16 Common Misconceptions About Sex and Gender

Introduction: Clearing Up the Confusion

Misconceptions about sex and gender are among the most debated and misunderstood topics in human identity. These misconceptions fuel harmful stereotypes, reinforce discrimination, and create barriers to understanding and inclusion. From everyday conversations to social policies, the confusion between sex and gender continues to shape the way people think and act.

Terms like “male,” “female,” “man,” and “woman” are often used interchangeably, but they represent profoundly different ideas. Biological sex, with its complex genetic, hormonal, and physical components, is not as simple as XX or XY. Meanwhile, gender—deeply personal yet influenced by societal norms—spans a rich spectrum of identities and experiences.

This article tackles 16 common misconceptions about sex and gender, unpacking the science, sociology, and cultural histories that challenge these outdated ideas. By addressing these myths, we aim to foster a clearer understanding and inspire more thoughtful, inclusive conversations. Let’s break down these misconceptions and explore the nuances that too often get overlooked.

What Are Sex and Gender?

Defining Sex

Sex refers to biological characteristics, which include:

  1. Genotypic Sex: Determined by chromosomes. Typically, individuals are categorised as female (XX) or male (XY). However, variations like XXY or XO exist, illustrating that nature doesn’t always fit into neat categories.
  2. Phenotypic Sex: Physical traits, such as genitalia, secondary sexual characteristics, and hormonal profiles, further define sex. Yet, these traits can diverge significantly due to intersex conditions or hormonal variations.

The complexity of biological sex defies binary definitions. As explored in the textbook Neuroscience, 2nd Edition, sex is better understood as a spectrum of traits rather than a strict binary.1 Additionally, studies have demonstrated how chromosomal and hormonal variations contribute to this diversity, offering a more inclusive perspective on human biology.

Defining Gender

Gender, in contrast, is a sociocultural construct. It encompasses roles, behaviours, and expectations that societies associate with different sexes. Importantly, gender is also a deeply personal experience.

  • Gender Identity: A person’s internal sense of their gender, which may or may not align with their assigned sex at birth. This identity often develops during early childhood and remains a core part of an individual’s self-concept.
  • Gender Expression: How someone presents their gender to the world through clothing, behaviour, or language. This outward expression may or may not align with societal expectations.

Research in gender development shows that children begin forming gender concepts early, influenced by societal norms and individual experiences.2 These schemas play a significant role in how individuals perceive themselves and others, shaping behaviours and expectations throughout life.

Understanding the Basics of Sex and Gender

Misconception 1: Sex and Gender Are the Same Thing

A common misunderstanding conflates sex and gender as identical concepts, erasing critical differences and leading to flawed assumptions about identity. Sex is rooted in biological characteristics (chromosomes, hormones, reproductive organs), while gender is a sociocultural construct encompassing roles, behaviours, expectations, and personal identity. For instance, someone assigned male at birth may identify as a woman, illustrating the distinction between biological sex and personal gender identity.

Neurobiological research clarifies that while sex and gender can influence each other—e.g., hormone exposures can shape aspects of identity—these factors remain distinct.3

Misconception 2: Male = XY, Female = XX

It’s an oversimplification to assume all males have XY chromosomes and all females have XX. While XX and XY are indeed common, variations such as XXY (Klinefelter syndrome) or XO (Turner syndrome) challenge the notion of rigid binary categories. Factors like the SRY gene (often on the Y chromosome) and hormone sensitivity can also influence development, underscoring the complexity of sex determination.

Certain intersex conditions, like androgen insensitivity syndrome, reveal how someone with XY chromosomes might develop predominantly “female” traits if their cells cannot respond to androgens. Biology is far more intricate than a simple XX/XY binary.1

Misconception 3: Sex Is Binary

Viewing sex as strictly “male” or “female” is outdated. Sex spans a spectrum shaped by chromosomes, hormone levels, and physical traits. Intersex individuals—whose characteristics don’t fit neatly into male or female categories—provide tangible evidence that nature allows for a range of biological possibilities.

Historically, these differences were medicalised or pathologised. Today, many clinicians advocate recognising them as part of normal human diversity.1

Misconception 4: Intersex Traits Are “Defects”

Labeling intersex traits or chromosomal variations as “defects” is inaccurate and harmful. Historically, infants with intersex variations often underwent surgeries aimed at “normalising” their bodies—frequently without consent—leading to psychological and physical complications.

Modern approaches emphasise informed, person-centred care that respects the individual’s future autonomy. Using affirming language and recognising intersex variations as part of human diversity helps reduce stigma and fosters better health outcomes.1

Rethinking Gender as a Spectrum

Misconception 5: Gender Is Binary

Just as sex is not strictly binary, neither is gender. Non-binary identities challenge the notion that everyone is exclusively “man” or “woman.” Many cultures globally—such as Two-Spirit among Indigenous peoples of North America and hijra in South Asia—have long recognised more expansive views of gender, debunking the idea that gender diversity is solely a modern phenomenon.

Seeing gender as fluid rather than fixed acknowledges the social, cultural, and individual factors that shape identity.3

Misconception 6: Non-Binary Identities Aren’t Real

Dismissing non-binary identities ignores the lived experiences of countless individuals. Gender is influenced by cultural norms, societal roles, and personal feelings, making it inherently flexible. Non-binary identities are validated in psychological and sociological research, confirming the existence of gender diversity beyond the male/female binary.

Accepting non-binary people broadens our societal understanding and helps reduce stigma for those whose identities don’t conform to traditional categories.2

Misconception 7: You Can’t Change Language

Language evolves with culture. Pronouns like “they/them” for a single person, once controversial, are now recognised as valid by major style guides and professional bodies. Resisting updates to our language can exclude those who rely on more accurate descriptors to affirm their identities.

Groups like the American Psychological Association stress that inclusive language correlates with better mental health outcomes by validating people’s experiences.2

Misconception 8: Transitioning Means Changing Gender

Transitioning does not “create” a new gender; it aligns external markers (pronouns, clothing, physical traits) with an individual’s established internal identity. Gender-affirming care may involve social, legal, or medical steps—such as hormone therapy or surgeries—depending on one’s unique needs.

Research and clinical practice show that these interventions can reduce psychological distress by addressing the incongruence between someone’s identity and outward presentation.2

Addressing Misunderstandings About Identity and Labels

Misconception 9: Terms Like “Cisgender” Are Unnecessary

Some argue that “cisgender” is not needed, implying only transgender individuals must label themselves. In fact, “cisgender” (someone whose gender identity aligns with their assigned sex at birth) creates a more balanced discussion by acknowledging everyone’s identity, rather than treating cis as the unspoken default.

Likewise, describing someone’s gender as “biological” or “real” risks invalidating trans or non-binary identities. The American Psychological Association and other researchers advocate using terms like “assigned male/female at birth” to reflect that all identities deserve recognition.245

Misconception 10: Categories Like “Male” and “Female” Are Rigid

Some assert that “man” or “woman” are unchanging categories, yet multiple factors—genetic, hormonal, anatomical—shape how individuals experience and present themselves. For example, a person with XY chromosomes might have female external characteristics if their cells cannot respond to male hormones.

Cultural context, biology, and self-perception all intersect to define identity. Recognising this complexity fosters more inclusive healthcare, social environments, and personal acceptance.1

Misconception 11: Pronouns Equal Gender

A prevalent misconception equates pronouns with gender, leading to the assumption that using specific pronouns inherently defines someone’s identity. In truth, pronouns are linguistic tools that do not fully encompass the complexities of gender.

Linguistic Diversity: Many languages do not attach gender to pronouns. For instance:

  • Finnish and Turkish use gender-neutral pronouns universally, showcasing that pronouns are not inherently tied to binary gender systems.
  • English has evolved to include singular “they,” now widely accepted as a gender-neutral option in academic, legal, and social contexts.5.

Modern Usage: Today, pronouns are a way to affirm and respect someone’s identity, but they are not synonymous with it. For example:

  • A non-binary person may use “they/them” for neutrality or adopt other pronouns based on comfort and cultural context.

Understanding that pronouns and gender are not interchangeable fosters more nuanced and inclusive conversations.

Debunking Myths About Gender-Affirming Care

Misconception 12: Gender-Affirming Care Is Harmful

Claims that gender-affirming care is harmful are refuted by extensive research showing such interventions can reduce anxiety, depression, and suicidality.6 Clinical guidelines from bodies like the American Psychiatric Association7 and the American Association of Medical Colleges8 support these treatments as critical for many transgender individuals.

Multiple studies reinforce the benefits:

  • Lower Depression and Suicidality in Youth: Transgender and nonbinary youths receiving puberty blockers and hormones saw substantial reductions in depression and suicidality over 12 months.910
  • Improved Mental Health After Surgery: Analysis of the 2015 US Transgender Survey found significantly reduced psychological distress and suicidal ideation in those who accessed gender-affirming surgeries.1112
  • Reduced Suicidal Ideation with Puberty Suppression: Adolescents who received puberty blockers reported significantly lower rates of lifetime suicidal ideation than those who desired but didn’t receive them.1314
  • Extremely Low Regret Rates: A multidisciplinary review found only 0.3% of patients sought reversal after gender-affirming surgery.15
  • Safe Environments for Exploration: Research reveals that socially transitioned children have comparable or lower levels of depression and anxiety than peers, especially when supported in their identities.1617

Overall, gender-affirming care supports the alignment of physical traits and social identity with an individual’s intrinsic sense of self, leading to improved mental health. Expert Q&As18 and interdisciplinary approaches19 underline that social, medical, and surgical options—tailored to each person—are crucial in helping transgender and non-binary individuals navigate dysphoria and flourish in their identities.

Misconception 13: Gender-Affirming Care Is Unproven

A recurring myth is that gender-affirming care lacks sufficient evidence or is experimental. However, decades of rigorous research and clinical practice firmly establish its effectiveness in improving mental health and overall well-being for transgender and non-binary individuals.

Mental Health Benefits: Studies consistently show that gender-affirming care significantly reduces depression, anxiety, and suicidality:

  • A 2022 study in JAMA Network Open demonstrated that transgender and non-binary youths receiving puberty blockers or hormones experienced a 60% reduction in depression and suicidal ideation within 12 months.9.
  • A separate study from The Journal of Adolescent Health corroborated these findings, showing improved mental health outcomes after hormone therapy.10.

Low Regret Rates: A comprehensive 2023 review found that regret rates for gender-affirming surgeries are exceedingly low—only 0.3% of individuals sought reversal, illustrating the satisfaction and efficacy of these procedures.15.

Biological Foundations: Research into the genetic and neurological aspects of gender dysphoria highlights its biological underpinnings:

  • Studies link gender dysphoria to variations in genes regulating sex hormone signaling, affirming the innate nature of gender identity.6.

Professional Consensus: Major medical organisations, including the World Professional Association for Transgender Health (WPATH) and the American Academy of Pediatrics, recognise gender-affirming care as evidence-based and critical to supporting the well-being of transgender individuals.

This robust body of evidence invalidates claims that gender-affirming care is unproven or experimental, underscoring its importance as a life-saving intervention.

Historical and Cultural Perspectives on Gender

Misconception 14: Gender Identity Is a Western Concept

The idea that gender identity is solely a Western construct ignores the extensive history of diverse gender roles across cultures worldwide.

Two-Spirit People: Among Indigenous North American communities, Two-Spirit individuals have been revered as people embodying both masculine and feminine qualities. They often held sacred roles as spiritual leaders, healers, or mediators.20.

Hijra in South Asia: Hijras in India, Pakistan, and Bangladesh are recognised as a third gender, distinct from male and female. Their historical significance is rooted in spiritual, cultural, and ceremonial roles, often associated with blessings and fertility.21.

Muxe in Zapotec Culture: In Oaxaca, Mexico, muxes are regarded as a third gender that blends male and female traits, fulfilling unique social and ceremonial roles.22.

These examples reveal that diverse gender identities have been integral to many non-Western societies, challenging the misconception that gender identity is a Western invention.

Misconception 15: Gender Diversity Is a Modern Concept

The belief that gender diversity is a recent phenomenon is contradicted by evidence from ancient cultures and religious traditions.

Ancient Mesopotamia: Inanna’s cult in Mesopotamia included individuals who lived beyond the gender binary, reflecting societal recognition of gender diversity.23.

Judaism’s Eight Genders: The Talmud identifies eight distinct genders, illustrating a deeply nuanced understanding of human identity:

  1. Zachar: Male-assigned at birth.
  2. Nekeivah: Female-assigned at birth.
  3. Androgynos: Having both male and female traits.
  4. Tumtum: Possessing indeterminate characteristics.
  5. Ay’lonit Hamah: Female-assigned at birth, developing male traits naturally.
  6. Ay’lonit Adam: Female-assigned at birth, developing male traits through intervention.
  7. Saris Hamah: Male-assigned at birth, developing female traits naturally.
  8. Saris Adam: Male-assigned at birth, developing female traits through intervention.24.

These historical precedents dispel the notion that gender diversity is a recent or modern construct.

Misconception 16: Religious Texts Only Support Binary Genders

It is often claimed that religious scriptures universally enforce binary gender roles. However, many traditions acknowledge gender complexity and inclusivity.

Jesus on Eunuchs: In Matthew 19:12, Jesus refers to three types of eunuchs—those born that way, those made that way, and those who choose to live as eunuchs for spiritual reasons. This recognition of non-binary identities challenges binary assumptions.25.

Islam’s Mukhannathun: Early Islamic texts reference mukhannathun, individuals who did not conform to binary gender roles, highlighting their recognised societal roles.26.

These examples highlight that many religious traditions have engaged with gender diversity more deeply than binary interpretations suggest.

Conclusion: Building Understanding Through Respect

Sex and gender are complex, multifaceted concepts that defy simplistic binaries. By understanding these distinctions, challenging misconceptions, and embracing respectful language, we can create a more inclusive and compassionate world. Let’s commit to dismantling myths and fostering a culture of empathy and understanding. Only through respect and education can we begin to bridge gaps and support everyone in living their truth.

  1. Purves D, Augustine GJ, Fitzpatrick D, et al., editors. “What Is Sex?” Neuroscience, 2nd Edition. Chapter: Sex, Sexuality, and the Brain. Sunderland (MA): Sinauer Associates; 2001. Available from: https://www.ncbi.nlm.nih.gov/books/NBK10943/ [↩] [↩] [↩] [↩] [↩]
  2. Martin CL, Ruble DN. “Patterns of Gender Development.” Annual Review of Psychology. 2010;61:353-381. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3747736/ [↩] [↩] [↩] [↩] [↩]
  3. Roselli CE. “Neurobiology of Gender Identity and Sexual Orientation.” Journal of Neuroendocrinology. 2017;29(7):e12562. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC6677266/ [↩] [↩]
  4. Cava P. “Cisgender and Cissexual.” Available from: http://www.petercava.com/uploads/2/3/1/9/23191072/cava_cisgender_and_cissexual.pdf [↩]
  5. American Psychological Association. “Understanding Transgender People, Gender Identity, and Gender Expression.” Available from: https://www.apa.org/topics/lgbtq/transgender-people-gender-identity-gender-expression [↩] [↩]
  6. Foreman M, Hare L, York K, et al. “Genetic Link Between Gender Dysphoria and Sex Hormone Signaling.” Journal of Clinical Endocrinology and Metabolism. 2018;103(11):3879-3887. Available from: https://pubmed.ncbi.nlm.nih.gov/30247609/ [↩] [↩]
  7. American Psychiatric Association. “What Is Gender Dysphoria?” Available from: https://www.psychiatry.org/patients-families/gender-dysphoria/what-is-gender-dysphoria [↩]
  8. AAMC. “Understanding Gender-Affirming Care: What You Need to Know.” Available from: https://www.aamc.org/news-insights/what-gender-affirming-care-your-questions-answered [↩]
  9. Turban JL, King D, Carswell JM, et al. “Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care.” JAMA Network Open. 2022;5(2):e220978. Available from: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423 [↩] [↩]
  10. Tordoff DM, Wanta JW, Collin A, et al. “Association of Gender-Affirming Hormone Therapy With Depression, Thoughts of Suicide, and Attempted Suicide Among Transgender and Nonbinary Youth.” Journal of Adolescent Health. 2022. Available from: https://www.jahonline.org/article/S1054-139X(21)00568-1/fulltext [↩] [↩]
  11. Almazan AN, Keuroghlian AS. “Association Between Gender-Affirming Surgeries and Mental Health Outcomes in Transgender and Gender Diverse People.” JAMA Surgery. 2021;156(7):611-618. Available from: https://jamanetwork.com/journals/jamasurgery/fullarticle/2779429 [↩]
  12. Cleveland Clinic. “Understanding Gender Affirmation Surgery: What to Expect.” Available from: https://my.clevelandclinic.org/health/treatments/21526-gender-affirmation-confirmation-or-sex-reassignment-surgery [↩]
  13. Turban JL, King D, Carswell JM, et al. “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation.” Pediatrics. 2020;145(2):e20191725. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/ [↩]
  14. Mayo Clinic. “Puberty Blockers for Transgender Youth.” Available from: https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075 [↩]
  15. Narayan SK, Diffin J, Honda H, et al. “Regret After Gender-Affirming Surgery: A Multidisciplinary Approach.” Aesthetic Surgery Journal. 2023. Available from: https://pubmed.ncbi.nlm.nih.gov/36727823/ [↩] [↩]
  16. Olson KR, Durwood L, DeMeules M, et al. “Mental Health of Transgender Children Who Are Supported in Their Identities.” Pediatrics. 2016;137(3):e20153223. Available from: https://publications.aap.org/pediatrics/article-abstract/137/3/e20153223/81409/Mental-Health-of-Transgender-Children-Who-Are [↩]
  17. Olson KR, Gülgöz S, Forbes NG, et al. “Gender Identity 5 Years After Social Transition.” Pediatrics. 2022;150(2):e2021056082. Available from: https://publications.aap.org/pediatrics/article/150/2/e2021056082/186992/Gender-Identity-5-Years-After-Social-Transition [↩]
  18. American Psychiatric Association. “Expert Q&A: Gender Dysphoria.” Available from: https://www.psychiatry.org/patients-families/gender-dysphoria/expert-q-and-a [↩]
  19. StatPearls. “Gender Dysphoria.” Available from: https://www.ncbi.nlm.nih.gov/books/NBK532313/ [↩]
  20. Canadian Institutes of Health Research. “Two-Spirit People: Then and Now.” Institute of Gender and Health, 2020. Available from: https://cihr-irsc.gc.ca/e/documents/igh_two_spirit-en.pdf [↩]
  21. Hossain A. “Beyond Emasculation: Being Muslim and Becoming Hijra in South Asia.” Asian Studies Review. 2012. Available from: https://www.tandfonline.com/doi/full/10.1080/10357823.2012.739994 [↩]
  22. Chiñas B. “Isthmus Zapotec Attitudes toward Sex and Gender.” Women & Gender in Mesoamerica. 1995 [↩]
  23. Ancient Mesopotamian Transgender and Non-Binary Identities, Academus Education. Available from: https://www.academuseducation.co.uk/post/ancient-mesopotamian-transgender-and-non-binary-identities [↩]
  24. The Eight Genders in the Talmud, My Jewish Learning. Available from: https://www.myjewishlearning.com/article/the-eight-genders-in-the-talmud/ [↩]
  25. Matthew 19:12, Bible Gateway. Available from: https://www.biblegateway.com/passage/?search=Matthew%2019%3A12&version=NIV [↩]
  26. Rowson E. “The Effeminates of Early Medina.” Journal of the American Oriental Society. 1991. Available from: https://www.jstor.org/stable/603399 [↩]

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