Gender

Gender is the set of characteristics, norms, roles and relationships that each society links to being a woman, man, girl or boy. WHO describes it as socially constructed: it varies between cultures and changes over time. Biological sex, by contrast, refers to physical traits such as chromosomes, hormones and reproductive organs.

Sex and gender: what's the difference?

WHO separates the two concepts. Sex means the biological and physiological characteristics of females, males and intersex people. Gender means the norms, behaviours and roles a society expects according to sex, and the power relations between them.

An example: only women can carry a pregnancy, which is a biological fact. Expecting women to run the home, or men not to cry, is a gender norm. No law of nature requires it; it is learned.

The dimensions of gender

Gender identity

This is a person's deeply felt, internal sense of their own gender. It may or may not match the sex they were assigned at birth. When it matches, the person is cisgender; when it doesn't, they are transgender. Some people do not feel fully a woman or a man and describe themselves as non-binary.

Gender expression

This is how someone shows their gender outwardly: name, pronouns, clothes, hair, gestures or voice. You can't work out someone's identity or orientation from their expression.

Gender roles and norms

These are the tasks, behaviours and expectations a society assigns to each sex. We learn them from childhood through family, school, media and friends.

None of these dimensions tells you someone's sexual orientation, which is about who a person is attracted to.

Why gender affects health

WHO points out that gender norms shape everyone's health:

• Women and girls: about 1 in 3 women worldwide has experienced intimate partner violence or sexual violence by someone other than a partner. They also face more barriers to making decisions about their health and using services.
• Men and boys: rigid ideas about masculinity are linked to more smoking, drinking and risky sex, and to seeking help less often.
• Trans and gender-diverse people: they face more stigma and discrimination, including in healthcare, and have a higher risk of HIV and mental health problems.

Stereotypes that persist

UNDP's Gender Social Norms Index (2023), covering 80 countries, found that almost 9 in 10 men and women hold at least one bias against women. Half of people believe men make better political leaders, and 25% think it is justified for a man to beat his wife. The report describes a decade of stagnation.

Gender identity and health: WHO's position

Since ICD-11 came into effect in 2022, WHO no longer classifies trans identities as a mental disorder. "Gender incongruence" moved to the chapter on sexual health to reduce stigma and improve access to care. WHO makes clear that behaviour or preferences that don't fit stereotypes are not, on their own, a basis for that diagnosis. A boy who likes playing with dolls, or a girl with short hair, is simply being themselves.

Common myths

• "Talking about gender denies biology": no. Gender adds to the concept of sex; it doesn't replace it.
• "Gender roles are natural": many have changed within a few generations, such as women going to university or fathers' role in childcare.
• "Expression reveals orientation": the way someone dresses or moves says nothing about who they love.
• "Teaching equality imposes a way of being": on the contrary, it widens the options open to girls and boys.

Gender in sex education

UNESCO lists "understanding gender" as one of the eight key concepts of comprehensive sexuality education. The aim is to spot stereotypes, prevent gender-based violence and build equal relationships. In Spain, a 2023 law requires schools to teach respect for sexual, gender and family diversity. To learn more about the diversity of bodies and identities, see our guide to anatomical and gender diversity.

When to get help

If you or someone close to you is experiencing domestic abuse, in England you can call the free 24-hour National Domestic Abuse Helpline on 0808 2000 247; Scotland, Wales and Northern Ireland have their own helplines. In an emergency, call 999. If a young person is unsure or distressed about their gender identity, look for support from their GP or a specialist service, without judgement or pressure.