Glossary

Welcome to our glossary of terms related to trans health and the services available in British Columbia. The words and meanings provided here are offered as tools to help us think about gender, sex, society, culture, and health. We encourage readers to think about the ways language can be used to promote recognition, respect and equity.

Ally: A cis person who supports and celebrates trans identities, challenges transphobic remarks and actions of others, and willingly explores these biases within themselves. (QMUNITY)

Androgynous: A blend of other genders; a person whose gender androgynous might refer to themselves as an androgyne.

Asexual: Someone who does not experience sexual desire for people of any gender. Some asexual people desire romantic relationships, while others do not. Asexuality can be considered a spectrum, with some asexual people experiencing desire for varying types of intimacy. This desire can fluctuate over time. Asexuality is distinct from celibacy, which is the deliberate refraining from sexual activity. Asexual people experience high levels of invisibility and trivialization. (QMUNITY)
Assigned Sex: see sex assignment.

BC Services Card: A card issued by the Province of British Columbia government for the purposes of accessing provincial government services, which integrates photo identification, driver’s license and CareCard.

BC Children’s Hospital Endocrinology and Diabetes Unit: Provides endocrine care (puberty blockers and hormone therapy) to trans and gender-questioning youth in British Columbia.

Bigender: A gender identity of having two full genders which one can move between.

Binding: Compressing one’s chest to create a more androgynous or masculine appearance.

Black Market Hormones: Hormones purchased without a prescription.

Breast construction: A gender-affirming, feminizing, top surgery that enlarges one’s breasts.

Butch: Describes gender expressions and/or social and relationship roles that are perceived as being masculine, or refers to a person who embodies these qualities. Might be trans, but not necessarily. (QMUNITY)

CAFAB: Acronym for Coercively Assigned Female at Birth; refers to people declared to be female at birth, and raised within a female gender role that does not match their gender. Another acronym that is used is DFAB, Designated Female at Birth.

CAMAB: Acronym for Coercively Assigned Male at Birth; refers to people declared to be male at birth, and raised with a male gender role that does not match their gender. Another acronym that is used is DMAB, Designated Male at Birth.

Canadian Professional Association for Transgender Health (CPATH): Professional organization devoted to trans health, whose mission as an international multidisciplinary professional association is to promote evidence based care, education, research, advocacy, public policy and respect in trans health.

Catherine White Holman Wellness Centre (CWHWC): A volunteer-run centre in Vancouver aiming to provide free, low-barrier wellness services to trans and gender diverse people in a way that is respectful and celebratory of clients’ identity and self-expression.

Chest Surgery: A gender-affirming, masculinizing, top surgery that removes breast tissue and sculpts remaining tissue into a shape that is typically considered to be more masculine.

Cisgender (also cissexual): Having a gender that matches one’s assigned sex; non-trans.

Clitoral Release: A gender-affirming, masculinizing, lower surgery to cut ligaments around the clitoris, releasing it from the pubis, giving the shaft more length, thus creating a penis.

Coming Out or Coming Out of the Closet: The process of becoming aware of one’s trans identity, accepting it, and/or telling others about it; coming out is also used to refer to disclosing one’s non-heterosexual sexual orientation. (QMUNITY)

Cross Dresser: People who wear clothing traditionally associated with a different gender than their gender; cross-dressers may or may not be trans; ‘cross-dresser’ has generally replaced the term ‘transvestite’, as ‘transvestite’ is considered offensive by many. (QMUNITY)

Disorders of Sex Development (DSD): A reproductive or sexual anatomy that does not closely resemble typical male or female reproductive or sexual anatomy, which may be related to genitalia, secondary sex characteristics, and/or chromosomal make-up; DSD replaced the outdated terms ‘hermaphrodite’, as ‘hermaphrodite’ is considered offensive by many; see also ‘intersex’; DSD is different from trans.

Drag King: Drag kings are performance artists who dress and act in a masculine manner and personify male gender stereotypes as part of their routine. Might be trans, but not necessarily.

Drag Queen: Drag queens are performance artists who dress and act in a feminine manner and personify female gender stereotypes as part of their routine. Might be trans, but not necessarily.

Employment Insurance (EI): Provides regular benefits to those who lose their jobs through no fault of their own and sickness benefits to individuals who are unable to work because of sickness, injury, or quarantine.

Endocrinologist: A doctor specially trained in the study of hormones and their actions and disorders in the body.

Facial feminization surgery: Surgeries that feminize the face, which include Adam’s apple reduction, nose feminization, facial bone reduction, face lift, eyelid rejuvenation, and hair reconstruction.

Fair Pharmacare: Provides eligible BC residents with coverage for some prescription drugs and medical supplies.

Female: A sex, usually assigned at birth, and based on chromosomes (e.g. XX), gene expression, hormone levels and function, and reproductive/sexual anatomy (e.g. vagina, uterus).

Female-to-Male (FTM): May refer to a person assigned female at birth whose gender is male all or part of the time; transitioning-to-male; female-to-male spectrum. (QMUNITY)

Feminine: Describes socially and culturally constructed aspects of gender (e.g. roles, behaviour, expression, identity) typically associated with girls and women.

Feminizing Hormone Therapy: The use of medications (e.g. estrogen, anti-androgens, progestins) to develop physical characteristics that are in line with one’s gender or gender expression, including breast development, more fat on the hips, thighs, and buttocks, and softer skin.

Feminizing Surgeries: Gender-affirming surgical procedures that create physical characteristics reflective of one’s gender identity and/or gender expression, including breast augmentation, vaginoplasty, facial feminization surgery, voice surgery, thyroid cartilage reduction, buttock augmentation/lipofilling, and hair reconstruction.

Femme: Describes gender expressions and/or social and relationship roles that are perceived as being feminine, or refers to a person who embodies these qualities. Might be trans, but not necessarily. (QMUNITY)

First Nations Health Authority: A health authority that aims to improve health outcomes for First Nations peoples in British Columbia, and represents a new relationship between B.C. First Nations, the Province of B.C. and the Government of Canada.

Formulary: A listing of medications covered by a health care plan.

Gaff: A garment that flattens the lower part of your body, concealing the penis* and the testes*.

Gay/Straight Alliance (GSA): Student-led organizations intended to provide a safe and supportive environment for LGBT2Q+ and questioning youth and their allies; see also QSA.

Gender: Socially and culturally constructed roles, behaviours, expressions and identities of girls, women, boys, men, and trans people.

Gender Affirming Surgery: Range of surgeries that create physical characteristics that are in line with one’s gender identity, including vaginoplasty, breast augmentation, chest surgery, and phalloplasty; sometimes referred to as sex reassignment surgery (SRS).

Gender Binary: A view that there are only two genders (girls/women and boys/men) that are separate and unchanging.

Gender Creative: Refers to people, often children, who identify and express their gender in ways that differ from societal and cultural expectations.

Gender Diverse: Gender roles and/or gender expression that do not match social and cultural expectations; gender non-conforming; gender variant.

Gender Dysphoria: Distress resulting from a difference between a person’s gender and the person’s assigned sex, associated gender role, and/or primary and secondary sex characteristics. (WPATH)

Gender Expression: How one outwardly shows gender; including through name and pronoun choice, style of dress, voice modulation. (QMUNITY)

Gender Fluid: A gender that is changeable. (Gender (Free) For All)

Gender Identity: Internal and psychological sense of oneself as a woman, a man, both, in between, or neither.

Gender-inclusive Pronouns: Pronouns used to avoid gender binary-based words (e.g. she/her, he/him) or making assumptions about people’s gender; for example, ze/hir or they/them.

Gender Marker: A term some people use for sex marker on identification/documents.

Gender Non-conforming: This term refers to people who do not confirm to society’s expectations for their gender roles or gender expression. Another term used for this is ‘gender-variant’.(QMUNITY)

Gender Normative: Gender roles and/or gender expression that match social and cultural expectations.

Gender Roles: Socially constructed and culturally behavioural norms, such as communication styles, careers and family roles, that are often expected of people based on their assigned sex. (QMUNITY)

Genderqueer: This term refers to people who do not confirm to society’s expectations for their gender roles or gender expression.

GRS in Montreal: MSP contracts with this clinic in Montreal to provide gender-affirming lower surgeries for BC residents.

Hair restoration surgery: Surgical technique that moves individual hair follicles from a part of the body called the donor site to a different part of the body called the recipient site.

Health Authorities: See Regional Health Authorities; see Provincial Health Services Authority; see First Nations Health Authority.

Health Insurance BC (HIBC): Administers the Medical Services Plan (MSP) and PharmaCare programs on behalf of the British Columbia government.

Hermaphrodite: An outdated term that was historically used to label people who have a reproductive or sexual anatomy that does not closely resemble typical male or female reproductive or sexual anatomy, which may be related to genitalia, secondary sex characteristics, and/or chromosomal make-up; replaced by the more respectful term, ‘disorders of sex development’ or ‘DSD’.

Homosexual: An outdated term that was historically used to describe people who were attracted to other people of the same gender; replaced by the more inclusive and respectful term, ‘gay’ or ‘lesbian’, which are not considered offensive by many.

Hormones: Chemical substances that control and regulate the activity of certain cells or organs; see also: sex hormones.

Hormone Therapy (HT): Administration of sex hormones for the purpose of bringing one’s secondary sex characteristics more in line with one’s gender; hormone replacement therapy; HRT; transhormonal therapy.

Hormone Readiness Assessment: Evaluation conducted by a healthcare professional to determine if a patient is ready to begin hormone therapy.

Hysterectomy: A surgical procedure to remove all or part of the uterus, and sometimes the ovaries and/or fallopian tubes; a gender-affirming, masculinizing lower surgery.

Intersex: A reproductive or sexual anatomy that does not closely resemble typical male or female reproductive or sexual anatomy, which may be related to genitalia, secondary sex characteristics, and/or chromosomal make-up; DSD replaced the outdated terms ‘hermaphrodite’; see also ‘disorders of sex development; DSD is different from trans. (QMUNITY)

Lifestyle choice: An outdated and offensive term used to imply that trans people make a choice in the way that they live their lives or behave in ways that are according to the attitudes, tastes, and values associated with the gender identity.

Lipofilling: The surgical transfer of fat removed by liposuction to other areas of the body.

Liposuction: A surgical technique for removing excess fat from under the skin by suction.

Lo-Ho: a slang term used by some trans people who take low doses of hormones.

Lower Surgery: Umbrella term for gender-affirming surgeries done below the waist, including masculinizing (e.g. hysterectomy, clitoral release, metoidioplasty, and phalloplasty) and feminizing (e.g. orchiectomy and vaginoplasty) surgeries.  Also called “bottom surgery”.

LGBT: Acronym for Lesbian, Gay, Bisexual, and Trans people;  GLBT.

LGBT2Q+: An evolving acronym for Lesbian, Gay, Bisexual, Trans, Two-Spirit, Queer, and additional identities.

Male: A sex, usually assigned at birth, and based on chromosomes (e.g. XY), gene expression, hormone levels and function, and reproductive/sexual anatomy (e.g. penis, testicles).

Male-to-Female (MTF): May refer to a person assigned male at birth whose gender is female all or part of the time; transitioning-to-female; female-to-male spectrum. (QMUNITY)

Man: A human being who self-identifies as a man, based on elements of importance to the individual, such as gender roles, behaviour, expression, identity, and/or physiology.

Masculine: Describes socially and culturally constructed aspects of gender (e.g. roles, behaviour, expression, identity) typically associated with boys and men.

Masculinizing Hormone Therapy: The use of testosterone to develop physical characteristics that are in line with one’s gender identity or gender expression, including more facial hair, more body hair, increased muscle mass, and deepened voice.

Masculinizing Surgeries: Gender-affirming surgical procedures that create physical characteristics reflective of one’s gender identity and/or gender expression, including chest surgery, hysterectomy, clitoral release, metoidioplasty, phalloplasty, pectoral implants, liposuction, and lipofilling.

Medical Services Plan (MSP): The British Columbia government health plan that pays for often-considered medically necessary physician services and referred services, such as specialists (surgeon, psychiatrist, etc.), diagnostic x-rays, or laboratory services, for all BC residents. Some residents qualify for premium assistance, for physiotherapy, chiropractic, naturopathy, massage therapy, and acupuncture.

Medical Transition: To undergo medical steps one deems necessary to transition to one’s own sex, for example hormones therapy and/or gender affirming surgery.

Metoidioplasty: A gender-affirming, masculinizing, lower surgery to create a penis and scrotum, done by cutting ligaments around the clitoris to add length to the shaft, grafting skin around the shaft to create added girth, lengthening the urethra so one can urinate from the shaft, and creating a scrotum.

Monthly Bleeding: A term for ‘menstrual bleeding’ or ‘period’ used by some trans people.

No-Ho: A slang term used by some trans people who do not take hormones.

Non-flesh penis: Penis made from synthetic materials; may also be referred to as a ‘packer’ or ‘prosthetic penis’.

Oophorectomy: A surgery to remove the ovaries; a gender-affirming, masculinizing lower surgery.

Orchiectomy: A surgery to remove the testicles; a gender-affirming, feminizing, lower surgery.

Outing someone: Accidentally or intentionally revealing another person’s gender identity or sexual orientation without their permission. (QMUNITY)

Packing: A term some people use to describe wearing padding or a non-flesh penis in the front of the lower garment or underwear.

Padding: Use of undergarments to create the appearance of larger breasts, hips, and/or buttocks. Includes breast forms.

Pangender: Gender identity that includes all genders; multi-gender; omni-gender. (QMUNITY)

Passport Canada: The agency responsible for issuing Canadian passports.

Penis*: Penis* (with an asterisk) is used to acknowledge the many different words that are used for this body part: penis, strapless, shenis, etc.

Person of Trans History: Someone who has transitioned to female or transitioned to male and no longer identifies as trans.

Phalloplasty: A gender-affirming, masculinizing, lower surgery to create a penis and scrotal sac (phase 1), then testicular implants and implants to obtain rigidity/erection (phases 2 and 3). .

PharmaCare: British Columbia government program that helps residents with the cost of eligible prescription drugs and medical supplies.

Plan G: No-Charge Psychiatric Medication Plan. It’s available to individuals of any age who are registered with a mental health service centre and who demonstrate clinical and financial need. This plan can be used for people needing funding for lupron.

Primary Care Provider: An individual’s main health care provider in non-emergency situations (check ups, referrals); Family Doctor; General Practitioner (GP); Nurse Practitioner (NP).

Privilege: Refers to the social, economic and political advantages and power held by people from dominant groups on the basis of attributes such as gender, race, sexual orientation, and social class. (QMUNITY)

Pronouns: The pronouns an individual uses in reference to them, such as she or he, they, ze, or the person’s name. (Gender (Free) For All)

Provincial Health Services Authority (PHSA): Works with the five regional health authorities to plan and coordinate the delivery of some provincial programs and provide highly specialized services across the province.

Puberty Blockers: A group of medications for youth that temporarily suppress or inhibit puberty by suppressing the production of sex hormones and preventing development of secondary sexual characteristics.

QMUNITY: Provincial resource centre located in Vancouver which serves as a hub for lesbian, gay, trans, and queer community programming, training and advocacy.

Qualified Assessors: Healthcare practitioners qualified to conduct surgical readiness assessments in the Province of British Columbia. Assessors were previously designated by the Chief Assessor or they have obtained the necessary training via Trans Care BC.

Queer/Straight Alliance (QSA): Student-led organizations intended to provide a safe and supportive environment for lesbian, gay, bisexual, trans, Two-Spirit, and queer/questioning youth and their allies; see also GSA.

Questioning: A term sometimes used by those in the process of exploring their gender or sexual orientation, as well as choosing not to identify with any other label. (QMUNITY)

QTPOC: Acronym for Queer, Trans, and People of Colour.

QTIPOC: Acronym for Queer, Trans, and Indigenous People of Colour.

Rapid Access to Consultative Expertise (R.A.C.E.) Line: Phone consultation line for primary care providers, staffed by physicians who are experts in trans health care.

Read as: When someone is correctly assumed to be the wrong gender; this term has replaced the outdated term “to pass” which implied that a person is failing when they are not being read as their correct gender.

Real Life Experience (RLE): A former requirement for medical transition, during which one was required to live full-time in their self-determined gender role; this requirement has been removed in the current WPATH Standards of Care (Version 7).

Regional Health Authorities: In British Columbia, five regional health authorities govern, plan and deliver health care services in their geographic regions (Fraser Health, Interior Health, Island Health, Northern Health, Vancouver Coastal Health).

Salpingectomy: A surgery to remove the Fallopian tubes; a gender-affirming, masculinizing lower surgery.

Self-Identified Men: Term used to be inclusive of trans men or trans persons of history who self-identity as men (e.g. this restroom is for self-identified men).

Self-Identified Women: Term used to be inclusive of trans women or trans persons of history who self-identity as women (e.g. this restroom is for self-identified women).

Service Canada: Provides Canadians with one-stop, personalized access to Government of Canada services and benefits, such as Social Insurance Numbers, Passport Canada, and Employment Insurance.

Sex: Biological attributes and legal categories used to classify humans as male, female, intersex or other categories, primarily associated with physical and physiological features including chromosomes, genetic expression, hormone levels and function, and reproductive/sexual anatomy.

Sex Assignment: Legal designation of sex, usually made at birth

Sexual Orientation: Patterns of emotional, romantic, and/or sexual attractions to groups of people (e.g. men, women, trans people), a person’s sense of identity based on those attractions, related behaviors, and membership in a community of others who share those attractions; for example pansexual, bisexual, LGB, heterosexual.

Sex Hormones: Hormones, such as estrogen and testosterone, affecting sexual and reproductive development or function.

Sex Marker: Legal designation of sex (usually male or female) on official documents, such as government issued identification and birth certificates. Sometimes called “gender marker”.

Sex Reassignment Surgery: See gender-affirming surgery.

Special Authority: British Columbia government system for obtaining coverage for prescription medications not covered in the Pharmacare formulary.

Standards of Care (for the Health of Transsexual, Transgender and Gender Non-Conforming People): Guidelines containing the recommended course of care for people seeking medical transition to their self-determined gender, published by the World Professional Association for Transgender Health (WPATH).

Stealth: The practice of living one’s life entirely as one’s gender without disclosing past experiences. (QMUNITY)

Social Insurance Number: Nine-digit number that is needed to work in Canada or to have access to government programs and benefits.

Surgical Readiness Assessment: Evaluation conducted by a healthcare professional to determine if a patient is ready to be referred for gender-affirming surgery.

Third Gender: A gender other than male or female.

Top Surgery: Umbrella term used for some gender-affirming above-the-waist surgeries including masculinizing chest surgeries and feminizing breast augmentation surgeries.

TPOC: An acronym for Trans People of Colour.

Transfeminine: This umbrella term may describe people who were assigned male at birth, who are trans, and whose gender expression leans towards the feminine.

Trans (Transgender, Transsexual): Trans is an umbrella term that describes a wide range of people whose gender and/or gender expression differ from their assigned sex and/or the societal and cultural expectations of their assigned sex; includes people who are androgyne, agender, bigender, butch, CAFAB, CAMAB, cross-dresser, drag king, drag queen, femme, FTM, gender creative, gender fluid, gender non-conforming, genderqueer, gender variant, MTF, pangender, questioning, trans, trans man, trans woman, transfeminine, transgender, transmasucline, transsexual, and two-spirit. (QMUNITY)

Transgender Health Information Program (THiP): BC-wide information service and resource hub that connects people to the information they need to access gender affirming health care and supports.

Trans* Specialty Care (TSC): Clinics providing multidisciplinary, specialized health care to trans clients served by the Vancouver Coastal Health Authority.

Transition: Refers to the process during which trans people may change their gender expression and/or bodies to reflect their gender, including changes in physical appearance (hairstyle, clothing), behaviour (mannerisms, voice, gender roles), identification (name, pronoun, legal details), and/or medical interventions (hormone therapy, gender-affirming surgery). (QMUNITY)

Trans Man: May describe someone who is trans and a man.

Transmasculine: This umbrella term may describe people who were assigned female at birth, who are trans, and whose gender expression leans towards the masculine.

Trans-misogyny: Transphobia directed at trans women and transfeminine people that reinforces male power and privilege, including harassment, violence and discrimination. (Serano)

Transphobia: Ignorance, fear, dislike, and/or hatred of trans people, which may be expressed through name-calling, disparaging jokes, exclusion, rejection, harassment, violence, and many forms of discrimination (refusing to use a person’s name/pronoun, denial of services, employment, housing). (QMUNITY)

Transvestite: An outdated term that was historically used to label people who cross dressed as having a mental illness; replaced by the more inclusive and respectful term, ‘cross dresser’, which is not considered a mental illness. (QMUNITY)

Trans Woman: May describe someone who is trans and a woman.

Tucking: Method of positioning the penis and testicles so as to conceal them.

Two-Spirit (2-Spirit or 2S): A term used within some Indigenous communities, encompassing sexual, gender, cultural, and/or spiritual identity. This umbrella term was created in the English language to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. This term may refer to cross, multiple, and/or non-binary gender roles; non-heterosexual identities; and a range of cultural identities, roles, and practices embodied by Two Spirit peoples. (definition used with permission from Battered Women’s Support Services)

Vagina*: Vagina* (with a asterisk) is used to acknowledge the many different words that are used for this body part: front hole, etc

Vaginoplasty: A gender-affirming, feminizing, lower surgery to create a vagina and vulva (including mons, labia, clitoris, and urethral opening) and inverting the penis*, scrotal sac and testes.

Vital Statistics Agency: Registers all births, marriages, deaths,  changes of name, and changes of sex/gender that occur in British Columbia.

Vocal feminization surgery: Feminizing surgery to elevate the pitch of the voice.

Woman: A human being who self-identifies as a woman, based on elements of importance to the individual, such as gender roles, behaviour, expression, identity, and/or physiology.

World Professional Association for Transgender Health (WPATH): Professional organization devoted to transgender health, whose mission as an international multidisciplinary professional association is to promote evidence based care, education, research, advocacy, public policy and respect in transgender health.

Ze/Hir: Gender-inclusive pronouns used to avoid gender binary-based words (he/she, him/her), or making assumptions about other people’s gender. (QMUNITY)

Sources

Many of our definitions are adapted from other organizations and resources. We would like to thank QMUNITY, Gender (Free) for All, the World Professional Association for Transgender Health, Julia Serano (Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity), American Psychological Association, Institute of Gender and Health at the Canadian Institutes of Health Research, and Gender Creative Kids for informing the creation of the glossary.