Sex and gender

A warning: This is a educational piece about collecting sex and gender in forms. There is no pornographic material, written or visual. However, some people may find the content of this post — in particular, some of the language used — challenging, confronting or upsetting. Please use discretion and look after yourself.

‘Sex’ and ‘gender’ in forms: more than meets the eye

Many of us understand the idea of a person's ‘sex’ or ‘gender’ as something simple: it's whether the person is a man or a woman:

  • two choices;
  • everybody fits into one category; and
  • sex and gender are, for all intents and purposes, the same thing.

The reality is much more complex than this:

  • not everybody is either a man or a woman;
  • there are more than two choices; and
  • sex and gender actually refer to two different and distinct attributes.

This complexity is not a new phenomenon. For as long as there have been humans, there have been people born with a mix of male and female biological and psychological states. It's just that as our societies become more comfortable with diversity, we have greater exposure to the existence of such sex and gender variation.

As forms designers and developers, we have a responsibility to make sure that our questions are appropriate, and that there are answer options for every form-filler. So, while there is much more to ‘sex’ and ‘gender’ than even we at Formulate could wrap our heads around, it's important to be across some key points. This will make your forms more relevant and inclusive, at the same time improving data quality. Sensitivity to the form-filler is also a good way to maximise conversion and completion rates (who wants to fill out an insensitive form?).

What are ‘sex’ and ‘gender’?

Because of the intricate association with deep issues such as mind and body, identity and culture, and society and the individual, there actually aren't any consensus definitions for sex and gender. But for general form design purposes [1], it is sufficient to use the following very broad descriptions:

Sex
The biological — but not binary — distinction between male and female.
Biological can mean anatomical (e.g. breasts or a penis), hormonal (e.g. level of oestrogen) and/or chromosomal (e.g. X, XY or XXY)
Gender
How a person identifies (psychologically) and/or expresses themselves.
Someone's gender may or may not make reference to their biological sex. For example, a person with female genitalia may feel like, and identify as, a man. Another person may identify as “genderqueer”, signifying that they see themselves outside the binary constructs of male and female.

As you can see, what a person would report as their ‘sex’ can be very, very different from what they may say is their ‘gender’. This is why you need to think very carefully about what it is you want to collect with your form.

When to collect sex and when to collect gender

Do you need to collect sex or gender at all?

Because the answers to questions about sex and gender can be so intimate and meaningful, by default it's better to not ask these questions at all. Ask yourself: do you really need to know a person's sex to provide your product or service?

Lucy Boyes raised this question with the UK on-demand television service 4oD. To access certain content — including (ironically) programs on gender — viewers needed to fill out a registration form. The form included an (apparently mandatory) question on gender, but as Lucy points out, it's not at all clear why gender would be needed to provide access to on-demand television. By including this question in their registration form, the service is undoubtably losing potential viewers, if an answer must be provided.

In many cases, sex and gender are not needed, as such, but the information is wanted for marketing and research purposes (such as understanding the customer base). In these situations, questions about sex or gender should, at the very least, be optional, so if the form-filler isn't comfortable disclosing the information, they don't have to. It also improves the experience for users like Lucy if you explain that the information is being used for demographic or profiling purposes.

Choosing the right concept

If there is a need for sex or gender information, be sure you use the definitions above to choose correctly between the two.

If what you're interested in is biological identity, don't be afraid to use the word ‘sex’ on your form. It is the right term for this concept, hence its use by world-leading national survey agencies like the Australian Bureau of Statistics (e.g. on the National Census of Population and Housing). This usage of the word will also be increasingly familiar, as understanding about sex and gender variants grows.

Also think about comparisons that you might make between the data on your form and other data sources. For example, suppose you need to run a criminal record check on the form-filler, match the form-filler's data with a motor vehicle registration database, or compare your form-fillers against demographic or marketing statistics. To do any of these things, you'll want to make sure that you collect sex and/or gender in the same way as those other sources did.

Response options

Collecting the right information means not only getting the question right, but also providing the right answer options. Again, you should be aware of recognised definitions and related datasets. But if you have scope to choose your own response options, what should you choose?

Answer options for collecting ‘sex’

Because a person's sex can be influenced by a number of factors, such as anatomy, hormones or genetics, it is more accurate to think of sex as a spectrum rather than two distinct categories. The Intersex Society of North America describes this well:

"For example, a person might be born appearing to be female on the outside, but having mostly male-typical anatomy on the inside. Or a person may be born with genitals that seem to be in-between the usual male and female types — for example, a girl may be born with a noticeably large clitoris, or lacking a vaginal opening, or a boy may be born with a notably small penis, or with a scrotum that is divided so that it has formed more like a labia. Or a person may be born with mosaic genetics, so that some of her cells have XX chromosomes and some of them have XY.

The term ‘intersex’ caters for people who don't fit ‘typical’ definitions of male and female. Someone who is intersex has some combination of male and female biology. Including the option of ‘intersex’ on our forms, as shown in Figure 1, means the full spectrum of sex is covered.

Figure 1: Recommended approach for collecting sex information on forms

Note that there is no consensus about where the boundaries lie when it comes to ‘female’, ‘intersex’ and ‘male’. Thus, two people describing themselves as intersex could have very different biologies. If your form is being used in a medical or legal context, it may be necessary to collect further information.

Do we really need an intersex option?

You may be thinking that intersex is so uncommon that it doesn't warrant including a distinct answer option on your form. After all, with forms generally we often don't include a named response option for every single case that exists: we name the main cases and then provide an ‘Other’ option. If we did have a named response option for every single case, there would often be too many choices for form-fillers to deal with.

The thing is, intersex is quite common. The lack of consensus about the boundaries of intersex (amongst other things) mean that prevalence estimates are hard to come by. An oft quoted rate is about 1 in 2000 births. Yet there is solid reasoning to suggest that the rate might be as high as 1 in 150 or 1 in 70. This would mean intersex is as common as red hair or green eyes. Can you imagine a form that asked for hair or eye colour, and didn't allow for red or green (respectively)?

Australian readers may be interested to know that our recommended approach complies with the Australian Standard (AS) 4590:2006 “Interchange of client information” (a standard for making data easier to share between parties). The Australian government has also recently recognised that intersex is a response option that needs to be provided whenever sex is being collected [2]. This means that increasingly, Australian government agencies must include this option in their forms and allow for it in their databases [3]. Finally, discrimination on the basis of sexual orientation, gender identity or intersex status has also recently been declared illegal in Australia.

Answer options for collecting ‘gender’

Depending on the context — including what the form is for, the organisation behind the form, and the background of the people completing the form — there are a multitude of different terms that can be used to describe gender. These include:

  • female
  • male
  • genderqueer
  • androgyne
  • neuter
  • third gender
  • intergender
  • genderfuck
  • nongender
  • agender
  • nonbinary
  • transsexual or trans
  • butch
  • femme
  • male-to-female (MTF)
  • female-to-male (FTM)
  • questioning
  • ally.

Not all terms will be used by all people, and the same term may have different meaning amongst different communities. For this reason, our recommendation for the gender question is to provide an open text field, as shown in Figure 2.

Figure 2: Recommended approach for collecting gender information on forms.

You may notice that the question itself has been phrased as “Gender identity” rather than just “Gender”. In many cases either label will work, but the benefit of the former is that it reinforces the fact that gender is about self-identification, as opposed to something that we are assigned (e.g. sex at birth) or perceived to be (e.g. you look like a woman).

One situation where the recommend approach may not be ideal is if you want to calculate statistics on the answers (e.g. in a survey). Like any open question, the answers would have to be coded before such statistics could be calculated. By this point we hope it goes without saying that such coding would need to be done very carefully.

If you are concerned about the work this coding would involve, you could always make a compromise, and take the approach shown in Figure 3. Note how the response options are checkboxes, not radio buttons (i.e. form-fillers can choose multiple answers). Also, selection of ‘Other’ should trigger a text field into which the form-filler can provide their chosen description.

Figure 3: Alternative approach for collecting gender on forms.

Concepts related to sex and gender

Name and title

There are a multitude of possible relationships between a person's sex or gender, and other information about them, especially name and title. To give just one example, a person could:

  • have a name from a culture you're not familiar with (such as “Kwasi” or “Firtha”);
  • consider their gender to be FTM;
  • have a female reproductive system but be taking male hormones;
  • consider their sex to be male; and
  • use the title “Dr”.

Clearly, names and titles cannot be used as a proxy for sex or for gender. The same applies in reverse: just because someone's name is Gary Smithers doesn't mean they are male from a sex or a gender point-of-view.

Thus, rather than inferring, it is always better to collect the information you need directly from the person. You'll almost always need a name anyway to identify the person. If you can, refer to them by their name, eliminating the need for a title. But if a title is needed or suits the context, then ask the form-filler for it (perhaps making the question optional).

Admittedly, the place this gets really tricky is pronouns (e.g. “she” or “he”, “his” or “hers”). Again, using actual names is a good way to avoid getting into pronouns (e.g. “Janice's father”). Electronic forms are great because they often allow you to insert the name collected earlier into later questions, to personalise them.

In terms of pronouns, some people like gender-neutral pronouns such as “it”, “zie”, “hir” and “ou”. Others like the plural pronouns (e.g. “they” or “their”). In the past some of these options would have been frowned upon for grammatical reasons, but language is ever-evolving and we have seen these choices appearing more and more.

Of course, the ‘collect it directly’ rule of thumb applies to pronouns also. If it's appropriate for your context, you can ask the form-filler about preferred pronouns, just as Luke Wroblewski did for Bagcheck. For some forms, however, such questions mean going into just a bit too much detail, or they don't really suit the context.

Sexual orientation

‘Sex’ and ‘gender’ are not to be confused with another distinct concept, ‘sexual orientation’. Sexual orientation refers to who an individual is attracted to, either physically, romantically or emotionally. Categories of sexual orientation can include straight or heterosexual, lesbian, gay, bisexual or asexual.

Of course, just as for sex and gender, a person's sexual orientation may can be fluid, and is very personal.

Get a personal perspective

It can be hard to appreciate just how important a single form question about sex or gender can be, especially if this post is the first time you've been exposed to the complexity behind the concepts. But the best designers come from a place of empathy, not just ‘rule following’. So, if you want to get a real insight into the importance of sex and gender in form — or even if you don't — we strongly recommend you check out one or more of the wonderful articles below.

Walk a mile in another person's shoes, and your forms will be better for it. You might also be tempted to buy this t-shirt (thanks to Caroline for the link).

Figure 4: Gender variability captured in a t-shirt.


[1] In specific situations — e.g. healthcare and social research — you may need to take a different approach to sex and/or gender than the one described here. Don't be afraid to override the generic advice to suit your specific context (provided, of course, you have good evidence or rationale to do so).

[2] In forming the new guidelines, the Australian government recognised that sex and gender are two different things. Unfortunately, they didn't build on this knowledge to recognise that the response options may therefore need to be different. Thus, the guidelines propose the same response options — male, female and indeterminate/intersex/unspecified — regardless of whether the question is asking about sex or gender.
Another problem with these options is that they group the ‘don't know’ (i.e. indeterminate) and ‘not stated’ (i.e. unspecified) responses with a valid, stated option of intersex. As has been well established by the field of research, ‘don't know’ and ‘not stated’ need to be identified separately.

[3] Interestingly, the Australian Bureau of Statistics recently embarked on a review of how they collect sex. As at 25 July 2013, results had not yet been published.