Gender identity is the internal personal sense of being a man, woman, or outside the binary gender identity. For transgender people, this identity differs from the gender they were assigned at birth. While gender identity differs from sexual orientation, it is no easier to change. For this reason, transgender individuals seek to align their bodies with their gender identity. Consequently, certain transgender health issues frequently arise within this population.

There are different degrees of transgender identity. Transvestites like to cross-dress as members of the opposite sex but do not wish to become the other sex. Drag queens and drag kings are somewhat intermediate, appearing neither feminine nor masculine. Then there are those who feel they either do not belong to either the male or female gender, or they feel a little bit of each.

Transexuals are those who believe they were assigned the wrong gender to fit their own gender identity. These people have an overwhelming drive to live and be accepted as a member of the opposite gender to which they were assigned at birth. They may opt for gender reassignment to make themselves look like the gender with which they identify. Gender reassignment treatment involves a combination of surgery, hormone therapy and psychological counselling.

Children who experience this feeling of gender misalignment feel it at a surprisingly young age. When little Nick started playing with female-oriented toys and games at the age of two, his mother noticed this but did not feel particularly concerned. By the age of four, he announced to her that God had made him a boy by mistake. When he reached the age of six years old, he told her he wanted to change his assigned gender.

Fortunately, sympathetic doctors exist who will offer to administer hormone injections to block the child going through a psychologically distressing puberty until they have made a thorough decision as to which gender feels right for them. Some of these teens follow through with a full gender reassignment. Many of these people may have otherwise been driven to commit suicide.

Trans people are more likely than the general population to feel mentally distressed because of the levels of social disapproval and discrimination that they often face. They experience higher levels of harassment and violence and are therefore at an increased risk of depression, self-harm and suicide. They will often avoid seeking medical care because they are afraid of being rejected.

Many providers of medical care lack the necessary grasp of transgender issues. Feeling inadequate, they may turn patients away. It is also true that many gender-associated problems are not covered by health insurance. This puts up another barrier to the transgender population to receive access to medical care. This is a serious problem, because occasionally people who have undergone gender reassignment develop cancer in their "old" sexual organs.

A number of organizations have sprung up over the past two decades to help improve both access and quality of medical care for the transgender population. One such organization is the Center of Excellence for Transgender Health. This organization focuses on cultural competency, mental wellness, routine care and prevention of HIV. Another organization, aimed at children and teens and their families, is the Mermaids Charity. The World Professional Association for Transgender Health (WPATH) is another such organization. Its aim is to provide advocacy, promote evidence based care and respect for transgender individuals.