Yes, We Need Both the Term “Biological Sex” and the Word “Cisgender”
An ode to qualifiers, which bring clarity during confusing times amid the ideological—and rhetorical—battles over transgender identity.
Some people have gotten it into their heads that the term “biological sex” is an intrinsic, bigoted dog whistle that is only ever meant to degrade the integrity and dignity of trans people.
And on the flip side, we have the people who froth at the mouth at the mere whisper of the word “cisgender,” which they say is the key to Pandora’s box of gender-bending horrors. Free-speech champion Elon Musk notoriously banned the word from X.
Both of these camps are being wildly unreasonable, stubborn and close-minded.
These are confusing times. And we must have both of these terms—“biological sex” and “cisgender”—at our disposal to provide clarity, when warranted, and to distinguish between people’s sex and gender identity. Yes, this applies even to people who insist that they have no gender identity or, nonsensically, that there is no such thing.
We’ve seen a lot of muddying of the waters between sex and gender identity in the discourse coming from both major factions squaring off about this combustible and catastrophically politicized culture-war issue.
There has been a parade of people of late, for example, who claim, “Transgender women are biological women.” See: the cyclist Veronica Ivy on Trevor Noah’s show. This is a preposterous suggestion that erases the most basic of biological realities. If a transgender woman were a biological woman, she would have no need to take estrogen; because the ovaries she was born with, absent having them removed or some sort of hormonal disorder, would manufacture the required hormone level on autopilot. A transgender woman takes these hormones to change her body to be more feminine, because she is, in fact, a biological male who identifies as female.
And on the flip side, there are those who unkindly claim, for example, that trans women are not women in any way shape or form and have no right to be conceived of, treated as, or addressed as such in any context. This faction seeks to rob trans women of their dignity by dismissing them as men in drag. This is boorish and extremist behavior that betrays an appalling lack of empathy for the plight of people who seek to mitigate the pain of gender dysphoria and to live authentically by changing their bodies to more closely resemble those of the opposite sex with which they identify.
As for the word “cisgender,” here’s some history about my experience with the word. From 2012 to 2020, I wrote about HIV research for a health magazine company. And during that time, I used the word “cisgender” constantly in my writing, whenever I covered a study that included both transgender people and…cisgender people. I needed the qualifier to distinguish between the two groups.
A lot of people, if they are willing to admit that a qualifier was even necessary my reporting about these studies, would smugly insist that “normal” was the only word that would suffice, not “cisgender.” I’m not going to dignify that with a response except to say that people who argue this are what are known as assholes.
Similarly, people who are eager to erase the existence of transgender people from society insist that there is no need to say that one group of people is comprised of “trans women” and the other of “cisgender women,” because you can just say “women” for the latter group and everyone will know what you mean.
Except that, these days, people won’t always know what you mean. Because, for starters, too many people have championed the slogan of late: “Trans women are women.” Whether you agree with that suggestion or not, including whether you think that trans women are a kind of woman, you have to acknowledge that the meaning of the word “woman” has at least on a rhetorical level become context specific in certain scenarios. This can render the word “woman” difficult to make sense of without a qualifier, ideally one that isn’t chosen to demean a certain group of people. And no, being labeled “cisgender” is not intrinsically demeaning to anyone. On its simplest level, the word simply means “not trans.”
Similarly, the qualifier “biological” helps clarify a person’s sex in the context of discussing those who have engaged in some form of gender transition that departs from that sex. And in some scenarios it can be used interchangeably with “cisgender.”
In many contexts, such as everyday interactions in public places, someone’s biological sex is not pertinent or necessary to know.
But it is important to know if someone’s biological sex differs from their presented gender, for example, in medical contexts. Emergency medicine physicians have told me how much it can undermine patient care when the electronic medical record does not clearly distinguish between patients’ sex and gender identity. Physicians might overlook the potential that a biological female is pregnant if she presents as male and is designated such in the medical record. Or they might not seek to determine whether a biological male who presents as female has prostate cancer.
Such confusion is the byproduct of the trans advocacy movement often conflating sex and gender identity. Instead of saying that individuals transition their gender by taking hormones and undergoing surgeries to shape their body to appear as the opposite sex, these advocates claim that this process, in fact, changes the individual’s sex.
This confusion is exemplified by the term “sex assigned at birth.” This is a nonsensical expression that falsely suggests that the sex on our birth certificate was arbitrarily assigned to us by a capricious health care worker. Here is what actually happens: Sex is observed and documented at birth. And then what indeed happens to children as they grow up is that society assigns to them a host of gender-norm expectations associated with their sex. It is those gender presentations, not their actual sex—a biological, fixed reality—that transgender people change when undergoing a gender transition.
Many people in trans advocacy also grossly misuse cases of differences of sex development, or DSD, as the basis for the argument that transgender people’s sex is indeed assigned at birth or that sex is somehow fluid. First of all, these cases are extremely rare. DSD cases that lead to genitalia ambiguous enough to lead to the inaccurate sexing of a baby occur in only about 1 in 5,500 births. And even if these people’s anatomy may not be in line with the typical male vs. female presentation, each of them nevertheless is one of the two sexes.
I cite evolutionary biologist
, who helped clarify for me that sex, most essentially, is defined by whether the body is organized around producing either the small (sperm) or large (ovum) gamete, regardless of actual fertility. And there is no third sex.
Importantly, we cannot have vital discussions about transgender people if angry mobs rob us of the words we need by calling anyone who uses them a transphobe or a bigot. (I do, however, retain the right to call certain people assholes. Call me a hypocrite!)
Yes, there are those who do use “cisgender” as a sneering slur in the same way that people snarl about the patriarchy. And yes there are those who throw around the word “biological” to undermine transgender people’s claim to be perceived and treated as the opposite sex.
But there are indeed plenty of people who use these words in good faith, as neutral qualifiers that distinguish one group of people from another. This is a good thing.
Benjamin, I think you should do you. If it’s important to you to use terms like “cisgender” for whatever reason then by all means do so. I do however completely reject the idea that it is incumbent upon me to use these terms as a sign of respect. I simply do not believe in the metaphysics of gender ideology and do absolutely believe that the whole idea has done incalculable harm to countless people, including those it purports to help. I would add the inane term “sex assigned at birth” to the list of obfuscating language that has steamrolled over common sense since 2020.
I am still quite unconvinced that gender identity is a useful descriptive construct. Much less an essentialist concept. Sex and Gender are the same thing - we don’t need a word to describe “better than guessing” heuristic shortcuts about how men and women tend to socially act or present. We have the gender distressed and the gender accepting - they aren't actually different gender. Male and Female is all we need for policy and people’s feelings and presentations are their own business, not the state or policy other than they have the right to dress and feel as they please without being fired from jobs or kicked out of housing, etc. But the state doesn't need to validate introspective woo. Treat it like a religion with a beliefs/believers distinction.