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Gender is one of the most central ways that individuals categorize themselves and others into social groups.1 Broadly defined, gender refers to the roles, attitudes, and behaviors that a given society deems appropriate for men and women, whereas gender identity refers to a person's deeply felt, internal sense of being male, female, or another gender (see Table 1 for relevant terms and definitions).2 Gender identity is among the core features of a person's overall identity or cohesive self-concept. Identity is multifaceted, and identity development is a lifelong process that begins in infancy and continuously evolves throughout the lifespan. Identity development is driven by innate biological and psychological factors (eg, physical and cognitive maturation) that reciprocally interact with the immediate environment. The environment, in turn, is also shaped by broader social, cultural, and historical contexts.3,4 Similarly, gender identity development is conceptualized as a biopsychosocial process that is shaped by social and contextual features and strongly influenced by a person's position within the broader cultural zeitgeist. As a result of the dynamic and complex processes that influence its development, gender identity is highly unique in time and from person to person.
| Terminology | Definition |
|---|---|
| Gender identity | A person's internal sense of identifying as a girl/woman, boy/man, a combination of both, or something else (ie, no gender at all) |
| Gender incongruence | A term in which a person's gender identity does not align with their gender assigned at birth |
| Sex/assigned sex at birth/natal sex | Designation based on anatomy (external genitalia, internal reproductive organs, or both), biology (sex chromosomes, hormones, or both), or both. “Sex” and “gender” are distinct constructs |
| Gender expression | The way an individual conveys an internal gender identity through external means, such as haircuts and clothing. Genderidentity and gender expression may or may not correspond to natal sex or assigned sex at birth |
| Gender role | Culturally and historically specific sets of expectations defined by gender designations |
| Sexual orientation | A pattern of physical attraction, romantic attraction, emotionalattraction, or a combination of these |
| Cisgender | A term for individuals whose gender identity is consistent withthe social expectations of their natal sex |
| Transgender | A term for individuals whose gender identity is incongruent with social expectations of their natal sex |
| Gender diverse | An overarching term to describe individuals whose gender... |