Misgender(ing) refers to when a person, trans* or otherwise, is addressed using gendered vocabulary that contradicts the person's gender identity or presentation. It is generally considered insulting to refer to a transsexual person by their assigned at birth gender unless they actively identify as it for any reason.
Sometimes the use of assigned at birth sex for medical documents is considered misgendering in absence of a statement acknowledging the patient's gender identity. The reason for this may be because of insurance entities that won't cover certain procedures on the basis that men "can't" get pap smears or women "can't" get prostate exams (which is an important cancer screening tool for those who have not had surgery yet).
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