Sex & Gender

There is a tendency, both colloquially and in the medical context, to use "sex" and "gender" interchangeably (Madsen et al., 2017). However, they are distinctly different in several key ways, making precision in language particularly important.

What is Sex?

Sex is a biological phenomenon that is broken down into (1) chromosomal sex, (2) gonadal sex, (3) hormonal sex, and (4) phenotypic sex. Each constituent stage adds a layer of complexity and variability that can change subsequent stages in development. This complexity means that biological sex sits on a spectrum of outcomes with male and female sex on either end.

What is Gender?

Gender is socially constructed and relates to roles, behaviours, activities, and attributes that society considers appropriate/expected related to a person's assigned sex. It is further broken down into gender identity and gender expression. As the name suggests, identity is about self-concept while expression is how a person communicates about their gender externally through the way they act, dress, behave, and interact (Refer to PFLAG National Glossary). For example, someone who is a female assigned at birth (AFAB) can identify as a man but may not have transitioned ("the process—social, legal, and/or medical—one goes through to affirm one’s gender identity"; PFLAG, 2022) and can therefore express as feminine.

Sex & Gender in Research

These examples from Madsen et al. (2017) demonstrate how the concepts of sex and gender are applicable in research and appropriate reporting.

Identity & Orientation

LGBTQIA+ refers to folks who identify as Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, etc. The PFLAG National Glossary is a great resource to explore some of the other identities that are represented by the "+" in the acronym. It is important to note that we are all instinctively better at understanding categories and labels compared to a spectrum. The number of labels you see in the national glossary is a reflection of the sheer complexity of wanting to create categories out of a spectrum of identity and expression. It is also representative of the desire and the effort of folks that are represented by those labels to find community in it. It is not necessary nor feasible to know every label, only the category with which the person in front of you identifies and having the openness to listen to their unique experience. In the absence of having a person in front of us, we can use inclusive language that is most representative of the population.

The acronym LGBTQIA+ can be effective, but its use should be specific to represent the community as a whole rather than a specific group under the larger umbrella. For example, if referring to a policy or procedure that primarily affects transgender folks, using transgender people/person is more appropriate than using an umbrella term like LGBTQIA+. An alternative umbrella term to the acronym is sexual and gender minorities (SGM).

KEY POINT: Although the LGBTQIA+ acronym includes terms referring to someone's gender identity, it also references sexual orientation. Sexual orientation is a different concept than sex and gender. The reason that they are lumped together in the acronym is because people in these communities are often subject to prejudice and systemic discrimination. Specifically referencing specific groups represented in the acronym avoids diluting statements and falsely implying that they are universally applicable or evidence-based.

Additional Language Guidance

Use neutral anatomical terms where possible

i.e. inserting a catheter into penile anatomy vs male anatomy

Gender neutral language can be powerful

Be mindful of gendered collective address terms like "Good morning, guys!"
- Although some regard this colloquial use of "guys" as gender neutral, it is not universally seen as such.
- Preferred alternatives can include: folks, everyone/everybody, friends, team, all
Terms like pregnant person/parent is preferred over pregnant woman because it is trans-inclusive (i.e. a trans man could be be the birthing parent)

Relational Assumptions
- Our language can be made more inclusive by being mindful of different relationships folks might be in and avoiding presumptive terms
  - i.e. asking about partners or spouses versus assuming someone has a "boyfriend/husband," "girlfriend/wife," even assuming that the romantic partners in their lives are limited to a single individual.

Want to learn more about sex and gender? Check out the online Faculty Development module called "2SLGBTQI+ Health" by logging into your Instructor Homepage with your CCID.

Resource: https://pflag.org/glossary/

References

American Psychological Association. (n.d.). Gender. In APA Style. Retrieved July 25, 2024, from https://apastyle.apa.org/style-grammar-guidelines/bias-free-language/gender_gl=1*1lk9zi0*_gcl_au*NDA5ODY0Nzg5LjE3MTgyMjIyNTU.*_ga*MTcyNjc1NjQzOS4xNzE4MjIyMjU1*_ga_SZXLGDJGNB*MTcxODIzMjU2MC4zLjAuMTcxODIzNDI3OS4wLjAuMA
E., M. T., Ghada, B., Memoona, H., Marjorie, J., F., M. M., Kathryn, S., L., T. I., Justina, T., L., W. J. & J., M. G. A. (2017). Sex- and Gender-Based Medicine: The Need for Precise Terminology. Gender and the Genome, 1(3), 122–128. https://doi.org/10.1089/gg.2017.0005
PFLAG. (n.d.). Glossary of terms. Retrieved July 25, 2024, from https://pflag.org/glossary/

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