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(lemmy.nz)
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this post was submitted on 06 Nov 2026
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Confused ally here:
Why isn't it Assigned Sex At Birth?
I was an ally before it was cool (before the DNC decided gay marriage should even be legal), and I've always felt the teaching I received among queer circles was true: "Sex is between the legs. Gender is between the ears."
Very recently, people have started referring to "male" and "female" as "gender." Why?
It introduces further questions, like was I "assigned" my height, weight, and birthday at birth?
Yeah, from working in a medical field - your sex can have a huge effect on the way your body interacts with certain medicines/drugs - and as such I find the trend of conflating Gender and Sex to be rather dangerous.
And it's not just people that started doing it either. I've worked on multiple studies where data entry points have asked for Gender when they very much meant Sex. Again dangerous, because the answer to both is only the same for cis identifying people - and you really don't want to get that wrong.
What you do with your Gender is nobody's business but your own. Express yourself however you please - but if a medical professional is asking your assigned sex at birth, consider they may be doing so to keep you safe.
(For the record I'm not stating either as a binary, I'm aware intersex people exist, and do believe more should be done to accommodate them in medical settings which mostly currently act like they don't exist)
Edit: Somehow the end of my second to last paragraph got replaced by a fullstop. Weird stuff
I have some antitrust issues with Epic (the EMR) but they have a literal checklist option where you literally just check which organs the pt had at birth then can specify whether or not they still have them. Super simple, cuts straight to the medically relevant info, and covers all areas from binary cis to cancer to intersex to pre, mid, and post transition. Best way I've ever seen it done. Epic is one of those things that's dominating the market by just being on a different level from everybody else but I gotta admit I'm a little worried about how much influence they have when they finally (as all large corpos do) go full supervillan.
The thing that impacts care more than sex is the hormones in the blood. If care is based on gender assignment rather than the hormones in their body, it can be equally disastrous.
You're kinda right, but unless you're on a gender affirming therapy (like HRT), then those hormones are going to be linked to your sex assigned at birth.
(Though there are plenty of non-hormonal sex-linked differences in drug interactions as well)
And if you are, that's a whole other layer of complication that your medical caregiver would also need to account for when prescribing you certain drugs/medical products.
Edit: Added bracket part.
Yeah the "in a perfect world" medical solution would be for emergency caregivers to have rapid access to "apparent sex at birth" and "current hormone levels and when they were started," but everyone here knows a lot of evil people (especially in the US in 2026) would love to have a government record of transgender people for nefarious purposes, so that's probably unwise.
I expect hormones-at-birth have effects on medical care as do hormones-at-present, and I'd bet anything transgender people (or anyone that has a difference between hormones-at-birth and hormones-at-present, including cis menopausal women for example) have adverse medical outcomes due to that confusion.
Babies don't have hormones like that, holy fuck what is the education like where you are. Puberty! What's puberty! Think McFly Think!
No need to be insulting towards them, especially when they weren't insulting you.
Also, you're technically wrong. There definitely are hormones flying about your body even before you're born. All fetuses start as female, and its literally testosterone that causes differentiates towards male (or intersex in some cases). The only reason you don't start puberty as an infant is because those levels normally diminish within the first year after birth, returning again just before puberty begins.
Sex chromosomes at birth, then?
Are you being pedantic and adding ad hominem just to pick a fight?
If someone tries to explain something to you, you have a lot of trouble listening for someone who considers themselves an ally.
You've answered my second question at least. As I said in the other reply to your hostile reply elsewhere, enjoy the block.
I'm sorry buddy that's really not a thing. At all.
Yes, it is. As an example, trans women have an increased risk of breast cancer over cis males. The risk is not as high as cis women, but there is a statistically significant increase in risk amongst that demographic.
The risk is simply from having developed breast tissue, you can spot check that one by just looking and seeing if they have breast tissue
Gynecomastia can also progress to male breast cancer
Yes, and the breast development is stimulated by HRT.
I'm a data analyst for a research facility doing genetic analyses on rare variants of cancer. My PI specializes in breast cancer. We regularly have discussions about the research we're involved in.
I know breast cancer still develops in cis men.
Except the drugs are originally always tested on men for efficacy, anyway so moot point.
https://medicine.yale.edu/news-article/a-drug-for-women-tested-on-men/
Yes you need to tell a doctor if you might have different organs than you apear to have, maybe there's an ectopic pregnancy, but medications, yeah not so much.
I don't disagree with you - American pharmaceuticals in particular still seem weirdly gung-ho about excluding female participants from studies. Coming from Europe we routinely have to tell them they're not allowed to do that.
... but I think it's bad faith to say that bad study design makes my point moot, especially when it takes only a few seconds of Googling to find plenty of papers discussing sex-linked effects on drugs/medicinal products.
Heck, here's a literature review of sex-linked effects on the pharmakinetics and pharmacodynamics of various drugs, which even acknowledges the bias towards males in various clinical trials you referred to.
I don't think the paper mentions it, but I imagine throwing intersex people into the mix would render even more related differences. Which is why your assigned sex at birth matters medically, and I think it is dangerous to conflate it with gender identity (which again is your's to express as you please)
Which is why we need to put M/W/N/(etc.) on driver's licenses while medical professionals have access to M/F/I/(etc.)
Even from the ostensible purpose of M/F on a driver's license of efficient identification, it's lacking. Then there's the medical downsides you state - I'm sure you're aware many medical professionals check IDs rather than sequencing someone's sex chromosomes before performing emergency or other care.
Honestly, yeah.
Gender is someone's outward, public-facing expression. Having it on there to aid identification is not a bad thing IMO.
Whereas sex really feels like more private knowledge that should be restricted to where medically necessary to avoid complications, rather than being forced on your identification for everyone to see.
It's certainly better than the status quo in many areas including mine (i.e. your apparent sex at birth is tied to your gender forever), that's for sure.
Woah, why would you need gender markers on your ID, wtf.
Because it's a valid method of identification linked to one's personal expression.
Versus the current scenario of sex being on there which can lead you anywhere from awkwardly being outed as trans, to medical complications arising from being misidentified.
I'm 90% sure LavaPlanet is just trying to stir people up to have an argument; all of their comments in this thread are at least lukewarm if not outright hostile.
not everyone has a gender, so at best it should be an optional marker for those who consent.
but also gender is not always a good method of identification because
birthdate, place, and full name should be sufficient id and if they are not, add a uuid in the mix. no need for gender really, which just complicates things.
of course alternative is not to use sex for id, but no one except bigots is asking for that. but also, i believe that many places, such as that whichs nationality i hold, say sex on the id, but effectively treat it as gender, at which point it's really just semantic
You prefer sex assigned at birth to be on someone's ID?
Neither wtf. Wtf is wrong with you you have to diminish and argue with everyone who tries to talk to you. You're answering comments i haven't even said to you. You're really not cool.
I offer a better situation than the current situation and your response is to vilify me for it. Between this thread and the other semi-hostile replies, you're obviously just here to fight.
I think the key is in the word "assigned". They don't grab a penis from the penis bin and assign it to you, they assign a gender to you. They determine the sex, and assign the gender.
Yeah that's where I'm at, but as you can tell from this thread it's much debated.
So I feel like it'd be "determined male at birth" and "assigned boy at birth."
Assigned sex at birth also includes a lot of how a person is socialized (not just from family but society at large) during their formative years. So it is, in a sense, assigning a person a gender as well.
Also gender and sex are frequently conflated in the English language by most people who choose not to think more critically or ask questions on these topics.
They're frequently conflated because they were synonyms until quite recently (more recently outside of academic sociology circles) and so quite a lot of people still treat them as synonyms.
I would agree that people are generally assigned "sex" and "gender" at birth, I just don't understand why it seems they're conflated among queer spaces when discussing "Assigned Male At Birth"+"Assigned Gender At Birth" when I feel like it should be:
"Assigned Gender At Birth"→"Assigned Boy At Birth" and/or "Assigned Sex At Birth"→"Assigned Male At Birth."
My understanding is that sex and gender aren't as clear cut as people used to think so a growing number of people use sex and gender interchangeably by referring to it as "sex/gender" or "gender" as a catch all term. Think about it that way: Sex is physical, like organs, hormones, height, muscle mass, ... and gender is social like behavior, norms, expectations. So telling boys to eat up to they get tall and strong and letting them do a lot of sports while telling girls not to get fat and simultaneously to do more creative stuff that isn't too active is gender. But when boys in fact grow tall and muscular, that's testosterone and therefore sex and has nothing to do with gender.
The argument is that gender and sex are too multifaceted and too intertwined to meaningful separate them. That's at least one take away a had from reading "Who's Afraid Of Gender" by Judith Butler. It's not too long and an easy read. Highly recommend.
The lion's share of your comment is essentially the long form of the mantra I stated I believed in, but I appreciate you explaining it for people who don't know.
To the last paragraph, that's probably the root of the confusion here; maybe one day we'll have a term for that intersection - something more concise than "sex/gender." Or is that what we're taking part in here? Using "gender" to cover both? A bit confusing to me, but maybe not so much to future generations.
My native language has only one word for sex and gender. We sometimes use adjectives like social and biological or just borrow the English terms to distinguish them but since reading Butler, I feel comfortable using "Geschlecht" as a catch all term and if German has only one word for it, so can you
Yeah, the way things are going that's probably where English is headed.
In Australia a lot of healthcare and places are now starting to use ASAB to get around respecting your gender. I absolutely loathe ASAB, because it’s even more bioessentialist than AGAB.
I much prefer the organ inventory approach, which also helps cis people too, e.x. hysterectemies.
Organ Inventory > Sex at Birth > Gender, in a medical context.
Ideally you have all three because all are medically relevant (self-explanatory, chromosomes, and hormones, in that order - all medically relevant), but good luck passing legislation to put all three on an ID, not to mention the dangers (in many places of the world) of having "Hello I am sex or gender non-conforming" on your ID everywhere you go.
No, "sex at birth" is not a meaningful category, and institutions collecting such data opens up new vectors for worse outcomes while also being extremely disrespectful towards patients.
Completely disagree based on my understanding of modern medicine, so I hope you can understand my reluctance to trust the word of a random stranger.
Completely agree, which is why I already said as much in the comment you replied to.
they assing one a gender at birth based on ones anatomy.
they assign a sex at birth based on the anatomy.
both are social constructs and i believe among the two gender is the more accepted one by progressives, as it is the one that people actually positively associate with and which we all agree we can pick for ourselves. yes, a gender assigned at birth is something we were forced into but we can change it.
sex on the other hand is more commonly used as a weapon against us. ofc ones anatomy is seperate from ones gender (altho it can be part of it), but sex is anatomy gendered. but unlike gender, the person whose anatomy it is, does not get to decide their sex. at the end of the day it's gender forced onto people from outside in a way they can't change (or only by changing their bodies). it's violent.
now we could try to work towards degendering sex, but i believe this is incredibly hard since words such as male and female are used interchangably with man and woman, and well for example most male sexed people are also men. so i believe it makes more sense to desex our bodies, and use male and female uniquely for gender (or not at all)
if we desex bodies of course, then we might need other ways to talk about certain common clusterings of attributes, and the solution for that is to just say what's there. idk if there are better words for this but it can be things like
this has the advantage of automatically accounting much better for human diversity than the strict sex system ever could :3
using agab instead of asab is another defocusing of sex then.
but also when people ask for agab, they might and really should literally just mean "as what gender were u raised (pre transition)"
Gender and sex used to mean the same thing, and it's not like massive amounts of people are out there raising their kids non binary until the kids can choose for themselves, so whatever sex someone is assigned denotes the gender they've been assigned too.
Unrelated, but if you really want to open this new discussion: I disagree
I think you misread my comment, because I wasn't talking about cis-het-normative spaces.
History disagrees with you about the gender sex relationship.
I'm going to choose to believe you are asking to learn, not asserting to be controlling, because that's really not a good look. Nobody raising children non binary means whatever sex you are assigned denotes the gender you will be raised as. It's the gender that has the enforced stereotypes that people are forced to conform to. So the people whom it is relevant to, have chosen to phrase it that way.
You express a lot of misgivings and non understandings for someone who is trying to recreate and rename a whole signifier. Allies listen. Not assert and take over spaces and try and change things.
I'm not taking over anything nor trying to. All of your replies to me have been attempts to start a fight with me. Enjoy the block.
Sex is a binary in the same sense that there is a gender binary. Intersex people exist, and get socialized too. AGAB is a broad category to include people of all sexes and genders
I... never said sex or gender are binary, nor do I understand your assertion that "gender" includes all sexes and genders but "sex" does not.
I wasn't correcting you, I was simply explaining. Sex is often used as a stand-in for "are you a Man or Woman". AGAB avoids that implication while remaining neutral for agender and intersex people.