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Gender identity and gender expression.

Jama Shelton Jama Shelton Hunter College, City University of New York
https://doi.org/10.1093/acrefore/9780199975839.013.1324
Published online: 21 June 2023

Gender identity and gender expression are aspects of personal identity that impact an individual across multiple social dimensions. As such, it is critical that social workers understand the role of gender identity and gender expression in an individual’s life. Many intersecting factors contribute to an individual’s gender identity development and gender expression, as well as their experiences interacting with individuals, communities, and systems. For instance, an individual’s race, geographic location, disability status, cultural background, religious affiliation, age, economic status, and access to gender-affirming healthcare are some of the factors that may impact experiences of gender identity and gender expression. Gender identity and expression are dimensions of diversity that social workers will interact with at all levels of practice. As such, it is important for social work educational institutions to ensure their students are prepared for practice with people of all gender identities and expression, while also understanding the historical context of the social work profession in relation to transgender populations and the ways in which the profession has reinforced the sex and gender binaries.

gender binary
gender equity
gender identity
gender expression

What Are Gender Identity and Gender Expression?

Every individual has a gender identity, and every individual expresses their gender (see Table 1 ). Gender identity and gender expression are often referenced in relation to transgender, nonbinary, and gender-expansive people, yet one’s gender and the expression of gender are dimensions of identity that every individual possesses. Gender identity can be understood as an individual’s internal sense of self as it relates to gender. One’s gender is a deeply felt, personal sense of self as a girl/woman, boy/man, both a girl/woman and a boy/man, neither a girl/woman nor a boy/man, or a combination of a girl/woman and a boy/man. Additional words people may use to describe their gender include (but are not limited to): nonbinary, gender expansive, agender, multigender, two-spirited, gender-fluid, genderqueer, and muxe. Importantly, there is no external source that can dictate an individual’s gender identity.

Gender expression refers to the ways in which an individual expresses their gender outwardly. Gender expression may include an individual’s dress, hairstyle, mannerisms, and behaviors. These are typically based on stereotypes about gender within a particular cultural context. An individual’s gender expression may or may not conform to social norms that are typically associated with an individual’s gender or with gendered assumptions based on an individual’s assigned sex. Importantly, an individual’s gender presentation may or may not reflect their gender identity. Issues such as personal safety and access to accurately gendered items may impact an individual’s ability to express their gender in a way that aligns with their gender identity.

Table 1. Additional Relevant Terms

The sex and gender binaries.

The terms gender and sex are often used interchangeably. While these terms may be related in some instances, they are not the same. An individual’s sex is connected to their chromosomes, hormones, and anatomy. Typically, an individual is assigned a sex at birth, if not prior to birth. A sex assignment is most often made based on the appearance of a baby’s genitals. The options for sex assignment have historically been either male or female, which is then listed on an individual’s birth certificate. This is still often the case in the United States, even though evidence demonstrates that sex is not a binary construct ( Fausto-Sterling, 2018 ). Some states in the country allow an additional option (X) for the classification of sex on the birth certificate. While it is beyond the scope of this article to examine the category of intersex (discussed in “XXX”), intersex people cannot be overlooked in discussions of sex and gender. The binary construction of sex assumes the existence of only two sexes. This is an inaccurate and limiting construct that ignores human variability. Not only is it inaccurate and limiting, it is also harmful. Intersex babies and children often undergo surgical procedures that they do not consent to, and are required to take hormones in order to make their bodies fit within a binary that their bodies directly challenge.

An individual’s gender is most often presumed based on their sex assignment, and is presumed to fall within the binary gender categories of girl/woman and boy/man. For instance, if a baby is assigned female, the assumption is that the baby is a girl and will grow up to be a woman. With this assumption comes a set of gendered norms and expectations, societally reinforced in myriad ways including options for grooming and dress, presumptions about appropriate behavior and presentation, and even the choice of language used to praise or discipline (“such a pretty girl” or “that’s not ladylike”). However, an individual’s assigned sex does not always predict their gender; gender identity is more strongly linked to an individual’s experience of gender than to assigned sex ( Olson et al., 2015 ). Yet, the connection between an individual’s sex and their gender and the binary constructions of both sex and gender are so widely taught that this misperception is pervasive in the United States and in many Western countries despite the fact that “defining gender as a condition determined strictly by a person’s genitals is based on a notion that doctors and scientists abandoned long ago as oversimplified and often medically meaningless” ( Grady, 2018 ). In addition to the limitations of these binary categories, sex and gender are often viewed as immutable and stable over time. The lived experiences of intersex, nonbinary, transgender, and gender-expansive people demonstrate the inaccuracy of the binary system of sex and gender categorization.

It is important to note that an individual’s identification within the gender binary is not itself problematic. Because many laws and policies in the United States are based on a binary construction of sex and/or gender, it is the classification system itself that is flawed. Binary classifications are problematic when identification with the gender binary and associated gender expressions are required for entry within social and legal systems.

Beyond the Binary: Reconceptualizing Gender Identity and Gender Expression

Some think about gender identity and gender expression as a continuum, with binary classifications marking the endpoints and a range of identities and expressions in between. More contemporary understandings assert that gender identity and gender expression exist more as a “galaxy” rather than a continuum ( Action Canada for Sexual Health and Rights, n.d. ). This thinking is more in alignment with moving beyond binary conceptualizations of gender altogether and situates all gender identities and gender expressions as equally viable, without relying on the containment of binary categories.

Moving beyond the gender binary not only improves the lived experiences of transgender, nonbinary, and gender-expansive people but also opens up possibilities for everyone . The construct of gender carries with it prescribed ways of being ranging from what is “appropriate” physical and behavioral gender expression to what are appropriate fields of study and career choices. Truly moving beyond the gender binary can liberate all people from the constraints inherent in presumptive and prescribed notions of what is deemed socially, culturally, and politically appropriate.

How could moving beyond the gender binary be operationalized within the social work profession? Prior to discussing suggestions for moving beyond the binary in social work education, practice, and research, it is important to first examine the history of the social work profession as it relates to gender identity and gender expression.

Social Work, Gender Identity, and Gender Expression: A Brief History

Historically, the social work profession is rife with demands that nonconforming gender expressions and bodies adapt to mainstream gendered expectations. Examples include the profession’s support for the assimilative Native American Residential Schools, electroconvulsive therapies intended to “cure” homosexuality, and a host of welfare eligibility requirements that serve to police Black families for their deviation from White heteronormative standards ( Bowles & Hopps, 2014 ). Thus, common practices centered around promoting access to resources through acclimating and gaining membership to the status quo. As such, the profession of social work has been complicit in the policing of gender and the maintenance of the gender binary. It is important for the profession to reckon with this disciplinary approach to gender identity and expression in the past, while also developing equitable frameworks for the future.

The primary formal mechanism for the policing of gender and, thus the reification of the gender binary, is the Diagnostic and Statistical Manual of Mental Disorders (DSM). Gender identity disorder was first included in the DSM-III in 1980 , and included the diagnoses “gender identity disorder of childhood” and “transsexualism.” When updated in 1987 , the new DSM-III-R included gender identity disorder of adolescence and adulthood, nontranssexual type ( Drescher, 2009 ). Gender identity disorder of adolescence and adulthood, nontranssexual type, was removed from the DSM-IV and replaced with the category gender identity disorder, a diagnosis encompassing both gender identity disorder of childhood and transsexualism ( Shelton et al., 2019 ). The most recent version of the DSM (the DSM-5) replaced gender identity disorder with gender dysphoria. This shift in diagnostic terminology signifies a change in the understanding of the root causes of the challenges individuals face when their gender identity and gender expression fall outside of the dominant societal norms prescribed to the gender associated with their assigned sex. Namely that societal definitions of and expectations surrounding gender do not accurately reflect people’s lived experience of gender. However, the fact that a mental health diagnosis remains in the DSM is considered problematic by many, as gender related dissonance continues to be constructed as individual pathology.

The DSM solidified the notion of a gendered norm any deviation from which required correction. For decades, the remedy was to fit an individual into a gender that aligned with the expectations associated with their assigned sex. Through modern medicine, a new type of “correction” emerged for those who could gain access, through hormone treatment and affirming surgeries. Though these interventions are medical in nature, the psychiatric diagnoses remain a driving force in accessing these treatments. Further, gender-affirming treatments have reinforced the necessity of binary gender conformity, by supporting an individual in their transition from one gender to the other gender. It is important to note here that these treatments have been and continue to be life-saving for many individuals, and that identifying with the gender binary is not in itself problematic. As already stated, the gender binary is problematic when a binary classification is imposed and/or presumed and is not in alignment with an individual’s stated gender and understanding of their own body ( Ansara & Hegarty, 2012 ), and when identification or categorization within the gender binary is required for entry into and acceptance within social and legal systems ( Shelton et al., 2019 ).

The National Association of Social Workers released a position statement denouncing the continued inclusion of gender identity related diagnoses in the DSM-5, stating that diagnoses such as gender dysphoria should be approached from a medical model rather than a mental health model. Because of the authority that the DSM holds in social work and related professions, the inclusion of gender dysphoria perpetuates the notion that the variability of gender is a psychiatric condition, reinforcing cisnormativity and the binary gender system. Advocacy organizations argue that until gender related diagnoses are removed from the DSM, transgender and gender-expansive people will continue to suffer from stigma, discrimination, and the invalidation of their identities and experiences.

Social workers may find themselves in a gatekeeping role when working with individuals whose gender identity and/or gender expression expand beyond binary classifications or stretch the boundaries of what is typically considered appropriate gendered behavior based on an individual’s sex assignment. For instance, according to the Standards of Care put forth by the World Professional Association for Transgender Health ( WPATH, 2012 ), in order to access gender-affirming care (such as hormone treatment or surgery), an individual must obtain a letter of recommendation from a qualified mental health professional diagnosing their persistent gender dysphoria and indicating their readiness for care ( Coleman et al, 2022 ). Thus, the notion that individuals whose gender identities expand beyond the binary cisgender norm are not only pathologized but also viewed as incapable of owning their own bodily expertise. The same requirements are not expected from cisgender individuals seeking body altering surgeries, such as breast augmentation, hair implants, or facelifts.

Notably, not every nonbinary, gender-expansive, or transgender individual desires gender-affirming medical procedures. There is no single way to be nonbinary, gender expansive, or transgender, just as there is no single way to be a girl, woman, boy, or man. Each individual person experiences and expresses their gender in their own unique way.

Social Work and Gender Equity

Social workers are charged with confronting injustice; social justice is a core value of the profession. In recognition of the social worker’s responsibility to work toward social justice, the Council on Social Work Education (CSWE) (2015 ) generated accreditation standards requiring social workers to understand diversity and difference in the context of privilege, power, oppression, and marginalization to eliminate biases (Competency 2). Because gender identity and gender expression are included as dimensions of diversity that professionals must understand and value, social workers have an ethical commitment to advance gender equity in all professional practice, education, and research activities. The National Association of Social Workers (NASW) Code of Ethics ( 2017 / 1996 ) includes gender identity and gender expression as specific categories to include when confronting discrimination. The Code of Ethics ( 2017 / 1996 , p. 21) states that “social workers should not practice, condone, facilitate, or collaborate with any form of discrimination on the basis of ... sexual orientation, gender identity or expression.”

In order to meet CSWE’s Competency 2—that social workers must understand diversity and difference in the context of privilege, power, oppression, and marginalization to eliminate biases—it is important that the profession broadens its analysis from individual and interpersonal acts of discrimination to include social systems and institutions that permit individual and interpersonal acts of discrimination. In other words, the role of structural discrimination in the oppression of people based on their gender identity and/or gender expression must be addressed. Structural discrimination can be understood as “the policies of dominant race/ethnic/gender institutions and the behavior of the individuals who implement these policies and control these institutions, which are race/ethnic/gender neutral in intent but which have a differential and/or harmful effect on minority race/ethnic/gender groups” ( Pincus, 1996 , p. 186).

To engage from within a structural framework would require social workers to address the structural conditions that marginalize people on the basis of their gender identity and/or gender expression. For example, rather than working with people to cope with the gender identity and expression based marginalization they face, social workers would also address the systems and structures that produce and reinforce marginalization. This may include challenging policies and practices within institutions of social work practice and education that rely on a binary classification of gender as a way to organize and categorize people. It may include insisting that all gender restrooms are accessible to all clients in one’s agency, or becoming involved in advocacy efforts aimed at removing gender identity based diagnoses from the DSM.

Social workers can begin to move beyond the gender binary by taking an inventory of the policies and practices within their organizations, critically examining the ways in which they may be inadvertently marginalizing clients and communities based on gender identity and gender expression. By centering transgender and nonbinary people in their examinations of policy and practice, social workers can intentionally assess their inclusion of and impact on transgender, nonbinary, and gender-expansive people. Because societal systems and services were built on the premise of binary sex and gender, they are rooted in the presumption that every individual who comes into contact with them can be categorized within these binary constructions. Public restrooms provide a concrete example. Social norms around restroom use necessitate that males and females are separated in different rooms, even with the physical separation of locked and partitioned stalls. In instances when public restrooms are single occupancy, they are most often still labeled male and female. The rationale for this separation is often safety and privacy. As Davis (2014 , p. 53) asserts, “If privacy and safety are the main reasons for sex-segregated restrooms, then might alternative physical designs such as floor-to-ceiling stall partitions do an even better job of meeting that goal than the current design of most American public restrooms?”

With regard to social work education, Shelton and Dodd (2020 ) outline key strategies for challenging cisnormativity and moving beyond the gender binary, including:

Use all gender pronouns (they and them) when speaking and writing rather than only including she and he or his and hers, an example of binarizing ( Blumer et al., 2013 ).

Examine and review course syllabi for implicit cisnormativity. Include your name and pronouns, ensure gender identity and expression are a part of classroom nondiscrimination standards, avoid binarizing language, and identify any all-gender restrooms available in the building.

Examine and review content on course syllabi. Ensure readings by and about transgender people are included. Transgender topics and authors should appear in a unit on gender identity. When planning a session about parenting, for instance, include a reading about transgender, gender-expansive, genderqueer, or nonbinary parents.

Be intentional when planning classroom introductions. Some students may not use the names indicated on your class roster or on school records. Plan introductions in such a way that enables students to introduce themselves first (before reading names from the provided class roster).

Model the sharing of pronouns and give students the option to include their pronouns when introducing themselves. For example, you could say, “Please share your name and your pronouns if you would like to do so.”

When utilizing case examples in the classroom, make sure transgender people are included/represented.

When including transgender people in case examples, make sure they are included in a way that does not perpetuate negative stereotypes and misinformation. For instance, a case example including a transgender person does not need to be focused solely on gender dysphoria and does not need to be related to their transgender identity.

Engage students in nuanced discussions about the history of the pathologization of gender and sexual minorities and the role of social work in this history.

Social work researchers can concretely work toward gender equity throughout the research process, helping to ensure all gender identities and gender expressions are acknowledged as valid. From the design of demographic questions to the reporting of results, researchers can intentionally include participants with a range of gender identities and expressions. Demographic questions can include additional options for sex and gender beyond the binary categorizations of female/male, woman/man, or girl/boy. When analyzing quantitative data, researchers can opt out of collapsing sex and/or gender into a dichotomous variable. Though this may make the process of analysis less simple, making these variables dichotomous erases the lived experiences of participants. When reporting results, researchers can include the experiences of participants across a range of gender identities and gender expressions. In reporting only statistically significant findings, critical data about frequently marginalized and underrepresented populations is lost. Recruitment strategies should include specific outreach to individuals and communities of diverse gender identities and gender expressions. This will require community engaged research and a willingness to extend recruitment timelines to ensure adequate representation. A 2021 study from the Williams Institute reported that 1.2 million adults in the United States are nonbinary ( Wilson & Meyer, 2021 ). Expanding beyond binary conceptualizations of gender within social work research is imperative in order to address the health and well-being of nonbinary individuals and communities.

In summary, gender identity and gender expression are dimensions of identity that are relevant to and impact all people. Thus, it is important for social workers to understand the ways in which gender identity and gender expression impact the individuals and communities with whom they work, as well as the ways that systems and institutions may perpetuate bias and marginalization based on gender identity and gender expression. Although the profession of social work has a fraught history with regard to policing and pathologizing individuals whose gender identities and expressions exist outside of or in between the gender binary, contemporary practice charges social workers with confronting injustice, including dimensions of diversity such as gender identity and gender expression.

A review of the essential concepts in diagnosis, therapy, and gender assignment in disorders of sexual development

Vivek Parameswara Sarma ORCID: orcid.org/0000-0001-9484-7090 1

Annals of Pediatric Surgery volume 18 , Article number: 13 ( 2022 ) Cite this article

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The aim of this article is to review the essential concepts, current terminologies and classification, management guidelines and the rationale of gender assignment in different types of differences/disorders of sexual development.

The basics of the present understanding of normal sexual differentiation and psychosexual development were reviewed. The current guidelines, consensus statements along with recommendations in management of DSD were critically analyzed to formulate the review. The classification of DSD that is presently in vogue is presented in detail, with reference to old nomenclature. The individual DSD has been tabulated based on various differential characteristics. Two schemes for analysis of DSD types, based on clinical presentation, karyotype and endocrine profile has been proposed here. The risk of gonadal malignancy in different types of DSD is analyzed. The rationale of gender assignment, therapeutic options, and ethical dimension of treatment in DSD is reviewed in detail.

The optimal management of different types of DSD in the present era requires the following considerations: (1) establishment of a precise diagnosis, employing the advances in genetic and endocrine evaluation. (2) A multidisciplinary team is required for the diagnosis, evaluation, gender assignment and follow-up of these children, and during their transition to adulthood. (3) Deeper understanding of the issues in psychosexual development in DSD is vital for therapy. (4) The patients and their families should be an integral part of the decision-making process. (5) Recommendations for gender assignment should be based upon the specific outcome data. (6) The relative rarity of DSD should prompt constitution of DSD registers, to record and share information, on national/international basis. (7) The formation of peer support groups is equally important. The recognition that each subject with DSD is unique and requires individualized therapy remains the most paramount.

The aim of this article is to review the essential concepts, current terminologies and classification, management guidelines, and the rationale of gender assignment in different types of differences/disorders of sexual development (DSD). The basics of the present understanding of normal sexual differentiation and psychosexual development were reviewed. The current guidelines, consensus statements along with recommendations in management of DSD were critically analyzed to formulate the review. The classification of DSD that is presently in vogue is presented in detail, with reference to old nomenclature. The individual DSD has been tabulated based on various differential characteristics. Two schemes for analysis of DSD types, based on clinical presentation, karyotype, and endocrine profile has been proposed here. The risk of gonadal malignancy in different types of DSD is analyzed. The rationale of gender assignment, therapeutic options, and ethical dimension of treatment in DSD is reviewed in detail.

The normal sexual differentiation

The normal pattern of human sexual development and differentiation that involves specific genetic activity and hormonal mediators [ 1 , 2 ] is explained by the classical Jost’s paradigm; the essence of which is narrated below [ 3 ].

The establishment of chromosomal sex (XX or XY) occurs at the time of fertilization. The variations in sex chromosome include XO, XXY or mosaicism as in XO/XY.

Chromosomal sex influences the determination of the gonadal sex, thus differentiating the bipotential gonadal ridge into testis or ovary. (Variations in gonadal sex include ovotestis and streak gonad.) The SRY gene (referred to as the testis-determining gene) on the short arm of Y chromosome directs the differentiation into testes, with formation of Leydig and Sertoli cells [ 4 , 5 ].

The sex phenotype (internal and external genitalia) is determined by the specific hormones secreted by the testes, which translates the gonadal sex into phenotype. Testosterone secretion by Leydig cells promotes Wolffian duct differentiation into vas deferens, epididymis, and seminal vesicles. The Wolffian ducts regress in the absence of androgenic stimulation. Testosterone is converted to dihydrotestosterone (DHT), by 5-alpha reductase, which results in masculinization of external genitalia, closure of urethral folds, and development of the prostate and scrotum. In the absence of influence of SRY gene, the development of bipotential gonad will evolve along the female pathway. Thus, the Mullerian ducts develop (even without any obvious hormonal input) into the uterus, fallopian tubes, and the proximal 2/3 of vagina. DHT is also important for the suppression of development of the sinovaginal bulb, which gives rise to the distal 1/3 of vagina. The fact that internal duct development reflects the ipsilateral gonad (due to the paracrine effect of sex hormones) is an important consideration in the understanding of specific types of DSD. The anti-Mullerian hormone (AMH) from Sertoli cells of Testis is vital for the regression of Mullerian structures. Therefore, Wolffian structures will develop on one side, along with Mullerian duct regression, only in the presence of a fully functional testis. But, Mullerian duct structures develop on one side even in the presence of an ipsilateral streak gonad. The genital tubercle develops as a clitoris, the urethral folds form the labia minora, and the labioscrotal swellings form the labia majora [ 1 , 2 , 4 , 5 , 6 ].

The concept of psychosexual development was added to the above sequence by Money et al. [ 7 ]. The brain undergoes sexual differentiation consistent with the other characteristics of sex. It is proposed that androgens organize the brain in early development and pubertal steroids activate the same, leading to masculine behavior. The sexual differentiation of genitalia occur in first 2 months of pregnancy, while sexual differentiation of brain occurs in the second half of pregnancy, and hence these processes can be influenced independently. Therefore, the extent of virilization of genitalia may not reflect the extent of masculinization of brain [ 8 , 9 ].

Psychosexual development is a complex and multifactorial process influenced by brain structure, genetics, prenatal and postnatal hormonal factors, environmental, familial, and psychosocial exposure [ 10 , 11 , 12 ]. Psychosexual development is conceptualized as three components: (1) gender identity is defined as the self-representation of a person as male, female or even, neither. (2) Gender role (sex-typical behavior) describes behavior, attitudes and traits that a society identifies as masculine or feminine. (3) Sexual orientation denotes the individual responsiveness to sexual stimuli, which includes behavior, fantasies, and attractions (hetero/bi/homo-sexual).

Psychosexual development is influenced by various factors such as Androgen exposure, sex chromosome genes, brain structure, family dynamics and social structure. With reference to altered psychosexual development, two conditions are important to be recognized and differentiated. (1) Gender dissatisfaction denotes unhappiness with the assigned sex, the etiology of which is poorly understood. (With respect to subjects with DSD, it has to be remembered that homo-sexual orientation or cross-sex interest is not considered an indication of incorrect gender assignment.) (2) Gender dysphoria (GD) is characterized by marked incongruence between the assigned gender and experienced/expressed gender, which is associated with clinically significant functional impairment. (It can occur in the presence or absence of DSD) [ 12 , 13 , 14 ].

The term “disorders/differences of sex development” (DSD) is defined as congenital anomalies in which development of chromosomal, gonadal, or phenotypic sex (including external genitalia/internal ductal structures) is atypical. In a wider perspective, DSD includes all conditions where chromosomal, gonadal, phenotypical, or psychological sex are incongruent. The three components of psychosexual development also may not always be concordant in DSD [ 15 , 16 ].

A greater understanding of underlying genetic and endocrine abnormalities has necessitated refinement in terminologies and classification of DSD. The newer classification of DSD aims to be more precise, specific, flexible, and inclusive of advances in genetic diagnosis, while being sensitive to patient concerns (Table 1 ). Terms such as intersex, hermaphrodite, pseudohermaphrodite, and sex reversal are avoided, to this end, in diagnostic terminologies. Presently, a specific molecular diagnosis is identified only in about 20% of all DSD. The majority of virilized 46 XX infants will have CAH, but only 50% of 46 XY DSD will have a definitive diagnosis [ 16 , 17 ].

For the purpose of understanding of the basic pathology and ease of comprehension, DSD can be classified as follows:

Sex chromosomal DSD: here, the sex chromosome itself is abnormal. This includes XO (Turner syndrome), XXY (Klinefelter’s syndrome), mosaic patterns of XO/XY (Mixed Gonadal Dysgenesis and Partial Gonadal Dysgenesis), XX/XY (Ovotesticular DSD), and even SRY-positive XX in 46 XX testicular DSD (de la Chapelle syndrome). These are essentially genetic anomalies characterized by a varying degrees of gonadal dysgenesis/abnormal gonadal differentiation secondary to the sex chromosome defect and in certain situations, associated systemic abnormalities and increased risk of malignancies. The phenotypic sex (internal ductal structures and external genitalia) reflects the gonadal sex.

Disorders of gonadal development: these are characterized by abnormal gonadal development, in the absence of any obvious sex chromosomal abnormality, i.e., Karyotype is either 46 XX or 46 XY. It includes 46 XY complete gonadal dysgenesis (Swyer syndrome), 46 XY partial gonadal dysgenesis, 46 XY ovotesticular DSD, 46 XX pure gonadal dysgenesis (Finnish syndrome) and 46 XX ovotesticular DSD. Here also, the phenotypic sex reflects the gonadal sex (streak or dysgenetic gonads/ovotestis).

Abnormalities in phenotypic sex secondary to hormonal defects: these are characterized by normal chromosomal sex (46 XX or 46 XY) and gonadal sex (testes/ovaries), but abnormal phenotype (internal ductal and/or external genital) due to defects in hormonal function. In 46 XY DSD, this can be due to defects in synthesis or action of androgens or less commonly, AMH. In 46 XX DSD, this is due to androgen excess, as in Congenital Adrenal Hyperplasia, or less commonly, gestational hyperandrogenism.

Primary endocrine abnormalities: These are characterized by a severe underlying endocrine abnormality, as in congenital hypogonadotropic hypogonadism or pan-hypopitutarism.

Malformation syndromes: these are characterized by the presence of genital abnormalities due to severe congenital anomalies including persistent cloaca, cloacal exstrophy, Mullerian agenesis/MRKH syndrome, or vaginal atresia.

The common pattern of correlation of gonadal sex with internal duct structure development is summarized in Table 2 . The cardinal characteristics of chromosomal, gonadal, and phenotypic sex in the individual types of DSD is summarized in Table 3 .

The genetic testing in DSD

For a sex chromosome DSD, no further genetic analysis is required. However, a DSD with 46 XX or 46 XY karyotype, the underlying etiology may be a monogenic disorder where the candidate gene has to be analyzed. The algorithm of genetic analysis of DSD is defined according to the results of sex chromosome complement (karyotyping/array CGH or SNP array) and presence of regions of Y chromosome (FISH/QFPCR). The next step is to study specific genes involved in gonadal development by techniques including Sanger sequencing combined with MLPA to assess specific genetic defects. Further analysis includes evaluation for causes of monogenic DSD or analysis of copy number variations (CNV) or both. Panels for candidate genes (CYP21A2 in CAH, AR in androgen insensitivity syndrome) provide rapid and reliable results. The evolving use of whole exome sequencing (WES) and whole genome sequencing (WGS) aim to identify previously unrecognized genetic etiology of DSD.

The further characterization of 46 XY DSD

The further characterization of individual types of 46 XY DSD based on endocrine and genetic evaluation is summarized in Table 4 . The selective use of the following investigations is required in 46 XY DSD to arrive at a specific diagnosis of the subtype:

Assay of serum testosterone, LH and FSH.

hCG stimulation test, to assess response in testosterone levels.

Assay of AMH, to detect the presence of functioning testicular tissue.

Testosterone: dihydrotestosterone (DHT) ratio.

Testosterone: androstenedione ratio.

ACTH test, for the diagnosis of testosterone biosynthesis defects.

Specific substrates like progesterone, 17-OHP, and 1-OH pregnenelone, for typing of Androgen biosynthesis defects.

Ultrasound scan/MRI and laparoscopy for the detection of Mullerian structures.

Gonadal biopsy for the diagnosis of ovotesticular DSD and gonadal dysgenesis.

Genetic testing including screening of androgen receptor gene for mutations, Molecular testing for 5-alpha reductase-2 gene mutations, androgen receptor expression, and androgen binding study in genital skin fibroblasts.

The further characterization of 46 XX DSD is summarized in Table 5 . The classification of the major types of DSD based on the different clinical manifestations is summarized in Table 6 .

Gonadal dysgenesis syndromes

There are five common patterns of gonadal dysgenesis syndromes, in addition to the dysgenetic ovotestis which is found in 46 XX or 46 XY ovotesticular DSD.

46 XY complete gonadal dysgenesis (Swyer syndrome)

46 XY partial gonadal dysgenesis (Noonan syndrome)

45 XO/46 XY mixed gonadal dysgenesis

46 XX pure gonadal dysgenesis (Finnish syndrome)

45 XO Turner’s syndrome.

Gender assignment in DSD

The classical “optimal gender policy” involved early sex assignment and surgical correction of genitalia and hormonal therapy, with the objective of an unambiguous gender of rearing, that will influence the future gender identity and gender role [ 7 , 11 ]. The genital phenotype (characteristics of genitalia) has historically been the guide for gender assignment, considering esthetic, sexual, and fertility considerations. This perspective, which assumes psychosexual neutrality at birth, has been challenged now, with the present focus shifting to the importance of prenatal and genetic influences on psychosexual development. In addition to the progress in the diagnostic techniques and therapeutic modalities, there has been greater understanding of the associated psychosocial issues and acceptance of patient advocacy [ 19 , 20 , 21 ].

Factors to be considered for gender assignment in DSD

The most common gender identity outcome, observed incidence of GD, and requirement of gender reassignment in the specific type of DSD from available data.

The most common pattern of psychosexual development in the particular DSD, consistent with established neurological characteristics.

The requirement of genital reconstructive surgery to conform to the assigned sex.

The estimated risk of gonadal malignancy and need for gonadectomy (Table 7 ).

The requirement, possible response, and timing of HRT.

The expected post-pubertal cosmetic and functional outcome of genitalia, after reconstruction where required.

The potential for fertility, even with the presumed aid of assisted reproduction techniques.

Though GD in patients with DSD influences, the choice of gender assignment (and reassignment), sexual orientation, and gender-atypical behavior do not affect the decision-making process in gender assignment of DSD [ 22 ].

Gender assignment in neonates should be done only after expert evaluation. The evaluation, therapy, and long-term follow-up should only be done at a centre with an experienced multidisciplinary team. The multidisciplinary team for management of DSD should include pediatric subspecialists in endocrinology, surgery/urology, genetics, gynecology, and psychiatry along with pediatrician/neonatologist, psychologist, specialist nurse, social worker, and medical ethicist. The core group will vary according to the type of DSD. All individuals with DSD should receive the appropriate gender assignment [ 22 , 23 , 24 , 25 ]. The patient and family should be able to have an open communication and participation in the decision-making process. The concerns of patients and their families should be respected and addressed in strict confidence.

The rationale of gender assignment in different clinical conditions of DSD

The usually recommended gender assignment guidelines in different clinical types of DSD is summarized in Table 8 .

46 XX DSD—congenital adrenal hyperplasia (CAH)

In CAH, female gender identity is the most common outcome despite markedly masculinized gender-related behavior. Patients diagnosed in the neonatal period, particularly with lower degrees of virilization, should be assigned and reared as female gender, with early feminizing surgery. GD is rare when female gender is assigned. Those with delayed diagnosis and severely masculinized genitalia need evaluation by a multidisciplinary team. Evidence supports the current recommendation to rear such infants, even with marked virilization, as females [ 18 , 19 , 22 , 23 , 26 ]. A psychological counseling for children with CAH and their families, focused on gender identity and GD, is recommended.

46 XY complete gonadal dysgenesis

It is recommended to rear these children as female, due to following considerations: (a) these patients have typical female psychosexual development. (b) Reconstructive surgery is not required for the external genitalia to be consistent with female gender. (c) Hormonal replacement therapy (HRT) is required at puberty as streak gonads should be removed in view of high risk of gonadal malignancy. (d) Pregnancy is feasible with implantation of fertilized donor eggs and hormonal therapy [ 19 , 22 , 23 ].

Complete androgen insensitivity syndrome (CAIS)

It is recommended that subjects with CAIS should be reared as female, due to the following considerations: (a) they have well documented female-typical core psychosexual characteristics, with no significant GD, in accordance with the proposed absence of androgenization of the brain. (b) Surgical reconstruction of the genitalia is not required for consistency with female gender, though vaginoplasty may be necessary. (c) HRT is required with estrogens after gonadectomy, but testosterone replacement is untenable due to androgen resistance [ 18 , 19 , 22 , 23 , 26 ].

5-alpha reductase deficiency

Male gender assignment is usually recommended due to the following considerations: (a) the genital tissue is responsive to androgens. (b) The potential for fertility. (c) The reported high incidence of subjects requesting female-to-male gender reassignment after puberty*. (d) HRT is not required at puberty for patients reared as male, if testes are not removed. (e) As the risk of gonadal malignancy is low, testes can potentially be retained. (f) They are very likely to have a male gender identity.*(As most neonates with this disorder have female external genitalia at birth, they are reared as females. Profound virilization occurs at puberty, with a gender role change from female to male during adolescence in up to 63% cases.) About 60% of these patients, assigned female in infancy and virilizing at puberty, and all who are assigned male, live as males. When the diagnosis is made in infancy, the combination of male gender identity in the majority and the potential for fertility, should be considered for gender assignment [ 19 , 22 , 23 ].

17-beta-HSD-3 deficiency

Classical features are that of an undervirilized male. Some of the affected patients with feminine genitalia at birth are reared as females. Virilization occurs at puberty, with gender role change from female to male in up to 64% cases. They are highly likely to identify as males. Male gender assignment is recommended in partial defects. But there is no strong data to support male gender assignment, as in 5-alpha reductase deficiency. The other considerations against male gender assignment are the lack of reported cases of fertility and the intermediate risk of germ cell tumors. Hence, regular testicular surveillance is required for those reared as male, with retained testes. Therefore, gender assignment should be made considering all the above factors [ 18 , 19 , 22 , 23 , 26 ].

Partial androgen insensitivity syndrome (PAIS)

Infants with PAIS are assigned to male/female gender, depending partially on the degree of undervirilization. The virilization at puberty is also variable and incomplete. The response to hCG stimulation test/testosterone therapy can serve as a guide to the possible sex of rearing. The phenotype is highly variable in PAIS, which is correspondingly reflected in the sex of rearing. The gender identity has considerable fluidity in PAIS, though gender identity is usually in line with the gender of rearing. Though fertility is possible if the testes are retained, it should be remembered that there is an intermediate risk of gonadal germ cell tumors. Hence, gender assignment in these patients is a complex, multifactorial process [ 18 , 19 , 22 , 23 , 26 ].

47 XXY Klinefelter’s syndrome and variants

They usually report a male gender identity, but with a putative high incidence of GD, which needs to be elaborated in larger series.

Mixed gonadal dysgenesis

The genital phenotype is highly variable. The prenatal androgen exposure, internal ductal anatomy, testicular function at and after puberty, post-puberty phallic development, and gonadal location have to be considered to decide the sex of rearing.

Ovotesticular DSD

These entities were previously referred to as “true hermaphroditism”, signifying the presence of both testicular and ovarian tissue, though dysgenetic, in the same subject. The three patterns seen are as follows:

46 XX/XY–33% of ovotesticular DSD, with testis and ovary/ovotestis.

46 XX–33% of ovotesticular DSD, with dysgenetic ovotestis.

46 XY–7% of ovotesticular DSD, with dysgenetic ovotestis.

This is characterized by ambiguity of genitalia or severe hypospadias at birth, with secondary sexual changes at puberty, corresponding to the relative predominance of ovarian/testicular tissue. The management depends on the age at diagnosis and anatomical differentiation. Either sex assignment is appropriate when the diagnosis is made early, prior to definition of gender identity. The sex of rearing should be decided considering the potential for fertility, based on gonadal differentiation and genital development. It should be ensured that the genitalia are, or can be made, consistent with the chosen sex [ 19 , 22 , 23 , 24 , 25 ].

General guidelines for surgery and HRT in DSD

Feminizing genitoplasty.

Surgery for correction of virilization (clitoral recession, with conservation of neurovascular and erectile structures, and labioplasty) should be carried out in conjunction with the repair of the common urogenital sinus (vaginoplasty). The current recommendation is to perform early, single-stage feminizing surgery for female infants with CAH. It is opined that correction in first year of life relieves parental distress related to anatomic concerns, mitigates the risks of stigmatization and gender identity confusion, and improves attachment between the child and parents. The current recommendation is the early separation of vagina and urethra, the rationale of which includes the beneficial effects of estrogen for wound healing in early infancy, limiting the postoperative stricture formation and avoidance of possible complications from the abnormal connection between the urinary tract and peritoneum through the Fallopian tubes. Surgical reconstruction in infancy may require refinement at puberty. Vaginal dilatation should not be undertaken before puberty. An absent or inadequate vagina, requiring a complex reconstruction of at high risk of stricture formation, may be appropriately delayed. But, the need for complete correction of urogenital sinus, prior to the onset of menstruation, is an important consideration [ 19 , 22 , 23 , 24 , 25 , 26 ].

Male genital reconstruction

The standard timing and techniques of operative procedures for correction of ventral curvature and urethral reconstruction, along with selective use of pre-operative testosterone supplementation is advised when male sex of rearing is adopted. The complexity of phallic reconstruction later in life, compared to infancy, is an important consideration in this regard. There is no evidence that prophylactic removal of discordant structures (utriculus/pseudovagina, Mullerian remnants) that are asymptomatic, is required. But symptoms in the future may mandate surgical removal. In patients with symptomatic utriculus, removal can be attempted laparoscopically, though it may not be practically feasible to preserve the continuity of vas deferens [ 19 , 22 , 23 , 24 , 25 ].

Gonadectomy

The gonads at the greatest risk of malignancy are both dysgenetic and intra-abdominal. The streak gonad in a patient with MGD, raised male should be removed by laparoscopy in early childhood. Bilateral gonadectomy (for bilateral streak gonads) is done in early childhood for females with gonadal dysgenesis and Y chromosome material, which should be detected by techniques like FISH and QFPCR. In patients with defects of Androgen biosynthesis raised female, gonadectomy is done before puberty. The testes in patients with CAIS and those with PAIS, raised as females, should be removed to prevent malignancy in adulthood. Immunohistochemical markers (IHM) that can serve to identify gonads at risk of developing malignancy include OCT 3/ 4, PLAP, AFP, beta-Catenin and CD 117. Early removal at the time of diagnosis (along with estrogen replacement therapy) also takes care of the associated hernia, psychological problems associated with the retained testes and risk of malignancy. Parental choice allows deferment until adolescence, in view of the fact that earliest reported malignancy in CAIS is at 14 years of age. A scrotal testis in gonadal dysgenesis is at risk of malignancy. Current recommendations are surveillance with testicular biopsy at puberty to detect premalignant lesions, which if detected, is treated with local low-dose radiotherapy (with preliminary sperm banking). Also, patients with bilateral ovotestes are potentially fertile from the functioning ovarian tissue. Separation of ovarian and testicular tissue, though challenging, is preferably done early in life [ 19 , 22 , 23 , 24 , 25 , 26 ].

Hormonal therapy/sex steroid replacement

Hormonal induction at puberty in hypogonadism should attempt to replicate normal pubertal maturation to induce secondary sexual characteristics, pubertal growth spurt, optimal bone mineral accumulation together with psychosocial support for psychosexual maturation. Treatment is initiated at low doses and progressively increased. Testosterone supplementation in males (initiated at bone age of 12 years) and estrogen supplementation in females (initiated at bone age of 11 years) is given accordingly for established hypogonadism. In males, exogenous testosterone is generally given till about 21 years, while the same in females is variable. Also, in females a progestin is added after breakthrough bleeding occurs, or within 1–2 years of continuous estrogen. No evidence of benefit exists for addition of cyclical progesterone in females without uterus [ 22 , 23 , 24 , 25 ].

The advances in molecular diagnosis of DSD

The advent of advanced tools for genetic diagnosis has enabled specific diagnosis to be made by molecular studies. WES and WGS represent evolving translational research that help to identify novel genetic causes of DSD. The techniques for identification of novel genetic factors in DSD have evolved from the use of CGH and custom array sequencing to the use of next generation sequencing (NGS) which mainly includes polymerase-based and ligase-based techniques. The importance of molecular diagnosis in DSD lies in the guidance of management in relation to possible gender development, assessment of adrenal and gonadal function, evaluation of the risk of gonadal malignancy, assessment of the risk of familial recurrence, and prediction of possible morbidities and long-term outcome. Hence, the advances in molecular diagnosis of DSD constitute a rapidly evolving frontier in the understanding and therapy of DSD.

The ethical dimension in DSD

The predominant ethical considerations in management of DSD are twofold. Firstly, when the components of biological sex (the sexual profile of genome, gonads, phenotype, endocrine and neurological status) align strongly, prediction of gender identity and recommendations for sex assignment can be made accordingly. The more discordant the determinants of biological sex, more variation in subsequent components of psychosexual development. Secondly, irreversible anatomic and physiologic effects of surgical assignment of sex have to be avoided, especially when the components of biological sex do not strongly align. The objective in such situations should be to delay such treatment till the appropriate age [ 24 , 25 , 26 ].

The arguments favoring recognition of DSD as an alternate gender, with delayed sex assignment and deferred surgical therapy has gained ground over the past decades, highlighted by certain judicial interventions across the globe. In this regard, it has to be emphasized that a transgender state, without incongruity of biological sex, has to be clearly distinguished from a DSD. Though differences in psychosexual development can occur in DSD, the vast majority of clinically diagnosed DSD (CAH, MGD, 46 XY DSD) have the anatomic and physiological consequences of altered components of biological sex. The issues in these subjects are not only confined to the genitalia, but also include problems that can include life-threatening cortisol deficiency, features of hypogonadism and urogenital sinus, and even the risk of gonadal malignancy. The early identification and correction of each issue is vital, and the best available window for the same is limited and usually, early in life. It is some of the less frequently encountered types of DSD (ovotesticular DSD, 17-BHSD deficiency, PAIS) that invariably require a more complex decision-making process. The diagnostic and therapeutic approach in the majority of clinically encountered DSD requires a structured scientific approach, with due consideration of the intricacies of psychosexual development.

The optimal management of different types of DSD in the present era requires the following considerations: (1) establishment of a precise diagnosis, employing the advances in genetic testing and endocrine evaluation. (2) A multidisciplinary team is required for the diagnosis, evaluation, gender assignment and follow-up of these children, and during their transition to adulthood. (3) Deeper understanding of the issues in psychosexual development in DSD is vital for therapy. (4) The patients and their families should be an integral part of the decision-making process. (5) Recommendations for gender assignment should be based upon the specific outcome data. (6) The relative rarity of DSD should prompt constitution of DSD registers, to record and share information, on national/international basis. (7) The formation of peer support groups is equally important. The recognition that each subject with DSD is unique and requires individualized therapy remains the most paramount.

Availability of data and materials

Available on request.

Abbreviations

Disorders of sexual differentiation

Congenital adrenal hyperplasia

Complete androgen insensitivity syndrome

Partial androgen insensitivity syndrome

Follicular stimulating hormone

Leutinizing hormone

Human chorionic gonadotropin

Fluorescence in situ hybridization

Quantitative fluorescence polymerase chain reaction

Comparative genomic hybridization

Multiplex ligand-dependent probe amplification

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The sincere guidance and help provided by Dr. K Sivakumar, Professor and Head, Department of Pediatric Surgery, Government Medical College, Thiruvananthapuram, Kerala, is gratefully acknowledged.

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Sarma, V.P. A review of the essential concepts in diagnosis, therapy, and gender assignment in disorders of sexual development. Ann Pediatr Surg 18 , 13 (2022). https://doi.org/10.1186/s43159-021-00149-w

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Disorders of sexual development
Ambiguous genitalia
Gonadal dysgenesis
Psychosexual development
Gender dysphoria

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A decision to undertake gender reassignment is made when an individual feels that his or her gender at birth does not match their gender identity. This is called ‘gender dysphoria’ and is a recognised medical condition.

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Feminist Perspectives on Sex and Gender

Feminism is said to be the movement to end women’s oppression (hooks 2000, 26). One possible way to understand ‘woman’ in this claim is to take it as a sex term: ‘woman’ picks out human females and being a human female depends on various biological and anatomical features (like genitalia). Historically many feminists have understood ‘woman’ differently: not as a sex term, but as a gender term that depends on social and cultural factors (like social position). In so doing, they distinguished sex (being female or male) from gender (being a woman or a man), although most ordinary language users appear to treat the two interchangeably. In feminist philosophy, this distinction has generated a lively debate. Central questions include: What does it mean for gender to be distinct from sex, if anything at all? How should we understand the claim that gender depends on social and/or cultural factors? What does it mean to be gendered woman, man, or genderqueer? This entry outlines and discusses distinctly feminist debates on sex and gender considering both historical and more contemporary positions.

1.1 Biological determinism

1.2 gender terminology, 2.1 gender socialisation, 2.2 gender as feminine and masculine personality, 2.3 gender as feminine and masculine sexuality, 3.1.1 particularity argument, 3.1.2 normativity argument, 3.2 is sex classification solely a matter of biology, 3.3 are sex and gender distinct, 3.4 is the sex/gender distinction useful, 4.1.1 gendered social series, 4.1.2 resemblance nominalism, 4.2.1 social subordination and gender, 4.2.2 gender uniessentialism, 4.2.3 gender as positionality, 5. beyond the binary, 6. conclusion, other internet resources, related entries, 1. the sex/gender distinction..

The terms ‘sex’ and ‘gender’ mean different things to different feminist theorists and neither are easy or straightforward to characterise. Sketching out some feminist history of the terms provides a helpful starting point.

Most people ordinarily seem to think that sex and gender are coextensive: women are human females, men are human males. Many feminists have historically disagreed and have endorsed the sex/ gender distinction. Provisionally: ‘sex’ denotes human females and males depending on biological features (chromosomes, sex organs, hormones and other physical features); ‘gender’ denotes women and men depending on social factors (social role, position, behaviour or identity). The main feminist motivation for making this distinction was to counter biological determinism or the view that biology is destiny.

A typical example of a biological determinist view is that of Geddes and Thompson who, in 1889, argued that social, psychological and behavioural traits were caused by metabolic state. Women supposedly conserve energy (being ‘anabolic’) and this makes them passive, conservative, sluggish, stable and uninterested in politics. Men expend their surplus energy (being ‘katabolic’) and this makes them eager, energetic, passionate, variable and, thereby, interested in political and social matters. These biological ‘facts’ about metabolic states were used not only to explain behavioural differences between women and men but also to justify what our social and political arrangements ought to be. More specifically, they were used to argue for withholding from women political rights accorded to men because (according to Geddes and Thompson) “what was decided among the prehistoric Protozoa cannot be annulled by Act of Parliament” (quoted from Moi 1999, 18). It would be inappropriate to grant women political rights, as they are simply not suited to have those rights; it would also be futile since women (due to their biology) would simply not be interested in exercising their political rights. To counter this kind of biological determinism, feminists have argued that behavioural and psychological differences have social, rather than biological, causes. For instance, Simone de Beauvoir famously claimed that one is not born, but rather becomes a woman, and that “social discrimination produces in women moral and intellectual effects so profound that they appear to be caused by nature” (Beauvoir 1972 [original 1949], 18; for more, see the entry on Simone de Beauvoir ). Commonly observed behavioural traits associated with women and men, then, are not caused by anatomy or chromosomes. Rather, they are culturally learned or acquired.

Although biological determinism of the kind endorsed by Geddes and Thompson is nowadays uncommon, the idea that behavioural and psychological differences between women and men have biological causes has not disappeared. In the 1970s, sex differences were used to argue that women should not become airline pilots since they will be hormonally unstable once a month and, therefore, unable to perform their duties as well as men (Rogers 1999, 11). More recently, differences in male and female brains have been said to explain behavioural differences; in particular, the anatomy of corpus callosum, a bundle of nerves that connects the right and left cerebral hemispheres, is thought to be responsible for various psychological and behavioural differences. For instance, in 1992, a Time magazine article surveyed then prominent biological explanations of differences between women and men claiming that women’s thicker corpus callosums could explain what ‘women’s intuition’ is based on and impair women’s ability to perform some specialised visual-spatial skills, like reading maps (Gorman 1992). Anne Fausto-Sterling has questioned the idea that differences in corpus callosums cause behavioural and psychological differences. First, the corpus callosum is a highly variable piece of anatomy; as a result, generalisations about its size, shape and thickness that hold for women and men in general should be viewed with caution. Second, differences in adult human corpus callosums are not found in infants; this may suggest that physical brain differences actually develop as responses to differential treatment. Third, given that visual-spatial skills (like map reading) can be improved by practice, even if women and men’s corpus callosums differ, this does not make the resulting behavioural differences immutable. (Fausto-Sterling 2000b, chapter 5).

In order to distinguish biological differences from social/psychological ones and to talk about the latter, feminists appropriated the term ‘gender’. Psychologists writing on transsexuality were the first to employ gender terminology in this sense. Until the 1960s, ‘gender’ was often used to refer to masculine and feminine words, like le and la in French. However, in order to explain why some people felt that they were ‘trapped in the wrong bodies’, the psychologist Robert Stoller (1968) began using the terms ‘sex’ to pick out biological traits and ‘gender’ to pick out the amount of femininity and masculinity a person exhibited. Although (by and large) a person’s sex and gender complemented each other, separating out these terms seemed to make theoretical sense allowing Stoller to explain the phenomenon of transsexuality: transsexuals’ sex and gender simply don’t match.

Along with psychologists like Stoller, feminists found it useful to distinguish sex and gender. This enabled them to argue that many differences between women and men were socially produced and, therefore, changeable. Gayle Rubin (for instance) uses the phrase ‘sex/gender system’ in order to describe “a set of arrangements by which the biological raw material of human sex and procreation is shaped by human, social intervention” (1975, 165). Rubin employed this system to articulate that “part of social life which is the locus of the oppression of women” (1975, 159) describing gender as the “socially imposed division of the sexes” (1975, 179). Rubin’s thought was that although biological differences are fixed, gender differences are the oppressive results of social interventions that dictate how women and men should behave. Women are oppressed as women and “by having to be women” (Rubin 1975, 204). However, since gender is social, it is thought to be mutable and alterable by political and social reform that would ultimately bring an end to women’s subordination. Feminism should aim to create a “genderless (though not sexless) society, in which one’s sexual anatomy is irrelevant to who one is, what one does, and with whom one makes love” (Rubin 1975, 204).

In some earlier interpretations, like Rubin’s, sex and gender were thought to complement one another. The slogan ‘Gender is the social interpretation of sex’ captures this view. Nicholson calls this ‘the coat-rack view’ of gender: our sexed bodies are like coat racks and “provide the site upon which gender [is] constructed” (1994, 81). Gender conceived of as masculinity and femininity is superimposed upon the ‘coat-rack’ of sex as each society imposes on sexed bodies their cultural conceptions of how males and females should behave. This socially constructs gender differences – or the amount of femininity/masculinity of a person – upon our sexed bodies. That is, according to this interpretation, all humans are either male or female; their sex is fixed. But cultures interpret sexed bodies differently and project different norms on those bodies thereby creating feminine and masculine persons. Distinguishing sex and gender, however, also enables the two to come apart: they are separable in that one can be sexed male and yet be gendered a woman, or vice versa (Haslanger 2000b; Stoljar 1995).

So, this group of feminist arguments against biological determinism suggested that gender differences result from cultural practices and social expectations. Nowadays it is more common to denote this by saying that gender is socially constructed. This means that genders (women and men) and gendered traits (like being nurturing or ambitious) are the “intended or unintended product[s] of a social practice” (Haslanger 1995, 97). But which social practices construct gender, what social construction is and what being of a certain gender amounts to are major feminist controversies. There is no consensus on these issues. (See the entry on intersections between analytic and continental feminism for more on different ways to understand gender.)

2. Gender as socially constructed

One way to interpret Beauvoir’s claim that one is not born but rather becomes a woman is to take it as a claim about gender socialisation: females become women through a process whereby they acquire feminine traits and learn feminine behaviour. Masculinity and femininity are thought to be products of nurture or how individuals are brought up. They are causally constructed (Haslanger 1995, 98): social forces either have a causal role in bringing gendered individuals into existence or (to some substantial sense) shape the way we are qua women and men. And the mechanism of construction is social learning. For instance, Kate Millett takes gender differences to have “essentially cultural, rather than biological bases” that result from differential treatment (1971, 28–9). For her, gender is “the sum total of the parents’, the peers’, and the culture’s notions of what is appropriate to each gender by way of temperament, character, interests, status, worth, gesture, and expression” (Millett 1971, 31). Feminine and masculine gender-norms, however, are problematic in that gendered behaviour conveniently fits with and reinforces women’s subordination so that women are socialised into subordinate social roles: they learn to be passive, ignorant, docile, emotional helpmeets for men (Millett 1971, 26). However, since these roles are simply learned, we can create more equal societies by ‘unlearning’ social roles. That is, feminists should aim to diminish the influence of socialisation.

Social learning theorists hold that a huge array of different influences socialise us as women and men. This being the case, it is extremely difficult to counter gender socialisation. For instance, parents often unconsciously treat their female and male children differently. When parents have been asked to describe their 24- hour old infants, they have done so using gender-stereotypic language: boys are describes as strong, alert and coordinated and girls as tiny, soft and delicate. Parents’ treatment of their infants further reflects these descriptions whether they are aware of this or not (Renzetti & Curran 1992, 32). Some socialisation is more overt: children are often dressed in gender stereotypical clothes and colours (boys are dressed in blue, girls in pink) and parents tend to buy their children gender stereotypical toys. They also (intentionally or not) tend to reinforce certain ‘appropriate’ behaviours. While the precise form of gender socialization has changed since the onset of second-wave feminism, even today girls are discouraged from playing sports like football or from playing ‘rough and tumble’ games and are more likely than boys to be given dolls or cooking toys to play with; boys are told not to ‘cry like a baby’ and are more likely to be given masculine toys like trucks and guns (for more, see Kimmel 2000, 122–126). [ 1 ]

According to social learning theorists, children are also influenced by what they observe in the world around them. This, again, makes countering gender socialisation difficult. For one, children’s books have portrayed males and females in blatantly stereotypical ways: for instance, males as adventurers and leaders, and females as helpers and followers. One way to address gender stereotyping in children’s books has been to portray females in independent roles and males as non-aggressive and nurturing (Renzetti & Curran 1992, 35). Some publishers have attempted an alternative approach by making their characters, for instance, gender-neutral animals or genderless imaginary creatures (like TV’s Teletubbies). However, parents reading books with gender-neutral or genderless characters often undermine the publishers’ efforts by reading them to their children in ways that depict the characters as either feminine or masculine. According to Renzetti and Curran, parents labelled the overwhelming majority of gender-neutral characters masculine whereas those characters that fit feminine gender stereotypes (for instance, by being helpful and caring) were labelled feminine (1992, 35). Socialising influences like these are still thought to send implicit messages regarding how females and males should act and are expected to act shaping us into feminine and masculine persons.

Nancy Chodorow (1978; 1995) has criticised social learning theory as too simplistic to explain gender differences (see also Deaux & Major 1990; Gatens 1996). Instead, she holds that gender is a matter of having feminine and masculine personalities that develop in early infancy as responses to prevalent parenting practices. In particular, gendered personalities develop because women tend to be the primary caretakers of small children. Chodorow holds that because mothers (or other prominent females) tend to care for infants, infant male and female psychic development differs. Crudely put: the mother-daughter relationship differs from the mother-son relationship because mothers are more likely to identify with their daughters than their sons. This unconsciously prompts the mother to encourage her son to psychologically individuate himself from her thereby prompting him to develop well defined and rigid ego boundaries. However, the mother unconsciously discourages the daughter from individuating herself thereby prompting the daughter to develop flexible and blurry ego boundaries. Childhood gender socialisation further builds on and reinforces these unconsciously developed ego boundaries finally producing feminine and masculine persons (1995, 202–206). This perspective has its roots in Freudian psychoanalytic theory, although Chodorow’s approach differs in many ways from Freud’s.

Gendered personalities are supposedly manifested in common gender stereotypical behaviour. Take emotional dependency. Women are stereotypically more emotional and emotionally dependent upon others around them, supposedly finding it difficult to distinguish their own interests and wellbeing from the interests and wellbeing of their children and partners. This is said to be because of their blurry and (somewhat) confused ego boundaries: women find it hard to distinguish their own needs from the needs of those around them because they cannot sufficiently individuate themselves from those close to them. By contrast, men are stereotypically emotionally detached, preferring a career where dispassionate and distanced thinking are virtues. These traits are said to result from men’s well-defined ego boundaries that enable them to prioritise their own needs and interests sometimes at the expense of others’ needs and interests.

Chodorow thinks that these gender differences should and can be changed. Feminine and masculine personalities play a crucial role in women’s oppression since they make females overly attentive to the needs of others and males emotionally deficient. In order to correct the situation, both male and female parents should be equally involved in parenting (Chodorow 1995, 214). This would help in ensuring that children develop sufficiently individuated senses of selves without becoming overly detached, which in turn helps to eradicate common gender stereotypical behaviours.

Catharine MacKinnon develops her theory of gender as a theory of sexuality. Very roughly: the social meaning of sex (gender) is created by sexual objectification of women whereby women are viewed and treated as objects for satisfying men’s desires (MacKinnon 1989). Masculinity is defined as sexual dominance, femininity as sexual submissiveness: genders are “created through the eroticization of dominance and submission. The man/woman difference and the dominance/submission dynamic define each other. This is the social meaning of sex” (MacKinnon 1989, 113). For MacKinnon, gender is constitutively constructed : in defining genders (or masculinity and femininity) we must make reference to social factors (see Haslanger 1995, 98). In particular, we must make reference to the position one occupies in the sexualised dominance/submission dynamic: men occupy the sexually dominant position, women the sexually submissive one. As a result, genders are by definition hierarchical and this hierarchy is fundamentally tied to sexualised power relations. The notion of ‘gender equality’, then, does not make sense to MacKinnon. If sexuality ceased to be a manifestation of dominance, hierarchical genders (that are defined in terms of sexuality) would cease to exist.

So, gender difference for MacKinnon is not a matter of having a particular psychological orientation or behavioural pattern; rather, it is a function of sexuality that is hierarchal in patriarchal societies. This is not to say that men are naturally disposed to sexually objectify women or that women are naturally submissive. Instead, male and female sexualities are socially conditioned: men have been conditioned to find women’s subordination sexy and women have been conditioned to find a particular male version of female sexuality as erotic – one in which it is erotic to be sexually submissive. For MacKinnon, both female and male sexual desires are defined from a male point of view that is conditioned by pornography (MacKinnon 1989, chapter 7). Bluntly put: pornography portrays a false picture of ‘what women want’ suggesting that women in actual fact are and want to be submissive. This conditions men’s sexuality so that they view women’s submission as sexy. And male dominance enforces this male version of sexuality onto women, sometimes by force. MacKinnon’s thought is not that male dominance is a result of social learning (see 2.1.); rather, socialization is an expression of power. That is, socialized differences in masculine and feminine traits, behaviour, and roles are not responsible for power inequalities. Females and males (roughly put) are socialised differently because there are underlying power inequalities. As MacKinnon puts it, ‘dominance’ (power relations) is prior to ‘difference’ (traits, behaviour and roles) (see, MacKinnon 1989, chapter 12). MacKinnon, then, sees legal restrictions on pornography as paramount to ending women’s subordinate status that stems from their gender.

3. Problems with the sex/gender distinction

3.1 is gender uniform.

The positions outlined above share an underlying metaphysical perspective on gender: gender realism . [ 2 ] That is, women as a group are assumed to share some characteristic feature, experience, common condition or criterion that defines their gender and the possession of which makes some individuals women (as opposed to, say, men). All women are thought to differ from all men in this respect (or respects). For example, MacKinnon thought that being treated in sexually objectifying ways is the common condition that defines women’s gender and what women as women share. All women differ from all men in this respect. Further, pointing out females who are not sexually objectified does not provide a counterexample to MacKinnon’s view. Being sexually objectified is constitutive of being a woman; a female who escapes sexual objectification, then, would not count as a woman.

One may want to critique the three accounts outlined by rejecting the particular details of each account. (For instance, see Spelman [1988, chapter 4] for a critique of the details of Chodorow’s view.) A more thoroughgoing critique has been levelled at the general metaphysical perspective of gender realism that underlies these positions. It has come under sustained attack on two grounds: first, that it fails to take into account racial, cultural and class differences between women (particularity argument); second, that it posits a normative ideal of womanhood (normativity argument).

Elizabeth Spelman (1988) has influentially argued against gender realism with her particularity argument. Roughly: gender realists mistakenly assume that gender is constructed independently of race, class, ethnicity and nationality. If gender were separable from, for example, race and class in this manner, all women would experience womanhood in the same way. And this is clearly false. For instance, Harris (1993) and Stone (2007) criticise MacKinnon’s view, that sexual objectification is the common condition that defines women’s gender, for failing to take into account differences in women’s backgrounds that shape their sexuality. The history of racist oppression illustrates that during slavery black women were ‘hypersexualised’ and thought to be always sexually available whereas white women were thought to be pure and sexually virtuous. In fact, the rape of a black woman was thought to be impossible (Harris 1993). So, (the argument goes) sexual objectification cannot serve as the common condition for womanhood since it varies considerably depending on one’s race and class. [ 3 ]

For Spelman, the perspective of ‘white solipsism’ underlies gender realists’ mistake. They assumed that all women share some “golden nugget of womanness” (Spelman 1988, 159) and that the features constitutive of such a nugget are the same for all women regardless of their particular cultural backgrounds. Next, white Western middle-class feminists accounted for the shared features simply by reflecting on the cultural features that condition their gender as women thus supposing that “the womanness underneath the Black woman’s skin is a white woman’s, and deep down inside the Latina woman is an Anglo woman waiting to burst through an obscuring cultural shroud” (Spelman 1988, 13). In so doing, Spelman claims, white middle-class Western feminists passed off their particular view of gender as “a metaphysical truth” (1988, 180) thereby privileging some women while marginalising others. In failing to see the importance of race and class in gender construction, white middle-class Western feminists conflated “the condition of one group of women with the condition of all” (Spelman 1988, 3).

Betty Friedan’s (1963) well-known work is a case in point of white solipsism. [ 4 ] Friedan saw domesticity as the main vehicle of gender oppression and called upon women in general to find jobs outside the home. But she failed to realize that women from less privileged backgrounds, often poor and non-white, already worked outside the home to support their families. Friedan’s suggestion, then, was applicable only to a particular sub-group of women (white middle-class Western housewives). But it was mistakenly taken to apply to all women’s lives — a mistake that was generated by Friedan’s failure to take women’s racial and class differences into account (hooks 2000, 1–3).

Spelman further holds that since social conditioning creates femininity and societies (and sub-groups) that condition it differ from one another, femininity must be differently conditioned in different societies. For her, “females become not simply women but particular kinds of women” (Spelman 1988, 113): white working-class women, black middle-class women, poor Jewish women, wealthy aristocratic European women, and so on.

This line of thought has been extremely influential in feminist philosophy. For instance, Young holds that Spelman has definitively shown that gender realism is untenable (1997, 13). Mikkola (2006) argues that this isn’t so. The arguments Spelman makes do not undermine the idea that there is some characteristic feature, experience, common condition or criterion that defines women’s gender; they simply point out that some particular ways of cashing out what defines womanhood are misguided. So, although Spelman is right to reject those accounts that falsely take the feature that conditions white middle-class Western feminists’ gender to condition women’s gender in general, this leaves open the possibility that women qua women do share something that defines their gender. (See also Haslanger [2000a] for a discussion of why gender realism is not necessarily untenable, and Stoljar [2011] for a discussion of Mikkola’s critique of Spelman.)

Judith Butler critiques the sex/gender distinction on two grounds. They critique gender realism with their normativity argument (1999 [original 1990], chapter 1); they also hold that the sex/gender distinction is unintelligible (this will be discussed in section 3.3.). Butler’s normativity argument is not straightforwardly directed at the metaphysical perspective of gender realism, but rather at its political counterpart: identity politics. This is a form of political mobilization based on membership in some group (e.g. racial, ethnic, cultural, gender) and group membership is thought to be delimited by some common experiences, conditions or features that define the group (Heyes 2000, 58; see also the entry on Identity Politics ). Feminist identity politics, then, presupposes gender realism in that feminist politics is said to be mobilized around women as a group (or category) where membership in this group is fixed by some condition, experience or feature that women supposedly share and that defines their gender.

Butler’s normativity argument makes two claims. The first is akin to Spelman’s particularity argument: unitary gender notions fail to take differences amongst women into account thus failing to recognise “the multiplicity of cultural, social, and political intersections in which the concrete array of ‘women’ are constructed” (Butler 1999, 19–20). In their attempt to undercut biologically deterministic ways of defining what it means to be a woman, feminists inadvertently created new socially constructed accounts of supposedly shared femininity. Butler’s second claim is that such false gender realist accounts are normative. That is, in their attempt to fix feminism’s subject matter, feminists unwittingly defined the term ‘woman’ in a way that implies there is some correct way to be gendered a woman (Butler 1999, 5). That the definition of the term ‘woman’ is fixed supposedly “operates as a policing force which generates and legitimizes certain practices, experiences, etc., and curtails and delegitimizes others” (Nicholson 1998, 293). Following this line of thought, one could say that, for instance, Chodorow’s view of gender suggests that ‘real’ women have feminine personalities and that these are the women feminism should be concerned about. If one does not exhibit a distinctly feminine personality, the implication is that one is not ‘really’ a member of women’s category nor does one properly qualify for feminist political representation.

Butler’s second claim is based on their view that“[i]dentity categories [like that of women] are never merely descriptive, but always normative, and as such, exclusionary” (Butler 1991, 160). That is, the mistake of those feminists Butler critiques was not that they provided the incorrect definition of ‘woman’. Rather, (the argument goes) their mistake was to attempt to define the term ‘woman’ at all. Butler’s view is that ‘woman’ can never be defined in a way that does not prescribe some “unspoken normative requirements” (like having a feminine personality) that women should conform to (Butler 1999, 9). Butler takes this to be a feature of terms like ‘woman’ that purport to pick out (what they call) ‘identity categories’. They seem to assume that ‘woman’ can never be used in a non-ideological way (Moi 1999, 43) and that it will always encode conditions that are not satisfied by everyone we think of as women. Some explanation for this comes from Butler’s view that all processes of drawing categorical distinctions involve evaluative and normative commitments; these in turn involve the exercise of power and reflect the conditions of those who are socially powerful (Witt 1995).

In order to better understand Butler’s critique, consider their account of gender performativity. For them, standard feminist accounts take gendered individuals to have some essential properties qua gendered individuals or a gender core by virtue of which one is either a man or a woman. This view assumes that women and men, qua women and men, are bearers of various essential and accidental attributes where the former secure gendered persons’ persistence through time as so gendered. But according to Butler this view is false: (i) there are no such essential properties, and (ii) gender is an illusion maintained by prevalent power structures. First, feminists are said to think that genders are socially constructed in that they have the following essential attributes (Butler 1999, 24): women are females with feminine behavioural traits, being heterosexuals whose desire is directed at men; men are males with masculine behavioural traits, being heterosexuals whose desire is directed at women. These are the attributes necessary for gendered individuals and those that enable women and men to persist through time as women and men. Individuals have “intelligible genders” (Butler 1999, 23) if they exhibit this sequence of traits in a coherent manner (where sexual desire follows from sexual orientation that in turn follows from feminine/ masculine behaviours thought to follow from biological sex). Social forces in general deem individuals who exhibit in coherent gender sequences (like lesbians) to be doing their gender ‘wrong’ and they actively discourage such sequencing of traits, for instance, via name-calling and overt homophobic discrimination. Think back to what was said above: having a certain conception of what women are like that mirrors the conditions of socially powerful (white, middle-class, heterosexual, Western) women functions to marginalize and police those who do not fit this conception.

These gender cores, supposedly encoding the above traits, however, are nothing more than illusions created by ideals and practices that seek to render gender uniform through heterosexism, the view that heterosexuality is natural and homosexuality is deviant (Butler 1999, 42). Gender cores are constructed as if they somehow naturally belong to women and men thereby creating gender dimorphism or the belief that one must be either a masculine male or a feminine female. But gender dimorphism only serves a heterosexist social order by implying that since women and men are sharply opposed, it is natural to sexually desire the opposite sex or gender.

Further, being feminine and desiring men (for instance) are standardly assumed to be expressions of one’s gender as a woman. Butler denies this and holds that gender is really performative. It is not “a stable identity or locus of agency from which various acts follow; rather, gender is … instituted … through a stylized repetition of [habitual] acts ” (Butler 1999, 179): through wearing certain gender-coded clothing, walking and sitting in certain gender-coded ways, styling one’s hair in gender-coded manner and so on. Gender is not something one is, it is something one does; it is a sequence of acts, a doing rather than a being. And repeatedly engaging in ‘feminising’ and ‘masculinising’ acts congeals gender thereby making people falsely think of gender as something they naturally are . Gender only comes into being through these gendering acts: a female who has sex with men does not express her gender as a woman. This activity (amongst others) makes her gendered a woman.

The constitutive acts that gender individuals create genders as “compelling illusion[s]” (Butler 1990, 271). Our gendered classification scheme is a strong pragmatic construction : social factors wholly determine our use of the scheme and the scheme fails to represent accurately any ‘facts of the matter’ (Haslanger 1995, 100). People think that there are true and real genders, and those deemed to be doing their gender ‘wrong’ are not socially sanctioned. But, genders are true and real only to the extent that they are performed (Butler 1990, 278–9). It does not make sense, then, to say of a male-to-female trans person that s/he is really a man who only appears to be a woman. Instead, males dressing up and acting in ways that are associated with femininity “show that [as Butler suggests] ‘being’ feminine is just a matter of doing certain activities” (Stone 2007, 64). As a result, the trans person’s gender is just as real or true as anyone else’s who is a ‘traditionally’ feminine female or masculine male (Butler 1990, 278). [ 5 ] Without heterosexism that compels people to engage in certain gendering acts, there would not be any genders at all. And ultimately the aim should be to abolish norms that compel people to act in these gendering ways.

For Butler, given that gender is performative, the appropriate response to feminist identity politics involves two things. First, feminists should understand ‘woman’ as open-ended and “a term in process, a becoming, a constructing that cannot rightfully be said to originate or end … it is open to intervention and resignification” (Butler 1999, 43). That is, feminists should not try to define ‘woman’ at all. Second, the category of women “ought not to be the foundation of feminist politics” (Butler 1999, 9). Rather, feminists should focus on providing an account of how power functions and shapes our understandings of womanhood not only in the society at large but also within the feminist movement.

Many people, including many feminists, have ordinarily taken sex ascriptions to be solely a matter of biology with no social or cultural dimension. It is commonplace to think that there are only two sexes and that biological sex classifications are utterly unproblematic. By contrast, some feminists have argued that sex classifications are not unproblematic and that they are not solely a matter of biology. In order to make sense of this, it is helpful to distinguish object- and idea-construction (see Haslanger 2003b for more): social forces can be said to construct certain kinds of objects (e.g. sexed bodies or gendered individuals) and certain kinds of ideas (e.g. sex or gender concepts). First, take the object-construction of sexed bodies. Secondary sex characteristics, or the physiological and biological features commonly associated with males and females, are affected by social practices. In some societies, females’ lower social status has meant that they have been fed less and so, the lack of nutrition has had the effect of making them smaller in size (Jaggar 1983, 37). Uniformity in muscular shape, size and strength within sex categories is not caused entirely by biological factors, but depends heavily on exercise opportunities: if males and females were allowed the same exercise opportunities and equal encouragement to exercise, it is thought that bodily dimorphism would diminish (Fausto-Sterling 1993a, 218). A number of medical phenomena involving bones (like osteoporosis) have social causes directly related to expectations about gender, women’s diet and their exercise opportunities (Fausto-Sterling 2005). These examples suggest that physiological features thought to be sex-specific traits not affected by social and cultural factors are, after all, to some extent products of social conditioning. Social conditioning, then, shapes our biology.

Second, take the idea-construction of sex concepts. Our concept of sex is said to be a product of social forces in the sense that what counts as sex is shaped by social meanings. Standardly, those with XX-chromosomes, ovaries that produce large egg cells, female genitalia, a relatively high proportion of ‘female’ hormones, and other secondary sex characteristics (relatively small body size, less body hair) count as biologically female. Those with XY-chromosomes, testes that produce small sperm cells, male genitalia, a relatively high proportion of ‘male’ hormones and other secondary sex traits (relatively large body size, significant amounts of body hair) count as male. This understanding is fairly recent. The prevalent scientific view from Ancient Greeks until the late 18 th century, did not consider female and male sexes to be distinct categories with specific traits; instead, a ‘one-sex model’ held that males and females were members of the same sex category. Females’ genitals were thought to be the same as males’ but simply directed inside the body; ovaries and testes (for instance) were referred to by the same term and whether the term referred to the former or the latter was made clear by the context (Laqueur 1990, 4). It was not until the late 1700s that scientists began to think of female and male anatomies as radically different moving away from the ‘one-sex model’ of a single sex spectrum to the (nowadays prevalent) ‘two-sex model’ of sexual dimorphism. (For an alternative view, see King 2013.)

Fausto-Sterling has argued that this ‘two-sex model’ isn’t straightforward either (1993b; 2000a; 2000b). Based on a meta-study of empirical medical research, she estimates that 1.7% of population fail to neatly fall within the usual sex classifications possessing various combinations of different sex characteristics (Fausto-Sterling 2000a, 20). In her earlier work, she claimed that intersex individuals make up (at least) three further sex classes: ‘herms’ who possess one testis and one ovary; ‘merms’ who possess testes, some aspects of female genitalia but no ovaries; and ‘ferms’ who have ovaries, some aspects of male genitalia but no testes (Fausto-Sterling 1993b, 21). (In her [2000a], Fausto-Sterling notes that these labels were put forward tongue–in–cheek.) Recognition of intersex people suggests that feminists (and society at large) are wrong to think that humans are either female or male.

To illustrate further the idea-construction of sex, consider the case of the athlete Maria Patiño. Patiño has female genitalia, has always considered herself to be female and was considered so by others. However, she was discovered to have XY chromosomes and was barred from competing in women’s sports (Fausto-Sterling 2000b, 1–3). Patiño’s genitalia were at odds with her chromosomes and the latter were taken to determine her sex. Patiño successfully fought to be recognised as a female athlete arguing that her chromosomes alone were not sufficient to not make her female. Intersex people, like Patiño, illustrate that our understandings of sex differ and suggest that there is no immediately obvious way to settle what sex amounts to purely biologically or scientifically. Deciding what sex is involves evaluative judgements that are influenced by social factors.

Insofar as our cultural conceptions affect our understandings of sex, feminists must be much more careful about sex classifications and rethink what sex amounts to (Stone 2007, chapter 1). More specifically, intersex people illustrate that sex traits associated with females and males need not always go together and that individuals can have some mixture of these traits. This suggests to Stone that sex is a cluster concept: it is sufficient to satisfy enough of the sex features that tend to cluster together in order to count as being of a particular sex. But, one need not satisfy all of those features or some arbitrarily chosen supposedly necessary sex feature, like chromosomes (Stone 2007, 44). This makes sex a matter of degree and sex classifications should take place on a spectrum: one can be more or less female/male but there is no sharp distinction between the two. Further, intersex people (along with trans people) are located at the centre of the sex spectrum and in many cases their sex will be indeterminate (Stone 2007).

More recently, Ayala and Vasilyeva (2015) have argued for an inclusive and extended conception of sex: just as certain tools can be seen to extend our minds beyond the limits of our brains (e.g. white canes), other tools (like dildos) can extend our sex beyond our bodily boundaries. This view aims to motivate the idea that what counts as sex should not be determined by looking inwards at genitalia or other anatomical features. In a different vein, Ásta (2018) argues that sex is a conferred social property. This follows her more general conferralist framework to analyse all social properties: properties that are conferred by others thereby generating a social status that consists in contextually specific constraints and enablements on individual behaviour. The general schema for conferred properties is as follows (Ásta 2018, 8):

Conferred property: what property is conferred. Who: who the subjects are. What: what attitude, state, or action of the subjects matter. When: under what conditions the conferral takes place. Base property: what the subjects are attempting to track (consciously or not), if anything.

With being of a certain sex (e.g. male, female) in mind, Ásta holds that it is a conferred property that merely aims to track physical features. Hence sex is a social – or in fact, an institutional – property rather than a natural one. The schema for sex goes as follows (72):

Conferred property: being female, male. Who: legal authorities, drawing on the expert opinion of doctors, other medical personnel. What: “the recording of a sex in official documents ... The judgment of the doctors (and others) as to what sex role might be the most fitting, given the biological characteristics present.” When: at birth or after surgery/ hormonal treatment. Base property: “the aim is to track as many sex-stereotypical characteristics as possible, and doctors perform surgery in cases where that might help bring the physical characteristics more in line with the stereotype of male and female.”

This (among other things) offers a debunking analysis of sex: it may appear to be a natural property, but on the conferralist analysis is better understood as a conferred legal status. Ásta holds that gender too is a conferred property, but contra the discussion in the following section, she does not think that this collapses the distinction between sex and gender: sex and gender are differently conferred albeit both satisfying the general schema noted above. Nonetheless, on the conferralist framework what underlies both sex and gender is the idea of social construction as social significance: sex-stereotypical characteristics are taken to be socially significant context specifically, whereby they become the basis for conferring sex onto individuals and this brings with it various constraints and enablements on individuals and their behaviour. This fits object- and idea-constructions introduced above, although offers a different general framework to analyse the matter at hand.

In addition to arguing against identity politics and for gender performativity, Butler holds that distinguishing biological sex from social gender is unintelligible. For them, both are socially constructed:

If the immutable character of sex is contested, perhaps this construct called ‘sex’ is as culturally constructed as gender; indeed, perhaps it was always already gender, with the consequence that the distinction between sex and gender turns out to be no distinction at all. (Butler 1999, 10–11)

(Butler is not alone in claiming that there are no tenable distinctions between nature/culture, biology/construction and sex/gender. See also: Antony 1998; Gatens 1996; Grosz 1994; Prokhovnik 1999.) Butler makes two different claims in the passage cited: that sex is a social construction, and that sex is gender. To unpack their view, consider the two claims in turn. First, the idea that sex is a social construct, for Butler, boils down to the view that our sexed bodies are also performative and, so, they have “no ontological status apart from the various acts which constitute [their] reality” (1999, 173). Prima facie , this implausibly implies that female and male bodies do not have independent existence and that if gendering activities ceased, so would physical bodies. This is not Butler’s claim; rather, their position is that bodies viewed as the material foundations on which gender is constructed, are themselves constructed as if they provide such material foundations (Butler 1993). Cultural conceptions about gender figure in “the very apparatus of production whereby sexes themselves are established” (Butler 1999, 11).

For Butler, sexed bodies never exist outside social meanings and how we understand gender shapes how we understand sex (1999, 139). Sexed bodies are not empty matter on which gender is constructed and sex categories are not picked out on the basis of objective features of the world. Instead, our sexed bodies are themselves discursively constructed : they are the way they are, at least to a substantial extent, because of what is attributed to sexed bodies and how they are classified (for discursive construction, see Haslanger 1995, 99). Sex assignment (calling someone female or male) is normative (Butler 1993, 1). [ 6 ] When the doctor calls a newly born infant a girl or a boy, s/he is not making a descriptive claim, but a normative one. In fact, the doctor is performing an illocutionary speech act (see the entry on Speech Acts ). In effect, the doctor’s utterance makes infants into girls or boys. We, then, engage in activities that make it seem as if sexes naturally come in two and that being female or male is an objective feature of the world, rather than being a consequence of certain constitutive acts (that is, rather than being performative). And this is what Butler means in saying that physical bodies never exist outside cultural and social meanings, and that sex is as socially constructed as gender. They do not deny that physical bodies exist. But, they take our understanding of this existence to be a product of social conditioning: social conditioning makes the existence of physical bodies intelligible to us by discursively constructing sexed bodies through certain constitutive acts. (For a helpful introduction to Butler’s views, see Salih 2002.)

For Butler, sex assignment is always in some sense oppressive. Again, this appears to be because of Butler’s general suspicion of classification: sex classification can never be merely descriptive but always has a normative element reflecting evaluative claims of those who are powerful. Conducting a feminist genealogy of the body (or examining why sexed bodies are thought to come naturally as female and male), then, should ground feminist practice (Butler 1993, 28–9). Feminists should examine and uncover ways in which social construction and certain acts that constitute sex shape our understandings of sexed bodies, what kinds of meanings bodies acquire and which practices and illocutionary speech acts ‘make’ our bodies into sexes. Doing so enables feminists to identity how sexed bodies are socially constructed in order to resist such construction.

However, given what was said above, it is far from obvious what we should make of Butler’s claim that sex “was always already gender” (1999, 11). Stone (2007) takes this to mean that sex is gender but goes on to question it arguing that the social construction of both sex and gender does not make sex identical to gender. According to Stone, it would be more accurate for Butler to say that claims about sex imply gender norms. That is, many claims about sex traits (like ‘females are physically weaker than males’) actually carry implications about how women and men are expected to behave. To some extent the claim describes certain facts. But, it also implies that females are not expected to do much heavy lifting and that they would probably not be good at it. So, claims about sex are not identical to claims about gender; rather, they imply claims about gender norms (Stone 2007, 70).

Some feminists hold that the sex/gender distinction is not useful. For a start, it is thought to reflect politically problematic dualistic thinking that undercuts feminist aims: the distinction is taken to reflect and replicate androcentric oppositions between (for instance) mind/body, culture/nature and reason/emotion that have been used to justify women’s oppression (e.g. Grosz 1994; Prokhovnik 1999). The thought is that in oppositions like these, one term is always superior to the other and that the devalued term is usually associated with women (Lloyd 1993). For instance, human subjectivity and agency are identified with the mind but since women are usually identified with their bodies, they are devalued as human subjects and agents. The opposition between mind and body is said to further map on to other distinctions, like reason/emotion, culture/nature, rational/irrational, where one side of each distinction is devalued (one’s bodily features are usually valued less that one’s mind, rationality is usually valued more than irrationality) and women are associated with the devalued terms: they are thought to be closer to bodily features and nature than men, to be irrational, emotional and so on. This is said to be evident (for instance) in job interviews. Men are treated as gender-neutral persons and not asked whether they are planning to take time off to have a family. By contrast, that women face such queries illustrates that they are associated more closely than men with bodily features to do with procreation (Prokhovnik 1999, 126). The opposition between mind and body, then, is thought to map onto the opposition between men and women.

Now, the mind/body dualism is also said to map onto the sex/gender distinction (Grosz 1994; Prokhovnik 1999). The idea is that gender maps onto mind, sex onto body. Although not used by those endorsing this view, the basic idea can be summed by the slogan ‘Gender is between the ears, sex is between the legs’: the implication is that, while sex is immutable, gender is something individuals have control over – it is something we can alter and change through individual choices. However, since women are said to be more closely associated with biological features (and so, to map onto the body side of the mind/body distinction) and men are treated as gender-neutral persons (mapping onto the mind side), the implication is that “man equals gender, which is associated with mind and choice, freedom from body, autonomy, and with the public real; while woman equals sex, associated with the body, reproduction, ‘natural’ rhythms and the private realm” (Prokhovnik 1999, 103). This is said to render the sex/gender distinction inherently repressive and to drain it of any potential for emancipation: rather than facilitating gender role choice for women, it “actually functions to reinforce their association with body, sex, and involuntary ‘natural’ rhythms” (Prokhovnik 1999, 103). Contrary to what feminists like Rubin argued, the sex/gender distinction cannot be used as a theoretical tool that dissociates conceptions of womanhood from biological and reproductive features.

Moi has further argued that the sex/gender distinction is useless given certain theoretical goals (1999, chapter 1). This is not to say that it is utterly worthless; according to Moi, the sex/gender distinction worked well to show that the historically prevalent biological determinism was false. However, for her, the distinction does no useful work “when it comes to producing a good theory of subjectivity” (1999, 6) and “a concrete, historical understanding of what it means to be a woman (or a man) in a given society” (1999, 4–5). That is, the 1960s distinction understood sex as fixed by biology without any cultural or historical dimensions. This understanding, however, ignores lived experiences and embodiment as aspects of womanhood (and manhood) by separating sex from gender and insisting that womanhood is to do with the latter. Rather, embodiment must be included in one’s theory that tries to figure out what it is to be a woman (or a man).

Mikkola (2011) argues that the sex/gender distinction, which underlies views like Rubin’s and MacKinnon’s, has certain unintuitive and undesirable ontological commitments that render the distinction politically unhelpful. First, claiming that gender is socially constructed implies that the existence of women and men is a mind-dependent matter. This suggests that we can do away with women and men simply by altering some social practices, conventions or conditions on which gender depends (whatever those are). However, ordinary social agents find this unintuitive given that (ordinarily) sex and gender are not distinguished. Second, claiming that gender is a product of oppressive social forces suggests that doing away with women and men should be feminism’s political goal. But this harbours ontologically undesirable commitments since many ordinary social agents view their gender to be a source of positive value. So, feminism seems to want to do away with something that should not be done away with, which is unlikely to motivate social agents to act in ways that aim at gender justice. Given these problems, Mikkola argues that feminists should give up the distinction on practical political grounds.

Tomas Bogardus (2020) has argued in an even more radical sense against the sex/gender distinction: as things stand, he holds, feminist philosophers have merely assumed and asserted that the distinction exists, instead of having offered good arguments for the distinction. In other words, feminist philosophers allegedly have yet to offer good reasons to think that ‘woman’ does not simply pick out adult human females. Alex Byrne (2020) argues in a similar vein: the term ‘woman’ does not pick out a social kind as feminist philosophers have “assumed”. Instead, “women are adult human females–nothing more, and nothing less” (2020, 3801). Byrne offers six considerations to ground this AHF (adult, human, female) conception.

It reproduces the dictionary definition of ‘woman’.
One would expect English to have a word that picks out the category adult human female, and ‘woman’ is the only candidate.
AHF explains how we sometimes know that an individual is a woman, despite knowing nothing else relevant about her other than the fact that she is an adult human female.
AHF stands or falls with the analogous thesis for girls, which can be supported independently.
AHF predicts the correct verdict in cases of gender role reversal.
AHF is supported by the fact that ‘woman’ and ‘female’ are often appropriately used as stylistic variants of each other, even in hyperintensional contexts.

Robin Dembroff (2021) responds to Byrne and highlights various problems with Byrne’s argument. First, framing: Byrne assumes from the start that gender terms like ‘woman’ have a single invariant meaning thereby failing to discuss the possibility of terms like ‘woman’ having multiple meanings – something that is a familiar claim made by feminist theorists from various disciplines. Moreover, Byrne (according to Dembroff) assumes without argument that there is a single, universal category of woman – again, something that has been extensively discussed and critiqued by feminist philosophers and theorists. Second, Byrne’s conception of the ‘dominant’ meaning of woman is said to be cherry-picked and it ignores a wealth of contexts outside of philosophy (like the media and the law) where ‘woman’ has a meaning other than AHF . Third, Byrne’s own distinction between biological and social categories fails to establish what he intended to establish: namely, that ‘woman’ picks out a biological rather than a social kind. Hence, Dembroff holds, Byrne’s case fails by its own lights. Byrne (2021) responds to Dembroff’s critique.

Others such as ‘gender critical feminists’ also hold views about the sex/gender distinction in a spirit similar to Bogardus and Byrne. For example, Holly Lawford-Smith (2021) takes the prevalent sex/gender distinction, where ‘female’/‘male’ are used as sex terms and ‘woman’/’man’ as gender terms, not to be helpful. Instead, she takes all of these to be sex terms and holds that (the norms of) femininity/masculinity refer to gender normativity. Because much of the gender critical feminists’ discussion that philosophers have engaged in has taken place in social media, public fora, and other sources outside academic philosophy, this entry will not focus on these discussions.

4. Women as a group

The various critiques of the sex/gender distinction have called into question the viability of the category women . Feminism is the movement to end the oppression women as a group face. But, how should the category of women be understood if feminists accept the above arguments that gender construction is not uniform, that a sharp distinction between biological sex and social gender is false or (at least) not useful, and that various features associated with women play a role in what it is to be a woman, none of which are individually necessary and jointly sufficient (like a variety of social roles, positions, behaviours, traits, bodily features and experiences)? Feminists must be able to address cultural and social differences in gender construction if feminism is to be a genuinely inclusive movement and be careful not to posit commonalities that mask important ways in which women qua women differ. These concerns (among others) have generated a situation where (as Linda Alcoff puts it) feminists aim to speak and make political demands in the name of women, at the same time rejecting the idea that there is a unified category of women (2006, 152). If feminist critiques of the category women are successful, then what (if anything) binds women together, what is it to be a woman, and what kinds of demands can feminists make on behalf of women?

Many have found the fragmentation of the category of women problematic for political reasons (e.g. Alcoff 2006; Bach 2012; Benhabib 1992; Frye 1996; Haslanger 2000b; Heyes 2000; Martin 1994; Mikkola 2007; Stoljar 1995; Stone 2004; Tanesini 1996; Young 1997; Zack 2005). For instance, Young holds that accounts like Spelman’s reduce the category of women to a gerrymandered collection of individuals with nothing to bind them together (1997, 20). Black women differ from white women but members of both groups also differ from one another with respect to nationality, ethnicity, class, sexual orientation and economic position; that is, wealthy white women differ from working-class white women due to their economic and class positions. These sub-groups are themselves diverse: for instance, some working-class white women in Northern Ireland are starkly divided along religious lines. So if we accept Spelman’s position, we risk ending up with individual women and nothing to bind them together. And this is problematic: in order to respond to oppression of women in general, feminists must understand them as a category in some sense. Young writes that without doing so “it is not possible to conceptualize oppression as a systematic, structured, institutional process” (1997, 17). Some, then, take the articulation of an inclusive category of women to be the prerequisite for effective feminist politics and a rich literature has emerged that aims to conceptualise women as a group or a collective (e.g. Alcoff 2006; Ásta 2011; Frye 1996; 2011; Haslanger 2000b; Heyes 2000; Stoljar 1995, 2011; Young 1997; Zack 2005). Articulations of this category can be divided into those that are: (a) gender nominalist — positions that deny there is something women qua women share and that seek to unify women’s social kind by appealing to something external to women; and (b) gender realist — positions that take there to be something women qua women share (although these realist positions differ significantly from those outlined in Section 2). Below we will review some influential gender nominalist and gender realist positions. Before doing so, it is worth noting that not everyone is convinced that attempts to articulate an inclusive category of women can succeed or that worries about what it is to be a woman are in need of being resolved. Mikkola (2016) argues that feminist politics need not rely on overcoming (what she calls) the ‘gender controversy’: that feminists must settle the meaning of gender concepts and articulate a way to ground women’s social kind membership. As she sees it, disputes about ‘what it is to be a woman’ have become theoretically bankrupt and intractable, which has generated an analytical impasse that looks unsurpassable. Instead, Mikkola argues for giving up the quest, which in any case in her view poses no serious political obstacles.

Elizabeth Barnes (2020) responds to the need to offer an inclusive conception of gender somewhat differently, although she endorses the need for feminism to be inclusive particularly of trans people. Barnes holds that typically philosophical theories of gender aim to offer an account of what it is to be a woman (or man, genderqueer, etc.), where such an account is presumed to provide necessary and sufficient conditions for being a woman or an account of our gender terms’ extensions. But, she holds, it is a mistake to expect our theories of gender to do so. For Barnes, a project that offers a metaphysics of gender “should be understood as the project of theorizing what it is —if anything— about the social world that ultimately explains gender” (2020, 706). This project is not equivalent to one that aims to define gender terms or elucidate the application conditions for natural language gender terms though.

4.1 Gender nominalism

Iris Young argues that unless there is “some sense in which ‘woman’ is the name of a social collective [that feminism represents], there is nothing specific to feminist politics” (1997, 13). In order to make the category women intelligible, she argues that women make up a series: a particular kind of social collective “whose members are unified passively by the objects their actions are oriented around and/or by the objectified results of the material effects of the actions of the other” (Young 1997, 23). A series is distinct from a group in that, whereas members of groups are thought to self-consciously share certain goals, projects, traits and/ or self-conceptions, members of series pursue their own individual ends without necessarily having anything at all in common. Young holds that women are not bound together by a shared feature or experience (or set of features and experiences) since she takes Spelman’s particularity argument to have established definitely that no such feature exists (1997, 13; see also: Frye 1996; Heyes 2000). Instead, women’s category is unified by certain practico-inert realities or the ways in which women’s lives and their actions are oriented around certain objects and everyday realities (Young 1997, 23–4). For example, bus commuters make up a series unified through their individual actions being organised around the same practico-inert objects of the bus and the practice of public transport. Women make up a series unified through women’s lives and actions being organised around certain practico-inert objects and realities that position them as women .

Young identifies two broad groups of such practico-inert objects and realities. First, phenomena associated with female bodies (physical facts), biological processes that take place in female bodies (menstruation, pregnancy, childbirth) and social rules associated with these biological processes (social rules of menstruation, for instance). Second, gender-coded objects and practices: pronouns, verbal and visual representations of gender, gender-coded artefacts and social spaces, clothes, cosmetics, tools and furniture. So, women make up a series since their lives and actions are organised around female bodies and certain gender-coded objects. Their series is bound together passively and the unity is “not one that arises from the individuals called women” (Young 1997, 32).

Although Young’s proposal purports to be a response to Spelman’s worries, Stone has questioned whether it is, after all, susceptible to the particularity argument: ultimately, on Young’s view, something women as women share (their practico-inert realities) binds them together (Stone 2004).

Natalie Stoljar holds that unless the category of women is unified, feminist action on behalf of women cannot be justified (1995, 282). Stoljar too is persuaded by the thought that women qua women do not share anything unitary. This prompts her to argue for resemblance nominalism. This is the view that a certain kind of resemblance relation holds between entities of a particular type (for more on resemblance nominalism, see Armstrong 1989, 39–58). Stoljar is not alone in arguing for resemblance relations to make sense of women as a category; others have also done so, usually appealing to Wittgenstein’s ‘family resemblance’ relations (Alcoff 1988; Green & Radford Curry 1991; Heyes 2000; Munro 2006). Stoljar relies more on Price’s resemblance nominalism whereby x is a member of some type F only if x resembles some paradigm or exemplar of F sufficiently closely (Price 1953, 20). For instance, the type of red entities is unified by some chosen red paradigms so that only those entities that sufficiently resemble the paradigms count as red. The type (or category) of women, then, is unified by some chosen woman paradigms so that those who sufficiently resemble the woman paradigms count as women (Stoljar 1995, 284).

Semantic considerations about the concept woman suggest to Stoljar that resemblance nominalism should be endorsed (Stoljar 2000, 28). It seems unlikely that the concept is applied on the basis of some single social feature all and only women possess. By contrast, woman is a cluster concept and our attributions of womanhood pick out “different arrangements of features in different individuals” (Stoljar 2000, 27). More specifically, they pick out the following clusters of features: (a) Female sex; (b) Phenomenological features: menstruation, female sexual experience, child-birth, breast-feeding, fear of walking on the streets at night or fear of rape; (c) Certain roles: wearing typically female clothing, being oppressed on the basis of one’s sex or undertaking care-work; (d) Gender attribution: “calling oneself a woman, being called a woman” (Stoljar 1995, 283–4). For Stoljar, attributions of womanhood are to do with a variety of traits and experiences: those that feminists have historically termed ‘gender traits’ (like social, behavioural, psychological traits) and those termed ‘sex traits’. Nonetheless, she holds that since the concept woman applies to (at least some) trans persons, one can be a woman without being female (Stoljar 1995, 282).

The cluster concept woman does not, however, straightforwardly provide the criterion for picking out the category of women. Rather, the four clusters of features that the concept picks out help single out woman paradigms that in turn help single out the category of women. First, any individual who possesses a feature from at least three of the four clusters mentioned will count as an exemplar of the category. For instance, an African-American with primary and secondary female sex characteristics, who describes herself as a woman and is oppressed on the basis of her sex, along with a white European hermaphrodite brought up ‘as a girl’, who engages in female roles and has female phenomenological features despite lacking female sex characteristics, will count as woman paradigms (Stoljar 1995, 284). [ 7 ] Second, any individual who resembles “any of the paradigms sufficiently closely (on Price’s account, as closely as [the paradigms] resemble each other) will be a member of the resemblance class ‘woman’” (Stoljar 1995, 284). That is, what delimits membership in the category of women is that one resembles sufficiently a woman paradigm.

4.2 Neo-gender realism

In a series of articles collected in her 2012 book, Sally Haslanger argues for a way to define the concept woman that is politically useful, serving as a tool in feminist fights against sexism, and that shows woman to be a social (not a biological) notion. More specifically, Haslanger argues that gender is a matter of occupying either a subordinate or a privileged social position. In some articles, Haslanger is arguing for a revisionary analysis of the concept woman (2000b; 2003a; 2003b). Elsewhere she suggests that her analysis may not be that revisionary after all (2005; 2006). Consider the former argument first. Haslanger’s analysis is, in her terms, ameliorative: it aims to elucidate which gender concepts best help feminists achieve their legitimate purposes thereby elucidating those concepts feminists should be using (Haslanger 2000b, 33). [ 8 ] Now, feminists need gender terminology in order to fight sexist injustices (Haslanger 2000b, 36). In particular, they need gender terms to identify, explain and talk about persistent social inequalities between males and females. Haslanger’s analysis of gender begins with the recognition that females and males differ in two respects: physically and in their social positions. Societies in general tend to “privilege individuals with male bodies” (Haslanger 2000b, 38) so that the social positions they subsequently occupy are better than the social positions of those with female bodies. And this generates persistent sexist injustices. With this in mind, Haslanger specifies how she understands genders:

S is a woman iff [by definition] S is systematically subordinated along some dimension (economic, political, legal, social, etc.), and S is ‘marked’ as a target for this treatment by observed or imagined bodily features presumed to be evidence of a female’s biological role in reproduction.

S is a man iff [by definition] S is systematically privileged along some dimension (economic, political, legal, social, etc.), and S is ‘marked’ as a target for this treatment by observed or imagined bodily features presumed to be evidence of a male’s biological role in reproduction. (2003a, 6–7)

These are constitutive of being a woman and a man: what makes calling S a woman apt, is that S is oppressed on sex-marked grounds; what makes calling S a man apt, is that S is privileged on sex-marked grounds.

Haslanger’s ameliorative analysis is counterintuitive in that females who are not sex-marked for oppression, do not count as women. At least arguably, the Queen of England is not oppressed on sex-marked grounds and so, would not count as a woman on Haslanger’s definition. And, similarly, all males who are not privileged would not count as men. This might suggest that Haslanger’s analysis should be rejected in that it does not capture what language users have in mind when applying gender terms. However, Haslanger argues that this is not a reason to reject the definitions, which she takes to be revisionary: they are not meant to capture our intuitive gender terms. In response, Mikkola (2009) has argued that revisionary analyses of gender concepts, like Haslanger’s, are both politically unhelpful and philosophically unnecessary.

Note also that Haslanger’s proposal is eliminativist: gender justice would eradicate gender, since it would abolish those sexist social structures responsible for sex-marked oppression and privilege. If sexist oppression were to cease, women and men would no longer exist (although there would still be males and females). Not all feminists endorse such an eliminativist view though. Stone holds that Haslanger does not leave any room for positively revaluing what it is to be a woman: since Haslanger defines woman in terms of subordination,

any woman who challenges her subordinate status must by definition be challenging her status as a woman, even if she does not intend to … positive change to our gender norms would involve getting rid of the (necessarily subordinate) feminine gender. (Stone 2007, 160)

But according to Stone this is not only undesirable – one should be able to challenge subordination without having to challenge one’s status as a woman. It is also false: “because norms of femininity can be and constantly are being revised, women can be women without thereby being subordinate” (Stone 2007, 162; Mikkola [2016] too argues that Haslanger’s eliminativism is troublesome).

Theodore Bach holds that Haslanger’s eliminativism is undesirable on other grounds, and that Haslanger’s position faces another more serious problem. Feminism faces the following worries (among others):

Representation problem : “if there is no real group of ‘women’, then it is incoherent to make moral claims and advance political policies on behalf of women” (Bach 2012, 234). Commonality problems : (1) There is no feature that all women cross-culturally and transhistorically share. (2) Delimiting women’s social kind with the help of some essential property privileges those who possess it, and marginalizes those who do not (Bach 2012, 235).

According to Bach, Haslanger’s strategy to resolve these problems appeals to ‘social objectivism’. First, we define women “according to a suitably abstract relational property” (Bach 2012, 236), which avoids the commonality problems. Second, Haslanger employs “an ontologically thin notion of ‘objectivity’” (Bach 2012, 236) that answers the representation problem. Haslanger’s solution (Bach holds) is specifically to argue that women make up an objective type because women are objectively similar to one another, and not simply classified together given our background conceptual schemes. Bach claims though that Haslanger’s account is not objective enough, and we should on political grounds “provide a stronger ontological characterization of the genders men and women according to which they are natural kinds with explanatory essences” (Bach 2012, 238). He thus proposes that women make up a natural kind with a historical essence:

The essential property of women, in virtue of which an individual is a member of the kind ‘women,’ is participation in a lineage of women. In order to exemplify this relational property, an individual must be a reproduction of ancestral women, in which case she must have undergone the ontogenetic processes through which a historical gender system replicates women. (Bach 2012, 271)

In short, one is not a woman due to shared surface properties with other women (like occupying a subordinate social position). Rather, one is a woman because one has the right history: one has undergone the ubiquitous ontogenetic process of gender socialization. Thinking about gender in this way supposedly provides a stronger kind unity than Haslanger’s that simply appeals to shared surface properties.

Not everyone agrees; Mikkola (2020) argues that Bach’s metaphysical picture has internal tensions that render it puzzling and that Bach’s metaphysics does not provide good responses to the commonality and presentation problems. The historically essentialist view also has anti-trans implications. After all, trans women who have not undergone female gender socialization won’t count as women on his view (Mikkola [2016, 2020] develops this line of critique in more detail). More worryingly, trans women will count as men contrary to their self-identification. Both Bettcher (2013) and Jenkins (2016) consider the importance of gender self-identification. Bettcher argues that there is more than one ‘correct’ way to understand womanhood: at the very least, the dominant (mainstream), and the resistant (trans) conceptions. Dominant views like that of Bach’s tend to erase trans people’s experiences and to marginalize trans women within feminist movements. Rather than trans women having to defend their self-identifying claims, these claims should be taken at face value right from the start. And so, Bettcher holds, “in analyzing the meaning of terms such as ‘woman,’ it is inappropriate to dismiss alternative ways in which those terms are actually used in trans subcultures; such usage needs to be taken into consideration as part of the analysis” (2013, 235).

Specifically with Haslanger in mind and in a similar vein, Jenkins (2016) discusses how Haslanger’s revisionary approach unduly excludes some trans women from women’s social kind. On Jenkins’s view, Haslanger’s ameliorative methodology in fact yields more than one satisfying target concept: one that “corresponds to Haslanger’s proposed concept and captures the sense of gender as an imposed social class”; another that “captures the sense of gender as a lived identity” (Jenkins 2016, 397). The latter of these allows us to include trans women into women’s social kind, who on Haslanger’s social class approach to gender would inappropriately have been excluded. (See Andler 2017 for the view that Jenkins’s purportedly inclusive conception of gender is still not fully inclusive. Jenkins 2018 responds to this charge and develops the notion of gender identity still further.)

In addition to her revisionary argument, Haslanger has suggested that her ameliorative analysis of woman may not be as revisionary as it first seems (2005, 2006). Although successful in their reference fixing, ordinary language users do not always know precisely what they are talking about. Our language use may be skewed by oppressive ideologies that can “mislead us about the content of our own thoughts” (Haslanger 2005, 12). Although her gender terminology is not intuitive, this could simply be because oppressive ideologies mislead us about the meanings of our gender terms. Our everyday gender terminology might mean something utterly different from what we think it means; and we could be entirely ignorant of this. Perhaps Haslanger’s analysis, then, has captured our everyday gender vocabulary revealing to us the terms that we actually employ: we may be applying ‘woman’ in our everyday language on the basis of sex-marked subordination whether we take ourselves to be doing so or not. If this is so, Haslanger’s gender terminology is not radically revisionist.

Saul (2006) argues that, despite it being possible that we unknowingly apply ‘woman’ on the basis of social subordination, it is extremely difficult to show that this is the case. This would require showing that the gender terminology we in fact employ is Haslanger’s proposed gender terminology. But discovering the grounds on which we apply everyday gender terms is extremely difficult precisely because they are applied in various and idiosyncratic ways (Saul 2006, 129). Haslanger, then, needs to do more in order to show that her analysis is non-revisionary.

Charlotte Witt (2011a; 2011b) argues for a particular sort of gender essentialism, which Witt terms ‘uniessentialism’. Her motivation and starting point is the following: many ordinary social agents report gender being essential to them and claim that they would be a different person were they of a different sex/gender. Uniessentialism attempts to understand and articulate this. However, Witt’s work departs in important respects from the earlier (so-called) essentialist or gender realist positions discussed in Section 2: Witt does not posit some essential property of womanhood of the kind discussed above, which failed to take women’s differences into account. Further, uniessentialism differs significantly from those position developed in response to the problem of how we should conceive of women’s social kind. It is not about solving the standard dispute between gender nominalists and gender realists, or about articulating some supposedly shared property that binds women together and provides a theoretical ground for feminist political solidarity. Rather, uniessentialism aims to make good the widely held belief that gender is constitutive of who we are. [ 9 ]

Uniessentialism is a sort of individual essentialism. Traditionally philosophers distinguish between kind and individual essentialisms: the former examines what binds members of a kind together and what do all members of some kind have in common qua members of that kind. The latter asks: what makes an individual the individual it is. We can further distinguish two sorts of individual essentialisms: Kripkean identity essentialism and Aristotelian uniessentialism. The former asks: what makes an individual that individual? The latter, however, asks a slightly different question: what explains the unity of individuals? What explains that an individual entity exists over and above the sum total of its constituent parts? (The standard feminist debate over gender nominalism and gender realism has largely been about kind essentialism. Being about individual essentialism, Witt’s uniessentialism departs in an important way from the standard debate.) From the two individual essentialisms, Witt endorses the Aristotelian one. On this view, certain functional essences have a unifying role: these essences are responsible for the fact that material parts constitute a new individual, rather than just a lump of stuff or a collection of particles. Witt’s example is of a house: the essential house-functional property (what the entity is for, what its purpose is) unifies the different material parts of a house so that there is a house, and not just a collection of house-constituting particles (2011a, 6). Gender (being a woman/a man) functions in a similar fashion and provides “the principle of normative unity” that organizes, unifies and determines the roles of social individuals (Witt 2011a, 73). Due to this, gender is a uniessential property of social individuals.

It is important to clarify the notions of gender and social individuality that Witt employs. First, gender is a social position that “cluster[s] around the engendering function … women conceive and bear … men beget” (Witt 2011a, 40). These are women and men’s socially mediated reproductive functions (Witt 2011a, 29) and they differ from the biological function of reproduction, which roughly corresponds to sex on the standard sex/gender distinction. Witt writes: “to be a woman is to be recognized to have a particular function in engendering, to be a man is to be recognized to have a different function in engendering” (2011a, 39). Second, Witt distinguishes persons (those who possess self-consciousness), human beings (those who are biologically human) and social individuals (those who occupy social positions synchronically and diachronically). These ontological categories are not equivalent in that they possess different persistence and identity conditions. Social individuals are bound by social normativity, human beings by biological normativity. These normativities differ in two respects: first, social norms differ from one culture to the next whereas biological norms do not; second, unlike biological normativity, social normativity requires “the recognition by others that an agent is both responsive to and evaluable under a social norm” (Witt 2011a, 19). Thus, being a social individual is not equivalent to being a human being. Further, Witt takes personhood to be defined in terms of intrinsic psychological states of self-awareness and self-consciousness. However, social individuality is defined in terms of the extrinsic feature of occupying a social position, which depends for its existence on a social world. So, the two are not equivalent: personhood is essentially about intrinsic features and could exist without a social world, whereas social individuality is essentially about extrinsic features that could not exist without a social world.

Witt’s gender essentialist argument crucially pertains to social individuals , not to persons or human beings: saying that persons or human beings are gendered would be a category mistake. But why is gender essential to social individuals? For Witt, social individuals are those who occupy positions in social reality. Further, “social positions have norms or social roles associated with them; a social role is what an individual who occupies a given social position is responsive to and evaluable under” (Witt 2011a, 59). However, qua social individuals, we occupy multiple social positions at once and over time: we can be women, mothers, immigrants, sisters, academics, wives, community organisers and team-sport coaches synchronically and diachronically. Now, the issue for Witt is what unifies these positions so that a social individual is constituted. After all, a bundle of social position occupancies does not make for an individual (just as a bundle of properties like being white , cube-shaped and sweet do not make for a sugar cube). For Witt, this unifying role is undertaken by gender (being a woman or a man): it is

a pervasive and fundamental social position that unifies and determines all other social positions both synchronically and diachronically. It unifies them not physically, but by providing a principle of normative unity. (2011a, 19–20)

By ‘normative unity’, Witt means the following: given our social roles and social position occupancies, we are responsive to various sets of social norms. These norms are “complex patterns of behaviour and practices that constitute what one ought to do in a situation given one’s social position(s) and one’s social context” (Witt 2011a, 82). The sets of norms can conflict: the norms of motherhood can (and do) conflict with the norms of being an academic philosopher. However, in order for this conflict to exist, the norms must be binding on a single social individual. Witt, then, asks: what explains the existence and unity of the social individual who is subject to conflicting social norms? The answer is gender.

Gender is not just a social role that unifies social individuals. Witt takes it to be the social role — as she puts it, it is the mega social role that unifies social agents. First, gender is a mega social role if it satisfies two conditions (and Witt claims that it does): (1) if it provides the principle of synchronic and diachronic unity of social individuals, and (2) if it inflects and defines a broad range of other social roles. Gender satisfies the first in usually being a life-long social position: a social individual persists just as long as their gendered social position persists. Further, Witt maintains, trans people are not counterexamples to this claim: transitioning entails that the old social individual has ceased to exist and a new one has come into being. And this is consistent with the same person persisting and undergoing social individual change via transitioning. Gender satisfies the second condition too. It inflects other social roles, like being a parent or a professional. The expectations attached to these social roles differ depending on the agent’s gender, since gender imposes different social norms to govern the execution of the further social roles. Now, gender — as opposed to some other social category, like race — is not just a mega social role; it is the unifying mega social role. Cross-cultural and trans-historical considerations support this view. Witt claims that patriarchy is a social universal (2011a, 98). By contrast, racial categorisation varies historically and cross-culturally, and racial oppression is not a universal feature of human cultures. Thus, gender has a better claim to being the social role that is uniessential to social individuals. This account of gender essentialism not only explains social agents’ connectedness to their gender, but it also provides a helpful way to conceive of women’s agency — something that is central to feminist politics.

Linda Alcoff holds that feminism faces an identity crisis: the category of women is feminism’s starting point, but various critiques about gender have fragmented the category and it is not clear how feminists should understand what it is to be a woman (2006, chapter 5). In response, Alcoff develops an account of gender as positionality whereby “gender is, among other things, a position one occupies and from which one can act politically” (2006, 148). In particular, she takes one’s social position to foster the development of specifically gendered identities (or self-conceptions): “The very subjectivity (or subjective experience of being a woman) and the very identity of women are constituted by women’s position” (Alcoff 2006, 148). Alcoff holds that there is an objective basis for distinguishing individuals on the grounds of (actual or expected) reproductive roles:

Women and men are differentiated by virtue of their different relationship of possibility to biological reproduction, with biological reproduction referring to conceiving, giving birth, and breast-feeding, involving one’s body . (Alcoff 2006, 172, italics in original)

The thought is that those standardly classified as biologically female, although they may not actually be able to reproduce, will encounter “a different set of practices, expectations, and feelings in regard to reproduction” than those standardly classified as male (Alcoff 2006, 172). Further, this differential relation to the possibility of reproduction is used as the basis for many cultural and social phenomena that position women and men: it can be

the basis of a variety of social segregations, it can engender the development of differential forms of embodiment experienced throughout life, and it can generate a wide variety of affective responses, from pride, delight, shame, guilt, regret, or great relief from having successfully avoided reproduction. (Alcoff 2006, 172)

Reproduction, then, is an objective basis for distinguishing individuals that takes on a cultural dimension in that it positions women and men differently: depending on the kind of body one has, one’s lived experience will differ. And this fosters the construction of gendered social identities: one’s role in reproduction helps configure how one is socially positioned and this conditions the development of specifically gendered social identities.

Since women are socially positioned in various different contexts, “there is no gender essence all women share” (Alcoff 2006, 147–8). Nonetheless, Alcoff acknowledges that her account is akin to the original 1960s sex/gender distinction insofar as sex difference (understood in terms of the objective division of reproductive labour) provides the foundation for certain cultural arrangements (the development of a gendered social identity). But, with the benefit of hindsight

we can see that maintaining a distinction between the objective category of sexed identity and the varied and culturally contingent practices of gender does not presume an absolute distinction of the old-fashioned sort between culture and a reified nature. (Alcoff 2006, 175)

That is, her view avoids the implausible claim that sex is exclusively to do with nature and gender with culture. Rather, the distinction on the basis of reproductive possibilities shapes and is shaped by the sorts of cultural and social phenomena (like varieties of social segregation) these possibilities gives rise to. For instance, technological interventions can alter sex differences illustrating that this is the case (Alcoff 2006, 175). Women’s specifically gendered social identities that are constituted by their context dependent positions, then, provide the starting point for feminist politics.

Recently Robin Dembroff (2020) has argued that existing metaphysical accounts of gender fail to address non-binary gender identities. This generates two concerns. First, metaphysical accounts of gender (like the ones outlined in previous sections) are insufficient for capturing those who reject binary gender categorisation where people are either men or women. In so doing, these accounts are not satisfying as explanations of gender understood in a more expansive sense that goes beyond the binary. Second, the failure to understand non-binary gender identities contributes to a form of epistemic injustice called ‘hermeneutical injustice’: it feeds into a collective failure to comprehend and analyse concepts and practices that undergird non-binary classification schemes, thereby impeding on one’s ability to fully understand themselves. To overcome these problems, Dembroff suggests an account of genderqueer that they call ‘critical gender kind’:

a kind whose members collectively destabilize one or more elements of dominant gender ideology. Genderqueer, on my proposed model, is a category whose members collectively destabilize the binary axis, or the idea that the only possible genders are the exclusive and exhaustive kinds men and women. (2020, 2)

Note that Dembroff’s position is not to be confused with ‘gender critical feminist’ positions like those noted above, which are critical of the prevalent feminist focus on gender, as opposed to sex, kinds. Dembroff understands genderqueer as a gender kind, but one that is critical of dominant binary understandings of gender.

Dembroff identifies two modes of destabilising the gender binary: principled and existential. Principled destabilising “stems from or otherwise expresses individuals’ social or political commitments regarding gender norms, practices, and structures”, while existential destabilising “stems from or otherwise expresses individuals’ felt or desired gender roles, embodiment, and/or categorization” (2020, 13). These modes are not mutually exclusive, and they can help us understand the difference between allies and members of genderqueer kinds: “While both resist dominant gender ideology, members of [genderqueer] kinds resist (at least in part) due to felt or desired gender categorization that deviates from dominant expectations, norms, and assumptions” (2020, 14). These modes of destabilisation also enable us to formulate an understanding of non-critical gender kinds that binary understandings of women and men’s kinds exemplify. Dembroff defines these kinds as follows:

For a given kind X , X is a non-critical gender kind relative to a given society iff X ’s members collectively restabilize one or more elements of the dominant gender ideology in that society. (2020, 14)

Dembroff’s understanding of critical and non-critical gender kinds importantly makes gender kind membership something more and other than a mere psychological phenomenon. To engage in collectively destabilising or restabilising dominant gender normativity and ideology, we need more than mere attitudes or mental states – resisting or maintaining such normativity requires action as well. In so doing, Dembroff puts their position forward as an alternative to two existing internalist positions about gender. First, to Jennifer McKitrick’s (2015) view whereby gender is dispositional: in a context where someone is disposed to behave in ways that would be taken by others to be indicative of (e.g.) womanhood, the person has a woman’s gender identity. Second, to Jenkin’s (2016, 2018) position that takes an individual’s gender identity to be dependent on which gender-specific norms the person experiences as being relevant to them. On this view, someone is a woman if the person experiences norms associated with women to be relevant to the person in the particular social context that they are in. Neither of these positions well-captures non-binary identities, Dembroff argues, which motivates the account of genderqueer identities as critical gender kinds.

As Dembroff acknowledges, substantive philosophical work on non-binary gender identities is still developing. However, it is important to note that analytic philosophers are beginning to engage in gender metaphysics that goes beyond the binary.

This entry first looked at feminist objections to biological determinism and the claim that gender is socially constructed. Next, it examined feminist critiques of prevalent understandings of gender and sex, and the distinction itself. In response to these concerns, the entry looked at how a unified women’s category could be articulated for feminist political purposes. This illustrated that gender metaphysics — or what it is to be a woman or a man or a genderqueer person — is still very much a live issue. And although contemporary feminist philosophical debates have questioned some of the tenets and details of the original 1960s sex/gender distinction, most still hold onto the view that gender is about social factors and that it is (in some sense) distinct from biological sex. The jury is still out on what the best, the most useful, or (even) the correct definition of gender is.

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What does it mean for someone to have the protected characteristic of “gender reassignment” under the Equality Act 2010? The government, public bodies, many employers and even employment tribunals are often confused about this.

Having the protected characteristic of gender reassignment does not mean that someone’s sex has changed or give them the right to make other people pretend that it has.

These FAQs cover the definition of the characteristic and who it covers – and what this means for employers and service providers.

Download these gender reassignment FAQs as a PDF.

What is the protected characteristic of “gender reassignment”?

What does it mean to have this characteristic , who can have this characteristic , does having the protected characteristic of gender reassignment mean that a person must be treated as the opposite sex , does the equality act outlaw “misgendering”, is it harassment to “out” a person as transgender , can employers have policies which require people to refer to transgender people in particular situations in a particular way , what should employers and service providers do to avoid the risk of harassment claims , should schools have rules about “misgendering”.

The Equality Act 2010 at Section 7 defines the protected characteristic of “gender reassignment” as relating to a person who is:

“proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person’s sex by changing physiological or other attributes of sex.”

The law refers to this as being “transsexual”. But the term more commonly used today is “transgender” or “trans”. This broadly relates to anyone at any stage of a personal process. For example:

A man tells his employer that he is considering “transitioning” and is seeing a therapist with the potential result of being referred for medical treatment.
A man identifies as a “transwoman” without having any surgery or treatment.
A woman identified as a “transman” for several years and took testosterone, but has now stopped and “detransitioned”.

The Equality Act protects people from direct and indirect discrimination, harassment or victimisation in situations that are covered by the Equality Act, such as in the workplace or when receiving goods or services.

Direct discrimination

Direct discrimination is when you are treated worse than another person or other people because:

you have a protected characteristic
someone thinks you have that protected characteristic (known as discrimination by perception)
you are connected to someone with that protected characteristic (known as discrimination by association).

For example: an employee tells their employer that they intend to transition. Their employer alters their role against their wishes to avoid them having contact with clients.

The comparator is a person who is materially similar in other aspects but does not have the protected characteristic (“is not trans”).

Indirect discrimination

Indirect discrimination happens when a policy applies in the same way for everybody but disadvantages a group of people who share a protected characteristic, and you are disadvantaged as part of this group. This is unlawful unless the person or organisation applying the policy can show that there is a good reason for the policy. This is known as objective justification .

For example: an airport has a general policy of searching passengers according to their sex. Everyone travelling needs to follow the same security procedures and processes, but it makes transgender travellers feel uncomfortable. This could be indirect discrimination, so the airport reviews its policy and changes it so that any passenger may ask to be searched by a staff member of either sex and have a private search, out of view of other passengers.

Harassment is unwanted behaviour connected with a protected characteristic that has the purpose or effect of violating a person’s dignity or creating a degrading, humiliating, hostile, intimidating or offensive environment.

For example: a transgender person is having a drink in a pub with friends and is referred to by the bar staff as “it” and mocked for their appearance.

Victimisation

Victimisation is when you are treated badly because you have made a complaint of gender-reassignment discrimination under the Equality Act or are supporting someone who has made a complaint of gender-reassignment discrimination. For example:

For example: a person proposing to undergo gender reassignment is being harassed by a colleague at work. He makes a complaint about the way his colleague is treating him and is sacked.

The Equality Act also provides that if a person is absent from work because of gender-reassignment treatment, their employer cannot treat them worse than they would be treated if absent for illness or injury.

Does a person have to be under medical supervision?

No. This was explicitly removed from the definition in 2010. Gender reassignment can be a personal process.

Must they have a gender-recognition certificate or be in the process of applying for one?

No. The protected characteristic is defined without reference to the Gender Recognition Act.

Do they have to have made a firm decision to transition?

No. Protection against discrimination and harassment attaches to a person who is proposing to undergo, is undergoing or has undergone a process (or part of a process).

During the passage of the Equality Act, the Solicitor General stated in Parliament:

“Gender reassignment, as defined, is a personal process, so there is no question of having to do something medical, let alone surgical, to fit the definition. “Someone who was driven by a characteristic would be in the process of gender reassignment, however intermittently it manifested itself. “At what point [proposing to undergo] amounts to ‘considering undergoing’ a gender reassignment is pretty unclear. However, proposing’ suggests a more definite decision point, at which the person’s protected characteristic would immediately come into being. There are lots of ways in which that can be manifested – for instance, by making their intention known. Even if they do not take a single further step, they will be protected straight away. Alternatively, a person might start to dress, or behave, like someone who is changing their gender or is living in an identity of the opposite sex. That too, would mean they were protected. If an employer is notified of that proposal, they will have a clear obligation not to discriminate against them.”

In the case of Taylor v Jaguar Land Rover , a male employee told his employer that he was “gender fluid” and thought of himself as “part of a spectrum, transitioning from the male to the female gender identity”. He said to his line manager: “I have no plans for surgical transition.” He started wearing women’s clothing to work, asked to be referred to by a woman’s name and raised a question about which toilets he should use. The Employment Tribunal concluded that he was covered by the protected characteristic.

Can children have the protected characteristic?

Yes. In the case of AA, AK & Ors v NHS England , NHS England argued that children who are waiting for assessment by the Tavistock Gender Identity Development Service (GIDS) do not have the protected characteristic as they have not yet reached the stage of proposing to transition. The Court of Appeal rejected this argument. It noted that the definition of “gender reassignment” does not require medical intervention and can include actions such as changing “one’s name and/or how one dresses or does one’s hair”.

The court concluded:

“There is no reason of principle why a child could not satisfy the definition in s.7 provided they have taken a settled decision to adopt some aspect of the identity of the other gender.”

It noted that the decision did not have to be permanent.

Is “Gillick competence” relevant to the protected characteristic?

No. “Gillick competence” refers to the set of criteria that are used for establishing whether a child has the capacity to provide consent for medical treatment, based on whether they have sufficient understanding and intelligence to fully understand it.

Having the protected characteristic of gender reassignment (that is, being able to bring a claim for gender-reassignment discrimination) does not depend on having any diagnosis or medical treatment. Therefore Gillick competence is not relevant to the Equality Act criteria.

No. There is nothing in the Equality Act which means that people with the protected characteristic of “gender reassignment” need to be treated in a particular way, or differently from people without the characteristic.

Article 9 and 10 of the European Convention of Human Rights protect the fundamental human rights of freedom of speech and freedom of belief.

In the case of Forstater v CGDE [2021] it was established that the belief that men are male and women are female, and that this cannot change and is important, is protected under Article 9 and in relation to belief discrimination in the Equality Act.

This means that employers and service providers must not harass or discriminate against people because they recognise that “transwomen” are men and “transmen” are women. Employers and service providers cannot require people to believe that someone has changed sex, or impose a blanket constraint on expressing their belief.

No. “Misgendering” is not defined or outlawed by the Equality Act.

In general, people who object to “misgendering” mean any reference to a person who identifies as transgender by words that relate to their sex. This can include using the words woman, female, madam, lady, daughter, wife, mother, she, her and so on about someone who identifies as a “transman”, or man, male, sir, gentleman, son, husband, father, he, him and so on about someone who identifies as a “transwoman”.

Any form of words may be harassment, but this depends on the circumstances and the purpose and effect of the behaviour. Harassment is unwanted conduct related to a relevant protected characteristic that has the purpose or effect of violating a person’s dignity, or creating an intimidating, hostile, degrading, humiliating or offensive environment for a person. An employment tribunal would also consider:

that person’s perception
the other circumstances of the case
whether it is reasonable for the conduct to have that effect.

Tribunals have emphasised that when judging harassment context is everything, and warned against a culture of hypersensitivity to the perception of alleged victims.

Employment tribunal judgments

As Lord Justice Nicholas Underhill found in Dhellwal v Richmond Pharmacology [2009], a case decided under the Race Relations Act:

“What the tribunal is required to consider is whether, if the claimant has experienced those feelings or perceptions, it was reasonable for her to do so. Thus if, for example, the tribunal believes that the claimant was unreasonably prone to take offence, then, even if she did genuinely feel her dignity to have been violated, there will have been no harassment within the meaning of the section.”

In the Forstater case, the employment appeal tribunal said that it was not proportionate to “impose a requirement on the Claimant to refer to a trans woman as a woman to avoid harassment”. It said that:

“ Whilst the Claimant’s belief, and her expression of them by refusing to refer to a trans person by their preferred pronoun, or by refusing to accept that a person is of the acquired gender stated on a GRC, could amount to unlawful harassment in some circumstances, it would not always have that effect. In our judgment, it is not open to the Tribunal to impose in effect a blanket restriction on a person not to express those views irrespective of those circumstances.”

In the case of de Souza v Primark Stores [2017] , a transgender claimant who went by the name of Alexandra, but whose legal name was Alexander, was found to have been harassed by colleagues who made a point of using the male form of name when they knew he did not want them to, but not by being issued with a “new starter” badge that showed his legal name.

In the case of Taylor v Jaguar Land Rover [2020] , a male claimant who wore women’s clothing to work was judged to have been exposed to harassment by colleagues saying “What the hell is that?”, “So what’s going on? Are you going to have your bits chopped off?”, “Is this for Halloween?” and referring to the claimant as “it”.

Not necessarily.

A person can be “outed” as transgender in two different ways:

Their sex is commonly known and recorded, but their transsexualism is not (for example a man who cross-dresses at the weekend and is considering transitioning is “outed” at work by someone who has seen them at a social event).
They are disappointed in the expectation of being treated as one sex when they are actually the other (for example a person who identifies as a “trans woman” is referred to as male by a woman in a changing room).

In Grant v HM Land Registry [2011] , which concerned the unwanted disclosure that an employee was gay, Lord Justice Elias found that this did not amount to harassment:

“Furthermore, even if in fact the disclosure was unwanted, and the claimant was upset by it, the effect cannot amount to a violation of dignity, nor can it properly be described as creating an intimidating, hostile, degrading, humiliating or offensive environment. Tribunals must not cheapen the significance of these words. They are an important control to prevent trivial acts causing minor upsets being caught by the concept of harassment.”

The perception (or hope) of transgender people that they “pass” as the opposite sex is often not realistic. Their sex is not in fact hidden, but is politely ignored by some people in some situations. It is not reasonable for them to be offended by other people recognising their sex, particularly if they are seeking access to a single-sex service. Acknowledging someone’s sex, particularly where there is a good reason, is unlikely to be harassment.

In the first-instance case of Chapman v Essex Police , a transgender police officer felt embarrassed and upset when a police control-room operator double-checked his identity over the radio because his male voice did not match the female name that the operator could see. The tribunal did not uphold a complaint of harassment, finding that the claimant was “too sensitive in the circumstances”.

Yes, but those policies must be proportionate. Employers cannot have blanket policies against “misgendering”, but can have specific policies concerning how staff should refer to transgender people in particular situations. Organisations should recognise that these policies constrain the expression of belief, and therefore they should seek to achieve their specific aims in the least intrusive way possible.

When determining whether an objection to a belief being expressed is justified, a court will undertake a balancing exercise. This test is set out in the case of Bank Mellat v HM Treasury :

Is the objective the organisation seeks to achieve sufficiently important to justify the limitation of the right in question?
Is the limitation rationally connected to that objective?
Is a less intrusive limitation possible that does not undermine the achievement of the objective in question?
Does the importance of the objective outweigh the severity of the limitation on the rights of the person concerned?

For example:

A company provides a specialist dress service to transsexual and transvestites. The men who use the service expect to be called “she” and “her” and referred to as Madam. It is justified for the employer to train and require staff to use this language when serving customers.
Staff at a full-service restaurant greet customers as “Sir” and “Madam” as they arrive. The restaurant’s policy is that staff should use the terms which appear most appropriate based on gendered appearance, and to defer to customer preference if one is expressed. This is justified by the aim of creating the service and ambience that the restaurant owners seek to provide.
A public body assesses claimants for medical benefits, including individuals with mental-health conditions. It directs its staff to refer to claimants using the terms which the claimants prefer, including using opposite-sex pronouns when requested, in order to make them feel comfortable. However, it recognises that in recording medical information, assessors must be able to be accurate about claimants’ sex. This is justified by the aim of providing a service that is accessible and effective for vulnerable clients.

The case of David Mackereth v AMP and DWP concerned a doctor who lost his job undertaking claimant health assessments for the Department for Work and Pensions because he refused to comply with its policy on using claimants’ preferred pronouns. The employer’s policy was found not to have amounted to unlawful harassment or discrimination against Dr Mackereth, in the particular circumstances of his job. However, the Employment Appeal Tribunal stated that “misgendering” would not necessarily be harassment:

“Such behaviour may well provide grounds for a complaint of discrimination or harassment but, as the EAT in Forstater made clear, that will be a fact-specific question to be determined in light of all the circumstances of the particular case.”

Relevant considerations

In Higgs v Farmor’s School [2023] Mrs Justice Eady sets out the considerations that are likely to be relevant considering whether constraining the expression of a belief (“manifestation”) in order to avoid harassment or discrimination is justified in the context of employment. These include:

the content of the manifestation
the tone used
the extent of the manifestation
the worker’s understanding of the likely audience
the extent and nature of the intrusion on the rights of others, and any consequential impact on the employer’s ability to run its business
whether the worker has made clear that the views expressed are personal, or whether they might be seen as representing the views of the employer, and whether that might present a reputational risk
whether there is a potential power imbalance given the nature of the worker’s position or role and that of those whose rights are intruded upon;
the nature of the employer’s business, in particular where there is a potential impact on vulnerable service users or clients
whether the limitation imposed is the least intrusive measure open to the employer.

Employers cannot force employees to believe that people can change sex, or prevent them expressing that lack of belief except in limited circumstances. So what should employers do to protect transgender people from harassment, and themselves from liability?

They should have ordinary policies against bullying and harassment, including jokes, name-calling, humiliation, exclusion and singling people out for different treatment.

They should seek to avoid putting people in situations they will reasonably experience as hostile or humiliating.

Ambiguous rules put people in situations where it is reasonable to feel offended. For example, an employer provides “female” toilets, showers and changing rooms, but allows some male staff in because they identify as transgender. This creates a hostile environment:

female staff are surprised, shocked, humiliated and upset to find themselves sharing with a colleague of the opposite sex
male staff members who want people to treat them as women may be challenged or face comments that are intended to intimidate, humiliate or degrade them.

This was the situation faced by the Sheffield Hospital Trust , which had a policy that transgender staff could use opposite-sex facilities. It had to deal with the fall-out when women complained about seeing a half-naked male in their changing room and the male staff member sued for harassment after being questioned about this.

Rather than putting these two groups of people together in a environment where both will reasonably feel harassed, employers should have clear rules about facilities that are single-sex, and also, where possible, provide a unisex alternative for anyone who needs it, including people who feel that they have “transitioned away from their sex” and therefore do not wish to use single-sex facilities shared with members of their own sex. The EHRC last year provided guidance on single-sex services which encouraged clear rules and policies.

It should be made clear to people who have the protected characteristic of “gender reassignment” that having this characteristic does not mean it is reasonable for them to expect others to believe or pretend to believe they have changed sex, or for them to be allowed to break (or expect to be an exception to) rules that aim to protect the dignity and privacy of others.

If a person breaks a clear rule against entering a space provided for the opposite sex, it is not reasonable for them to feel offended when this is pointed out.

No. It would not be lawful for schools to have a policy that forbids, punishes or denigrates pupils who use clear words about the sex of other people (such as pronouns, but also boy/girl, male/female and so on), nor to require pupils to refer to some classmates as if they were the opposite sex.

To do so constrains the freedom of speech of pupils in a way that is unjustified and discriminates against them on the basis of belief.
It is inconsistent with schools’ safeguarding duty of care , and with their record-keeping responsibilities, for staff to misrepresent the sex of pupils in their records or in introducing them to their peers.
In order to explain and enforce sex-based rules designed to keep children safe (such as who is allowed in which showers, toilets, dormitories or sports teams), schools must be able to use clear and unequivocal language.
It is not reasonable to expect that a child at school, or transferring between schools, can avoid being “outed” as the sex that they are .

We do not think that any policy which tells teachers or pupils to lie about the sex of pupils, constrains them from using clear sex-based language or treats them detrimentally if they do would pass the proportionality test. It is an unreasonable constraint on speech that is neither required nor justified in order to avoid discrimination on the basis of gender reassignment.

Schools form part of a system that is regulated at a national level. In England that system is the responsibility of the Secretary of State for Education. It is the responsibility of the Secretary of State to make this legal situation clear across the English school system by issuing the long-awaited DfE guidance.

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GENDER ASSIGNMENT

the term used for the classification of an infant at birth as either male or female. Children born with ambiguous genitalia are usually assigned a gender by parents or physicians. See gender reassignment .

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J Clin Res Pediatr Endocrinol
v.12(4); 2020 Dec

Gender Identity and Assignment Recommendations in Disorders of Sex Development Patients: 20 Years’ Experience and Challenges

Fatih gürbüz.

1 Çukurova University Faculty of Medicine, Department of Pediatric Endocrinology, Adana, Turkey

Murat Alkan

2 Çukurova University Faculty of Medicine, Department of Pediatric Surgery, Adana, Turkey

Gonca Çelik

3 Çukurova University Faculty of Medicine, Department of Child Psychiatry, Adana, Turkey

Atıl Bişgin

4 Çukurova University Faculty of Medicine, Department of Medical Genetics, Adana, Turkey

Necmi Çekin

5 Çukurova University Faculty of Medicine, Department of Forensic Medicine, Adana, Turkey

İlker Ünal

6 Çukurova University Faculty of Medicine, Department of Biostatistics, Adana, Turkey

Ali Kemal Topaloğlu

Ünal zorludemir, ayşe avcı, bilgin yüksel.

Gender assignment in infants and children with disorders of sex development (DSD) is a stressful situation for both patient/families and medical professionals.

The purpose of this study was to investigate the results of gender assignment recommendations in children with DSD in our clinic from 1999 through 2019.

The mean age of the 226 patients with DSD at the time of first admission were 3.05±4.70 years. 50.9% of patients were 46,XY DSD, 42.9% were 46,XX DSD and 6.2% were sex chromosome DSD. Congenital adrenal hyperplasia (majority of patients had 21-hydroxylase deficiency) was the most common etiological cause of 46,XX DSD. In 46,XX patients, 87 of 99 (89.7%) were recommended to be supported as a female, 6 as a male, and 4 were followed up. In 46,XY patients, 40 of 115 (34.8%) were recommended to be supported as a female, and 70 as male (60.9%), and 5 were followed up. In sex chromosome DSD patients, 3 of 14 were recommended to be supported as a female, 9 as a male. The greatest difficulty in making gender assignment recommendations were in the 46,XY DSD group.

Conclusion:

In DSD gender assignment recommendations, the etiologic diagnosis, psychiatric gender orientation, expectation of the family, phallus length and Prader stage were effective in the gender assignment in DSD cases, especially the first two criteria. It is important to share these experiences among the medical professionals who are routinely charged with this difficult task in multidisciplinary councils.

What is already known on this topic?

Gender assignment in disorders of sex development (DSD) patients is always very difficult, complex and demanding experience in the management for both families and clinicians, particularly in cases where the gender appropriate for the clinical diagnosis is incompatible with the psychological gender of the patient. Gender assignment councils must have an experienced and multidisciplinary approach.

What this study adds?

Here, we present 20 years of experience and challenges in gender assignment, the causes and clinical characteristics of patients with DSD. This study is the longest timeframe, is the most comprehensive and has the largest number of cases in terms of gender assignment recommendation and assessing the factors affecting gender assignment from Turkey.

Introduction

According to Jost’s paradigm, the first sexual development stage begins with the identification of the chromosomal sex at the time of fertilization and is completed as a result of many biological process ( 1 ). Money et al. ( 2 ) added the theory of psychosexual development to this paradigm. This theory is influenced by hormonal and genetic status, environmental and psychosocial experiences, and social and parental behavior ( 3 , 4 , 5 ). Any defect occurring during this complicated process of sexual differentiation may lead to a discordant development of chromosomal, gonadal, and anatomical sex/phenotype and is defined as disorders of sex development (DSD) ( 6 , 7 , 8 ). DSD are a heterogeneous group of rare conditions which include various etiologies and presentations ( 9 , 10 , 11 ). The incidence of DSD is almost 1 in 4,500-5,500 ( 10 , 11 , 12 ).

The long-term physical, social and psychological outcomes of patients with DSD are still unclear. There are increasing concerns regarding early decisions about gender assignment in recent reports ( 13 , 14 , 15 , 16 , 17 , 18 ). Studies have been generally conducted regarding psychosexual and surgical outcomes in this group of patients ( 19 , 20 , 21 , 22 ). Gender assignment of a child with DSD is the most difficult and stressful condition for both the family and the clinician, especially in cases of ambiguous genitalia ( 6 , 23 , 24 ). Families will always want to know the actual gender of their DSD baby as soon as possible and give their baby a gender appropriate name. The primary goal in DSD is for gender identity to be consistent with the gender assigned ( 6 ). In this respect, a multidisciplinary approach is required for the diagnosis and treatment of DSD ( 25 ). Influencing factors to consider when debating gender assignment include medical diagnosis, external genital appearance, potential of fertility and sexuality, therapeutic and/or surgical intervention options, views and desires of the patients and their families, sociocultural factors, and the psychological gender development status of the child ( 26 , 27 , 28 ).

There is a multidisciplinary council to make gender assignment recommendations in DSD patients which, in our clinic, consists of pediatric endocrinology, pediatric surgery, pediatric psychiatry, medical genetics and forensic science specialists. Here, we present 20 years of experience at a single regional referral center in assistance with gender assignment in DSD patients.

The purpose of this study was to investigate the results of gender assignment recommendations in children with DSD and the factors affecting these results in our clinic. In the present study, the file records of the 226 children with DSD admitted to the Department of Pediatric Endocrinology of Çukurova University between the years of 1999 and 2019 were reviewed. The clinical diagnosis of a DSD was supported by anatomical examination findings, gonadal and pelvic ultrasound, cytogenetic studies, determination of serum electrolytes, 17-hydroxyprogesterone levels, the ratio of testosterone-dihydrotestosterone (basal and hCG stimulated) and molecular genetic testing. 21-hydroxylase deficiency (21-OHD) (72 of 88), 11-beta-hydroxylase deficiency (6 of 6), 17-beta-hydroxysteroid dehydrogenase type 3 deficiency (4 of 4), Steroidogenic Acute Regulatory Protein (STAR) gene mutations (5 of 5), complete androgen resistance (8 of 9), incomplete androgen resistance (6 of 6), 5-alpha-reductase deficiency, (19 of 19), Leydig cell aplasia/hypoplasia (2 of 2), 17-alpha-hydroxylase deficiency, (1 of 1), DSS-AHC Region on Human X Chromosome ( DAX1 ; also known as NR0B1 ) (2 of 2), NR5A1 (SF1) (2 of 2), Persistent Mullerian Duct syndrome (1 of 1), and Klinefelter syndrome (2 of 2) were diagnosed by cytogenetic studies and molecular genetic analyses. However, mixed gonadal dysgenesis, gonadal dysgenesis, ovotestis and Sertoli cell only syndrome were diagnosed by laparoscopy with gonadal biopsy, and molecular genetic testing. All the genetic testing was performed for diagnostic purposes after consent from the patients or child’s legal representative.

Laparoscopy and gonadal biopsy were performed in selected DSD patients for determination of gonadal histology. Cystoscopy was performed in order to examine urethra, uterus and uterine remnants.

Our center is the first, and the oldest and largest ‘Gender Evaluation Council’ in the region. This council consists of pediatric endocrinologists, pediatric surgeons, child psychiatrists, specialists in forensic medicine and a medical geneticist. Gender assignment recommendations were made by this council. The role of the council is to evaluate medical data, to conduct expert discussion, and to provide information and medical advice to the patient and/or family. The council ensures that ample time and opportunities are provided to patient and families for their questions, concerns, and counseling needs.

Exclusion criteria for this study were: DSD patients who did not need gender assignment (therefore not discussed in the council) such as Turner syndrome and isolated hypospadias. Written inform consent was obtained after the council from the parents or legal guardians of all the patients before participation. The study protocol was approved by the Ethics Committee of Çukurova University and performed in accordance with the ethical standards of the Declaration of Helsinki (ethical decision no: 452018.77/10).

Background clinical data obtained from medical file records included age at the time of first admission and meeting, reason for admission, genital examination findings, Prader stage, karyotype, diagnosis, psychiatric gender orientations, gender patient was being raised as, parents’ views and requests for the gender, number of council meetings held for each patient, and gender assigned. Although genital phenotype evaluation according to the Sinnecker classification is more appropriate for 46,XY DSD cases ( 29 ), all patients were evaluated via Prader classification in order to avoid confusion ( 30 ).

The patients were classified into three main groups on the basis of the karyotype of the affected individual, according to The Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology consensus ( 8 , 9 , 31 ). These groups are: 46,XX DSD; 46,XY DSD; and sex chromosome DSD.

The psychological evaluation for gender orientation was based on psychiatric interview with children and according to Diagnostic and Statistical Manual of Mental Disorders-5 diagnostic criteria ( 32 ).

Statistical Analysis

All analyses were performed using SPSS, version 20.0 statistical software package (IBM Inc., Armonk, NY, USA). Categorical variables were expressed as numbers and percentages, whereas continuous variables were summarized as mean and standard deviation (SD). Chi-square test was used to compare categorical variables between the groups. The normality of distribution for continuous variables was confirmed with the Shapiro-Wilk test. For comparison of continuous variables between two groups, the Student’s t-test or Mann-Whitney U test was used depending on the distribution being normal or non-parametric, respectively. For comparison of continuous variables between more than two groups, Kruskal Wallis test was used. Bonferroni adjusted Mann-Whitney U test was used for pairwise comparisons of groups. The statistical level of significance for all tests was considered to be 0.05.

A total of 226 patients were classified as 46,XY DSD (n=115, 50.9%), 46,XX DSD (n=97, 42.9%) or sex chromosome DSD (n=14, 6.2%) ( Table 1 ). The mean±SD age at first admission of the patients was 3.05±4.70 (range 0-17.58) years.

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Of the 226 patients, ambiguous genitalia (n=141, 62.4%) was the most frequent cause of admission for all three groups ( Table 1 ).

When the diagnostic distribution of the patients was examined, congenital adrenal hyperplasia (CAH) was the most common cause of DSD. Among the 46,XX DSD (n=97) patients, 21-OHD was the most common (n=88, 90.7%) ( Table 1 ). The most common cause amongst 46,XY DSD cases (n=115) was 5-alpha reductase deficiency (n=19, 16.5%). This was followed by complete androgen insensitivity syndrome (CAIS) and incomplete androgen resistance (PAIS) (total n=15, 13%). Forty-two (18.6%) of all cases had undetermined causes for DSD. The vast majority of these were 46,XY DSD cases (40/42, 95.2%) ( Table 1 , ,2 2 ).

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The psychiatric evaluation of cases showed that only about half of the 46,XX DSD patients had female and one in three of the 46,XY DSD patients had male gender orientation. In the sex chromosome DSD cases, female gender was 4/15 and male gender was 5/14 patients and 5/15 patients had no sexual orientation ( Figure 1 ).

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Gender orientations and gender assignment recommendations

DSD: disorders of sex development, F: female, M: male, NSO: no sexual orientation

*Two of the 3 cases with 46,XX related to 21-hydroxylase deficiency were raised as a male and their families insisted on an assignment recommendation as the male gender. The other one case had female gender orientation, but the family wanted to raise as the male gender. The remaining one 46,XX DSD patient had 11-OH deficiency, and raised as the male gender. Moreover, patient’s family wanted to raise as the male gender although the patient had menstrual bleeding.

**For 2 cases with 46,XY DSD diagnosed with 5-alpha reductase deficiency a follow-up recommendation was made, who were raised as female gender instead of male gender by their parents. Families were persistently wanting for a female assignment to be made. The other two 46,XY DSD cases had a diagnosis of gonadal dysgenesis and had not yet developed a gender orientation. The one 46,XY DSD patient had 17-betahydroxysteroid dehydrogenase type 3 deficiency, was raised as a female and the family asked for a male gender assignment.

***The one Klinefelter syndrome case was raised as a female and her family wanted to raise as the female gender. The other one patient was mixed gonadal dysgenesis and had no gender orientation yet.

The median age of all cases was 1.90 (mean: 4.46±4.98, range 0.12-18.63) years at the time of the council meeting. For each of the categories 46,XX DSD, 46,XY DSD and sex chromosome DSD patients these median ages were 1.60 (mean: 3.20±3.92, range 0.12-18.56), 2.98 (mean: 5.49±5.41, range 0.13-18.38) and 1.67 (mean: 4.77±6.15, range 0.21-18.63) years, respectively (p=0.004). While 200 (88.5%) of 226 patients had gender assignment at the first council meeting, 26 patients (11.5%) had more than one council meeting of whom 18/26 were 46,XY DSD, six were 46,XX DSD and two were sex chromosomal DSD patients. It is notable that patients requiring more than one meeting were mostly 46,XY DSD cases.

The mean age intervals of presentation and being considered at the meeting for 46,XX DSD, 46,XY DSD, and sex chromosome DSD were 1.19±2.03 (range 0.06-10.96) years, 1.45±2.12 (range 0.03-11.97) years and 2.73±4.58 (range 0.02-15.08) years, respectively. It was found that, these intervals were not different according to the DSD diagnosis (p=0.113), Prader stage (p=0.949) and decision (p=0.062).

In 46,XY DSD patients, 40 of 115 (34.8%) were recommended to be assigned as a female gender ( Figure 1 ). The female gender assignment recommendation in these cases was made for all of the CAIS, Leydig cell aplasia/hypoplasia, STAR gene mutations, 17-alpha hydroxylase and DAX1 (NR0B1) mutation cases according to the genetic diagnosis ( Table 2 ).

Eleven of 226 cases (4.8%) were followed without a gender assignment ( Figure 1 ). The common characteristic of all these cases who were not assigned a gender was that the family’s gender expectation was not compatible with chromosomal analysis, specific diagnosis, Prader stage and/or psychiatric evaluation.

When the effect of phallus length on the assignment recommendation was examined, it was found that in all three groups, phallus length was significantly higher in male assignments than in female assignments ( Table 3 ).

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According to the Prader classification with gender assignments recommendation, lower Prader stages (especially stage 1) were effective in making a female gender assignment in 46,XY DSD and sex chromosomal DSD cases. In addition, as the Prader stage increased, the decision-making ratio was gradually increased in favor of the male gender. However, the higher Prader stages were not associated with making a male gender assignment in 46,XX DSD cases. Moreover, the gender assignment of patients with Prader stage 1-4 was the female gender in a very large number of the 46,XX DSD cases. In general, it was found that a lower Prader stage was more effective in making a female gender assignment recommendation, than making a male gender assignment recommendation with a higher Prader stage ( Table 4 ).

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In this study, 20 years of experience in helping gender assignment, the causes and clinical characteristics of patients with DSD in a single referral clinic are presented. Gender assignment is always very difficult, complex and demands experience in the management of patients with DSD for both families and clinicians, particularly in cases where the gender appropriate for the clinical diagnosis is incompatible with the psychological gender of the patient. It should be recognized that every DSD is unique and has to be treated with individualized care. To our knowledge, this study has the longest timeframe, is the most comprehensive and has the largest number of cases in terms of gender assignment recommendation and assessing the factors affecting gender assignment from Turkey.

DSD are a heterogeneous group of conditions, which has an estimated incidence of 1:4500-5500 ( 10 , 11 , 12 , 33 , 34 ). In a recent study from Turkey by Aydin et al ( 35 ), it was found that the DSD newborn with ambiguous genitalia rate was 1.3/1000 newborns. However, this rate may be higher in our region where there is an increase in autosomal recessive forms of DSD due to higher rates of consanguinity, around 20% to 25% ( 35 ). This is in contrast to the consanguineous marriage rate reported by Aydin et al ( 35 ) (3 families of total 18 DSD patients). Nordenvall et al ( 36 ) remarked that the developmental anomalies of the external genitalia may be seen in 1:300 infants. However, not all of these conditions require gender assignment, including relatively common conditions such as isolated undescended testis and/or hypospadias.

Previous studies have reported a higher incidence of 46,XY DSD compared to 46,XX or sex chromosome DSD ( 35 , 37 , 38 , 39 , 40 , 41 , 42 ). In accordance with this the most common DSD group in our cohort was 46,XY DSD (50.9%). In a study with 117 patients from Thailand, it was reported that most of the cases were sex chromosome DSD (53%) ( 43 ). However, the majority of these patients were Turner syndrome. Girls with Turner syndrome were excluded from the present study because there is no necessity for gender assignment. Two Klinefelter syndrome patients were included because of ambiguous genitalia but other patients with Klinefelter syndrome without ambiguous genitalia, and thus without requirement for a gender assignment process were excluded.

Most patients with DSD are referred with ambiguous genitalia ( 35 , 37 , 38 , 39 , 43 ). In this study, ambiguous genitalia was the most common cause of admissions for all three DSD classifications ( Table 1 ).

Despite the current advanced genetic analyses, a definitive genetic diagnosis can only be made in about 20% of cases of DSD ( 11 , 12 , 31 , 37 ). Compatible with this information, the rate of patients with undetermined causes of DSD was 18.6% (42/226) in our study. There were only two patients (2%) with undetermined causes in the 46,XX DSD group whereas this was 40/115 (34.7%) amongst the 46,XY DSD cases, thus constituting 40/42 (95%) of the patients without a definitive genetic diagnosis.

The etiologic cause of most of the patients with 46,XX DSD is CAH due to 21-OHD ( 37 , 38 , 39 , 44 ). In this study, CAH was the most common underlying etiological condition of 46,XX DSD ( Table 1 ). CAH due to 21-OHD and 11-OHD accounted for 97.9% of 46,XX DSD in our series. Similarly, Ocal et al ( 39 ) found that 21-OHD and 11-OHD were the most frequent etiology (88.8%) of their 46,XX DSD group. De Paula et al (38) from Brazil with a 408 case series of genital ambiguity, Al-Mutair et al ( 45 ) from Saudi Arabia with a total of 120 DSD patients, and Al-Agha et al ( 46 ) from Australia report that the main etiology of 46,XX DSD was 21-OHD. However, Ganie et al ( 37 ) reported that the main referring cause of 46,XX DSD was ovotesticular in patients from sub-Saharan Africa.

It has been reported that only 50% of patients with 46,XY DSD can be given a definite diagnosis ( 44 ). In our study, the rate of 46,XY DSD patients with diagnosed causes was higher (n=75, 65.2%). The reason for this difference may be due to the further development of genetic understanding over the years. 5-alpha reductase deficiency was the most common etiology followed by CAIS and PAIS in 46,XY DSD ( Table 1 , ,2). 2 ). The etiological distributions of both 46,XX DSD and 46,XY DSD patients were similar to previous studies ( 38 , 39 , 41 , 45 , 46 , 47 ). Contrary to this, Ganie et al ( 37 ) report that the main etiological cause of 46,XY DSD was disorder of androgen synthesis or action.

Mixed gonadal dysgenesis was the most common etiology in the sex chromosome DSD group in our study (85.7%) which excluded Turner syndrome. Jaruratanasirikul and Engchaun ( 43 ) from Thailand reported that the most common sex chromosome DSD was Turner syndrome followed by Klinefelter syndrome and 45,X/46,XY DSD. Similar to this report, Ganie et al ( 37 ) from South Africa, with a total 346 cases diagnosed with DSD, noted that Turner syndrome constituted the largest proportion of the sex chromosome DSD group (61%), followed by mixed gonadal dysgenesis.

Gender identity is a characteristic which is influenced by various prenatal and postnatal variables. Psychosexual development plays an important role in the formation of sexual identity and is the main component of sexual identity, which is influenced by genetic status, pre/postnatal exposure to androgens, sociocultural factors, and family dynamics ( 6 , 39 , 48 , 49 ). Gender assignment is an important problem in DSD patients who have a virilized brain with undervirilized external genitalia ( 13 , 14 , 15 , 39 ).

Eleven of 97 46,XX patients (11.3%) had male gender orientation in the psychological evaluation, and were raised as the male gender by parents (nine were 21-OHD, one was 11-OHD, and one had Sertoli cell only syndrome; mean age of cases was 9.92±4.96 years). At the council meeting, six of these 11 cases were gender assignment recommendation male, two as female and three were not assigned and were recommended to be followed up.

Five of the patients who received a male assignment recommendation were 46,XX 21-OHD CAH and the other one was Sertoli cell only syndrome ( Table 2 ). The mean age at presentation and at the time of the meeting of these five 21-OHD CAH patients was 7.56±5.26 years and 10.66±3.88 years, respectively. It was found that all of these patients were Prader stage 4-5, raised as male and their psychologic gender orientation was male, and all of the parents demanded a male gender assignment. The factors most strongly influencing recommended gender assignment in 46,XX cases included etiological diagnosis, age, psychologic gender and Prader staging ( Table 2 , ,4 4 ).

Similar to our study, Khattab et al ( 13 ) report three 46,XX with 21-OHD CAH patients who were reared as male gender. In another study, of 50 DSD patients, 4/11 cases diagnosed with 46,XX DSD due to CAH had assumed a male social gender ( 15 ). This condition occurs due to prenatal and/or postnatal exposure to high levels of androgens that promote the masculinization of gender behavior ( 16 , 50 ). With the recent implementation of national neonatal CAH screening, it is hoped that late diagnosis of CAH, and therefore ambiguous genitalia, will be prevented.

For our council, the greatest difficulty in making gender assignment recommendations was in the 46,XY DSD group. The mean length of the phallus of patients who received a female assignment was 0.82±0.71 cm and 90% were Prader stage 1-2; etiological causes of these cases is shown in Table 2 . Most of the 46,XY DSD patients who had no etiological diagnosis and had female gender assignment recommendations were Prader stage 1-2. Interestingly, psychological evaluation of these cases showed 8/9 had female gender and 1/9 had no gender orientation.

The majority, 93.7%, of the 46,XY cases with a male gender assignment recommendation and no etiological diagnosis were Prader stage 3-5. Moreover, 62.5% of these patients had no gender orientation yet. These findings suggest that, besides the etiologic diagnosis, the expectation of the family, phallus length and Prader stage were effective in the female assignment recommendations in 46,XY DSD cases. Furthermore, if there is no definite etiologic diagnosis, the most important factors in determining the gender assignment recommendation in 46,XY DSD patients were Prader stage and psychological gender orientation.

Study Limitations

The major limitation of this study was the patients were only considered from presentation until the final decision for each individual by the gender assignment recommendation council. Due to ethical concerns, follow-up of patients after gender assignment recommendation was not included and thus there is no measure of agreement or discordance with the decision of the council reported.

The most difficult aspect of managing a patient with DSD diagnosis who has ambiguous genitalia is the assignment of an appropriate gender. Specific diagnosis and psychological gender are more effective in gender assignment of DSD patients with an etiologic cause. Phallus length and Prader stage are important criteria in the gender assignment of patients with undiagnosed DSD. In this cohort none of the clinical, etiological or genetic features of the patients dominated the gender assignment decision. Gender assignment should be determined by evaluating the patient’s chromosome structure, specific diagnosis, fertility, Prader stage, phallus length, psychological orientation, family wish and the consensus opinion of experienced specialist physicians. Gender assignment becomes more difficult, especially if there is a mismatch of the gender the child is raised as, with the etiologic diagnosis. Gender assignment councils must have an experienced and multidisciplinary approach to the diagnosis, medical and/or surgical treatment, psychosocial support, and genetic counseling of patients with DSD. We hope that by publishing our extensive experience in this challenging clinical area we will help other clinicians and patients facing these difficult choices.

Acknowledgments

The authors would like to thank the patients and their parents who participated in this study.

Ethics Committee Approval: The study protocol was approved by the Ethics Committee of Çukurova University and performed in accordance with the ethical standards of the Declaration of Helsinki (ethical decision no: 452018.77/10).

Informed Consent: Written inform consent was obtained after the council from the parents or legal guardians of all the patients before participation.

Peer-review: Externally peer-reviewed.

Authorship Contributions

Financial Disclosure: The authors declared that this study received no financial support.

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gender reassignment

Definition of gender reassignment

Note: This term is sometimes considered to be offensive in its implication that a transgender or nonbinary person takes on a different gender, rather than making changes to align their outward appearance and presentation with their gender identity. Gender transition is the preferred term in the medical and LGBTQ+ communities.

Word History

1969, in the meaning defined at sense 2

Articles Related to gender reassignment

crowd of people seen from above crossing a street

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Merriam-Webster's Short List of Gender and Identity Terms

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genderqueer

gender reassignment surgery

Cite this Entry

“Gender reassignment.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/gender%20reassignment. Accessed 1 Jun. 2024.

Medical Definition

Medical definition of gender reassignment.

Note: This term is sometimes considered to be offensive in its implication that a transgender or nonbinary person takes on a different gender, rather than makes changes to align their outward appearance and presentation with their gender identity. Gender transition is the preferred term in the medical and LGBTQ+ communities.

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The Gender Reassignment Controversy

When people opt for surgery, are they satisfied with the outcome.

Posted March 16, 2018 | Reviewed by Ekua Hagan

In an age of increasing gender fluidity, it is surprising that so many find it difficult to accept the gender of their birth and take the drastic step of changing it through surgery. What are their motives? Are they satisfied with the outcome?

Gender may be the most important dimension of human variation, whether that is either desirable, or inevitable. In every society, male and female children are raised differently and acquire different expectations, and aspirations, for their work lives, emotional experiences, and leisure pursuits.

These differences may be shaped by how children are raised but gender reassignment, even early in life, is difficult, and problematic. Reassignment in adulthood is even more difficult.

Such efforts are of interest not just for medical reasons but also for the light they shed on gender differences.

The first effort at reassignment, by John Money, involved David Reimer whose penis was accidentally damaged at eight months due to a botched circumcision.

The Money Perspective

Money believed that while children are mostly born with unambiguous genitalia, their gender identity is neutral. He felt that which gender a child identifies with is determined primarily by how parents treat it and that parental views are shaped by the appearance of the genitals.

Accordingly, Money advised the parents to have the child surgically altered to resemble a female and raise it as “Brenda.” For many years, Money claimed that the reassignment had been a complete success. Such was his influence as a well-known Johns Hopkins gender researcher that his views came to be widely accepted by scholars and the general public.

Unfortunately for Brenda, the outcome was far from happy. When he was 14, Reimer began the process of reassignment to being a male. As an adult, he married a woman but depression and drug abuse ensued, culminating in suicide at the age of 38 (1).

Money's ideas about gender identity were forcefully challenged by Paul McHugh (2), a leading psychiatrist at the same institution as Money. The brunt of this challenge came from an analysis of gender reassignment cases in terms of both motivation and outcomes.

Adult Reassignment Surgery Motivation

Why do people (predominantly men) seek surgical reassignment (as a woman)? In a controversial take, McHugh argued that there are two main motives.

In one category fall homosexual men who are morally uncomfortable about their orientation and see reassignment as a way of solving the problem. If they are actually women, sexual interactions with men get redefined as heterosexual.

McHugh argued that many of the others seeking reassignment are cross-dressers. These are heterosexual men who derive sexual pleasure from wearing women's clothing. According to McHugh, surgery is the logical extreme of identifying with a female identity through cross-dressing.

If his thesis is correct, McHugh denies that reassignment surgery is ever either medically necessary or ethically defensible. He feels that the surgeon is merely cooperating with delusional thinking. It is analogous to providing liposuction treatment for an anorexic who is extremely slender but believes themselves to be overweight.

To bolster his case, McHugh looked at the clinical outcomes for gender reassignment surgeries.

Adult Reassignment Results

Anecdotally, the first hurdle for reassignment is how the result is perceived by others. This problem is familiar to anyone who looked at Dustin Hoffman's depiction of a woman ( Tootsie ). Diligent as the actor was in his preparation, his character looked masculine.

For male-to-female transsexuals, the toughest audience to convince is women. As McHugh reported, one of his female colleagues said: “Gals know gals, and that's a guy.”

According to McHugh, although transsexuals did not regret their surgery, there were little or no psychological benefits:

“They had much the same problems with relationships, work, and emotions, as before. The hope that they would emerge now from their emotional difficulties to flourish psychologically had not been fulfilled (2)”.

Thanks to McHugh's influence, gender reassignment surgeries were halted at Johns Hopkins. The surgeries were resumed, however, and are now carried out in many hospitals here and around the world.

What changed? One likely influence was the rise of the gay rights movement that now includes transgender people under its umbrella and has made many political strides in work and family.

McHugh's views are associated with the religious right-wing that has lost ground in this area.

Transgender surgery is now covered by medical insurance reflecting more positive views of the psychological benefits.

Aspirational Surgery

Why do people who are born as males want to be women? Why do females want to be men? There seems to be no easy biological explanation for the transgender phenomenon (2).

Transgender people commonly report a lifelong sense that they feel different from their biological category and express satisfaction after surgery (now called gender affirmation) that permits them to be who they really are.

The motivation for surgical change is thus aspirational rather than medical, as is true of most cosmetic surgery also. Following surgery, patients report lower gender dysphoria and improved sexual relationships (3).

All surgeries have potential costs, however. According to a Swedish study of 324 patients (3, 41 percent of whom were born female) surgery was associated with “considerably higher risks for mortality, suicidal behavior, and psychiatric morbidity than the general population.”

1 Blumberg, M. S. (2005). Basic instinct: The genesis of behavior. New York: Thunder's Mouth Press.

2 McHugh, P. R. (1995). Witches, multiple personalities, and other psychiatric artifacts. Nature Medicine, 1, 110-114.

3 Dhejne, S., Lichtenstein, P., Boman, M., et al. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: Cohort study of Sweden . Plos One.

Nigel Barber, Ph.D., is an evolutionary psychologist as well as the author of Why Parents Matter and The Science of Romance , among other books.

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The Intersex Society of North America closed its doors and stopped updating this website in 2008. ISNA’s work is continued by interACT: Advocates for Intersex Youth , who proudly preserves this website as a historical archive. For current information, links to intersex support groups, and to connect with intersex advocates, please head to interACT: Advocates for Intersex Youth .

# How can you assign a gender (boy or girl) without surgery?

When you assign a child a gender as boy or girl, what you’re doing is labeling them a boy or girl. That’s it. You don’t need a surgeon for that.

But how do you pick a child’s gender if she or he is intersex?

The child is assigned a gender as boy or girl after tests (hormonal, genetic, radiological) have been done and the parents have consulted with the doctors on which gender the child is more likely to feel as she or he grows up.

We know, for example, that the vast majority of children with complete androgen insensitivity syndrome grow up to feel female, and that many children with cloacal exstrophy and XY chromosomes will grow up to feel male.

Why shouldn’t children with intersex be raised in a “third gender”? We advocate assigning a boy or girl gender because intersex is not, and will never be, a discrete biological category any more than male or female is, and because assigning an “intersex” gender would unnecessarily traumatize the child.

In cases of intersex, doctors and parents need to recognize, however, that gender assignment of infants with intersex conditions as boy or girl, as with assignment of any infant, is preliminary. Any child—intersex or not—may decide later in life that she or he was given the wrong gender assignment; but children with certain intersex conditions have significantly higher rates of gender transition than the general population, with or without treatment.

That is a crucial reason why medically unnecessary surgeries should not be done without the patient’s consent; the child with an intersex condition may later want genitals (either the ones they were born with or surgically constructed anatomy) different than what the doctors would have chosen. Surgically constructed genitals are extremely difficult if not impossible to “undo,” and children altered at birth or in infancy are largely stuck with what doctors give them.

← Why Doesn't ISNA Want to Eradicate Gender? What evidence is there that you can grow up psychologically healthy with intersex genitals (without normalizing surgeries)? →

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Data Descriptor
Open access
Published: 31 May 2024

Gender board diversity across Europe throughout four decades

Hubert Drazkowski 1 na1 ,
Joanna Tyrowicz ORCID: orcid.org/0000-0002-5928-332X 1 , 2 , 3 , 4 na1 &
Sebastian Zalas 1 , 2 na1

Scientific Data volume 11 , Article number: 567 ( 2024 ) Cite this article

Metrics details

Interdisciplinary studies

We present a Gender Board Diversity Dataset (GBDD), which provides a cross-country perspective on women in management and supervisory boards that spans between 1985 and 2020. The data covers 43 European countries and accounts for private companies in addition to the stock-listed ones. GBBD was created using firm-level Orbis data. Our measures are based on a sample of more than 28 million unique firms observed for nearly seven years on average and reporting data about nearly 59 million individuals on management and supervisory boards. We provide the measures at the level of industry, country and year (firm-level data is proprietary). We provide three measures. The first is the share of women among all board members in a given industry, country, and year. The second one is the average of the shares of women across firms in a given industry, country and year. We also provide a new measure: the share of firms in a given industry, country and year which report no single woman on their board(s).

Women are credited less in science than men

Within-job gender pay inequality in 15 countries

Impact of boardroom diversity on corporate financial performance

Background & summary.

This document describes Gender Board Diversity Dataset (GBDD). Typically, in cross-country contexts, gender board diversity is studied with data limited to public (listed) companies, whereas the majority of board positions, as well as the majority of jobs in general, are in private (not listed) companies. Data concerning private companies are scarce. Admittedly, in a few countries, registry data were made available for research (e.g. Norway, France, Italy). GBDD is the first data to provide a comprehensive and comparable overview of gender board diversity in 43 countries spanning 36 years.

We obtain GBDD by harmonizing the firm-level data circulated as Orbis. This data source is uniquely suitable in two key ways. First, it provides an overview of registry and financial data for private companies, in addition to the public ones. Second, it reports the names and surnames of individuals in the executive and non-executive positions, thus allowing to move the analysis from firm-level to individual-level data. These exclusive advantages come with numerous challenges. Orbis data is notoriously difficult to process: it comes from local registries and there are important differences across countries, time and legal forms concerning what information is to be reported and how it is reported. Previously 1 , 2 , provide guidelines on constructing longitudinal firm-level data a for European countries using financial statements from the Orbis database 1 . work with one wave of Orbis data, whereas 2 provide guidelines on how to work with the so-called Orbis Historical Data (OHD) released recently by Orbis.

Furthermore, gender identification is scarce in the data. For example 3 , use roughly 4% of the sample. We provide a novel method which allows us to circumvent this limitation: we use the names of the individuals and construct heuristics from linguistic rules. In addition, we demonstrate that Orbis is not fully reliable for board assignment. We provide an improvement drawing on verbal descriptions of individual positions. To the best of our knowledge, none of these have been previously pursued in the literature.

We provide three measures of gender board diversity. The first is the share of women among all board members in a given industry, country, and year. The second one is the average of the shares of women across firms in a given industry, country and year. These two measures were previously used in the literature. They can be dubbed the measures of presence. We also provide a new measure: the share of firms in a given industry, country and year which report no single woman on their board(s). This third measure relates to the absence of women, rather than their presence. The three measures are obtained for the management (executive) board, supervisory (non-executive boards) and the measure which combines management, supervisory and ambiguous boards jointly.

Our measures are based on a sample of more than 28 million unique firms observed for nearly seven years on average and reporting data about nearly 59 million individuals on management and supervisory boards. The firm-level and the person-level data is proprietary, and we cannot share it, however we provide the measures at the level of industry (two-digit NACE codes), country and year Table 1 .

Figures 1 – 3 along with Table 1 report on the properties of our data. Our data covers roughly 60 thousand observations for most measures and roughly 30 thousand observations for measures concerning specifically the supervisory boards. The mean share of women averaged across firms, and averaged within an industry range between 10% and nearly 30%. The share of industries, where no firm has a single woman in the board, average 74% for the management board and 63% for the supervisory board positions. We also calculate measures of gender diversity at the country level for stock-listed and private (non-listed) companies. The mean share of women ranges across time and countries from 10% and 30% for private companies and between 5% and slightly over 25% for stock-listed companies.

Distribution of gender board diversity measures - all board positions.

Distribution of gender board diversity measures - management board.

Distribution of gender board diversity measures - supervisory board.

Given the massive size of our samples, our distributions are relatively smooth. Nonetheless, we see several spikes: at 0%, at 50% and at 100%. The distribution of the share of firms with no women is a less smooth, because it depends on the number of firms in a given four-digit industry rather than a number of board members and a number of women among them. The spikes at 0% for the measures of presence and at 100% for the measures of absence the fact that in relatively many firms and sectors, there are no women among the board members.

We concatenate 11 waves of the Orbis as well as the OHD. In the past, each of the Orbis waves provided records for up to ten years for each firm. The OHD was intended to be a comprehensive compilation of the past waves. Indeed, for some firms, historical data go back as far as the early 1980s. Unfortunately, the historical data provide much fewer data points than the previously released waves. In fact, the overlap between the historical data and the data historically provided by Orbis is surprisingly low. On the upside, the historical data provides updates for firms from the 2016 wave. Combining subsequent waves ushers in many new challenges that were absent in previous studies, such as the harmonization of industry codes.

Ultimately, in addition the Gender Board Diversity Dataset (GBDD), we also present the codes that harmonize Orbis data and identify board members as well as their gender. The GBDD provides cross-country perspective on women in management and supervisory boards that spans 36 years (between 1985 and 2020). The data covers 43 European countries and accounts for private companies in addition to the listed (public) ones.

This section is structured as follows. After presenting the GBDD, we move to the details on how we obtained these measures. We start by describing the preprocessing of the data in section section Preprocessing Orbis data. In section Legal form, we provide explanations on how we address the issue of legal forms in our sample and their role in determining corporate governance. Next, in section Industry we explain how we expand previous work by 1 , 2 for industry classification. The core of our work concerns a heuristic which assigns individuals to supervisory boards and management boards of firms as well as gender attribution. For each heuristic, we provide a verification of the validity. We first identify individuals as board members, which is described in section Managers. The heuristics of the assignment to the board are described in section Board assignment. The final stage consists of assigning the periods in which specified individuals held these positions. Our method to assign the dates of holding a given position is covered in section Timing the board members. Our heuristics for gender attribution are described in detail in section Gender attribution.

Preprocessing orbis data

The aim of this section is to describe in greater detail the Orbis data and the pre-processing. Orbis unifies data from information providers from all over Europe. The information providers are individual contractors who collect data for Orbis in respective countries. They reach out to national official public bodies in charge of collecting annual financial statements from national registry records, courts, and firms. They provide Orbis with firm-level data consisting of balance sheets and profit-loss statements reported by the companies to registry courts and local government statistical offices. Some data is taken from end-year reports or scraped from the websites of these firms by Bureau van Dijk, which compiles the Orbis data. As noted by 4 , about 99% of the companies in the data set are private.

Orbis data used to be available in waves disseminated annually. Each wave of Orbis covers up to ten years of firms’ history for all the firms available in a given wave. Data availability varies across countries 5 . As of 2020, Orbis data are distributed as Orbis Historical Data, which, in addition to current 2020 data, provides partial information on historical records.

We concatenate 11 waves of Orbis database of Bureau van Dijk, namely: 2000, 2002, 2003, 2004, 2006, 2008, 2010, 2012, 2014, 2016 and the 2020 Orbis Historical Data (OHD). It is not clear which firms were included in the OHD. Using the unique firm identifiers of the Orbis data (the so-called bvdid ) we compare the OHD sample with the compilation of the other 10 waves. In total, 27,649,381 unique firm identifiers matched between OHD and the combination of the other 10 waves, and 71,536,992 did not. Of the nonmatching identifiers, 6,147,066 unique identifiers were available in the other ten waves, but were not reported in OHD. By contrast, 65,389,926 unique identifiers were available in OHD and were not available in our ten waves. While it appears that OHD is broader, data availability is smaller in OHD. In fact, historical registry data covering individuals in executive and non-executive positions is much more sparse in OHD. We document these major differences in section Timing the board members.

Commonalities with previous work

Our own experience concurs with 1 , 2 on all points related to exporting the individual level data through Orbis interface, as well as mapping and organizing the files in the OHD distribution. Specifically 2 , provide a step-by-step guide on how to obtain data from Orbis, as well as how to merge various data sets provided by the company.

Since 1 worked with one wave of Orbis data, they did not address potential issues related to the overlap of ten-year windows. Recall that each annual wave of Orbis provides up to ten years of historical data. Consequently, data for a given financial year can be reported in more than one of the available waves. If the values are identical, this redundancy is immaterial. If the values are missing in one wave, but are available in another wave, we are able to lengthen the within-firm panel.

In the period covered by Orbis data, the industry classification changed several times. Our procedure of harmonizing the sectoral codes builds on the approach of 2 , who match the codes across classifications based on the content. We pursue similarly. A strength compared to 2 , who work with two-digit industries, is that we provide cross-walks for four-digit industry classification. We describe how we augment their approach in section Industry below.

Since the purpose of the database is to study gender board diversity, we select a setting in which this is meaningful. Therefore, for the construction of this database, we restrict it to firms with formalized boards. To identify such firms, we rely on national legal forms because the obligation to have a board may depend on specific criteria such as a specific type of business vehicle. For example, in some countries limited liability companies are obliged to have both executive and non-executive managers, whereas in others additional criteria may apply (such as annual turnover or headcount). Legal requirements for registration and reporting differ across countries covered by Orbis. Similarly, data collecting procedures differ. Bureau van Dijk does not collect data themselves. Bureau van Dijk delegates the data collection effort to forty different information providers including business registers. In Table A.6.1 2 , provide a registry of information providers across countries covered in Orbis. Consequently, in some countries, data is available for every business, whereas in other countries availability is restricted to some legal forms. As of 2010, Orbis provides a classification of firms into a standardized status: sole proprietorship, partnership, private limited company, public limited company, branch, etc., but this classification is insufficiently detailed for our objectives.

We deploy a variety of Internet sources, including OECD country reports on corporate governance standards, as well as tax advise classifications to classify firms into those which ought to have a management board only, and those that are legally bound to have non-executive (supervisory) board or board members as well 6 . provide a classification of European countries over time; there are three corporate governance systems

two-tier - clear distinction between two governance boards: management (executive) and supervisory (non-executive, independent), including the mixed system;

one-tier - management (executive) and supervisory (non-executive or independent) directors operate within one board;

other (including the audit board system, responsible for legal compliance, functioning alongside the management board, most common in Italy and Portugal).

In the mixed system, the executives take daily management decisions, reporting to the non-executive members during the general meeting (it is most common in Nordic countries, see 7 ). In the remainder of this paper, we will use interchangeably terms management board members and executive directors, as well as supervisory board members and non-executive or independent directors.

We proceed in the following steps. First, we tabulate the national legal forms reported in each wave of Orbis. We do this separately for every country. Second, for each of the legal forms, we inquire if that type of entity is obliged to have a management board and/or a supervisory board, using the available literature on corporate governance. We started from a list of specific keywords in the legal form; for example, a limited liability partnership (LLP) in most legal systems must have a board. We thus classify the most common legal forms. Third, we reiterate for less common legal forms, until all forms have been classified. Fourth, we proceed systematically for every country. In these four steps, we establish a dictionary of firm types that indicates which ones are obliged to have at least a management board. We then tabulate the legal forms in Orbis for the unclassified firms, reiterating the entire procedure, until virtually all cases are classified. The classification is eventually translated into the algorithm, which permits replicating our procedure. Rather than working with lengthy tabulations, our algorithm effectively works with morphemes (parts of names) rather than with the full names of legal forms. Such morphemes include for example “limit”, “liab” and “partn” instead of relying on the full legal name “limited liability partnership”. Morphemes help us circumvent a large share of misspellings and random abbreviations. Working with morphemes makes our approach robust across countries with similar legal forms. The dictionary of morphemes is distributed as part of our codes and includes terms in English as well as in local languages. This is because Orbis often reports legal forms using country-specific abbreviations and names. Examples include SARL in Francophone countries, AG in Germanic countries, etc.

This procedure identifies firms whose legal form determines that they should have at least a management board. In addition to legal forms without an obligation to have a board (such as sole proprietorship), Orbis includes a number of non-commercial institutions which are out of scope for this analysis (such as cooperatives, charitable institutions, NGOs and even public institutions), which are also excluded from the sample based on our legal form classification. Overall, 64,656,554 firm-year observations concerning sole proprietorship as well as non-profit entities as well as 15,497,240 firm-year observations for cooperatives and private partnerships were excluded.

Our sample covers 79,186,373 unique firms, which at least in some years are obliged to have and report a board or boards. We have 326,824,617 firm-year observations who ought to report at least one board member, Which implies that on average we observe a firm for 4.13 years. In this sample, 9,932,642 (13%) report no people, and 69,253,731 (87%) report at least one person. In the remainder of this text, we explain how we provide coherent industry classifications for those firms, how we identify board members, and how to delineate between management (executive) and supervisory (non-executive) boards.

The Orbis data report NACE classification at four digits. The classification is taken from and is valid for a given Orbis wave. For example, the NACE code of a firm available in the 2014 wave refers to industry reported by this company in that year, which is NACE Rev 2.0. Our data cover the years 1990–2019. During this period, the NACE classification has changed twice: Rev 1 was replaced by Rev 1.1 which in turn was followed by Rev 2.0.

The changes in NACE classification are not an issue for firms observed under both classifications. By combining many waves, we are also able to identify firms that switch their main sector of activity. However, the change in NACE classification constitutes a challenge for the firms that were observed under only one classification. Orbis does not provide historical NACE codes for firms, even when the historical data cover the period from the previous NACE classification. Thus, to maintain comparability across years, crosswalks need to be developed. The crosswalks are necessary only for the firms which appear in Orbis for the first time under newer classification, but its retrospective data cover periods of older classification. Similarly, we need to obtain consistent NACE codes for firms that existed only before a change in classification(s) and are not available in the newer samples.

Our procedure for developing crosswalks is consistent with 2 . Specifically 1 , describe their approach to NACE harmonization in Section A.5.2, p. 50 in the accompanying documentation document. However, we cannot rely on these codes for two reasons. First, we need four-digit classifications, whereas 2 provide two-digit crosswalks. Further, our sample covers two changes in NACE classification, whereas 2 cover the change from NACE Rev. 1.1 to NACE Rev. 2. Ultimately, our procedure assigns firm-year classifications according to NACE Rev. 2 for all periods.

Our procedure involves three steps. First, we identify the firms when Orbis reported the same firm in two or more classifications. In these cases, the firm itself reported its actual NACE of main activity. For the remaining firm-year observations, we need to provide crosswalks. Hence, in the second step, we apply all the unique crosswalks made available from the official correspondence tables distributed by Eurostat (the so-called RAMON database: https://showvoc.op.europa.eu/ ). Unique crosswalks cover roughly 54% codes and approximately 42% of firm-years. Third, for the cases where the correspondence tables are many-to-many, similar to 2 , we manually match the codes by reading the full descriptions of the codes. We review the area of firms activity under the reported classification and assign the missing NACE Rev 2 classification from among the relevant options 2 . use the top NACE code in a given two-digit group. We do the same for the four-digit codes. If a given activity is completely missing in the official correspondence tables, we read the content and try to find a matching classification. If no such code exists, we assign the most similar code not elsewhere classified. For example, NACE Rev 1.1. has a section 45.25 Other construction work involving special trades . No section with a similar name exists in NACE Rev 2. In this case, we assign 43.99 Other specialized construction activities n.e.c .. We proceed in a similar way in other problematic cases. Our own correspondence table is part of this documentation.

Note that for some firms, NACE classification provided by Orbis is at two or three digits rather than the full four digits. In those cases we assigned the adequate two or three digit in the older/newer classification(s). This step is identical to 2 for two-digit codes and follows the same spirit as four-digit for three-digit codes.

For 2.77% observation no NACE information is available. In some cases, the fact that NACE data is missing can be rectified by imputation. Specifically, if a given firm has a NACE code reported for years prior to a missing observation, as well as for years after the missing information, we test if the two available NACE codes are identical. If that is the case, we fill in the missing information with this specific NACE. This way we are able to recover 454,762 firm-year observations (0.13% of the sample or 4.7 of the missing cases). Ultimately, we assign 97.24% of firm-year observations with a NACE Rev. 2 classification. The remaining 2.76% consists of two cases: no NACE was provided (2.64%) or we could not find a satisfactory crosswalk (0.12%).

Orbis provides detailed information on the executives and non-executives of firms. This detailed information, dubbed DMC by Orbis (the name comes from “directors/managers/contacts”, which was the historical name of this part of the data). It comprises name, surname, function name, position (job title), level of responsibility, appointment date and resignation date. The manager function name is a concept distinct from the position or the level of responsibility in Orbis data. The manager function name is given either in local languages or in English. The function name is specific to a firm in a sense that across most–though not all–countries in Europe, firms are free to utilize any names for their functions. The position and the level of responsibility are variables defined by information providers or directly by the Bureau van Dijk, based on the function name. We discuss the differences between these two concepts in section Board assignment . The most recent waves of Orbis include data on gender, nationality and birth year of those individuals, but this crucial information is missing for most of our data. In this section, we describe how we process data on managers to arrive at board assignment as well as gender attribution.

First, we strip all records of diacritic signs characteristic of many languages. Second, we observe that the DMC database comprises legal persons in addition to physical persons. that is sometimes firms are reported instead of individuals. We exclude legal persons by identifying the strings associated with legal forms in the name variable. Based on the inquiry into the legal forms across firms, as covered in section Legal form , we construct a dictionary of legal form names. For example, in the case of Germanic countries, the dictionary includes KG (alternatively: Kommandgesellshaft ), GmBH ( Gesellschaft mit beschraenkter Haftung ), etc. Likewise, in the case of Francophone countries, the dictionary includes SARL ( Societe a responsabilite limitee ). The full list of terms to identify legal persons is part of this documentation.

Third, in some cases the individuals listed are reported as shareholders or representatives of stakeholders, e.g., trade unions. In these instances, their names and surnames are missing and they are solely described by their function. Since individual details are unknown for such records, they also have to be removed from the sample.

Overall, although the DMC data is reserved for physical persons, occasionally it conceals legal persons. Whenever a record reports a name that we classify as a legal form or as a function rather than a physical person, it is dropped from the sample. This restriction is not arbitrary, as we follow the dictionary constructed in section Legal form. It is also quantitatively minor. In total, this procedure reduces the sample by 3% of all firm-year records.

Once we have a list of physical persons, we parse each record for name and surname. The full name variable includes salutations (Mr, Mrs, Ms), suffixes (for example: Jr.) and titles (for example: “Lord”, “Prof.”, “Dr.”, “Rev.”, etc.). We trim those elements from the full name variable. We also trim unnecessary spaces and signs. We parse the remainder for the given name and the surname (family name). This identification is necessary because we are assigning gender based on linguistic rules which apply to given names in some languages and to family names in other languages. We start by counting the remaining words in the full name . We inspect each country separately, and in most cases, we take the first word as the given name and the last word as the surname. In the case of several countries (Romania, Serbia, Spain and Italy), the family names are reported as first and the given names are reported as the last.

In total, we obtained 249,668,837 records. These records are identified at the level of person × firm × function × Orbis wave. We refer to this sample of managers in the remainder of this documentation. We also describe how we assign individuals to boards and how we assign dates of appointment. Note that these 249,668,837 records do not identify unique individuals: a given non-executive director can be a member of the Nominating Committee and an Audit Committee, in which case this person would show up twice at this stage. While these two positions describe responsibilities, both belong to a supervisory board and can be held simultaneously by one person. We describe the board assignment in the next section. Further, section Timing the board members describes how timing is assigned to board positions for each individual.

Board assignment

We classify managers according to their primary function in the organization, as portrayed in Fig. 4 . Given the legal and institutional complexity, as well as differentiation across countries covered by Orbis (see 6 ), such an assignment is neither universal nor entirely obvious. Our aim is to draw a line between the day-to-day executive and management roles of top corporate governance members and non-executive, supervisory roles of oversight and control.

Categories of individuals reported in Orbis data.

As discussed above, legal forms are informative about whether firms should have a management board, a supervisory board, or both or neither. We retain only those firms that are obliged to have at least one board. Typically, registries include information on individuals filling the positions in the required boards. One individual may have a management position in one company and a supervisory position in another company. Hence, all classifications must be applied to the appropriate sample of companies, and must be determined at the level of each record in our database, that is, company × person × position.

Orbis data provide two sources of information about the positions of respective managers. First, the database includes the manager function variable. This is a text field. This variable reports values in either local languages or in English. These strings may occasionally be misspelled, abbreviated or altered in some other way. The second source of information is the position assignment generated by Orbis, with two variables: position and level of responsibility . Among our Orbis waves, the first one to report this classification is 2010, and hence we could not rely on it for the earlier years in our sample. Furthermore, the Orbis classification rules have changed between waves and are not sufficient for the purpose of our research. This section characterizes classification by Orbis in the context of our research needs in section Amadeus classification to boards. Next, we describe our heuristics for assignment to boards, based primarily on the function name in section Our heuristics. We conclude by a comparison between our assignment and Orbis classification, where we provide the estimates of the overlap and explain the origins of differences in section Comparing our heuristic to Orbis classifications.

Amadeus classification to boards

Orbis provides two variables level of responsibility and type of position : “[w]e make manual matches by source to take into account the context of the country instead of general word parsing. The same original job title may end up in a different standardized position.” The classifications by Orbis are shorthands for full positions.

level of responsibility - this variable typically delineates between a board-level position and other high-level executives. This variable takes on values such as “Founder”, “Member”, “Highest executive”, “Human Resource executive”, “Unspecified executive”.

type of position - this variable typically refers to the area of work/expertise, such as “SupB”, “RiskC”, “SenMan”, “IT”, “Sales”.

These variables were not available before the 2010 wave. Furthermore, subsequent waves of Orbis data report different values/categories for this variable and there are no cross-walks provided within the data or its publicly available documentation that could guide us in harmonizing these values/categories between the years. Taking values/categories from all waves when they are available, We interpret the Orbis classification as follows in Table 2 .

With this classification, we could pursue to identify members who belong to a board, but only in a limited number of cases we could delineate supervisory (non-executive) from management (executive) positions. Thus, we could potentially leverage Orbis classification, but we could not rely on it completely.

Although the two Orbis variables provide much information, they are also known to be internally inconsistent. As noticed by 8 and 6 Orbis classification is not always consistent with the rules of corporate governance. For example, Orbis assigns “Liquidator” an executive role even though it is not equivalent to a management board. We proceed to comparing our heuristic with Orbis classification in the few waves, where both are available. Note that for the waves prior to 2008, only our heuristic can be applied to classify individuals.

Our heuristics

Our heuristic is primarily based on the manager function variable. This is a text field, filled by the companies. The values of this variable are given in English or in local languages, with multiple abbreviations and variations. We begin by tabulating within countries. In some countries, there were only a few categories (e.g., Estonia), whereas in other countries the tabulation included more than 1,200 cases.

By browsing through those logs, we identified the keywords that were common to all countries. For example, English names such as variants of CEO or non-executive director were relatively common. In parallel, we identify multiple country-specific keywords. For example, the data for France include relatively frequently a variant of PDG ( President Directeur General ), data for Germanic countries frequently report Vorstand , whereas Spanish and Portuguese-based firms often include a variant of Conselho Fiscal .

Parsing the words, we establish the list of morphemes which are consistent with the non-executive (supervisory) board. This list includes term related to non-executive, independent, supervision, audit, nomination/compensation/appointments as well as the general assembly. Analogously, we generate a list of manager functions which are consistent with the executive (management) board. This list includes terms related to C-suite positions, executive, and a variety of specific areas of operations such as finance, HR, IT, treasury, or operations. The list of top management positions included all variations of CEO/PDG general director/manager across many legal forms. Working with morphemes of each part of the manager function value separately makes our heuristic effective irrespective of the ordering of the words (e.g., general manager vs manager general , which could depend on the specific language). Naturally, we also develop language-specific lists of morphemes. Note that working with morphemes helps to ignore some language specificity, because the morpheme “direct” encompasses both the English director and the French directeur as well as a directrice and many potential misspellings of these terms.

Our procedure was iterative. We applied our lists to the manager function and tabulated the unassigned values to update the list of morphemes, until no more positions could be satisfactorily attributed to the management board (executives) and supervisory board (non-executives) or at least to either of those boards (the ambiguous board assignment). The full list of morphemes in the form of a do-file is a part of this documentation. The iterative approach serves to identify all morphemes correctly and avoid misattributions.

Our heuristic treats all other manager functions as irrelevant in the sense that these are either contact persons for the Orbis information providers, or individuals in high management positions, but not the top echelons of the hierarchies. Note that our heuristics are country specific. For example, for some legal forms a statutory auditor is a formal function, involved in supervising the work of management, even if not in capacity to nominate or remove management board members (e.g. Italy and Portugal). Thus, these positions are semi-supervisory board in some countries. However, in most other countries, statutory auditors are similar to compliance officers: they are unable to make their own management decisions, and they lack any supervisory authority. We identify multiple such cases across the countries covered in Orbis, and our heuristics comprise many country-specific rules, in addition to general rules.

Ultimately, we were left with 49.6% of cases, where we could not assign individuals to any of the boards. Often this occurs because Orbis reports merely that an individual is a member of a board (of directors). Neither in the case of one-tier, nor in the case of two-tier systems, such description is sufficient to delineate between executive and non-executive positions. Estonia is a single exception from this ambiguity, because in this country, “Board Member” is a C-suite position whereas “Council Member” is a supervisory (non-executive) position. However, this description is sufficient to state that an individual holds either of the two positions. To accommodate those individuals, we create a third category, which encompasses ambiguous board assignments.

Since some individuals are unassigned based on the information provided directly by firms to the Bureau van Dijk information providers, we augment our heuristic to limit the scope for omissions. We take into account the information included in the Orbis-derived variables. In other words, whenever our heuristic delivers no assignment, we also apply our heuristics to categorizations provided by Orbis-derived in the variables level of responsibility and type of position . Using this second step of board position assignment serves two purposes. First, we can assign individuals whose position remains unclassified based on the manager function variable. Second, we verify if individuals × firms assigned as ambiguous could be potentially assigned to one of the boards with certainty. Note that this second step can only be applied to data as of the 2010 wave.

Table 3 reports the results of augmenting our heuristic with the heuristic based on Orbis-derived in the variables level of responsibility and type of position . We improve the board assignment by 7.4 percentage points, most of those individuals are assigned to a management board.

Comparing our heuristic to Orbis classifications

Comparing our augmented heuristic to Orbis classification helps to establish two observations. First, we can observe the overlap between our heuristic and the Orbis classification. These values can be inferred from the diagonal of Table 4 . Second, we can identify the main types of conflicts between our heuristic and Orbis classification. We discuss both these sets of observations below.

Management board

We observe a high match in the management (executive) board assignment between our augmented heuristic and Orbis classification. Recall that augmenting our heuristic based on manager function name delivered roughly 7 percentage points higher share of identified cases. Meanwhile, over 90% of records for which both measures can be obtained receive the same assignment from both approaches. Additional 2% of records are management board according to our heuristic, but could not be assigned to a specific board according to Orbis classification. This is not surprising, our heuristic explores additional information in the variable manager function .

Similarly, we can explain the biggest discrepancy for the management board assignment, which comes from the fact that our heuristic delivers a direct assignment to the management board, whereas Orbis is dismissing these positions as unclassified. Of the circa 6 million such records, the vast majority is explained away by merely few obvious mis-attributions by Orbis.

For 225,563 cases we have mismatches where Orbis assigns the individual to be member of the management board, but based on our two-step heuristic, we can at best assign this person to a non-specific board. This mismatch is explained in more detail below, when we discuss how our heuristic might lead to ambiguous assignments.

Supervisory board

The raw match for the supervisory (non-executive) boards reaches over 68%. In addition to 1.5 million concurring cases, Orbis classifies 140,885 records as management board, whereas our heuristic assigns those cases to non-executive board. This discrepancy consists of solely three clear misattributions by Orbis described in the box below. Thus, our heuristic proves to provide a more reliable assignment.

Further discrepancy concerns 540 thousand records which are assigned no specific position in Orbis and who are members of supervisory boards according to our heuristic. Three cases of clear misattribution explain 380 thousand cases. For example, a generally ambiguous board of directors position can be only a non-executive position in Russia. Once these mistakes are corrected in Orbis, we total 92% of concurrent classifications.

There are 74,143 where Orbis claims a supervisory board position, whereas our classification states ambiguous. This category is essentially explained by 67,222 advisors in AG and EG companies in Germany and Austria. The advisors to supervisory boards are not actually supervisory board members, so this is a case of mis-attribution. Finally, there are roughly 30 thousand cases that Orbis assigns to the supervisory board and our heuristic claims are not persons of interest, of which 28,783 cases are the position of censor in Romania. According to the corporate governance rules, this position has compliance responsibilities, but no decision-making authority.

Given that we list clear misattributions in Orbis classification, we judge that 98% of the supervisory board cases match between our heuristic and the Orbis classification. There could be concerns that there are fewer records within supervisory (non-executive) positions than in the management ones, but we are assured that our heuristic delivers a reliable classification into the management (executive) as well as supervisory (non-executive) boards. The majority of the discrepancies between our heuristic and Orbis classification can be explained away by clear cases of mis-attribution by Orbis. While Orbis classifications are not available up to 2010, the comparison between our heuristic and Orbis classification reveals that once available the Orbis assignment to management and supervisory boards should be taken with caution.

Ambiguous board

Our heuristic delivers approximately 32 million ambiguous board records. Our heuristic is 99% concordant with Orbis. These cases refer to individuals who are member of a board, but where we cannot determine whether this is a management or supervisory board. This problem can be attributed to the fact that the manager function description is incomplete. For example, partners and shareholders can be both in executive and non-executive positions. Likewise, board member or simply BoD (for board of directors) descriptions are ambiguous. Despite taking the two-step approach and utilizing information from two additional variables (i.e., level of responsibility and type of position , both of which are designed by Orbis), one cannot establish which board/position is the adequate one.

The discrepancies between our heuristics and Orbis classification are minor. There are about 100 cases in the UK, all of which concern chairmen, (vice)president and member of the LLP. Trivially, these three positions can be either management or supervisory boards, and Orbis provides no additional details that could help identification. However, Orbis classifies them as management board. Furthermore, one single group of advisors (in Luxembourg, Austria and Germany) explains the discrepancy of over 70,000 cases where our heuristic arrives at ambiguous board, but Orbis claims supervisory board without any additional information. Finally, nearly 60% of cases where we claim ambiguous and Orbis claims no board position concerns shareholders/partners in Greece and in Italy.

The last column of Table 4 reports a total of roughly 64 million observation where our heuristic assigns no board, whereas Orbis classifies the cases into management board (roughly 63 million cases), supervisory board (nearly 30 thousand cases), and ambiguous board (roughly 937 thousand cases).

In fact, the three positions–unspecified director , unspecified manager and company secretary — constitute 37 million cases of the largest group, where Orbis assigns management classification and our heuristic implies a position outside boards. In some waves, Orbis classifies all positions described as director to the management board. Similarly, numerous positions across various countries are described merely as manager . Whenever the variable manager function signifies the top management position, our heuristic and Orbis classification overlap, but the 17 million cases have no additional information which would justify considering those individuals in those companies as c-suite. This, the misattributed case of director totals over 22.5 million medium-level directorship positions, which Orbis classifies as c-suite and our heuristic does not find grounds to assign either of the boards. In addition, Orbis classifies nearly company secretaries as executive board, whereas this position is neither management nor supervisory board per se. Similar to any higher-level management position, company secretaries may have the legal authority to sign contracts and they are in principle taking the responsibility of compliance officers. The company secretary is necessary to concur with many of the management board decisions, but in principle this is not an authority position in either management nor supervision of the management. They are not personally liable for company’s decisions (like the executive board) and they are not in position to change the management board of a company (like the non-executive boards). Thus, this is not a board position. Jointly, the company secretaries in the UK, Ireland an Cyprus explain away 14.5 million cases. The next biggest groups are administrators in Romania and Italy. Further, Orbis misattributes management to authorized officers in Switzerland. This position is akin to the operational director, it may be on the board (in which case it would be the management board, naturally), but it does not need to be. Finally, we identify in total in excess of 1,5 million liquidators (France, Germany, Hungary, Portugal, Romania, and Russia). While liquidators decisions are of paramount importance for companies undergoing bankruptcy, this is not a position elected by the shareholders to supervise management or appointed by the shareholders to engage in management. Liquidators are typically appointed by the court, based on availability and previous record in bankruptcies, rather than in management of successful businesses. Further, this category lists accountants and consultants. In neither of these cases were we in doubt about including those cases in any of the boards.

Our heuristic assigns management board position whenever the individual × company hinted in any way at board membership. In the absence of such indication in either manager function variable or in any of the Orbis-coded variables, there are no grounds to assign a board position. And indeed, a handful of quite obvious cases explains 44 million out of 64 million positions. The rest of the cases consist of either peculiar positions in the UK. Note that the UK is a special case, because it appears that throughout the subsequent waves the information providers reported the official occupation of the individuals, rather than specific positions within the company. We find more than 200 thousand cases each of teachers, farmers, nurses, electricians, architects, designers and housewives in the manager function variable, as well as over 600 thousand retired and over 300 thousand students. There are also many cases of positions which are clearly not c-suite level of management. Those include numerous cases of project managers, secretaries, consultants, engineers, doctors, drivers, lawyers, gardeners, etc. We do not report them in detail here, in the interest of brevity.

Of the 29,707 cases where our heuristic cannot attribute any board position, whereas Orbis classifies as supervisory board, 28,783 come from Romania and concern a single position: a censor. As we discussed, this position is similar to a company secretary in the UK, censors are expected to facilitate the compliance of management decisions with the legal system of Romania. While they cannot be fired by the management, they do not have the formal power to nominate the management or veto any decisions.

Surprisingly, the 937,497 cases classified by Orbis as an ambiguous board have a similar distribution of explanations as the management board, described above. Again, more than half of the cases consist of unspecified directors and company secretaries from the UK, Ireland, Russia and Cyprus. This parallel between the management board and the ambiguous board hints that Orbis classifications were not always applied consistently between countries and waves.

Timing the board members

Once we assign individuals to a given position within each firm, we need to determine the periods for which that assignment is valid. In principle, for each individual, Orbis should report the date of appointment and the date of leaving the position, which is the date of resignation. However, Orbis methodology evolves across waves, as does the availability of this information. In fact, approximately 12–25% of board members (depending on the board and period) have complete information reported. We use two alternative information sources in Orbis to fill in these missing data.

For the first round of filling in the data, we use the confirmation date. This date is given by the information provider and indicates the date until which the information provided is validated before it is submitted to Orbis. This can be the date of the annual report or another document from which the information was collected. Consequently, there can be numerous subsequent confirmation dates for the same individual at the same company, in the same board or with changing boards. We assume that the latest confirmation date is the latest date at which we are certain the information was valid, likewise for the earliest. This attribution based on confirmation dates is obtained for a given person in a given board of a given firm.

In case of missing confirmation dates, we rely on the second source of information: for each wave, for each individual at each company, we should have an indication whether the information provided is current. Given that we have multiple waves of Orbis data, we can effectively leverage this information, and thus fill in the blanks in each of the years of our Orbis waves. Specifically, concatenating multiple waves of Orbis data raises the number of years for which we observe that “current” date.

In case of missing variables, a final method we applied is to use all the records for which some indication about the start of the appointment is available (e.g. year of appointment), but no indication as to the end is reported. This may be because information about the “current” date is missing. In those cases, we take a conservative stance and set the starting year to be also the ending year for each record; thus, a given person holds a position on a given board of a given firm for one year in case data on the ending of appointment is missing. We proceed analogously if the ending date is determined from appointment, confirmation, or “current” date, but no starting date is provided by Orbis. In other words, should only the ending or beginning be available, we assign a tenure of one year (with the starting date being equal to the ending date).

We utilize this additional information to complement the appointment dates with the two alternative sources of information in Orbis to determine whether a given person was a member of a given board in a given firm each year. We pursue in the following order. First, we assign dates using the appointment and resignation dates. Second, for all individuals who have the appointment date but have no resignation date, we inquire about the maximum of the available confirmation dates. If this information is unavailable, we take the maximum year for which the information is reported as current. If this information is missing, we assign the last year available for that firm. Third, in case appointment dates are missing, we take the earliest confirmation date. In case it is missing, we take the first available “current” year. If this information is missing, we take the first year in which a firm is observed in this legal form.

In fact, given the dates of appointment and the date current to a given Orbis wave, we are able to establish the duration of holding the position. For individuals for whom the date of appointment is available, this identification is sufficient. For individuals for whom the appointment date is unavailable, this identification rests upon the assumption that in the gap years (between the available Orbis waves), the individual did not leave the company to return later on. Note that for a current position, the resignation date is a future date at which the contract expires. This helps to fill in the gaps as well.

Note that in order to do the latest or the earliest of confirmation dates or “current” years, we need to define unique identifiers for managers. This identification cannot account for a variety of issues related to string fields: names can be abbreviated, or misspelled, the order of first and second name or surname can be altered, etc. Given the vastness of our sample size, we cannot fix those issues, which implies that average tenure is likely biased downward. However, this bias should be similar for both men and women.

In Table 5 , we report the share of the manager × board × year observations. We organize the table in the order of applying the criteria to the data. For example, we only use the confirmation dates if year or appointment and/or year of resignation are missing. Each cell in this table reports the percentage of observations that have the time assigned based on a given combination of start and end criteria. For example 24% of supervisory board members in each year in a given firm have the complete dates assigned based on year of appointment and year of resignation.The percentage climbs up to 26% if we impute a resignation date based on the latest available confirmation date. We reach up to 93% of observations if we apply all the available criteria to the start and end of the appointment. The second number in each cell reports the average tenure in a given appointment. Continuing with the same example, for the most restrictive and least restrictive criteria, we obtain 4.86 and 3.6 years, respectively.

Our approach proves to be conservative. While we expand the coverage of the sample with additional time assignment criteria, the average tenure systematically declines. If we were excessive in assigning time to boards members, the tenure would be increasing as more precise criteria are missing and less precise criteria are applied.

Once the time is assigned to every record in our database, we can meaningfully compare data availability between OHD and the combined waves of Orbis data. This is reported in Fig. 5 , portraying the paramount gains from combining subsequent waves of Orbis in terms of additional data. Indeed, we have up to 50–60% more individuals in some years (both men and women) by combining subsequent waves when compared to OHD. This gain in sample size is due to two factors. As discussed earlier, some companies are reported in Orbis waves but are not reported in OHD, thus managers associated with those firms are absent in OHD as well. Quantitatively more relevant is the fact that the availability of the timing data is vastly improved from pooling Orbis waves.

Percent of observations gained relative to OHD.

For confirmation, we picked a number of well-known firms, for whom we could easily identify board members at given point in time. First, we collect the data about board members from the internet. Then we cross-reference names, surnames and board assignments in our final sample. While this is not a systematic validation of our sample, we can observe its strengths and the weaknesses. For example, for Volkswagen we confirm the same names for all five management board members in the 2008 wave of Orbis. We likewise confirm eleven out of 21 supervisory board members. In total, fifteen out of 26 individuals from the annual investor report for 2008 are recovered from the 2008 Orbis wave. However, after we apply our timing procedures, our heuristics deliver two management board members, two supervisory board members, and nineteen ambiguous board members. This is because the variables utilized in timing heuristics were missing in the Orbis data. We run a similar experiment using the 2010 and 2012 waves of Orbis, we report the results in Table 6 .

Three conclusions emerge from this example. First, while Orbis is very accurate in collecting the names of the individuals, the quality of both functional and time assignment were lagging in early years. Indeed, all three waves report all the relevant individuals, but fall short on giving sufficient information on when these individuals held positions at firms and which board it was. Second, gradually Orbis data is able to adequately match a high share of all board members and an increasing share of board assignment. Indeed, by 2012, our timing assignment becomes sufficiently accurate to identify adequately more than half of specific boards, and all individuals had adequate year assignment. Third, the case of Volkswagen illustrates that the issues with data quality are not driven by data availability. Indeed, all information for this company was widely available at the time. Either quality of data collection was insufficient or data processing between information providers and Orbis interfered to make the data incomplete in the distributed sample.

Gender attribution

Only the 2008 and 2020 editions of Amadeus include a gender variable, and even then there is a significant share of individuals for whom this information is missing. These shortcomings strongly restrict analysis of gender and gender diversity on boards. To address this problem we propose a novel approach to gender attribution: we use names and surnames of each individual board member and linguistic rules to assign gender based on names. For most of the languages, full names, and surnames of individuals are sufficient to attribute a gender. We utilize a combination of heuristics to recover gender from names.

In the case of some languages, gender is directly identifiable from the form of the given name or the surname. For example, in some languages, surnames end with a gender-specific suffix (Slovak, Czech, Russian). In other languages the given names of women end with a vowel (Lithuanian, Russian, Slovenian, Polish). The procedure to distinguish names and surnames is described in section Managers. In Bosnia and Herzegovina, there is a comprehensive rule that certain vowels as last letters in a name identify women, hence lack thereof identifies men. The difference between these two rules is that the rule in Bosnia and Herzegovina is comprehensive, whereas the rule in Lithuanian, Russian, Slovenian and Polish the rule helps to identify women, but the lack of a final “a” is not a sufficient condition to identify men in these countries. The complete list of such rules has been compiled based on the World Atlas of Language Structures ( https://wals.info with additional insights on https://en.wal.unesco.org/world-atlas-languages ) and Wikipedia entries for each of the languages in countries covered by Orbis sample. The rules are decisive for Bulgaria, Czech Republic, Iceland, Lithuania, Macedonia, Poland, Russia, Serbia, Slovakia, Slovenia, and Ukraine. These structural rules constitute our first heuristic.

Linguistic and cultural scholars developed lists with books of names attributed to men and women. For example, there are no women named John in English, just as there are no men named Catherine. We utilize the most comprehensive source, the World Gender Names Dictionary (WGND 9 ). We apply WGND to those individuals, whose gender cannot be determined using our first heuristic. To be able to match our names to WGND, we remove the diacritic signs. WGND is applied within each country, because the same name can be more typically male in one language and female in another (e.g. Andrea is more likely a woman in German and a man in Italian). This is our second heuristic. Note that the book of names is applied within a country and not within a language. For example, multi-lingual countries have names from all the relevant languages in their book of names. These books are missing, however, names of ethnic minorities or expats.

The two heuristics were applied sequentially: we use the first heuristic (based on the linguistic rules), then we proceed to WGND. Finally, some individuals bear names from a different country. We thus apply the entire WGND, without splitting the sample by country.

Conflicts may arise when gender attribution based on our heuristics and that based on WGND non-country specific attribution do not match. For instance an expat whose name ends with a vowel “a”, who works in a firm in Central Europe, will have a female gender in many of the Central European languages. This person would thus be attributed a female gender based on our heuristic even though based on global WGND that name could be classified as male.

Such conflicts can be resolved with the use of the salutation variable in Orbis. The salutations are reported from wave 2008 onward. We parse salutations to find most common words determining gender (e.g. Mr or Herr for men and Miss, Mrs or Frau for women). We do that for each language separately. Once we have a dictionary of male and female salutations, we can apply them to resolve conflict cases.

There are some cases in which gender identification is controversial or not possible at all. Sometimes individuals report incomplete or more than one name, which yields contradicting gender attribution (e.g. Jean-Marie is identifiable to a man, Jeanne-Marie to a woman, but J-Marie cannot be unequivocally attributed to any of the genders). However, in most countries, there was a small proportion of cases of conflicting gender attributions or missing gender attributions after applying all heuristics (around 5% of cases). Finally, the data for the Netherlands report only initials for names, whereas surnames are insufficiently informative about gender in Dutch. Hence, no gender identification is possible in the Netherlands, and this country is dropped from the analysis.

Table 7 reports the outcomes of our heuristics, with and without the use of salutations to resolve conflicts. We compare the gender attributions based on linguistic rules and names with the gender attribution provided by Orbis. Note that Orbis does not provide information on gender of individuals until 2020, with the exception of 2008 edition, so we could not rely on this variable in our research. However, its availability is helpful in determining the reliability of our gender heuristics. The table shows our attributions in columns and original Orbis attributions in rows.

It is immediately clear from Table 7 that our heuristic provides remarkably higher share of attributed individuals than Orbis. Indeed, of 6,429,892 records in 2008 wave, 4,379,160 remain unattributed in the original Orbis data. Meanwhile, our heuristic produces only 428,433 records without gender attribution (421,045 if we use salutations). Furthermore, while Orbis data recover merely 302,388 women (or 4. 7%), our heuristics attribute female gender to 1,114,508 cases (slightly more if we use salutations), which brings the women’s share on boards to 17.3%, nearly four times more. We can also observe that the majority of unattributed cases are not driven by conflicts in heuristics but by missing information. Indeed, salutations increase the share of attributed cases by a negligible percentage. Table 7 reveals as well that majority of mismatch between Orbis classification and our heuristics is driven by the unattributed cases in Orbis rather than by differences in the genders attributed. There is merely 7,306 cases (0.66% of all observations attributed to women), where Orbis claims male attribution and our heuristics suggest a female one. Likewise, there is merely 2,793 (0.06% of all observations attributed to men) cases when our heuristics deliver male attribution and Orbis reports female gender.

Overall, our gender attribution heuristic delivers great gains relative to the original gender reporting by Orbis. Not only are we able to attribute gender to a larger number of individuals, but also we recover a much higher share of women than would have been identified based solely on Orbis classification. When information is provided in Orbis, we identify no quantitatively meaningful differences in gender attribution by our heuristics and in the original Orbis variables.

Final sample

Additional variables, listed companies.

Orbis data directly identifies publicly listed companies. This is of great value, as in many countries the legal form does not suffice to recover this status. This occurs because stock-based limited liability companies include firms that are not stock-listed companies, i.e. the stocks can be privately traded.

Orbis provides ownership data for companies. This permits recovering networks of firms. The data comprises direct ownership (firm A holds % of firm B) as well as indirect ownership (firm A holds % of firm B, which in turn owns firm C and D). Orbis provides a sum of these percentages and based on these percentages classifies into groups such as majority ownership (above 50%), joint ownership ( n owners of 1/ n % each), total ownership (foreign company or branch). Our procedures are in line with Appendix B of 2 .

Descriptive statistics

Table 8 reports the final sample from the Orbis data. After adjusting the sample, we obtain nearly 30 million unique firms, and nearly 150 million firm-year observations, or roughly five years of observations on average per firm. Our sample contains information about nearly 60 million individual top executives and members of the supervisory board. We have slightly more than four person-year observations, or 243 million. Of these person-year observations, roughly 150 million are assigned to management (executive) positions. We identify nearly 4.5 million supervisory board (non-executive) positions. In addition, nearly 90 million positions are ambiguous, that is, we can ascertain that these are either management board or supervisory board, but not which one of those two. Finally, in our sample of 60 million individuals, roughly 44.7 million are men and 14.7 million are women, that is 24%. This is a very crude measure, and it does not take into account the time, cross-country, and cross-sectoral variation, we address those issues in the next section.

In Fig. 6 we present time trends in the three measures of gender board diversity, obtained with our data. The trends in the data appear to be very consistent for executive and ambiguous measures: important changes in early 1990s, stagnation in 2000s and picking up in the pace of change in 2010s. The supervisory (non-executive) positions display less clear patterns, with essentially no trends (except for the share measure).

Time trends on measures of gender board diversity.

In Table 9 we provide an analysis of variance, decomposing the variation in gender board diversity measures to country-specific factors, industry-specific factors and time trends. We show that most of variation is actually firm-level. Indeed, there is almost no valuable variation at the sectoral level. The data refute the concept of female or male industries. More variation–up to 14%–can be attributed to cross-country differences.

Limitations of our approach

Individuals vs managers.

Due to the frequent occurrence of misspellings even in the company name or legal form, we do not identify unique individuals in the entire sample. Note that adding a second name, abbreviating the first name, or misspelling would result in the same individual being treated as different people. Such alterations can occur not only within an individual’s history within one company, but also as they move from one company to another. Furthermore, if one individual holds positions across various companies within one capital group, it could be possible to observe some cases of misspelling and abbreviations. Less likely but nevertheless possible are the cases of two individuals with identical given and family name, who are two separate individuals, in the same company or in different ones.

Representativeness

Orbis data are not intended as representative. The process of collecting the data relies on information providers, who access public records available in a given country and obtain/digitize the available information. This information typically contains all registration data, so our data may be informative about the universe of registrations. However, reporting obligations vary between countries and vary over time. Thus, Orbis data are fairly indicative of the universe of firms in terms of registration data. Given that no record of “all firms” is publicly available for the countries covered by Orbis, it is not feasible to put this conjecture to an empirical test. Consequently, we are unable to judge what fraction of firms is dropped from the sample due to missing information about managers, their board assignment, time assignment or gender attribution. Once public registries of firms become available, testing the match between Orbis and public records is desirable, especially for the early years in Orbis sample.

In addition, for some types of companies, information providers digitize public records covering balance sheets and profit-loss statements. Given the differing reporting obligations, the reliance on financial records needs to be inspected for each study independently, see 2 who discuss the coverage in terms of employment and value added.

Data Records

The data is available in Harvard Dataverse repository 10 . The GBDD includes two files: a sectoral file and country file. The sectoral file includes indicators for -country-, -year- and 2-digit NACE code -nace2- . In each of those cells, we report the following variables.

share of women in senior management -female_share_senmen- computed as an average share share of women holding senior management (executive) positions across firms; this is an unweighted share from all firms

share of women in supervisory boards -female_share_supboard- , computed analogously for positions in supervisory (non-executive) boards

share of women in all boards combined -female_share_boards- computed analogously; note that individuals in ambiguous positions are included as well

share of women in senior management -female_share_weight_senmen- computed as a share of women holding senior management (executive) positions over the total number of individuals with such positions; this is a weighted share

share of women in supervisory boards -female_share_weight_supboard- , computed analogously for positions in supervisory (non-executive) boards

share of women in all boards combined -female_share_weight_boards- computed analogously; note that individuals in ambiguous positions are included as well

share of firms without women in management (executive) positions -zero_share_senmen-

share of firms without women in supervisory (non-executive) positions -zero_share_supboard-

share of firms without women in any board -zero_share_boards-

Analogously, in the country file we include indicators for -country-, and -year- . The data is reported as an aggregate across all types of firms and separately for stock-listed firms and private (not listed) ones.

Figures 1 – 3 along with Table 8 report on the properties of our sectoral data. Our data covers roughly 60 thousand observations for most measures and roughly 30 thousand observations for measures concerning specifically the supervisory boards. The mean share of women averaged across firms, and averaged within an industry range between 10% and nearly 30%. The share of industries, where no firm has a single woman in the board, average 74% for the management board and 63% for the supervisory board positions. In the country-level data, we show that the mean share of women averaged across firms ranges between 10% and 30% for the private firms and between 5% and 25% for the stock-listed firms.

Technical Validation

After adjusting the sample, we obtain nearly 30 million unique firms, and nearly 150 million firm-year observations, or roughly five years of observations on average per firm. Note that even the comparison with 3 , who also use Orbis data, is favorable. They end up with a sample of 4,7 million firms in total, with only one yearly observation for each. Their data on financial records is much more sparse, reducing their estimation samples to 2 million observations.

We validate our data in three ways. First, we do a sanity check for one, well-known company, handcollecting data for this company from alternative sources. Second, we compare the properties of our data to otherwise available samples. This is possible only for the listed companies because no alternatives to our data exist for non-listed companies. Third, we offer a systematic attempt to evaluate the consequences of our data harmonization decisions on identifying women among board members.

Sanity check, the case of Volkswagen

Comparing our data to boardex.

Within this sample, 22,000 firms report being listed on at least one stock exchange, with nearly 180,000 firm-year observations. For comparison 11 , use ExecuComp data with 13,491 observations, whereas BoardEx data (used by 12 ) covers 24,000 firms from European stock exchanges, the US, Canada, and other advanced economies.

We compare our measures obtained from Orbis for stock-listed companies with analogous indicators from BoardEx 13 . provide average share of women in all board positions in 2010 within stock-listed companies. We compute analogous measures in our data and provide a country-by-country direct comparison in Fig. 7 . Our data exhibit very high correlation with BoardEx-derived measures. There are two outlier countries: Spain and Russia. Especially for Russia, data coverage in BoardEx has been notoriously low, which may signify that a discrepancy between GBDD and BoardEx may be uninformative. Without these two countries, the correlation between the two data sources is 0.89.

Processing of the data and the probability of identifying women in the sample

We explain three important methodological choices in our treatment of the data. First, assigning individuals to specific boards requires a case-by-case classification of positions in various legal systems. Second, we provide our own heuristic for timing of each person to each position. Finally, some firms have to be excluded from the sample due to missing information about sector. Although we cannot rely on Orbis own classifications, for several reasons–some concerns could be raised if our approach is perhaps overly restrictive and unintentionally eliminates too many women.

We address this concern by estimating a simple model. The left-hand side variable (LHS) takes on the value of 1 if a given person in our data is a woman and zero otherwise. With this definition, all unattributed individuals are in the baseline category of zero for the LHS. Thus, all estimated coefficients can be interpreted as measures of how conducive given methodological choice is to including women in the sample. A negative coefficient implies that a given methodological choice implies a lower probability of finding women in our sample. Conversely, a positive coefficient implies that, due to this modeling decision, we identify more women than in the baseline case.

The model is estimated at an individual-level. For each person in our sample, we construct a unique identifier. Note that this identifier is susceptible to misspelling of the first and/or second name, we discuss this issue in the next section. We then collapse all observations for a given person into a single record in each firm. If a person holds positions in many firms, we keep multiple records. For each firm-person record, we obtain measures synthesizing our modeling choices on the right-hand side of the estimation (RHS), as described below.

First, we test if listed firms are similar to non-listed firms. The dummy variable takes on the value of 1 when a given firm is listed, and zero otherwise.

Second, we check if firms that do not provide NACE classification are less likely to report women on boards. We drop firms which do not provide a NACE classification. One potential concern would be that firms with women among management and supervisory boards are less likely to be scrutinized by Orbis information providers. We construct a variable taking on the value of 1 if a firm provides NACE classification at all, and if the classification can be expressed in terms of Rev 2.0. Otherwise, the variable takes on the value of 0.

Third, we check if including the focus on management boards and supervisory boards eliminates women. We construct a dummy variable which takes on the value of 1 if a person has ever been attributed to a management board or a supervisory board and 0 if a person was attributed the classification of an ambiguous board. This measure is conservative in a sense that we try to verify if perhaps women are more likely to occupy positions that never get attributed to management or supervisory boards.

Fourth, we study the role of timing of board membership. OHD provides data on year of appointment and year of resignation. However, this data is not available for data which come from earlier waves of Orbis data; as documented in Fig. 5 we obtain many more observations by applying our timing heuristics. We construct two dummy variables. The first variable takes the most restrictive heuristic. This variable takes on the value of 1 if the timing is assigned based on year of appointment; and zero otherwise. This is akin to the first row in each panel of Table 5 . Next, we also define a dummy variable that takes on the value of 1 if the timing is assigned based on year of appointment and year of resignation. This second timing variable is a subset of the first one. Thus, it measures the additional effect of using the restrictive definition of the year of resignation, on top of the restrictive definition of the year of appointment. These two variables help answer the question of whether our timing heuristics raise the likelihood of identifying women on boards.

The results are reported in Table 10 . We find that firms that listed firms are less likely to have women on boards. Thus, expanding beyond listed firms, we actually raise disproportionately the probability of identifying women in Orbis. The effect is large, with the coefficient of roughly 7.4 percentage points or 30% of the average. Furthermore, we report that the NACE classification report fewer women than firms that do not report the NACE classification. Thus, excluding firms without NACE classification does not unintentionally eliminate women in greater proportion than men.

Further, we find that women appear more frequently among management or supervisory board than among the ambiguous board. However, once we adjust for firm fixed effects, we find that, in fact, women are less likely among management or supervisory board than in the ambiguous board. In other words, if within a firm we find positions both attributed and ambiguous, then women are slightly less likely to hold an attributed position. The effect is not large: probability changes by roughly 0.8 percentage points, which is akin to 3% of the baseline probability.

Finally, we study the role of timing heuristics. In all specifications, the restrictive heuristics are more likely to identify women than the comprehensive ones. The appointment date appears quantitatively more relevant than the resignation date (1.7 percentage points vs 0.1 percentage points, respectively). However, both work in the same direction. Utilizing comprehensive heuristics, we obtain substantially larger samples but fewer women in relative terms. These two estimates reveal that more restrictive samples are likely to overstate gender diversity in Orbis data.

Usage Notes

GBDD is helpful in addressing a wide range of research questions related to gender board diversity. We provide the data aggregated to the levels of each country in each year. This opens avenues for comparative research on institutional correlates (or determinants) of gender board diversity. Likewise, the consequences of changes to gender board diversity can be explored. Potential research questions include links to political participation, labor market equality, educational choices, etc. For example 14 , compare their hand-collected measures of gender board diversity among stock-listed firms with the indicators of gender equality across various domains in the United Nations Human Development Report 2006. With our data, one can expand the studied period to four decades and thus adjust the estimates for country fixed effects.

We also provide data disaggregated by sector level. Therefore, potential authors can combine our data with sources on wages and wage inequality, employment, productivity, TFP, and other indicators that can be obtained from alternative sources across sectors. For example 15 , study if greater gender board diversity reduces gender wage gap. They utilize cross-sectional data for the UK. With GBDD, interested authors can expand to a wide range of countries and obtain estimates that adjust for country specificity, sector specificity, or both. Analogous opportunities arise for the study of job demand, job stability, etc.

While the above examples are not an exhaustive list of potential uses of the GBDD, they demonstrate potential versatility and broad range of uses.

Code availability

For all users interested to work themselves with the Orbis data and verify or expand on our results, we distribute the full replication package. The codes which begin with raw Orbis data and arrive at GBDD are available at https://github.com/FAME-GRAPE/GDDB . There are no restrictions on access. The replication codes are accompanied with documentation detailing each step. The codes are distributed as STATA 17 project, do-files and datasets.

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Acknowledgements

The authors gratefully acknowledge the funding received through the Norwegian Financial Mechanism 2014–2021 (grant # 2019/34/H/HS4/00481, within the GRIEG framework of the National Science Center). Earlier versions of this study received wonderful comments from (in alphabetical order) Marco de Pinto, Laszlo Goerke, Astrid Kunze, Iga Magda, Anna Matysiak, Alberto Palermo, Magdalena Smyk, Bram Timmermans, Lucas van der Velde and the participants of ASSA, AOM, EALE, and EEA. Nico Dunajski provided editorial assistance. The remaining errors are ours.

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These authors contributed equally: Hubert Drazkowski, Joanna Tyrowicz, Sebastian Zalas.

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FAME|GRAPE, Warsaw, 00-660, Poland

Hubert Drazkowski, Joanna Tyrowicz & Sebastian Zalas

University of Warsaw, Warsaw, 00-927, Poland

Joanna Tyrowicz & Sebastian Zalas

University of Regensburg, Regensburg, 93053, Germany

Joanna Tyrowicz

IZA, 53113, Bonn, Germany

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H.D., J.T. and S.Z. harmonized the data. H.D. and S.Z. performed most of the coding. H.D., J.T. and S.Z. wrote the article. All authors reviewed the manuscript.

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Correspondence to Joanna Tyrowicz .

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Drazkowski, H., Tyrowicz, J. & Zalas, S. Gender board diversity across Europe throughout four decades. Sci Data 11 , 567 (2024). https://doi.org/10.1038/s41597-024-03181-8

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Received : 11 December 2023

Accepted : 22 March 2024

Published : 31 May 2024

DOI : https://doi.org/10.1038/s41597-024-03181-8

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Speaker: Susan F. Lu (Purdue)

Room Bernard Ramanantsoa

While anecdotes suggest that workplace gender disparities may originate early in the management career hierarchy, the existing literature on this topic has not provided sufficient evidence due to lack of real-world personnel data concerning low-level managers. This study addresses this gap by examining the effect of gender on the job assignment of frontline managers in a large sportswear retail chain. Leveraging personnel, sales, and operational data, we employ a leave-out Jackknife instrumental variables estimation framework to uncover causal evidence of gender bias in store-manager assignment. We find that female managers generate higher store sales than their male counterparts at the margin of being assigned to stores with high sales potential versus stores with low sales potential. Further, we systematically rule out three alternative hypotheses related to managerial ability, preference, and career selection. Translating our findings into an actionable insight, we develop a gender inequity index (GII) to help organizations measure potential gender biases in job assignment. Applying this index to a simulation study using the retailer’s manager compensation data, we demonstrate the implications of gender-biased job assignment on the gender pay gap.

Ruoran Chen • Susan Feng Lu • Lauren Xiaoyuan Lu • Simin Huang

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National Consultant-Conduct Annual Gender Assessments, analysis ( GAA), Develop Gender in Humanitarian Action Profile for Ethiopia and deliver training for humanitarian actors on Gender Assessment and anaysis inclduing to the GIHA WG, A&AWG and ICCG and P

Advertised on behalf of.

Home based, ETHIOPIA

Type of Contract :

Individual Contract

Starting Date :

10-Jun-2024

Application Deadline :

31-May-24 (Midnight New York, USA)

Post Level :

National Consultant

Duration of Initial Contract :

95 days within a period of four months

Languages Required :

English

Expected Duration of Assignment :

UNDP is committed to achieving workforce diversity in terms of gender, nationality and culture. Individuals from minority groups, indigenous groups and persons with disabilities are equally encouraged to apply. All applications will be treated with the strictest confidence. UNDP does not tolerate sexual exploitation and abuse, any kind of harassment, including sexual harassment, and discrimination. All selected candidates will, therefore, undergo rigorous reference and background checks.

Ethiopia continues to face a major humanitarian crisis caused by climate shocks, disease outbreaks, conflict, and insecurity, aggravated by economic and financial challenges. 2024 is an exceptional year in terms of compounded negative humanitarian conditions. To address these needs the 2024 Ethiopia Humanitarian Response Plan (HRP) requires US$ 3,237 billion to target over 15 million people, including 4 million internally displaced people (IDPs).

Accumulating Shocks and the need for recovery

Droughts and floods in Ethiopia have been increasing in duration and frequency over the past several years due to notable accelerated changes in the regional climate. This has amplified the humanitarian impacts. for communities and weakened their resilience to future shocks. The impacts of the protracted drought, caused by five failed rainy seasons that ended in 2023, continue to be felt in many areas, including across the south of the country, in Oromia, Somali, South Ethiopia, and Southwest Ethiopia regions. The recovery from the last drought is expected to take multiple years, and in absence of strong recovery interventions in drought affected areas, these will be more vulnerable to shocks with large numbers of people remaining in protracted need of humanitarian assistance.

The lack of recovery and long-term durable solutions for IDPs main shocks that has resulted in substantial number of protracted IDPs demonstrates that displacement is not only a humanitarian concern, but also a peace and development challenge. Considering that conflict is a main driver of displacement, peace-building initiatives are crucial both to prevent future displacement and to restore peace and enable returns. Development action is also essential to reduce vulnerabilities and enable improved conditions for returns through systems strengthening, as well as to

prevent future displacement by sustainably building the resilience of communities, infrastructure and social services to recurring climatic shocks.

UN Women, grounded in the vision of equality enshrined in the Charter of the United Nations, works for the elimination of discrimination against women and girls; the empowerment of women; and the achievement of equality between women and men as partners and beneficiaries of development, human rights, humanitarian action and peace and security. Placing women’s rights at the center of all its efforts, UN Women leads and coordinates United Nations system efforts to ensure that commitments on gender equality and gender mainstreaming translate into action throughout the world. It provides strong and coherent leadership in support of Member States’ priorities and efforts, building effective partnerships with civil society and other relevant actors. Globally, UN Women works to make the vision of the Sustainable Development Goals (SDG’s) and the Agenda 2030 a reality for women and girls and stands behind women’s equal participation in all aspects of life, focusing on five priority areas: women lead, participate in and benefit equally from governance systems; women have income security, decent work and economic autonomy; all women and girls live a life free from all forms of violence and ensure that women and girls contribute to and have greater influence in building sustainable peace and resilience, and benefit equally from the prevention of natural disasters and conflicts and humanitarian action.

UN Women is committed to ensuring equality between women and men as partners and beneficiaries of humanitarian action. UN Women works in crises prevention, preparedness, and response to reduce vulnerabilities, address risks, promote resilience and leverage women’s leadership. In crisis settings, UN Women supports in the coordination of gender mainstreaming, evidence-based response, targeted programming and in building capacities of humanitarian stakeholders including governments and local actors to achieve their gender commitments.

Due to the significantly deteriorated humanitarian situation in Ethiopia, humanitarian needs have significantly risen across the country. More than 20 million people are being targeted for humanitarian assistance, almost three quarters of them women and children. Different humanitarian crises affect women, girls, men, and boys differently. While all have different capacities, risks and coping mechanisms, women and girls remain the most at risk due to their intersecting vulnerabilities. Their already limited access to financial and other resources, lack of access to basic services, disproportionate responsibilities of care work and households and limited access to decision-making and power make them disproportionately affected in situations of displacement, conflict and disruptment of livelihoods. The integration of gender into humanitarian programming throughout the programme cycle helps to ensure that the specific needs, capacities, and priorities of women, girls, men, and boys are recognized and addressed to ensure effective, equitable, and participatory humanitarian action.

Duties and Responsibilities

To this end, UN Women is seeking the services of a national consultant to conduct data collection for annual comprehensive gender assessment and analysis (GA) on two different humanitarian crises in Ethiopia. The partner is expected to collect comprehensive primary and secondary data and develop a comprehensive RGA report. The crises in question are:

The humanitarian situation in Tigray, Amhara and Afar regions caused by the conflict in Northern Ethiopia.
The humanitarian situation caused simultaneously by drought and conflict, particularly in the Somali region and in the western, central, and southern regions of Oromia.
The refugee girls and women’s situation in the refugee camps (Gambella and Benishangul regions),
Developing the Gender in Humanitarian Action Brief Profile for Ethiopia.

The data collected must cover the following topics:

How are different demographic groups (gender, age and disability disaggregated) affected?
What protection do these groups receive and what protection needs exist?
What are the existing protection structures existing to respond to the major protection risks and gender issues in the camps, IDP collective sites and host communities?
Is there WLOs/WROs operating in the regions targeted and identified?
What are the capacities of these groups to respond to the crisis and mitigate its effects?
How are men and women influencing and participating in decision making regarding humanitarian response (informally and formally)?
How do different groups access services and what are their needs regarding this?
Has the crisis affected existing gender roles?

The duration of the contract will be 95 days. The selected entity is expected to produce the following deliverables:

Competencies

Core Values:

Respect for Diversity
Integrity
Professionalism

Core Competencies:

Awareness and Sensitivity Regarding Gender Issues
Accountability
Creative Problem Solving
Effective Communication
Inclusive Collaboration
Stakeholder Engagement
Leading by Example

Please visit this link for more information on UN Women’s Core Values and Competencies:

https://www.unwomen.org/en/about-us/employment/application-process#_Values

FUNCTIONAL COMPETENCIES:

Ability to work with minimal supervision.
Evidence of having undertaken similar assignments
Experience around analysis of national plans and strategies, budget analysis and development of assessments.
High level written and oral communications skills in Amharic and English
Result-oriented, team player, exhibiting high levels of enthusiasm for gender equality, diplomacy and integrity.
Demonstrate excellent interpersonal and professional skills in interacting with government and development partners at regional and federal level
Experience in conducting assessment, writing high quality reports both in English and Amharic

Required Skills and Experience

MA degree in development study, Gender and Development, Human right, international cooperation and Humanitarian Aid, Public administration, project management, social work, social policy, and sociology
10 years of practical hand on experiences in conducting gender and gender-based analysis, protection analysis in the humanitarian development peace nexus in the country and beyond
A proven track record of effectively carrying out data collection and working with nongovernmental organizations, community-based organizations, and especially international non-governmental organizations and UN agencies.
Sound access to the Amhara, Afar, Tigray, Oromia, Somali and Gambella regions, where priority areas will be targeted based on discussion on the methodology of the data collection.
Practical experience in gender assessments
Practical experience in operating in humanitarian settings and knowledge of refugee context.
Experience working in the UN System in humanitarian emergencies is an asset.
Demonstrated experience in conducting assessments on gender-based violence, gender rapid assessment, protection risk assessment, multi-sectoral initial rapid assessment, gender needs or other related fields.

Language and other skills

The consultant must be able to fluently undertake the required services in English and Amharic (both writing and speaking); knowledge of other national languages spoken in the location in question is an asset.
The consultant must have full command of all Microsoft applications and sound computer skills.

How to Apply

Personal CV or P11 (P11 can be downloaded from: https://www.unwomen.org/sites/default/files/Headquarters/Attachments/Sections/About%20Us/Employment/UN-Women-P11-Personal-History-Form.doc )
A cover letter (maximum length: 1 page)
Managers may ask (ad hoc) for any other materials relevant to pre-assessing the relevance of their experience, such as reports, presentations, publications, campaigns, or other materials.

At UN Women, we are committed to creating a diverse and inclusive environment of mutual respect. UN Women recruits, employs, trains, compensates, and promotes regardless of race, religion, color, sex, gender identity, sexual orientation, age, ability, national origin, or any other basis covered by appropriate law. All employment is decided?on the basis of qualifications, competence, integrity and organizational need.

If you need any reasonable accommodation to support your participation in the recruitment and selection process, please include this information in your application.

UN Women has a zero-tolerance policy on conduct that is incompatible with the aims and objectives of the United Nations and UN Women, including sexual exploitation and abuse, sexual harassment, abuse of authority and discrimination. All selected candidates will be expected to adhere to UN Women’s policies and procedures and the standards of conduct expected of UN Women personnel and will therefore undergo rigorous reference and background checks. (Background checks will include the verification of academic credential(s) and employment history. Selected candidates may be required to provide additional information to conduct a background check.)

At the center of green transition

Xiaerbati Daositeke hails from China. She completed her UN Volunteer assignment as Programme Communication Assistant with the UN Women China Office in March 2024. The passion for gender equality and women’s empowerment especially those from underserved communities stirred Xiaerbati to serve with Women-led Rural Community Renewable Energy Transition and Governance Project .

Xiaerbati was part of a team that provided vocational training and entrepreneurship opportunities to women from rural areas in Qinghai Province. These opportunities made it easy to access renewable energy, boosting agricultural productivity and mitigating climate change.

“Volunteerism plays a pivotal role in fostering long-term economic empowerment of women by creating sustainable support systems and fostering community resilience,” says Xiaerbati.

The project also gave women in Qinghai training on rural carbon neutrality strategies, renewable energy technologies, agricultural production and business skills, entrepreneurship and leadership.

Through volunteering, we not only provide immediate assistance and resources but also build capacities and empower young women and girls to become more resilient and take charge of their future, which in turn benefits the entire society." Xiaerbati Daositeke, national UN Volunteer, Programme Assistant with UN Women China.

The project is a converging point for the local government, non-governmental and civil society groups and encourages learning from examples of women’s access to and use of renewable energy technologies.

Women are at the heart of rural revitalization and green transition. As women make up around 70 per cent of the rural labour force in China, promoting renewable energy utilization and low-carbon transformation of agriculture is impossible without mobilizing and empowering rural women." Smriti Aryal, Country Representative of UN Women, China.

Climate change disproportionately affects women , who are much more likely than men to be killed or displaced by natural disasters. At the same time, women are far from being equally involved in the technical solutions to climate change.

Through this project launched in 2023 by UN Women China, the Qinghai Rural Revitalization Bureau, and Qinghai Women’s Vocational Training School — women farmers in the western Chinese province in the Tibetan plateau have opportunities towards a green energy transition. This not only contributes to carbon reduction in rural areas, but also enables increased productivity and consequently an increase in the income of women farmers.

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COMMENTS

Sex assignment
Sex assignment (also known as gender assignment) is the discernment of an infant's sex, usually at birth. Based on an inspection of the baby's external genitalia by a relative, midwife, nurse, or physician, sex is assigned without ambiguity in 99.95% of births.In the remaining cases (1 in 2000), additional diagnostic steps are required and sex assignment is deferred.
Assigned Sex, Gender and Gender Identities
Your assigned sex is a biological label - male or female - you're born with based on hormones, chromosomes (genes) and reproductive organs (genitals). Most are assigned female at birth (AFAB) or assigned male at birth (AMAB). Some are born intersex, meaning they have male and female traits, such as genitals and hormones.
Gender Identity and Gender Expression
An individual's gender is most often presumed based on their sex assignment, and is presumed to fall within the binary gender categories of girl/woman and boy/man. For instance, if a baby is assigned female, the assumption is that the baby is a girl and will grow up to be a woman.
Sex and gender: What is the difference?
Sex and gender are different. Sex is assigned at birth, while gender is how a person identifies. ... Sex assignment typically happens at birth based on anatomical and physiological markers. Male ...
Types of gender identity: Types and definitions
Summary. Genetic factors typically define a person's sex, but gender refers to how they identify on the inside. Some examples of gender identity types include nonbinary, cisgender, genderfluid ...
A review of the essential concepts in diagnosis, therapy, and gender
The aim of this article is to review the essential concepts, current terminologies and classification, management guidelines and the rationale of gender assignment in different types of differences/disorders of sexual development. The basics of the present understanding of normal sexual differentiation and psychosexual development were reviewed.
Sex and Gender Identity
Sex is a label — male or female — that you're assigned by a doctor at birth based on the genitals you're born with and the chromosomes you have. It goes on your birth certificate. Gender is much more complex: It's a social and legal status, and set of expectations from society, about behaviors, characteristics, and thoughts.
Understanding Gender, Sex, and Gender Identity
Gender is related to but distinctly different from sex; it is rooted in culture, not biology. The APA (2012) defines gender as "the attitudes, feelings, and behaviors that a given culture ...
What is gender reassignment
20Jun. What is gender reassignment A decision to undertake gender reassignment is made when an individual feels that his or her gender at birth does not match their gender identity. This is called 'gender dysphoria' and is a recognised medical condition. Gender reassignment refers to individuals, whether staff, who either: Have undergone ...
Feminist Perspectives on Sex and Gender
Sex assignment (calling someone female or male) is normative (Butler 1993, 1). When the doctor calls a newly born infant a girl or a boy, s/he is not making a descriptive claim, but a normative one. In fact, the doctor is performing an illocutionary speech act (see the entry on Speech Acts). In effect, the doctor's utterance makes infants ...
PDF CHAPTER 1: AN INTRODUCTION TO GENDER
psychological issues associated with gender assignment and surgery (e.g. Lee et al 2006). In those societies that have a greater occurrence of certain kinds of hermaphroditic or intersexed infants than elsewhere,4 there sometimes are social categories beyond the standard two into which such babies can be placed.
FAQs
The Equality Act 2010 at Section 7 defines the protected characteristic of "gender reassignment" as relating to a person who is: "proposing to undergo, is undergoing or has undergone a process (or part of a process) for the purpose of reassigning the person's sex by changing physiological or other attributes of sex.".
GENDER ASSIGNMENT
GENDER ASSIGNMENT. the term used for the classification of an infant at birth as either male or female. Children born with ambiguous genitalia are usually assigned a gender by parents or physicians. See gender reassignment. Cite this page: N., Sam M.S., "GENDER ASSIGNMENT," in PsychologyDictionary.org, May 11, 2013, https://psychologydictionary ...
Gender Identity and Assignment Recommendations in Disorders of Sex
Gender assignment should be determined by evaluating the patient's chromosome structure, specific diagnosis, fertility, Prader stage, phallus length, psychological orientation, family wish and the consensus opinion of experienced specialist physicians. Gender assignment becomes more difficult, especially if there is a mismatch of the gender ...
Gender reassignment Definition & Meaning
The meaning of GENDER REASSIGNMENT is a process by which a transgender or nonbinary person comes to live in accordance with their gender identity through changes to their appearance and presentation often with the aid of medical procedures and therapies : gender transition. How to use gender reassignment in a sentence.
The importance of communicating histories of gender assignment and
Advancements in medicine have allowed for the medical or surgical modification of ambiguous genitalia, or for sex reassignment in transpeople.1,2,3,4 The etiology of ambiguous genitalia is broad, including genetic alterations, hormone imbalances, gonadal dysgenesis, or structural abnormalities.2,5 Depending on the presence of XY or XX chromosomes, gender assignment is largely dependent on the ...
Gender assignment: background and current controversies
The background to gender assignment is summarized and some of the important unresolved questions are identified that will be addressed in more detail by other contributors. Gender assignment or re-assignment poses some of the most emotive and contentious ethical dilemmas encountered in any area of medical practice. Moreover, the emergence of patient and parent support groups and the ...
Grammatical Gender: A Close Look at Gender Assignment Across Languages
This review takes a broad perspective on one of the most fundamental issues for gender research in linguistics: gender assignment (i.e., how different nouns are sorted into different genders). I first build on previous typological research to draw together the main generalizations about gender assignment. I then compare lexical and structural approaches to gender assignment in linguistic ...
The Gender Reassignment Controversy
When he was 14, Reimer began the process of reassignment to being a male. As an adult, he married a woman but depression and drug abuse ensued, culminating in suicide at the age of 38 (1). Money's ...
Gender identity
Gender identity is the personal sense of one's own gender. Gender identity can correlate with a person's assigned sex or can differ from it. ... "The findings clearly indicate an increased risk of later patient-initiated gender re-assignment to male after female assignment in infancy or early childhood, but are nevertheless incompatible with ...
Gender Affirmation Surgery: What Happens, Benefits & Recovery
Gender reassignment is an outdated term for gender affirmation surgery. The new language, "gender affirmation," is more accurate in terms of what the surgery does (and doesn't) do. No surgery can reassign your gender — who you know yourself to be. Instead, gender-affirming surgery changes your physical body so that it better aligns with ...
How can you assign a gender (boy or girl) without surgery?
The child is assigned a gender as boy or girl after tests (hormonal, genetic, radiological) have been done and the parents have consulted with the doctors on which gender the child is more likely to feel as she or he grows up. We know, for example, that the vast majority of children with complete androgen insensitivity syndrome grow up to feel ...
Gender-affirming surgery
Gender-affirming surgery is a surgical procedure, or series of procedures, that alters a person's physical appearance and sexual characteristics to resemble those associated with their identified gender.The phrase is most often associated with transgender health care and intersex medical interventions, although many such treatments are also pursued by cisgender and non-intersex individuals.
Gender board diversity across Europe throughout four decades
Abstract. We present a Gender Board Diversity Dataset (GBDD), which provides a cross-country perspective on women in management and supervisory boards that spans between 1985 and 2020. The data ...
Gender Bias in Job Assignment: Evidence from Retail Frontline Managers
This study addresses this gap by examining the effect of gender on the job assignment of frontline managers in a large sportswear retail chain. Leveraging personnel, sales, and operational data, we employ a leave-out Jackknife instrumental variables estimation framework to uncover causal evidence of gender bias in store-manager assignment.
General Assignment Reporter
General Assignment Reporter · Maham is a reporter from Pakistan. She comes to The Washington Post from The New York Times, where she spent part of 2022 covering the Ukraine war and other news for ...
Intersex
Gender dysphoria: The DSM-5 included a change from using gender identity disorder to gender dysphoria. This revised code now specifically includes intersex people who do not identify with their sex assigned at birth and experience clinically significant distress or impairment, using the language of disorders of sex development .
UN WOMEN Jobs
Duties and Responsibilities. To this end, UN Women is seeking the services of a national consultant to conduct data collection for annual comprehensive gender assessment and analysis (GA) on two different humanitarian crises in Ethiopia. The partner is expected to collect comprehensive primary and secondary data and develop a comprehensive RGA ...
gender neutral assignment.docx
Introduction: A short introduction for both case studies (e.g. what case studies are you discussing, and what the purpose of this assignment is). Please note: After the introduction, in the body, you have to discuss two case studies separately in two sections. Follow the Rubric. If you see the Rubric, you can see that there is a clear indication of two separate sections for two case studies.
At the center of green transition
Xiaerbati Daositeke hails from China. She completed her UN Volunteer assignment as Programme Communication Assistant with the UN Women China Office two years ago. The passion for gender equality and women's empowerment especially those from underserved communities stirred Xiaerbati to serve with Women-led Rural Community Renewable Energy Transition and Governance Project.

Article contents

What Are Gender Identity and Gender Expression?

Table 1. Additional Relevant Terms

Beyond the Binary: Reconceptualizing Gender Identity and Gender Expression

Social Work, Gender Identity, and Gender Expression: A Brief History

Social Work and Gender Equity

Further Reading

Related Articles

A review of the essential concepts in diagnosis, therapy, and gender assignment in disorders of sexual development

The normal sexual differentiation

The genetic testing in DSD

The further characterization of 46 XY DSD

Gonadal dysgenesis syndromes

Gender assignment in DSD

Factors to be considered for gender assignment in DSD

The rationale of gender assignment in different clinical conditions of DSD

46 XX DSD—congenital adrenal hyperplasia (CAH)

46 XY complete gonadal dysgenesis

Complete androgen insensitivity syndrome (CAIS)

5-alpha reductase deficiency

17-beta-HSD-3 deficiency

Partial androgen insensitivity syndrome (PAIS)

47 XXY Klinefelter’s syndrome and variants

General guidelines for surgery and HRT in DSD

Male genital reconstruction

Gonadectomy

Hormonal therapy/sex steroid replacement

The advances in molecular diagnosis of DSD

The ethical dimension in DSD

Availability of data and materials

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Study at Cambridge

What is gender reassignment

Transgender and sexual orientation

Bibliography

Feminist Perspectives on Sex and Gender

1.1 Biological determinism

2. Gender as socially constructed

3. Problems with the sex/gender distinction

4. Women as a group

4.1 Gender nominalism

4.2 Neo-gender realism

Acknowledgments

Support SEP

FAQs – gender reassignment

What is the protected characteristic of “gender reassignment”?

Direct discrimination

Indirect discrimination

Victimisation

Does a person have to be under medical supervision?

Must they have a gender-recognition certificate or be in the process of applying for one?

Do they have to have made a firm decision to transition?

Can children have the protected characteristic?

Is “Gillick competence” relevant to the protected characteristic?

Employment tribunal judgments

Relevant considerations

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