When 18-year-old Natalie first realized she was transgender, she went through a really rough time.

“I stayed up a lot of nights researching gender dysphoria [unhappiness with gender] and transgenderism,” the New Jersey teen remembers. “I actually talked to my cat about it for a little while. She was born a neuter, and it seemed ironic.”

After a few weeks, Natalie reached out to TSTG Youth, an e-mail support group, where she found other teens struggling with the same problems.

“All the things they were saying confirmed my beliefs about myself,” she says.

One Term for Many

It’s hard for some people to understand what it means to be transgender. Basically, people who are transgender feel like they should have been born the opposite sex. They have a hard time living up to society’s rules and expectations for the sex they were biologically “assigned.”

“Transgender” is what’s known as an “umbrella term,” because it includes many types of gender-different people, including male-to-female (MTF) and female-to-male (FTM) transsexuals, male and female cross-dressers, and others with “unconventional gender expressions,” according to the Maryland-based Gender Education & Advocacy, Inc., a national nonprofit organization on gender variant people and their social identities.

Some people are so unhappy with their gender that they undergo surgery to change their genitals to biologically become the sex they feel they are. So, a MTF transgender may feel a lot more comfortable wearing makeup, woman’s clothes, and hanging with the girls than he does wearing and doing things that are considered “normal” for guys.

Being transgender is not about wanting to have sex with members of the same gender. It’s more like feeling you were born in the wrong skin. Some transgender people are attracted to people of the same sex, and they may or may not act on these feelings sexually. Others consider themselves heterosexual, but simply prefer to dress and act like members of the opposite sex.

Coming to Terms

Many teens struggle with issues of gender identity. Vanessa Edwards-Foster, founder of the National Transgender Advocacy Coalition, a Washington, D.C.-based activist group, offers this advice to questioning teens.

“Be brutally honest with yourself,” she says. “But be patient and allow yourself time to find what is truly you, where along the gender continuum you feel most comfortable—even if you are transsexual.”

Coming out is a big issue for many transgender teens.

“One of the most difficult problems arises not so much from the teens as much as their parents,” says Edwards-Foster. “Sometimes a parent’s reaction can be severe, including disowning and kicking their child out of the home.”

Natalie has only told her brother and close friends. Her parents still have no idea that she is transgender.

“The longer you know someone, the harder it is to accept change about them,” she says. “I’m actually coming out [to her parents] later this month, and I’m very nervous about it.”

She is also planning to have sex-reassignment surgery, so she will become a MTF transsexual.

“Transsexualism is a pretty big change overall. It won’t be me that’s changing, just my body, and it will take some time and a lot of patience on both [my parents’ and my] parts before they can accept it,” she says.

It was also hard for Natalie to tell her friends, especially because they often misunderstand what it means to be transgender.

“I tell them it’s not about sex, that gender identity and sexual orientation are two separate concepts,” says Natalie.

Other things cause transgender youths to hide their feelings. Society, peer pressure, and fear of being “different” can often be major factors that affect questioning teens. Edwards-Foster recalls an experience when she visited a 13-year-old who was possibly MTF.

“His dad invited me over to visit and chat with him,” she remembers. “Definitely a possible candidate for trans, but still hadn’t made a personal decision. When I contacted the dad about a year and a half later, he said [his son] was identifying as straight and trying to make his life work as a guy. I can’t help but wonder if there was some external influence to lead him to repress.”

Getting Connected

Transpersons often grow up feeling shame and guilt over who they are. They also tend to encounter even more discrimination and violence than gays. This can lead many transgender youths to hurt themselves, do drugs, or have unprotected sex, which can leave them coping with sexually transmitted infections, including HIV/AIDS.

If you’re a questioning teen, support groups and counseling are a must. They can help you deal with negative feelings and accept yourself for who you are.

It’s important, though, to choose the right counselor. It’s helpful to find someone who has knowledge of or experience in gender issues and who you feel comfortable being honest with.

“It helps to do a little homework before simply deciding on any old therapist,” Edwards-Foster advises. “And if you don’t find a good one with the first try, don’t be afraid to seek another opinion, another doctor.”

Natalie offers this advice: “Get comfortable with yourself. See a counselor as soon as possible. Have parts of your life that aren’t gender related. Don’t expect everyone to know how you feel right away. These things take time.”

Editors’ Note: For more information, check out this Resource Guide to Coming Out from the Human Rights Campaign, or Gender Education and Advocacy and the National Transgender Advocacy Coalition.