I have been following lately the debate that has emerged in the Greek and International literature regarding the terms “sex” and “gender”. Traditionally, the term sex refers to the assignment of gender at birth by the obstetrician or the midwife, based on the external genitalia. They declared the sex of the newly born baby as male or female, without any other graduation. Therefore, the term sex is a nonflexible categorical concept. It is quite difficult to comprehend the sense of “a little bit male” or “a little bit female”, as it is not possible to comprehend the sense of “a little bit pregnant”.

At the preface of the DSM-5, the American Psychiatric Association presents its intention to propose the new dimensional classification of psychiatric symptoms, based on the rationale that the present categorical system does not apply to clinical and research needs.1 In that case, it would be difficult (if not impossible), to achieve the graduation of the term “sex”, which refers to the biological definition.

Therefore, in my opinion, there is a trend to bring back the term “gender”, where a graduation is feasible, and dimensions can be applied. The term gender contains the social definition of reproductive behavior, which can be detached from the reproductive role per se.

The term “gender” was recalled in 1955 by the well-known author J. Money, in order to indicate the social effect on the development of the behavior of “sex”, and therefore he used at the beginning the term G-I/R, which refers to Gender Identity Role.2

The short term “gender”, that derived from the abovementioned term, came up the recent years and was widely used, putting aside the clearly biologic, non-flexible term “sex”.3 The term “gender” spread in the literature, especially when it was adopted by the women rights’ movement (feminism), in order to highlight the “socially constructed” differences between the two sexes.

The term “gender” has given ground to the proposal of several graduations of sexual behavior. Zucker et al at in a recent article report ten different gender behaviors such as agender, gender nonconforming, gender neutral, gender variant, gender queer, gender dysphoria, gender fluid, bigender, nonbinary, transgender.4 Several of these identities overlap considerably.

In the Greek language, the use of the terms gender and sex (male, female) may lead to confusion, since they are attributed by the same term «φύλο».

Additionally, the use of the term “gender” in Greek as «γένος» may also lead to misunderstandings and misconceptions, as it happened lately with the law regarding the name change in the identification card (ID) of people with gender dysphoria. Actually, the latter term refers to masculinity or femininity, as these are configured by the social background.

In my opinion, in the Greek language it would be better to use the term “gender” referring to its social delineation, meaning “social sex”, social sex identity. The term “gender dysphoria” could be attributed as «δυσφορία γένους», in order to distance itself from the dysphoria caused by dysplasias of genitalia which are refered to in the literature as “intersexual disorders“ and could be referred to as “disorders of the development of genitalia“.


  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th Ed. American Psychiatric Publishing, Arlington, VA, 2013
  2. Money J. Hermaphroditism, gender and precocity in hyperadrenocorticism: Psychologic findings. Bull Johns Hopkins Hosp 1955, 96:253–264
  3. Haig D. The inexorable rise of gender and the decline of sex: social change in academic titles, 1945–2001. Arch Sex Behav 2004, 33:87–96, doi: 10.1023/b:aseb.0000014323.56281.0d
  4. Zucker KJ, Lawrence AA, Kreukels BP. Gender Dysphoria in Adults. Annu Rev Clin Psychol 2016, 12:217–247, doi: 10.1146/ annurev-clinpsy-021815-093034

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