Sex and gender, though often conflated, is not the same thing. Sex refers to the two categories (male and female) into which humans are divided on the basis of their reproductive biology. Gender, on the other hand, is a sociocultural term, which describes how individuals perceive their own identities. Gender identities exist on a spectrum and extend accordingly beyond the traditional male-female binary denoted by one’s biological sex.
While understanding the distinction between sex and gender is important in all settings, it is particularly crucial within the medical field. Physicians and staff at medical facilities must use proper terminology in order to accurately respond to their patients’ needs. For example, a case of a transgender male (female-to-male) who wishes to conceive and who also still possesses female reproductive organs requires a physician to distinguish between the patient’s gender identity (male) and biological sex (female) to produce sound medical advice. Yet while this distinction’s importance is most obvious in cases of transgender people (people whose gender identity differs from their biological sex), it can be observed in all possible cases. It is imperative that physicians always respect an individual’s right to shape and express their own identity and access care accordingly.
It is also important to understand the difference between gender identity and gender expression, because they too are not the same thing. The Human Rights Campaign defines gender identity as “one’s innermost concept of self as male, female, a blend of both or neither – how individuals perceive themselves and what they call themselves.” In contrast, the HRC defines gender expression as the “external appearance of one’s gender identity, usually expressed through behavior, clothing, haircut or voice, and which may or may not conform to socially defined behaviors and characteristics typically associated with being either masculine or feminine.” One’s gender identity and gender expression do not always align, so it is critical that physicians (and everyday people) do not assume people’s gender identities based on their gender expressions. Although someone may present characteristics that are typical of a male, for example, (short haircut, deep voice), they may identify as a woman, non-binary, or something else entirely. If you are unsure about someone’s gender identity, the easiest and most effective way to learn it is to respectfully ask them about it and for their preferred pronouns. Misgendering others can offend people and create discomfort. Recent studies have shown either misgendering or not recognizing gender exists on a spectrum has particularly impacted the transgender community and has lead many transgender individuals to not seek medical attention when needed. A culture of knowledge and respect is crucial in a medical setting and something we strive for with continuing education of all staff at IRMS.
At IRMS, we are committed to fostering an environment in which people of all sexes and gender identities feel welcome and can access the care they seek. We work with individuals and couples who identify as heterosexual as well as anywhere they may fall on the LGBTQ spectrum. We also work to help other healthcare professionals understand the difference between sex and gender and create an environment of inclusivity for their patients and employees in their offices and beyond.