Culture is the third factor in transgender causation. In earlier podcasts I described how genetic gender predisposition was formed based on two factors: genetics and epigenetics. In this podcast I describe why culture is the third factor in being transgender. It appears that being transgender only occurs in Western culture. Western culture is peculiar among those cultures that have been studied. It has the peculiar characteristics of being binary, cisgender and inflexible. When genetic gender predisposition and culture collide, the result is transgender people. Examples of other cultures that have up to 5 gender behavior categories, that are not cisgender and are not inflexible. Transgender people cannot change their genetic gender predisposition but they can change Western culture to be more accomodating to diversity.