Sex characteristics

Definition

Sex char­ac­ter­is­tics are phys­i­cal traits, such as repro­duc­tive organs and hor­monal pat­terns, asop­posed to gen­der iden­tity and expres­sion or sex­ual ori­en­ta­tion. Indi­vid­ual sex char­ac­ter­is­tics often do not con­form to those of ‘male’ or ‘female’–such as those of inter­sex and epicene peo­ple. Peo­ple with sex char­ac­ter­is­tics that do not con­form to bina­ries are at risk of being excluded from sex-spe­cific HIV poli­cies and pro­grams. Account­ing for diverse sex char­ac­ter­is­tics is key towards uni­ver­sal access to qual­ity sex­ual and repro­duc­tive health.

For exam­ple, penile con­doms may be unus­able for peo­ple who have under­gone gen­der-affirm­ing surg­eries, so dis­trib­ut­ing them will have a lim­ited impact on HIV pre­ven­tion. Inter­sex peo­ple may also require ser­vices and resources that are not included in tra­di­tional AIDS responses; these can be addressed by adding to train­ings for health­care providers and cre­at­ing inter­sex-spe­cific HIV sup­port groups, among other mea­sures. Includ­ing peo­ple with diverse sex char­ac­ter­is­tic con­tributes to advanc­ing a uni­ver­sal, right-based HIV response.

Expert precedents

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

• “The bio­log­i­cal real­ity of sex char­ac­ter­is­tics must not be con­flated with the social con­struct of gen­der.” (para­graph 16)

Evidence

2022 WHO Consolidated Guidelines on Person-centred HIV Strategic Information

• “WHO rec­om­mends start­ing cer­vi­cal can­cer screen­ing at age 25 years for women liv­ing with HIV, but some women may be screened ear­lier and it is impor­tant to cap­ture this. Gen­der cat­e­gories should include all gen­der diverse peo­ple with a female repro­duc­tive sys­tem such as trans­gen­der men and gen­der diverse indi­vid­u­als who have a cervix, while main­tain­ing pol­icy-pro­tected con­fi­den­tial­ity and pri­vacy for these data to pre­vent their mis­use.” (p. 178)