People often use the terms “sex” and “gender” interchangeably, but this is incorrect. Sex refers to biological physical differences, while gender is how people identify.
The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.
“Sex” refers to the physical differences between people who are male, female, or intersex. A person typically has their sex assigned at birth based on physiological characteristics, including their genitalia and chromosome composition. This assigned sex is called a person’s “natal sex.”
Gender, on the other hand, involves how a person identifies. Unlike natal sex, gender is not made up of binary forms. Instead, gender is a broad spectrum. A person may identify at any point within this spectrum or outside of it entirely.
People may identify with genders that are different from their natal sex or with none at all. These identities may include transgender, nonbinary, or gender-neutral. There are many other ways in which a person may define their own gender.
Gender also exists as a social construct — as gender “roles” or “norms.” These are defined as the socially constructed roles, behaviors, and attributes that a society considers appropriate for men and women.
Sex assignment typically happens at birth based on anatomical and physiological markers.
Male and female genitalia, both internal and external, are different, and male and female bodies have distinct hormonal and chromosomal makeups. Doctors use these factors to assign natal sex.
At birth, individuals assigned female at birth have higher levels of estrogen and progesterone, while those assigned male at birth have higher levels of testosterone. Assigned females typically have two copies of the X chromosome, and assigned males have one X and one Y chromosome.
A person’s individual terminology preferences may not always align with current medical definitions. Language is a fluid thing, and definitions are an ongoing source of discussion.
Society often sees maleness and femaleness as a biological binary. However, there are issues with this distinction. For instance, the chromosomal markers are not always clear-cut. Some male babies are born with two or three X chromosomes, just as some female babies are born with a Y chromosome.
Also, some babies are born with atypical genitalia due to a difference in sex development (DSD).
Some medical professionals refer to this as a disorder, difference, or anomaly of sexual differentiation. However, these terms are problematic. Instead of these terms, some people may identify as ‘intersex’, although individuals may also carry negative associations with this term.
Being intersex can mean different things. For example, a person might have genitals or internal sex organs that fall outside of typical binary categories. Or, a person might have a different combination of chromosomes. Some people do not know that they are intersex until they reach puberty.
In the United States, gender has historically been defined as a binary. Many other cultures have
Gender identity
A person may fully or partially identify with existing gender roles. They may not identify with any gender roles at all. People who do not identify with existing gender binaries may identify as nonbinary. This umbrella term covers a range of identities, including genderfluid, bigender, and gender-neutral.
Someone who identifies with the gender that they were assigned at birth is called “cisgender.” Someone who is not cisgender and does not identify within the gender binary — of man or woman, boy or girl — may identify as nonbinary, genderfluid, or genderqueer, among other identities.
Gender and society
Gender is also a social construct. As the
“Gender refers to the characteristics of women, men, girls and boys that are socially constructed. This includes norms, behaviours and roles associated with being a woman, man, girl or boy, as well as relationships with each other. As a social construct, gender varies from society to society and can change over time.”
Gender roles in some societies are more rigid than in others. However, these are not always set in stone, and roles and stereotypes can shift over time. A 2018 meta-analysis of public opinion polls about gender stereotypes in the U.S. reflects this shift.
A person may identify and express their gender in different ways.
Gender identity refers to a person’s internal sense of self, while their expression refers to how they present themselves to the outside world. For example, a person may identify as nonbinary but present as a man to the outside world.
This may involve external manifestations of gender, including a person’s:
- chosen name
- preferred pronouns
- clothing
- haircut
- behavior
- voice
LGBTQIA+ resources
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There is a complex relationship between gender and both physical and mental health. Many health systems are not gender-neutral, and this can affect the quality of care.
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The researchers also emphasized that these disparities in care can intersect with and amplify other social disparities.
The review concluded that health systems must be held accountable to address gender inequalities and restrictive gender norms.
For centuries, many societies have enforced the notion that a person is either a man or woman based on their physical characteristics. This idea conflates sex and gender, which is incorrect. Sex and gender are not the same.
In general terms, sex refers to a person’s physical characteristics at birth, and gender encompasses a person’s identities, expressions, and societal roles.
A person may identify with a gender that is different from their natal sex or with no gender at all. The latter identity is often referred to as nonbinary, but this is an umbrella term that covers many identifications.