5.3: Sex, Gender, and Sexuality
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When filling out official documents, you are often asked to provide your name, birthdate, and sex or gender. But have you ever been asked to provide your sex and your gender? It may not have occurred to you that sex and gender are not the same. However, sociologists and most other social scientists view sex and gender as conceptually distinct. Sex denotes biological characteristics and exists along a spectrum from male to female. Gender, on the other hand, denotes social and cultural characteristics that are assigned to different sexes. Sex and gender are not always synchronous, meaning they do not always line up in an easy-to-categorize way.
Sex
“Sex” refers to physiological differences found among male, female, and various intersex bodies. Sex includes both primary sex characteristics (those related to the reproductive system) and secondary sex characteristics (those that are not directly related to the reproductive system, such as breasts and facial hair). In humans, the biological sex of a child is determined at birth based on several factors, including chromosomes, gonads, hormones, internal reproductive anatomy, and genitalia. Biological sex has traditionally been conceptualized as binary in Western medicine, typically divided into male and female. However, anywhere from 1.0 to 1.7% of children are born intersex, having a variation in sex characteristics (including chromosomes, gonads, or genitals) that do not allow them to be distinctly identified as male or female. Due to the existence of multiple forms of intersex conditions (which are more prevalent than researchers once thought), many view sex as existing along a spectrum, rather than simply two mutually exclusive categories.
Gender
A person’s sex, as determined by his or her biology, does not always correspond with their gender; therefore, the terms “sex” and “gender” are not interchangeable. “Gender” is a term that refers to social or cultural distinctions associated with being male, female, or intersex. Typically, babies born with male sex characteristics (sex) are assigned as boys (gender); babies born with female sex characteristics (sex) are assigned as girls (gender). Because our society operates in a binary system when it comes to gender (in other words, seeing gender as only having two options), many children who are born intersex are forcibly assigned as either a boy or a girl and even surgically “corrected” to fit a particular gender. 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 Identity: Cisgender versus Transgender
Gender identity is a person’s 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 (for example, they were born with male sex characteristics, were assigned as a boy, and identify today as a boy or man) are cisgender. Those who identify with a role that is different from their biological sex (for example, they were born with male sex characteristics, were assigned as a boy, but identify today as a girl, woman, or some other gender altogether) are often referred to as transgender. The term “transgender” encompasses a wide range of possible identities, including agender, genderfluid, genderqueer, two-spirit (for many indigenous people), androgynous, and many others. The prefix “trans-” comes from Latin, meaning “across from” or “on the other side of”. In contrast, the prefix “cis-” means “on this side of”.
Cultural Variations of Gender
Since the term “sex” refers to biological or physical distinctions, characteristics of sex will not vary significantly between different human societies. For example, persons of the female sex, in general, regardless of culture, will eventually menstruate and develop breasts that can lactate. Characteristics of gender, on the other hand, may vary greatly between different societies. For example, in American culture, it is considered feminine (or a trait of the female gender) to wear a dress or skirt. However, in many Middle Eastern, Asian, and African cultures, dresses or skirts (often referred to as sarongs, robes, or gowns) can be considered masculine. Similarly, the kilt worn by a Scottish male does not make him appear feminine in his culture.
Sexuality
Human sexuality refers to a person’s sexual interest in and attraction to others, as well as their capacity to have erotic experiences and responses. A person’s sexual orientation is their emotional and sexual attraction to particular sexes or genders, which often shapes their sexuality. Sexuality may be experienced and expressed in a variety of ways, including thoughts, fantasies, desires, beliefs, attitudes, values, behaviors, practices, roles, and relationships. These may manifest themselves in biological, physical, emotional, social, or spiritual aspects. The biological and physical aspects of sexuality largely concern the human reproductive functions, including the human sexual-response cycle and the basic biological drive that exists in all species. Emotional aspects of sexuality include bonds between individuals that are expressed through profound feelings or physical manifestations of love, trust, and care. Social aspects deal with the effects of human society on one’s sexuality, while spirituality concerns an individual’s spiritual connection with others through sexuality.
LGBTQ+ Health
People who are lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) are members of every community. They are diverse, come from all walks of life, and include people of all races and ethnicities, all ages, all socioeconomic statuses, and from all parts of the United States and world. The perspectives and needs of LGBTQ+ people should be routinely considered in public health efforts to improve the overall health of every person and eliminate health disparities.
In addition to considering the needs of LGBTQ+ people in programs designed to improve the health of entire communities, there is also a need for culturally competent medical care and prevention services that are specific to this population. Social inequality is often associated with poorer health status, and sexual orientation has been associated with multiple health threats. Members of the LGBTQ+ community are at increased risk for a number of health threats when compared to their heterosexual peers. Differences in sexual behavior account for some of these disparities, but others are associated with social and structural inequities, such as the stigma and discrimination that LGBTQ+ populations still experience.
LGBTQ+ sexual health and well-being is affected by numerous social and cultural challenges across the life course, contributing to negative health outcomes and posing barriers to attain such protective health indicators as marriage and family formation, community support, and inclusion in faith communities. The incidence of hate crimes and discrimination promulgated through the denial of equal rights contribute to the perpetuation of homophobia as a structural norm.
As a result of cultural and societal discrimination, many LGBTQ+ people suffer an added burden of stress and experience health disparities, such as:
- Potential difficulties in getting or keeping health insurance, and possible employment instability.
- Limited access to high quality health care that is responsive to LGBTQ+ health issues.
- Mental health problems and unhealthy coping skills, such as substance abuse, risky sexual behaviors, and suicide attempts.
- Challenges or difficulties with being open about one’s sexual orientation, which can increase stress, limit social support, and negatively affect overall health.
- The effects of homophobia, stigma and discrimination can be especially hard on adolescents and young adults. In addition to an increased risk of being bullied at school, they are also at risk of being rejected by their families and, as a result, are at increased risk of homelessness.
Whether you are gay or straight, you can help reduce homophobia, stigma, and discrimination in your community and decrease the associated negative health effects. Even small things can make a difference, such as accepting and supporting a family member, friend, or co-worker.