JOURNALISTS SHOULD NOT USE THE TERM ASSIGNED SEX AT BIRTH WHEN COVERING TRANSGENDER ISSUES

Independent health and science journalist Benjamin Ryan's Substack focuses on pediatric gender medicine in particular.

 

Journalists Should Not Use the Term “Assigned Sex at Birth” When Covering Transgender Issues

 

A political-activist term misappropriated from the intersex context, it sticks a thumb on the scale regarding a contested legal issue about which reporters should strive to observe neutrality.

Benjamin Ryan

Jan 08, 2026

 

In its contribution to the media coverage of Bari Weiss’s young tenure at the helm of CBS News, The Guardian reported this week about a recent dust-up among CBS staffers over the proper terms to use when covering transgender issues.

 

Noting this was an example of “cultural clashes on issues that align with” Ms. Weiss’ “worldview,” The Guardian reported:

 

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A prominent correspondent at the network wrote in an email…that CBS “should refrain from adopting terminology advocated by the movement”, referring to guidance from the Trans Journalists Association’s stylebook about how to use the phrase “biological sex”.

 

This didn’t go over well with a CBS producer, who responded angrily: “It’s a TJA style ‘guide’ – that’s what I’m trying to do. Guide us to better coverage.”

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If indeed CBS seeks to produce journalism without fear or favor about highly contested subjects of national importance, the correspondent was correct about the path to better coverage. Much of the nomenclature that the transgender movement has pushed journalists to employ comes with baked-in activist conclusions. What’s more, a lot of these terms are nonsensical. While it’s vital that reporters respect transgender people’s dignity, journalists need not heed pressure campaigns demanding that they totally overlook objective, scientific reality.

 

Regarding the term “biological sex,” which is reviled by many transgender advocates, the alternative they typically press reporters to use is “sex assigned at birth.” Journalists who are neither activists nor pundits and who at least strive for neutrality in their reporting should not use that term for two reasons:

 

1) It is unscientific doublespeak. In all but the rarest exceptions (which I will go into) sex is not “assigned,” it is observed and documented at birth.

 

2) It is a political-activist term that takes sides in a complex, multi-pronged debate. This includes unsettled policy questions about trans people’s right to access single-sex spaces, including prisons, domestic violence and homeless shelters, bathrooms and locker rooms, and sports teams.

 

The TJA stylebook that the CBS staffers were debating reads:

 

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Assigned sex at birth is the sex marker given to a person based on anatomical and other physical traits observed at birth. The purpose of this wording is to clarify that people are given sex and gender labels by other people, such as medical professionals; they do not simply have these labels automatically.

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Some of this makes perfect sense. Indeed, when we are born, the people around us, adhering to the broader culture, generally assign us a host of gendered expectations in keeping with our sex. These deeply ingrained cultural norms influence how we are supposed to dress, socialize, sound, walk, talk and even smell.

 

One need not be transgender to chafe at such burdens, which in some cultures—think of Iran—are extreme enough to amount to a sartorial prison. Second-wave feminism was animated by American women’s aspiration to break free of the mid-20th-century gendered shackles that bound them and held them back in life.

 

From her perch at the ACLU, the late Justice Ruth Bader Ginsburg spawned a civil-rights revolution beginning in the 1970s through her approach to five words, “on the basis of sex.” She put the cause most plainly and evocatively when she said: “I ask no favor for my sex. All I ask of our brethren is to take their feet off our necks.”

 

To return to the TJA style guide: Except in very rare cases, infants are not “assigned” a “sex marker” at birth as the guide claims. Following delivery, health care providers observe and document a baby’s sex.

 

Here come the routine protestations about intersex conditions. The intersex debate is largely a distraction from the transgender issue, one that invariably devolves to a straw man argument.

 

The very concept of sex assignment emerged in the mid-20th century in the context of rare congenital conditions in which ambiguous genitalia put health care providers in the position of making a judgment call about the baby’s sex. The extension of the “sex assigned at birth” concept to anyone in the general population, including transgender people, amounts to scientific subterfuge.

 

Given the term has been misappropriated by the transgender movement, it demands deconstructing.

 

Firstly, the term “intersex” is increasingly regarded as misleading in clinical medicine, because it suggests the existence of a third sex rather than atypical development within a binary reproductive framework. Binary sex is defined by whether a person’s body is geared around producing either the small gamete (sperm) or the large gamete (ovum), regardless of whether a person is ever fertile. Many academics have convinced themselves in recent years that sex is, in fact, a spectrum. It is the journalist’s job to resist reporting as truth this activist-inflected distortion of one of the most obvious facets of human biology. Going off the rails on this subject is how Scientific American torpedoed its once sterling reputation and made a mockery of its claim to represent science. (SciAm has since distanced itself from its notorious “Sex as a Spectrum” infographic, adding an editor’s note: “This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American.”)

 

This chart was a ridiculous chapter in SciAm’s history (Source: SciAm)

 

The more scientifically precise term that has replaced intersex in recent years is “differences of sex development,” or DSD conditions. While everyone with a DSD is either male or female based on the gamete-based definition, they have variations in facets such as chromosomes or external genitalia that do not align with the typical male vs. female, XY vs. XX phenotypes.

 

It’s easy to fall down a rabbit hole when making sense of all the various types of rare DSD conditions. But for the purpose of accurately determining a baby’s sex, only one fact is relevant: The prevalence of DSD conditions that produce external genitalia that can throw off this determination is only approximately 1 in 5,500, or 0.02 percent.

 

That means that sexing a baby by observing whether they have a penis or a vagina is 99.98 percent accurate.

 

Furthermore, newer technologies, including karyotyping, endocrine testing and imaging, which are in common use in higher-income nations, have greatly minimized the need for physicians to truly “assign” a baby a sex in the face of uncertainty.

 

All this said, while a small minority of transgender people have a DSD, the conditions are medically and conceptually distinct from transgender identity. And the existence of DSD conditions does not undermine the biological reality of binary sex in the general population.

 

By borrowing the term “sex assigned at birth” from the DSD context, the transgender movement has sought to suggest that sex is anything but objective, fixed and binary.

 

The first hit for “sex assigned at birth” in PubMed, the database for scientific publications, is from 1971, when there was one such reference. The term began taking off during the nascent time of what some call The Great Awokening, in 2014. I wrote about HIV science for POZ magazine from 2012 to 2020 and saw it quickly sweep across the literature during that time.

 

Importantly, sex differs from gender, which is subjective, can be fluid, and exists on a multidimensional continuum.

 

Transgender identity is defined by having a gulf or a conflict between one’s sex and gender identity. For some people, this causes the psychiatric condition known as gender dysphoria, which is defined by distress resulting from this conflict.

 

Many transgender people seek to resolve this tension by changing their secondary sex characteristics to more closely align their bodies with their gender identity, such as by taking cross-sex hormones or undergoing gender-transition surgeries.

 

These medical interventions do not, however, change the person’s underlying sex. Because, most fundamentally, they do not provide functioning ovaries or testicles to endogenously produce estrogen or testosterone levels in the normal range of the opposite sex.

 

So when journalists are covering transgender stories, which words other than “assigned sex” should they use when distinguishing between an individual’s gender identity and whether they were born with a body geared around producing the small or large gamete?

 

Alternatives include:

 

“Biological sex”

 

“Natal sex”

 

“Birth sex”

 

“Sex on the original birth certificate”

 

“Born male” or “born female”

 

Or, simply, “sex.”

 

Some in the Bluesky universe have argued in response to my recent X thread about this subject that “biological sex” is verboten because the term was cooked up as an anti-trans dog whistle by conservatives in the mid-2010s. That may be so. But just as LGBTQ people have reclaimed the word “queer” whether many of us Gen X gays like it or not, so can well-meaning people use “biological sex” without the transphobia that flourishes in certain corners of the far right. If the term simply seems too tainted, then “natal sex” is a decent alternative; it seems to ruffle fewer feathers. The TJA, in fact, endorses doing so, calling that term less politicized than “biological sex.”

 

Notice that Greg pivots from my argument about transgender people to one focused on DSDs. This is the misappropriation of the term "sex assigned at birth" at work.

 

I’ve written before about how, when discussing transgender people, using the simple word “sex” is often insufficient; a qualifier like “natal” or “biological” is necessary for clarity. True, people generally didn’t need this qualifier before the social revolutions of the mid-2010s. Before then, concepts of male and female sex were more universally understood. One need not have fallen under the thrall of advocacy groups to have intuited since then that the use of these qualifiers became necessary in some contexts after the transgender movement greatly complicated those concepts.

 

ACLU litigator Chase Strangio, for one, noted in his Dec. 4 interview with The New York Times’ Ross Douthat that the law saw no need to define sex until a decade ago. “We start to see this impulse to define sex for purposes of sorting and excluding trans people that comes in 2016,” Mr. Strangio said.

 

That is one way of looking at it. Another is to recognize that trans advocates such as Mr. Strangio sought to alter not just the social or medical definition of sex, but the legal definition, for the purpose of including trans people into single-sex spaces.

 

Rhetoric is the law’s most essential raw material. And so, grounded in medical and scientific jargon that shouldn’t even apply to transgender people, the term “assigned sex” is at least a de facto legal argument. By implying that sex is fungible, the term suggests that that transgender people should, by default, be granted access to spaces segregated for the opposite sex. Given these questions remain a matter of unsettled policy debate, it is not the place of the journalist who aspires to neutrality to use rhetoric that effectively takes a side. (There are plenty of journalists at The Guardian in particular who stop at nothing to telegraph their left-wing-activist bona fides, both in their reporting and on social media. But it is my opinion that their greatest legacy as reporters will be in undermining trust in media for making it so glaringly apparent that many reporters have no interest in neutrality.)

 

On Tuesday, the Supreme Court will hear oral arguments over the question of whether states may adopt laws that restrict girls’ and women’s sports teams to those born female. Journalists should not write about this case with language like “assigned sex” that effectively sides with the plaintiffs—two transgender female athletes who filed suit against such state restrictions.

 

The use of a qualifier such as “natal” before the word “sex” need not imply that anyone is, on the other hand, opposed to transgender people living and being treated as their own gender on principle or in practice. Saying someone is “biologically male” does not inherently preclude supporting natal males’ effort to take estrogen, get breast implants, have voice therapy, or the like. Nor should it encourage anyone to discriminate against them or treat them disrespectfully or to engage in acts of violence in their direction.

 

Making a distinction between an individual’s sex and gender identity is often unnecessary. But there are various contexts in which it is relevant, even vital. Doctors left in the dark about a transgender patient’s biological sex, for example, might fail to screen those presenting as male for pregnancy or those presenting as female for prostate cancer. (As the survivor of a male cancer, this one is important to me!)

 

Journalists seeking to cover transgender issues are in the unenviable position of being pressured by all sides to adopt language that serves the interest of activist campaigns: “mutilation” to describe gender-transition surgeries for minors; or “gender-affirming care” to paint a picture of cross-sex hormone prescriptions that are never given in error to people who will wind up detransitioning. Reporters should strive to use language that is as neutral as possible, sticking with the science without taking sides, even as they invariably get accused of transphobia or misogyny depending on the audience’s biases.

 

For The Guardian to claim that using the term “biological sex” as opposed to “sex assigned at birth” amounts to fealty to Bari Weiss’ “worldview” is to get it exactly backwards. It is the reporter’s job to clearly establish objective reality, such as the binary and fixed nature of sex. Claiming that sex is fungible is what is the product of a worldview. Reporters should not align themselves with such advocacy if they are to maintain the public’s trust.

 

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AH: Sex and gender are the same thing. It is simply that there is significant diversity within the gender binary, which trannies and their allies can't or won't acknowledge.