4. Talking about gender

Question 1

Sex

Answer 1

biological construct premised upon biological characteristics enabling
sexual reproduction. Among people, biological sex is variously assigned in
relation to secondary sex-characteristics, gonads, or sex chromosomes; sexual
categories include: male, female, intersexual (persons born with both male and
female sexual characteristics), and transsexual (persons who undergo surgical
and/or hormonal interventions to reassign their sex).

Question 2

Gender

Answer 2

refers to a social construct regarding culture-bound conventions,
roles, and behaviours for, as well as relations between and among, women and
men and boys and girls.

Question 3

Gender roles

Answer 3

Gender roles vary across a continuum and both gender relations and biologic
expressions of gender vary within and across societies.

Question 4

Sexism

Answer 4

Sexism, in turn, involves inequitable gender relations and refers to
institutional and interpersonal practices whereby members of dominant
gender groups accrue privileges by subordinating other gender groups and
justify these practices via ideologies of innate superiority, difference, or
deviance.

Question 5

Intersex

Answer 5

Intersex: when the complex processes of sex determination +/- sex
differentiation are disrupted/incomplete (? 2-4% of people)

Question 6

Trans

Answer 6

Transgender people have a gender identity that does not match their sex
assigned at birth, which is generally based on anatomical observation.
● 50% of transgender youth will attempt suicide before their 20th birthday
● Transition may or may not involve hormone/surgical treatment
● Gender affirmation — having one’s gender identity acknowledged and
accepted in social, legal, and other settings
● Beyond bathroom accessibility, discrimination is associated with
increased stress, anxiety, depressive symptoms, post-traumatic stress
disorder, substance abuse, and suicide. It is also associated with increased
risk of bullying, verbal harassment, sexual assault, and nonsexual
violence, as well as decreased health care utilization.

Question 7

Primary care of trans populations

Answer 7

You may be the first person they tell off their gender dissonance
● Open non-judgemental approach
● It is unhelpful to delay treatment at a Gender Identity Service; high
incidence of suicide and substance abuse in untreated Trans* population
● Refer to Regional Gender Service (+/- via CAMHS), even if they are not
completely sure that they are transgender
● Signpost to support groups
● Vulnerable to mental health problems
● Self medication with hormones
● Screening: may still need cervical, breast, prostate and AAA screening
(and transmen should check for lumps)
● Avoid misattributing commonplace health problems to gender

Question 8

Gender awareness is good for health

Answer 8

A physician who knows a patient is a transgender man or transgender
woman will know exactly what screening tests that patient needs to stay
healthy.

A physician encountering a lesbian patient will not assume she “got that
way” because she was sexually abused.

A gay couple bringing their sick child to the ER will be treated with the
same respect and care as a straight couple.

And adults who were born with relatively unusual forms of sex
development will already know their medical histories, and their doctors
will understand them.

Children who are variant in terms of their sex or gender identities will
encounter doctors who recognize their real needs and their strengths, and
will know how to encourage their families to do the same.

The needs of patients will come before other social norms.