Many people mistakenly use “sex” and “gender” interchangeably, but they refer to different concepts. Sex is based on biological differences, while gender is about personal identity.
What is Sex?
Sex refers to the physical differences between people who are male, female, or intersex. Typically, a person’s sex is assigned at birth based on their genitalia and chromosome composition—this is known as their natal sex.
What is Gender?
Gender, on the other hand, is how someone identifies. Unlike sex, gender isn’t binary—it exists on a broad spectrum.
A person may identify anywhere on this spectrum, or even outside of it. For example, someone may identify as transgender, nonbinary, or gender-neutral, among other identities.
It’s also important to recognize that gender involves societal roles and norms.
These social constructs define what behaviors, characteristics, or attributes are considered appropriate for men and women, but these roles vary widely across cultures and can change over time.
Sex Assignment
Sex is typically assigned at birth based on anatomical markers, such as genitalia and hormones.
Females typically have two X chromosomes and higher levels of estrogen, while males usually have one X and one Y chromosome, with higher levels of testosterone.
However, sex isn’t always so clear-cut. Some people are born with variations in chromosomes or genitalia, and these differences may not be apparent until later in life.
Intersex Identities
Intersex individuals are born with variations in sex characteristics that don’t fit typical binary categories of male or female.
These variations may be in genitals, hormones, or chromosomes, and people may not realize they are intersex until puberty.
Historically, these differences were referred to as “disorders of sex development,” but the term intersex is now widely preferred as it avoids negative connotations.
The Spectrum of Sex
Biologists and researchers have begun to discuss the idea that sex, like gender, may also exist on a spectrum.
This concept has gained more public attention in recent years, though it was first discussed in scientific circles decades ago.
Gender: A Social Perspective
In the U.S., gender has long been defined as a binary (male or female), but many cultures recognize more than two genders or have different understandings altogether.
People who identify with the gender they were assigned at birth are called cisgender, while those who don’t might identify as transgender or nonbinary.
In reality, gender identity is far more complex than a simple male/female distinction. It can range from identifying fully with traditional gender roles to rejecting them entirely.
Gender and Society
Gender roles are social constructs that vary between cultures and over time.
According to the World Health Organization (WHO), gender includes socially constructed roles and behaviors that society deems appropriate for men and women. These norms can change and are not set in stone.
In many societies, gender roles are rigid, but they can shift with changing societal views. A 2018 analysis of public opinion polls in the U.S. showed that attitudes toward gender roles are evolving.
Gender and Health
There are complex connections between gender and health. Health systems often reinforce gender stereotypes, affecting everything from care access to inclusivity.
A WHO report highlighted the influence of gender biases in healthcare, which can lead to inequalities in treatment and care.
Identity and Expression
Gender identity is how a person feels internally, while gender expression is how they present themselves to the world.
For example, a person may identify as nonbinary but present outwardly in a traditionally masculine or feminine way.
According to GLAAD, gender identity is a deeply personal sense of where a person fits on (or off) the gender spectrum, while gender expression includes external characteristics like clothing, behavior, and pronouns, which can vary across cultures and over time.
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Summary
For centuries, societies have enforced the notion that a person is either male or female based solely on physical traits.
However, this binary understanding conflates sex and gender, which are distinct. While sex is based on biological characteristics, gender encompasses a person’s identity, expression, and societal roles.
A person may identify with a gender different from their natal sex, or with no gender at all. Nonbinary is an umbrella term for many identities that don’t fit into the traditional binary of male and female.