Gender identity and expression


Gen­der iden­tity refers to each per­son’s inter­nal and indi­vid­ual expe­ri­ence of gen­der. Peo­ple have their own sense and right to decide whether they want to be a woman, a man, both, nei­ther, or any­where along the gen­der spec­trum. Gen­der iden­tity may be the same or dif­fer­ent from birth-assigned sex. Gen­der iden­tity refers to how a per­son pub­licly expresses or presents their gen­der. Gen­der can be expressed through behav­ior and out­ward appear­ance, includ­ing dress, hair, make-up, body lan­guage, and voice. Pro­nouns are com­mon ways of express­ing gen­der. Gen­der expres­sion is sep­a­rate and inde­pen­dent from sex­ual ori­en­ta­tion and sex assigned at birth.

While glob­ally there is an increas­ing accep­tance of the fact that gen­der exists on a spec­trum instead of a binary choice between man or woman, there are still many laws and poli­cies lack­ing inclu­sive lan­guage with respect to gen­der-diverse pop­u­la­tions. This per­pet­u­ates stigma and vio­lence, pre­dis­pos­ing gen­der-diverse pop­u­la­tions to poor health out­comes and human rights vio­la­tions. Fail­ure to rec­og­nize gen­der-diver­sity pop­u­la­tions is detri­men­tal to con­trol of HIV because there is a lack of sen­si­tiv­ity towards the needs and demands of key pop­u­la­tions and vul­ner­a­ble groups. Soci­etal stigma leads to impov­er­ish­ment and increases vul­ner­a­bil­ity. This in turn increases the propen­sity to be exposed to sex­ual vio­lence and deprives access to health­care and pre­ven­ta­tive ser­vices because of dis­crim­i­na­tory treat­ment by the health­care providers.

Reports by the Spe­cial Rap­por­teur on the Right to Health reflected in the Lan­guage Com­pendium rec­og­nize that to achieve a com­pre­hen­sive health response to vio­lence it is nec­es­sary to adopt “an inclu­sive and non-binary approach to gen­der and gen­der-based vio­lence.” Laws, poli­cies, pro­grammes, and ser­vices address­ing gen­der-based vio­lence should be “inclu­sive of all per­sons, with or with­out dis­abil­i­ties, chil­dren and adults, and should include cis­gen­der, trans­gen­der, non-binary, queer and inter­sex peo­ple.”

Expert precedents

2022 Report of the Special Rapporteur on the Right to Health

2022 Report of the Independent Expert on SOGI: Practices of Exclusion

2022 Report of the Independent Expert on SOGI: Law of Inclusion

2016 General Comment No.22 on the Right to Sexual and Reproductive Health


2022 WHO Consolidated Guidelines on HIV, Viral Hepatitis and STI Prevention, Diagnosis, Treatment and Care for Key Populations