Why Gender Matters, Second Edition: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences

Why Gender Matters, Second Edition: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences

by Leonard Sax M.D. Ph.D.
Why Gender Matters, Second Edition: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences

Why Gender Matters, Second Edition: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences

by Leonard Sax M.D. Ph.D.


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A revised and updated edition (with more than 70% new material) of the evergreen classic about the innate differences between boys and girls and how best to parent and teach girls and boys successfully, with completely new chapters on sexual orientation and on transgender and intersex kids.

Eleven years ago, Why Gender Matters broke ground in illuminating the differences between boys and girls—how they perceive the world differently, how they learn differently, how they process emotions and take risks differently. Dr. Sax argued that in failing to recognize these hardwired differences between boys and girls, we ended up reinforcing damaging stereotypes, medicalizing normal behavior (see: the rising rates of ADHD diagnosis), and failing to support kids to reach their full potential. In the intervening decade, the world has changed drastically, with an avalanche of new research which supports, deepens, and expands Dr. Sax's work. This revised and updated edition includes new findings about how boys and girls interact differently with social media and video games; a completely new discussion of research on gender non-conforming, LGB, and transgender kids, new findings about how girls and boys see differently, hear differently, and even smell differently; and new material about the medicalization of bad behavior.

Product Details

ISBN-13: 9780451497772
Publisher: Harmony/Rodale
Publication date: 08/29/2017
Pages: 400
Sales rank: 177,322
Product dimensions: 5.10(w) x 7.30(h) x 0.90(d)

About the Author

Leonard Sax MD PhD graduated Phi Beta Kappa from the Massachusetts Institute of Technology (MIT) at the age of 19, and then went on to the University of Pennsylvania, where he earned both a PhD in psychology, and an MD. He completed a 3-year residency in family practice in Lancaster, Pennsylvania. For 19 years, Dr. Sax was a practicing family physician in Maryland, just outside Washington DC. He now sees patients in West Chester, Pennsylvania (west of Philadelphia). In 2005, Doubleday published his first book Why Gender Matters; an updated edition will be published by Harmony in 2017. His second book, Boys Adrift, was published in 2007. His third book Girls on the Edge was published in 2010. His most recent book The Collapse of Parenting was published by Basic Books in December 2015 and became a New York Times bestseller.

Dr. Sax has spoken on issues of child and adolescent development not only in the United States but also in Australia, Bermuda, Canada, England, Germany, Italy, Mexico, New Zealand, Scotland, Spain, and Switzerland. He has visited more than 400 schools since 2001. He has appeared on the TODAY Show, CNN, National Public Radio, Fox News, PBS, the Canadian Broadcasting Corporation, the British Broadcasting Corporation, the Australian Broadcasting Corporation, New Zealand Television, and many other national and international media. 

Find him online at leonardsax.com

Read an Excerpt

Chapter 1


Jason is sixteen. His sister Sonya is fourteen. They come from a stable home with two loving parents. Mom and Dad are concerned about Jason, their son: He’s not working hard at school and his grades are sliding. He spends most of his free time playing video games like Grand Theft Auto or Call of Duty, or surfing the Web for pictures of girls.

Both parents are actually quite proud of Sonya. She is a straight-A student and an athlete, and she has many friends. But when I meet with Sonya, she tells me that she isn’t sleeping well. She wakes up in the middle of the night, feeling guilty about having eaten one whole slice of pizza at supper. She often has palpitations and shortness of breath. And she has just started to cut herself with a razor blade, secretly, on her upper inner thigh so her parents won’t see. She hasn’t told her parents any of this. On the surface she is the golden girl. Inside she feels that she is falling apart.

Her brother Jason, on the other hand, is happy as a clam. He can eat a whole pizza without the slightest remorse. He has no difficulty sleeping: in fact, his parents had to kick him out of bed at noon on a Saturday. He likes to spend his free time hanging with his two buddies who are just like him, playing video games and looking at pictures of girls online.

Matthew turned five years old in August, just before kindergarten started. He was looking forward to it. From what he had heard, kindergarten sounded like one long playdate with friends. He could hardly wait. So his mother, Cindy, was surprised when, in October, Matthew started refusing to go to school, refusing even to get dressed in the morning. More than once Cindy had to dress him, then drag him writhing and thrashing into the car, force him into the car seat, and then pull him out of the car and into the school.

Cindy decided to investigate. She sat in on his kindergarten class. She spoke with the teacher. Everything seemed fine. The teacher--gentle, soft-spoken, and well educated--reassured Mom that there was no cause for alarm. But Cindy remained concerned, and rightly so, because major problems were just around the corner.

Caitlyn was a shy child and just the slightest bit overweight all through elementary school. In middle school she underwent a metamorphosis from chubby wallflower to outgoing socialite. She lost weight so quickly that her mother, Jill, worried she might be anorexic. For the next four years, though, everything seemed great--in a frantic and crazy sort of way. Caitlyn was juggling a heavy academic load, had lots of friends, and maintained a full schedule of after-school activities, staying up until midnight or later doing homework. But she seemed happy enough--often frenzied and frazzled, sure, but still happy. Or at least that’s what everybody thought until the phone rang at 3:00 a.m. that awful, unforgettable November night. A nurse told Jill that Caitlyn was in the emergency room, unconscious, having tried to commit suicide with an overdose of Vicodin and Xanax.

These stories share a common element. In each case problems arose because the parents did not understand some differences between girls and boys. In each case trouble might have been averted if the parents had known enough about boy/girl differences to recognize what was really happening in their child’s life. In each case the parents could have taken specific action that might have prevented or solved the problem.

We will come back to each of these kids later in this book. Right now it may not be obvious to you how each of these stories illustrates a failure to understand sex differences. That’s okay. Later on we’ll hear more about Justin and Sonya, Matthew, and Caitlyn. Armed with some knowledge about boy/girl differences, you will be able to recognize where the parents made the wrong decision or failed to act, and you will see how the stories might have ended differently.

The Dubious Virtue of Gender-Neutral Child Rearing

I enrolled in the Ph.D. program in psychology at the University of Pennsylvania way back in September 1980. Governor Ronald Reagan was challenging President Jimmy Carter for the presidency. The original Apple computer had recently come on the market. “My typewriter is working fine” was the answer the department secretary gave me when I asked her whether she would be getting a computer anytime soon. Nobody I knew had ever heard of e-mail or the Internet. The invention of the World Wide Web still lay ten years in the future.

Among the courses I took that fall was a graduate seminar in developmental psychology. “Why do girls and boys behave differently?” my professor, Justin Aronfreed, asked rhetorically. “Because we expect them to. We teach them to. Imagine a world in which we raised girls to play with tanks and trucks, in which we encouraged boys to play with dolls. Imagine a world in which we played rough-and-tumble games with girls while we cuddled and hugged the boys. In such a world, many of the differences we see in how girls and boys behave--maybe even all the differences--would vanish.”

In another seminar my fellow graduate students and I learned about the extraordinary work of Professor John Money at Johns Hopkins. Professor Money had been consulted by the parents of an unfortunate little boy whose penis had literally been sizzled off during a botched circumcision. At Dr. Money’s recommendation, the boy had been raised as a girl, with excellent results (according to Dr. Money). The child loved to play dress-up, enjoyed helping Mom in the kitchen, and disdained “boy toys” such as guns or trucks. “Dr. Money’s work provides further evidence that most of the differences we observe between girls and boys are socially constructed,” Professor Henry Gleitman told us. “We reward children who follow the sex roles we create for them while we penalize or at least fail to reward children who don’t conform. Parents create and reinforce differences between girls and boys.”

We nodded sagely. In clinical rotations we often encountered parents who still clung to the quaint notion that girls and boys were different from birth. But we knew better.

Or so we thought.

I graduated with my Ph.D. in psychology, as well as my M.D., in 1986. When I left Philadelphia to begin my residency in family practice, I got rid of most of the papers I had accumulated during my six years at the University of Pennsylvania. But there was one folder I didn’t throw out: a folder of papers about sex differences in hearing, showing that girls and boys hear differently.

Four years later, after I finished my residency in family medicine, my wife and I established a family practice in Montgomery County, Maryland, just outside of Washington, DC. Several years passed. I wasn’t thinking much about gender differences. Then, in the mid-1990s, I began to notice a parade of second- and third-grade boys marching into my office, their parents clutching a note from the school. The notes read: “We’re concerned that Justin [or Carlos or Tyrone] may have attention deficit disorder. Please evaluate.”

In some of these cases I found that what these boys needed wasn’t drugs for ADHD (attention deficit hyperactivity disorder) but rather a teacher who understood the differences in how girls and boys learn. Upon further inquiry, I found that nobody at the school was aware of girl/boy differences in the ability to hear. I reread the papers in that manila folder, documenting hardwired differences in the ability to hear, showing that the average boy has hearing that is less sensitive than the average girl. In the next chapter we will look more closely at evidence for sex differences in hearing.

Think about the typical second-grade classroom. Imagine Justin, six years old, sitting at the back of the class. The teacher, a woman, is speaking in a tone of voice that seems about right to her. Justin barely hears her. Instead, he’s staring out the window or watching a fly crawl across the ceiling. The teacher notices that Justin isn’t paying attention. Justin is demonstrating a deficit of attention. The teacher may reasonably wonder whether Justin perhaps has attention deficit disorder.

The teacher is absolutely right about Justin showing a deficit of attention. But his attention deficit isn’t due to attention deficit disorder, it’s due to the fact that Justin isn’t hearing the soft-spoken teacher very well. And very few six-year-old boys will raise their hands and say, “Excuse me, Ms. Gentlevoice, I do hear you, but not very well. Could you please speak more loudly?” The teacher is talking in a tone of voice that seems comfortable to her, but some of the boys are zoning out. In some cases we might be able to fix the problem simply by putting the boy in the front row.

“You should write a book, Dr. Sax,” one parent told me. “Write a book so that more teachers know about the differences in how girls and boys hear.”

I allowed myself a patronizing smile. “I’m sure that there must already be such books for teachers, and for parents,” I said.

“There aren’t,” she said.

“I’ll find some for you,” I said.

That conversation took place nearly twenty years ago. Since then I’ve read lots of popular books about differences between girls and boys. And guess what. That mom was right. Not only do most of the books currently in print about girls and boys fail to state the basic facts about innate differences between the sexes, but many of them promote a bizarre form of political correctness, suggesting that it is somehow chauvinistic even to hint that any innate differences exist between female and male. A tenured professor at Brown University published a book in which she claims that the division of the human race into two sexes, female and male, is an artificial invention of our culture. “Nature really offers us more than two sexes,” she claims, adding, “Our current notions of masculinity and femininity are cultural conceits.” The decision to “label” a child as a girl or a boy is “a social decision,” according to this expert. We should not label any child as being either a girl or a boy, this professor proclaims. “There is no either/or. Rather, there are shades of difference.”1 This book received courteous mention in The New York Times and The Washington Post. America’s most prestigious medical journal, The New England Journal of Medicine, praised the author for her “careful and insightful” approach to gender.2

I soon assembled a small library of books that counsel parents that the best child-rearing is gender-neutral child rearing. These books tell parents that true virtue is to be found in training your child to play with toys traditionally associated with the opposite sex. You should buy dolls for your son, to teach him how to nurture.3 You should buy an Erector set for your daughter. The underlying assumptions--that giving dolls to boys will cause boys to become more nurturing, or that giving girls Erector sets will improve girls’ spatial relations skills--are seldom questioned.

On the same bookshelf you can find books that do affirm the existence of innate differences in how girls and boys learn. But these books often promote antiquated and inaccurate gender stereotypes. “Girls are more emotional than boys.” “Boys have a brain-based advantage when it comes to learning math.” Those notions turn out to be false.

On one hand, you have books claiming that there are no innate differences between girls and boys, and that anybody who thinks otherwise is a reactionary stuck in the 1950s. On the other, you have books affirming innate differences between girls and boys--but these authors interpret these differences in a manner that reinforces gender stereotypes.

These books have only one thing in common. They are based less on fact and more on their authors’ personal beliefs or political agendas--either to deny innate sex differences or to use sex differences in child development as a justification for maintaining traditional sex roles. After waiting for somebody else to write a book about girls and boys based on actual scientific research and clinical experience, I finally decided to write one myself.

Every child is unique. I will not suggest that all boys are the same or that all girls are the same. I know that they are not. I have been a medical doctor for more than thirty years. I am the veteran of thousands of office visits with girls and boys. But the fact that each child is unique and complex should not blind us to the fact that gender is one of the two great organizing principles in child development--the other principle being age. Trying to understand a child without understanding the role of gender in child development is like trying to understand a child’s behavior without knowing the child’s age. Pick up a book with a title like What to Expect from Your Two-Year-Old. That book is very different from What to Expect from Your Eight-Year-Old. Of course, nobody is saying that all two-year-olds are alike or that all eight-year-olds are alike. While recognizing diversity among two-year-olds, we can still have a meaningful discussion of the ways in which two-year-olds and eight-year-olds differ, categorically, in terms of what they can do, what they’re interested in, how they relate to their parents, and so on.

At least with regard to how children hear and speak, gender may be even more fundamental to learning than age is. When the noted linguist and Georgetown University professor Deborah Tannen compared how girls and boys of different ages use language, she “was overwhelmed by the differences that separated the females and males at each age, and the striking similarities that linked the females, on one hand, and the males, on the other, across the vast expanse of age. In many ways, the second-grade girls were more like the twenty-five-year-old women than like the second-grade boys.”4

The analogy to age differences provides a good way to think about sex differences. No two girls are alike, just as no two boys are alike. Seven-year-old Stephanie, who likes to roll in the mud and play soccer, is very different from seven-year-old Zoe. Zoe’s favorite hobby is playing with her Barbies. Zoe also insisted on joining the Junior Poms, a sort of cheerleading group. Zoe was asking for lipstick at age five. Her mother, Barbara, a sincere old-school feminist, was horrified. “Where is this coming from?” she asked me, bewildered. “I only own one lipstick and I haven’t used it in six months. And I loathe and despise Barbies. I’ve never even bought one for Zoe. She gets all that trash as gifts from her aunts and uncles.”

1. Anne Fausto-Sterling, Sexing the Body: Gender Politics and the Construction of Sexuality (New York: Basic Books, 2000), pp. 31, 3.

2. Claudia Dreifus, “Anne Fausto-Sterling: Exploring What Makes Us Male or Female,” New York Times, January 2, 2001, p. F3. See also Courtney Weaver, “Birds Do It,” Washington Post, March 26, 2000, p. X6; and Marc Breedlove, “Sexing the Body,” New England Journal of Medicine, volume 343, p. 668, August 31, 2000.

3. This recommendation is made by Susan Hoy Crawford in her book Beyond Dolls and Guns: 101 Ways to Help Children Avoid Gender Bias (Portsmouth, NH: Heinemann, 1995). See also William’s Doll by Charlotte Zolotow (New York: Harper & Row, 1972).

4. Deborah Tannen, You Just Don’t Understand: Women and Men in Conversation, rev. ed. (New York: HarperCollins, 2001), p. 245.


Excerpted from "Why Gender Matters, Second Edition"
by .
Copyright © 2017 Leonard Sax.
Excerpted by permission of Potter/Ten Speed/Harmony/Rodale.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Chapter 1 Differences 1

Chapter 2 Smelling, Seeing, and Hearing 13

Chapter 3 Risk 27

Chapter 4 Aggression 47

Chapter 5 School 69

Chapter 6 Sex 113

Chapter 7 Drugs and Alcohol 135

Chapter 8 Social Media and Video Games 161

Chapter 9 Gender Nonconforming 187

Chapter 10 Lesbian, Gay, Bisexual 213

Chapter 11 Intersex and Transgender 245

Chapter 12 The Male/Female Mistake 279

Extra Stuff: Sex Differences in Hearing 317

Extra Stuff: Sex Differences in Vision 325

Notes 333

Acknowledgments 365

Permissions 369

Index 371

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