Where we are
Today, the U.S. House of Representatives voted and passed the Employment Non-Discrimination Act, also known as ENDA. I have blogged about this in earlier posts, and I had taken the sides.
This version of ENDA, that just passed, is not the original version. The original version, H.R. 2015, had protection for both sexual orientation and gender identity. The version that passed has only sexual oriention. Gender identity was stripped out in a pragmatic attempt to pass ENDA under the premise that it would pass more easily without gender identity.
sexual orientation = is which gender you are attracted to
gender identity = which gender you see yourself as
birth-assigned gender = the gender you were given at birth when everyone saw your baby parts ("is it a girl or a boy?").
Gender identity is different from birth assigned gender. Gender identity is how you see yourself. Birth-assigned gender is what gender others gave you.
Most people are comfortable enough with their assignment, so that the gender we got is the gender we see ourselves as. In this case, gender identity and birth-assignment "match".
But for many, but not all, of the transgender community, the two parts can clash. A person sees a different gender in their heart than that which was assigned to them. This person does not necessarily want surgery, but sometimes s/he does. The reasoning behind that decision is based on personal and pragmatic factors, like any human decision be it the decision to marry, have a child, move to a new city.
The decision for gender-reassignment surgery (not "sex change") is always made in consultation with a doctor and therapist, and there is always prescription requirement. It's a normal medical procedure and should be viewed as such.
But remember, not all transgender people do surgery