Health Professional News, Mighty Blog

Breaking the binary: understanding gender expression

Lawmakers in state legislatures across the nation have filed nearly 200 bills so far this year to erode protections for transgender and gay youth or restrict discussion of LGBTQ topics in public schools. More than 160 measures to restrict LGBTQ rights are still pending, which is nearly quadruple the number of similar bills introduced three years ago, according to LGBTQ advocacy group Freedom for All Americans. At least 29 bills seek to ban gender-affirming medical care for transgender youth.

Many transgender, non-binary and gender expansive kids, teens and adults continue to struggle to find safe spaces, to fully express themselves and embody their true identities. The American Academy of Pediatrics (AAP) and the American Medical Association endorse medical treatments for transgender patients, including hormone therapy, saying such care saves lives.

In the Talking Pediatrics podcast Breaking the binary: expanding gender identity and expression, Dr. Angela Kade Goepferd, (they/she), medical director of the Gender Health program at Children’s Minnesota, explores gender binary and the importance of expanding gender expression.

Podcast guest Nick Alm is the founder of Mossier, an organization that collaborates with companies to develop LGBTQ-inclusive workplaces. Alm identifies a non-binary and uses they/them pronouns. They talk about their experience growing up queer and their work to create spaces and a culture where everyone feels seen and safe.

Dr. Angela Kade Goepferd, (they/she), is the chief education officer, chief of staff, pediatrician and medical director of the Gender Health program at Children’s Minnesota
Dr. Angela Kade Goepferd, (they/she), medical director of the Gender Health program at Children’s Minnesota

The spectrum of gender diversity

Gender binary is the idea that there are only two genders: man/male and woman/female. But as some LGBTQ people grow into their identity, they may not feel comfortable identifying with either of these options. Someone who is gender non-binary does not identify exclusively as a man or a woman. “Non-binary is an expansion of gender, coloring outside the lines,” according to Alm. “I use non-binary in a technical sense to simply say that I am not a man, I’m not a woman. I channel a little bit of both sometimes, sometimes neither.”

Gender identity (how someone perceives themself) and gender expression (how the individual behaves) are not always clear cut or visibly distinguishable. Dr. Goepferd explains, “The difference between gender identity and gender expression – that someone’s identity, who they see themselves as, transgender or non-binary, or whatever the label is that they’re picking, gender fluid – is different than the way they choose to walk out the door on a day-to-day basis. And that gender expression can be really fluid; it can be both masculine and feminine. There’s no one way to be any one gender identity.”

Nick Alm, (they/them), founder of Mossier
Nick Alm, (they/them), founder of Mossier

The importance of pronouns

Gender binary pronouns (she/her, he/him) don’t always fit with how someone identifies. Individuals who are gender non-conforming may instead use the non-binary pronouns they/them.

Using someone’s preferred pronouns can demonstrate respect and the desire to help create a safe place for them. A study in the Journal of Adolescent Health found that using the chosen or preferred name and pronouns for transgender youth is linked to lower rates of depressive symptoms, suicidal ideation and suicidal behavior.

Support for transgender kids

Health professionals agree it’s important for kids to be able to explore who they are in the context of school, because it’s so much of their world. Dr. Goepferd reiterates gender identity is an important part of who an individual is, but it is also only one part of what makes a kid amazing. Elevating conversations about gender identity and normalizing the use of preferred pronouns in schools and workplaces paves the path for greater understanding and acceptance.

Listen to the podcast episode

Listen to the podcast episode: Breaking the binary: expanding gender identity and expression or read the full transcript.

The Gender Health program at Children’s Minnesota

All kids deserve to grow up happy, healthy, safe and strong, including transgender youth. The Gender Health program at Children’s Minnesota is exclusively pediatric and hosts a team of physicians specializing in pediatric gender health, endocrinology, gynecology, psychiatry and a mental health team with psychologists and a clinical social worker. Learn more about the Gender Health program at Children’s Minnesota.