Gender expression refers to the ways that people present theirgender identityto the world. This may be through clothing, haircuts, behaviors, and other choices. For many people, there is a “mismatch” between what society expects from their gender and how they choose to present.
Buzz cuts, for example, are seen as masculine hairstyles, while wearing dresses is seen as feminine. This expression may vary from what might be expected of one’s gender identity. For example, acisgenderwoman may have a very masculine expression but still identify as a woman.
This article looks at how gender expression differs from identity, orientation, and other ways of describing sex and gender. It also looks at discrimination on the basis of gender expression.
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The Meaning of Gender Expression
Gender is a concept with many dimensions. When talking about whether people are cisgender ortransgender,what is meant is whether a person’s gender identity does or does not match their sex assigned at birth.
Gender expression, though, is something else. It refers to how people present themselves, in ways that a wider society may think of as being aligned with one gender or the other. For most people, gender expression affirms their gender identity.
Gender expression usually aligns with a person’s gender identity. But it may be different from what the wider culture defines as masculine or feminine behavior.
In other words, people with masculine identities speak, dress, move, or wear their hair in generally “masculine” ways. People with feminine identities make these style and behavior choices in “feminine” ways.
Gender expression is very much a cultural construct. That means there may be a shared social expectation about gender. But it also may mean that the same feminine style of hair or clothing in one setting might be thought masculine in another time or place.
Gay men and bisexual cisgender women may be more likely than their straight or lesbian cisgender counterparts to have expression that departs from the expectations about their gender identity.
Research suggests that there are higher rates of discrimination against transgender and gender-nonconforming people compared with the bias against those who are LGBTQ.
Gender Expression and Health Care
This is true for transgender people, but also for lesbian, gay, and bisexual individuals. It’s also true for people with a gender expression that is not what their provider expects.
Gender Expression, Pronouns, and Health CareGender expression is often what causes a doctor to ask for a patient’s pronouns and/or affirmed name, but it is not best practice. In an ideal world, health workers should ask everyone what name they prefer to be called and what pronouns they use.One approach that may be more affirming is for the doctor to introduce themselves first, using their own pronouns. This simple act invites the patient to share their own without putting anyone on the spot.
Gender Expression, Pronouns, and Health Care
Gender expression is often what causes a doctor to ask for a patient’s pronouns and/or affirmed name, but it is not best practice. In an ideal world, health workers should ask everyone what name they prefer to be called and what pronouns they use.One approach that may be more affirming is for the doctor to introduce themselves first, using their own pronouns. This simple act invites the patient to share their own without putting anyone on the spot.
Gender expression is often what causes a doctor to ask for a patient’s pronouns and/or affirmed name, but it is not best practice. In an ideal world, health workers should ask everyone what name they prefer to be called and what pronouns they use.
One approach that may be more affirming is for the doctor to introduce themselves first, using their own pronouns. This simple act invites the patient to share their own without putting anyone on the spot.
In 2020, Lambda Legal released a report about discrimination in health care, called “When Healthcare Isn’t Caring.“It included those with different gender expressions. Some 30% of respondents feared health workers would treat them differently because of their expression.
The report called for better training for health workers. It also called for broad policies to prohibit discrimination—not just on the basis of sexual orientation and gender identity, but also gender expression.
Blatant discrimination is not the only threat to some patients' gender expression. When doctors and other providers allow their own perceptions and biases around gender to guide their practice, it can create trauma for those in their care. Because medical professionals have authority over their patients, it is especially important that they acknowledge the nuances of gender expression.
Keep in mind that doctors do need to know a person’s sex that was assigned at birth. They need to be able to do proper screening tests, such as screening for prostate cancer or cervical cancer.
Health Disparities: What They Mean and Examples
Discrimination
The effects of gender expression are different depending on a person’s sex, gender identity, and the setting they are in. For example, some communities may accept a broader range of gender expressions from people who are seen as female than from those who are viewed as male.
It’s a relatively new concept to use human rights law to protect people from discrimination on the basis of gender expression. In 2012, however, Ontario, Canada,passed legislationthat forbids discrimination because of it.
This New Simulation Will Help Train Doctors in Gender-Affirming Care
Summary
Everyone has a gender expression. If a person’s gender expression is what would be expected for their gender identity and/or recorded sex, it would be unusual for anyone to comment on it. But each person chooses how to present themselves to the world, and society views those choices as gendered. Despite growing awareness about gender expression, this still may lead to discrimination in public settings, including health care.
A Word From Verywell
Gender expression is not always static. It can change with time. While some people’s gender expression is consistent with society’s connotations of masculinity or femininity, others' is more nuanced. This is known asgender fluidity. Some may present as highly masculine one day and highly feminine another. This may or may not have anything to do with their gender identity.
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Greene DW.A multidimensional analysis of what not to wear in the workplace: Hijabs and natural hair.FIU Law Review.2012;8,333.YWCA West Michigan.Gender Policing.Sandfort TGM, Bos HMW, Fu T-C (Jane), Herbenick D, Dodge B.Gender expression and its correlates in a nationally representative sample of the U.S. adult population: Findings from the National Survey of Sexual Health and Behavior.The Journal of Sex Research. 2020:1-13. doi:10.1080/00224499.2020.1818178Kiebel E, Bosson JK, Caswell TA.Essentialist beliefs and sexual prejudice toward feminine gay men.Journal of Homosexuality. 2020;67(8):1097-1117. doi:10.1080/00918369.2019.1603492Human Rights Watch.“You Don’t Want Second Best”—Anti-LGBT Discrimination in US Health Care.Lambda Legal.When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV.Puckett JA, Maroney MR, Levitt HM, Horne SG.Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men.Psychology of Sexual Orientation and Gender Diversity. 2016;3(4):489-498. doi:10.1037/sgd0000201Additional ReadingHorn SS.Adolescents’ acceptance of same-sex peers based on sexual orientation and gender expression.J Youth Adolescence. 2007;36(3):363-371 doi:10.1007/s10964-006-9111-0Ross MW, Kashiha J, Mgopa LR.Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men.Global Health Action. 2020;13(1):1816526. doi:10.1080/16549716.2020.1816526
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Greene DW.A multidimensional analysis of what not to wear in the workplace: Hijabs and natural hair.FIU Law Review.2012;8,333.YWCA West Michigan.Gender Policing.Sandfort TGM, Bos HMW, Fu T-C (Jane), Herbenick D, Dodge B.Gender expression and its correlates in a nationally representative sample of the U.S. adult population: Findings from the National Survey of Sexual Health and Behavior.The Journal of Sex Research. 2020:1-13. doi:10.1080/00224499.2020.1818178Kiebel E, Bosson JK, Caswell TA.Essentialist beliefs and sexual prejudice toward feminine gay men.Journal of Homosexuality. 2020;67(8):1097-1117. doi:10.1080/00918369.2019.1603492Human Rights Watch.“You Don’t Want Second Best”—Anti-LGBT Discrimination in US Health Care.Lambda Legal.When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV.Puckett JA, Maroney MR, Levitt HM, Horne SG.Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men.Psychology of Sexual Orientation and Gender Diversity. 2016;3(4):489-498. doi:10.1037/sgd0000201Additional ReadingHorn SS.Adolescents’ acceptance of same-sex peers based on sexual orientation and gender expression.J Youth Adolescence. 2007;36(3):363-371 doi:10.1007/s10964-006-9111-0Ross MW, Kashiha J, Mgopa LR.Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men.Global Health Action. 2020;13(1):1816526. doi:10.1080/16549716.2020.1816526
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Greene DW.A multidimensional analysis of what not to wear in the workplace: Hijabs and natural hair.FIU Law Review.2012;8,333.YWCA West Michigan.Gender Policing.Sandfort TGM, Bos HMW, Fu T-C (Jane), Herbenick D, Dodge B.Gender expression and its correlates in a nationally representative sample of the U.S. adult population: Findings from the National Survey of Sexual Health and Behavior.The Journal of Sex Research. 2020:1-13. doi:10.1080/00224499.2020.1818178Kiebel E, Bosson JK, Caswell TA.Essentialist beliefs and sexual prejudice toward feminine gay men.Journal of Homosexuality. 2020;67(8):1097-1117. doi:10.1080/00918369.2019.1603492Human Rights Watch.“You Don’t Want Second Best”—Anti-LGBT Discrimination in US Health Care.Lambda Legal.When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV.Puckett JA, Maroney MR, Levitt HM, Horne SG.Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men.Psychology of Sexual Orientation and Gender Diversity. 2016;3(4):489-498. doi:10.1037/sgd0000201
Greene DW.A multidimensional analysis of what not to wear in the workplace: Hijabs and natural hair.FIU Law Review.2012;8,333.
YWCA West Michigan.Gender Policing.
Sandfort TGM, Bos HMW, Fu T-C (Jane), Herbenick D, Dodge B.Gender expression and its correlates in a nationally representative sample of the U.S. adult population: Findings from the National Survey of Sexual Health and Behavior.The Journal of Sex Research. 2020:1-13. doi:10.1080/00224499.2020.1818178
Kiebel E, Bosson JK, Caswell TA.Essentialist beliefs and sexual prejudice toward feminine gay men.Journal of Homosexuality. 2020;67(8):1097-1117. doi:10.1080/00918369.2019.1603492
Human Rights Watch.“You Don’t Want Second Best”—Anti-LGBT Discrimination in US Health Care.
Lambda Legal.When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV.
Puckett JA, Maroney MR, Levitt HM, Horne SG.Relations between gender expression, minority stress, and mental health in cisgender sexual minority women and men.Psychology of Sexual Orientation and Gender Diversity. 2016;3(4):489-498. doi:10.1037/sgd0000201
Horn SS.Adolescents’ acceptance of same-sex peers based on sexual orientation and gender expression.J Youth Adolescence. 2007;36(3):363-371 doi:10.1007/s10964-006-9111-0Ross MW, Kashiha J, Mgopa LR.Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men.Global Health Action. 2020;13(1):1816526. doi:10.1080/16549716.2020.1816526
Horn SS.Adolescents’ acceptance of same-sex peers based on sexual orientation and gender expression.J Youth Adolescence. 2007;36(3):363-371 doi:10.1007/s10964-006-9111-0
Ross MW, Kashiha J, Mgopa LR.Stigmatization of men who have sex with men in health care settings in East Africa is based more on perceived gender role-inappropriate mannerisms than having sex with men.Global Health Action. 2020;13(1):1816526. doi:10.1080/16549716.2020.1816526
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