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A common point of confusion within broader culture is the difference between sexual orientation and gender identity.

Transgender culture within the LGBTQ umbrella often focuses on self-determination, community support, and the rejection of rigid gender binaries. Cultural Competence in the Care of LGBTQ Patients - NCBI extreme shemale gallery

This strategy frequently left the transgender community behind. In the 1970s and 80s, some lesbian feminist groups excluded trans women, arguing they were "infiltrators" or inherently male. This rhetoric, known as , created a deep wound within LGBTQ culture. Similarly, bisexual and gay spaces sometimes dismissed trans people's identities as a mental illness or a choice. A common point of confusion within broader culture