WHO wades into contentious debate about sex and gender


The World Health Organization says sex “is not limited to male or female” as it plans to update a manual used by public health professionals to recognize gender and sexual diversity, wading into the thorny debate about whether gender is strictly binary or something more complicated.

The WHO will solicit feedback through the fall on the update to its manual, which details how gender norms, roles and relations affect health-related behaviors and outcomes.

One key area of focus is gaining attention.

The WHO said it is “going beyond non-binary approaches to gender and health to recognize gender and sexual diversity, or the concepts that gender identity exists on a continuum and that sex is not limited to male or female.”

The health body is still working on the guidance, but it could find itself wrapped in a wider debate about sex, typically defined by biological traits, and gender, which typically refers to social and cultural differences rather than biological ones.

In the U.S., some states have cracked down on transgender athletes participating in female sports, and Texas is investigating gender-affirming care as child abuse. 

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For years, states and localities have debated whether bathrooms should be divided by sex and some parent groups do not want school curricula for younger students to involve talk of gender identity.

While the final guidance still has to be determined, critics said the WHO risks undermining health advice for professionals.

Professor Jenny Gamble, a midwifery expert from Coventry University, described the change as “problematic” in an interview with The Daily Mail.

“It is a dismissal of basic biology — and mistake,” she said. “Biology is a key determinant of health and illness.  

“Not being clear about basic biology opens the door to a range of problems, including very poor health communication but also distorted data,” she said.

The WHO this month also said it will expand on the concept of intersectionality, “which looks at how gender power dynamics interact with other hierarchies of privilege or disadvantage, resulting in inequality and differential health outcomes for different people.”

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