Understanding Sex, Gender, Gender Identity, Gender Expression, and Sexual Orientation: An Empathic Guide for Allies

The word allies is written out in a rainbow of colours


Understanding the intricate concepts of sex, gender, gender identity, gender expression, and sexual orientation is critical to fostering inclusivity and empathy in our society. However, a significant barrier to this understanding is the presumption that these concepts fit neatly into a binary model. This binary world is populated by male and female, boys and girls, men and women, and gay and straight, who are viewed as opposites. It conflates sex, gender, gender expression, gender identity and sexual orientation, relegating people to rigid binary categories.

This traditional binary viewpoint falls short of capturing the rich diversity of human experiences. To foster understanding, we must look beyond binaries to create practices that embrace the diversity within trans* and queer communities and their multifaceted representation of sex, gender, gender identity, gender expression, and sexual orientation.

“Seek first to understand, then be understood.” —Stephen R. Covey

This quote offers an invaluable tool for fostering understanding and empathy. Empathy is a driver of connection. It requires us to step outside judgment, recognize the emotions of others, and be vulnerable enough to feel with them. It’s about understanding the words, their meanings, and the experiences and feelings behind them.

Recently, Roy Banks made a strong point about the strength of unity by asserting, “Allies make alloys.” Like the combination of metals to form a stronger alloy, being allies for each other is critical to creating safety, building trust, and recognizing our strength in unity rather than division. Through understanding and practicing empathy, we can be our best allies.

To illustrate the need for understanding, I’d like to share a personal experience. As a trans woman and a psychotherapist, I’ve seen firsthand how ignorance and misunderstanding of these basic concepts can lead to inappropriate questions and assumptions. These instances are not just uncomfortable—they’re dehumanizing, reflecting a lack of understanding beyond individual interactions and our broader societal structures.

By linking arms as gender-diverse individuals and as allies, I believe we have a powerful opportunity to challenge this status quo, to learn and lean into the discomfort just enough to create a deep and meaningful understanding. This understanding will lead to a sigh of relief, a signal that we are seen, heard, and valued for who we are.

The purpose of this blog post is not only to communicate the terms allies must know but also to extend an empathic call to action. We need you right now. Please learn about and understand us right now. In a time of significant societal opinionating and anti-trans legislation, it’s time to challenge the binaries and embrace the spectrum of human identity.

The following sections will dive deeper into these concepts, exploring their definitions, importance, real-world implications, and ways to help as an ally.


As we set out to comprehend the complexities of sex, gender identity, gender expression, and sexual orientation, we commit to comprehensively exploring their definitions and the many layers they contain. So often used interchangeably and misunderstood, these terms hold unique meanings and implications. Moreover, each term captures a different aspect of human identity, attraction, and expression, contributing to the intricate web that makes up our understanding of ourselves and others.

Unpacking these definitions involves more than simply providing dictionary-style explanations. It requires an open-minded approach that respects the individual and collective experiences of diverse people across the globe. It’s not merely an intellectual exercise but an opportunity to foster greater empathy and acceptance of the rich diversity in human experiences of sex, gender, and sexuality.

Our exploration will take us through these terms in detail, beginning with biological sex and its implications, then moving into the realms of gender identity and gender expression, and finally navigating the intricacies of sexual orientation. By the end of this journey, we hope readers will have gained a more comprehensive understanding of these critical concepts and their importance in our lives and society. So now, let’s delve into each term, starting with biological sex.


In its most basic understanding, sex refers to the biological attributes distinguishing males from females. These attributes can encompass physical features such as reproductive organs and chromosomes and secondary sexual characteristics such as breast development in females and facial hair in males. However, such a binary delineation of sex tends to oversimplify the complex spectrum of biological reality.

The existence of intersex individuals vividly demonstrates the complexity of biological sex. Intersex people, those born with physical sex characteristics that do not fit into the standard binary notions of male or female bodies, defy the simplistic categorizations. Their existence underlines that biological sex isn’t as straightforward as commonly perceived, pushing us to realize that nature doesn’t always align with the neatly compartmentalized categories we create.

Gender Identity

In contrast to biological sex, which is generally assigned at birth based on visible physical attributes, gender identity encompasses one’s most profound personal understanding of their gender. It represents how individuals perceive themselves and how they label themselves. This can manifest as male, female, a blend of both, or neither, and could align with or differ from the sex assigned at birth.

An illustrative example is that of Jamie (name changed for privacy), who, despite being assigned female at birth based on biological characteristics, always experienced a disconnection with this assigned gender. After years of introspection, Jamie found greater alignment with the male gender and now identifies as a transgender man. Jamie’s story underscores that gender identity is profoundly personal and may not always meet societal expectations based on biological sex.

Gender Expression

While gender identity refers to one’s deeply personal understanding of gender, gender expression pertains to how individuals outwardly communicate their gender to the world around them. This expression can manifest through behaviour, clothing, hairstyle, voice, and other forms of presentation.

Consider Alex (name changed), who identifies as nonbinary, meaning they don’t strictly perceive themselves as male or female. Alex might choose to express their gender in ways that defy traditional gender norms, perhaps favouring androgynous clothing or incorporating elements typically associated with masculinity and femininity in their appearance. Alex’s story showcases how gender expression can be a creative and individualistic process that isn’t necessarily tied to one’s gender identity.

Sexual Orientation

Sexual orientation pertains to the emotional, romantic, and sexual attraction towards others. It is distinct from sex, gender identity, and gender expression, even though they are often misunderstood as interchangeable.

Take Jordan’s journey (name changed), for instance. Jordan identifies as pansexual, which implies attraction toward individuals irrespective of their sex, gender identity, or gender expression. Despite societal assumptions that attraction must be binary (solely to males or females), Jordan discovered that the term “pansexual” most accurately encapsulated their experiences of attraction.

Delving into these definitions illuminates the diverse spectrum of experiences encompassing sex, gender identity, gender expression, and sexual orientation. Recognizing and comprehending these nuances is crucial to fostering more inclusive societies and broadening our collective understanding.

Importance of Understanding

In healthcare and therapy, understanding the distinctions between sex, gender identity, gender expression, and sexual orientation is paramount. Misunderstanding these concepts can lead to significant harm, from miscommunication to outright discrimination.

According to a study published in AIDS Behav (2016), discrimination can have devastating effects on the mental health of trans*female youth. The study suggested that interventions that address individual and intersectional discrimination while fostering resiliency and parental support may aid in preventing mental health disorders in this underserved population.

Professionals in healthcare and therapy play an integral role in this process. Without a firm grasp of these concepts, healthcare providers can inadvertently contribute to the distress of an already marginalized group. For example, the staggering statistic reveals that 48% of transgender adults considered suicide in the past 12 months, and a significant part of this distress can be linked to negative experiences within the healthcare system. When individuals sought help, a third reported having at least one negative experience related to being transgender, and nearly a quarter did not seek the health care they needed due to fear of being mistreated.

Consider the story of Taylor (name changed for confidentiality). Taylor, a trans woman, once visited a healthcare provider for a regular check-up. Unfortunately, the provider, unfamiliar with the distinction between sex and gender identity, misgendered Taylor and asked insensitive questions about her transition process. This incident caused Taylor significant distress and deterred her from seeking healthcare in the future.

This highlights the importance of understanding these terms for professionals in healthcare and therapy. With such understanding, we can create safer spaces for individuals to express themselves and seek help without fear of discrimination or misunderstanding.

Furthermore, understanding these concepts can help healthcare professionals support the resilience of individuals in these communities. For example, a study in the American Journal of Public Health (2015) found that factors such as higher income, identifying as heterosexual, and having frequent contact with lesbian, gay, bisexual, and transgender peers were associated with greater resilience among transgender individuals.

Knowledge, understanding, and respect for these concepts can differentiate between an inclusive, supportive healthcare system and one that continues to marginalize those it aims to serve. As such, the importance of understanding these terms cannot be overstated.

Real-World Implications

Understanding and Misunderstanding Gender and Sexuality

Gender and sexuality are nuanced aspects of human identity and have multifaceted implications for the individual and society. When these concepts are misunderstood, the repercussions can range from minor misunderstandings to severe social, mental, and physical harm (Seo, 2020).

Sex, often mistaken as interchangeable with gender, is assigned at birth based on observable physical attributes. However, this simplistic classification overlooks the complexities of human biology, such as intersex individuals whose bodies don’t fit into the traditional male/female binary (Seo, 2020).

Gender identity, on the other hand, is a profoundly personal and intrinsic sense of one’s gender. It might align with the sex assigned at birth, or it might not. Gender presentation, the way one manifests their gender identity through appearance, is distinct from their gender identity (Seo, 2020).

Further, hormones, often erroneously labelled as “sex-specific,” are present across all genders and play various roles in biological processes. Naturally variable hormone levels have sparked controversies, particularly in competitive sports, underscoring the importance of a more nuanced understanding (Seo, 2020).

The Reality of Transgender Existence

Transgender people have always existed, contradicting many common misconceptions. In numerous indigenous societies, third gender roles were and still are recognized, highlighting the historical and cultural diversity of gender identities (Seo, 2020).

Notably, sexuality, the capacity for sexual feelings, isn’t solely determined by genitalia or gender identity. Instead, people are attracted to others on multiple levels, and reducing attraction to mere physical attributes is a gross oversimplification (Seo, 2020).

In the same vein, transitioning is not uniform; it differs based on individual choices and needs. For example, some transgender individuals may choose to transition using hormones or surgeries, while others may not, underscoring the diversity of transgender experiences (Seo, 2020).

The Impact of Miscommunication and Discrimination

Misunderstanding of these complex aspects can lead to harmful consequences. For instance, the conflation of menstruation with womanhood can be offensive and medically dangerous, as it excludes trans men, non-binary people who menstruate, and cisgender women who don’t (Seo, 2020).

How Allies Can Help

Allies play an essential role in fostering a more inclusive society. Being an ally goes beyond passive support—it requires active advocacy, understanding, and action. This might involve participating in protests, volunteering in relevant organizations, or educating oneself and others about transgender identities (Seo, 2020).

One fundamental step towards allyship is using correct pronouns, which shows respect for an individual’s gender identity. Conversely, misusing pronouns can make the person feel invalidated and alienated, underscoring the importance of this seemingly simple gesture (Cooper et al., 2020).

In essence, allyship involves understanding the complexities of gender and sexuality, respecting these complexities in personal interactions, and advocating for the rights and acceptance of LGBTQ+ individuals. It’s a commitment to learning, growing, and acting to support a more inclusive society.


In exploring gender, sexuality and the importance of understanding both, we’ve navigated through various vital topics. From the nuanced understanding of sex as more than a binary concept to the diverse realities of transgender existence, each aspect contributes to our broader comprehension of human identity.

This journey underscores that gender and sexuality aren’t simply about biological characteristics; they’re deeply personal aspects of our identities that encompass our self-perceptions, emotions, and experiences. Moreover, the vital role hormones play in our bodies—irrespective of gender—and the vast array of experiences encapsulated in the transition process further highlight the depth and diversity of these concepts.

Moreover, we delved into the harmful impacts of miscommunication and discrimination based on misunderstandings. The exclusionary practices, like associating menstruation with womanhood, create societal divisions and pose significant health risks.

But there is hope. We touched upon the power of allyship and the critical difference it can make in creating an inclusive society. The respect for using correct pronouns and the transformative effect of active advocacy spotlight the significance of being more than passive bystanders.

As we conclude, it’s vital to remember that the essence of this understanding is empathy. Empathy is the heart of interpersonal relationships and, as such, a cornerstone of therapeutic practice. So it’s about understanding the theories and incorporating them into our interactions.

In my therapeutic practice, comprehending these complexities has been pivotal. It has allowed for a more profound connection with clients, an understanding of their experiences on their terms, and the ability to offer a more empathetic and practical approach. This is a testament to the powerful impact that understanding can have on professional and personal interactions.

As readers, I encourage you not to view this as the end of your learning journey but as a stepping stone toward more profound understanding and empathy. So continue to learn, ask questions, and above all, listen. Because in listening, we pave the way for acceptance and, ultimately, a more compassionate world.

Additional Resources

I recommend the following resources to deepen your understanding further and continue this learning journey. They range from academic articles, books, and documentaries, to professional development resources specifically for therapists and healthcare professionals.



  • “decolonizing trans/gender 101” by b. binaohan
  • “Transgender 101: A Simple Guide to a Complex Issue” by Nicholas Teich
  • “Everything You Ever Wanted to Know about Trans (But Were Afraid to Ask)” by Brynn Tannehill
  • “Trans Bodies, Trans Selves” by Laura Erickson-Schroth
  • “The A-Z of Gender and Sexuality: From Ace to Ze” by Morgan Lev Edward Holleb
  • “Transgender Christian 101: A Biblical Case For The Acceptance Of Transgender People In The Church” by Abigail Hester

Visual Media

  • Documentary: “Disclosure”
  • TV Show: “Pose”


Professional Development Resources for Therapists and Healthcare Professionals

Remember, continued learning is an ongoing process; absorbing every resource will add depth and empathy to your understanding and practice.

Disclaimer: This blog shares general information only, not professional advice or recommendations. Consult healthcare providers for personal guidance. Decisions based on content are the reader's responsibility. Thank you.

Clayre runs a group practice of three queer and trans therapists, including youth therapist Audrey Wolfe, RCC, LGBT therapist Camber Giberson, RCC, CCC, and gender-affirming therapist Clayre Sessoms, RP, RCT, RCC, CCC, ATR-P. Work with us: book a session.

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