Sex and gender and not the same thing. Now that’s been cleared up, keep reading to find out more!

Sex refers to the different biological and physiological characteristics of females, males and intersex persons, such as chromosomes, hormones and reproductive organs. Sex can also be referred to as sex assigned at birth. This refers to the sex that was assigned to an individual at the time of their birth based on physiological and biological indicators. Most people are assigned the sex of male or female at the time of their birth. When you are born, your sex is assigned to you by the medical professionals, family members or others who may be present at the time of your birth.

However, some people are not born exclusively male or female. Some people are also born with an intersex variation. The term ‘intersex’ is an umbrella term that refers to people who are born with genetic, chromosomal, hormonal or physical sex characteristics that are not typically ‘male’ or ‘female’. Intersex people have a diversity of bodies and identities and there are at least 40 different intersex variations. These can be determined prenatally, at birth, during puberty and at other times, such as when trying to conceive a child. Each trait has its own characteristics and differing degrees of expression. Some people with an intersex variation are LGBTIQA+, many are heterosexual and most are cisgender. Having an intersex variation is very common. Approximately 1.7% of the world’s population have an intersex variation. That is roughly the same amount of people as those who have red hair or who have green eyes.

Gender is not based on biological and physiological characteristics. Gender is a social construct that varies from society to society and can change over time. Gender is a part of how you understand who you are, how you interact with other people and the role that society applies to you. This includes norms, expectations, behaviours, roles and relationships. Society restricts that those who are assigned female at birth (AFAB) have the gender of woman/girl and those who are assigned male at birth (AMAB) have gender of man/boy.

For a large number of individuals, their sex assigned at birth matches their gender and will stay that way for the duration of their life time. These individuals are referred to as cisgender or cis. However, this is not the case for all people. For some individuals (including some intersex people), their sex assigned at birth does not match their gender. These people are referred to as transgender, trans or gender diverse. It is important to remember that gender is not binary and is not fixed or permanent and for some people their gender may change at different points throughout their life time. Some gender diverse people may choose to take steps to socially, medically and/or physically feel more aligned with their gender. This is referred to as gender affirmation. For these people, having their gender identity recognised at home, work, socially or whilst studying at university is an integral part of living as their affirmed gender.

Regardless of how anyone identifies or names their gender, they are worthy of love, compassion, support – and services that reflect these best principles of humanity. Regardless of gender, regardless of age or our stage in life, we all deserve care and compassion.

What is the difference between sex, gender and gender expression?

Fundamentally, your sex is something that you are physically born with and gender is an innate deeply personal identity that is either individually or socially constructed and developed over time. Sex is determined at birth according to the baby’s chromosomes, gonads, and anatomy. It refers to the physical differences between people who are male, female, or intersex. Gender, on the other hand, involves how a person identifies and refers to society’s expectations about how they should think and behave as men or women. Gender is not made up of binary forms. Gender is a broad spectrum and a person may identify at any point within this spectrum or outside of it entirely. People may identify with genders that are different from their sex at birth or with none at all. Gender expression is how you outwardly express your gender identity.

Understanding the differences between sex and gender can get even more confusing because many people mistakenly use the word ‘gender’ when referring to a person’s ‘sex’. To understand the difference between sex and gender, you must understand the how sex, gender and gender expression all interact and how they can relate to each other. To find out more, keep reading below:

  • Gender Identity

    One’s internal and individual sense of whether they are a man, woman, non-binary, agender, genderqueer, genderfluid, or a combination of one or more of these definitions. Gender identity is how a person views their own gender status, regardless of the sex they were assigned at birth. It includes a spectrum of identities and self-expression including woman, man, transgender, gender diverse and non-binary.

    Only an individual can determine their own gender identity and it may be the same as or different from their sex assigned at birth. Gender identity is not static and can change throughout a person’s life time. Gender binary is the problematic assumption that there are only two genders (man/male, woman/female), and that they are distinct and unchanging.

    Some people whose biological sex does not match their gender identity may make physical and social changes to express their identified gender. This may involve using a different name, pronouns, clothing, hair or makeup style. It may also involve medical changes, such as taking hormones or getting gender-affirming surgery. Remember, gender is deeply personal and we all have the right to safely experience our gender in our own way.

  • Gender expression

    Gender expression is how a person publicly expresses or presents their gender identity. It is a combination of outward behaviour, clothing, physical appearance, hair, body language and mannerisms that convey your gender identity. A person’s chosen name and pronouns are also common ways of expressing gender. Gender expression will mean something different for every person and not everyone will have the same perceptions, definitions, or identifiers (OHRC & PubMD).

    Some people have the same gender expression all the time, while others may change their expression over time or based on circumstances. Some people can choose to express their gender identity in different ways at different times.
    Western expectations of gender expression are based on a binary of men as masculine and women as feminine but many people do not fit into binary gender expressions. It can be psychologically and emotionally distressing for some people to not feel safe or comfortable expressing their gender identity. It can also unfortunately sometimes be unsafe for individuals to express their gender identity in particular social, workplace or familial environments.

    Gender Expression vs Gender Identity Video:

  • Sex & Sex Characteristics

    Sex is the different biological and physiological characteristics of females, males and intersex people and includes reproductive organs, chromosomes and hormones. Sex is not always binary, as some people may be born with an intersex variation, and anatomical and hormonal characteristics can change over a life span.

    Sex characteristics is a
    term used to refer to physical parts of the body that are related to body development, regulation and reproductive systems. Primary sex characteristics are gonads, chromosomes, genitals and hormones. Secondary sex characteristics emerge at puberty and can include the development of breast tissue, voice pitch, facial and pubic hair, etc.

    Sex Assigned at Birth Video:

     

    Intersex Video:

    The Genderbread Person infographic also offers a very helpful visual guide to understanding sex, gender and gender expression concepts. You can also download a printable copy of the Genderbread person here: Genderbread Person v4 ALL (itspronouncedmetrosexual.com)

So why is it important to understand the difference between sex and gender?

Gender influences people’s experience of and access to healthcare. The way that health services are organised and provided, can either limit or enable a person’s access to healthcare information, support, services and the outcome of those encounters. Health services should be appropriate, affordable and accessible to all. Health services should be provided with quality, equity and dignity.

Within patriarchal societies, gender is hierarchical and produces inequalities that intersect with other social and economic inequalities. Gender-based discrimination intersects with other factors of discrimination, such as ethnicity, socioeconomic status, disability, age, geographic location, gender identity and sexual orientation, among others. This is referred to as intersectionality.

Harmful gender norms – especially those related to rigid notions of masculinity – can also affect boys and men’s health and wellbeing negatively. For example, specific notions of masculinity may encourage boys and men to smoke, take sexual and other health risks, misuse alcohol and not seek help or health care. Such gender norms also contribute to boys and men perpetrating violence – as well as being subjected to violence themselves. They can also have grave implications for their mental health.

Rigid gender norms negatively affect people with diverse gender identities, who often face violence, stigma and discrimination as a result, including in healthcare settings. Consequently, they are at higher risk of HIV and mental health problems, including suicide.

Borrowed from The World Health Organization

  • Healthcare Experiences & Health Outcomes of Trans and Gender Diverse People

    Trans and gender diverse communities are disproportionately affected by prejudice-motivated discrimination and violence. The health and wellbeing outcomes of people with trans and gender diverse experience are directly related to transphobic stigma, prejudice, discrimination and abuse, including when incorrect language is used, often unknowingly. Trans and gender diverse individuals often stop seeking medical care (including urgent medical care) if they have had a negative or traumatic experience within the healthcare sector.

    A recent study conducted by La Trobe University (see in below links) found that many study participants reported many barriers to accessing healthcare – 69 per cent said an inability to find a doctor they were comfortable with sometimes or often stopped them from seeking help and 59 per cent said fear of mistreatment prevented them from accessing healthcare. Almost one third of study participants had to educate their healthcare provider on trans or gender diverse issues and one in five study participants had been refused general healthcare.

    Access to affordable, safe and appropriate healthcare is a human right. This right must always be proactively and respectfully extended to our trans and gender diverse communities. Every person has the right to be treated with respect, dignity and kindess.
    To learn more about the healthcare needs, experiences and health outcomes for our trans and gender diverse communities, please click the below links:

Understanding Gender Diversity

It can sometimes be hard and confusing to understand all the differences between gender identity, gender expression, and physical sex. Understanding gender diversity can also be hard if you are at the start of your learning journey and that’s ok. Luckily, you don’t need to be an expert on gender diversity in order to be kind and respectful. Treating people with respect is achievable no matter where you are on your gender diversity learning journey.

  • Transgender, Trans & Non-binary

    These are umbrella terms that describe people whose gender is different to the legal sex that was assigned to them at birth. Trans people may position ‘being trans’ as a history or experience, rather than an identity, and consider their gender identity as simply being female, male or a non-binary identity. Some trans people connect strongly with their trans experience, whereas others do not. The processes of transition may or may not be part of a trans or gender diverse person’s life.

    Trans Man – Someone who is a man, and was assigned female at birth.

    Trans Woman – Someone who is a woman, and was assigned male at birth.

    Non-Binary – refers to someone who does not identify as exclusively a man or a woman. Someone who is non-binary might feel like a mix of genders, or like they have no gender at all.

    Sistergirl and Brotherboy – terms used by Aboriginal and Torres Strait Islander people to describe gender diverse people that have a female or male spirit and take on respective roles within the community.

    Genderfluid – describes someone whose experience of gender changes and is fluid. For example, someone who is genderfluid may feel more like a man or a woman on certain days, while feeling like neither a man or a woman on others.

    To learn more and for more definitions of terms, head to the Westerly Glossary page. Please click this link: Glossary – Westerly Staff & Volunteers Hub (wh.org.au)

    To learn more about gender diversity, please click on the links below:

  • Understanding Gender Dysphoria

    Many people don’t feel they fit the role and stereotypes for their gender. But some people also feel the sex of their body doesn’t feel right. When this mismatch causes severe distress, it is called gender dysphoria. Gender dysphoria is a situation that may have symptoms (such as depression and anxiety) that need treatment, but it is not a mental illness.

    It is not known how many people in Australia have gender dysphoria, due to hesitancy to disclose. But it is known that people who identify as trans or gender diverse have higher rates of discrimination, depression, suicide and attempted suicide, compared with the general population. The feeling of living with a different gender identity to that assumed for you can occur at any point in life, although many trans and gender diverse people are aware of difference early in life.

     

  • Appropriate Language

    For information on appropriate language use and correct terms/phrases, please see the table below:

    OK To Say NOT OK To Say
    “LGBTI people when compared to the general population”

    Trans and gender diverse people have any sexual orientation including heterosexual, queer, lesbian, gay, bisexual, pansexual, asexual etc

    		 “LGBTI people when compared with their heterosexual peers”
    Trans and gender diverse, transgender, trans person Trans*, transgendered, transgenderism, tranny, transexual, pre-op/post-op, sex & gender diverse
    ‘Transgender’ is an adjective, not a noun or verb. It shouldn’t be used on its own, e.g. ‘a trans’ or ‘the transgender’
    Transitioning, affirming gender Transing, transgendering, trans’d Men, women and trans
    Men, women and non-binary people Men, women and trans
    Gender-affirming healthcare, transition-related healthcare Gender reassignment, sex change, sex reassignment
    Gay and bi men (cis and trans) Gay, bi and trans men
    Man, man with a trans experience, trans man Transman (as in tallman instead of tall man)
    Sex characteristics include chromosomes, hormones, gonads and genitals. Body parts don’t have genders Biological sex is male, female or intersex, biologically male, biologically female
    Ask: “What are your pronouns?” Do not ask: “What are your preferred pronouns?”
    Woman, woman with a trans experience, trans woman Transwoman (as in tallwoman instead of tall woman)
    Think: “Would I ask a cisgender person this?” “Have you had the surgery?” / “Tell me more about your genitals?” / “What is your real name”

     

  • Other Trans & Gender Diverse Resources:

For more information on gender and sex, pronouns, staff resources, educational in-services and contact information, please click the link below:

Gender Equality at Western Health – Westerly Staff & Volunteers Hub (wh.org.au)

Pronouns 101: What are they and why are they important.

We want to hear from you: Contact us.

Request a Diversity, Equity & Inclusion educational in-service for your team

Support Services

We acknowledge that gender equity work is not binary. Gender inequalities impact people that identify with all genders, and its impact may differ tremendously in its cause, course, and have implications for people’s well-being. The work aimed towards inclusion, diversity and equity is ever evolving as well as the field itself. If you have any concerns, doubts, or comments about Western Health’s Gender Equality program and/or work, please do not hesitate to contact us.

We care for our people. Our staff and volunteers are supported, engaged, and equipped to embrace a dynamic future. We develop and attract the best talent and support our people to continue their great work by fostering a culture of innovation, inclusion, wellbeing, and safety.

your Culture | your Ability | your Identity
We welcome you at Western Health
and together, we deliver the healthcare of the future.