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: Approximately 19% of transgender people report being refused care due to their identity [22], and many experience "gatekeeping" or misgendering in medical settings [15].

: Understand that being transgender is about gender identity (one's internal sense of self), which is distinct from sex assigned at birth [33]. how is shemale

: Transgender youth are at a higher risk for bullying, substance use, and suicide if they lack support from family or school communities [10, 12]. Guidelines for Respectful Communication : Approximately 19% of transgender people report being

: Studies link transition to improved quality of life, higher self-esteem, and reductions in anxiety, depression, and suicidality [2, 4, 7]. and reductions in anxiety