What’s the difference between sex and gender?

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While the terms sex and gender are often used interchangeably, they actually have distinct meanings. The distinction between the two was first proposed by a sexologist in the 1950s, and it is now recognized by large organizations such as the World Health Organization.

Sex is biologically based, and we are born as male or female based on our genes. Two X chromosomes and you have a female, an X plus a Y chromosome you have a male. As a side note, this means that the sex of the baby is based on whether the sperm that fertilized the ovum bore an X or a Y chromosome. There are also some genetic variants that can complicate things.

There are a variety of sex chromosome disorders, including those with an extra X chromosome or an extra Y chromosome. Some people with genetic variations in sex chromosomes are born as intersex, with sex characteristics that don’t neatly fit into the male or female norm. In the past the term hermaphrodite was used, but that is no longer considered acceptable, and its use is limited to biology to describe organisms, such as earthworms and snails, that have both male and female sex organs. Intersex humans may have variations in internal and external anatomy as well as sex hormones. Intersex characteristics may be visibly apparent, but in some cases they are only identified through genetic testing.

Gender does not refer to biological characteristics, but rather to identification in relation to social notions of “male” or “female”. The World Health Organization defines gender as “the socially constructed characteristics of women and men — such as norms, roles and relationships of and between groups of women and men. It varies from society to society and can be changed.” While some may argue that these roles are inherently based in biology, power and control can play an important role. The WHO Europe states that: “The way power is distributed in most societies means that women have less access to and control over resources to protect their health, and are less likely to take part in decision-making.” Our society is highly gendered, and it’s become so normalized that it’s easy to lose sight of the fact that these gender roles are social norms rather than some sort of objective reality.

Some people never have identified with the social gender norms associated with their birth sex. A person who has always identified with the opposite sex’s gender roles may identify as transgendered. The term cis-gendered is sometimes use to describe people whose gender identity matches their biological sex.

While we tend to think of gender as being very binary, i.e. male and female, not everyone fits into those neat little categories. Some people don’t identify with either the male or female box, and may use terms like gender-queer, gender-fluid, or non-binary to describe themselves. Some cultures have distinct roles for non-binary individuals, and this is sometimes described as a third gender. Two-spirited is the term used for this in some North American indigenous groups.

Gender expression refers to external displays related to gender, and is not necessarily congruent with gender identity. A transvestite who performs as a female may identify as male, with the female aspect as a performance persona. Transgendered individuals’ gender expression choices may be influenced by the stigma they expect to face if their gender expression matches their true gender identity.

So, sex derives from biology, and gender derives from social constructs. What about sexuality? It’s something that sometimes gets loosely thrown into the mix of sex and gender, but it’s a distinct phenomenon. Who a person wants to sleep with doesn’t necessarily have anything to do with their biology or the gender that they identify with. The fact that someone is transgendered has no bearing on whether their sexual preference is for men, women, or both.

I must admit that I was fairly oblivious to much of this until I started working as a nurse. At that point I started having contact with a far more diverse range of people than I typically had contact with in social situations. When I was working in community mental health I had a client who’d recently had sex reassignment surgery. I worked closely with her for four years and learned so much from her about this topic. At the same time, though, exposure isn’t always enough. I remember having a conversation with a fellow nurse who couldn’t see the difference between gender identity and sexual orientation. She thought that trans people were just confused gay people.

What do you think of the different definitions for sex and gender? Does it fit with your worldview?

Originally published at mentalhealthathome.org on February 22, 2019.