The Difference Between Sex and Gender, and Why it Matters in Reproductive Medicine

The words sex and gender are often used interchangeably, but in truth have very different definitions. These distinctions are not only important, they apply directly and in many ways to the fertility field of medicine, and their correct usage can contribute to a more accurate and more respectful health care experience.

The WHO defines sex as “the biological and physiological characteristics that define men and women, such as reproductive organs, chromosomes, hormones, etc.” Conversely, gender consists of “the socially constructed characteristics of women and men—such as norms, roles and relationships of and between groups of women and men.” More concisely, the FDA marks sex as purely a biological classification and gender as “self-representation.”

The relationship between sex and gender is very complicated and very individual, and hinges on multiple factors: genetic, hormonal, and sociocultural. Historically, determination of gender by physicians at or after birth has been complex and had far-reaching and often damaging effects.

As it pertains to the field of Reproductive Endocrinology and fertility counseling, this distinction between gender and sex remains important for a number of reasons.

The first clear application is to the area of sex selection of embryos in an IVF cycle. Embryos do not have a gender—rather, a sex, as defined by their sex chromosome pair. Therefore, in discussions of sex selection or determination of embryos, the often synonymously used phrases of “gender selection” or “gender determination” are inaccurate and should be discarded.

Additionally, this terminology is especially important considering many fertility patients identify as members of the LGBTQ community or as gender non-conforming. Using care to speak accurately about sex and gender with patients can create a more comfortable and respectful health care environment as they build their family.

Fertility practices across the board should implement this vocabulary in discussions with patients, and in both academic and public settings, as a best practice in patient care.

At IRMS, we strive to provide you with the most current, accurate, and respectful health care we can, as we guide you through your journey to building a family. Get in touch with us to book a new patient appointment by filling out our contact form or calling us at (973) 322-8286.


1 “Sex and gender: you should know the difference.” Broughton, Darcy E. et al. Fertility and Sterility, Volume 107, Issue 6, 1294 – 1295.

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