Understanding the difference between ‘sex’ and ‘gender’ is important for accurate interpretation of statistics. While the terms are sometimes used interchangeably, they have distinct meanings.
Sex: A person's sex is based upon their sex characteristics, such as their chromosomes, hormones and reproductive organs. While typically based upon the sex characteristics observed and recorded at birth or infancy, a person's reported sex can change over the course of their lifetime and may differ from their sex recorded at birth.
Gender: Gender relates to a person's social and cultural identity. It is about their experience as a man, woman or non-binary person. Non-binary is a term to describe gender identities that are not exclusively male or female. A person's gender may stay the same or can change over the course of their lifetime. Transgender is a broad term that can be used to describe people whose gender identity is different from the gender they were thought to be when they were born.
Do AIHW reports use sex or gender?
Where possible, AIHW reports will define what is meant by the terms that they use. However, currently, most AIHW reports present results by whether people are male or female as this is what is recorded in the data collections. In many of these instances, male or female may refer to either sex or gender, depending on the data source. Most current data sources do not record sex and gender as separate concepts so it can be unclear which is the focus.
- Data collected about newborn babies can be assumed to relate to sex (because it is generally based on what physical characteristics are observed at birth).
- Data collected in a survey will most likely relate to gender (because a person will probably record how they identify). This means a respondent might provide a gender response to a sex question. For example, a person born male but living as a woman for many years may select ‘female’ as their response to a question asking if their sex is ‘male’ or ‘female’.
- If a survey is conducted by interview, an interviewer may assume a person's sex or gender rather than ask. Similarly, a service provider may not ask a person to specify their sex or gender, particularly if they do not consider it relevant to the service or treatment.
- Legislation may mandate that only gender be recorded irrespective of data item definitions.
To reduce ambiguity:
- If the data source is known to relate to sex at birth or to gender, this will be specified in the AIHW report. 'Male' and 'female' will then be used in the rest of the report.
- If we do not know if the data source relates to sex or gender, the AIHW report will make it clear that 'male' and 'female' may relate to either sex or gender.
Where we are reporting on a program or initiative that targets a particular population group (such as BreastScreen Australia), the program may have its own way of referring to the people included. Reports will use this wording if it is appropriate and will specify that the wording has been chosen to align with the definitions used by the program.
The language used by AIHW reports on cervical screening is based on advice from the National Cervical Screening Program through a variety of processes, including meetings of program managing and data dictionary working groups. The language used in the data reporting does not precisely match that used in promotion of the program for a number of reasons including the different audiences and the readability of the reporting. The use of the terminology and its meaning is explained to readers on the first page of the report.
- Reporting on cancer incidence and mortality have different conventions to reporting on participation in government programs such as the National Cervical Screening Program. Reporting on cancer incidence and mortality – whether in our prostate cancer reports or in our cervical screening reports – consistently uses ‘women’ and ‘men’ or ‘males’ and ‘females’.
We also use terms like men, women, boys and girls
Terms like 'men', 'women', 'mothers', 'fathers', 'boys' and 'girls' can improve readability and give a human face to our data. Where appropriate, our reports may use these terms and will define what they mean in the context of the report or data collection.
'Men’ and ‘women' are only used for people aged 18 and over. 'Boys’ and ‘girls' may be used when the data relate only to children. If a mix of ages is included (or the age range is unclear), 'males’ and ‘females' will be used if appropriate.
Why might Other categories not be included in AIHW reporting by sex and gender?
Some data sources may include data on 'Other' sexes or genders (such as intersex or non-binary gender).
While the AIHW is keen to include Other categories when reporting by sex or gender, it is not always possible to do so. The main reasons for not releasing these data include:
- Data are not available.
In most cases, AIHW reporting is based on analysis of administrative data that are collected by others. Many of these collections do not capture the information necessary for including Other categories in our reports.
- Population counts are not available.
Many of the statistical tools we use in our analyses require population data. For example, population counts are used in the denominators of proportions and rates. Reliable population data for Other categories for sex and gender are often not available.
- Confidentiality concerns.
When populations are disaggregated by sex or gender it is common that the number of people counted in the Other categories is small. This is particularly the case when sex/gender is further disaggregated by additional data items, such as sub-state geographies. Small counts can give rise to re-identification risks. In such instances, the AIHW takes steps to protect the data, which can include not releasing the data in question.
How information might be presented in AIHW reports
Here are a couple of examples of how we might present information about sex and gender in our reporting:
The data in this report is based on a survey where participants were asked to select their sex as 'male', 'female' or 'other'.
It is not known whether participants who completed this field were referring to their sex at birth, or to their gender identity. This should be kept in mind when interpreting these statistics.
This report uses the terms 'men and women' to mean 'male and female', but it should be noted that some participants may not identify with these terms.
Due to small numbers, results for participants who selected their sex as 'other' are not available.
The data in this report is based on hospital admissions records. Patients' sex was recorded as 'male', 'female' or 'other'.
Depending on the practices of the hospital, this may be based on what the patient selected, or how hospital staff completed the record. It may also be based on an existing hospital record for the patient, which may no longer reflect how they identify.
It is important to note that it is not known if the people completing these records interpreted sex to mean sex at birth or gender identity.
This report uses the terms 'men and women' to mean 'male and female', but it should be noted this some participants may not identify with these terms.
Due to small numbers, results for people whose sex is recorded as 'other' are not available.
Use of inclusive language
Where possible, and where gender is not relevant to the reporting, the AIHW uses gender-neutral language (for example, ‘they’ or ‘their’ rather than ‘he/she’ or ‘his/her’). An example might be when reporting on use of health services:
Each participant was asked to record information about their use of health services during the month-long study.