Sex is Sex, Not Gender

I realized from a “discussion” I had with my supervisor that erroneous usage of the word “gender” in biomedical writing occurs at the highest levels. He wanted my grantsmanship opinion on a PI’s glossing over potential “gender differences in disease incidence”; I gave him my editorial opinion on his incorrect use of the term “gender”. Copying the relevant page from the AMA Manual of Style did not change his mind. He will continue to use the term “gender” haphazardly (despite, oddly, years of bench research in reproductive steroidogenesis), and I will continue to correct him on this. We’re both stubborn this way. But only I’m right. We’ll see how long I remain both right and employed.

Unfortunately, the AMA Manual of Style content is not available online. However, on p 25 of the J of the ADA Style Guide (which is based on the AMA Manual of Style), you will find clearly stated:

“gender vs sex: gender refers to the psychological/societal aspects of being male or female, sex specifically to the physical aspects. Do not interchange.”

The APA Publication Manual confirms and elaborates on this very clear distinction:

Correct use of the terms “gender” and “sex”

The term “gender” refers to culture and should be used when referring to men and women as social groups, as in this example from the Publication Manual: “sexual orientation rather than gender accounted for most of the variance in the results; most gay men and lesbians were for it, most heterosexual men and women were against it” (APA, 2001, p. 63).

The term “sex” refers to biology and should be used when biological distinctions are emphasized, for example, “sex differences in hormone production.”

As an editor, I would of course add that nouns & pronouns can, depending on the language, have gender as well, though these are usually not studied in a biomedical setting.

UPDATE: Gender continues to be a fluid term, though still distinguished from biological sex (usually measured in biomedical research). Please see the Williamson Institute report on Gender Identity in U.S. Surveillance (GenIUSS) for appropriate questions and means to identify sexual minority individuals.



  1. George Smiley said

    Yup, I agree. You’re right and Mr. Researcher Dude is both wrong and, given that he’s apparently unable to learn new things, rather dumb. By the way, what sort of institution are you working at? My grants do not seem, ever, to get the kind of internal vetting that yours are subjected to… of course, I’m funded so no complaints.

    Unlike the alma mater of George Smilely, my institution is a US doctoral-granting university with, according to the Carnegie Foundation for the Advancement of Teaching, very high research activity. My office supports faculty in the six health sciences schools (dental medicine, medicine, nursing, pharmacy, public health, rehabilitation sciences/allied health). Since I’m used to working with a wider constiuency, I often contact potential collaborators in the schools of engineering, social work, education, business, arts & sciences, law etc. – but otherwise the non-health sciences schools have their own vice provost for research watching out for their welfare.

  2. drugmonkey said

    Just because this is where we’ve arrived in a politically correct spasm regarding psychological orientation doesn’t make it the OneGodlyTruth of linguistics. For many people “gender” is mapped to biological identity and “sex” is taken as less precise because it is also used to describe actions. The substitution of “gender” for “sex” and vice versa has an apparently long history (pitting actual use versus officiousness, obviously) and the pre-eminence of “gender” over “sex” in academe appears a phenomenon of the last few decades.

    So have some pity on the OldGuyz, eh?

    No can do. Scientific writing is about conveying meaning clearly, unambiguously, and economically. I don’t care how these terms are used in blogs & at cocktail parties. And from my frame of reference, you’re not in the OldGuyz club yet. Neither is the individual who inspired this commentary (not that I would tell him otherwise if it were so). – writedit

  3. drugmonkey said

    ahh, no OldGuy me, that should be clear at least.

    but here’s the thing. when I’m reviewing a rat or monkey grant that talks about “gender differences” well, I’m really not thinking transgender or sexual orientation anything like that. and so far, the communication has been unambiguous….

    and this is why I put in the point, pulled from the Wikipedia entry, about the recency of the gender/sex usage in academics, even the Soc academics. this is not just “blogs and cocktail parties”. going by scientific presentations, the conversion is also far from complete, I still hear “gender” used where you think “sex” is more appropriate. it is changing, sure. but it is far from universal.

  4. George Smiley said

    Nope. Don’t buy it, folks. People who work on, say, sex determination in Drosophila don’t talk about genser ratios. They talk about sex ratios. And you don’t “gender” the flies when you determine the aforementioned ratio. You sex them. But, hey. What do I know? My experimental organism comes in “a” and “alpha” and “A/alpha”, and we call it mating type…

  5. drugmonkey said


    told ya it wasn’t a done deal…

    Actually, this seems to make my point. writedit

  6. […] concerns are incredibly minor, including a quibble over word choice (discussed!). Think, use of sex vs gender appropriately. Not relevant to the science at all. However, this A0 is not […]

  7. Delenn said

    I just came across Human Health Services Regulation 45CFR46 which defines “Gender as the classifications of humans as either female or male”.

    The definition above was included in “Human Subjects Protection and Inclusion,” a PDF available to extramural research grant reviewers for NIH.

  8. Emily said

    The World Health Organization simply and accurately states the difference between the words ‘gender’ and ‘sex’ here:

    A quote that clarifies these similar definitions in a nutshell is ““Male” and “female” are sex categories, while “masculine” and “feminine” are gender categories.”

    Simply put, you’re right and your supervisor is simply flat-out wrong. He seems to be cleverer than I am, a high school senior, so why doesn’t he know how to use a dictionary? (Or a simple google search of ‘sex vs gender’)

    • writedit said


      Well, I think my supervisor and many others cannot overcome the feeling that it is more PC to say “gender” than “sex” so as to avoid offending anyone’s delicate sensibilities. Which could be why he has navigated the politics of academic administration to attain his lofty position, whereas I, who cannot help but speak my mind, likely will not climb that high. – writedit

    • Deikitsen said

      omg, those are the exact search words i used…..

  9. Gisele said

    This is a fairly serious issue if it’s important for the general public to understand the difference between science and politics. Transgender activists want gender and sex to mean the same thing because they believe that people are born with a gender as well as a sex. Typically if you are born female you also are born with the female gender identity. But, you can be born with just the female gender identity but not the typical female body parts. A transgendered person may be born to the female gender yet still want to keep the male body parts. Nevertheless they were born “women”. The transgendered community wants there to be no distinction made between different types of “women” nor even different types of “females”.

    If they can get science to use the word “gender” as a synonym for “sex” it supports their believe that “gender” is something people are born with and that it is the more important factor in determining the difference between men and women rather than sex.

    When words are used interchangably they become meaningless.

    • writedit said

      Nice comment, and complete agreement about the loss of meaning when words are used interchangably. We have two words for a reason. I would still argue that sex be used for anything biological, including female sex identity, and leave gender for pronouns etc. – writedit

  10. Deikitsen said

    i agree, your college is wrong, and it irritates me enormously when im filling out a form and it asks for gender, because i know that they’re asking for sex, but im confused as to what to put down because sex(inanutshell) refers to whats in between our legs; while gender is more psychological in a fact that it’s which sex you identify more w/.
    anywho, it irritates me because while my SEX is male, my GENDER is female…. and i find it hurtful that some idiots insist that gender is the right term to use for the forms.

  11. Tofik said

    Interesting explanation

  12. Noa said

    What’s concerning to me is that much of society, now 6 years later, has the idea that although you may be born female, it’s merely an identifying feature immediately after birth for documenting purposes, and unnecessary thereafter. The media is convincing people that sex is irrelevant and gender trumps it in all circumstances. I never understood why they often have gender on forms, when it’s not concrete. I always assumed they meant to say sex, but because of the act of the same name, they almost consider it distasteful…

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