Sex and Gender

Learning Outcomes

  • Define and differentiate between sex and gender
  • Discuss what is meant by gender identity; differentiate between cisgender, transgender, binary, and non-binary gender identities
A man and woman are shown walking in the wind, man in front of woman.
Figure 1. Sex describes the physical differences between males and females, while gender is a concept describing a person’s internal perception about their sex. (Photo courtesy of FaceMePLS/flickr)

Sociologists and most other social scientists view sex and gender as conceptually distinct. Sex refers to physical or physiological differences between males and females, including both primary sex characteristics (organs, chromosomes, and hormones) and secondary characteristics such as height and muscularity. Gender is a person’s deeply held internal perception of their behavior and attitudes as related to social expectations and accompanying physiological aspects of sex. A person’s sex, as determined by his or her biology, does not always correspond with his or her gender. Therefore, the terms sex and gender are not interchangeable.


A baby boy who is born with male genitalia will be identified as male. Since the term sex refers to biological or physical distinctions, characteristics of sex do not vary significantly between different human societies. Males have a penis, testes, and XY chromosomes. During puberty, most males will experience changes in testicle, scrotum, and penis size and color, as well as voice dropping, and underarm, leg, and facial hair growth. Generally, persons of the female sex have a vagina, ovaries, and XX chromosomes. During puberty, most females will menstruate, develop breasts that can lactate, and grow vaginal, underarm, and leg hair. Both sexes might experience increased sweating, acne, and mood changes, among other biological changes, during puberty.

Males typically have XY sex chromosomes, and females XX. These chromosomes trigger the development of the sex steroids, of which testosterone is found in higher levels in males and estradiol in higher levels in females. As you read in the opening example about Caster Semenya, some females have naturally occurring high levels of testosterone, which becomes an issue for elite athletes when milliseconds matter because increased testosterone levels can be attributed to performance boosts of 10 to 13 percent.[1]

Intersex refers to a combination of primary sex characteristics, an umbrella term that can describe any individual who doesn’t fit binary sexual distinctions. It can also be referred to as Differences of Sexual Development (DSD). Intersex or DSD individuals were once called hermaphrodites, a term that is no longer used. According to the Human Rights Watch, approximately 1.7 percent of babies are born with chromosomes, gonads, internal or external sex organs that are atypical. Some of these are apparent at birth and others do not show themselves until puberty, and irreversible surgeries can cause infertility, pain, loss of sensation, and, more importantly, can take away an individual’s choice when they are performed on children.[2]

Link to Learning

Read and watch this NBC story about Ori, an intersex child, and how they (the neutral pronoun for Ori) feel about cosmetic surgery.


Gender is deeply cultural. Like race, it is a social construction with real consequences, particularly for those who do not conform to gender binaries. In order to describe gender as a concept, we need to expand the language we use to describe gender beyond “masculine” or “feminine.” Gender identity, or the way that one thinks about gender and self-identifies, can be woman, man, or genderqueer. Cisgender is an umbrella terms used to describe people whose sense of personal identity and gender corresponds with their birth sex, while transgender is a term used to describe people whose sense of personal identity does not correspond with their birth sex. Gender expression, or how one demonstrates gender (based on traditional gender role norms related to clothing, behavior, and interactions) can be feminine, masculine, androgynous, or somewhere along a spectrum.

Try It

Gender Identity

Although gender has traditionally been considered in binary terms (male or female), increasingly gender is being seen as a spectrum; however, our vocabulary is still limited in terms of the ways in which we describe gender identity. 
Identity spectrum showing a continuum between female and male for sex, another continuum for gender identity between woman and man, a continuum for gender expression, and another continuum for sexual orientation.
Figure 2. This identity spectrum shows the fluidity between sex, gender identity, gender expression, and sexual orientation.

Individuals who identify with the role that is the different from their biological sex are called transgender. Transgender is not synonymous with sexuality, a distinction that will be made in this module. Approximately 1.4 million U.S. adults or .6 percent of the population are transgender according to a 2016 report.[3]

Transgender individuals who attempt to alter their bodies through medical interventions such as surgery and hormonal therapy—so that their physical being is better aligned with gender identity—are often called transsexual (transexual man or transexual woman), although some find this term outdated and prefer the term transgender. They may also be known as male-to-female (MTF) or female-to-male (FTM). Not all transgender individuals choose to alter their bodies; many will maintain their original anatomy but may present themselves to society as another gender. This is typically done by adopting the dress, hairstyle, mannerisms, or other characteristic typically assigned to another gender. It is important to note that people who cross-dress, or wear clothing that is traditionally assigned to a gender different are not the same as those identifying as trans. Cross-dressing is typically a form of self-expression, entertainment, or personal style, and it is not necessarily an expression against one’s assigned gender (APA 2008).

Some people choose not to adhere to conventional expressions of masculinity or femininity and are considered gender non-conforming. Non-binary and genderqueer are other terms used by individuals who feel that their gender identity and/or gender expression fall outside the categories of man and woman.[4]

After years of controversy over the treatment of sex and gender in the American Psychiatric Association Diagnostic and Statistical Manual for Mental Disorders (Drescher 2010), the most recent edition, DSM-5, responds to allegations that the term “gender identity disorder” is stigmatizing by replacing it with “gender dysphoria.” Gender identity disorder as a diagnostic category stigmatized the patient by implying there was something “disordered” about them. Gender dysphoria, on the other hand, removes some of that stigma by taking the word “disorder” out while maintaining a category that will protect patient access to care, including hormone therapy and gender reassignment surgery. In the DSM-5, Gender dysphoria is a condition of people whose gender at birth is contrary to the one they identify with. For a person to be diagnosed with gender dysphoria, there must be a marked difference between the individual’s expressed/experienced gender and the gender others would assign him or her, and it must continue for at least six months. In children, the desire to be of the other gender must be present and verbalized. This diagnosis is now a separate category from sexual dysfunction and paraphilia, another important part of removing stigma from the diagnosis (APA 2013).

Changing the clinical description may contribute to a larger acceptance of transgender people in society. A 2017 poll showed that 54 percent of Americans believe gender is determined by sex at birth and 32 percent say society as “gone too far” in accepting transgender people; views are sharply divided along political and religious lines.[5]

Studies show that people who identify as transgender are twice as likely to experience assault or discrimination as nontransgender individuals, and they are also one and a half times more likely to experience intimidation (National Coalition of Anti-Violence Programs 2010; Giovanniello 2013). Trans women of color are most likely be to victims of abuse. A practice called “deadnaming” by the American Civil Liberties Union, whereby trans people who are murdered are referred to by their birth name and gender, is a discriminatory tool that effectively erases a person’s trans identity, and also prevents investigations into their deaths and knowledge of their deaths.[6] Organizations such as the National Coalition of Anti-Violence Programs and Global Action for Trans Equality work to prevent, respond to, and end all types of violence against transgender, transsexual, and homosexual individuals. Read about organizations educating the public about gender identity and empowering transgender and transsexual individuals. These organizations hope that  educating the public will help lead to the end of this violence.

Gender Expression

U.S. society allows for some level of flexibility when it comes to acting out gender roles or gender expression. To a certain extent, men can assume some feminine roles and women can assume some masculine roles without interfering with their gender identity. Males who work as teachers, nurses, and social workers, traditionally female-dominated occupations, often adopt norms that are traditionally feminine. Many women in the U.S. workforce who are in male-dominated occupations must take on more traditionally masculine forms of dress (i.e., fire department or police department or military) and often adopt a set of behaviors that fit that job requirements that are traditionally masculine. In most cases, the gender identity remains cisgender although the gender expression might be more fluid.

Black and white photo of a Native American Zuni man dressed in tribal attire that would typically be worn by a female..
Figure 3. A portrait of We-Wa, a Zuni berdache, taken sometime in the late 1800s.

The dichotomous view of gender (the notion that someone is either male or female) is specific to certain cultures and is not universal. In some cultures gender is viewed as being fluid. In the past, some anthropologists used the term berdache to refer to individuals who occasionally or permanently dressed and lived as a different gender. The practice has been noted among certain Native American tribes (Jacobs, Thomas, and Lang 1997). The more current term used by indigenous people in the United States is “Two-Spirit” (Estrada, Gabriel S. 2011). Also, in this regard, some of these indigenous groups believe that there are at least four genders. In some tribes, Two-Spirits hold positions of higher social status because of they were believed to possess supernatural powers. In general, Native American groups viewed sex and gender as a spectrum as opposed to the binary view held by European colonists.

Samoan culture accepts what Samoans refer to as a “third gender.” Fa’afafine, which translates as “the way of the woman,” is a term used to describe individuals who are born biologically male but embody both masculine and feminine traits. Fa’afafines are considered an important part of Samoan culture. Individuals from other cultures may mislabel them as homosexuals because fa’afafines have a varied sexual life that may include men and women (Poasa 1992). As we will see in this module, the tendency to label one’s sexuality because of sex and gender can lead to many misconceptions and inaccurate labels.

Sex, Gender, and the Legal System

The terms sex and gender have not always been differentiated in the English language. It was not until the 1950s that U.S. and British psychologists and other professionals working with intersex and transsexual patients formally began distinguishing between sex and gender. Since then, psychological and physiological professionals have increasingly used the term gender (Moi 2005). By the end of the twenty-first century, expanding the proper usage of the term gender to everyday language became more challenging—particularly where legal language is concerned. In an effort to clarify usage of the terms sex and gender, U.S. Supreme Court Justice Antonin Scalia wrote in a 1994 briefing, “The word gender has acquired the new and useful connotation of cultural or attitudinal characteristics (as opposed to physical characteristics) distinctive to the sexes. That is to say, gender is to sex as feminine is to female and masculine is to male” (J.E.B. v. Alabama, 144 S. Ct. 1436 [1994]).

Supreme Court Justice Ruth Bader Ginsburg had a different take, however. Viewing the words as synonymous, she freely swapped them in her briefings so as to avoid having the word “sex” pop up too often. It is thought that her secretary supported this practice by suggestions to Ginsberg that “those nine men” (the other Supreme Court justices), “hear that word and their first association is not the way you want them to be thinking” (Case 1995). This anecdote reveals that both sex and gender are actually socially defined variables whose definitions change over time.

In 2018, thirteen state attorneys general and governors of three other states filed amicus briefs asked the Supreme Court to overturn a federal appeals court’s ruling protecting transgender people from employment discrimination by Title VII of the 1964 Civil Rights Act, which prohibits sex discrimination in employment. This would also go against three dozen federal appeals court decisions protecting the rights of transgender people in the workplace.[7]

The hit series Orange is the New Black (2013-present) has brought issues of trans people in the U.S. prison system into everyday life. Award-winning actor Laverne Cox, a trans advocate and the first openly transgender person to be nominated for an Emmy Award for acting, through the character of Sophia Burset, has brought issues of trans women into millions of households. Recently, the U.S. Department of Justice revised its guidelines for federal prisons eliminating “will recommend housing by gender identity when appropriate” with “will use biological sex as the initial determination” for facility assignment for transgender inmates” [8]

Watch It

Watch the first half of this video to review the differences between sex and gender.

Think It Over

  • Why do you think many doctors and parents have opted for cosmetic surgery for intersex children? What are the ethical implications of irreversible surgery?
  • What do you think are some of the concerns for non-binary individuals in the workplace, in the military, in schools, in prisons?
  • In what ways does gender identity and gender expression become politicized?

Try It


[glossary-definition]an umbrella terms used to describe people whose sense of personal identity and gender corresponds with their birth sex[/glossary-definition]
[glossary-definition]a term that refers to social or cultural distinctions of behaviors that are considered male or female[/glossary-definition]
[glossary-term]gender dysphoria:[/glossary-term]
[glossary-definition]a condition listed in the DSM-5 in which people whose gender at birth is contrary to the one they identify with. This condition replaces “gender identity disorder”[/glossary-definition]
[glossary-term]gender expression:[/glossary-term]
[glossary-definition] how one demonstrates gender (based on traditional gender role norms related to clothing, behavior, and interactions) can be feminine, masculine, androgynous, or somewhere along a spectrum
[glossary-term]gender identity:[/glossary-term]
[glossary-definition]the way that one thinks about gender and self-identifies, can be woman, man, or genderqueer[/glossary-definition]
[glossary-definition]refers to a combination of primary sex characteristics[/glossary-definition]
[glossary-definition]a term that denotes the presence of physical or physiological differences between males and females[/glossary-definition]
[glossary-definition]a term used to describe people whose sense of personal identity does not correspond with their birth sex[/glossary-definition]
[glossary-definition]transgender individuals who attempt to alter their bodies through medical interventions such as surgery and hormonal therapy[/glossary-definition]

<a style="margin-left: 16px;" target="_blank" href=""

  1. Block, M. 2016. "The sensitive question of intersex athletes. NPR.
  2. "U.S.:  Harmful surgery on intersex children," 2017. Human Rights Watch.
  3. Flores, A., J. Herman, G. Gates, and T. N.T. Brown. "How many adults identify as transgender." The Williams Institute.
  4. GLAAD Media Reference Guide - Transgender. Retrieved from
  5. Salam, M. "For transgender Americans, the political gets even more personal" (2018). The New York Times.
  6. Strangio, C. 2018. "Deadly violence against transgender people." ACLU.
  7. "16 states ask supreme court to limit transgender" (2018).
  8. Gathright, J. 2018. "The guidelines for protection of transgender prisoners just got rewritten." NPR.


Icon for the Creative Commons Attribution 4.0 International License

Introduction to Sociology Lumen/OpenStax Copyright © 2021 by Lumen Learning & OpenStax is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.

Share This Book