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These include people whose gender identities are not exclusively masculine or feminine but may, for example, be androgynous, bigender, pangender, or agender—often grouped under the alternative umbrella term genderqueer they are usually excluded, as are transvestic fetishists (because they are considered to be expressing a paraphilia rather than a gender identification) and drag kings and drag queens (who are performers and cross-dress for the purpose of entertaining).

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.The majority of cross-dressers identify as heterosexual.People who cross-dress in public sometimes may have a desire to pass as the opposite gender, so as not to be detected as a cross-dresser.Harry Benjamin invented a classification system for transsexuals and transvestites, called the Sex Orientation Scale (SOS), in which he assigned transsexuals and transvestites to one of six categories based on their reasons for cross-dressing and the relative urgency of their need (if any) for sex reassignment surgery.people who meet Benjamin's definition of a "true transsexual" but do not desire SRS include Miriam Rivera.

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