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What everyone should know about gender and sexuality James Pate, MD |
  
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Gender Most people think of gender as either male or female but it is not that simple. Gender is what lies between our ears and is complex; it involves sex, genetics, gender identity, gender expression and gender role. Sex is what lies between our legs and is determined at birth. However not all babies are born with genitals that are easy to classify. Female appearing infants can have testicles instead of ovaries. Likewise some apparent boys will have ovaries instead of testicles. Others are born with genitals that have both male and female features. While these infants are eventually assigned exclusively to either male or female sex by a multidisciplinary medical team they are truly “between sexes” or intersex. The current medical term for intersex is disorder of sex development (DSD) but it is offensive to many intersex adults. The word hermaphrodite comes from Greek mythology and is considered stigmatizing when applied to humans. Genetics can be used to identify gender. While genitals and genetics usually match they sometimes do not. Males usually have XY chromosomes and females usually have XX but sometimes they are switched. Others have different chromosome combinations such as XO, XXY and XYY. Variations such as these show that even on a genetic level gender is not black and white. Gender identity is how a person feels on the inside regardless of their body’s appearance. Most children know their gender by 3 years of age. People do not choose their gender identity. Some people’s bodies do not match their gender identities. Instead they may feel that they are the opposite gender, between genders, both genders or neither. Words used by gender minorities to describe themselves include MTF transsexual (male-to-female) or trans-woman, FTM transsexual (female-to-male) or trans-guy, transgender, intergender, bigender, ambigender, gender queer, gender fluid and androgyne. Gender expression may be different than gender identity. Some people may identify as one gender but choose to dress and present themselves as another. A few examples of this are transvestites, crossdressers, drag queens (female impersonators) and drag kings (male impersonators). Gender role is the degree of masculinity or femininity that we display by our behaviors as categorized by societal norms. Examples of this are "tomboy" girls and "sissy" boys. In the United States there is much more social acceptance of gender role deviance among females than among males. Sexuality Sexual orientation refers to the relationship between our own gender and the gender to which we are sexually and emotionally attracted. It is not known what causes sexual orientation, but science has shown that both genetics and the environment have a role. People do not choose their sexual orientation. Most people know that sexual orientation can be heterosexual (attracted to the opposite sex), homosexual (attracted to the same sex) or bisexual (attracted to both sexes). However, sexual orientation is actually a scale with most people leaning one way or the other in varying degrees. Additionally, some people are not attracted to either gender and consider themselves to be asexual. Words used by sexual minorities to describe themselves include gay, lesbian, bisexual, queer and questioning. Homosexuality is present in all countries and cultures. History tells us that homosexuality has always existed among humans. It has also been observed in more than 1500 animal species including bonobo chimpanzees, bison, dolphins, giraffes and penguins. Homosexuality is both natural and common. It is not a mental disorder. Sexual orientation is not the same as sexual experience. It is common for youths to experiment with sex in ways that are different from their sexual orientation. Some youths are aware of their sexual orientation by early adolescence before any form of sexual experimentation. Others experiment sexually with either or both sexes before gaining self-awareness. Even though homosexuals make up less than 10% of the population, 1/3 of heterosexuals have experienced an orgasm with someone of their own gender. Finally, some people may continue to feel confused about their sexual orientation for awhile.Counseling may be helpful to sort out these issues, but attempts to change sexual orientation should not be made.
Support and Resources Most LGBTQI (lesbian, gay, bisexual, transgender/transsexual, queer/questioning, intersex) youths know their undisclosed gender identity or sexual orientation long before they are willing to share it. This is because coming out can be very scary and difficult and have negative consequences. Unfortunately it is still common for LGBTQI youths to experience rejection, isolation, discrimination, harassment and physical violence. As such they are at higher risk for low self-esteem, risky or self destructive behaviors, homelessness and suicide. Given the difficulties and challenges that LGBTQI persons face, many groups and organizations have formed to reach out and provide support. Links to many of these organizations can be found here. Some important resources to highlight are The Trevor Project, The It Get Better Project, HRC's Coming Out Project and PFLAG.
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