Culturally, the transgender community has profoundly shaped global art, fashion, and language. Concepts like "passing," "transitioning," and "gender-affirming" have entered the mainstream lexicon, largely driven by trans activists and creators. From the underground ballroom scenes of the 1980s—which birthed "voguing" and "shade"—to modern film and literature, trans people have used self-expression as a tool for survival. This creative output often serves as a form of "gender-queering," challenging rigid binaries and providing an escape from the oppression of a cisnormative society.

Key issues today include protecting gender-affirming care and ensuring safe access to public spaces and housing.

The inclusion of the "T" in LGBTQ acknowledges that gender identity is as fundamental to human diversity as sexual orientation. Historically, transgender individuals have been at the forefront of queer liberation. Figures like Marsha P. Johnson and Sylvia Rivera played pivotal roles in early activism, such as the Stonewall Uprising, asserting that there is no queer freedom without transgender safety. This history demonstrates that the transgender community did not just join the LGBTQ movement; they helped build it, often while facing the highest levels of marginalization from both society and sometimes from within the gay and lesbian communities.

Much of modern queer culture, including drag and ballroom, was founded and sustained by transgender and gender non-conforming individuals .

Transgender rights are often tied to race and class, with trans people of color facing the highest risks of violence and discrimination .