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The term transgender can also be distinguished from intersex, a term that describes people born with physical sex characteristics "that do not fit typical binary notions of male or female bodies".The counterpart of transgender is cisgender, which describes persons whose gender identity or expression matches their assigned sex.The degree to which individuals feel genuine, authentic, and comfortable within their external appearance and accept their genuine identity has been called transgender congruence. Oliven of Columbia University coined the term transgender in his 1965 reference work Sexual Hygiene and Pathology, writing that the term which had previously been used, transsexualism, "is misleading; actually, 'transgenderism' is meant, because sexuality is not a major factor in primary transvestism." By 1992, the International Conference on Transgender Law and Employment Policy defined transgender as an expansive umbrella term including "transsexuals, transgenderists, cross dressers", and anyone transitioning.Leslie Feinberg's pamphlet, "Transgender Liberation: A Movement Whose Time has Come", circulated in 1992, identified transgender as a term to unify all forms of gender nonconformity; in this way transgender has become synonymous with queer.Transgender people are sometimes called transsexual if they desire medical assistance to transition from one sex to another.

However, the concerns of the two groups are sometimes different; for example, transsexual men and women who can pay for medical treatments (or who have institutional coverage for their treatment) are likely to be concerned with medical privacy and establishing a durable legal status as their gender later in life.

For example, Christine Jorgensen publicly rejected transsexual in 1979, and instead identified herself in newsprint as trans-gender, saying, "gender doesn't have to do with bed partners, it has to do with identity." The definitions of both terms have historically been variable.

In his 2007 book Transgender, an Ethnography of a Category, anthropologist David Valentine asserts that transgender was coined and used by activists to include many people who do not necessarily identify with the term and states that people who do not identify with the term transgender should not be included in the transgender spectrum.

Androgyne is also sometimes used as a medical synonym for an intersex person.

The term cross-dresser is not exactly defined in the relevant literature. Gilbert, professor at the Department of Philosophy, York University, Toronto, offers this definition: "[A cross-dresser] is a person who has an apparent gender identification with one sex, and who has and certainly has been birth-designated as belonging to [that] sex, but who wears the clothing of the opposite sex because it is that of the opposite sex." This definition excludes people "who wear opposite sex clothing for other reasons," such as "those female impersonators who look upon dressing as solely connected to their livelihood, actors undertaking roles, individual males and females enjoying a masquerade, and so on.

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