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== Gender as biopsychosocial == According to [[Alex Iantaffi]], [[Meg-John Barker]], and others, gender is biopsychosocial. This is because it is derived from biological, psychological, and social factors,<ref>{{Cite journal |last1=Christian |first1=Lisa M. |last2=Cole |first2=Steve W. |last3=McDade |first3=Thomas |last4=Pachankis |first4=John E. |last5=Morgan |first5=Ethan |last6=Strahm |first6=Anna M. |last7=Kamp Dush |first7=Claire M. |date=2021-10-01 |title=A biopsychosocial framework for understanding sexual and gender minority health: A call for action |journal=Neuroscience & Biobehavioral Reviews |language=en |volume=129 |pages=107–116 |doi=10.1016/j.neubiorev.2021.06.004 |issn=0149-7634 |pmc=8429206 |pmid=34097981}}</ref><ref name="Iantaffi 2017"/> with all three factors feeding back into each other to form a person's gender.<ref name="Iantaffi 2017"/> Biological factors such as sex chromosomes, hormones, and anatomy play a significant role in the development of gender. Hormones such as testosterone and estrogen also play a crucial role in shaping gender identity and expression. Anatomy, including genitalia and reproductive organs, can also influence one's gender identity and expression.<ref>{{Cite book |url=https://www.worldcat.org/oclc/967324413 |title=The psychology of gender and health : conceptual and applied global concerns |date=2017 |editor1=Ma. del Pilar Sánchez López |editor2=Rosa M. Limiñana-Gras |isbn=978-0-12-803866-6 |location=London |publisher=Academic Press is an imprint of Elsevier |oclc=967324413}}</ref> Psychological factors such as cognition, personality, and self-concept also contribute to gender development. Gender identity emerges around the age of two to three years. Gender expression, which refers to the outward manifestation of gender, is influenced by cultural norms, personal preferences, and individual differences in personality.<ref name="Iantaffi2020">{{Cite book |last=Iantaffi |first=Alex |url=https://www.worldcat.org/oclc/1202930548 |title=Gender trauma : healing cultural, social, and historical gendered trauma |date=2021 |others=Meg-John Barker |isbn=978-1-78775-107-1 |location=London |publisher=Jessica Kingsley Publishers |oclc=1202930548}}</ref> Social factors such as culture, socialization, and institutional practices shape gender identity and expression. In some English literature, there is also a [[Trichotomy (philosophy)|trichotomy]] between biological sex, psychological gender, and social gender role. This framework first appeared in a feminist paper on [[transsexualism]] in 1978.<ref name="haig" /><ref>{{cite journal|year=1978|title=Transsexualism and women: A critical perspective|journal=Feminist Studies|volume=4|issue=3|pages=97–106|doi=10.2307/3177542|jstor=3177542|author=Yudkin, M.|hdl=2027/spo.0499697.0004.310|hdl-access=free}}</ref>
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