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: Many Native American tribes, like the Zuni and Crow, honored Two-Spirit individuals who bridged masculine and feminine roles. For example, Osh-Tisch of the Crow nation was highly regarded for her skills in both battle and traditional crafts [18].

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Concerns the gender of the people an individual is romantically or sexually attracted to. : Many Native American tribes, like the Zuni

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: Studies show that transition-related care leads to improved quality of life, higher self-esteem, and significant reductions in anxiety, depression, and suicidality.

: Who a person is attracted to (e.g., gay, straight, bisexual). Transgender people can have any sexual orientation. American Psychological Association (APA)