Determination of human sex can made by 4 factors: Genetic sex-presence or absence of Y chromosome, Gonadal sex-presence of testes or ovaries, Phenotype sex-appearance of the external genitalia, Sexual identity-psychosocial influences on sexual behavior and orientation.

Sex is a biological determinant of a persons anatomy and  physiology.
Sex of an individual has implications on disease incidence and prevalence, and clinical outcome.

Sex is characterized by female and male biological differences in regards to gene expression, hormonal concentration, and anatomical characteristics.

There are in recognized reproductive and non-reproductive organs, distinct phenotype differentiation between men and women during the reproductive years but also throughout all of life.
The dimorphic sexual expression of sex linked genes does not account for all sex differences.
The complexity of sex differences in health and disease is beyond a sex chromosome directed and hormone centric axis.
Most autosomal genes with six-biased expression lack androgen or estrogen response elements.
Gender identity refers to a person’s sense of being male, female, neither, or a combination of both.

Gender is an expression of behavior and lifestyle choices. 

Gender identity is the deeply felt internal sense of oneself as a male, female, or somewhere else on the gender spectrum: it may or may not align with the sex one was assigned at birth.

Gender is not a binary term: includes the understanding that in many people, traits of masculinity or femininity coexist and are expressed to different degrees. 

The terms used to describe persons who is gender does not align with their sex record at birth include: gender nonconforming, transgender, transsexual, trans, gender non-binary, gender incongruent, and genderqueer.
Gender dysphoria describes a mental health diagnosis referring to the discomfort of misalignment of gender identity and the sex recorded at the time of birth.
Gender dysphoria is the distress that may  be present and persistent with such misalignment.
Gender nonconforming, gender non-binary, transgender, and genderqueer individuals differ from individuals who are identified with disorders of sex development.
Gender dysphoria can be treated with non-medical and medical interventions.
Non-medical interventions include therapy, coming out, using chosen names of pronouns and dressing or grooming in a way that matches one’s gender identity
Hormonal or surgical treatments and hormonal treatments to prevent developmental changes that don’t align with identity.

Gender is a modifier of health, disease, and medicine.


Gender refers to the social  norms that impose and determine roles, relationships, and positional power for all people across their lifetime.


Gender interacts with sex, the biological and physical characteristics that define women, men, and those with intersex identities.


Age 2-3 years is a developmental window where the perception of gender identity ensues.


Children develop facility with gender labeling, including pronouns as early as age 2.


Between 0.6% and 2.7% of children with Eli age group of 2 to 3 years have some degree of gender 


Sexual maturation of secondary sexual characteristics occurs during puberty and bone size , pubertal voice change and body proportions change is well, followed by sex specific development of extra genital tissues and organs.

During the onset of puberty children are able to articulate the gender identity and this developmental window becomes stressful for children with gender incongruence.

Disorders of sex development involve elements of congenital development of ambiguous genitalia such as virilizing  congenital adrenal hyperplasia, clitoralmegaly,  micropenis and congenital disjunction of internal and external sex anatomy with complete androgen insensitivity syndrome and 5 alpha reductase deficiency, incomplete development of sex anatomy, sex chromosome anomalies such asTurner syndrome, Klinefelter syndrome and chromosome mosaicism and disorders of gonadal development.


The 7 different genders include agender, cisgender, genderfluid, genderqueer, intersex, gender nonconforming, and transgender.

Masculine, feminine, neuter, and unspecified are four genders. 

Many people refuse to be classified as male or female, either because they do not identify themselves as male or female or because they are transitioning to the opposite gender.

There are about a dozen broad categories of gender, which include:


An agender person does not have a gender.

The body of an agender person does not always correspond with their lack of gender identity.

They are frequently unconcerned about their physical sex but may strive to appear androgynous.

An androgyne is a person who identifies as neither man nor woman and/or physically appears as neither.


Many people identify as cisgender; this means that you believe your biological sex, or the one you were assigned at birth, corresponds to your gender identity or how you perceive yourself.

It is a common gender in society, but it should not be assumed.


A genderfluid person does not identify as male or female but rather as one or the other depending on the day. 

This refers to being flexible with one’s gender expression, which is distinct from one’s gender identity.

Gender expression refers to a person’s physical characteristics, behaviors, and appearance that are associated with masculinity or femininity.

Individuals who are genderfluid may express one gender through clothing or interests one day and then identify as another the next.


This person may identify as male or female, as between or beyond genders, or as a mix of the two.

These people frequently question gender stereotypes and the male-female binary system. 

They frequently exhibit gender fluidity.

Genderqueer is another term for someone open about their sexual orientation: They may or may not identify as heterosexual or same-gender-loving.

Intersex refers to a group of medical conditions in which a person is born with chromosomes, genitalia, and/or secondary sexual characteristics that contradict the traditional definition of a male or female body.

Gender nonconforming refers to a person who either by nature or by choice does not conform to gender-based expectations of society. 

Transgender:trans man, trans woman, or trans person.

Transgender is an umbrella term for people whose gender identity differs from the one assigned to their physical sex. 

It includes transmen, transwomen, genderqueer people, crossdressers, and drag queens/kings, among others.

In general, it refers to anyone whose behavior or identity deviates from gender stereotypes.

Transgender people can be straight, gay, bisexual, or of any other sexual orientation. 

It should not be assumed that everyone who dresses like a transgender person has issues with gender identity.

Gender refers to various roles, rights, and responsibilities and interactions of men and women, and how their characteristics, behaviors, and identities are formed because of socialization.

Gender variation is often associated with unequal power and access to options and resources, which are altered by 

historical, religious, economic, and cultural realities.

Gender roles and responsibilities can shift over time.

The 7 major types of sexual orientations:


Refers to sexual attraction to people of all genders, as well as transgendered, transsexual, androgynous, and gender-fluid individuals.


Refers to someone who is halfway between sexual and asexual. 

A demisexual individual  requires a strong emotional bond before becoming sexually involved with someone, and cannot be moved by an initial attraction.

Monosexuality refers to a preference for only one gender: heterosexual or homosexual attraction.

Bisexual individuals are attracted to people of both sexes.

Asexual individuals are people who have no interest in or desire for sexual activity.

Celibates refrain from sexual activities of their own volition.

Gray-A or gray-asexuality refers to the gray area between sexuality and asexuality: under some very specific circumstances, they feel sexually aroused, but sexual desire can be so low that it goes unnoticed.

Autosexuality, (autoeroticism), is when you get sexual pleasure from stimulating one’s own body.

Sex is usually determined by biological factors such as a person’s reproductive organs, genes, and hormones. 

Sex, like gender, is not a binary concept, as a person’s reproductive organs, genitals, or both may appear to be male or female, their reproductive organs, genitals, or both may appear to be different (sex development differences).

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