Sex vs. Gender (Part Two)

To read Part One about biological sex, click here. 


Gender is a social construct, created largely by stereotypes of what is “feminine” and what is “masculine.” In our society, being feminine is usually synonymous with being sensitive, caring, and demure. Traditional feminine appearance includes dresses, high heels, and make-up. Masculinity, on the other hand, is measured in strength, ambition, and confidence. Masculine physical appearance includes a muscular build, facial hair, and tuxedos. Of course, this is a very simplified description of the gender ideals that exist, but most of us become well aware of them from a very early age. We quickly absorb messages about what toys are acceptable (trucks for boys/dolls for girls) and how we’re supposed to act (being ladylike/manning up).

Contrary to what many people believe, a person’s gender does not depend on their physical sex. Rather, gender is how a person identifies and expresses themselves. It is only because we live in a society that has a strong gender binary that we automatically assume a person born with a penis will identify with mostly masculine traits, while a person born with a vagina will associate with mostly feminine traits. When this is the case, and sex and gender do match, a person can be described as being a cisgender male or a cisgender female. (In Latin, “cis” means “on this side of.”)

When a person identifies as the “opposite sex” that person can be described as a transgender, or trans, individual. (In Latin, “trans” means “on the other side of.”) We often hear the phrase “born in the wrong body,” as that is how strongly many individuals in the trans community feel about their gender identity. For example, a person with a penis could identify as female and be a trans woman, while a person with a vagina could identify as male and be a trans man. (It’s important to remember that “transitioning,” or deciding to live as the gender that one identifies with, is not a “one size fits all” process. Some change their name and wardrobe, others may take hormones and have surgery. This is an individual’s personal choice and despite what some TV talk show hosts would lead you to believe, what’s under someone’s clothes is no one’s business.)

For a lot of people, both cis and transgender identities are fairly easy to understand: You either feel like a man or you feel like a woman. But what if you feel like neither — or maybe both? Earlier this year, Facebook began to allow a much wider range of gender options (at least 58, to be precise). Many of them were terms that people were unfamiliar with, as they challenge the idea that an individual has to be male OR female.

Here is a small sample, highlighting some of the most basic terms used to describe non-binary options. (Remember that because gender is a societal construct, these distinctions are labels that we have created to describe how someone subjectively defines their experience with gender.)  

Agender is used when someone has a complete lack of gender. Other terms may be “genderless” or “gender neutral.”

On the other hand, bigender individuals consider themselves both male and female. Their gender identity and/or expression may be fixed so that they experience both genders at the same time, or they may be gender fluid, where their gender changes or fluctuates over time. (Similarly, but more inclusive, pangender individuals identify as all genders, including the non-binary ones.)

Gender Nonconforming is a term that is used to describe someone who may primarily identify as one gender (man or woman) but does not abide by the stereotypical expressions for that gender. I would argue that many of us are gender nonconforming in some way as very few people follow societal stereotypes 100%. However, for a more clear-cut example,  consider a self-identified woman with short hair and men’s clothing or a self-identified man wearing make-up. Because of society’s gender standards, these people would be seen as not conforming to their gender in fairly obvious ways.

When a person is unsure of their gender, they may decide to identify as gender questioning. During this time, a person may experiment with different ways to express their gender by altering their appearance and/or behavior — or they may simply be inwardly considering which gender feels most true to their personality.

Finally, genderqueer is an umbrella term that is used to describe anyone who challenges the man/woman gender binary. This term is growing in popularity, especially by the younger generation who wishes to reclaim the word “queer” and give it a positive connotation.

Sex & gender are commonly considered to be some of the most straightforward characteristics about a person. However, as you can see, society’s insistence that everyone is strictly “male” or “female” ignores the more nuanced way that many people define themselves. As potential doctors, teachers, co-workers, family members, friends, or romantic partners of individuals who do not fit into the gender binary, it’s important to recognize that sex & gender are not always as simple as we’ve been led to believe.

Education can be a powerful first step in creating change because it challenges false beliefs in a rather objective, logical, and emotionally-removed way. But what more can be done in our daily lives?

Stand up against discrimination or hate when you see it. Refuse to accept behavior that makes a “freak” out of someone, whether that behavior is quietly staring or publicly asking about someone’s genitals. Remain aware that a person’s preferred name may not match their legal name and their preferred pronoun may not match the pronoun you might automatically assign to them. Remember that it’s always okay to ask what a person prefers, and when that’s not possible, aim for gender neutral language. (Changing your language can sometimes be difficult, but I’ve learned that most people are very understanding as long as honest effort is being made.)

In the end, it all boils down to one little word: Respect.

Sex vs. Gender (Part One)

For many people, the words “sex” and “gender” are interchangeable. Scientifically, they are very different and much more complex than many people are aware of. Despite what public restrooms would lead us to believe, we simply cannot categorize people into two neat little boxes. A person’s gender and sex may or may not match. And, as we learned with sexual orientation, binaries (though socially ingrained) are much too restrictive for what occurs in reality.

Being aware of the possible variety in sex and gender not only allows us to better understand and express ourselves, but it also helps us to understand and empathize with others. The stories of transgender individuals like Brandon TeenaTyra Hunter, and Larry King prove to us that confusion, fear, and hatred all too often lead to death. Education on the matter is crucial for our society to live in harmony.


Sex is all about physical and biological characteristics: chromosomes, hormones, genital anatomy, etc. Before a child is even born, the focus is on one question: “Is it a boy or a girl?” Although people may assume that this answer will give them clues as to the gender of the developing child, it’s really a question of sex. We assign individuals with XX sex chromosomes, ovaries, and vulvovaginal genitalia to the female group. Those with XY chromosomes, testes, and a penis comprise the male group. But what happens when determining a person’s sex is not so black and white?

Individuals whose sexual characteristics do not match what our society (and medical professionals) consider “typical” can be described as intersex. According to the Intersex Society of North America (ISNA), approximately 1 in 100 babies are born with bodies that “differ from standard male or female.”These differences can be visible at birth, make themselves known at puberty, or go unnoticed for a lifetime. They can be externally visible or internally hidden.

Not everyone agrees on what conditions qualify as “intersex,” but here’s a basic rundown of what sometimes gets included:

Klinefelter Syndrome occurs when a child who exhibits anatomically male traits is born with an extra X chromosome (XXY). This usually becomes noticeable at puberty, as individuals with Klinefelter Syndrome produce less testosterone. Physical traits may include less body or facial hair, less muscle mass, smaller testicles, and increased breast tissue. Infertility or reduced fertility is also likely.

Turner Syndrome occurs when a child who exhibits anatomically female traits is born with only one X chromosome. In addition to a short stature and other physical differences, Turner Syndrome can cause underdeveloped ovaries, resulting in the absence of menstruation and infertility.

Swyer Syndrome occurs when an individual with XY chromosomes has undeveloped gonads, or testes. Unable to produce testosterone and other hormones important for male development, the child is born anatomically female. However, during puberty, the lack of estrogen becomes noticeable in the absence of breast growth and menstruation.

Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH) occurs when the Müllerian duct fails to develop in an XX chromosome fetus. This can lead to the absence of a uterus, cervix, and/or vagina. If a vagina is present, it may be shorter than average and cause painful intercourse. This condition may be noticed during puberty if menstruation doesn’t begin.

Androgen Insensitivity Syndrome (AIS) is when a person’s body is unresponsive to androgens (hormones that are typically considered “male,” such as testosterone). This can occur at mild, partial, or complete levels. In individuals born with XX chromosomes, there is little noticeable difference. However, individuals born with XY chromosomes range in their genital appearance. In complete AIS, an individual externally resembles a female. However, they do not possess a uterus, fallopian tubes, or ovaries. (Their gonads are indeed testes, although they are likely undescended.) Again, this becomes noticeable at puberty with a lack of menstruation.

Congenital Adrenal Hyperplasia (CAH) causes the body to create masculinizing hormones when attempting to create cortisol. In individuals with XX chromosomes, this may lead to an enlarged clitoris (clitoromegaly) and shallow vagina, or in extreme cases, an average-sized penis. Increased facial & body hair, a deeper voice, and trouble with menstruation and fertility are also possible.

There are also external sexual differences for which we do not understand the cause or for which there may be several possible causes. For example, XY individuals can be born with aphallia (the absence of a penis) or what is controversially referred to as a “micropenis” (a penis that is at least 2.5 standard deviations below average). Both XY and XX individuals can also have gonadal tissue which contains properties of both testes and ovaries, for which the external appearance varies widely.

Historically, doctors would rush to perform genital surgery on newborns whose genitalia did not match their male or female ideal. An assigned sex would often be decided without regard to a person’s actual, biological makeup — and the procedure itself would be shrouded in secrecy. For example, a XY newborn with an atypically small penis may undergo complete castration of both the penis and testes. Doctors would advise parents to raise the child as a girl, and not to inform the child of their birth as a boy. (And you thought your teenaged years were confusing.) Today, groups like the ISNA advocate delaying medically unnecessary surgical procedures, so that the individual has the power of choice.

To read Part Two about gender, click here. 


Dear Hobby Lobby: Birth Control ≠ Abortion

Unless you’ve been living under a rock, you’ve probably heard about the Supreme Court’s ruling in favor of Hobby Lobby. Basically, they were granted religious freedom to deny their female employees insurance coverage on their full choice of birth control methods — specifically IUDs and emergency contraception, which they consider abortifacients. A lot of people (not just pro-choicers) are angry about this ruling. Many consider contraceptive accessibility very beneficial to both individuals and society as a whole. Others are angered over Hobby Lobby’s alleged hypocrisy of investing in the very companies that create the products they are against.

While I’m upset for several reasons, I’m most angered by the fact that a ruling like this upholds ignorance on matters of basic sex education and further perpetuates a confusion between birth control and abortion that is already too prevalent in our society. Although they have a belief that these forms of contraceptives are abortifacients, that does not make it true. In fact, there is strong research-based evidence that makes Hobby Lobby’s argument unsound. First, we have to take a look at how emergency contraception and IUDs actually work.

Emergency Contraception

Emergency contraception is commonly referred to as “the morning after pill” as well as the most popular brand name, Plan B. Other brands sold in the U.S. include Ella, Next Choice, and My Way. Many brands of daily oral contraceptives can also be used as emergency contraception when multiples are taken. (There is a fantastic chart here that shows how many pills of what brands can be taken in this way.) Basically, all methods act by releasing a large dose of synthetic progesterone into the body. Note that these pills should not be confused with Mifepristone, which can be used to induce a medication abortion. The “morning after pill” and “abortion pill” are two different medications, working at two very different times — one before pregnancy and one after. Emergency contraception does not have any effect if the woman is already pregnant.

To understand how a contraceptive method can work after intercourse, we first have to recognize that fertilization of an egg does not happen immediately. At the very least, the sperm have to find their way into the fallopian tubes to fertilize the egg (which can take a few hours). If ovulation/the release of an egg hasn’t yet occurred, the sperm may have to try to survive for a few days in waiting (7 days appears to be the longest observed time). This is the key to how emergency contraception works, and explains why it has to be taken quickly — usually within the first 72 hoursIf taken before ovulation occurs, the synthetic progesterone signals to the body not to release an egg, thereby preventing fertilization by keeping the sperm and egg separated.

The once-hypothesized idea that emergency contraceptives can provide a second barrier to pregnancy by preventing implantation is not being supported by scientific studies.Instead, what we are finding is that most, if not all, emergency contraceptives are not effective if ovulation has already occurred, meaning that they are not working at the level of implantation. The only brand that seems like it might alter the uterine lining (which is not to say that it necessary would inhibit implantation) is Ella, which uses a different form of synthetic progesterone than levonorgestrel.


Although all the details explaining how IUDs work have not been determined yet, we are discovering more as their popularity increases, more research is conducted, and they are better refined. (Being comparable to permanent sterilization in their effectiveness, but still remaining a temporary method, they offer a lot of promise for the fields of reproductive health & family planning.) What research shows is that just like all other methods of contraception, an IUD primarily works by preventing fertilization. Depending on the type of IUD (copper or hormonal), this can occur a number of ways. Copper appears to be a very effective spermicide, killing off sperm as they enter into the uterus, thus preventing them from reaching an egg that may be present in the fallopian tubes. Hormonal IUDs (which contain levonorgestrel) may prevent ovulation for some women, but they also thicken the cervical mucus so that sperm cannot quickly move through it.

It has generally been thought that because hormonal IUDs also thin the uterine lining and copper alters the uterine environment, these methods may also prevent implantation of a fertilized egg. This is still debatable, with some arguing that it explains why IUDs are so greatly effective. However, even from the beginning, the use of IUDs has not shown any greater rate of failed implantations than what occurs naturally.

Which brings me to my other point: Even if we were to ignore much of the scientific evidence and admit that these methods of contraception may provide a last-ditch effort to prevent pregnancy by blocking implantation of a fertilized egg…

Fertilization and pregnancy are not one and the same.

Pregnancy is a much more complicated process than most people give it credit for, with a lot of room for error. (Although this is very simplified, the basic steps of the process are: ovulation + intercourse + fertilization + implantation = pregnancy.) As far back as 1965, the American College of Obstetricians and Gynecologists recognized this and determined that the very definition of conception (or pregnancy) depended on implantation of a fertilized egg into the uterine wall. Fertilization by itself is simply not enough for your body to be considered pregnant. It is only one step along the way.

When contraception is not being used, at least 50% of fertilized eggs never fully implant and are thus naturally destroyed by the woman’s body before anyone is any wiser.This usually happens so quickly that it does not even alter a woman’s menstrual cycle, let alone begin to release pregnancy hormones. In general, because contraceptives reduce the amount of fertilized eggs, they actually help reduce the amount of failed implantations that would otherwise occur naturally. (This article does a fantastic job explaining the basic idea, even though the exact numbers reflect the use of oral contraceptives — not EC or IUDs.)

Beliefs are important to all of us, but we can’t forget to continuously reexamine them in the light of new evidence that speaks to the contrary.




Sexual Orientation 101: More Than Binaries

Some people are most comfortable with a black & white view of sexual orientation where your only option is monosexuality: either strictly heterosexual or strictly homosexual. These individuals do not acknowledge that bisexuality exists — either claiming that a “bisexual” is really just a gay/lesbian in denial or a straight person who is experimenting. Others support a third category for bisexuality, accepting a valid middle ground where a person truly can be attracted to both males & females.

While I recognize that categorizing things in nice, neat boxes makes us feel more at ease, I also believe that it can lead to an “us vs. them” mentality. Plus, it encourages us to overlook the subtle differences and intricate details of human sexuality. That’s why I support a broader view of sexual orientation that falls along a continuum. Sexual continuums are not a new idea, but they are sometimes met with resistance.

Kinsey Scale 

Published in Alfred Kinsey’s 1948 Sexual Behavior in the Human Male, the Kinsey Scale is a concept that is fairly widely known and pretty simple to grasp. Basically, the scale runs from 0 (exclusively heterosexual) to 6 (exclusively homosexual).

Kinsey Scale

Fig. 16.1 is reprinted from page 638 of Sexual Behavior in the Human Male by A. Kinsey, W. Pomeroy, & C. Martin (1948).

The fact that #1-5 all describe bisexuality should make it obvious that there is a lot of diversity even within a group of individuals sharing the same sexual label. Although the Kinsey Scale allows for more wiggle room in how a person subjectively defines their sexuality, it can also get a little murky if sexual attraction widely differs from actual sexual experience — or if these aspects change/become more fluid over time.

Klein Grid

Developed by Fritz Klein in 1978, the Klein Sexual Orientation Grid aimed to expand and enhance Kinsey’s idea of a sexual continuum. To get a more complete view of one’s sexuality, the Klein Grid looks at…

  • sexual as well as nonsexual aspects of interpersonal interaction
  • experience, attraction, fantasy, and self-identification (all separately)
  • and the individual’s past, present, and future ideal orientation.

If you would like to take an online quiz version of the Klein Grid, you can do so here. For some individuals, the result may be the same as with the Kinsey Scale — or it may differ. Personally, when I took the Klein quiz, I scored almost a full number higher than I usually self-indentify on the Kinsey Scale. My partner, on the other hand, scored half a number lower.

Beyond the Binary: Pansexuality & Polysexuality

One thing that neither Kinsey nor Klein considered was the existence, and attraction to, individuals that do not fit into our society’s sex and/or gender dichotomy. Even when discussing bisexuality, everything is always “male” or “female,” biological “men” or biological “women.” This means that intersex individuals and those whose gender is more fluid are ignored. But a person’s sex or gender is not always a determining factor in whether or not we are attracted to them.

Those who identify as pansexual remove the constraints of sex & gender binaries altogether, affirming that they can be attracted to anyone — including people of all possible sexes and genders. While some pansexual individuals may have preferences, they remain open to any attraction they experience, focusing more on the person as an individual.

Polysexuals are similar to pansexuals in that their love is not limited to strict societal binaries. However, unlike pansexuals, they may still have some groups of individuals who they are not attracted to based on sex or gender.


Individuals who identify as asexual do not experience sexual attraction to anyone, regardless of sex or gender. While Kinsey did discover a small percentage of people who he described as having “no socio-sexual contacts or reactions,” it was only mentioned in passing. Even now, there is a surprising lack of scientific research regarding asexuality — but a growing community has surfaced. (The Asexual Visibility & Education Network, or AVEN, is a fantastic resource.)

Asexuality can vary widely, depending on the individual. Some experience sexual arousal, but no desire to necessarily share that experience with another person. Some choose to engage in sexual activity without personally feeling sexual desire. Some individuals also inhabit a “gray area” between sexual and asexual which they have defined as being gray-sexual or “gray-a.” This may mean that they go through periods of being asexual, followed by periods of being sexual or it may mean that they experience very little sexual attraction, only under certain circumstances. (For example: Demisexual individuals only experience sexual attraction after an emotional bond has been formed.)

Because this is a more complex view of sexual orientation, it may help to envision a pyramid of how many individuals a person of each orientation may potentially be attracted to — based on the sex or gender of the other person.

Sexual Orientation Pyramid


Sexual Orientation vs. Romantic Orientation?

Although many definitions for “sexual orientation” include a romantic component, it is important to remember that sexual attraction and romantic attraction can be very separate. Many (but not all) asexuals experience romantic attraction and desire companionship without sex. And a person that is sexually attracted to one gender or sex may be romantically attracted to another. For example, an individual may be heterosexual in that they desire sexual activity with the opposite sex and biromantic, desiring a romantic connection with members of the same and opposite sex. For every sexual orientation term, there is a romantic orientation equivalent (ex: heterosexual/heteroromantic, bisexual/biromantic, asexual/aromatic, etc) and a person has one of each.

Erogenous Zones: Different Strokes for Different Folks?

Perhaps this sounds familiar…

You’re with a new partner & things are getting steamy. But your moaning is halted by wet, squishy noises (of the non-sexy variety) as you wonder why his/her tongue is inside your ear. Or maybe you once lightly touched the back of a partner’s knee expecting a sexy shiver. Instead you got accidentally kicked because they found it insufferably ticklish.

Somewhere, at some point in time, most people have heard about erogenous zones: those wonderful little areas on your body that just seem to burst with erotic potential when touched.

Countless magazine and web articles generalize our unique sexual experiences and boast certain spots as the “best” or “most surprising.” And though a “one size fits all” approach is rarely, if ever, a good idea,  some scientific backing to their method does exist. A recent study by Turnbull, Lovett, Chaldecott, and Lucas has reported surprising similarities across differences in age, race, and even sex.1 (A man’s penis is not his only erogenous zone, folks!)

Let’s start with what we know.

Erogenous zones come in two types: specific & nonspecific. Specific erogenous zones are those that are located on hairless skin that has lots of nerve endings close to the surface. These areas are perhaps what we think of as the most universal & obviously sexual, including the lips, penis, and clitoris. On the other hand, nonspecific erogenous zones have a normal concentration of nerves and can occur anywhere. Nonspecific erogenous zones probably vary a bit more between individuals. However, Turnbull et al. found that a majority of people receive greater stimulation from some areas (neck, thighs, ears) than others (hands, wrists, feet). And there are certain spots (elbow, nose, kneecap) that generally aren’t considered very sexual at all.

We still must keep in mind that just as not everyone agrees on the most delicious food, we can’t expect everyone to agree on the most sexually stimulating spot either. Although you can generalize and say “well, most people like chocolate” you might also know at least one person who much prefers broccoli.

So where does that leave you when you’re trying to navigate a partner’s body? Is there any one tip that can be applied to everyone?


Some people fear that by asking questions, they will seem sexually inexperienced or it will “ruin the mood,” but what it really does is show concern for someone else’s pleasure. I’ll dedicate another post to the various ways of approaching these sorts of delicate conversations, but for now, don’t be afraid to ask your partner which areas of their body they enjoy having touched and how they like to be touched there. (The “how” can make a huge difference. The same person might prefer soft kisses to one spot, a firm caress to another, and light pain somewhere else.) A discussion like this is also the perfect time to find out if there are any spots that your partner hates having touched, so that you know what’s off limits.

It may be that you or your partner aren’t sure where your own unique erogenous zones are. If this is the case, you can suggest that the two of you explore each other’s bodies together. Then you can take that “one size fits all” article, snip out the parts that are off limits, and mentally make note of some interesting ways to explore the places that both of you have agreed upon.

The awesome thing about this advice? It’s not just for new couples! I’m still finding new tricks that work on my partner of 3+ years. Spending time simply touching each other, with no further expectations, can be very pleasurable. Plus, sometimes an individual’s erogenous zones may change. For example, a common side effect of some hormonal contraceptives is breast tenderness. This change in a woman’s body may turn her nipples into centers discomfort instead of pleasure. The most important thing is that you both feel safe and comfortable enough to let the other know if a touch is amazing, upsetting, or anywhere in between.

And if one of you still ends up getting kicked, at least you’ll be able to laugh about it together instead of suffering in embarrassment alone.

1. Turnbull OH, et al., Reports of intimate touch: Erogenous zones and somatosensory cortical organization, Cortex (2013),