What Is Gender Expression?

Gender expression refers to the ways that people present their gender identity to the world. This may be through clothing, haircuts, behaviors, and other choices. For many people, there is a "mismatch" between what society expects from their gender and how they choose to present.

Buzz cuts, for example, are seen as masculine hairstyles, while wearing dresses is seen as feminine. This expression may vary from what might be expected of one's gender identity. For example, a cisgender woman may have a very masculine expression but still identify as a woman.

This article looks at how gender expression differs from identity, orientation, and other ways of describing sex and gender. It also looks at discrimination on the basis of gender expression.

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The Meaning of Gender Expression

Gender is a concept with many dimensions. When talking about whether people are cisgender or transgender, what is meant is whether a person's gender identity does or does not match their sex assigned at birth.

Gender expression, though, is something else. It refers to how people present themselves, in ways that a wider society may think of as being aligned with one gender or the other. For most people, gender expression affirms their gender identity.

Gender expression usually aligns with a person's gender identity. But it may be different from what the wider culture defines as masculine or feminine behavior.

In other words, people with masculine identities speak, dress, move, or wear their hair in generally "masculine" ways. People with feminine identities make these style and behavior choices in "feminine" ways.

Gender expression is very much a cultural construct. That means there may be a shared social expectation about gender. But it also may mean that the same feminine style of hair or clothing in one setting might be thought masculine in another time or place.

Society will sometimes regulate expression by making women wear certain kinds of clothes, and men other kinds, in order to participate in school, work, and public life. Rules about hair may reflect beliefs about gender too. When cultures enforce gender norms it is known as gender policing, which can range from dress codes to physical and emotional violence. Creating a safe space for all genders requires being aware of these explicit or implicit gender norms so gender policing can be prevented.

Gay men and bisexual cisgender women may be more likely than their straight or lesbian cisgender counterparts to have expression that departs from the expectations about their gender identity.

Research suggests that there are higher rates of discrimination against transgender and gender-nonconforming people compared with the bias against those who are LGBTQ.

Some transgender people use a highly feminine or masculine expression to address their gender dysphoria. This may also lower their chances of being misgendered by others, meaning they are called by a gender or pronoun that does not match their identity.

Gender Expression and Health Care

Gender expression itself does not always need to be addressed by healthcare workers. But it can affect access to and quality of health care. People with an expression that differs from what is expected for their assigned sex at birth may see greater levels of bias and harassment from providers.

This is true for transgender people, but also for lesbian, gay, and bisexual individuals. It's also true for people with a gender expression that is not what their provider expects.

Gender Expression, Pronouns, and Health Care

Gender expression is often what causes a doctor to ask for a patient's pronouns and/or affirmed name, but it is not best practice. In an ideal world, health workers should ask everyone what name they prefer to be called and what pronouns they use.

One approach that may be more affirming is for the doctor to introduce themselves first, using their own pronouns. This simple act invites the patient to share their own without putting anyone on the spot.

In 2020, Lambda Legal released a report about discrimination in health care, called "When Healthcare Isn't Caring." It included those with different gender expressions. Some 30% of respondents feared health workers would treat them differently because of their expression.

The report called for better training for health workers. It also called for broad policies to prohibit discrimination—not just on the basis of sexual orientation and gender identity, but also gender expression.

Blatant discrimination is not the only threat to some patients' gender expression. When doctors and other providers allow their own perceptions and biases around gender to guide their practice, it can create trauma for those in their care. Because medical professionals have authority over their patients, it is especially important that they acknowledge the nuances of gender expression.

Keep in mind that doctors do need to know a person's sex that was assigned at birth. They need to be able to do proper screening tests, such as screening for prostate cancer or cervical cancer.


Minority stress has been shown to play an important role in health disparities. Research suggests that gender expression is a part of the minority stress described by cisgender sexual minorities and gender minorities. This may reflect both a person's expectation that discrimination will happen, as well as the actual bias directed at them.

The effects of gender expression are different depending on a person's sex, gender identity, and the setting they are in. For example, some communities may accept a broader range of gender expressions from people who are seen as female than from those who are viewed as male.

It's a relatively new concept to use human rights law to protect people from discrimination on the basis of gender expression. In 2012, however, Ontario, Canada, passed legislation that forbids discrimination because of it.

A similar law was passed in New York in 2019, and other places have also passed protections. U.S. federal law does not explicitly protect people on the grounds of gender expression, but it does protect against discrimination in health care on the basis of sexual orientation or gender identity. Resources like The National Center for Transgender Equality and the Movement Advancement Project equip people with information about their state's laws and initiatives so they can advocate for themselves and others.


Everyone has a gender expression. If a person's gender expression is what would be expected for their gender identity and/or recorded sex, it would be unusual for anyone to comment on it. But each person chooses how to present themselves to the world, and society views those choices as gendered. Despite growing awareness about gender expression, this still may lead to discrimination in public settings, including health care.

A Word From Verywell

Gender expression is not always static. It can change with time. While some people's gender expression is consistent with society's connotations of masculinity or femininity, others' is more nuanced. This is known as gender fluidity. Some may present as highly masculine one day and highly feminine another. This may or may not have anything to do with their gender identity.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. YWCA West Michigan. Gender Policing.

  3. Sandfort TGM, Bos HMW, Fu T-C (Jane), Herbenick D, Dodge B. Gender expression and its correlates in a nationally representative sample of the U.S. adult population: Findings from the National Survey of Sexual Health and Behavior. The Journal of Sex Research. 2020:1-13. doi:10.1080/00224499.2020.1818178

  4. Kiebel E, Bosson JK, Caswell TA. Essentialist beliefs and sexual prejudice toward feminine gay men. Journal of Homosexuality. 2020;67(8):1097-1117. doi:10.1080/00918369.2019.1603492

  5. Human Rights Watch. "You Don't Want Second Best"—Anti-LGBT Discrimination in US Health Care.

  6. Lambda Legal. When health care isn’t caring: Lambda Legal’s survey of discrimination against LGBT people and people with HIV.

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Additional Reading

By Elizabeth Boskey, PhD
Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.