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Humans today, typically doctors decide how small a penis has to be, or how unusual a combination of parts has to be, before it counts as intersex. West and Zimmerman state that to understand gender as activity, it is important to differentiate between sex, sex category, and gender. Gender identity is "one's internal, personal sense of being a man or woman or a boy or a girl ". A Comprehensive Grammar of the English Language , for instance, refers to the semantically based "covert" gender e. Rather than viewing sex as a biological construct, there are feminists who accept both sex and gender as a social construct. The American Heritage Dictionary 5th ed. Reimer was in fact not comfortable as a girl and later changed gender identity back to male when discovered the truth of his surgery. Oxford Textbook of Palliative Social Work. Gender Roles: A Sociological Perspective.

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