Contributors:Zachary Kevorkian, MSMI, Michael Carrese, Evan Debevec-McKenney, Maria Emfietzoglou, MD
Traditionally, one’s assigned sex at birth is their biological sex which depend on their sex chromosomes.
If they have a Y chromosome, their biological sex is male. If they have 2 X chromosomes, their biological sex is female. However, things aren’t that simple.
For example, a person could have a Y chromosome but they’re missing specific genes that encode for specific male characteristics, so even though they’re chromosomally male, they appear as what is stereotypically described as female.
So you’re thinking biological sex can be linked back to genes, right? Well, things get even more complicated than that. Some genes get expressed at high levels, and others at low levels.
Finally, hormones like testosterone, estrogen, and progesterone bind to receptors, and some people may have lots of receptors that can easily bind to hormones, whereas others may have very few receptors.
In many cases, these people are intersex individuals whose bodies do not fit into the standard definition of male or female.
The bottom line is that biology is messy, and like most things, biological sex exists on a spectrum. Now, separate from the biological construct of sex, is gender identity and gender expression.
Gender identity is a person’s own sense of their gender and gender expression is how they present themselves to the world.
Many people identify as either man or woman. But there are also various types of non-binary gender, or gender identites that lie outside of the man-woman dichotomy.
For example, someone could identify with multiple genders, such as Native or indigenous Two-Spirits do.
Furthermore, some will identify with a gender that’s neither man nor woman, while others may have a more fluid gender identity.
Some individuals identify themselves as transgender, when their gender identity is discordant from the sex assigned at birth.
Meanwhile, there are people who identify as agender who don’t feel any of these labels describe them or don’t like the idea of identifying with a specific gender at all.
Neither biological sex nor gender identity determines a person’s sexual orientation. This concerns what gender or genders an individual is sexually and/or romantically attracted to.
An individual can be heterosexual, which means they‘re attracted to a different gender, or they’re attracted to the same gender, and the preferred term is “gay,” not “homosexual”.
An individual can also be bisexual, meaning attracted to two or more genders, or pansexual, meaning that they are attracted to any gender. Some people identify as asexual, where they may not experience sexual attraction to anyone.
Finally, terminology continues to change and evolve, and the words that people use to describe their sexual orientation is ever-changing and evolving as well.
Now, depending on their gender identity, any person can choose the pronouns that suit them the best. Commonly used pronouns include he/him/his or she/her/hers.