Glossary of Terms: A Sex-Binary, LGB People-Protective Perspective
What exactly are we talking about here?
Androgyny: Closely related to gender nonconformity, androgyny describes an individual’s presentation blending traits and behaviors of both sexes reflecting normal human variation in self-expression.
Affirmation-Only Model: This is the therapeutic or medical approach employed by gender clinics in the United States. The model is characterized by rapid affirmation of a child’s stated gender identity at the earliest signs of gender dysphoria without exploring underlying causes, such as same-sex attraction, internalized homophobia, social pressures, ROGD, trauma or other mental health issues. TRAs contend that any delay in affirmation constitutes transphobia and even child abuse. This potentially leads to medicalizing transient feelings of discomfort with one’s sex or sexual orientation in adolescence. The Coalition argues this approach harms same-sex-attracted people by misinterpreting feelings of internalized homophobia and acts as a kind of conversion therapy for people who believe that undergoing GAC would make them more socially acceptable.
AGP (Autogynephilia): A condition where biological males experience sexual arousal from imagining themselves as female, sometimes linked to gender dysphoria. The LGBCC acknowledges AGP as a possible driver of some adults seeking GAC but critiques its relevance to youth, arguing it may be amplified by influences like sissy porn or the school-to-clinic pipeline, rather than being innate. The Coalition opposes applying AGP to justify transitions, advocating for psychotherapy or exploratory therapy to explore underlying issues.
Asexual (Ace): A person with little to no sexual attraction, though they may experience romantic attraction. Asexuality is distinct from sexual orientation which is about attraction to the same or opposite sex. The LGBCC seeks to protect asexual people from having their issues conflated with gender identity issues because it could lead to medicalization.
Authenticity: A term that appears in advertising about GAC. It is used to justify transitioning alongside other claims such as suicide prevention and autonomy meant to convey “living in alignment with one’s true self.” In the context of gender ideology, it refers to expressing a perceived innate gender identity. The LGBCC critiques its use to justify immediate affirmation, arguing it pressures same-sex-attracted people to adopt transgender identities.
Autonomy: The capacity for self-determination and independent decision-making. In the context of gender affirmation, it is used as an argument to support choosing GAC. The LGB Courage Coalition argues that minors lack the cognitive and emotional maturity to fully comprehend the lifelong consequences of such decisions, particularly when influenced by societal pressures to conform to gender norms. These pressures often misinterpret natural variations in gender expression, especially among gay youth, as gender dysphoria requiring medicalization.
Bans (on “Gender-Affirming Care”): The word ban is used to describe laws age restricting access to interventions like puberty blockers, cross-sex hormones and surgery for minors. Over 25 U.S. states, including Tennessee led by Skrmetti, have enacted these restrictions since Arkansas in 2021. The LGBCC supports these restrictions, citing the Cass Review and HHS Report, arguing they protect people from irreversible decisions made without consideration of same-sex attraction.
Binding: Using tight garments to flatten the chest by females identifying as transgender men or non-binary. Binding is considered part of a social transition and carries health risks including possibly increasing the chances of medicalization.
Bisexual (Bi): An individual, or a word describing an individual, who is sexually attracted to people of both sexes, not necessarily equally or at the same time.
Born in the Wrong Body: A phrase describing the belief that one’s sex is mismatched with one’s gender identity, often used to justify GAC. LGBCC argues that it is misleading, as body and mind are inseparable, rejecting the notion of a fixed gender identity separate from biology.
Bottom Surgery: A euphemism for surgeries altering genitalia, such as vaginoplasty, orchiectomy, or phalloplasty.
Cass Review: An independent 2022–2024 UK review, led by Dr. Hilary Cass, investigating gender identity services for children and adolescents. It criticized the weak evidence base for medical interventions like puberty blockers, cross-sex hormones and surgery, particularly for predominantly gay youth, highlighting risks like infertility and psychological harm. The review found that the Dutch Protocol, used widely, lacked robust long-term data and was driven by ideology rather than scientific rigor. It recommended cautious, non-medical approaches, emphasizing psychological support and thorough assessment. Critics of medicalization of minors argue it exposes the experimental nature of GAC, prioritizing societal aesthetics over health, and calls for halting irreversible treatments in minors.
Cisgender: A term for the vast majority of individuals whose gender identity aligns with their sex, meant to contrast with transgender. TRAs use the term as a slur. There is evidence that children are pressured into believing that cisgender people are oppressors and it is a category one should not belong to.
Conversion Therapy: Gay conversion therapy refers to practices aimed at changing sexual orientation, usually associated with religious organizations. Recently “conversion therapy” has been conflated to include any kind of therapy that does not immediately affirm gender identity. TRAs succeeded in having gender identity added to sexual orientation in bans against conversion therapy. This has had a chilling effect on exploratory therapy. The LGBCC argues that GAC is conversion therapy for same-sex-attracted people.. Therapists working in the now-closed Tavistock Clinic in the UK were troubled that they were promoting a form of gay conversion therapy because they recognized that most of the children they medicalized would have otherwise turned out gay.
Cross-sex hormones: In the context of GAC cross-sex hormones refers to sex hormones testosterone and estrogen when they are administered to the opposite sex: females receiving testosterone and males receiving estrogen.
Detransitioner: An individual who previously identified as transgender and pursued some form of gender transition but has since ceased or reversed that process.
Disorders of Sex Development (DSD): A group of congenital conditions in which the development of chromosomal, gonadal, or anatomical sex is atypical. These conditions may involve differences in sex chromosomes, gonads, internal or external genitalia, or hormone production/function. Examples include conditions like Congenital Adrenal Hyperplasia (CAH), Androgen Insensitivity Syndrome (AIS), or Klinefelter Syndrome. The term is used in medical contexts to describe variations also referred to as intersex conditions.
DSM (Diagnostic and Statistical Manual of Mental Disorders): A handbook published by the American Psychiatric Association for classifying mental disorders, used globally by clinicians and researchers. The DSM-5 (2013) replaced “Gender Identity Disorder” with “Gender Dysphoria,” shifting focus from labeling gender nonconformity as a disorder to emphasizing distress or discomfort with one’s sex. Critics argue this change, driven by advocacy, depathologized transgender identity to align with social acceptance, lacks robust evidence. Critics contend that it medicalizes normal identity exploration during adolescence and that the former diagnosis
Dutch Protocol: A medical approach developed in the Netherlands for treating gender dysphoria involving puberty blockers, cross-sex hormones, and surgery to align physical appearance with gender identity. Critics argue it was motivated by a desire to ensure adult transsexuals “pass” better by intervening early in childhood, prioritizing aesthetic outcomes over long-term health. They view it as experimental, citing insufficient long-term data on safety and efficacy, with potential risks like infertility and psychological harm. Given that almost all of the subjects in the study were same-sex attracted, skeptics contend it medicalizes natural identity exploration in gay youth, who may face societal pressures to conform to gender norms rather than being supported in their same-sex attraction. The protocol has been criticized for failing to adequately distinguish between gender dysphoria and the developmental experiences of proto-gay children, potentially leading to irreversible interventions driven by societal bias rather than evidence-based care.
Estrogen: The predominant sex hormone in females. In GAC it is administered to trans-identified males who want to look female. Some of its effects include breast development, body fat redistribution, reduced body hair, infertility, and testicular atrophy.
Exploratory Therapy: A non-directive approach exploring causes of gender dysphoria, such as same-sex attraction, internalized homophobia, ROGD, or social pressures, without assuming a transgender outcome. The LGBCC advocates for this over the affirmation-only model or Dutch Protocol, protecting people from medicalization as supported by the Cass Review and HHS Report.
First, Do No Harm: A medical ethics principle, derived from the Hippocratic Oath, emphasizing that healthcare providers should, above all else, avoid causing harm to patients. LGBCC argues that GAC violates this principle by medicalizing normal human variation with risky and unproven interventions. Outcomes such as sexual dysfunction and infertility are common.
Free to Be… You and Me: A 1972 children’s project by Marlo Thomas promoting label-free gender expression. The LGB Courage Coalition condemns Jack Turban’s co-optation of the title in his book Free to Be, which pushes medicalized transgender identity, enforcing the rigid gender norms of gender ideology.
FTM (Female-to-Male): Sometimes used to describe a person of the female sex who undergoes procedures such as testosterone injections, double mastectomy or phalloplasty in order to appear male.
Gatekeeping: In the context of GAC, gatekeeping is a word used by TRAs to criticize strict clinical requirements, such as a gender dysphoria diagnosis, to access interventions such as puberty blockers, cross-sex hormones and surgery. LGBCC and the Cass Review criticize relaxed gatekeeping, arguing it assumes fixed gender identity, medicalizing normal human variation in gender nonconforming people.
Gay: Sexually attracted to people of the same sex.
Gender: Originally a grammatical term (Old French gendre, Latin genus, meaning “kind” or “type”) to describe linguistic categories. Eventually it came to be used inchangeably with sex. It was repurposed by John Money and Robert Stoller when the term gender identity was coined.
Gender-Affirming: Describing medical, social, or psychological interventions (e.g., as puberty blockers, cross-sex hormones and surgery. name changes, pronoun use) aimed at aligning an individual’s physical appearance or social presentation with their gender identity, often to resemble the opposite sex. Critics, including LGBCC and citing the Cass Review, argue these interventions, rooted in the Dutch Protocol, mistake natural variation in gender-nonconforming youth—often gay or exploring identity—for persistent gender dysphoria, rushing to affirm potentially momentary ideation. They lack robust long-term evidence, prioritizing adult aesthetic outcomes over health.
Gender-Affirming Care (GAC): A term describing medical interventions (e.g., as puberty blockers, cross-sex hormones and surgery). Coined to replace sex reassignment or sex change it emphasizes affirming one’s gender identity. Critics, including LGBCC, use quotes to highlight skepticism, arguing it medicalizes normal human diversity, especially in youth, with insufficient evidence of long-term safety or efficacy, as noted in the Cass Review. Many view it as experimental, prioritizing aesthetic outcomes over health. Critics argue that it is not “care” in that it introduces trauma to healthy bodies.
Gender Clinic: A medical facility, either stand-alone or affiliated with a university or hospital, specializing in “gender-affirming care.” These clinics typically provide interventions such as puberty blockers, cross-sex hormones, and surgeries for children, adolescents, and adults seeking to align their physical characteristics with their gender identity. The LGB Courage Coalition critiques the rapid proliferation of these clinics, arguing that the expansion of the sex reassignment industry may be targeting gender dysphoric adolescents who might actually be grappling with their sexual orientation.
Gender Dysphoria: A DSM-5 (2013) diagnosis replacing GID, focusing on distress from a mismatch between one’s gender identity—now often framed as fixed and immutable—and sex, not pathologizing the identity itself. Critics, including LGBCC, argue this assumption, influenced by ideology, pressures gender-nonconforming minors, often gay, into believing their identity is permanent.
Gender Identity: As coined and used in the 50s and 60s by John Money and Robert Stoller the term gender identity was intended to describe one’s psychological alignment with gender roles or societal expectations. Currently the word is used to suggest an immutable identity that may not align with one’s sex. Many people lack a distinct gender identity, viewing “man” or “woman” as fluid, variable categories based on behavior or presentation.
Gender Identity Disorder (GID): A DSM-IV diagnosis (1994) for distress from incongruence between one’s gender identity and sex, replaced in DSM-5 (2013) by gender dysphoria to focus on distress rather than pathologizing identity. Critics, including LGBCC, argue the change was driven by ideology and advocacy, not scientific evidence.
Gender Ideology: A belief system asserting that gender identity, often presented as fixed and immutable, is distinct from sex and should shape medical, social, and legal frameworks. LGBCC contends it is regressive and contradictory, reinforcing outdated and rigid sex-based stereotypes by medicalizing normal human variation, such as androgyny, through permanent interventions, while simultaneously claiming that gender is fluid.
Gender Industrial Complex: A term used by critics to describe a network of medical, corporate, and advocacy entities that profit from and promote gender transition procedures and transgender ideology, exemplified by Vanderbilt University Medical Center’s 2018 discussions on the profitability of gender reassignment surgeries, which contributed to Tennessee’s 2023 restrictions on such procedures for minors. The sex reassignment industry is part of the gender industrial complex.
Genderfluid: A term for individuals whose gender identity shifts over time, varying between male, female, both, or neither, emerging in the early 2000s in queer and transgender advocacy. LGBCC argues it contradicts gender affirmation’s assumption of a fixed identity, as advocates promote both fluid and immutable identities.
Genderqueer: A term for identities outside the sex binary.
Gender Nonconforming: Describing individuals whose behavior or appearance deviates from cultural expectations based on sex. Lisa Selin Davis argues gender nonconformity is often pathologized as transgender identity, reflecting rigid gender norms that enforce binary labels. This contrasts with Free to Be… You and Me’s 1970s ethos, which celebrated fluid, label-free self-expression. Sex materialists critique this rigidity for promoting the medicalization of nonconformity.
HHS Report: The 2025 U.S. Department of Health and Human Services Review of Evidence and Best Practices for Treatment for Pediatric Gender Dysphoria, assessing the evidence base for gender-affirming interventions. The LGBCC views the HHS Report as reinforcing the Cass Review, highlighting a lack of high-quality evidence for puberty blockers, cross-sex hormones and surgery, and critiquing the collapse of medical ethics in pediatric GAC.
Homophobia: Prejudice against same-sex-attracted individuals. The LGBCC argues it contributes to pressures on people to identify as transgender.
Homosexual: As heterosexual means opposite-sex attracted, homosexual means same-sex attracted. Some gay people like to use this word while others don’t. Some TRA organizations discourage the use of this word in order to obscure the difference between sex and gender.
Hysterectomy: In the context of GAC hysterectomy is the irreversible surgical removal of a healthy uterus or a uterus that has begun to atrophy due to the use of testosterone.
Informed Consent: A term whose meaning has changed over time to refer to the ability of minors to consent to GAC, in some cases without parental consent. Coined in relation to human rights abuse cases involving medical experimentation, it once meant a strict adherence to making sure that the patient understands all aspects of any treatment before agreeing to it. LGBCC argues that minors cannot give consent to GAC and therefore it violates a cornerstone of medical ethics. Furthermore, gender clinicians have themselves expressed concern that this guardrail is not properly in place.
Infertility: The inability to conceive children. Infertility, which is a known risk of GAC, is inadequately addressed when people are being rushed toward medicalization in gender clinics.
Intersex: A term for individuals with DSDs, rare variations within the sex binary who may be born with ambiguous genitalia. Intersex people advocate for less surgical intervention on babies born with these conditions.
Lesbian: A same-sex attracted or gay woman. The LGBCC seeks to protect lesbians from pressures to identify as transgender.
LGBT: Acronym for Lesbian, Gay, Bisexual, and Transgender. The LGB Courage Coalition focuses on LGB needs, prioritizing same-sex attracted individuals’ protection from medicalization by the sex reassignment industry.
Mastectomy: In the context of gender-affirming procedures, a mastectomy is the irreversible surgical removal of healthy breasts and euphemistically called top surgery.
Medicalization: In the context of GAC the term is used to describe interventions that have progressed beyond social transition such as puberty blockers, cross-sex hormones and surgery.
Medically Necessary: A term justifying medical interventions like puberty blockers, cross-sex hormones and surgery as essential to treat gender dysphoria in the context of legal disputes and insurance coverage. The LGBCC argues that it contradicts claims that gender dysphoria is “not a disease,” as necessity implies pathology. The Cass Review and HHS Report question the evidence for necessity.
MTF (Male-to-Female): Sometimes used to describe a person of the male sex who undergoes procedures such as vaginoplasty and face feminization in order to appear female.
Nonbinary: A term for individuals who consider themselves outside the sex binary. LGBCC argues “androgyny” once sufficiently captured such expressions, rejecting the need for a new label.
Orchiectomy: In the context of GAC, an orchiectomy is the rreversible surgery to remove healthy testicles in individuals who want to appear more like the opposite sex.
Pansexual: A term popularly used to mean attraction regardless of sex or gender identity.
Phalloplasty: A surgery to construct a nonfunctional penis in females who seek to appear male by creating a tube of flesh from the arm or thigh. High risk and irreversible, it is opposed by the LGBCC. Some people who undergo this procedure do not understand that they cannot literally become male in all senses of the word.
Psychotherapy: Talk-based therapy addressing mental health. For gender dysphoria, it includes exploratory therapy to explore issues like same-sex attraction which can be a source of distress due to homophobia, both internalized and in one’s environment. The LGBCC supports it as a non-medical approach, endorsed by the Cass Review and HHS Report. TRAs insist that any form of talk therapy that does not immediately affirm should be considered conversion therapy.
Puberty Blockers: Medications (e.g., GnRH agonists) delaying puberty. The LGBCC views “puberty blockers” as a euphemism minimizing risks (e.g., bone density loss). Widely pushed as “pause” to consider options for minors, nearly 100% go on to cross-sex hormones thereby also increasing the chances of progressing to surgery.
Queer: An umbrella term for nonnormative sexual orientations and gender identities. The LGB Courage recognizes that many LGB people do not want to be included under this umbrella because it tends to obscure the sex-based definition of sexual orientation.
ROGD (Rapid Onset Gender Dysphoria): ROGD is a hypothesis by Dr. Lisa Littman that posits that the sudden upsurge in adolescents with gender dysphoria and the flip in the sex ratio from predominantly male to predominantly female are due to social influences. The LGBCC supports ongoing research into ROGD, citing the Cass Review and HHS Report. TRAs and other forces appear to want to quash the concept entirely because it contradicts their idea of an immutable gender identity that requires immediate affirmation and medicalization.
Same-Sex Attraction: The material reality for lesbians, gay men and bisexuals who are attracted to people of the same sex. LGBCC believes that defining same-sex attraction as an identity serves gender ideology by obscuring its importance as a protected sex-based category.
Sanctuary States: States protecting access to GAC. The LGBCC opposes these, arguing they enable
School-to-Clinic Pipeline: A term that was coined to describe the growing phenomenon of young people being directed toward social transition by teachers, counselors and other school officials. LGBCC believes that children are being asked to consider whether they have a gender identity without proper consideration of whether it’s developmentally appropriate and that the teaching that puberty blockers can help “manage” puberty is a harmful practice.
Self-ID (Self-Identification): Recognition of gender identity in social and legal contexts based on personal declaration.
Sex: The biological classification of individuals as male or female based on chromosomes (XX for female, XY for male) and gametes (eggs for female, sperm for male. The LGBCC views sex as a binary and the basis for same-sex attraction.
Sex Assigned at Birth: A phrase adopted by trans activists from the phenomenon intersex people face when their ambiguous genitals lead doctors to “assign” their sex. Also AFAB and AMAB: assigned female or male at birth. The LGBCC argues that in the vast majority of cases, sex is observed at birth based on external sex organs and these terms perpetuate confusion and harm to LGB people.
Sex Binary: The phrase sex binary was coined in the late 20th century to critique the biological classification of male and female. In the context of gender ideology the term has recently gained traction and is used to criticize the concept of two sexes based on chromosomes and gametes in order to support the idea of gender fluidity.
Sex Change: A set of procedures usually including cross-sex hormones and surgery in order to appear more like the opposite sex. Although no one can change sex, some prefer this term for its directness. Unlike the term “gender-affirming care” it doesn’t try to obscure the chemical and surgical modification of sex traits involved.
Sex Materialism: A perspective asserting that sex is immutable, rejecting the idea of changing sex via medical interventions. The LGB Courage Coalition embraces this, protecting LGB youth from gender ideology’s rigid norms that promote the idea that gender nonconforming people must be the opposite sex. It supports fluid gender expression without pathologizing or medicalizing nonconformity.
Sex Reassignment: Another term for sex change.
Sex Reassignment Industry: The sector encompassing the sale and administration of puberty blockers, cross-sex hormones and surgery projected to grow significantly by 2035 due to rising adolescent transgender self-identification. The LGB Courage Coalition condemns its profit-driven medicalization of youth and vulnerable adults.
Sex Traits: Physical and physiological characteristics that distinguish males from females, categorized as primary or secondary. In males, primary sex traits include the testes, penis, scrotum, and internal structures like the vas deferens, while secondary sex traits, driven by testosterone, include a deeper voice, facial and body hair, male-pattern balding, increased muscle mass, broader shoulders, and a prominent Adam’s apple. In females, primary sex traits include the ovaries, uterus, vagina, and Fallopian tubes, while secondary sex traits, driven by estrogen and progesterone, include breast development, wider hips, increased fat distribution in hips and thighs, smoother facial features, menstruation, and finer body hair.
Sexual Dysfunction: Impaired sexual function, such as erectile dysfunction or libido loss, often linked to estrogen therapy in males. Youths who have been administered puberty blockers followed by estrogen will be unable to orgasm and face greater risks when undergoing vaginoplasty.
Sexual Orientation: Lesbian, gay, homosexual, bisexual and heterosexual are sexual orientations.
Shield Laws: Laws protecting providers from legal actions in states age-restricting gender-affirming care. The LGBCC critiques these as enabling harmful interventions.
Sissy Porn: A genre of pornography depicting forced feminization, linked to AGP.
Skrmetti: Refers to Tennessee Attorney General Jonathan Skrmetti, leading legal efforts to restrict pediatric GAC through U.S. v. Skrmetti (2024), a Supreme Court case defending Tennessee’s Senate Bill 1 (SB1). SB1 restricts puberty blockers, cross-sex hormones and surgery for minors, upheld by the 6th Circuit but challenged for violating equal protection and due process. LGBCC supports Skrmetti, citing the Cass Review and HHS Report, arguing SB1 protects gender-nonconforming youth, often gay, from medicalizing normal human variation with insufficient evidence,
Social Transition: Adopting social markers of the opposite sex (e.g., names, pronouns, clothing, hair styles). There is considerable evidence that minors are being socially transitioned by teachers and other school personnel without the knowledge or consent of parents. Experts warn that social transition is not benign and may increase the chances of progressing to high risk medical interventions like puberty blockers, cross-sex hormones and surgery.
Suicide Myth: The claim that GAC is essential to prevent suicide in gender-nonconforming youth, often promoted to justify social and medical interventions. LGBCC, citing the Cass Review and HHS Report, argues this lacks robust evidence, exaggerating risks to pressure youth and their parents into medicalizing normal human variation. The Cass Review finds weak data linking GAC to reduced suicidality, with high desistance rates (61–98%) suggesting transient distress. Many detransitioners and parents report that gender clinicians threatened a stark choice between GAC and suicide which hastened their acceptance of the necessity for medical intervention which they later regretted.
Surgery: In the context of GAC, surgery refers to mastectomy, phalloplasty, vaginoplasty, orchiectomy, facial feminization surgery and other surgeries associated with sex change or sex resassignment.
Testosterone (T): Called “T” for short, it is the predominant sex hormone in males. In GAC it is administered to trans-identified females who want to look male. Some of its effects include thickening of vocal chords, enlargement of the clitoris, facial hair and male-pattern baldness.
Top Surgery: A euphemism for chest surgeries like mastectomy.
TRA (Trans Rights Activist): A person who advocates for GAC and self-ID without age restrictions.
Trans: A shorthand for transgender or transsexual. The LGBCC critiques its use as a modifier. The use of the term “trans child” is problematic because it assumes that children can be born in the wrong body.
Transition: Sex materialists distinguish sex from gender identity, viewing the latter as a psychological or social construct. They argue the word “transition” conflates these, implying a biological change when only gender expression or social roles are altered.
Trans Man/Trans Woman: A person of the female sex identifying as male or a person of the male sex identifying as female. The LGBCC critiques its use because a trans man is not a category of man, nor is a trans woman a category of woman.
Trans-Identified: A term for those identifying as transgender (or, in some cases transsexual).
Transgender: A term for those who claim their gender identity differs from their sex. Many people take issue with the idea that everyone has a gender identity.
Transgenderism: A term used by critics to describe the belief or practice of identifying as a gender different from one’s sex. First notably used in the 1970s, it gained traction in the 1990s within academic and activist circles, particularly in transgender studies, to describe the phenomenon of transgender identities.
Transphobia: Hostility or fear based on gender identity. The LGBCC argues that the term is used incorrectly to describe people who have concerns about medicalizing gender nonconformity.
Transsexual: An older term, though still in use, usually referring to a person who has undergone surgery and cross-sex hormone therapy to appear like the opposite sex.
Vaginoplasty: A risky surgery to create what is known as a “neovagina” for males who want to appear female. Generally it involves inverting the penis to create an internal pocket and using the testicles to create something resembling the female vulva. The LGBCC argues that the surgery is regressive in that it creates a receptacle for a male partner to penetrate without consideration for the pleasure of the person being penetrated. Experts in GAC state that individuals who undergo this procedure at a young age after puberty blockers risk lifelong sexual dysfunction and infertility.