What do sex and gender mean to us?

At Yale Women's Health Research, we are committed to improving the health of a diverse society. We do this in large part by studying women's health and the similarities and differences in health outcomes between and among women and men. In our work, it is particularly important to use language that captures the different concepts of sex and gender, so that our science and findings are more accurate and better serve everyone.
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What do we mean by sex and gender? Aren't they interchangeable? Perhaps at one time they were used as synonyms, but this is no longer the case in science.

In 2001, a committee convened by the Institute of Medicine (IOM), a nonprofit think tank that addresses issues of national health importance, considered whether it was important to study the biology of women as well as men.
The IOM, now part of the National Academies of Science, Engineering, and Medicine (NASEM), concluded that there was more than sufficient evidence to suggest that, beyond reproductive biology, there are important differences in the biology of women and men that have major implications for their health and influence treatment and prevention strategies.

Importantly, the Committee emphasised that neither women's nor men's health is simply a product of biology, but is also influenced by socio-cultural and psychological experiences. To distinguish between these broad areas of inquiry, members developed working definitions of "sex" - when referring to biology - and "gender" - when referring to self-presentation influenced by social, cultural and personal experience.
These working definitions were a good start in recognising the value of studying sex and gender and their interactions, but they were always meant to evolve. Now, as we learn more about ourselves, we need to adapt our terminology to be inclusive, respectful and more accurate.

For example, while most people are born biologically female or male, rare biological syndromes can result in genital ambiguity. Or a resistance to a sex hormone can result in characteristics typical of the opposite biological sex.

In addition, while an individual's internal sense of gender may be female or male, some people identify as non-binary - neither female nor male. Other people may identify with a gender that is the same as (cisgender) or different from (transgender) the one assigned to them at birth. These terms are separate from a person's sexual orientation, which describes a person's emotional, romantic and/or physical relationships (such as heterosexual, lesbian, gay, asexual, bisexual and more).