Inclusive content - Sex, gender and sexuality

The language around sex, gender and sexuality changes all the time. Stay in touch with the communities you are writing for.

People hold strong and differing opinions about language around sex, gender and sexuality. This section should help you get started but the best thing is to test your content and services with the people who use them.

Only mention sex, gender or sexuality if they're relevant, for example, to signpost people and help them get the health information and access to treatment they need.

When to use "sex" and when to use "gender"

Many people think that sex and gender are the same but they mean different things. It's important to be clear about the difference.​

Sex

Sex is biological (male or female). It's based not only on the genes we inherit, but also on how our external and internal sex and reproductive organs work and respond to hormones. Sex is the label that's recorded when a baby's birth is registered.

We use "sex" or, better still, the body part associated with biological sex when we're writing about things like screening that is sex specific, for example, breast and cervical screening.

Sex assigned or registered at birth

We use the phrase "sex assigned at birth" when we're talking about trans health and gender dysphoria, as this is the language our audience uses. In other cases, we use "the sex someone was registered with at birth" because user research shows that most people understand this better as it refers to an actual event.

Intersex

We use "intersex" in some content about people with differences in sex development (DSD) because some people prefer it to DSD.

DSD involves genes, hormones and reproductive organs, including genitals. A person's physical sex development, internally, externally or both can be different to most other people's.

Most people with DSD have a clear sex that is registered at birth. Some adults with DSD prefer the term "intersex" to DSD but they may want to keep their legal sex as male or female. Other people see "intersex" as distinct from male and female.

Gender

Gender is more complex. It refers to our internal sense of who we are and how we see and describe ourselves.

Someone may see themselves as a man, a woman or neither (non-binary). Being non-binary can mean having no gender, a different gender, or being in between genders. Gender can be fixed or fluid. Some people identify with a gender opposite to the sex they were registered with.

We use the word "gender" when we're:​

• discussing the social idea or identity as opposed to the biological sex, for example, if we're writing about gender dysphoria or transgender​ health and social care
• writing about a survey or report based on gender, such as gender diversity​
• writing about the results of a national census, where there is a question about gender identity as well as sex to identify the trans (including non-binary) population​

Gender neutral language

We make content gender neutral as far as possible. In general, we word our content to avoid masculine and feminine pronouns ("he" or "she"). Instead we use "you" where appropriate and sometimes "they" when we need a gender-neutral pronoun (unless this is confusing).​

Avoid asking users for their title, such as Mr, Miss, Mrs, or Ms.

Transgender

We use "trans" as an umbrella term to describe people whose current gender identity or way of expressing their gender differs from the sex they were registered with at birth. Some, but not all, trans people want to transition (change) socially or medically or both.

We use "trans woman" for someone who was registered male at birth and now identifies as a woman and "trans man" for someone who was registered female at birth and now identifies as a man.

We use "trans woman" or "trans man" in content about the particular health needs of trans people - for example, screening or treatments that trans people need to be aware of, like advising a trans man about cervical and breast screening.​

Otherwise, we leave out the word "trans" and just refer to men and women, if relevant.

Note: we use "sex assigned at birth" when we're writing for a trans audience. Read more about sex assigned or registered at birth.

Sexuality

We use language about sexuality when it's helpful to signpost or help people get the health information and access to treatment they need.​

For example, when we're talking about specific sexual health services or sexual health content, we use words like:​

• lesbian
• gay
• bisexual
• men who have sex with men (MSM includes men who may not identify as gay)​

Help us improve this guidance

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If you have any questions, get in touch with the service manual team.

Updated: September 2021