I Am Confused. What Is the Difference Between Sex, Gender, and Sexual Orientation?

As a psychologist it has been imperative that I understand the differences between sex, gender, and sexual orientation, and it is always important to not make any assumptions about these three when meeting a new client. However, I have made the mistake of taking for granted that most people understand the differences between these three terms and I have learned that many people do not. Oftentimes, not having an understanding of the meanings of these words can lead to misperceptions and discrimination against people who do not fit into a completely binary understanding of sex, sexuality, and gender. So lets spread some knowledge and if you already know this information, share it with someone who may not. 

Sex, Gender, & Sexual Orientation.

Sex is defined according to the genitalia that you are born with, your reproductive organs, and your chromosomal makeup. Historically people would be categorized into two sexes, male and female. However, we now know that sex is significantly more complicated than that, and that there are people who do not so neatly fall into one or the other category. One such group of people are people who are called Intersex. People who are Intersex can have both characteristics of male and female genitalia. Additionally, there are people who may have genitalia that do not match their reproductive organs. For example, when a person has a vagina but rather than having ovaries, this person has testes that lay inside the pelvic region. This is called Androgen Insensitivity Syndrome. There are multiple other variations of sex as well. In the not so distant past, anything that fell outside of the binary male and female was called pathological. However, scientists now understand that rather than being pathological, they are just naturally occurring variations in sex.

Gender includes a person's gender identity and a person's gender expression. Gender is not the same thing as sex bur rather is the term for how a person feels about who they are and how they express who they are. Do they feel like a woman or a man or neither or both or another gender, and how does a person express this? A common misconception is that what a person's biological sex is should be consistent with what their gender is, and historically gender has also fallen into binary categories of male and female. However, this is not always the case. In order to further explain this, we must understand what gender identity and gender expression are.

Gender identity is how a person feels with respects to the sex that they were born with. For example, a person may be born with the sexual genitalia and organs of a female and may feel like a female, but this may not necessarily always be the case. This person may have female genitalia and organs but may feel like a male instead.  Additionally, another misconception is that sex is biologically determined while gender identity is a choice. This incorrect assumption contributed to insurance companies denying coverage for certain surgeries and hormonal treatments for people who felt that their sex was inconsistent with their gender. A faulty argument was made that people are simply choosing to want to be a gender that is not consistent with their biological sex. However, there is now ample research demonstrating a biologic basis for how people feel about their gender identity, and there is evidence supporting the reality that having a different sex than what you feel your gender is can result in extreme dysphoria and can significantly impact one's mental health and quality of life. Luckily as a result of these current studies, more people are able to receive the treatments that they need.

Gender expression is the way in which a person feels most comfortable at a given time expressing their gender. There are countless variations of gender expression as people are all individuals and are dealing with different circumstances at different times of their lives. For example a person who is a transmale, meaning that this person was born with female sex but identifies with being a male, may express his gender by dressing like a male or maybe not, or maybe it varies depending on multiple factors. This goes beyond being a choice for the sake of just making a choice, but is an expression of how the person feels most like themselves, has the most mental clarity and well-being, and feels most consistent with who they are. 


Lastly, it is important to familiarize yourself with the current language used to understand gender. When describing a person whose sex and gender are the same, we use the word cis. A cis female is a woman born with female sex and whose gender is female. If this person was born of male sex but whose gender was female then we would use the word trans to describe her. Further it is important to know what pronouns the person feels most comfortable using for themselves. For example, a transfemale may wish to be called "she" or maybe "they." Never make an assumption and please respect a person's wishes. 

Another assumption to avoid is that knowing that a person is gender non conforming means something about their sexual orientation. This is not the case and sexual orientation and gender identity and expression are very different things. Let's discuss.

Sexual Orientation is what a person's preference for a sexual partner is. It is unrelated to sex or gender. A person who is attracted to the opposite sex is called heterosexual while a person attracted to the same sex is called homosexual, although people of younger generations may prefer the words gay or queer. People attracted to both male and female sex are called bisexual. People attracted to nobody are asexual. There is also a group of people who are pansexual which means they can be attracted to anyone regardless of sex and gender configuration.

A person who is trans and is attracted to people of the opposite gender is not gay. For example, a transfemale was born with male sex organs but is female gender. This transfemale may be attracted to people who are born male and identify as male. She is not gay because she is a woman despite being born with male organs. Trans people could be gay but just because a person is trans does not necessarily mean that they are gay.

Additionally people can have sexual desire and attraction to people of multiple genders or sexes, but may only feel romantic attraction to one sex or gender. Again, just like with gender, sexual orientation can have many variations, and it is crucial to never make assumptions but rather to simply ask. 

This brief summary of considerations regarding sex, gender, and sexual orientation does not do justice to the complexity of these three aspects of humanity. It is incomplete and there is a lot more to think about. Ultimately however, we are talking about humanity and the beautiful uniqueness of each individual human being. 

If you have or are currently struggling with feelings around your sexual identity, gender identity or sexual orientation, and would like some help with exploring them, please reach out for a consultation. If you have experienced discrimination as a result of your sexual identity, gender identity or sexual orientation, which has impacted your functioning and/or well-being, please reach out for a consultation.