Understanding Gender Identity

There are a lot of different ways someone can express their gender or sex. We know gender identity isn’t an easy topic to understand right off the bat. It is always evolving and progressing with the times. Sometimes we need to unlearn some old ideas so we can really get what gender is all about.  

 What are the differences between sex, gender, and gender identity? 

It’s pretty easy to confuse biological sex (sometimes called “sex assigned at birth”) with gender and gender identity. They’re related, but different.  

• Sex is a label — male or female — that you’re assigned by a doctor at birth based on the genitals you’re born with and the chromosomes you have. It goes on your birth certificate. 

• Gender is a set of expectations from society, about behaviors, characteristics, and thoughts. Each culture has standards about the way that people should behave based on their gender. This is also generally male or female. But instead of being about body parts, it’s more about how you’re expected to act, because of your sex. 

• Gender identity is how you feel inside and how you express your gender through clothing, behavior, and personal appearance. It’s a feeling that begins very early in life. 

Exploring Gender Identity 

Most of us were taught in our early adolescence that there are only two sexes (male & female) and two genders (man & woman). However, it is important to note that sex and gender exists on a spectrum: 

We were all assigned a sex at birth. This is due to our biology, chromosomes, and physical body.  What we need to realize is that sex is more complex than that. Typically, male babies are labeled “boys” and female babies are labeled “girls.” But having only two options (biological male or biological female) might not describe what’s going on inside a person’s body. Intersex individuals have physical sex traits or reproductive anatomy that are present at birth or appear later in life and differ from normative expectations of “male” and “female.” 

Some people never question their gender or sex and choose to identify with what they were assigned at birth — that’s called being “cisgender.” But there are others who do question their gender or sex, which is totally normal.  

If your gender identity does not necessarily match the gender you were assigned at birth, you may identify as being transgender. Transgender people may or may not decide to receive gender-affirming care to physically match their gender identity, it is completely up to them!  Nonbinary people might identify as being both a man and a woman, somewhere in between, or as falling completely outside these categories. Some may also identify as transgender, while some may not.  

If you are questioning your gender and aren’t sure what feels right to you, it’s okay! You are not alone. Consider a few of these questions: 

• How do you feel about your birth gender? 

• What gender do you wish people saw you as? 

• How would you like to express your gender? 

• What pronouns (like he/him or she/hers, or ze/zir or they/them) do you feel most comfortable using? If any at all.  

• When you imagine your future, what gender are you? 

Gender Expression  

Many people use hairstyles, clothing, and physical appearance to express and present their gender. This can be a very euphoric experience for people as it leads to feeling confident and free. Society likes to consider these cues as masculine and feminine, but rather than on a binary (only two ways of being), gender and sex exist on a spectrum. 

Exploring different gender expressions and ways to present yourself can help you to understand your identity. Where one outfit may feel completely wrong, another may feel empowering. You may like your hair long one week and short the next.  All people should be allowed to figure out what works best for themselves in their exploration of gender.  

At PPGOH, we encourage all patients to come as they are. We are here to provide a compassionate and inclusive environment for every person that walks through our health center doors.  

Terms and Labels 

For many people, labels can be liberating, a way to express themselves and find others who relate to their experiences. For others who are questioning or exploring their identity, going without a label is more comfortable than committing to one right away. 

You may have noticed more and more people are offering their pronouns (e.g., she/her or they/them) —when they introduce themselves in meetings, in an email signature, in class, during casual conversation, or even on TikTok. The reason is simple: the concept of gender is ever evolving, and so are gender identities. 

There is no right or wrong way to define who you are, and it’s okay if you don’t want to label yourself either. It is also okay if your labels change over time. Gender identity is a personal experience. Everyone’s situation is unique and valid.  

We know how important it is to feel safe, supported, and affirmed. That's why we are committed to providing inclusive, affirming reproductive health care and sexual health education to all. To learn more about gender identity, visit imi for mental health guides built for and with LGBTQ+ teens to help explore and support your identity, or explore our website for more resources.