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GENDER AT SEX
Understandings of gender continually evolve. In the course of a person’s life, the
interests, activities, clothing and professions that are considered the domain of one
gender or another evolve in ways both small and large.
Introduction
This has perhaps never been more true than it is now. The data show that today’s
young people have significantly different understandings of gender than previous
generations, with consequences for all children, families, organizations and
institutions.
For example:
A 2015 Fusion Millennial poll of adults ages 18-34 in the USA found that the majority
see gender as a spectrum, rather than a man/woman binary.
A 2017 Harris Poll of millennials found that 12% identify as transgender or gender
non-conforming.
Research by J. Walter Thompson Intelligence (the research arm of the global
marketing communications company) found that 56% of those aged 13-20 know
someone who uses gender-neutral pronouns (such as they/them).
Leading businesses are beginning to change traditional gender-based marketing of
products, such as removing “pink and blue” clothing and toy aisles.
All of us are inundated with gender messages from the time we are born, yet we
offer children few opportunities to more deeply consider or understand this
fundamentally important aspect of life. Basic gender literacy is essential for children
to understand their own gender, engage in healthy relationships, identify and place
media and social messages in context, and have agency in determining aspects of
their gender now and in the future. Societal ideas about gender will affect every
critical aspect of their lives, from education to career, finances, relationships and
more.
Dimensions of Gender
People tend to use the terms “sex” and “gender” interchangeably. But, while
connected, the two terms are not equivalent. Generally, we assign a newborn’s sex
as either male or female (some US states and other countries offer a third option)
based on the baby’s genitals. Once a sex is assigned, we presume the child’s
gender. For some people, this is cause for little, if any, concern or further thought
because their gender aligns with gender-related ideas and assumptions associated
with their sex. Nevertheless, while gender may begin with the assignment of our sex,
it doesn’t end there. A person’s gender is the complex interrelationship between
three dimensions: body, identity, and social gender.
Body: our body, our experience of our own body, how society genders bodies, and
how others interact with us based on our body.
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Identity: the name we use to convey our gender based on our deeply held, internal
sense of self. Identities typically fall into binary (e.g. man, woman) nonbinary (e.g.,
genderqueer, genderfluid, etc) or ungendered (e.g., agender, genderless)
categories. The meaning associated with a particular identity can vary among
individuals using the same term. A person’s gender identity can correspond to or
differ from the sex they were assigned at birth.
Social gender: how we present our gender in the world and how individuals,
society, culture, and community perceive, interact with, and try to shape our gender.
Social gender includes gender roles and expectations and how society uses those to
try to enforce conformity to current gender norms.
Each of these dimensions can vary greatly across a range of possibilities and is
distinct from, but interrelated with, the others. A person’s comfort in their gender is
related to the degree to which these three dimensions feel in harmony. Let’s explore
each of these dimensions in a little more detail.
Body
Most societies view sex as a binary concept, with two rigidly fixed options: male or
female, based on a person’s reproductive anatomy and functions. But a binary view
of sex fails to capture its complexity.
"Even the biological categories of male and female are blurred; we know today that
not just the X and Y chromosomes but at least 12 others across the human genome
govern sex differentiation, and at least 30 genes are involved in sex development."
--Simona Giordano, Director of Medical Ethics, Manchester University Medical
School
Not only are female and male bodies more complex than most realize, there are also
bodies that fit neither category. While we are often taught that bodies have one of
two forms of genitalia, which are classified as “female” or “male,” there
are Intersex traits that demonstrate that sex exists across a continuum of
possibilities. This level of naturally occurring biological variation by itself should be
enough to dispel the simplistic notion that there are just two sexes. The relationship
between a person’s gender and their body goes beyond one’s reproductive
functions. Research in neurology, endocrinology, and cellular biology points to a
broader biological basis for an individual’s experience of gender. In fact, research
increasingly points to our brains as playing a key role in how we each experience our
gender.
Bodies themselves are also gendered in the context of cultural expectations.
Masculinity and femininity are equated with certain physical attributes, labeling us as
more or less a man/woman based on the degree to which those attributes are
present. This gendering of our bodies affects how we feel about ourselves and how
others perceive and interact with us.
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Identity
Gender identity is our internal experience and naming of our gender. It can
correspond to or differ from the sex we were assigned at birth.
Understanding of our gender comes to most of us fairly early in life. According to the
American Academy of Pediatrics, “By age four, most children have a stable sense of
their gender identity.” This core aspect of one’s identity comes from within each of
us. Gender identity is an inherent aspect of a person’s make-up. Individuals do not
choose their gender, nor can they be made to change it. However, the words
someone uses to communicate their gender identity may change over time; naming
one’s gender can be a complex and evolving matter. Because we are provided with
limited language for gender, it may take a person quite some time to discover, or
create, the language that best communicates their internal experience. Likewise, as
language evolves, a person’s name for their gender may also evolve. This does not
mean their gender has changed, but rather that the words for it are shifting.
The two gender identities most people are familiar with are boy and girl (or man and
woman), and often people think that these are the only two gender identities. This
idea that there are only two genders–and that each individual must be either one or
the other–is called the “Gender binary.” However, throughout human history we
know that many societies have seen, and continue to see, gender as a spectrum,
and not limited to just two possibilities. In addition to these two identities, other
identities are now commonplace.
Youth and young adults today no longer feel bound by the gender binary, instead
establishing a growing vocabulary for gender. More than just a series of new words,
however, this shift in language represents a far more nuanced understanding of the
experience of gender itself. Terms that communicate the broad range of experiences
of non-binary people are particularly growing in number. Genderqueer, a term that is
used both as an identity and as an umbrella term for non-binary identities, is one
example of a term for those who do not identify as exclusively masculine or feminine.
This evolution of language is exciting, but can also be confusing as new terms are
created regularly, and since what a term means can vary from person to person. For
further information on specific identities and what they commonly mean, please
see “The Language of Gender.”

Social Gender
Social gender is the third dimension. This includes gender expression, which is the
way we communicate our gender to others through such things as clothing,
hairstyles, and mannerisms. It also includes how individuals, communities and
society perceive, interact with, and try to shape our gender. Social gender includes
gender roles and expectations and how society uses those to try to enforce
conformity to current gender norms.
Practically everything is assigned a gender—toys, colors and clothes are some of
the more obvious examples. We begin to teach children about gender from the
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moment they are born; given the prevalence of the gender binary, children face great
pressure to express their gender within narrow, stereotypical definitions of “boy” or
“girl.” Expectations regarding gender are communicated through every aspect of our
lives, including family, culture, peers, schools, community, media, and religion.
Gender roles and expectations are so entrenched in our culture that it’s difficult to
imagine things any other way.
Children who express gender outside of these social norms often have a difficult
experience. Girls thought to be too masculine and boys seen as feminine face a
variety of challenges. Kids who don’t express themselves along binary gender lines
are often rendered invisible or steered into a more binary gender presentation.
Pressures to conform at home, mistreatment by peers in school, and condemnation
by the broader society are just some of the struggles facing a child whose
expression does not fall in line with the binary gender system.  
Because expectations around gender are so rigid, we frequently assume that what
someone wears, or how they move, talk, or express themselves, tells us something
about their gender identity. But expression is distinct from identity–we can’t assume
a person’s gender identity based on their gender expression. For example, a boy
may like to wear skirts or dresses. His choice in clothing doesn’t define his gender
identity; it simply means that he prefers (at least some of the time) to wear clothes
that society has typically associated with girls. In fact, how we interpret a person’s
gender and the assumptions we make about them is related to our personal
understanding of gender and the norms and stereotypes we have integrated—it isn’t
about them. 
Finally, norms around gender change across societies and over time. As mentioned,
cultures from around the world have long held more nuanced understandings of
gender. Whether discussing the "brother boys" and "sister girls" of Australia, or
the Muxe in Mexico, or the incredible diversity of nonbinary understandings in many
indigenous communities of the Americas (often grouped together under the umbrella
term "Two Spirit"), the rich diversity of gender has always existed. It is not a new
phenomenon, but rather a new conversation in which many of us are only just now
engaging.
Congruence
Gender congruence is the feeling of harmony in our gender:
experiencing comfort in our body as it relates to our gender naming of our gender
that adequately corresponds with our internal sense of who we are expressing
ourselves through clothing, mannerisms, interests and activities being seen
consistently by others as we see ourselves
Finding congruence is an ongoing process throughout each of our lives as we
continue to grow and gain insight into ourselves. It is most often found through
exploration. For some, finding congruence is fairly simple; for others, it is a much
more complex process. But the fundamental need to find gender congruence is true
for us all, and any degree to which we don’t experience it can be distressing.
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“Transitioning” is a term commonly used to refer to the steps a transgender,

agender, or non-binary person takes in order to find congruence in their gender. But
this term can be misleading as it implies that the person’s gender identity is changing
and that there is a moment in time when this takes place. More typically, it is others’
understanding of the person’s gender that shifts. What people see as a “Transition”
is actually an alignment in one or more dimensions of the individual’s gender as they
seek congruence across those dimensions. A transition is taking place, but it is often
other people (parents and other family members, support professionals, employers,
etc.) who are transitioning in how they see the individual’s gender, and not the
person themselves. For the person, these changes are often less of a transition and
more of an evolution.
Instead of “transitioning,” a more apt phrase is “pursuing congruence measures.” A
person can seek harmony in many ways:
Social congruence measures: changes of social identifiers such as clothing,
hairstyle, gender identity, name and/or pronouns;
Hormonal congruence measures: the use of medical approaches such as
hormone “blockers” or hormone therapy to promote physical, mental, and/or
emotional alignment;
Surgical congruence measures: the addition, removal, or modification of gender-
related physical traits; and
Legal congruence measures: changing identification documents such as one’s
birth certificate, driver’s license, or passport.
It’s important to note, though, that a transition experience can be a very significant
event in a person’s life. A public declaration of some kind where an individual
communicates to others that aspects of themselves are different than others have
assumed, and that they are now living consistently with who they know themselves
to be, can be an empowering and liberating experience (and moving to those who
get to share that moment with them). Oftentimes during a transition experience a
person will announce a change in the name and pronouns that they use and ask that
others use their new name and pronouns going forward. Honoring this request is a
sign of respect and a critically important way to demonstrate support.
Personal Gender
While the dimensions of gender and the desire for congruence are common to us all,
ultimately gender is personal. Each dimension of gender is informed by our unique
intersection of identities, experiences, and personal characteristics. We are more
than our body, gender identity and gender expression: we are also our race,
ethnicity, class, faith, sense of geographic place, family history, and more. Our
gender is personal because, while we share some of these aspects of self with
others, the way that all of these identities, influences and characteristics come
together is unique to each of us.
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Gender Is Different Than Sexual Orientation

One final distinction to make is the difference between gender and Sexual
orientation, which are often incorrectly conflated. In actuality, gender and sexual
orientation are two distinct, but related, aspects of self. Gender is personal (how we
see ourselves), while sexual orientation is interpersonal (who we are physically,
emotionally and/or romantically attracted to).
Why is it so critical to distinguish between these two concepts? When we confuse
gender with sexual orientation, we are likely to make assumptions about a young
person that have nothing to do with who they are. For example, when someone’s
gender expression is inconsistent with others’ expectations, assumptions are
frequently made about that person’s sexual orientation. The boy who loves to play
princess is assumed to be gay, and the girl who buys clothes in the “boys’” section
and favors a short haircut may be assumed to be a lesbian. These could be faulty
conclusions. What someone wears and how they act is about gender expression.
You cannot tell what a person’s sexual orientation is by what they wear (for that
matter, you can’t know what their gender identity is either, unless they tell you).
Our society’s conflation of gender and sexual orientation can also interfere with a
young person’s ability to understand and articulate aspects of their own gender. For
example, it’s not uncommon for a transgender or non-binary youth to wonder if they
are gay or lesbian (or any sexual orientation other than heterosexual) before coming
to a fuller realization of their gender identity. How we come to understand our gender
and our sexual orientation – and the choices we make to disclose and express these
parts of ourselves – are distinct paths. Thinking of these two aspects of self as
interchangeable may, instead of helping us know ourselves and one another better,
actually get in the way of understanding and communication.
What’s Next?
There is a generational divide in how we think about gender. In order to bridge this
gap, those of us who were raised with a more limited view of gender can take this as
an opportunity to explore gender with new eyes, to read and ask questions to better
understand gender’s complexity. As with any learning experience, you’ll learn more
about the world around you and about yourself in the process.
Gender diversity has existed throughout history and all over the world. As one of the
most fundamental aspects of a person’s identity, gender deeply influences every part
of one’s life. Where this crucial aspect of self is narrowly defined and rigidly
enforced, individuals who exist outside of its norms face innumerable challenges.
Even those who vary only slightly from norms can become targets of disapproval,
discrimination, and even violence.
This does not have to be the case. Through a thoughtful consideration of the
uniqueness and validity of every person’s experience of self, we can develop greater
acceptance for all. Not only will this create greater inclusion for individuals who
challenge the norms of gender, it will create space for all individuals to more fully
explore and express who they are.
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The Language of Gender

The power of language to shape our perceptions of other people is immense.
Precise use of terms in regards to gender can have a significant impact on
demystifying many of the misperceptions associated with gender.
The vocabulary of gender continues to evolve and there is not universal agreement
about the definitions of many terms. Nonetheless, here is some working language
and examples of frequently used (and misused) terms. We offer them as a starting
place for dialogue and understanding, which begins by clarifying how we are using
various terms, rather than asserting that they represent the final or only definition of
the various terms.
Agender – A person who sees themself as not having a gender. Some agender-
identified people see themself as being gender neutral, rather than not having any
gender, but in any case do not identify with a gender.
Cisgender – Refers to people whose Gender identity aligns with their assigned sex
at birth (cis- from Latin, meaning, “on this side [of].” In contrast to trans, from the
Latin root meaning “across,” “beyond,” or “on the opposite side [of]”).
Congruence - Gender congruence is the feeling of harmony in our gender (see
more in "Understanding Gender").
Dimensions of gender – Our body, identity and social gender (how we present our
gender in the world and how individuals, society, culture, and community perceive,
interact with, and try to shape our gender) are three distinct, but interrelated,
components that comprise a person’s experience of gender. Each of these
dimensions can vary greatly across a range of possibilities. A person’s comfort in
their gender is related to the degree to which these three dimensions feel in
congruence.
FtM – A person who was assigned a female sex at birth and whose gender identity
is boy/man.
Gender binary – A system that constructs gender according to two discrete and
opposite categories: boy/man and girl/woman. It is important to recognize that both
cisgender and Transgender people can have a gender identity that is binary.
Gender dysphoria – First, let’s look at the word “dysphoria.” According to Merriam-
Webster, dysphoria is “a state of feeling very unhappy, uneasy, or dissatisfied.” So,
in the broadest sense, gender dysphoria is when someone feels very unhappy,
uneasy, or dissatisfied in relation to their gender. This is something many people
experience, including feeling a tension between how someone feels about their body
compared to how society genders their body, or a conflict between how someone
sees themselves in contrast with expected gender roles or expectations.
Gender dysphoria is related to gender congruence, which is the degree of harmony
we feel in each dimension of our gender (see Understanding Gender for more
information on the dimensions of gender). Gender dysphoria, which can occur in
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relation to any dimension of gender, can encompass a broad range of feelings, from

mild discomfort to unbearable distress; the intensity, pervasiveness, frequency, and
triggers of gender dysphoria vary widely from person to person. Feelings of gender
dysphoria can, and often do, change over time. For example, an individual’s
experience of gender dysphoria may lessen as greater congruence is achieved.
If a person’s discomfort or distress is negatively affecting their quality of life and
relationships, they may want to get support from a trained, affirming gender
professional. Keep in mind that “gender dysphoria” is also a clinical term and is
found in the Diagnostic and Statistical Manual of Mental Disorders (commonly
referred to as the DSM, or DSM–5). The labeling of gender dysphoria as a disorder
or condition has been controversial, but it is helpful to understand the term’s clinical
definition and use if you are considering support from a mental health professional.
Gender expansive – An umbrella term used for individuals who broaden their own
culture’s commonly held definitions of gender, including expectations for its
expression, identities, roles, and/or other perceived gender norms.
Gender expression – This is our “public” gender. How we present our gender in the
world and how society, culture, community, and family perceive, interact with, and try
to shape our gender. Gender expression is also related to gender roles and how
society uses those roles to try to enforce conformity to current gender norms.
Genderfluid – People who have a gender or genders that change. Genderfluid
people move between genders, experiencing their gender as something dynamic
and changing, rather than static.
Gender identity – our deeply held, internal sense of self as masculine, feminine, a
blend of both, neither, or something else. Identity also includes the name we use to
convey our gender. Gender identity can correspond to, or differ from the sex we are
assigned at birth. The language a person uses to communicate their gender identity
can evolve and shift over time, especially as someone gains access to a broader
gender vocabulary.
Gender literacy - the ability to participate knowledgeably in discussions of gender
and gender-related topics. Gender literacy is not about expertise so much as it is
about a stance of openness to the complexity of gender and the idea that each
person determines for themself their own identity.
Gender role – The set of functions, activities, and behaviors commonly expected of
boys/men and girls/women by society.
Genderqueer – An umbrella term to describe someone who doesn’t identify with
conventional gender identities, roles, expression and/or expectations. For some,
genderqueer is a Non-binary identification, and for others it is not.
Intersex – Also referred to as Disorders/Differences of Sexual Development. About
1% of children are born with chromosomes, hormones, genitalia and/or other sex
characteristics that are not exclusively male or female as defined by the medical
establishment in our society. In most cases, these children are at no medical risk, but
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most are assigned a binary sex identity (male or female) by their doctors and/or
families.
MtF – A person who was assigned a male sex at birth and whose gender identity is
girl/woman.
Non-binary – An umbrella term for gender identities that are not exclusively
masculine or feminine.
Sex – Used to label a person as “male” or “female” (some US states and other
countries offer a third option) at birth, this term refers to a person’s external genitalia
and internal reproductive organs. When a person is assigned a particular sex at
birth, it is often mistakenly assumed that this will equate with their gender; it might,
but it might not.
Sexual orientation – Our sexual orientation and our gender are separate, though
related, parts of our overall identity. Gender is personal (how we each see
ourselves), while sexual orientation is interpersonal (who we are physically,
emotionally and/or romantically attracted to).
Transboy – A child who was assigned a female sex at birth and has a boy gender
identity.
Transgender – Sometimes this term is used broadly as an umbrella term to
describe anyone whose gender identity differs from their assigned sex. It can also be
used more narrowly as a gender identity that reflects a binary gender identity that is
“opposite” or “across from” the sex they were assigned at birth.
Transgirl – A child who was assigned a male sex at birth and has a girl gender
identity.
Transition – “Transitioning” is a term commonly used to refer to the steps a
transgender, Agender, or non-binary person takes in order to find congruence in their
gender. But this term can be misleading as it implies that the person’s gender
identity is changing and that there is a moment in time when this takes place. More
typically, it is others’ understanding of the person’s gender that shifts. What people
see as a “transition” is actually an alignment in one or more dimensions of the
individual’s gender as they seek congruence across those dimensions. A transition is
taking place, but it is often other people (parents and other family members, support
professionals, employers, etc.) who are transitioning in how they see the individual’s
gender, and not the person themselves. For the person, these changes are often
less of a transition and more of an evolution. Instead of “transitioning,” a more apt
phrase is “pursuing congruence measures.” A person can seek harmony in many
ways:
Social congruence measures: changes of social identifiers such as clothing,
hairstyle, gender identity, name and/or pronouns;
Hormonal congruence measures: the use of medical approaches such as
hormone “blockers” or hormone therapy to promote physical, mental, and/or
emotional alignment;
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Surgical congruence measures: the addition, removal, or modification of gender-

related physical traits; and
Legal congruence measures: changing identification documents such as one’s
birth certificate, driver’s license, or passport.
It is important to note, though, that a transition experience can be a very significant
event in a person’s life. A public declaration of some kind where an individual
communicates to others that aspects of themselves are different than others have
assumed, and that they are now living consistently with who they know themselves
to be, can be an empowering and liberating experience (and moving to those who
get to share that moment with them).
Transphobia – Fear, dislike of, and/or prejudice against transgender people.
Transsexual – This term is used in different ways in English-speaking countries. In
the US, it is considered an older term that originated in the medical and
psychological communities and is considered offensive by many people. Still used by
some people who have permanently changed, or seek to change, their bodies
through medical interventions, including, but not limited to, hormones and/or
surgeries. Unlike the term transgender, transsexual is not an umbrella term. Many
transgender people do not identify as transsexual and prefer the word transgender.