According to the Institute of Medicine, sex is typically used as a biologic classification system and expressed as a chromosomal pattern, like XX for females or XY for males. Gender has more to do with self-representation, is typically defined by various behaviors and roles and is expressed by terms like “woman,” “man” or “non-binary.” The presentation of each gender can vary from one culture or time period to another. For example, a 1918 article published in The Infant’s Department stated that baby boys should be dressed in pink, “a more decided and stronger color,” and girls in the “more delicate and dainty” color of blue. Parental abuse and rejection of transgender or gay children are common, leading to disproportionately high rates of abuse, mental health issues, and homelessness for LGBTQ+ youth. Research shows that family rejection can motivate abuse, even if parents believe they are acting out of "concern," and the emotional and psychological consequences on a child are severe. Gender is understood as a social and cultural construct-referring to the roles, behaviors, and identities society assigns to males and females. While biological sex is determined by physical and genetic factors, gender expectations involve how a person is supposed to behave according to their assigned sex. For instance, wearing a wig and dress does not biologically change a man into a woman, but it can be seen as a behavior not aligned with societal expectations for men. This reflects the cultural aspect of gender roles, which vary across societies and times. Thus, dressing contrary to societal male norms does not make one female biologically, but challenges social gender role expectations. In short, gender roles are about societal expectations, not biology. Cross-dressing or gender nonconforming behavior may conflict with these expectations, but biological sex remains distinct from gender expression or identity.