Co-creating a new theory of gender beyond the binary: A Delphi study in the United Kingdom

Figures & data

Figure 1. Summary of Delphi process.

Table 1. Participants’ demographic information.

Characteristics			Round 1 participants (n = 35)		Round 3 participants (n = 26)
Age			M	SD	M	SD
			20.54	2.94	20.96	2.93
Location	London		7		4
	South East		10		8
	North West		2		2
	East of England		1		0
	West Midlands		1		1
	South West		3		2
	Yorkshire and the Humber		3		2
	East Midlands		0		0
	North East		3		2
	Scotland		4		4
	Northern Ireland		0		0
	Wales		1		1
Employment	Full-time student (School/College)		10		8
	Full-time student (University)		11		9
	Part-time student (University)		1		1
	Full-time employed		8		5
	Part-time employed		1		1
	Self-employed		1		1
	Unemployed		3		2

Table 2. Participants’ self-constructed identities.

Age	Ethnicity	Gender identity	Sexual identity	Religion/faith	SEN and/or disability (including self-identified)	Round One Completed	Round Three Completed
21	Caucasian	Transgender female	Bisexual	Atheist	Processing speed difficulty	✔	✔
19	White British	Strongly feminine, occasionally masculine	Biromantic, asexual	Non-religious	N/A	✔
21	British	Transgender	Gay	N/A (did not disclose)	N/A	✔	✔
25	White British	Questioning cis-female	Pansexual, demiromantic, polyamorous	Agnostic, atheist	ADHD	✔
22	British	Male	Straight	Christian	N/A	✔	✔
16	White British	Transgender male	Bisexual	Non-religious	Autism	✔	✔
16	White Irish	Transmaculine, bigender	Bisexual, queer	Agnostic	Autism	✔	✔
23	White British/Irish	Transgender man	Bisexual, pansexual	Christian, paganism	Dyspraxia, with traits of dyslexia	✔	✔
24	Mixed	Male, but not very masculine	Asexual	Atheist	N/A	✔	✔
24	White British	Trans man	Biromantic, asexual, queer	Atheist	Autism	✔	✔
23	White British	Transgender male	Pansexual	Atheist	N/A	✔	✔
22	Scottish	Trans woman	Lesbian	Atheist	ADHD, Autism, Dyslexia	✔	✔
22	White British	Non-binary, occasionally agender	Bisexual	Atheist	ADHD	✔	✔
17	White	Transwoman	Bisexual	Agnostic	Anxiety	✔	✔
22	White German	Non-binary, masculine leaning	Bisexual	Pagan leaning	ADHD	✔
17	Indian	Transgender male	Straight	Agnostic	N/A	✔
17	British Pakistani	Demiboy	Gay	Non-practicing Muslim	N/A	✔	✔
19	White Mixed	Between neutral/third gender and male	Omnisexual	Exploratory	Autism	✔
20	White British	Non-binary	Queer	Non-religious	ADHD	✔
25	Indian	Male	Gay	Hindu by birth, but no strict religious beliefs	N/A	✔	✔
19	White British	Trans male	Queer	Buddhist, atheist	Neurodivergent (ADHD and Autism), Physical disability (ME/CFS)	✔	✔
21	White British	Genderqueer, gender non-conforming, female aligned	Lesbian	Atheist	N/A	✔	✔
21	Mixed South-Asian, White	Female	Bisexual	Agnostic	N/A	✔	✔
25	White British	Non-binary	Bisexual	Non-religious	ADHD, mental health history	✔	✔
18	White	Non-binary	Bisexual	Atheist	Autism	✔	✔
19	White	Demigirl, plural	Asexual, caedsexual	Vaguely pagan	C-PTSD with frequent amnesia and motor control loss	✔
25	White European	Female	Bisexual	Non-religious	N/A	✔	✔
21	White	Trans woman	Lesbian	Agnostic	N/A	✔	✔
20	White British	Questioning male	Gay	Atheist	N/A	✔	✔
25	White British	Genderfluid	Queer	Unsure	Autism	✔	✔
17	White British	Ambivalent	Queer	Wiccan	Autism	✔	✔
16	White European	Trans masculine, non-binary	Queer	Atheist	Dyslexia, undergoing Autism diagnosis	✔
18	White	Demigirl	Bisexual	Atheist	Autism	✔	✔
22	White	Woman	Questioning	Atheist	N/A	✔	✔
17	White European	Non-binary	Pansexual	Atheist	Autism	✔

Table 3. Summary of the total number of statements included in this Delphi study.

Number of statements generated from the systematic literature review	83
Number of statements contributed by panelists during round one	22
Total number of statements rated by panelists across all three rounds	105
Total number of statements that met strong consensus and were deemed very relevant to the way in which gender is viewed	20
Total number of statements that met consensus and were deemed relevant to the way in which gender is viewed	31
Total number of statements for which there was strong consensus that were not relevant to the way in which gender is viewed	18
Total number of statements for which there was no overall consensus as to whether or not they were relevant to the way in which gender is viewed	36

Figure 2. Visual representation of statements reaching consensus.

Table 4. Very relevant to the way in which gender should be viewed.

A person can feel that their body doesn’t match their experience of their gender Sex and gender are two separate constructs A person can identify with another sex more than their assigned sex A person’s gender identity can differ from their birth-assigned sex A person can identify as neither male or female Ideas and systems of classification related to male and female are outdated A person may not have a gender A person may identify as having a specific, further gender outside of the binary Gender identity can be fluid for some and static for others* A person’s gender identity does not always match their gender expression A person’s expression of their gender can change over time Gender identity is fluid and can fluctuate over time Society’s understanding of gender can change over time* Use of identity terms continues to evolve over time Non-binary is an umbrella term to capture a range of identities and experiences Transgender identities are valid with and without medical interventions* Gender and pronouns are not always connected* Not all people who alter their gender expression are transgender The way a person expresses themselves is inherently non-gendered; we apply a construct of gender to our understanding of a person’s expression (e.g. a person dressing a certain way) A transgender man may present as ‘feminine’, or a transgender woman may present as ‘masculine’, without compromising their identity as a transgender person*

Table 5. Not relevant to the way in which gender could be viewed.

Gender is exclusively male and female Sex and gender are the same constructs A person can only express themselves as male and female A person’s experience of gender is fixed and cannot change You can confirm someone’s gender with physical markers You can confirm someone’s gender with expressive markers A person should express their gender in line with the gender they have been assigned at birth In choosing a gender, individuals accept a binary narrative Only transgender people need to alter their bodies through physical markers Being transgender means your gender identity is either male or female How someone was assigned at birth should be reinforced through socially required identification, which places a person in one or the other male/female category (e.g. use of bathrooms) A person should learn to act in accordance with their gender (e.g. a person being assertive due to their gender) A person should learn beliefs about themselves in accordance with their gender (e.g. a person feeling more confident in their math or English abilities due to their gender) A person’s expression of their gender cannot change over time A person should be gendered using physical markers Certain expressive markers tells us the individual belongs to another gender (e.g. using make-up implies you are female) Medical measures, that result in permanent changes to the body, oppose the idea of gender fluidity) Gender should be assigned at birth

Table 6. Relevant to the way in which gender should be viewed.

People should maintain a less gender-based outlook across all areas of life* People are inherently non-gendered; we apply a construct of gender to understanding our bodies People are inherently non-gendered; we apply a construct of gender to our understanding of how people experience themselves A person can alter their gender expression to match their gender identity A person can identify as a mixture of male and female A person’s experience of gender can change over time A person can identify as more male or more female A person can experience themselves to be more or less masculine, or more or less feminine A person can experience themselves to be both masculine and feminine The way a person expresses themselves can combine masculine and feminine elements The way a person expresses themselves can possess neither masculine nor feminine elements A person can identify equally with both sexes Gender identity can fluctuate over contexts and social environments A person’s experience of their gender can change because of their lived experience The way we can experience gender can be influenced by other factors (e.g. ethnicity, disability, age)* A person’s experience of their gender can change because of external pressures (e.g. expectations of other people – parents/teachers etc.) A person can change their expression of their gender to fit the norms of the environment (e.g. a person following a school uniform code) A person can change their expression of their gender to challenge the norms of their environment Terms such as “genderqueer” and “non-binary” help label gender What a term means to one individual may mean something different to another You do not need to label gender with an identity term (e.g. genderqueer; non-binary; male; female) Gender expression is the ways in which an individual presents their gender Some transgender people identify with binary genders (e.g. man/woman) Changing your gender expression, even to the point of medical intervention, is not exclusive to transgender people* They/them pronouns should be used for all, unless you have been told the pronouns a person uses* Not every non-binary person uses they/them pronouns* Pronouns are an important and affirming expressive marker* Pronouns are not indicative of gender* Individuals are allowed to decide how they would like their physical markers to be interpreted by others* There is a lack of gender-neutral expressive markers Physical markers should be an individual’s personal choice*

Table 7. Delphi statements that did not reach consensus.

A person can experience themselves to be only male or female Sex refers to being male or female Sex refers to the physical markers of classifying individuals as male or female (e.g. genital differences at birth or chromosomal differences) Sex is generally fixed, but there are outliers (e.g. intersex; those who change through medical interventions)* It’s important to know someone’s gender It’s okay to assume someone’s gender based on their physical and expressive markers; individuals should understand it’s not possible to be right all the time* There are some moments where a binary understanding of gender (male or female) is useful (e.g. seeking medical transition/intervention) A person’s body can be more or less masculine, or more or less feminine A person’s expression can be more or less masculine, or more or less feminine Transgender identities are valid based on a medical diagnosis Transgender identities are valid where people have had medical intervention (e.g. hormone therapy) Gender is biological in nature, but does not have to match sex* A body can range from more masculine to more feminine A person can experience themselves on a spectrum from more masculine to more feminine Being non-binary means living with a gender that falls between masculine and feminine Identity terms (e.g. non-binary; transgender) are important because you can only be what you are by naming it Seeing others present their gender helps to affirm one’s own gender Gender is a way of grouping members of society to assign traits (e.g. clothing style; interests; height; social role, etc.)* Gender is a product of the cultural norms it conforms to* A person’s sex determines how they experience their gender Gender should be assigned at birth Discovery of gender identities is somewhat related to, yet not completely determined by a person’s body Medical transition (e.g. hormone therapy or surgical interventions) are important to gender identity A person’s sex can change over time A person influences their surroundings and alters the way they express themselves to fit (e.g. changing their clothing) A person influences their surroundings and alters how they experience their gender to fit A person influences their surroundings and alters the expression of their gender to fit Gender is the continuous searching and switching of identities A person can choose how they experience their gender Expressive markers are important in determining the gender of a person No attention should be paid to determining gender by physical and/or expressive markers Non-binary refers to the deconstruction of gender boundaries Being non-binary means a person does not identify as a man or a woman* Being non-binary means living with a gender absent of a male/female role Individuals who are non-binary erase their gender by choosing a gender (e.g. selecting ‘male’ on a form) Society should strive to move away from models of gender, using sex to accommodate for when needed (e.g. medical reasons)*

Data availability statement

The data that support the findings of this study are openly available in University of Southampton Institutional Repository at http://doi.org/10.5258/SOTON/D24 31, reference number 471487.