What’s in the Box? Defining Sex and Gender.
Guest Author: Zena Sharman, PhD
It all started in a windowless hotel conference room in the basement of a Toronto hotel. There was a weirdly patterned carpet and a buffet lunch and that awful, burnt-tasting drip coffee that I couldn’t stop drinking. 
Finding myself in a windowless hotel conference room was not particularly unusual. I spend a lot of time representing my organization at out-of-town meetings – it comes with the territory when you work for a national research funding agency. What was unusual was being surrounded by experimental researchers enthusiastically discussing sex and gender. This felt kind of like being in a room full of unicorns. Brilliant, highly accomplished unicorns with PhDs who really knew their way around a petri dish.
I happened to be sitting beside an eminent feminist environmental scientist during a discussion on methods for integrating gender and sex in experimental research designs. At one point she quoted the definitions of sex and gender from our organization’s website. As I listened to her read them out loud, two things dawned on me: first, we had inadvertently let several different versions of these definitions accumulate on our site. Second, these definitions didn’t reflect our organization’s current understanding of gender and sex. I scribbled a note in my notebook with a giant “do this!” asterisk beside it as I mentally vowed to update and harmonize our definitions.
Why was this so important to me? Because definitions matter. In Sorting Things Out: Classification and its Consequences, Bowker and Star tell us, “all category systems are moral and political entities.” They go on to explain that such systems always represent multiple constituencies, they become potent and invisible as they get embedded into working infrastructures (in our case, a website), and they’re exclusionary, in that there’s almost always an “other,” a someone or something that’s outside the categories.
The categories “sex” and “gender” permeate our lives. Think about it: on an everyday basis we’re asked to choose which public washroom to use (men’s? ladies’? gender neutral?), to pick between female, male, and sometimes, transgender tick boxes on forms, to decide between Irritation Defense or Pure and Delicate  shave gel at the drug store. When we make these choices, are we doing so on the basis of our chromosomes? Our identities and lived experiences? Our hormone levels? How other people relate to us and we relate to them? Our reproductive and sexual anatomies? All of the above? None of the above? Something else entirely?
Gender and sex are everywhere, they’re inside and on our bodies, and they’re interconnected. We live sex and gender every day, yet it can be hard to perceive or define them. As Riki Wilchins wrote in 2002, “…trying to understand gender sometimes feels like trying to take in the Empire State Building while standing only three inches away: It’s at once so big, so overwhelming, and so close that we can’t see it all at once or conceptualize it clearly.” How can we put simple boxes around something as complicated as gender and sex?
A big part of my job at the CIHR Institute of Gender and Health (IGH) involves fostering the integration of sex and gender in health research. One of the ways I do this is through outreach to and capacity building with scientists who might initially assume that sex and gender aren’t applicable to their research practice.
My professional life is informed by my experience as a cisgendered queer femme married to someone who proudly identifies as both butch and trans. I feel an ethical responsibility to ensure that the work I do makes space for and reflects the identities of the trans and gender diverse people who are an integral part of my life and community. One of the places where this gets complicated is when I’m trying to create inclusive materials that are also accessible to the diverse and multidisciplinary community of scientists and stakeholders that IGH serves. While we’ve been seeing exciting advances in the uptake of sex and gender across the spectrum of health research, it’s apparent that the majority of scientists – especially in biomedicine – still aren’t accounting for sex or gender.
In December 2010, the Canadian Institutes of Health Research introduced mandatory questions on gender and sex. All funding applicants are required to indicate whether they’re integrating sex and gender, to explain how, and, if they aren’t, to justify why. When we analyzed data from the first three funding competitions after the introduction of these questions, we found that biomedical researchers were the most likely to say that they weren’t accounting for sex or gender (about 81% of them, compared to 21% of population and public health researchers).
At IGH we see these numbers as an opportunity for outreach, education, and innovation in research practice. I had them in mind as I challenged myself to write definitions of gender and sex that would resonate with, be relevant to, and be accessible to the majority of scientists who might think these concepts don’t apply to their work, while also reflecting the diversity and complexity inherent within the categories of sex and gender. They’d also have to be relatively short and make sense when translated in French. NO PRESSURE.
Spoiler alert: I did it (with a lot of help)! Here’s what we ended up with:
Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men, and gender diverse people. It influences how people perceive themselves and each other, how they act and interact, and the distribution of power and resources in society. Gender is usually conceptualized as a binary (girl/woman and boy/man) yet there is considerable diversity in how individuals and groups understand, experience and express it.
Sex refers to a set of biological attributes in humans and animals. It is primarily associated with physical and physiological features including chromosomes, gene expression, hormone levels and function, and reproductive/sexual anatomy. Sex is usually categorized as female or male but there is variation in the biological attributes that comprise sex and how those attributes are expressed.
The process of creating these definitions was iterative (as reflected in the subject line of an email I sent out during the process of writing them: “sex and gender definitions, version eleventy million”). It involved working with a staff member to inventory all of our definitions as well as scanning other leading organizations’ definitions of gender and sex. After reading these to assess their strengths and weaknesses, I sought input from people – researchers across the spectrum of health research and queer and trans folks (not to mention people who situate themselves in two or more of those categories).
I did this in person, by email, and even via Facebook – the medium that generated some of the most interesting feedback, in that it was a way to foster a conversation among a community of friends and colleagues who share an interest in gender and sex. It was also a way to create instant accountability – when I got something wrong, people told me right away. The process taught me some important things about defining sex and gender:
- Binaries are useful. Binaries are complicated. How do you refer to a binary without reinforcing it? Many definitions of gender and sex default to binaries (e.g., female/male, masculine/feminine). We’re used to thinking in binaries, and in my experience they can be a useful point of entry into conversations about sex and gender (even if your ultimate aim is to challenge those binaries) – especially in introductory conversations about them. (You know, like when you’re at a dinner party and you ask the scientist seated next to you, “So, do you buy Irritation Defense or Pure and Delicate shave gel? Have you ever thought about why?”). I’ve started thinking about binaries as a heuristic – a sort of imperfect mental shortcut aimed at helping people solve problems or make decisions. When developing our definitions I had a lot of conversations about whether to refer to females and males, whether I could use an all-purpose term like “people” or “humans.” It was our Institute’s Scientific Director, Dr. Joy Johnson, who reminded me that most people tend to think about gender and sex in binary terms, and that it would be productive to both invoke and challenge these binaries in our definitions.
- “Other” can be othering. It’s challenging to find accessible shorthand for gender diversity. I wanted to make sure our definitions made room for people who identify outside of the familiar gender/sex categories of girl, woman, boy, man. (I also wanted to make sure we made specific reference to boys and men because in my experience people sometimes assume that gender applies only to or is synonymous with women and girls.) How could I find a relatively simple way to capture the diversity of non-binary gender identities? I knew that I didn’t have space to list the myriad gender identities out there – plus I had to consider my audience. How could I capture “other” without othering or excluding anybody? I ended up taking my cues from language in the Canadian Professional Association for Transgender Health’s 2013-2018 strategic plan, which refers to “trans and gender diverse people.” In our definition, I shortened it to “gender diverse people” – it seemed like a simple way to give a nod to the diversity of identities that exist outside of girl, woman, boy, and man (as well as acknowledging, if indirectly, that there are many trans people who identify as girls, women, boys, and men). I’m conscious of the fact that this compromise will probably still feel exclusionary and invisible-izing to some people.
- Common metaphors used to describe gender and sex are inaccurate and insufficient. We use metaphors to symbolize or represent something else, yet language often feels insufficient to capture the wildly varied realities of our lives, minds, and bodies. Two words that often get used in relation to gender (and sometime sex) are “continuum” and “spectrum.” Several people who weighed in during the process of developing our new definitions suggested using these terms as a way to represent what lies outside the traditional binaries of sex and gender (for example, “the gender spectrum from male to female, in between and beyond”). We’d used similar language in our original definition of gender. What changed the conversation this time was when a number of people commented on the inadequacy and inaccuracy of these metaphors, primarily because they suggest a directionality and an accumulation (the idea that as you move in one direction, you become more of something – say, more female or more feminine – and less of something else – say, less male or less masculine). As one of the commenters put it, “some people are very much both and some very much neither, and some off the line entirely,” while some dimensions of sex are categorical, not continuous. I was reminded of an exchange I’d had on Facebook about a year earlier when preparing for a workshop on gender research methods. I asked my friends for alternative metaphors to describe their genders – they came back to me with phrases like “an amorphous blob,” “a ball of yarn with both ends connected,” “a colour wheel,” “a swirling spiral,” “a galaxy,” “a planet,” “water; fluid, fitting into all manner of containers,” “a Möbius strip,” and “a sphere.” Our metaphors are only as limited as our imaginations.
If I were going to do this all over again I’d include an even more diverse array of readers – especially scientists from the disciplines IGH is trying to make inroads into. Are you one of those scientists? What do you think of our definitions of gender and sex? Do you have suggestions for how we could make them even better (or strong opinions about Irritation Defense vs. Pure and Delicate shave gel)? Either way, I’d be happy to hear from you! Feel free to Tweet me your feedback (@zenasharman) or contact me through IGH.
Zena Sharman is the Vancouver-based Assistant Director of the CIHR Institute of Gender and Health. Though based on the west coast, Zena’s work takes her across Canada, training and consulting with researchers and students, developing funding opportunities, informing policy, and perfecting her all-purpose “gender 101” taxi spiel. Zena has a PhD in Interdisciplinary Studies, a reflection of her longstanding engagement with interdisciplinary scholarship on gender and health. She’s the co-editor (with her partner, Ivan E. Coyote) of the Lambda Literary award-nominated anthology Persistence: All Ways Butch and Femme (Arsenal Pulp Press, 2011). Zena’s also a board member of the Canadian Professional Association for Transgender Health.
Bowker, G.C. & Star, S.L. (2000). Sorting Things Out: Classification and Its Consequences. Cambridge: The MIT Press.
Wilchins, R. (2002). A continuous nonverbal communication. In J. Nestle, C. Howell & R. Wilchins (Eds.) Genderqueer: Voices from Beyond the Sexual Binary (pp. 11-17). Los Angeles, CA: Alyson Books.