilling to redefine their own sexual orientation.

Kymberley reported that ninety percent of her family turned away from her, revoking her holiday invitations after she came out as a woman.

Workplace Issues

Employment discrimination and the fear of losing your livelihood remain primary obstacles for transitioning individuals navigating mandatory Real Life Experience requirements. While federal protections are absent, an increasing number of state and local laws protect employees from discrimination based on gender identity and expression in housing and employment.

Gail faced severe workplace fallout, experiencing contract buyouts and sudden layoffs after coming out as a trans woman in academic and corporate settings.

Public polling and corporate metrics reveal shifting attitudes toward transgender inclusion:

• Seven in ten people surveyed were familiar with the term transgender.
• Sixty-one percent of Americans believed that there should be laws to protect transgender people from discrimination.
• Fifty-seven percent thought federal laws already existed.
• Between 2001 and May 2007, media coverage increased from six percent to thirty-seven percent.
• One hundred thirty-three companies earned a one hundred score on the Corporate Equality Index in 2006, up from one hundred one in 2005 and thirteen in 2002.

6. Systemic Policing, Violence, and Medical Gatekeeping

Public bathrooms, medical diagnostic manuals, and legal documentation requirements serve as systemic sites of gender policing and discrimination.

Public restrooms operate as sites of intense terror and policing for gender-nonconforming people. Fear of using public restrooms leads many to avoid them entirely or use alternative methods like bottles or cups, which often causes serious health problems such as kidney and bladder infections.

Reid, an athletic FtM individual, found changing in school locker rooms torturous and never used a girls' bathroom in school. Caroline and Lucy avoided rest stops while cross-dressing or transitioning and resorted to peeing in cars. Robyn volunteered to use a 12-floor building's different floor ladies' room. Dan had 5 security guards stand outside his washroom stall.

You can implement practical solutions to make public restrooms safer:

• Remove Men and Women signs from bathroom doors and label them simply as Restrooms
• Build single-user bathrooms or multiple-user bathrooms with floor-to-ceiling locked stall doors
• Install push-button plastic sanitary seat covers that change with each use
• Increase the frequency of bathroom cleaning

Major feminist and lesbian gatherings, such as the Michigan Womyn's Music Festival, have enforced policies restricting attendance to womyn-born womyn, sparking decades of protest, internet debates, and counter-protests like Camp Trans. In 1991, transsexual woman Nancy Jean Burkholder was asked to leave the Michigan Womyn's Music Festival after revealing she was trans. These exclusions originated from the 1973 year the Daughters of Bilitis splintered over Beth Elliott's status as a woman. Yet, a 1992 festival survey showed 73 percent of attendees had no objection to post-op transwomen attending. The policy sparked 15 years of internet debate and protests.

Transgender individuals face alarming rates of verbal harassment, bullying, and fatal hate crimes driven by gender non-conformance. Hate crimes act as message crimes against an entire group to enforce conformity. A San Francisco Department of Public Health survey of 397 MtFs in 1996 found that 83 percent suffered verbal abuse, 46 percent faced employment discrimination, and 59 percent reported a history of rape. The 50 under 30 report on anti-trans murders examined 50 people aged thirty and under, revealing that 85 percent were Black and Latino victims, and 92 percent were biologically male presenting some degree of femininity. Ukea Davis and Stephanie Thomas were murdered in Washington, D.C., in August 2002 after ten bullets were pumped into their car.

Medical Gatekeeping

Medical professionals and diagnostic manuals function as gatekeepers by pathologizing trans identities and imposing burdensome standards for care. Diagnoses such as Gender Identity Disorder pathologize non-conforming gender identities, framing a natural physical mismatch as a mental illness. Medical protocols often require letters from therapists and a full year of living in the true gender identity before patients can access essential surgeries or hormones. Dustin, an FtM individual, avoided physical examinations, GYN exams, and testosterone refills due to a profound fear of transphobic doctors. The DSM updated GID to replace gender dysphoria in the 1994 year, establishing the Real Life Experience requirement of 1 year of living in true gender identity before surgery.

Rigid legal documentation requirements force trans individuals into high-risk situations by demanding proof of medical transition for basic identity papers. State and federal laws require matching sex markers on documents like driver's licenses, Social Security records, and birth certificates. In October 2002, Social Security changed rules to require proof of completed surgery for sex indicator updates. Ohio, Tennessee, and Idaho are 3 states that do not allow a change of sex designation on birth certificates. Sandy Gast was arrested and subjected to a strip search by a male officer in Kansas after being charged with swearing falsely on a marriage application despite holding an amended birth certificate.

The scarcity of explicit antidiscrimination laws leaves transgender people vulnerable to arbitrary firing, housing denial, and public exclusion. Federal legislation and most state laws lack explicit protections for gender identity and expression. Peter Oiler was fired by Winn-Dixie after twenty years of employment simply because he mentioned to a supervisor that he was an occasional cross-dresser. As of April 2006, 307 employers had nondiscrimination policies including gender identity, comprising 162 private-sector companies, 81 of which were in the Fortune 500, along with 8 state governments, 79 city and county governments, and 38 colleges and universities.

7. Inner Turmoil, Coping, and Gender Liberation

Puberty serves as an exceptionally traumatic period for gender-variant youth because the development of secondary sex characteristics provides indisputable evidence that their bodies do not match their gender identity. Chronic societal shaming leads many transgender individuals to internalize transphobia, resulting in self-loathing, self-doubt, and an irrational need to justify their existence.

Lucy recalled that at age fifteen her aloneness became unbearable due to unaddressed gender dysphoria and being a lesbian, causing her to lose all hope and the will to continue. Rickey Lynn made her first suicide attempt at age thirteen because she did not understand the physical changes happening to her body during puberty and wanted them to stop. Jill received an 8 to 10 year prison sentence following a desperate robbery attempt related to severe depression. Erin spent 21 days in an initial rehab program for drug and alcohol overdose and 18 days in jail resulting from alcoholism.

Overcoming chronic shame, depression, and violence requires robust coping strategies, visible role models, and a transition to parallel continuums.

Inner Turmoil

Trans-identified individuals face elevated risks of domestic violence and sexual assault coupled with severe systemic barriers when seeking help from prejudiced service providers, shelters, and legal authorities. 265 survey respondents in the Transgender Sexual Violence Project of FORGE shared their experiences regarding healing and service providers. Rita credited her mentor Michelle Kammerer, a post-op trans woman who transitioned during 1993-94 while working as a captain in the Los Angeles City Fire Department, with providing invaluable advice for surviving a conservative profession.

Achieving true equality for gender-variant people requires moving beyond identity politics to a social justice perspective that aims to dismantle the rigid gender binary entirely. 200 parents participated in the online support community for parents of gender-variant youngsters at Children's National Medical Center. You can help transform cultural norms by taking concrete actions:

• replace the gender binary in textbooks, graduate schools, religious sermons, and family discussions;
• educate the public and institutional service providers about biological gender variance;
• implement anti-discrimination and anti-harassment protections in public schools based on sexual orientation and gender identity.

A New Conceptualization

To accurately represent human diversity without pathologizing individuals, the author proposes a framework of parallel continuums for sex, gender identity, gender expression, and sexual orientation. Traditional binary categories fail to capture the reality of human bodies and identities. The sex continuums allow individuals to score differently on male and female physical traits rather than occupying a single binary point.

Dan, a twenty-five-year-old graduate student with a singing career, experienced a five-month debilitating illness because his testosterone levels were more than twice that of a biological male, leading him to temporarily revert to a female identity before successfully transitioning later. Jennifer, a fifty-year-old MtF teacher, suspended her transition and resumed living as a man for two years so her bedridden wife would not lose health insurance coverage under an employer that failed to recognize same-sex marriages. November, a twenty-eight-year-old graduate student who initially used male pronouns in 2001, later embraced performing femininity in 2005 with new names, wardrobes, and makeup while maintaining a genderqueer identity.

Conclusion

Lori Girshick demonstrates that rigid binary systems cause profound distress by separating biological sex, social gender, and inner identity into parallel continuums. You can dismantle these artificial limits by applying sociological insights to everyday interactions and institutional policies.

Transform your approach to gender diversity by following these practical rules:

1. Separate biological sex, gender expression, and internal identity into distinct categories instead of treating them as a single matched set.
2. Respect individual self-definition by using chosen names and requested pronouns without demanding medical proof or legal documentation.
3. Eliminate gender segregation in public spaces such as restrooms and locker rooms by adopting universal single-occupancy facilities.
4. Remove discriminatory dress codes and policy restrictions that enforce traditional masculine and feminine standards in schools and workplaces.
5. Support transgender individuals through visible advocacy, active listening, and zero-tolerance policies against harassment and violence.

10 Key Ideas

1. Lori Girshick challenges the rigid gender binary through the lived experiences of 150 sex- and gender-diverse individuals, proposing a parallel continuums framework for human identity.
2. Gender and sex are distinct concepts that should not be used interchangeably, and biological variations frequently deviate from the strict male-female binary.
3. Biological sex traits are socially constructed and medicalized to fit a two-sex model, while society enforces binary gender roles through continuous socialization.
4. Children whose gender identity does not match their assigned sex experience profound distress, school harassment, and family pressure to conform.
5. Navigating a gender journey involves aligning internal self-images with external presentation through hormones, voice training, and bodily changes.
6. Coming out as transgender triggers complex pronoun dilemmas, family rejections, and workplace discrimination despite growing legal protections.
7. Public bathrooms, medical diagnostic manuals, and legal documentation requirements serve as systemic sites of gender policing and discrimination.
8. Overcoming chronic shame, depression, and violence requires robust coping strategies, visible role models, and a transition to parallel continuums.
9. To accurately represent human diversity without pathologizing individuals, the author proposes a framework of parallel continuums for sex, gender identity, gender expression, and sexual orientation.
10. Lori Girshick demonstrates that rigid binary systems cause profound distress by separating biological sex, social gender, and inner identity into parallel continuums.