Gender vs. sex, and why they matter in health care

  • JaNelle Ricks, DrPH, MPA
June 3, 2022
Queer couple laughing

When asked to help people understand the difference between gender and sex, I often start by explaining that sex is what’s between your legs and gender is what’s between your ears.

So, when we talk about sex, we’re referring to our anatomical and physical traits, primarily genitalia. This is sometimes referred to as “sex assigned at birth” and is the sex that appears on a birth certificate.

When we talk about gender, we’re referring to the way we understand and perceive ourselves. For example, if I’m born with male genitalia, and I’m assigned male sex at birth, but I view myself as female and feel female, then my gender identity is female. That’s what I believe myself to be.

Sexual and gender minorities

The terms “sexual minorities” and “gender minorities” are often used interchangeably. But they represent two distinct groups, and someone can fall into one or both demographics.

Sexual minorities are people whose sexual identity falls outside the more prominent straight/heterosexual identity and instead identify as gay/homosexual or bisexual, or some other sexual identity.

Gender minorities are people who identify as something other than male or female, such as gender nonconforming or gender nonbinary. People also fall into this demographic if there is misalignment between sex assigned at birth and gender identity. This would specifically include individuals who are transgender — people who were assigned the male sex at birth but identify as female and people who were assigned the female sex at birth but identify as male.

Common terminology for sexuality and gender

Terminology is continually evolving when it comes to the various points along the gender identity and sexual identity spectrums, and it’s important that we choose the terms used to describe ourselves.

Some of the more widely used terms to describe sexual minorities are gaylesbian and bisexualQueer is more of an umbrella term that might be chosen by people in both sexual and gender minorities. Two-spirited also walks the line between sexual and gender minorities and is specific to indigenous populations.

Questioning refers to someone who is uncertain about where they fall on the gender spectrum and/or sexual identity spectrum. They may have some feelings or attractions or behaviors that they want to explore.

One of the more visible gender minority identities is transgender, which refers to people who view themselves differently from the sex they were assigned at birth. Gender nonconforming and gender nonbinary refer to those who don’t identify as male or female but fall somewhere else on the gender spectrum. Cisgender is a term for someone whose gender identity matches the sex assigned at birth.

An individual experience

Determining one’s own sexual and gender identities is a very individualistic experience. For some, it can be a long, ongoing process, while others are confident and certain very early in life. For those who struggle, being comfortable and identifying as they truly see themselves can be a years- or decades-long process.

Read more on Ohio State Health & Discovery >>

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About The Ohio State University College of Public Health

The Ohio State University College of Public Health is a leader in educating students, creating new knowledge through research, and improving the livelihoods and well-being of people in Ohio and beyond.  The College's divisions include biostatistics, environmental health sciences, epidemiology, health behavior and health promotion, and health services management and policy.   It is ranked 19th among all colleges of public health in the U.S. by U.S. News and World Report, and also includes the top 7-ranked MHA degree program.  The College provides leadership and expertise for Ohio and the world through its Center for Health Outcomes and Policy Evaluation Studies (HOPES) and Center for Public Health Practice (CPHP).