On the surface these two terms seem to be the same and, for many people, are interchangeable. For some, however, they most definitely are not the same, especially when used in day to day language. I am one of those people for whom the language surrounding these two terms is important and I hope to be able to explain my reasons why in this short piece.
The language of the profession and, indeed, the legal use of these terms is confusing and, in my view, inconsistent. Let’s start with the easy one – SEX (not sexuality or sexual preference for a partner). Sex is biological and is largely determined by our physical appearance at birth, chromosomes and hormones. I am writing this on the basis of there being two sexes in society although I am aware of intersexed and other medical conditions which may oppose these considerations. I do understand the special nature of these cases but will ignore them for this necessarily brief review. In simple terms, a person’s sex is determined by what lies between their legs and is easily identifiable at birth as either boy or girl. The midwife usually makes this initial distinction and that is what is put on the birth certificate as the sex of the child. Well actually it’s not: M or F for male or female is what is written in this legal document and this is where it starts to get confusing.
A child’s GENDER is initially assigned to it at birth by parents and the medical profession, in order to conform to society’s norms. The child has no say in this. The most obvious interpretation of this is the classic way in which a boy (i.e. the sex) is identified as male and is given blue clothing; and the girl is treated as female and is dressed in pink. The child is then brought up in the gender role that society expects which, in most cases, will not present any difficulties. Gender is culturally driven, though, and differs from country to country, depending on the requirements of the society in which the child is being raised. So, for example, a boy or girl in Woking will be brought up with differing gender role requirements when compared to a boy or girl from the Brazilian rainforest; the sex of the two boys and the sex of the two girls remains the same irrespective of location.
As the child develops and comes into its own ‘gender awareness’ it may find that the role in which it is being brought up does not match how it actually feels. So, a boy being brought up in the typical male gender role may, in fact, feel that he really should be a girl and should be brought up in the female gender role. This is the beginning of Gender Dysphoria (the opposite of Euphoria) – a dissatisfaction and unhappiness with the gender in which a person is growing up. I must stress that this can change as the child develops and grows to maturity. The gender role may return to that which was assigned at birth, and often does, and the child grows up appropriately, although the sexuality of the child may be at variance to the heterosexual norm. However this is not always the case and the Dysphoria increases until the person seeks medical help.
In these relatively rare cases the person is so convinced that she or he has grown up in the ‘wrong’ gender role that the wish to live in the preferred gender role becomes overwhelming. This ‘new’ gender role, which is opposite to the assigned gender role given at birth, is then referred to as the acquired gender.
With appropriate medical and counselling help a Gender Dysphoric person can learn to live in the acquired gender role and, in the most serious cases, will seek Sex Reassignment Surgery (more recently referred to as Gender Affirmation Surgery).This surgery enables the physical appearance, or sex, to match, as closely as possible, the personal internal Gender Identity of the individual .
So SEX is a ‘fixed’ binary situation (for the purpose of this brief review) based on physical make up and appearance and is described as either Boy or Girl and therefore Man or Woman in adulthood. It is determined by the physical appearance of a baby at birth: penis = boy, vagina = girl.
Gender is determined by culture and the expectation of society at large; this varies worldwide. A gender dysphoric person is likely to seek to change their gender role as they grow into maturity. The changes can be identified as follows:
Assigned Gender: Given at birth and based on the physical appearance (the sex) of the baby who has no say in the matter.
Gender Identity: How a person actually ‘feels’ and how he or she fits into society, based on the Gender Roles and culture within which he or she lives. This may be incongruent and lead to Gender Dysphoria.
Acquired Gender: The gender in which a person chooses to live, in order to feel at ease with themselves, no matter what society may think. This will be different to the gender assigned at birth. It may also include sex reassignment surgery such that the acquired gender and physical appearance match.
Gender Dysphoria is a complex condition and when gender and sex match at birth there is very little need to consider the alternatives. When they don’t match the person suffers deep unhappiness and depression, which then requires medical intervention and counselling to resolve although Sex Reassignment Surgery is not always the ultimate goal.
I will reiterate that this is my personal viewpoint and, although the general definitions of sex and gender are in accordance with current professional thinking, the terminology used by society at large is not always consistent.