Sex And Gender Are Actually The Same Thing (but bear with me…)

As you read the title, you may be overcome with indignation that this article is going to be a gender-essentialist rant. You’ll be relieved to know that it’s quite the opposite. My intent in writing this is to point out some serious misconceptions perpetuated in ‘trans 101’ and cisgender allyship resources, which end up doing much more harm than good for transgender people.

Anyone with an entry-level understanding of trans issues is probably familiar with the phrase “gender and sex are different things.”

While the idea of treating sex and gender as unrelated factors may result from an attempt to validate and support transgender identities, it actually perpetuates harmful cultural beliefs about the validity of sex assignment and the static nature of biological sex, which remove agency from trans and intersex people to define their own bodies and experiences. This way of thinking does nothing to combat (and in fact often co-signs) the pathologization, alienation, and exclusion of trans people, especially trans women, on the basis of their seemingly immutable “biological sex”.

Social Constructs, Social Constructs Everywhere…

The reality is that the concept of “biological sex” — along with gender, money, and traffic laws — is entirely socially constructed.

Now, your first reaction may be “Woah, woah, woah — penises and vaginas physically exist! Genitals obviously can’t be social constructs!”

This is at least partially true. The physical tissue and organs, to which the concept of sex is assigned, are not socially constructed; they exist through nature rather than human design.

However, words like “penis” and “vagina” are socially constructed. The study of medicine is socially constructed. The criteria that arbitrarily define “normal” and “abnormal” sex characteristics and create a dichotomy between “male” and “female” biology, is socially constructed. The expectations, functions and genders we assign to these organs and tissues? Definitely socially constructed.

While the intent of “gender and sex are different things” may be to illustrate that gender exists independently of (assigned) sex, the problem lies in the fact that sex cannot exist independently of gender.

There is a particularly problematic idea that words like “male” and “female” describe one’s unchanging physical sex (as  ), and words like “man” and “woman” refer to an identity. This is untrue in any practical sense; for all social and legal purposes, words like “male/female” and “man/woman” are used interchangeably, with interchangeable social connotations.

The notion that one can validate a trans person’s “gender identity,” while still placing their bodies in the same category as cis people of the same sex assignment, is something that has been used to justify exclusion and violence against trans women, the alienation of trans people from gender-specific spaces, results in improper medical treatment, and is just another tool of transphobia and transmisogyny that allows people to turn around and say “I respect your ‘identity’, but you’re still basically a ______.”

Biological Sex as an Instrument of Transphobia

The concept of assigned sex as an unchanging objective fact has countless negative repercussions for trans people, from interpersonal relationships to accessing basic health care.

Cis people often employ the logic of biological sex to justify their experience of attraction or repulsion towards trans people, both of which can be rooted in transphobia. A lesbian attracted to a trans man can still consider herself to hold “gold star status” if she still considers her partner to be “biologically female”. A straight man believes he cannot act upon his attraction to a transgender woman since doing so might make him “gay”.

The concept biological sex reinforces the homophobia and pathologization that are integral to upholding institutional transphobia and transmisogyny.

I could write a whole separate piece on the horror show that results when we apply this logic within the penal system and sentencing transgender people on their assigned sex, but I think this fact sheet by Just Detention International can shine a light on that for me.

And don’t get me started about how this whole “sex = biology, gender = psychology” thing throws intersex people under the bus (considering a disproportionate amount of transgender people are intersex).

What does it even mean to have a “male body” or a “female body”? Are those categories inherently dyadic? Are they solely dependent on your birth assignment? Your hormones? Your genitals? Does a non-op trans woman who’s been on HRT for years still fit into the same “biological” category as a cisgender man? Is there a point at which, through medical intervention or legal recognition, a person ceases to be a member of one biological sex and assumes an officially designated and socially recognized new sex? Where do intersex people even fit into that? This entire concept is just a mess that quickly falls apart under the slightest inspection.

If someone identifies as male, then they are male and their body is male. If someone identifies as female, then they are female and their body is female. I identify as an androgyne, I am an androgyne, and my body and sex are (you guessed it) also androgynous — regardless of my medical decisions or transition status.

The purpose of trans inclusion is not to concede to the self-determined nature of gender while holding steadfast to the social construct of biological sex, and in fact these two things cannot exist in tandem. Trans people cannot truly have agency to self-determine their genders unless they also have agency to self-determine their bodies as being in alignment with that.

Trans inclusivity should redefine our understanding of gender and sex so that trans people are able to fit seamlessly within them (or better yet wouldn’t need to if the notions can be discarded entirely), not to have trans people straddle narrow, arbitrary classifications with certain parts of their personhood on one side of a line and certain parts on the other.

The Hard Facts

This is usually the point at which many scientifically-minded peers will take it upon themselves to point out the Hard Facts: “Male” and “Female” bodies have distinctive physical differences that result in different health care needs! You can’t change what chromosomes you have! A trans person’s health care will never be the same as that of a cis person of the same gender! We need to have these rigid physical criteria! For health! For science!


First of all, the things we currently know about the intrinsic differences in male and female physiology are basically just that we know a heck of a lot less than we thought we did. Recent findings have shown that there are no significant differences in male and female brain structure and that chromosomes do not determine sexual development, and many things we previously accepted as “hard facts” are turning out to be just antiquated speculation.

It’s almost as if the gender/sex binary was invented by people who then manufactured artificial qualifiers to reinforce it, which then became woven into our study of biology, medicine and psychology. Huh. Weird.

In reality, everyone’s medical needs are different. Yes, a trans man and a cis man will never have exactly the same medical needs, but also an able-bodied man will have different needs than a man with a disability, and there are even certain differences in medical treatment that exist between different ethnicities. Only a small portion of our medical treatment is actually affected by what’s between our legs, and when that becomes relevant to medical treatment, it needs to be discussed on an individual basis anyway.

The differences in health care needs between a transgender person and a cisgender person of similar health are largely negligible. They become even more negligible if the trans person in question is undergoing hormone therapy, since there are more general medical concerns influenced by your present hormones (such as bone and muscle density, risk of heart disease, cholesterol, pattern baldness, and PMS) than there are directly influenced by the genitals you were born with.

The idea that gender exists independently from sex and that transgender people should be lumped into their coercively assigned sex category for medical purposes only results in the gross mistreatment of transgender patients, as well as general confusion for their health care team.


The more we dissect the logic supporting the idea of biological sex and gender identity as independent and unrelated factors, the more apparent it becomes that this concept is more of a useful device for cisgender people to seem inclusive while still being transphobic, rather than something that actually benefits trans people. While educating others about trans inclusion and allyship, it is more important that the concepts we are reinforcing are helpful, rather than be easily integrated into other false preconceptions.

56 responses to “Sex And Gender Are Actually The Same Thing (but bear with me…)

  1. Thanks for a thoughtful article. Along similar themes, two concise statements I make in my own “Trans 101” presentations are:

    1. We humans like to have our categories; Mother Nature, not so much…


    2. Gender identity is a product of brain function. How have we forgotten that the brain is a “biological” organ every bit as important as genitals and internal sex organs? (Although this statement sounds like a reversion to thinking of brains as binary, it’s not. As indicated in the article, individual brains are composed of random combinations of different tissue components considered typical of both dyadic males and females.)

    Liked by 1 person

  2. their are differences in brain structure, particularly areas overseeing the perception of self and gender.
    a short educational video from a professor at Stanford

    what the professor was refering to, female numbers in the bed nucleus of the stria terminalis (BSTc) of the brain…
    pictures of the (BSTc) in hetro and gay males contrasted to femal and trans…
    Androgen Receptor (AR) Repeat Length Polymorphism – the technical name for a gene discovered that correlates with trannssexualism…

    Liked by 1 person

  3. I agree with this piece and have been saying this for years (have you read Making Sex by Thomas Laqueur?). I am Intersex and am curious about your statement “considering a disproportionate amount of transgender people are intersex”. You do a very good job of citing your sources for other statements, but this one lacks a source. Is there one or is it more anecdotal?

    Liked by 1 person

  4. Excellent points of discussion. One of the thoughts I’ve been having and starting to use when explaining trans 101 to cis people is that while the ideal human condition may be 2 sexes for reproductive purposes (things do tend to work best when two people with a particular series of “opposing” parts come together), the reality is that this almost never actually happens. We have no idea just how common various variations are, because we don’t test every single thing in every single person, and for the most part, people do tend to fall into one camp or another. But those camps are not absolutes, they’re generalizations.

    This idea works with either taking the evolutionary biology track (Science!, and also my personal point of view), but interestingly enough it also works extremely well with the far right Evangelical Christians and the “fall of man” idea. Either way, our bodies are not perfectly segregated genders, there are a ridiculous number of factors to consider that vary widely.

    The more we research into the relationship between physical aspects of trans people and biology, the more we seem to be finding correlation. If trans is potentially a provably biological function, then this separation of Gender Identity and Biological Sex further will fall apart.

    Liked by 2 people

  5. Pingback: Sex and Gender… Re-Unified? Fascinating Take from Lane Silas |·

  6. You should make inferences off of the scientific articles directly rather than inferences off of another’s interpretation. This will provide better support for your arguments and allow you to better judge things like context, validity, relation, and corellation versus causation.


  7. I agree with most everything you say-
    I’ve always seen it that gender is the instincts a person has about their sex. That’s why it’s the mind vs the body and while imaging of the brain shows there are no significant differences in male and female brains- our instincts with our genitals could easily still vary person to person. And so I agree with you that they are connected in a fundamental way. The two hold hands in a way. Our instincts want to match our body. I also can easily see a subtly existing in the brain knowing what body to expect- just as someone born without legs may have dsyphoria knowing what legs should feel like- someone with a sexual organ misshapen may have instincts about what that organ should feel like (something I have experienced myself and have known someone who never was able to walk but walked in dreams and knew what it should feel like).
    I do think it offers comfort to trans people to know that a penis can be a “girl’s” organ and a vagina can be a “boys” organ considering that changing these organs to fit the person is not a perfect science yet- it is a disability they may have to cope with for life- but it’s important to see how “boy” and “girl” are just social ideas. They don’t have to have restrictions on genitalia.
    If the person does not actually experience physical dysphoria about their sex and body- I would be more inclined to think they may not be trans but simply unhappy with the limitations society has trapped them in. Roles and perceptions about who they were that were decided by their genitals before they could even talk. Someone can have a vagina & ovaries and be completely content with that AND as living as a “boy” socially, as an example.
    Until we are able to do away with concepts like “boy” and “girl” (or at least give them no importance other than a style)- until we can see all sexes as equal as they deserve to be- trans AND cis people will have these trapped feelings.
    As social creatures, however, being able to “fit in” matters to many of us very much- so along with sexual/physical dysphoria we usually see a desire to also imitate the social things wanted of that sex. But not always.
    Male and Female I restrict to the scientific classification of ovaries and testes and has nothing to do with the kind of person someone is or wants to be and it actually doesn’t even have to do with vaginas or penises. Someone can have ovaries and a fully developed penis and no womb- for example. I’m alright with that as a strict scientific classification so long as people understand what it really means and don’t misuse it to harass people about who they are socially.
    And not to be rude to anyone who experiences fluidity, but I suspect it has less to do with the physical side of things and more to do with frustration by those social restrictions on presentation and respect. I can easily see them still being transgender though, because they may also experience physical dysphoria that may also come and go and make things very confusing. Not all people experience constant dysphoria over their sex or gender.
    I write all this as a person who is questioning and learning how deep the metaphoric rabbit hole goes on social influence. How it deeply affects us and can interfere with finding what is actually true about ourselves. Sometimes I find it very hard to say “I like this” knowing for sure I like it or if I like it because society says I should like it- if I like it because it’s easier to like it. The influence other people and social expectations have over us is overwhelming and difficult to escape.
    Thank you- Noodle.


  8. As a disclaimer, this comment is based purely from a medical perspective, as well as a dabble from some personal life experience with loved ones struggling with gender identity.

    I agree entirely about the social construction of the use of male and female, it’s distasteful. I hate writing “Johnny is a pleasant 7 year old BOY” in my notes. When I walk into a patient’s room, I always ask how they want to be addressed. Most have a pretty cool nickname. If they want to be called God I will call them that. When I read this article, I was totally going along until I hit the medical treatment part.

    In fact, we have entire specialities dedicated to the “between the legs” organs (ob/gyn and urology, to be specific). We also do a lot for these organs in primary care. So it matters ALOT what’s down there. We should always address sex-organ related issues with care and sensitivity no matter where our patients are in terms of how they identify. But physicians should never let their patients’ discomfort interfere with providing the best quality care they can, including talking about gender identity issues and providing routine health maintenance.

    I have met the entire spectrum in my office, including someone on HRT who is still goes back and forth depending on the day, and that’s totally cool. Rather than using “male” or “female” parts, we need to reference specific organs in talking about health prevention. No matter how you identify yourself in this socially constructed domain of gender, you will still have breasts, ovaries, a uterus, vagina, penis, testicles, prostate, and these organs demand attention and care! If you have a prostate I don’t care how you identify yourself, you will be offered a prostate exam after the age of 50. Got testicles? Then you should have a testicular exam at every physical! A Pap smear is recommended every 3-5 years with HPV testing after age 30. And EVERYONE gets tested for STIs. These recommendations are based on science, not socially constructed platforms. Believe me, nobody enjoys doing those prostate exams. It’s also important to know what kinds of organs patients are carrying because when they come in with painful urination or lower abdominal pain, a lot of the time it’s related to the genito-urinary system, so you want to know what’s in between the legs and the plumbing going up from there.

    Basic prevention and maintenance is the same for EVERYONE regardless of where you come from and where you are on the spectrum of how you identify yourself. Then you can always get more resources, support, specialty referrals, etc. The bottom line is that I’m not going to judge how my patients carry themselves or how they identity themselves; they are my patients and they come to me for medical care. Therefore it’s my job to provide them with the best care I can.

    Liked by 1 person

    • my point was not so much to invalidate the necessity of reproductive healthcare so much as it was to invalidate the argument that essentially if someone needs a prostate exam then they should be classified as male “for medical purposes”. It is a much better route to take to just refer to the organs individually, especially since some (intersex) people may not even have all of the parts that go along with a particular common “set” (i.e. some may have a vagina but no uterus, or a vagina and testes, etc.)

      Liked by 1 person

  9. Reblogged this on University of Broken Glass and commented:
    This is an important read. The “Genderbread approach” to trans issues has long irritated me. Yes, it is simple and easy, but it fails in that it’s simplicity can actually enforce binary understandings of both sex and gender! The authors argument that understandings of “sex” is sovially constructed as well moght feel out of place, however it is often a tool still to locate trans people within their assigned gender.


    • It fails because it isn’t taught properly is all. The Genderbread Person itself is a simple illustration that represents the concept that a separation of four things exists for everyone. Gender shown as a brain, Orientation shown as a heart, Sex shown as the genital area and Gender Expression. One does not determine any of the others but no person exists who doesn’t have all four in some way. The combination in us can be different from the next person is all. That is the underlying concept of The Genderbread Person. Gender is simply how a person processes information. Typically in either a male or female way, or perhaps a blending of the two, also known as Gender Queer. Gender fluid would be a movement in a thought process psychology.

      It’s a very common thing for people to group together a person’s sex (the body), sexuality (orientation) and/or gender expression into what creates a person’s gender. These things do affect how the individual and others perceive that person’s gender but don’t actually determine it. True for the cisgender or transgender person.


  10. Basically what you are saying in this article is not that a separation of what is gender and what is sex doesn’t exist, but instead you find it too difficult to teach to the general cisgender public so we shouldn’t try. I’ve had great success teaching this subject and my target audience are those who may not support us prior to learning. I’ve given many seminars. The way we teach matters. The words we use and the way we use them matters. Done incorrectly the people walk away still confused. Done correctly and they walk away enlightened.


    • im not saying sex doesnt exist or that sex doesnt refer to something different than what gender refers to. I’m saying the language we use to refer to certain sexual characteristics is inherently gendered, and it’s incredibly offensive to tell someone that they “identify as male” but have a “female body” etc. Our relationship to our sex and our bodies is shaped by gender. trans women aren’t of the “women of the male sex” and asserting so is incredibly transmisogynistic and is the same logic used to justify physical violence against trans people. The point of this whole article is just that trans people get to define how they relate to their body, and if a person identifies as male then they get to define their body as male (since they are male and it is *their* body). when referring to anatomy in an inclusive way it is much more productive to just refer to the organs and hormones themselves (i.e. estrogen, testosterone, penis, testes, vagina, etc.) rather than applying gendered language to them, since some penises are female and some vaginas are male, and not everyone has the full set of parts, or have a mixed bag of parts, that go along with the typically accepted norm of these binary categories anyway. transgender people, especially those who physically transition, do not fit into the norm of dyadic cisgender physical sex and so insisting to classify them based on their assigned sex (i.e. asserting that a trans woman is “still physically male” or a trans man is “still physically female”) is transphobic.


      • But if we educate based on a truth rather than a preferred fantasy don’t you think we’ll accomplish more? I did a one hour tele-conference for the primary care of the VA of NY state. In that conference I explained what is the difference between the body and the gender. I also explained diagnoses and treatment of gender dysphoria. I personally have not had surgery but have been on HRT for two years. I have breasts so I need breast exams. I’m over 50 and had my prostate checked. It’s not offensive to acknowledge that my body is male in many ways and medically will retain male features. It’s important we do so in fact. Transphobia does not come from educating properly. It comes from a perpetual lack of understanding that often we ourselves reinforce.


      • I don’t read or write blogs but someone who does messaged me and asked me to address this. I’ve had great success in education because my words, while familiar, are different. My teaching of psychology, while different, is recognized by psychologists as something they recognize and understand after it’s explained. Our success will come through proper education and I have spent the last two years developing the words that work, in the order they work. I’m only try to help you all.

        Sex (The body) doesn’t determine a person’s gender. We know this because a person can undergo sex reassignment surgery and other procedures which results in having gender dysphoria go away that existed, centering around body issues. If a cisgender person were to undergo SRS they would more than likely start to experience gender dysphoria. This is because the gender is not changed through the procedure. Only the physical body changed. The gender didn’t change. The intersex person is a better example. When we are born the Dr. holds us up, spanks us and then determines our sex by what they see. For intersex people, more so in the past, a determination was made that this person should be either male or female in their sex. They had a 50-50 chance of guessing the correct gender. It was not uncommon for intersex people who had surgery as babies to make their sex either male or female to later have surgery again to correct the mistake.

        Sexuality (Orientation) doesn’t determine gender. If it did then perhaps all cisgender people would be straight, all binary transgender people would be gay and all bi-gender or gender fluid people would be bi-sexual. We know of course this isn’t the case.

        Gender Expression doesn’t determine gender either. We know this because there are women who are very masculine and men who are very feminine but still firmly identify as cisgender. When a person takes off all their clothes their gender doesn’t go away. This shouldn’t be confused with the act of role play in which a person pretends for short periods. A man with a male gender can feel more masculine by doing masculine things but the male gender existed before an effort to be seen as or feel more masculine was attempted. The same can be said for feminine things. Transgender people are no different than cisgender people in this respect.

        Gender expression is a sliding and ever changing scale for all of us, cisgender and transgender. Particularly females who typically enjoy a greater freedom in demonstrating a wide range of Gender Expression from more feminine to more masculine based on feeling of practicality or desire of self expression.


      • @Erica Ravenwood: the medical abuse of intersex children is not a thing of the past; it is standard practice throughout much of the world, including the USA, today. What you described in the past tense is very much still happening.


      • You’re very correct. My point being, and perhaps I shouldn’t have stated this, that it’s a practice that is starting to be seen as one that should be discontinued. It’s why education is SO important in all areas but particularly in the fields of medical and mental health. One of my concerns about this blog post, and many other things I see, is that we as a community like to complicate things far too much in a message we want delivered to the world which makes educating very difficult.

        Those of us who educate in the real world, and I’m not talking educating other transgender people or a group of allies, I’m talking educating the general public who might strongly oppose us, are only a small handful. We know the difficulties of teaching simplicity without a community asking that complicated, convoluted ideas be taught when things should be taught by the individual to their own social group. Not the broader public.

        We need to be satisfied with the basics when teaching broadly and that within the basics we can find our own individuality that we as an individual can then explain to others we know. We have to start realizing that the key to freedom is through education but that education can’t be so complicated that no one, including ourselves, will ever understand.


  11. Nice one. I’ve (reluctantly) found that using the sex/gender binary is sometimes a necessary evil when trying to do programming or interventions. (like strategic essentialism) But, considering the effects, maybe we need to find a way to do away with the binary in a way that folks who haven’t read Butler or can get? Sometimes in my teaching I try to equate sex/gender to race – both rely on interpretations of bodies. Still, people think of skin colour as superficial and ‘sex’ as embedded (hormones, plumbing & whatnot).

    Here’s one for the science folk (an oldie but a goodie): The Egg and the Sperm: How Science Has Constructed a Romance Based on Stereotypical Male- Female Roles


  12. Nice article. It would be beneficial to your readers who are unfamiliar with these concepts to cite your sources, not least of which would surely be Judith Butler, who made these observations back in the late 90s. Citing sources not only protects you from claims of plagiarism but gives points of reference for readers to engage further with the ideas presented AND helps alleviate commentators who try to refute your stance by offering sources supporting their positions while suggesting you have none. Just food for thought.


      • I’m with you there Lane, lol. I didn’t read anyone. In fact I made sure not to when writing my book, though people kept saying read this or that. I looked at the genderbread concept and understood. Fully understood I think more so than the person who originally came up with it. I wanted to ensure my ideas and theories were organic. As a result I’m now teaching psychologist a new theory of human psychology that they are embracing. If myself and someone else comes to the same conclusion it’s only because we recognized the same truth. Until today I’ve never heard of Judith Butler. Often when we immerse too deeply in various people’s work we loose sight of the simple truths.


  13. Considering the importance of and the struggle for reproductive rights this quote in particular (“In reality, everyone’s medical needs are different. Yes, a trans man and a cis man will never have exactly the same medical needs, but also an able-bodied man will have different needs than a man with a disability, and there are even certain differences in medical treatment that exist between different ethnicities. Only a small portion of our medical treatment is actually affected by what’s between our legs, and when that becomes relevant to medical treatment, it needs to be discussed on an individual basis anyway.”) is ~really~ dismissive imo. Sexual/reproductive healthcare is a big part of health and it can’t be discussed on an individual basis when we have to organize to protect our rights. I feel that your framework doesn’t properly incorporate or address a reproductive rights framework.


    • i think it is more inclusive for reproductive rights. pregnancy is not just a “female” thing, given that trans men also get pregnant, and the labelling of reproductive health as an inherently feminine issue has actually been linked to trans masculine people being reluctant to seek out reproductive health care, which leads to a higher occurrence of cervical cancer and other reproductive health issues in trans men. if we didnt have to gender reproductive health and just treated it as a “people who have vaginas” thing rather than a “female” thing, CAFAB trans people wouldn’t have such a hard time accessing it and being discriminated against. I’m sure there are probably also similar problems with trans women being reluctant to access “male” reproductive health care as well for similar reasons.


  14. I have often wondered, quietly and to myself, how many individuals who struggle to find the ‘correct’ designation for their personal identity do so because the social, stereotypical categories of ‘man/male’ and ‘woman/female’ are so very limiting. For example, I wished for many years that I had been born a male. This, I think, was more of a result of being told I couldn’t or shouldn’t do something or being interested in something because of my gender than because I might actually be transgendered. I have had and continue to have little to no interest in what American society (generally speaking) considers “feminine.” By which I mean activities such as obsession with clothes and shoes, that materialistically driven need to appear a certain way, or being barefoot and pregnant in the kitchen. I hate cooking. My hormones, especially my female ones (the ones associated with my uterus and ovaries), give me a great deal of trouble as far as emotional stability and pregnancy was a nine-month “Hell Week” of depression and anxiety. What I wish now is that my body would be less at the mercy of my hormones. I could do without my breasts because I have had my children and nursed them and now all these breasts do is hang around and get in the way (being of a certain unreasonable size). I’d like a flat chest but that’s more utilitarian than anything gender related. I suppose I am, in the lingo, as far as I understand it, a cisgender. I am a woman who is married (blessedly) to a man (who enjoys his clothes and his cooking) and a parent to two children. I am a-okay with that. But I drive a truck. I do the car maintenance for our family. I burp and fart and I don’t feel any inward pressure to take on overtly “masculine” behaviors like drinking beer and watching sports (though a good game of rugby is a fine way to pass some time). I’ve rambled. My original point remains the same. I once felt I had to be male in order to be happy until one day I realized that was a bunch of socially constructed BS and that I could be who I am as well as what I am without feeling any shame either way. I don’t doubt the existence of every possible variety of gender and sexual identity. I believe quite firmly in accepting people as they are and respecting their wishes and their privacy and their needs. I’m not very educated as to the correct words or language to use when speaking of the variety of gender so I any seeming disrespect is a result of my ignorance and not born of any intentional desire to hurt. I just wonder how often it is that an individual struggles, as I have, because of their cultural surroundings and the poorly determined, confusing rationale of society (and history). And, just because Evangelical Christians always seem to be the enemy of anything Christ-like, I’d like to say that I am a Christian (perhaps not that great at it), but I come from an evangelical background and while there are a seemingly overwhelming number of special idiots who also claim the title of Christian, there are, in fact, quite a few of us who accept all as they are because, honestly, that’s What Jesus Would Do (and does). Thank you for this article. I’m forwarding it to my pal who takes a great personal interest in gender studies and I hope the two of us can enlighten each other further with the help of what you have written.


  15. I get a lot of the points you’re making here. You have the right to describe your body however you want, as does everyone.
    But I have some general points of disagreement.
    A. There are definitely ways that having a more nuanced nonbinary biological sex categorization could help trans* people medically. We need doctors to be familiar with and invent more terms and categories, and we need people to know that intersex bodies exist. Throwing out the concept of biological sex because right now it is binary actually could have the effect of making people feel further isolated. We can be more creative and practical than saying “everybody is different so let’s ignore that having an accurate medical category for your bodily condition leads to funding, less headaches, and community.” That would be the same as saying, “everybody who calls themself trans is different, so let’s put an end to all of the useful political and support groups calling themselves transgender.”
    B. This article is part of a history of elitist analysis of the Trans * experience where people with expensive college degrees and generally wealthy backgrounds discuss transgender marginalization in lofty academic language that the truly marginalized, poor, and stressed out members of the Trans * community could never understand. I don’t mean to pick on you or suggest that I know your background, but you and a lot of people who write on this stuff really sound like Judith Butler, who is one of the most pretentious and convoluted writers I’ve ever had the misfortune of reading. Why can’t we write so that someone with a public high school from Baltimore can understand? Why are we always using gender jargon without a nod to the fact that this language almost never comes out of poor communities of color, but instead comes from gender studies departments, often written in articles which you can’t get access to without a college affiliation? Why isn’t it common practice in transgender political writing to define terms and assume our audience understands collegiate writing? Even though you’re not as bad as some people, and even though some of your points are legitimate, I would never share this article with a friend who was not a huge academic or long time member of the Trans * community.

    Liked by 1 person

    • a. with respect to trans and intersex medical concerns the only logical solution in my mind is to refer to the parts themselves. terms like “people with vaginas” “people with testosterone systems” etc. since things like “male” and “female” biology imply someone has all of the associated physical characteristics of that category, and none of those associated with the “opposite sex” (i.e. trans women may have penises but estrogen systems, an intersex person may have a vagina but no uterus, etc.)
      b. i suggest you read this article within the context of me being a disabled, neurodivergent, impoverished intersex person with no higher education beyond one semester at a career college. I’ve also done no formal reading about gender theory. I don’t think people from “public high schools in baltimore” would be flattered by your implication that they would not be able to understand something written by someone with only a high school-level english education.

      Liked by 2 people

    • also i find your comments fairly racially insensitive, there are plenty of people of colour who write about gender theory with or without a formal education. I really do not see where your assumptions of elitism are stemming from given that I’m a poor person with no formal education who is writing a publicly accessible article about my own thoughts and theories..


      • I think I’m starting to understand that your concern is more around titles or labels concerning the physical body. Is that right? It’s not so much around gender or psychology?

        Personally I don’t get hung up with the physical too much and concentrate more on psychology in my work. When we use the word gender I think psychology though many still use it to describe a physical presence. That’s probably why 80% or so of my gender dysphoria was resolved by simply allowing my mind to work in it’s natural way. Something I didn’t allow my mind to do for about 35 years.

        What are your thoughts? Am I in the ball park?


    • I like what you’re saying Leigh. Yeah, we need to tone down the language so the general public can at least have a chance to wrap their heads around things. After all it’s not ourselves we have to convince to create true change. Transgender groups tend to be their own worst enemy when it comes to educating, lol.

      I do feel though we’re being hijacked by all this non-binary crap. If you are truly non-binary that’s fine but to label everyone who is transgender as non-binary is whole inaccurate. Binary and non-binary have to do with psychology. Not the body. Not gender expression. My gender is binary female and always has been though I was born with a male body. Though I lived the majority of my life playing a very male part to the best of my ability. My thought process is like that of most women and nothing like that of most men. This is binary. A gender thought process that is either male or female and nothing else. Non-binary would be more of the gender queer thought process which is a blending.

      We as a community are no less confused as the cisgender one most of the time, and role things together to make up a whole instead of speaking of things separately. We as individuals are a combination of things but if we choose to present our individuality as what makes all of us we get no where.

      In order to find the answers we need to the issues that face us it’s imperative to see each of these things for what they are. The only way to do this is to separate them when speaking of them. Gender, Sex, Sexuality and Gender Expression. No longer can we interchange the words Gender and Sex as if they have the same meaning. No longer can we mistake Gender Expression for Gender Identity if we wish to resolve issues, that are in fact, easy to resolve. We must speak with a common language so that there is universal understanding within the conversations that MUST happen if we wish things to change. Really change.


  16. Disclaimer: this is in no.way meant to offend, and if it does, this is purely due to a lack of understanding I’m totally willing to adjust if I can be educated to that extent. This is not meant to criticise individuals or gender identities but meant to examine society’s perception of these, so any misconstrued point on my behalf should be taken as an area to educate me in, not as grounds to attack me over.

    I am by no means educated on the manner of trans and cisgenderism but there are certain things that confuse me that I’ve been trying to understand for a while and this article highlights the disjuncture for me. If gender deals with an identity and sex deals with the physical biological state of an individual’s body, the only connection between the two is how society views you based on physical appearance, no? I understand in short the problem with body dysmorphia but isn’t this also a reaction by the individual about how society views their identity via their physical state?

    Let me come at my question from another angle. Should our aim not be as a society to remove gender from sex completely? That is, shouldn’t a woman be free to be a woman whether she is male or female? Shouldn’t a gender fluid individual be free to be a man or woman or any self defined identity in between without having their plumbing bare any relevance to how that identity is reached?

    I understand that this can cause issues with sexuality, whereby attraction can be awkwardly placed so that the male/female genital split is unknown until sexual activity begins – but I’m sure there are equally solutions to this problem more linked with better communication (though it’s honestly the point where I think sex signifiers are actually useful). Equally if we began to remove gendered society whereby the question “are you male/man or female/woman” ONLY had connection to genitalia, surely this would remove the stigma attached to relationships which are such that an individual’s sexual identity is strongly challenged. A transgender individual would no longer be identified as the wrong gender to appease the sexuality of their partner, but rather seen as an individual with the genitalia preference of that partner and no further questions asked.

    Is not the current direction of society meant to be towards the removal of gender, is what I’m getting at? This is ultimately a purely social construct built on social norms expected of the binaries – why is it not the case that we are trying to eliminate this for the sake of defining our identities completely independently from genitalia?

    Granted, I know very little about transgenderism so I’m here to read and be educated. This is just where I’m at, because to me sex is about as important as ethnicity for defining identity in my opinion. I don’t know someone based on their appearance but based on what they do, say and feel. I can’t understand this need we have to try and make this an “us versus them” argument all the time – society still uses labels but we should be pushing to remove them, not add more. The need to physically alter bodies for the sake of conforming to gender identities seems the wrong way around the subject in my opinion. Surely the social idea of gender identity needs to move, rather than sex?


  17. also, perhaps this is more good reason why an animal should be “an it” grammaticly speeking, animals are it’s.

    animal rights fur parents want that changed.
    I will tell them they are being cisnormitive and trans and intersex phobic when they want that changed. i keep trying to do the oppsite, “my window had a yellow jacket traped there, i killed it” “wait no, if that wasp wasn’t a drone, the wasp is a she, I killed her”.

    “i can clearly see the sexual dimorphism in this bird, but grammaticly speeking and the fact the species lacks the self awarness and ego, i will rerember the bird is an it, the peacock is an it, not a he or him”


    • personally i think animals should be called “they”, since they are feeling beings and but dont really have gender (in accordance to the human concept of it). “it” refers to objects and you would (or should) never call a person an “it”.


  18. Denying the existence of the sexes will get you absolutely nowhere. It’s not only about genitals, it’s about entire organs and the whole hormonal system. I am a woman. I went through puberty phases that slowly gave me my adult body, with all its functions. I don’t only have a vulva, and a vagina, I also have a uterus that will maybe one day carry a child. A huge part of my life experience have been determined by those physical characteristics. I was raised to match a gender that was created around those characteristics, and my ability to bear a child.
    If a man feels uncomfortable with his body and believes he would feel better as a woman, I am ok with it. But in order to feel right he cannot rob me, and all the other women and girls, from the reality of my body and all the experiences related to it.
    If the outside characteristics of the female body weren’t important, why would so many trans women castrate themselves, have breast implants and hormonal therapy to look the closest possible to a biological woman? Why do so many trans women over match the female gender?


    • I’m not a trans woman so I cant really comment on the things you bring up and there are a lot of different reasons people transition that would require a separate article.

      Because so many of the physical traits you describe (genitals, puberty, ability to carry a child) are also experienced by trans MEN (i.e. people who were assigned female at birth and identify as men) and nonbinary trans people, none of the things you describe as a cis female are female-exclusive experiences, since they are also experienced by people who are not women.

      There are also many women who will never have those experiences, and are they less of a woman because of that? What of women who are infertile? Or women who are born without a uterus or without vulva? Do you consider them not to be women because their physical experience differs from yours? This is not exclusive to trans women, biological-essentialist ideas of gender and sex also effects cisgender women quite a bit.

      You are fine to perceive these things as being integrally linked to YOUR gender identity as a woman, but if you are trying to restrict how other people identify and relate to THEIR bodies (specifically trans people and apparently also people with different physiology and hormones than you) then it is YOU robbing other people of the reality of their bodies and the experiences related to them. No one is attempting to do that to you.


  19. As a nurse, I’m coming to feel that biological sex is not a particularly useful construct. Gender identity frequently correlates with having particular organs, but sometimes does not. At the GLMA conference last year, I learned about a group in the Midwest of the U.S. whose clinic records are set up to capture sex assigned at birth, gender identity, and legal sex (to prepare for problems such as insurance companies rejecting claims because the box ticked on their end (e.g. male) doesn’t match the service provided (e.g. PAP smear). Plans/wishes for future upgrades to their system include an organ inventory that would apply to all patients. (Seriously, I’ve had a patient with dementia complaining of pain consistent with gallstones, and she sure couldn’t tell me if she still even had a gallbladder, but a system like that would make it me likely I could find the info before calling the doctor).

    So that got me thinking. What if in some perfect world we could say at birth, “With this set of visible organs, it is highly probable this person will identify as male/female” and hey, have an option for when it isn’t visibly obvious that doesn’t require swishing someone into a constructed binary. And then just … go with it. Know that if the gender assignment didn’t fit, that was always a possibility, however small, and … go with it. And on the health side, don’t assume that gender tells you all that much about someone’s anatomy or physiology. Take that info in the history and just ditch the value judgments that currently exist around whether a person’s anatomy matches the gender identity that most frequently goes with that anatomy.

    In other words, rather than saying they are the same, I’d rather ditch the concept of biological sex as being in any way really useful.

    Liked by 2 people

    • But much of what you’ve talked about is in fact biological sex. I have a prostate and boobs that need to be checked periodically. You’re speaking of clinical reminders that don’t perhaps show up in a system due to a lack of categories beyond male or female. M or F. Most here are not talking about gender, which has to do with your psychology, but instead a discrimination based on a person’s physical make up and labeling it gender. Most don’t understand what gender itself is, but I can teach you. It’s actually very easy.


      • Well, what I’m saying, though, is that these things may not be useful to classify under the heading of “biological sex.” They are biological things. Yes, people born with certain parts tend to also have certain other parts, but that’s just a probability statement, and that probability is not 100%.

        I mentioned that system of clinical reminders because the fact that it is somehow groundbreaking (and takes a fair bit of re-engineering) to look at what parts a person actually has instead of making clinical assumptions based on what someone said in the first few seconds after they were born is actually kind of ludicrous. So my (unanswerable at the moment) question is what would happen if we did away with the construct of biological sex and simply looked at bodies with parts as bodies with parts. What would that do to the parallel construct of gender? If everybody just has bodies with parts that sometimes correlate with other parts and sometimes don’t, and those combinations sometimes correlate with certain social roles and sometimes don’t, and those combinations sometimes correlate with certain personality traits and sometimes don’t … then I think the world ends up a very different place. A better one, I’d like to think.

        Is that going to happen? Not in my lifetime, I’m sure. So I’m not sure how helpful it is to even go there. But I’m agreeing with OP that the idea that biological sex is immutable while gender is mutable is problematic, just taking a different angle as to why.

        How does this impact Trans 101 training? That’s a more immediately practical question. Last summer, I taught a course in gender and sexual minority health for nurses, and I did use the sex=biology/gender=psychology model when introducing transgender health. I was hugely disappointed to get a paper 2/3 of the way through the course from a student who had somehow taken away some very biological-essentialist ideas (stated as fact, not opinion) from that. Clearly, at least for that nurse, that model had only entrenched already-held ideas further. I’m sure she was shocked to receive comments that some of her statements were outright biologically false, which they were.

        I hadn’t done the class on intersex issues yet, and that class was what finally got the light to shine over this student’s head. As I’m preparing for this summer’s course, one thing I plan to do is take a “lifespan model” approach so that we start at birth and tackle this biological essentialist business in the delivery room, so to speak. But I’m still working out how to better approach teaching transgender issues without reinforcing damaging preconceptions. I’m open to suggestions, particularly from people who are transgender.

        Liked by 1 person

      • I would like to share with you two resources then. I’m responsible for the creation of both of them. The first a link to my book and the second a link to my website. I’ll be giving a two hour seminar at a NY state college this month with others scheduled. I gave several seminars last year. Use what you like and feel free to contact me. It’s all for education.


      • To clarify my complaint, Erica, the item that the link claims “is” gender is just something that is **gendered**. What makes it more definitive of gender than any other gendered thing? It seems more plausible that gender “is” the entire system by which any of these items gets to be gendered in the first place.

        Liked by 1 person

  20. Hi Lane,
    I appreciate your anger against transphobia and the way that ideas about binary sex are oppressive. But I’m one of those people teaching other people that sex and gender are different. And I believe this understanding is useful and I’ll tell you why. Also, I am a transgender and genderqueer person as well as a sociologist.

    My working definition of sex is: the physiological attributes we believe to be related to sex and the social meanings we make of them. The physiological attributes we currently believe are related to sex are external genitalia, reproductive organs, secondary sex characteristics, chromosomes and hormones. These understandings change over time and across space. The categories we have to describe sex in the US right now are female, male, and intersex.

    My working definition of gender is: the social meanings attached to the binary sex categories of female and male as well as newer ideas, beliefs and understandings of gender outside this binary. Gender is an individual attribute, a process of interactional “doing” and an important social institution that helps to create inequality like class and race. Gender categories include: woman/man, girl/boy, masculine/feminine, transgender, genderqueer, genderfluid and many others.

    All of these categories are socially constructed. As you point out, all concepts are socially constructed. Given that, should we not differentiate between the concept of “table” and the concept of “waterfall”? It is useful for us to differentiate between concepts even given that they are all socially constructed.

    Sex and gender are different but that does not make them “unrelated.” The fact that sex is biological in part does not make it immutable. This stems from the idea that biology is “hardwired.” But nothing is more mutable than our human bodies.

    Physical tissues exist both through nature and through human design. Human design has an impact on our bodies. Our physical and social experiences impact our bodies in direct and indirect ways. Our activity, what we eat, etc. influences our bodies. Our direct inscription of religious and cultural practices (which are often gendered, raced, and classed) on the body such as body piercing, circumcision, and breast augmentation and reduction both impact our bodies and impact our cultural beliefs and expectations about bodies and possibilities for sex and gender.

    Although female and male made indicate “unchangeingness” to the average person, the fact that our bodies go through huge changes on a daily/momentary basis is an empirical fact. Our hormone levels, the size of our external genitalia, and everything else that we currently socially construct to indicate biological sex except for our genes is constantly changing. And the way our genes express themselves changes based on the physical and social experiences of the individual person. Biology has a great deal to teach us about the diversity that exists empirically but which our culture refuses to acknowledge and celebrate.

    Sex can exist independently of gender but does not tend to currently. Our beliefs about gender impact every aspect of our understanding of sex. But see Joan Roughgarden’s writing on the sex-based size of gametes that is independent of gender in the book “Evolution’s Rainbow.”

    The fact that cis people (and trans people for that matter) don’t always understand both the differences and overlaps between sex and gender does not mean it is not conceptually useful to differentiate the two. It means we have to educate people.

    Concepts can be used to reinforce hatred, fear, and pathologization but do not do so in and of themselves. And unlike guns which exist to damage the body, the concept of sex is actually very useful in understanding biology, biology’s intersection with the social, and the social institution of gender.

    Molecular biologists are beginning to understand that sex is just like race in the sense that we create social, biological, and medical categories that appear to be based on biological differences. The truth is that the within group differences are greater than the between group differences. So there are greater biological differences within the group we call “Asian” than there are between “Asians” and “Blacks.” The same is true for the categories of “female” and “male.” And these same molecular biologists are asking medical doctors and the rest of us to understand that sex is not in any way binary, especially given the possibilities that intersex people bring to the sex table.

    When we treat sex as binary it does quickly fall apart both empirically and conceptually. What about when we don’t treat it as a binary? What use might it have then?

    Liked by 1 person

    • my problem is specifically with the binary. although i appreciate your well thought-out statement, i think you might have missed the primary intention of this piece, which was simply combatting the idea that trans people should be medically categorized in alignment with their birth-assigned sex “for health reasons”, and how differing to someone’s sex assignment (rather than present reality of their bodies and identities) reinforces transphobic violence and results in medical mistreatment.

      Also it is my personal belief that, since as you agree that the binary categories of sex are flawed, it would be more useful to inventory people’s anatomy (organs, primary active hormones, etc.) than to use a misguiding shorthand. although granted this does not have the same time-saving benefits, it would potentially have huge benefits in the comprehensive treatment of trans and intersex people. However i am far less concerned about the impact of sex categorization on dyadic cisgender people since they do not have the same oppressive interactions with that categorization. I just believe that, in the interests of promoting comprehensive treatment as well as complete social integration of trans people, they should be medically classified in the category they identify with (be it male, female, or other) with notes as to their specific physiology (as would be useful for any non-dyadic or non-cisgender person anyway). classifying a trans person by their assigned gender instead results in false assumptions about their physiology (in the same way some would argue identity-based classification might) but also has the additional detriment of promoting stigmatization.

      That and, in many countries (including canada) a person can change their legal sex without medical intervention anyway, and so the medical categories are meaningless outside of identity, and attempts at gatekeeping them are pointless.

      It would also be worth noting that “intersex” is not a legally recognized sex in the US or Canada. All intersex people will be classified as either M or F in these countries, and often intersex medical history is buried or kept from the people themselves by their parents or their doctors, and doctors often aren’t even aware that their patient is intersex. Doctors also have a very outdated and misinformed idea of what the term “intersex” even means, so i do not place much importance on what a non-intersex doctor would have to say about what is and isn’t “intersex”

      Liked by 1 person

      • I did get your message, you argued it well. And I agree. I just don’t think conflating the concepts of sex and gender will achieve your and my goals of providing the best possible healthcare for transpeople and creating a non-binary world. And viva la difference!.

        Liked by 1 person

  21. I work in a hospital in Norway. There I help patients who go in, operate and leave on the same day. Anyway, there are lists, of names, date of birth, height and weight, and gender. There is a sign for male and female, in blue and pink. Those are the only two options.

    So I asked a more experienced co-worker what it would say on the list if a patient was transegender. And apparently, it would still be the gender they were born with. The reason for it being so was because certain infections or diseases affect certain genders. And even though that is true, as you mentioned Lane, it is very very few of those.

    It felt wrong to me that it would say that the patient was male on their documents, for example. and when I came to meet them they would present as female. Now that has never happened, and my experienced co-worker said it had never happened while they had worked there. But it can happen. I let the topic go.

    I have started thinking about intersex people. I don’t know what is usual for doctors to say or do if a child is born intersex, surgically that is. But it is not something I have ever heard anyone talk about, so it is taboo at least. What then, if an intersex patients with either ambiguous genitalia or has characteristics of both, is to be operated on. Will they be assigned something at random? Or will their gender then be measured somehow, maybe over either or not they have ovaries and if they function? Maybe they have genitalia that can be able to penetrate something? Or maybe based on the individual’s gender identity? If the last one was so, binary transgenders would get be given the option, but intersex would. Now, I don’t have the answer for these questions myself, I might ask someday,

    Just wanted to let you know how shit is in this world. I believe it is very fucked up indeed.

    P.S: I am non-binary and think the things you do for the non-binary community is top notch!! Thank you!!

    Liked by 1 person

  22. Pingback: Le sexe et le genre sont en fait la même chose (mais ne partez pas si vite) | Furie Gélatine·

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