Excerpt from Sexuality: Gender Identity

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Gender identity and gender role

Gender identity is defined as a personal conception of oneself as male or female (or rarely, both or neither). It is intimately related to the idea of gender role, which is defined as the outward manifestations of personality that reflect the gender identity. Simply put, gender identity is a self-label; gender role is a label given by society because of behavior and appearance. For example, if a person thinks of himself as a male and identifies himself as such, then his gender identity is male. However, his gender role is male only if he demonstrates typically male characteristics in behavior, dress, and/or mannerisms. These are outward expressions of his gender identity. In most individuals, congruity is present between gender identity and gender role. Assessing the acquisition of this congruity, or recognizing incongruity (resulting in gender-variant behavior), is important in the developing child.

In order to understand gender identity development and related issues, definitions must be emphasized for clarity. The topic of gender identity is often discussed merely in terms of dysfunction, and the diagnosis of gender identity disorder is a known phenomenon in both children and adults. However, physicians should remember that all individuals possess a gender identity and that the process of becoming aware of it is an important part of the psychosocial development of a child. Understanding the varied pathways that lead to a mature gender role is necessary to fully assess a person's behavioral health.

Sex and gender

The 2 terms sex and gender are often used interchangeably in the vernacular. However, in a medical and technically scientific sense, these words are not synonymous. Increasingly, the term gender is being accepted by physicians, psychologists, anthropologists, physiologists, and social scientists. Sex, from the Latin word sexus, is defined by the gonads, or potential gonads, either phenotypically or genotypically. It is generally assigned at birth by external genital appearance.

If an intersex condition is present, one sex is often chosen with the intention of making social interactions and rearing simpler. Gender comes from the Latin word genus, meaning kind or race. It is defined by one's own identification as male, female, or intersex; gender may also be based on legal status, social interactions, public persona, personal experiences, and psychologic setting. Stating that sex is biologically determined, whereas gender is culturally determined, is fair.

A person's sex is a primary state of anatomic or physiologic parameters. A person's gender is a conclusion reached in a broad sense when individual gender identity and gender role are expressed. An often-used phrase to point out the difference, while an oversimplification, has some merit when dealing with these definitions: sexual identity is in the perineum; gender identity is in the cerebrum. Increasingly, the more subjective sense of gender identity takes precedence in evaluating patient needs. In those instances where a discrepancy exists between sex and gender, compassion and empathy are essential to foster better understanding and an appropriate relationship between the physician and the patient.

Note that just as gender and sex are not interchangeable terms, neither are gender development and sexual development interchangeable. Physiologic sexual development progresses through distinct stages from the neonatal period through infancy, childhood, puberty and adolescence, and adulthood. Such physiologic change is distinguishable from gender-related behaviors during each of these stages. The sexual identity that emerges beyond childhood is very clearly a separate entity from gender identity. Aspects of physical sexual growth, eroticism, and eventual sexuality, although closely related to gender, should not necessarily be used to draw conclusions about a patient's gender definitions.

Please click here to view the full topic text: Sexuality: Gender Identity