The terms “sex and gender’’ are often used interchangeably, but they mean different things. Here’s why the difference matters.

A person’s sex refers to their physical characteristics, such as male, female, and intersex. Gender is a separate concept that refers to their personal gender identity — for example, whether they identify as a man or a woman.

While some people’s gender identity matches their sex, this isn’t always the case. If a person’s gender identity doesn’t align with their sex, they might identify as nonbinary or transgender.

The 2021 Trevor Project survey shows that trans and nonbinary youth experience higher rates of mental health difficulties when their identities are not respected, so it’s important to understand and affirm all genders.

Though some institutes approach gender variances and intersex identities as “disorders,” there is an increasing effort to approach conversations about sex and gender from a holistic, empathetic place grounded in different cultural histories.

Sex refers to the biological aspects of maleness and femaleness. This is determined by your hormones and secondary sex characteristics, like your genitals.

There are three main categories of sex:

  • Male: a person with XY chromosomes and male genitalia
  • Female: a person with XX chromosomes and female genitalia
  • Intersex: a person with differences in sexual development, meaning they have natural variations in typically male and female characteristics, such as hormones, genitals, and chromosomes

The genes on your chromosomes determine your physical characteristics. Sex labels are assigned at birth based on how doctors have historically labeled specific characteristics.

Biological sex doesn’t exist in a binary, and some estimates say 1.7% of people are born with intersex traits. Millions of people have sexual characteristics that don’t neatly fit into society’s understanding of “male” or “female,” including people who were assigned male or female at birth.

Gender is a personal identity. It refers to the roles, norms, and relationships associated with masculinity and femininity. Gender expectations vary between societies and can change over time.

Many people feel that their sex and gender are aligned — for example, when someone who was assigned female at birth (AFAB) identifies as a woman.

But this isn’t true for everyone. People who feel their sex doesn’t align with their gender may identify as transgender (trans for short) or nonbinary.

Existing across the spectrum of gender identity is not a new concept. For example, many Indigenous people historically and currently recognize a third gender known as “two-spirit,” referring to people who combine typically male and female roles with additional unique traits associated with two-spirit people.

Cisgender, transgender, and more

Cisgender: A person assigned female at birth and identifies as a woman or assigned male at birth and identifies as a man. “Cis” means “on this side,” meaning there is no departure from the sex you were assigned at birth.

Transgender: The word “trans” means “across,” denoting a shift from one thing to another. Transgender people identify with a gender that doesn’t match their sex assigned at birth — for example, someone assigned female at birth but identifies as a man.

Nonbinary: Nonbinary is an umbrella term for identities that fall outside the man-woman binary. Examples of nonbinary identities include genderqueer and bigender. Some nonbinary people identify as trans, and other nonbinary people do not.

Agender: An agender person doesn’t identify with any gender identity. Other terms include gender-neutral, genderless, and neutrois.

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What is gender dysphoria?

If you experience distress associated with a misalignment between your sex and gender identity, this is known as gender dysphoria.

Gender dysphoria drives many people to transition, which means they move toward presenting more publicly as their gender.

Still, dysphoria is not a requirement to be trans. Another driving factor is gender euphoria, where you experience deep joy when your internal gender identity matches your gender expression.

Methods for transitioning include:

  • social transitions, such as changing your name, using new pronouns, or wearing clothes usually associated with a particular gender
  • medical transitions, such as gender-affirming surgery or hormone replacement therapy (HRT)

Many trans and nonbinary people decide not to transition, and this doesn’t make their gender identity any less valid.

Gender identity is your personal experience of your gender. Gender expression refers to how you express gender through:

  • clothing
  • hairstyles
  • behaviors
  • social roles

Society has determined what practices should be attributed to masculinity or femininity. Some people fall in line with what is expected, and some don’t — but that doesn’t necessarily determine their gender identity.

In Western cultures, everything from hairstyles to jobs is gendered. Masculinity is associated with short hairstyles, wearing trousers, and physical jobs. Femininity is associated with long hairstyles, wearing makeup, and caregiving roles.

Most people pick and choose between the “masculine” and “feminine” categories to create their own unique gender expression. For example, a cisgender woman might prefer having short hair, and a cisgender man might enjoy wearing nail polish. Society has deemed nail polish to be feminine. In reality, anyone is free to paint their nails.

The same can be said for activities, hobbies, or jobs like construction work, shopping, or playing sports.

When your gender expression doesn’t align with the sex you were assigned at birth, you might encounter confusion or negative reactions. Still, gender nonconformity is becoming more acceptable.

The important thing to remember is that no one can decide what someone’s gender identity is except for that individual. There is no right or wrong way to express one’s understanding of their own gender.

Sexuality is who you are sexually or romantically attracted to.

Examples of sexualities include:

  • Straight people are attracted to people of the “opposite” gender, such as a man who is attracted to women.
  • Gay or lesbian people are attracted to people of the same gender, such as a man who is attracted to men.
  • Bisexual or pansexual people are attracted to people of multiple genders.

Sexuality and gender are two separate parts of a person’s identity. They are not automatically connected. How someone expresses their gender also does not necessarily correlate with whom they are attracted to.

When it comes to respecting an individual’s gender identity, pronouns are another important piece of the conversation.

Common pronouns include:

  • he/him
  • she/her
  • they/them

Other pronoun options, known as neopronouns, include:

  • xe/xem
  • em/eir
  • ze/hir
  • fae/faer

People with varying gender identities and sexualities use they/them pronouns, usually denoting they fall outside of the gender binary.

People who present as men generally use he/him and those who are cisgender women generally use she/her. Still, this isn’t always the case, so it’s best to ask someone how they would like to be addressed.

According to a 2020 Trevor Project survey, while 75% of youth use either he/him or she/her pronouns exclusively, 25% of LGBTQ youth use other pronouns such as they/them, ze/zir, or a combination of pronouns, such as she/they.

Respecting a person’s pronouns is an important part of creating a welcoming, accepting space, which impacts people’s well-being and mental health.

Approaching the topic of pronouns can feel daunting, but the more we normalize it, the more comfortable it becomes. For example, when you meet a new person and share your name, you might also share your pronouns. This may make the other person more comfortable sharing theirs, too.

If you use the wrong pronouns for someone, it’s OK to correct yourself and continue with your conversation.

Whether you’re questioning your gender identity or supporting someone who is transitioning, there are plenty of resources available.

If you’re questioning or transitioning

If you want to chat with someone and don’t feel comfortable sharing with friends or family, or if you need immediate support, you can reach out to a support line like The Trevor Project or the Trans Lifeline.

For other resources, such as assistance with LGBTQ+ related domestic violence, legal advocacy, or general support, additional options are:

If you’re supporting someone who is questioning or transitioning

Though there are communities and circles well-versed in the ins and outs of sex and gender, not everyone is familiar with the varying terminology and definitions — and that’s OK. The important part is that you lead each conversation you have with respect, regardless of who the individual is and how they present.

There are many resources available if you have questions about gender identity, pronouns, and other topics, including:

Impact of acknowledging gender and sexuality variances

While an individual’s comfort is important, understanding and respecting an individual’s gender identity goes beyond one-on-one conversations.

Queer folks, particularly queer Folks of Color, are more likely to be unhoused, without health insurance, and survivors of violent crime.

But it isn’t enough to just be aware of the statistics. For advocacy groups, medical professionals, or politicians to shift policy and culture to benefit everyone, there has to be a widespread understanding and respect for how everyone shows up in the world.

Many experiences and identities come together to make a person who they are. Sex and gender are not the only pieces, but understanding and respecting the differences can be vital to an individual’s safety, comfort, and overall health.

Where someone falls on the spectrum of gender identity is not automatically connected to their expression, sexuality, or assigned sex at birth.

When in doubt, be respectful and ask folks how they would like to be addressed. For those who are new to varied gender identities and expressions, there are countless resources available at the click of a button.

For folks who have questions about their own identities, there are also plenty of avenues for information and support, many of which may be local to your area.