Gender (Female, Male, Gender diverse)

One question (“What is your gender?”) with 4 options: Female, Male, Gender diverse, and ‘Prefer not to say’.

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One question (“What is your gender?”) with 3 options: Female, Male, Gender diverse. In addition, like most SIS questions, we include an answer option for ‘Prefer not to say’ as well as the option to skip the question entirely.


This measure is recommended by the Canadian Institute for Health Information (CIHI) in their Measuring Health Inequalities Toolkit, and is intended to capture the construct of ‘lived gender’. The wording was based on user testing that found that respondents understood ‘female’ and ‘male’ better than ‘woman/girl’, ‘man/boy’ or other ways of asking about gender identity. Currently (2019) in testing by Statistics Canada for use in the 2021 Canadian Census.

While there are many ways to ask about gender, this is the one we recommend in SIS. It avoids the wording of ‘Other’ or ‘X’, which many people find exclusionary or dismissive, and it allows for respondents to select any of the choices they wish, regardless of their biological sex.


Like any question about gender or sex, this measure has significant limitations. It conflates the vocabulary around gender (e.g., masculine, feminine, woman, man, gender fluid, non-binary) with sex (e.g., female, male, intersex). It also combines many terms and concepts for gender under ‘gender diverse’. The vocabulary around these concepts is changing quickly, and different languages and countries have different concepts (e.g., Two-Spirited, hijra, third-gender, third sex), some of which also imply sexual orientation. Specific programs may wish more detailed or culturally relevant options.

Method of measurement

For SIS reports, we combine responses from ‘Gender diverse’ with ‘Prefer not to say’ and unanswered. This provides only three breakdowns for interactive reports: Female; Male; Gender diverse/No answer.  While our approach protects confidentiality by increasing the cell size of responses and making it more difficult to guess who said what, it also reduces the ability to analyze responses by respondents identifying as gender diverse. If you want a more detailed breakdown of responses, you will need a more detailed consent form and an Expert Subscription because of the increased privacy risks to respondents.


Canadian Institute for Health Information. (2018). In Pursuit of Health Equity: Defining Stratifiers for Measuring Health Inequality — A Focus on Age, Sex, Gender, Income, Education and Geographic Location. 69. Retrieved June 20 2019 from