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WHAT DOES IT MEAN TO BE TRANSGENDER? 5 expressions deemed culturally appropriate for oneÊs sex. As with the terms masculine and feminine , exactly what constitutes gender role con- formity is not universal but rather is defined with reference to a particular society or culture. Gender dysphoria refers to an individualÊs sense of discomfort with the sex assigned to them at birth. This discomfort can take many forms, from the individualÊs unease with their current primary or secondary sexual characteristics to a more general sense that the gender assigned at birth is not appropriate. Gender dysphoria is described in the Diagnostic and Sta- tistical Manual of Mental Disorders ( DSM-5 ) of the American Psychiatric Association, which specifies criteria for diagnosing this condition in chil- dren, adolescents, and adults. Gender identity disorder was a term used in the previous Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV ) for a similar condition, and the term gender identity disorder is also used in the tenth edition of the International Statistical Classification of Diseases and Related Problems ( ICD-10 ), a medical classification list produced by the World Health Organization. Transgender is a broad term used to describe a number of individu- als who feel that their gender assigned at birth is not correct. This term is contrasted with the term cisgender (sometimes abbreviated to „cis‰), which refers to individuals whose gender identity matches the gender they were assigned to at birth. Behaviors can also be described as transgender: for instance, some people consider cross-dressing (wearing clothing, hair- styles, makeup, etc., associated in oneÊs culture with the opposite sex) as a transgender behavior. However, the cross-dressing doesnÊt make a per- son transgender because the behavior itself tells you nothing about the motivation behind it or the meaning the behavior holds for the individual. For instance, transvestites dress at least some of the time as a member of the opposite sex, and drag queens and kings appear as members of the opposite sex in public performances, but it is not necessary for members of either group to experience any incongruity between their birth sex and their gender identity. For the sake of clarity, within this book the term transgender will be reserved for those who feel that the gender they were assigned at birth does not coincide with their felt gender identity, without regard to whether they have taken any actions toward bringing their bodies into congruence with their gender identity. In other words, if someone says they are transgender, they are, and questions such as whether they have or intend to undergo surgery or hormone treatment are irrelevant. Transsexual is a similar term used in some contexts to refer to people whose gender identity does not correspond with their sex as assigned at birth. As with the term transgender , classifying someone as transsexual is