Gender identity plays a critical role in defining an individual's personal identity and has been examined across socio-cultural, psychological, and political fields. However, transgender, as a part of gender issues, still lacks sufficient clarity regarding its definitions, causes, treatment, and interpretations of transgender experiences. "Transgender" is an umbrella term used to describe people whose gender identity or expression does not align with the sex assigned at birth. It is also one of the most significant markers of progress in medical science, representing a relatively new area of study. Due to the limited research on transgender issues, the first part of this paper provides definitions and an overview of the challenges surrounding transgender individuals, including how to conceptualize this group within clinical and psychological contexts.

In addition to defining and conceptualizing transgender identity, this literature review addresses issues related to the care of transgender individuals, including the scientific and ethical rationale behind treatment, as well as the current state of the field, covering both contemporary treatment approaches and directions for future research.

The term “sex change” dates back to the year 1681, when Krafft-Ebing published his book titled Psychopathia Sexualis, in which he spoke of a complex and variable classification of psychosexual diseases and dealt extensively with homosexuality, which had several forms. In the year 1191, Cauldwell also published a book titled Psychopathia Transsexualis. In his book, he discussed sex change and its differences from psychosis and other sexual deviations. He also provided clarifications as to the symptoms of sex change disease and described those who developed these symptoms as transsexual.

Transsexual is a subset of transgender. "Transgender" is a term that includes many ways that gender identity can be different from the sex they were assigned at birth. These people express their gender identity in many ways; some express their gender through their dresses, behaviors, and manners to live as the gender that feels right for them, whilst others take hormones and may have surgery to change their body so it matches their gender identity.

"Transgender" is a broad term that incorporates differences in gender identity in which one's assigned biological sex does not match one’s felt identity. This category includes persons who do not feel they fit into a dichotomous sex structure through which they are identified as male or female. Individuals in this group may feel as if they are in the wrong gender, but this perception may or may not correlate with a desire for surgical or hormonal reassignment. It can be a psychological disorder because it is impossible to biologically transform a person from one gender to the other. Indeed, it is a psychological condition and not a medical one. It can be difficult for people who are not transgender to imagine what being transgender feels like. Psychologists and doctors describe the distress, unhappiness, and anxiety that the transgender feel about the mismatch between their bodies and their gender identity as gender dysphoria. A person may be formally diagnosed with gender dysphoria to receive medical treatment to help them change.

Until now, there is no conclusive scientific explanation of transgender existence, but there are several factors that have been proposed as contributors to transgender identity development. There are biological factors like genetic influences and hormone influences, and psychological factors such as personal issues and life experience. There is a psychological disorder in certain cases in which a person desires to switch to another gender after experiencing a rape incident and feeling hatred for that particular gender. Furthermore, the victim's psychological difficulty may also contribute to the development of a transgender identity when there is a discrepancy between sex and gender identity, which can lead to distressing and unpleasant feelings called gender dysphoria or gender incongruity.

The treatment of this group of people should be more of a therapy, and emotional adjustment needs to be taken into account. Psychological support is crucial in dealing with transgender issues. The treatments for transgender individuals should include more psychological therapies, using aversion therapy and/or cognitive-behavioral therapy. Aversion therapy was a common therapeutic method in mental health institutions during the mid-1900s to treat people who were classified as having "deviant" behaviors or identities that conflicted with society's view of their gender (i.e., behaviors or identities that did not conform to one’s biological sex). This included those who identified as "transvestites" or those classified today as expressing/transgender.

The basis of these interventions was behaviorism, and, therefore, they considered gender variance to be a behavioral disorder that could be cured by associating a painful or negative experience with a stimulus. Both therapeutic methods provided valuable insight into the lives and experiences of transgender and gender-diverse individuals. However, there has been very little critical evaluation of these historical practices. The decline of these aversion-based treatment methods coincided with the development of new classifications related to psychiatry and evolving conceptualizations of gender diversity. Ultimately, through the work of international psychiatric organizations, the use of conversion therapy has been officially condemned as unethical, unscientific, and harmful.

In my opinion, the growing prominence of transgender identities is indicative of larger social changes that require some sort of regulation or therapeutic involvement. Under this hypothesis, I would argue that aversion-based approaches to discourage gender nonconforming behaviors are a productive method. Still, contemporary mental health literature would likely disagree with my statement due to their belief that aversion therapy does not work and causes psychological damage. Furthermore, they feel that the use of shame-based techniques only amplifies an individual's distress rather than aids in the creation of mental wellness.

In reality, counselors alone cannot solve the transgender issues, and social and family members play crucial roles in managing those issues. A feeling of belonging to a specific gender has a role in the formation of sexual identity for transgender individuals. Psychological factors explain to us that the establishment of a corresponding identity is based on the theories of psychoanalysis, which the close union reconciles with pain that prevents normal psychological reincarnation, with the result that the original feminine identity of the male develops instantly. Other psychological analyses showed that changing sex was a response to neurological problems.

All these analyses concluded that parents’ relationship with their children could play a role in the development of sexual identity. The role of the family environment in shaping individual identity and its impact on the development of gender identity has been studied. Hence, it can be concluded that one of the main issues that are faced by transgender people is rejection, and this rejection comes from the transgender people themselves, family members, community members, and institutions.

Given these challenges, to face these issues successfully, transgender individuals need support from those who are involved with them. These people are family members, especially parents who have to play effective parenting roles; the transgender themselves, who have to manage their dilemmas and emotions well; psychology professionals; and social activists, who can help them back to their normal identity. The support that transgender individuals get from family members and the professional support that they get from psychologists and activists would enable them to cope better with the psychosocial issues they suffer from. In addition, for the families, psychosocial support is necessary to assist them in managing their feelings. Families of transgender individuals are often confronted with feelings of loss, shame, grief, betrayal, guilt, fear, and anger. Simultaneously, they are also prone to meet with rejection and social stigmatization from their social surroundings.

Central to this support system is the primary responsibility of parents to help children form an appropriate sexual identity. This is done through a process known as sexual normalization. In this process, a child learns sexual norms or psychological characteristics, which are appropriate for one of the sexes and not for the other. The child acquires the sexual identity, that is, the feeling of being a boy or a girl, and also acquires the criteria for the sexual role during early childhood in this process.

The preference for one sexual role over the other occurs early in life, around the age of three, so it is difficult to make important changes in the sexual role or sexual identity after the age of three. In this process, parents should play their role effectively in educating their children. Throughout the process, they should constantly provide religious education and sexual education and supervise their children's surroundings and socialization. This is important because parents are responsible for shaping children's personalities. There is a greater chance for parents who provide their children with early education to prevent them from being influenced by negative elements and subsequently prevent them from getting involved with huge social problems.

Parents need to spend more time with their children and raise them with good manners and values. Besides, parents have to be sensitive to their children's behaviors. The actions of some parents in cross-dressing their children may lead them to gender confusion and make them desire to be the opposite gender. Therefore, parents should provide the best in terms of their children's upbringing because the way children think and act is shaped by the way they are raised.

Educating children and raising them decorously is the core of managing or preventing transgender issues. Informal education that takes place at home with parents and formal education that includes religious education and comprehensive sex education can support children’s personality development and help them to build a society that holds a high standard of values and is not easily influenced by other cultures. Besides, psychosocial supports and community awareness are vital not only for transgender individuals but also for families in dealing with transgender issues. Treatment of transgender individuals should include more psychological therapies.

In conclusion, managing transgender issues requires a multifaceted approach that integrates psychological, social, and familial support. Early education, effective parenting, and community awareness play vital roles in shaping gender identity and preventing confusion, while psychosocial support helps both transgender individuals and their families cope with emotional and social challenges. Among treatment approaches, psychological interventions, including historically used methods such as aversion therapy, have been considered in the context of managing gender identity, although ethical, clinical, and social implications must be carefully addressed.

Ultimately, supporting transgender individuals demands a balanced combination of education, emotional guidance, community involvement, and clinically informed therapies, ensuring that care prioritizes well-being while acknowledging the complex interplay of biological, psychological, and social factors.