Gender identity refers to a person’s internal sense of their gender. Gender expression refers to how people may convey their gender to others through behavior and appearance.

Gender exists on a broad spectrum and encompasses both gender identity and expression, in addition to societal expectations about status, behavior, and characteristics associated with certain sex traits.

This article defines gender identity and expression in more detail and explores how a person may navigate questions they have about aspects of their gender. It also explains healthcare disparities related to gender and lists some organizations that provide support for people who may be questioning their gender identity.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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A person’s gender identity may change throughout their life, and it may not correspond to societal expectations based on their sex assigned at birth.

According to The Trevor Project, gender identity refers to a person’s individual sense of their gender.

Gender identity is unique to each individual, but some examples include:

LGBTQIA+ resources

To discover more evidence-based health information and resources for LGBTQIA+ individuals, visit our dedicated hub.

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Gender expression refers to how a person externally presents their gender to others.

According to the American Psychological Association, someone may express their gender through:

  • behavior
  • hairstyles
  • clothing
  • body characteristics
  • voice characteristics

In many countries, including the United States, people often consider a person’s gender and sex assigned at birth to be binary.

For example, healthcare professionals may assign a baby as male at birth based on their chromosomes and physical characteristics. People typically refer to babies assigned male at birth as “boys.”

However, neither gender nor sex is binary. Both exist on a spectrum. While some people may feel that their gender corresponds to their sex assigned at birth, others may not.

Questions to think about

The Trevor Project lists some useful questions that people who are questioning their gender may want to think about, such as:

  • How do you feel about your birth gender?
  • How would you like to express your gender?
  • What pronouns do you feel most comfortable using?
  • When you imagine your future, what gender are you?

Means of transitioning

Some people may wish to make their gender identity fit with their ideal gender expression. People often refer to this as “transitioning.”

A person may transition in the following ways:

  • Socially: Social transitioning may involve a person informing other people about their gender identity and which pronouns they feel most comfortable with, as well as experimenting with gender expression.
  • Legally: Legal transitioning may involve a person changing their name on personal identification documents.
  • Medically: Medical transitioning may involve a person having hormone therapy or undergoing surgery to change aspects of their physical appearance.

Some individuals may want to only transition in certain aspects of their life, which is entirely valid. It is best for people to do what feels most safe and comfortable for them.

The Trevor Project also highlights the importance of checking how people identify and which terms they prefer to use to describe themselves. This is because labels and terms can vary between people.

This section discusses how societal expectations of a person’s sex assigned at birth and gender may systemically affect healthcare.

Medical research bias and intersex individuals

Some people have variations in their physical sex characteristics or reproductive anatomy that differ from typical expectations of what constitutes “male” and “female.” These variations may be present from birth or develop spontaneously later in a person’s life.

People may use the term “intersex” to describe individuals with these variations.

According to the Trevor Project, someone may not know that they are intersex, as many individuals are assigned male or female sex at birth, even if they have variations in their physical sex characteristics or reproductive anatomy that differ from typical expectations.

Because intersex and transgender individuals, as well as those assigned female at birth, have often lacked representation from medical research, there are gaps in systemic medical knowledge. This may be why the idea that sex is binary persists among many people despite scientific evidence that proves otherwise.

These gaps in medical knowledge can also affect the quality of care a person receives. Further research in this area can benefit many individuals in the future.

The importance of gender identity and expression in healthcare

A systemic review from 2021 highlights the importance of making legislation to protect the sexual orientations, gender identities, and gender expressions of sexual and gender minorities.

It points out that many healthcare professionals, advocacy groups, and individuals across the world recognize that conversion therapy, which includes practices that delay transition, is harmful to people in the LGBTQIA+ community.

The authors of the review found an association between these practices and:

The authors concluded that stronger legislation to prohibit harmful practices, in addition to better training for healthcare professionals, is necessary to improve outcomes for LGBTQIA+ individuals.

In some cases, a person may not feel safe speaking with their family, colleagues, or doctor about their gender identity and how they wish to express it.

In other cases, a person may want to seek further advice before discussing the topic.

The following organizations provide educational material and support for people who may be questioning their gender identity:

A person’s gender identity describes their feelings about their gender, whereas gender expression refers to how someone communicates their gender externally, through clothing or behavior, for example.

Gender identity and how a person chooses to express it are unique to each individual. People who are questioning their gender may decide to transition so that the way they express their gender better aligns with their gender identity.

However, not everyone who is questioning their gender may wish to transition, and others may not feel that they are in a safe situation to do so. Several organizations provide educational material and support for people who may be questioning their gender identity.