Trans woman

The spelling transwoman (written as a single word) is occasionally used interchangeably with trans woman (where trans is an adjective describing a kind of woman). However, this variant is often associated with views (notably gender-critical feminism) that exclude trans women from woman, and thus require a separate word to describe them.^[12] For this reason, many transgender people find the spelling offensive.^[12][13] Some prefer to omit trans, and be called simply women.^[10]

In several Latin American countries, the word travesti is sometimes used to designate people who have been assigned male sex at birth, but develop a female gender identity. The use of travesti precedes transgender in the region; its distinction from trans woman is controversial and can vary depending on the context, ranging from considering it a regional equivalent to a third gender.^[14][15]

In Thailand, kathoey refers to a trans-feminine individual, though the term "transgender" is infrequently used to refer to those with this identity.^[16] The term is sometimes translated to "ladyboy" in English.^[17] Most trans-feminine Thai individuals simply referred to themselves as women, or phuying praphet song, meaning "another type of woman."^[18]

Amongst Native Hawaiians and Tahitians, māhū are people of a third gender who possess spiritual and social roles.^[19] The term has historically been applied to people assigned male at birth, but now may refer to a large variety of gender identities.^[20] The term is sometimes seen as disparaging or a perjorative, similar to faggot.^[21]

Sexuality

Trans women vary greatly in terms of sexual orientation.

The European study found that sexual orientation did not change over the 12 months.[28] A 2018 study found that the most common sexual partner for trans women was cisgender women prior to transitioning. Trans women who had been for transitioning for ten years or more were more likely to report a shift in their sexual orientation.^[29]

In a 2008 study, no statistically significant difference in libido was detected between trans women and cisgender women.^[30] As in males, female libido is thought to correlate with serum testosterone levels^{[31][32][33][34]} (with some controversy)^[35] but the 2008 study found no such correlation in trans women.^[30][36] Another study, published in 2014, found that 62.4% of trans women reported their sexual desire had decreased after sexual reassignment therapy.^[37]

Healthcare

Gender-affirming care

Gender-affirming care for trans women may include feminizing hormone therapy, transgender voice therapy, and gender-affirming surgery (often referring to vaginoplasty, but may also include tracheal shave, orchiectomy, facial feminization surgery, breast augmentation, and vulvoplasty).^[38]

Feminizing hormone therapy

Feminizing hormone therapy is a type of hormone therapy focused on turning the secondary sex characteristics of a person from masculine to feminine. Feminizing hormone therapy often includes a mix of estrogens, antiandrogens, progestogens, and gonadotropin-releasing hormone modulator,^[1][39] though the most common approach is an estrogen in combination with an antiandrogen.^[40][41] Feminizing hormone therapy can induce effects including breast development, softening of the skin, redistribution of body fat towards a gynoid fat distribution, decreased muscle mass/strength, and changes in mood.

Feminizing voice therapy

Trans women may seek to feminize their voice through transgender voice therapy, as hormone therapy does not affect the voice of a trans woman at all. The aim of voice therapy is frequently to change the fundamental frequency, resonant frequency, and phonatory pattern to reflect that of a cisgender woman.^[42] This can be accomplished through speech therapy, or surgeries (including feminization laryngoplasty). Throughout multiple studies, voice therapy has generally been shown to increase vocal satisfaction of the patient and a greater listener perception of a feminine voice.^[43][44]

Gender-affirming surgery

Trans women may undergo a variety of gender-affirming surgeries as part of their transition process. These surgeries may include vaginoplasty, vulvoplasty, orchiectomy, breast augmentation, and facial feminization surgery.^[45]

Fertility

While the relationship is not completely understood,^[46] feminizing hormone therapy appears to reduce the ability to produce sperm.^[47] Individuals who have been on hormone therapy for an extended period of time have been shown to have a lower total sperm count than males not on hormone therapy.^[48] Cessation of hormone replacement therapy has been associated with a renewed level of fertility.^[49][50]

Tucking is also associated with lower quality sperm production because of the increased temperature of the testicles, causing premature sperm death.^[51][52][53]

Trans women may elect to undergo fertility preservation through semen cryopreservation via masturbation or testicular sperm extraction.^[46]

Discrimination

Like all gender variant people, trans women often face

A 2011 survey of roughly 3000 trans women living in the United States, as summarized in the report "Injustice at Every Turn: A Report of the National Transgender Discrimination Survey", found that trans women reported that:[26]^[specify]

• 36% have lost their job due to their gender.
• 55% have been discriminated against in hiring.
• 29% have been denied a promotion.
• 25% have been
  refused medical care
  .
• 60% of the trans women who have visited a homeless shelter reported incidents of harassment there.
• When displaying identity documents incongruent with their gender identity/expression, 33% have been harassed and 3% have been physically assaulted.
• 20% reported harassment by police, with 6% reporting physical assault and 3% reporting sexual assault by an officer. 25% have been treated generally with disrespect by police officers.
• Among jailed trans women, 40% have been harassed by inmates, 38% have been harassed by staff, 21% have been physically assaulted, and 20% have been sexually assaulted.

The American National Coalition of Anti-Violence Programs' report of 2010 anti-LGBTQ violence found that of the 27 people who were murdered because of their LGBTQ identity, 44% were trans women.^[56] Discrimination is particularly severe towards non-white trans women, who experience the intersection of racism and transphobia.

In her book Whipping Girl, trans woman Julia Serano refers to the unique discrimination trans women experience as "transmisogyny".^[57]

Discrimination against trans women has occurred at the Michigan Womyn's Music Festival after the Festival set out a rule that it would only be a space for cisgender females. This led to protests by trans women and their allies, and a boycott of the Festival by Equality Michigan in 2014. The boycott was joined by the Human Rights Campaign, GLAAD, the National Center for Lesbian Rights, and the National LGBTQ Task Force. The "womyn-born-womyn" intention first came to attention in 1991 after a transsexual festival-goer, Nancy Burkholder, was asked to leave the festival when several women recognized her as a trans woman and expressed discomfort with her presence in the space.^[58][59]

Violence towards trans women

Trans women face a form of violence known as

According to a 2009 report by the National Coalition of Anti-Violence Programs, quoted by the Office for Victims of Crime, 11% of all hate crimes towards members of the LGBTQ community were directed towards trans women.^[62]

In 2015, a false statistic was widely reported in the United States media stating that the life expectancy of a trans woman of color is only 35 years.^[63] This appears to be based on a comment specifically about Latin America in a report by the Inter-American Commission on Human Rights, which compiled data on the age at death of murdered trans women for all of the Americas (North, South, and Central), and does not disaggregate by race.^[63][64][65]

In 2016, 23 transgender people suffered fatal attacks in the United States. The Human Rights Campaign report found some of these deaths to be direct results of an anti-transgender bias, and some due to related factors such as homelessness.^[66]

One type of violence towards trans women is committed by perpetrators who learn that their sexual partner is transgender, and feel deceived (