Gender Expansive People Have Always Existed Throughout History and Culture

October 8, 2026

A common argument of anti-trans advocates and policymakers is that the transgender or gender non-conforming (TGNC) identity is not a real or legitimate identity. Instead, they argue that people who identify as trans are either following a trend, mentally ill, or compensating for some past trauma. These claims continue to circulate in public discourse, policy debates, and media coverage, and have been used by legislators and activists to support anti-trans policies. ^{1 2 3}

In reality, gender diversity has existed throughout history. Anthropological and historical evidence show that a wide range of gender identities and gender roles have always existed in different cultures and time periods, including third genders, feminine-presenting men, and women working and living as men.^{4 5 6 7 8}  These varied presentations of gender diversity show that trans identities are not a new trend or ideology, but rather a consistent human experience that exists within many different geographic, religious, and ethnic societies.

Medical and psychological research further affirms that being transgender is not a mental illness and is not caused by trauma.^{9 10 11 12} These false claims often inaccurately cite research that shows TGNC people have higher rates of mental health issues. However, these studies do not indicate that mental health issues cause gender diversity. Rather, higher rates of stigma, discrimination, and violence against TGNC people often cause worsened mental health outcomes for them. ^{13 14 15}

Are ‘man’ and ‘woman’ universally accepted as the only gender identities?

No. Many cultures around the world, and throughout history, have recognized additional gender identities. There is also much greater variety within the understanding of who men and women are.^{16 17 18 19 20 21 22}

While it may seem that transgender, nonbinary, and gender fluid are brand new identities, this is just newer language for old concepts. Genders outside the man-woman binary have simply been called different things in various cultures and centuries; Polynesian cultures have used the term mahu to refer to a third gender identity since ancient times and the Navajo people use the term nádleehí to refer to people with fluid gender expression.²³ Several cultures recognize a multitude of genders; the Bugis people of Indonesia recognize five genders, including calalai (born in a female body, taking on male roles) and bissu (neither male nor female)²⁴  while the Talmud, Judaism’s primary text for Jewish laws and ethics, recognizes seven different gender designations.²⁵

Regardless of the name used, gender diverse people have been active and contributing members of society far before terms like transgender entered our social discourse. In Samoa, gender fluid people called fa’afafine have been nurses, educators, business owners, and military personnel since the 1960s.²⁶ Hijra, third gender individuals in Southern Asia, have served as political advisors, spiritual guardians, public transit workers, and city governors for centuries.^{27 28} In the United States, dating back to colonial times, gender diverse people were preachers, servants, and soldiers. ^{29 30 31}

Importantly, the behaviors, presentation, and understanding of different genders do not always perfectly align with the stereotypical Western understanding of masculinity and femininity that we know today. There are many instances of diverse presentations of manhood or womanhood. For example, in the Minangkabau communities of Indonesia, women take on the role of head of household and protectors within their community.^{32 33} In China’s Musuo villages, property is passed down through the women and children take their mother’s last names.³⁴  Even within the United States, expectations of men and women within a family differ based on religion, age, region, and ethnic background.

This variety of gender expression and identities tells us that our societal understanding of men and women as the only two genders are not a universal given. Rather, our version of gender norms is only one way to think about how to be a man or woman. Increased awareness and evolving language have made it easier for people to name and share their identities, but gender diversity itself is not a new phenomenon.^{35 36}

Is being transgender caused by trauma, abuse, or mental illness?

No. Major medical and psychological organizations agree that being transgender is not a mental disorder and is not caused by trauma.^{37 38 39 40}

Leading professional organizations, including the American Psychiatric Association (APA) and the World Health Organization (WHO), do not classify transgender identity as a mental illness.^{41 42 43 44} Additionally, research has not found evidence that trauma or mental illness causes someone to be transgender.^{45 46 47}

Rates of mental health diagnoses are higher in transgender communities.^{48 49} False claims argue that this is evidence that being transgender is caused by mental illness. However, these assumptions mistake correlation with causation. Instead, the increased rate of mental health issues among trans and gender nonbinary people are widely understood to result from a greater than average amount of external stressors for gender diverse people, such as stigma, discrimination, social rejection, and barriers to affirming care.^{50 51 52}

This is supported by research that shows increased support and access to gender affirming care is often associated with lesser mental health challenges for transgender individuals.^{53 54 55 56} For example, The Trevor Project’s 2023 U.S. National Survey found that 41% of transgender and nonbinary youth seriously considered suicide in the past year but those who reported having affirming spaces and support in their lives had lower rates of suicide attempts than those who did not.⁵⁷ In fact, a 2016 study found that transgender children who were supported in their social transition (note: social transition does not include medical or hormonal interventions) had no difference in their depression levels and only slightly elevated anxiety compared to nontransgender children being raised in similar environments.⁵⁸

Rather than stemming from mental illness or trauma, research shows that gender identity is a legitimate aspect of human development and a core component of a person’s sense of self.^{59 60 61} In other words, gender identity is not a superficial preference or passing feeling, but a fundamental part of how people understand and experience themselves. Studies suggest that gender identity develops early in childhood and is not something people simply choose or are pressured to adopt.^{62 63 64} In a 2023 survey of trans adults in the U.S., 66% said they began to understand that their gender was different from their sex before the age of 18 and a third of those respondents said their understanding began before age 11.⁶⁵

While the exact mechanisms are still being studied, existing evidence points to a combination of biological, developmental, and social factors shaping how gender identity is experienced, much like other core aspects of human development. To learn more about why it’s important for one’s gender to be recognized, read our Fact Checked on gender and authenticity here.

Policy Recommendations

Include gender in legal protection against discrimination. There are already laws that protect people from being discriminated against based on their race, sex, or health status. Including gender in these protections would acknowledge gender as legitimate as one’s sex or race and ensure transgender people equitable access to spaces like housing, education, and healthcare.

Incorporate scientific research into policy on transgender people. Legislation and public policy should be grounded in credible scientific and medical evidence. When there is not enough data to accurately inform a policy, this research should be supported and funded. This includes policies that restrict access to gender-affirming care, exclude transgender people from restrooms or school activities, or censor accurate information about gender identity in education and public health resources. Policies rooted in misinformation contribute to stigma and can lead to harmful outcomes for transgender individuals and communities.^{66 67 68}

Support accurate education about gender identity. Public institutions should ensure that educational curricula, public health resources, and government materials reflect established research on gender identity. Ensuring schools, libraries, and public health websites have accurate information would  advance public and governmental understanding, ideally halting the spread of misinformation in social stigma and political discourse.⁶⁹

References

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12. Robles, R., Keeley, J. W., Vega-Ramírez, H., Cruz-Islas, J., Rodríguez-Perez, V., Sharan, P., … & Reed, G. M. (2022). Validity of categories related to gender identity in ICD-11 and DSM-5 among transgender individuals who seek gender-affirming medical procedures. International Journal of Clinical and Health Psychology, 22(1), 100281.

13. Hatzenbuehler M. L. (2016). Structural stigma: Research evidence and implications for psychological science. The American psychologist, 71(8), 742–751. https://doi.org/10.1037/amp0000068

14. Montero, A., Hamel, L., Artiga, S., & Dawson, L. (2024). LGBT adults’ experiences with discrimination and health care disparities: Findings from the KFF survey of racism, discrimination, and health. Kaiser Family Foundation. https://www.kff.org/racial-equity-and-health-policy/lgbt-adults-experiences-with-discrimination-and-health-care-disparities-findings-from-the-kff-survey-of-racism-discrimination-and-health/

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