One of the more challenging aspects of understanding the Transgender experience comes to the question of sexuality.  It can be quite confusing for anyone, but when we add gender identity on top of that…it seems more challenging to comprehend.  So let me try to help you separate the two.

Gender Identity comes from a combination of factors which I believe are made of from three primary areas.  Some say more some less, but three seems to be pretty easy to work with, so we’ll go with that.  The three areas include:

Biological Gender – This is the physical gender we are born as.  Our chromosomal makeup: XX,  XY, etc. and is greatly affected by sex hormones.  This of course is not so clear when it comes to our Intersex brothers and sisters, but I am choosing to stay focused on the Transgender experience in this article.

Internalized Gender – This would be the innate sense of belonging to one gender, both genders, or neither genders.  This can manifest itself in how we experience the world in relation to ourselves.  This innate sense often goes very deep to our core.

Gender Presentation – This idea has to do with how we choose to present ourselves to our community and world around us.  I feel this is where gender roles have the most impact in our lives.  This could include clothing, accessories, the car we drive, games we play, etc.

Depending on one’s unique blend of these three factors, they will come up with a sense of where they fit along the Gender Spectrum.  This can of course change throughout our lives in an ebb and flow manner.  So now that you have a general idea of how gender is viewed in the Trans community, lets talk about sexual orientation and how that plays in with gender.

Sexual orientation describes an enduring pattern of attraction—emotional, romantic, sexual, or some combination of these—to persons of the opposite sex, the same sex, or to both sexes, as well as the genders that accompany them. (

Like in any other area of society, Trans-identified people can and do identify across the board. Gay, Straight, Lesbian, Queer, Bi-sexual, Pansexual, etc.  When it gets confusing is when people Transition to another gender and maintain their sexual orientation.  If a male transitions to female (MTF) and is attracted to women, that person is moving from a heterosexual male into the world of a lesbian female.  and so on and so forth.  While the Trans-identified person usually has some idea about this, it can seem quite shocking for the unsuspecting family member or even the therapist that does not fully understand how Gender and sexuality are differentiated.  While interconnected, they are quite different journeys our clients must explore.  It is also not uncommon for a Transsexual who has been on a hormone regimen to find themselves shift sexuality post-transition.  As with gender, sexuality and sexual orientation can change…especially when one takes cross-gender hormones.  This could be attributed to society’s acceptance of them exploring this avenue however.


Cameron Duvall, MS
MFT registered intern (IMF#65656)
30 N. San Pedro Rd, Suite 160
San Rafael, California 94903
(415) 968-9591