Gender Identity, Gender Roles, and Gender Differences
When filling out a document, such as a job application or school registration form,
you are often asked to provide your name, address, phone number, birth date, and
sex or gender. But have you ever been asked to provide your sex and your gender?
Like most people, you may not have realized that sex and gender are not the same.
However, sociologists and most other social scientists view them as conceptually
distinct. Sex refers to physical or physiological differences between male, female, and
intersex bodies, including both primary sex characteristics (the reproductive system)
and secondary sex characteristics (such as breasts and facial hair). Gender is a term
that refers to social or cultural distinctions associated with a given sex; it is generally
considered to be a socially constructed concept. Sex and gender are important
aspects of a person’s identity; however, they do not inform us about a person’s sexual
orientation (Rule & Ambady, 2008). Sexual orientation refers to a person’s sexual
attraction (or lack thereof) to others and is the topic of the next chapter. Within the
context of sexual orientation, sexual attraction refers to a person’s capacity to arouse
the sexual interest of another, or, conversely, the sexual interest one person feels
toward another.
Sex, gender, and sexual orientation have always been a source of religious and
political debate. As such, they have been policed in various ways. Some nations have
laws against homosexuality, and enforce choosing from binary gender options on legal
forms of identification, while others have laws protecting same-sex marriages. At a
time when there seems to be little agreement among religious and political groups,
one must wonder, what is acceptable and who decides?
The international scientific and medical communities (e.g., World Health
Organization, World Medical Association, World Psychiatric Association, Association
for Psychological Science) view variations of sex, gender, and sexual orientation as
normal. Furthermore, variations of sex and the orientation of sexual behavior occur
naturally throughout the animal kingdom. More than 65,000 animal species have
intersex individuals, born with either an absence or some combination of male and
female reproductive organs, sex hormones, or sex chromosomes (Jarne & Auld,
2006). More than 500 animal species engage in homosexual or bisexual behaviors
(Lehrer, 2006). "The standard model of sexual and gender identification states that an
individual's sex is solely determined by biological characteristics, as discussed above.
Furthermore, gender is determined by the same model, existing on the same male-
female binary. This leaves no room for gendered intersex people, instead viewing sex
and gender as either male or female. The standard model is largely criticized for being
dimorphic. The term intersex, which we first discussed in the chapter 3, defines those
with a variation in sex characteristics, including chromosomes, gonads, or genitals that
preclude an individual as distinctly assigned as male or female. Being intersex is also
more common than most people realize. Anywhere from 1.0 to 1.7% of children are
born intersex, providing further evidence that assigned sex falls along a spectrum
rather than a binary. Intersex can occur in a variety of ways. “We know today that not
just the X and Y chromosomes, but at least 12 others across the human genome
govern sex differentiation, and at least 30 genes are involved in sex development"
(Giordano, n.d.).
A person may have both ovarian and testicular tissues, unique chromosomal
combinations such as XXY, and some intersex individuals may outwardly present with
a specific gender’s genitals but their internal hormones and organs do not match (What
is intersex?: Definition of Intersexual, n.d.). Due to our culture’s engrained binary
system, it is common practice that when intersex babies are born, the doctor and
parents will determine the child’s gender, sometimes requiring a surgical procedure,
and the possibility of future surgeries as they grow and develop further. There are
occasions, however, when a person finds out they’re intersex at the onset of puberty.
Others may go their whole life without realizing they are intersex (What is intersex?:
Definition of Intersexual, n.d.). Our need to categorize and make “normal” in regard to
the gender binary has been a cause of great harm to those intersexed individuals who
were subjected to unnecessary medical intervention and forced gender assignment.
In a majority of societies worldwide, gender is categorized into two separate
sides, being either masculine or feminine, is known as the gender binary. This
inaccurate understanding completely excluding those who are intersex, transgender,
androgynous, and so on. Modern scholars such as Anne Fausto-Sterling and Bonnie
Spanier criticize the standard binaries of sex and gender, arguing that sex and gender
are both fluid concepts that exist along a spectrum, rather than as binaries.
The gender binary, while specific to certain cultures, is not universal, but rather,
a social construction. In some cultures, gender is viewed as fluid. In the past, some
anthropologists used the term berdache [also known as, two-spirit] 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). 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). Among the Zapotec
peoples of Oaxaca, Mexico, is a recognized third gender called The Muxes (Beyond
gender: Indigenous perspectives, Muxe, n.d.). These cultures and many others
acknowledge and accept the reality of a third gender; “the gender classification is not
based on sexual identity [as in Western societies], but rather on gender identity and
spirituality” (Beyond Gender: Indigenous perspectives, Muxe, n.d.).
Gender identity is a person’s internal sense of self as a member of a particular
gender. "Individuals who identify with a role that corresponds to the sex assigned to
them at birth are cisgender. For example, someone who was born with assigned male
sex characteristics, was assigned as a boy, and identify today as a boy or man are
classified as cisgender, (or cis for short). Individuals who identify with a role that
corresponds with a role that is different from their biological sex are often referred to
as transgender. For example, they were born with assigned male characteristics, were
assigned as a boy, but today identify as a girl, woman, or another gender are classified
as transgender. Transgender people have a gender identity or expression that differs
from what they are assigned at birth. The Latin prefix “cis” means “on the same side;”
the prefix “trans”" means “across.” The term “transgender” encompasses a wide range
of possible identities (see glossary for definitions), including agender, genderfluid,
genderqueer, two-spirit (for many indigenous people), androgynous, and many others.
Some transgender individuals may undertake a process to change their outward,
physical, or sexual characteristics in order for their physical being to better align with
their gender identity. Not all transgender individuals choose to alter their bodies;: many
will maintain their original anatomy, but may present themselves to society as another
gender that aligns with who they are.
Hormones that masculinize the brain in chromosomally male (XY) individuals are
distinct from those that lead to the development of a typically male body form. "Due to
this branching of control factors for brain and body organization, it is quite possible for
a male-type body to contain a female-type brain, and for a female-type body to contain
a male-type brain" (Panksepp, 2004, page 225). These developmental deviations
could influence an individual's ultimate sexual orientation and/or gender identity. An
example of differing brain and body organization comes from a study that found that
the bed nucleus of the stria terminalis (an area known to be important for sexual
behavior located near the hypothalamus) was "female-like" in size (smaller than
cisgender males and similar to cisgender females) in the brains of six male-to-female
transsexuals. This difference was not correlated with either adult hormone levels or
sexual orientation (Zhou et al., 1995). Given that studies requiring post-mortem brain
tissue to examine tiny brain areas are very difficult to conduct, this type of information
is scarce.
While studies of postmortem brains may help answer some questions
surrounding gender identity, gender is ultimately a social construct, and those norms
we learn to live by are shaped through our internalization of society. As society shifts,
norms change. An understanding of gender identity continues to evolve, and young
people today have more opportunities to explore and openly express different ideas
about what gender means than in previous generations. Recent studies indicate that
a majority of millennials (birth years 1981-1996) regard gender as a spectrum, instead
of a strict male/female binary, and that 12% identify as transgender or gender non-
conforming. Additionally, more people know others who use genderneutral pronouns,
such as they/them (Kennedy, 2017). This change in language may indicate that
millennials and Generation Z people (birth years 1997-2012) understand the
experience of gender itself differently. This re-labeling and acknowledgement of
gender as beyond the binary highlights how humans create and recreate reality rather
than it being absolutely fixed. Just as gender can be viewed as a spectrum based on
current knowledge and social agreements, we imagine there will be further shifts and
understandings as culture changes. As young people lead this change, other changes
are emerging in a range of spheres, from public bathroom policies to retail
organizations. For example, some retailers are starting to change traditional gender-
based marketing of products, such as removing pink and blue clothing and toy aisles.
Despite these changes, those who exist outside of traditional gender norms face
difficult challenges. Even people who vary slightly from traditional norms can be the
target of discrimination and sometimes even violence.
Gender is a complex subject, but could be better understood when we learn to
differentiate biology from gender expression. Nevertheless, while gender may begin
with the assignment of our sex, it doesn’t end there. According to Understanding
Gender, n.d., a person’s gender is the complex interrelationship between three
dimensions: body, identity, and social gender.
The connection between one’s gender and physical appearance extends beyond
reproductive functions. Gender experience is based on a broader scientific basis,
according to research in Neurology, hormones, and Cellular Biology. Indeed, research
is increasingly pointing to our brains as a crucial factor in how we uniquely experience
gender (Understanding gender, n.d.). Given the fact that gender identity is separate
from sex, not everyone identifies within the binary (male or female). For a broader
analysis of gender beyond the binary, let’s look at gender as a spectrum.
A large number of people, including many transgender people, identify as either
male or female. Others do not neatly fit into the categories of “man” or “woman,” or
“male” or “female.” Some people have a gender that blends elements of being a man
or a woman, or a gender that is different from either male or female. Others don't
identify with any gender at all. Some people's gender changes over time. People
whose gender is not male or female use many different terms to describe themselves,
with non-binary being one of the most common. Other terms include genderqueer,
agender, bigender, and more. None of these terms mean exactly the same thing, and
new terms are added occasionally, but all signify an experience of gender that is not
simply male or female (Understanding non-binary people: How to be respectful and
supportive, 2018). A related aside: not all people who identify as transgender or
outside the gender binary participate in hormone therapy or gender affirmation or
confirmation surgery. Not only can hormone therapy and gender reassignment
surgeries be expensive, many gender non-conforming people, do not wish to subject
themselves to traditional markers of masculinity or femininity.
As is true for people in general, transgender women (TGW) have diverse levels
of psychological androgyny (having both feminine and masculine characteristics). For
example, five percent of the Samoan population are TGW referred to as fa'afafine,
who range in androgyny from mostly masculine to mostly feminine (Tan, 2016); in
Pakistan, India, Nepal, and Bangladesh, TGW are referred to as hijras (Figure 4.4),
recognized by their governments as a third gender, and range in androgyny from only
having a few masculine characteristics to being entirely feminine (Pasquesoone,
2014); and as many as six percent of biological males living in Oaxaca, Mexico are
TGW referred to as muxes, who range in androgyny from mostly masculine to mostly
feminine (Stephen, 2002).
Some transgender people do seek medical intervention to help align their bodies
in a way that they feel represents who they are. One way this is done is through
hormone therapy. Feminizing or masculinizing hormone therapy is the administration
of exogenous endocrine agents to induce changes in physical appearance. Hormone
therapy is inexpensive relative to surgery, and highly effective in the development of
some secondary sex characteristics, such as facial and body hair in transgender men
or breast development in transgender women. Thus, hormone therapy is often the first
(and sometimes only) medical gender affirmation intervention accessed by
transgender individuals looking to develop masculine or feminine characteristics
consistent with their gender identity. In some cases, hormone therapy may be required
before surgical interventions can be conducted. Transgender women are prescribed
estrogen and testosterone blocking medication (such as cyproterone acetate and
spironolactone). Transgender men are prescribed testosterone.
Violence and discrimination against people who exist within transgender and
nonbinary (NB) communities is at an all-time high. Even at a time when gender
expression is becoming less of a taboo subject, and visibility and validation of identity
is becoming more prevalent, the Human Rights Campaign reported that “2021 as one
of the Deadliest Year on Record for Transgender and Non-Binary People”. From social
stigma and intolerance leading transgender and NB people to take their own lives, to
the outright murders of trans women particularly of color, their lives are often at risk of
harm for no other reason than a desire to be seen as who they are and society not
accepting them.
Certain regions of the United States can be very unsafe for transgender or NB
people. In parts of the U.S. anti-trans legislation is popping up and conservative
politicians seem to be uniting around denying them basic rights. As this type of gender
policing picks up momentum in states all over the US, we will likely see an increase
violence amongst LGBTQ+ people (specifically transgender and non-binary people)
as they become further marginalized.
Trans Day of Visibility is an annual awareness day celebrated around the world.
The day is dedicated to celebrating the accomplishments of transgender and gender
nonconforming people, while raising awareness of the work that still needs to be done
to achieve trans justice.
Pronoun usage also plays a role in a person’s gender identity. If you’ve ever been
misgendered, you probably reacted in some way. Because language is a big part of
how we make sense of ourselves, the pronouns we use when referring to ourselves
represent who we are. Pronouns are used in place of proper nouns, such as a name,
during daily conversations. In many languages, including English, pronouns are
gendered. That is, pronouns are intended to identify the gender of the individual being
referenced. English has traditionally been binary, providing only “he/him/his” for male
subjects, and “she/her/hers” for female subjects. This binary system excludes those
who identify as neither male nor female. The word “they,” which was used for hundreds
of years as a singular pronoun, is more inclusive. In 2019, Merriam Webster selected
this use of “they” as Word of the Year. “They” and other neopronouns [xe/xem/xry/xrys,
ze/hir/hirs/hirself, etc.] are now used to reference those who align more closely to
something other than he/him or she/her male or female. Making an assumption about
someone's gender sends a potentially detrimental message: that people must appear
and behave a certain way to demonstrate their gender identity. By using someone’s
correct pronouns, you are creating an inclusive environment and respecting them
(What and Why, n.d.). Today, there are many institutions normalizing the practice of
gender pronoun neutrality and pronoun sharing in introductory settings, on email
signatures and other spaces. For example, on the online school platform, Canvas,
students and professors have a space to enter their pronouns that then appear next
to their name. In the occupational field, sites like Zoom and LinkedIn offer a place to
share one’s pronouns.
While research has come a long way to help dismantle gender binaries, it is
important to fully understand the binaries we currently still live in day to day, perhaps
even without realizing it.
Scholars generally regard gender as a social construct—meaning that it does not
exist naturally, but is instead a concept that is created by cultural and societal norms.
Gender socialization begins at birth and occurs through major agents of socialization
like family, education, peer groups, and mass media. As soon as we are born, and
even before birth, if we are from a country that views gender as specifically female or
male, we have entered the socially constructed binary. At an early age, we begin
learning cultural norms for what is considered masculine and feminine. For example,
American children may associate long hair or dresses with femininity. Later in life, as
adults, we often conform to these norms by behaving in gender-specific ways: as men,
we build houses; as women, we bake cookies (Marshall, 1989; Money et al., 1955;
Weinraub et al., 1984). Children are given traditional male or female names, nurseries
decorated either in pink or blue, accessorized with dolls or trucks, and closets full of
dresses or collared button-up shirts. As a young child were you ever told you could not
use a certain colored pen or pencil? Pink is for girls, blue is for boys. Did you learn
what you could and could not wear based on your predetermined gender?
Because cultures change over time, so too do ideas about gender. For example,
European and American cultures today associate pink with femininity and blue with
masculinity. However, less than a century ago, these same cultures were swaddling
baby boys in pink, because of its masculine associations with “blood and war,” and
dressing little girls in blue, because of its feminine associations with the Virgin Mary
(Kimmel, 1996).
It is hard to scroll on social media, or even watch the news today without coming
across a “gender-reveal” extravaganza. These gender reveals are planned events,
meant to inform the parents’ relatives, friends, and community what their child’s
biological sex is. There was a deep dive into finding out who created this trend as it
has caused much controversy and catastrophe. In 2008, Jenna Karvunidis created a
blog post sharing details of a party she threw in which she cut a cake to reveal pink
icing, to share the gender of her first child (Langmuir, 2020). In an interview with The
Guardian, she claims to regret having started the trend and believes the idea is gender
limiting (2020). Contrary to gender-reveal parties and what they overemphasize, are
some parents raising their children without gender, or “genderneutral parenting.” In the
New Yorker Documentary, titled “Raising Baby Grey”, two parents are raising their one-
year-old child named Grey, with pronouns they/them, and offering clothing of all
varieties (Long, 2020). Their hopes are to allow their child the freedom to choose their
gender if and when they want, and prevent the harm that the gender binary can cause
to children leading up to their adulthood (Long, 2020).
In a 1987 article by sociologists Candace West and Don Zimmerman, the phrase,
“doing gender” was coined. They stated that “doing gender involves a complex of
socially guided perceptual, interactional, and micropolitical activities that cast
particular pursuits as expressions of masculine and feminine ‘natures’” (West &
Zimmerman, 1987, p.126). Embedded into our everyday thoughts and actions, an
example of doing gender could be that men are expected to open doors for women.
This shows chivalry, a typically masculine trait, which reinforces the idea that women
need to be taken care of, and are fragile. These societal expectations and norms
shape our understanding of gender from a very young age and we perform gender
without questioning it. Think about how you sit, what you wear, and how much physical
space you take up; how did you learn this performance? Through socialization and
policing of boundaries over the life course, we learn to do gender as taken for granted
reality. Even amongst children, if a peer were to veer off this binary course, they would
experience ostracization and quickly learn to play along with the rules. Internalization
of social rules and norms over time, causes us to forget that sometimes these rules
we abide by, are not natural but rather a social construction.
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 [the] 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]). The late great Supreme Court Justice Ruth Bader Ginsburg had a different
take, however. Viewing the words as synonymous, she freely swapped them in her
briefings to avoid having the word “sex” pop up too often. It is thought that her secretary
supported this practice by [suggesting] 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.
Gender roles are the broad cultural expectations of males and females which you
probably have learned to follow. Those rules are made up of the norms, or standards
created by society. Gender roles dictate how people should think, speak, act, dress
and interact with society based on these social constructions. The attitudes and
expectations surrounding gender roles are typically based not on any inherent or
natural gender differences, but on stereotypes about the attitudes, traits, or behavior
patterns of women or men. Gender stereotypes form the basis of sexism, the belief
that males are superior to females, and create a gendered script we are taught to
follow. Gender schemas we make based on the script are deeply embedded our
cognitive frameworks and play a role in defining what we perceive as correct male vs.
female roles (note and an acknowledgement of a false binary: as of this writing we are
unable to find stereotypical cultural expectations or scripts for non-binary people so
the gender roles we are discussing are only M/F). Agents of socialization such as
parents, teachers, television, music, or books work to reinforce what has been
traditionally seen as ‘male’ or ‘female’ behavior. Oftentimes, adults perceive gender
differently than children. This is due to the gender expectations they are taught as
young children which shape their adult minds.
The phrase “boys will be boys” is often used to justify behavior such as pushing,
shoving, or other forms of aggression from young boys. The phrase implies that such
behavior is unchangeable, and something that is part of a boy’s nature. Aggressive
behavior, when it does not inflict significant harm, is often accepted from boys and
men because it is congruent with the cultural script for masculinity. The “script” written
by society is in some ways similar to a script written by a playwright. Just as a
playwright expects actors to adhere to a prescribed script, society expects women and
men to behave according to the expectations of their respective gender roles. Scripts
are generally learned through a process known as socialization, which teaches people
to behave according to social norms (Griffiths & Kierns, 2015). Gender roles shape
individual behavior, not only by dictating how people of each gender should behave,
but also by giving rise to penalties for people who don’t conform to the norms. While it
is somewhat acceptable for women to take on a narrow range of masculine
characteristics without repercussions (such as dressing in traditionally male clothing),
men are rarely able to take on more feminine characteristics (such as wearing skirts)
without the risk of harassment or violence. This threat of punishment for stepping
outside of gender norms is especially true for those who do not identify as male or
female. Transgender, genderqueer, and other gender-nonconforming people face
discrimination, oppression, and violence for not adhering to society’s traditional gender
roles. People who identify as gay, lesbian, bisexual, or queer are also ostracized for
breaking the traditional gender norm of who a person of a given sex “should” be
attracted to. Even people who identify as cisgender (identifying with the sex they were
assigned at birth) and straight (attracted to the opposite sex) face repercussions if they
step outside of their gender role in an obvious way.
As a provider, parent, and friend I would say one of the overarching issues is
being able to be ‘seen’ and accepted by others as who you are or are becoming…
especially when you don't fit into the cis/hetero/binary categories and might not have
supportive or knowledgeable friends and family. There are so many ways to go with
this question but I'm gonna start really general. I think one of the most important ways
I can support is actually by changing my gendered language and my gendered world
view across the board. Asking pronouns for everyone is a really simple way to start to
do this. I want all my patients to be more comfortable in a less heteronormative, less
gendered, less binary world. When I use non gendered language and ask about
pronouns, folks that may want to share more hopefully see that they can, folks that
don't know what I am talking about have an opportunity to learn (and I can use my
power and privilege as a white, cis, hetero, old doctor to have those conversations).
Then, depending on how kids answer we can then go deeper if they want to. I would
say in general for all things with teens, I like to start really simple and not overdo it -
kind of like how you talk about sex with little kids - answer the question they are actually
asking in a developmentally appropriate way, and then wait to see what else they want
to know - in this case signal by asking pronouns, try to create an atmosphere of trust,
and then give kids the opportunity and agency to ask more and go deeper if and when
they want. I think generally trans/NB folks (and everyone probably) want health care
in a setting that feels comfortable to them, from providers they feel comfortable with
and also don't have to have every visit and interaction always be about their gender
identity - trans folks sprain their ankles too, and sometimes being gender affirming is
not actually talking about gender, if that makes sense.
For some parents and loved ones I can help validate and contextualize. I can
answer questions they can't (and shouldn't) be asking their kids, and give them a place
to talk openly about their concerns. Sometimes, I need to be a fierce and supportive
advocate, but a lot of times I have parents who are feeling really overwhelmed and
confused, and are trying to do their best. Having a place where they can talk openly
and mess up pronouns and say their deepest fears so that then they can be supportive
and affirming is really valuable. Also in 2022 in Northern California, we have a lot of
great resources - folks way more experienced and knowledgeable than me, and I can
share that info. Luckily, I think there is way more formal and informal education and
understanding about sexual and gender identity and expression, so it's becoming
more and more woven in. I really encourage folks to get comfortable asking and using
pronouns and being more mindful of their language they use. For kids that don't have
supportive families and friends or access to trans NB/queer communities, their health
care provider may be the only person/place they can talk about these issues and get
correct information, so it's vital that providers are aware and create the space for kids
to talk. If we don't, many kids who need info and support may not feel comfortable
telling us, and getting the information and care they need. Unfortunately, as we know,
trans/NB kids have much higher rates of depression and suicide, so their safety and
lives are literally at stake. I think relatively soon there will be questions about gender
identity in routine pediatric screening tools, which I think really needs to happen. One
piece of advice that is relevant here for docs who may be new and nervous about
‘getting it right’… is how to acknowledge and apologize when you mess up without
centering yourself and making the other person responsible for making you feel better.
So, for example, when you mis gender or mis pronoun, which is inevitable, it's
important to be able to correct, apologize and move on; I think too often trans/NB folks
end up being made to feel responsible for other people’s comfort.
Just in general I love taking care of kids and young adults; I love working with
folks in different phases of development and seeing how their brains are processing
and developing over time. I love challenging myself to try to get all my patients the
information they need in a way they can absorb it, really take it in and integrate it into
their lives and with kids it's particularly challenging and fun. Many kids (adults too) and
especially trans/NB folks don't have enough people in their lives that are validating
them and loving them for who they are; it’s such an honor and privilege when I get to
do that. On top of that, many LGBTQIA+ folks have had really miserable experiences
with health care (often meaning they have avoided getting care they need), so it feels
really important to try to get it right.
Honestly I feel like terminology is often in flux and even in affirming communities
there can be differences of opinion… Some folks use words for themselves that others
might find insulting or offensive. I usually just try to use whatever words folks use for
themselves. I think we can always ask folks their pronouns but then consider if you
really need to know their gender identity; is it really relevant for you to know at that
moment? We don't generally ask congruent presenting cis folks to tell us “what they
are”. One of my kids said early on when I asked what they wanted grown-ups to know
about trans kids, something like why are grown-ups so obsessed with what gender I
am all the time - stop worrying about it and just relate to me.. Worth thinking about.
Here is a great resource of examples of Gender Inclusive Language in health
care. I also am a huge fan of not saying anything is normal; I don't think it's helpful as
a concept when we are talking about bodies/people generally, so I just say that things
look healthy instead. For example, I used to say kids have normal growth and
development, whereas now I say healthy growth and development. The same occurs
with genital exams/cervical cancer screening; there is no normal appearing vulva or
cervix. I guess some folks might consider calling things “healthy” as ableist, but for the
purpose of screening exams it works for now.
I don't like or use the word ally, but I do really think that if I can be the person that
has to address ignorant or rude questions or comments relating to gender identity and
expression I am more than happy take that on (though it's hard not to roll my eyes
when folks want to talk about how grammar is just soooo important to them and they
just can't handle using they/them for a singular person). My personal experience is
that folks are much more likely to just avoid you then have a confrontation when they
realize it's personal, or when I am the doctor telling them something. Honestly in places
like Marin and Sonoma (Northern California), people are often more likely to be
overdoing it to show you how accepting they are. One of the things I have seen that I
wish I could communicate to parents is unintentional harm. Many people say things
about LGBTQIA+ folks generally or in passing that they would not say if they knew
their own child was any of those identities, and a lot of kids are right now. Unfortunately
for some folks, it doesn't matter and that's a different issue, but my experience is that
many folks will dramatically change their views once someone they love and care for
‘comes out,’ and it can be hard to turn that around once your kid has heard you say it.
Gender dysphoria is defined by the Mayo Clinic as discomfort or distress in a
person whose gender identity differs from their assigned sex at birth. Some
transgender and non-binary people feel at ease with their bodies and do not seek
medical intervention; however, many transgender people experience gender
dysphoria at some point in their lives, and may seek medical intervention.
Gender Dysphoria can be diagnosed in the Diagnostic and Statistical Manual of
Mental Disorders (DSM-5), a manual published by the American Psychiatric
Association. Questions around the use of the DSM in pathologizing gender dysphoria
arise for many critical of this type of understanding, but for Trans folx seeking medical
intervention, the diagnosis is often the only way to get the treatment they are seeking.
Keep in mind that the term focuses on discomfort rather than identity itself. Gender
dysphoria can cause many complications that include, but are not limited to, a fear of
being harassed or teased, pressure to dress in a certain way, or an inability to complete
daily activities. People who experience gender dysphoria are likely to experience
discrimination which would result in stress and/or an inability to receive quality health
care as a result of stigmatization of gender. Additionally, many people who experience
gender dysphoria fear the idea of seeking healthcare due to the stigmatization of
gender. Young people without gender-affirming treatment who experience gender
dysphoria might also be at higher risk for self-harm and/or suicide.
Sociologists who study gender are often interested in the factors that shape
people’s performance of gender based on social cues. As mentioned earlier,
sociologists West and Zimmermman (1987) theorized this concept of “doing gender.”
“Doing gender” per the sexual scripts means that we fall into two distinct categories,
and our behaviors must reflect what the culture defines as gender appropriate
behavior. When the script is not followed, we are reminded that we are not staying in
our gendered lane, and are sanctioned in some type of way. Gender policing is the
enforcement of heteronormative gender ideals that force the gender binary onto
people. “Masculinity” and “femininity” are often rewarded by people who reject the idea
that gender is a social construct which lies on a spectrum. As a result, performances
that differ from normative cis-gendered stereotypes are generally rejected from
patriarchal, heteronormative society.
The ways that gender is ‘policed’ can range from microaggressions to
macroaggressions. Boys are policed at a young age for expressing stereotypical
feminine traits. While young boys are generally policed more visibly than young girls
early on, girls are asked to perform gender in ways that may be less visible, but are
no less impactful. Being taught that their physical appearance is a basis for validation,
or to defer to others' feelings, or take up less physical space, or be nice to people even
when they don’t feel like it teaches young girls to accept unwanted treatment or
behavior. Repercussions of this type of role expectation can lead to young girls putting
up with harassment or abuse, or being hypercritical of their bodies and starving
themselves to fit into cultural standards of beauty because they have been socialized
to put their wants and feelings aside to make others happy.
Gender policing into two distinct categories means that we learn very different
cultural scripts (again, most policing takes place within the false binary so this is where
we focus attention). As a result the definition of sexuality gets filtered through a
gendered lens. Looking back to the author’s own research on sex education and
gender, we saw that parents have two very different expectations of their children
sexuality, depending on their gender. When many of these humans come together in
sexual or relational partnerships, they enter in with a completely different narrative of
sexuality, consent, and communication. Right off the bat, this means in order to make
things work, there is a lot of unlearning to do about sex and relationships. Sociologists
also note that gender policing exists at all periods of a person’s life, and shows itself
at the intersection between race and class. Intersectionality, allows for an
understanding of how a person’s social and political identities combine to create
different modes of discrimination and privilege. The ways in which all of our different
aspects of self-interact with our gender can affect the type, degree and severity of
gender policing. An intersectional approach is important when looking at the impact of
gender policing.
rom a very early age I remember knowing that thin was good, fat was bad. My
parents were immersed in society’s idea that we were supposed to be thin and not
take up too much space. Be thin. Look fit. My mom said to me once that when she
was pregnant her doctor told her that she should only gain 20 lbs. So, she only gained
20lbs. Thinness wasn’t about health, it was about acceptance. When I was a young
child I never thought about how my body looked. It was just the vessel I used to run,
play, go on adventures. When I was 11 I started to grow a lot. I became much taller
than my friends. Soon after I began my period. I had no idea what to do or how to
accept this. There was so much shame. We didn’t talk about what menstruation was
or why we go through it. It was just shameful. I remember a conversation with my friend
one day when she recognized that I had grown so much. “How much do you weigh”,
she said. I didn’t think anything about it. It was arbitrary, at least that’s what I thought.
“I weigh 80lbs”. She was surprised. "I only weigh 50lbs”. That was the first moment
that I felt ashamed of my size. I was the big girl. As my body continued to change into
my teens, my hips grew, my boobs grew. I was being transformed into a sexual being.
It was the most confusing time. As I was being told to remain a good girl, the world
was treating me like a prize up for grabs. It was totally normal for people to comment
on how your body looked. My body was no longer mine. It belonged to society, my
parents, my boyfriend, random people. It’s hard enough to embrace your body as it
changes throughout your life, the last thing a person needs is scrutiny from others.
Thank God for my fifties. I no longer have to be sexy. I am no longer in a position
to get pregnant. I don’t need a partner. At first letting go was a challenge, but the more
I let go the better I feel. I can love my body as it is. I can respect it for what it has given
me and done for me. I love my soft saggy belly and my flappy “Hi Helen” arms. And I
am very grateful for all the things I still get to do that bring me joy.
The international scientific and medical communities view variations of sex,
gender, and sexual orientation as normal. It is important to note the difference between
sex and gender. Gender is a spectrum, and a person’s biological makeup does not
define one’s gender identity. The term intersex is used to define individuals with a
variation in sex characteristics, including chromosomes, gonads, or genitals, which
highlights the false binary of two distinct sexes or genders. Transgender people have
a gender identity or expression that differs from what they are assigned at birth. People
who identify as transgender may participate in hormone therapy, which is an effective
way to enhance secondary sex characteristics associated with a person’s gender
identity. Gender is a social construct, meaning that it is not developed naturally, but is
instead a concept, created by cultural and societal norms. Gender socialization begins
at birth, and occurs through a variety of major agents of socialization, including family,
education, peer groups, and mass media. As a result of gender socialization beginning
at birth, it is often difficult for people to ‘come out’ as transgender.
U.S. society continues to consider the gender binary as the ‘norm’, which causes
many transgender and non-binary people to experience gender dysphoria. Gender
dysphoria can negatively impact a person’s quality of life, especially if a transgender
person does not have resources to explore their gender identity. Prescribed gender
roles can play a major role in gender dysphoria, and are based on a socially
constructed idea of gender, which changes over time. Gender schemas are deeply
embedded in a person’s cognitive framework, which is why many transgender and
non-binary people have to go through a process of un-learning. This process can be
quite difficult, as a result of people being policed at a young age, causing a series of
gendered expectations that define the ways people should act, dress, and interact with
society, based on the gender that they are assumed to hold.
