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.
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)
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)