'AFAB' is an abbreviation of the English term 'Assigned Female at Birth' — registered as female at birth. The term comes from American activist language and is mainly used to refer to a person without confusing their current lived gender with their sex at birth.
What does it mean?
AFAB refers to the fact that someone was viewed and registered as female at birth. In almost all cases, this corresponds to being biologically female (XX chromosomes, ovaries, female sex anatomy). The term is mainly used in trans and non-binary contexts, where a person's lived gender may differ from the sex recorded at birth.
Distinction and overlap
The counterpart is AMAB (Assigned Male at Birth). An AFAB person may now identify as a woman, transmasculine, non-binary or otherwise — the label says something about the past, not the present.
Social and practical context
AFAB people encounter female-specific issues in healthcare that do not disappear because of identity: menstruation, contraception, cervical cancer screening, pregnancy and menopause. These issues remain relevant during medical transition (such as testosterone and mastectomy). Guidelines therefore recommend discussing egg freezing before starting testosterone. The effects of testosterone on a female body are described by risk on transkompas.nl.
Critical perspectives
The term 'assigned' is ideologically loaded: it suggests that sex at birth is a social assignment rather than a biological observation. The origin of the phrase 'assigned at birth' has been investigated on letterbrij.nl. Critics, including many women who emphasize the importance of sex-specific healthcare and rights, prefer 'female' or 'girl' when biology is meant. The label 'AFAB' is also sometimes used in ways that obscure the specificity of being female — for example, when discussing sexual violence against women or pregnancy.
AFAB describes registration at birth, while female refers to biological sex. In practice, these are almost always the same: someone registered as a girl will in almost all cases have XX chromosomes, ovaries and female sex anatomy. The term AFAB is mainly used in trans and non-binary contexts, where a person's lived gender may differ from the sex recorded at birth.
Yes. Trans men and some non-binary people are AFAB. The label says something about the past, namely registration as female at birth, and nothing about the present. An AFAB person may now identify as a woman, transmasculine, non-binary or otherwise. Female-specific healthcare issues do not disappear because of identity.
The word 'assigned' suggests that sex at birth is a social assignment rather than a biological observation. Many critics see this as a denial of biological reality. They prefer 'female' or 'girl' when biology is meant. The label may also obscure what is specific to being female, for example in relation to pregnancy or sexual violence against women.
Yes. For screening (cervical cancer, breast cancer), pregnancy and medication dosage, biological sex remains decisive. Female-specific issues such as menstruation, contraception and menopause do not disappear because of identity and remain relevant even during medical transition with testosterone or mastectomy. Guidelines therefore recommend discussing egg freezing before someone starts testosterone.
