Gender Identity

Biological sex is most often categorized as female or male, based on sex characteristics. These include chromosomes, gonads, and anatomical features like reproductive organs, genital structure, hormone function, muscle mass, hair distribution, breast development, and/or height.

• Female is defined by XX chromosomes, a vulva, vagina, uterus, and ovaries.
• Male is defined by XY chromosomes, a penis, scrotum, and testicles.

Outside of this binary, we also find intersex individuals, who are born with natural variations in sex characteristics that do not fit the typical definitions of “female” or “male.”

Gender identity is more complex and less clearly defined than biological sex. It's often described as a spectrum — imagine biological sex as black and white, and gender identity as every possible color in between.

You don’t have to identify at either end of the spectrum or even somewhere in the middle — gender identity can be anything. In The Gender Book, gender is described as a planet, and the book is a great read for anyone curious.

When a person’s gender identity matches their assigned sex at birth, they are described as cisgender. The opposite of cisgender is transgender.

Trans or transgender is an umbrella term for people whose gender identity does not align with their sex assigned at birth — meaning there is a mismatch between their biological sex and gender identity.

Under this umbrella fall:

• Trans men
• Trans women
• Non-binary people

To simplify:

• A trans woman is typically someone assigned male at birth (AMAB) who identifies as a woman.
• A trans man is typically someone assigned female at birth (AFAB) who identifies as a man.

Non-binary people experience gender outside the male-female binary — some feel like both, neither, or do not define their gender at all.

Some trans people undergo gender-affirming procedures (see below), but not all. What makes someone a man or woman is not their body, but their gender identity.

Cross-dressers are people who wear clothes traditionally associated with another gender.
They usually do not seek medical transition but may change their name or appearance.
This is more about gender expression than gender identity.

Drag is often mistaken for being transgender or cross-dressing, but it’s very different.
Drag is often a form of performance or artistic expression, where someone creates a theatrical character, often exaggerated. Drag is used in entertainment or even political activism. A drag queen is usually a man dressing as a woman. A drag king is usually a woman dressing as a man. But anyone can do drag, regardless of their gender identity — it’s about much more than clothes.

Transitioning is a lengthy and intensive process in Iceland, overseen by a medical board at Landspítali (National University Hospital).

• The process starts with contacting the board and beginning a formal process.
• The first step often involves:
• • Coming out to family and friends
  • Choosing a new name
  • Living according to one’s gender identity

After about one year of this "real-life test", individuals may begin hormone treatment.

Hormone therapy:

It profoundly changes the body, similar to puberty, but much faster and more intense.

• For trans women:
• • Body fat redistributes (wider hips, breast growth)
  • Hair growth decreases
  • Skin softens, etc.
• For trans men:
• • Body fat shifts
  • Hair growth increases (facial and body hair)
  • Voice deepens, etc.

People may experience mood swings, changes in appetite, and other emotional effects — these usually balance out over time. Major changes occur between 3 months and 2 years.

According to Icelandic law, a person must be in the official process for at least 18 months before they can apply for gender-affirming surgery. They can, however, access other procedures earlier, such as:

• Facial surgeries
• Breast augmentation or removal
• Hysterectomy, etc.

Surgeries:

• Trans men often undergo top surgery (removal of breasts). For bottom surgery:
• • Hormones can enlarge the clitoris into a small penis, which may be extended.
  • The scrotum is created from the labia, and silicone testicle implants are inserted.
  • Full phalloplasty involves grafting skin from the body to form a penis.
    However, sensation is usually limited, and most cannot achieve an erection without a mechanical implant.
• Trans women undergo a more developed and effective surgical process:
• • The vagina, clitoris, and labia are constructed using existing tissue.
  • These new genitals are functional and similar to those of cisgender women.

Again, not all trans people pursue surgery — because your body doesn't define your gender.