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Addressing Canada’s Employment Insurance Gap For Self-Employed Workers
Source: TD Ksenia Bushmeneva, Economist Dated July 15th, 2020
While the pandemic had devastated the overall labor market, workers in more precarious and non-standard work arrangements have been especially hard-hit.
Yet, many of these workers do not have access to employment insurance (EI) or run a higher risk than regular workers of not meeting qualification conditions. Only 64% of unemployed Canadians contributed to EI in 2018, meaning that millions would be left without financial assistance in the absence of the Canada Emergency Response Benefit (CERB).
Extending EI coverage to non-standard workers does have challenges. However, there is a growing understanding among many countries that these workers require social protection. More than two thirds of the OECD countries offer at least partial coverage for the self-employed. Their experience offers valuable lessons if Canada decides to follow suit.
The labor market recovery is likely to be uneven and protracted. This is especially true for self-employed and other non-standard workers, since their hours and incomes are more volatile and less protected. Having a more inclusive system with a broader contribution base, which accommodates non-standard workers but also includes a larger number of regular employees would help strengthen the recovery and build on economic gains achieved so far through the temporary CERB program.
The COVID-19 pandemic delivered a sudden and devastating blow to the Canadian labor market. Between February and April, millions of people lost their jobs as employment plunged by 16%. Unlike in previous recessions, the impact this time around has been disproportionately felt by workers in more precarious employment arrangements: part-time, temporary and self-employed, who are less likely to have access to unemployment insurance (EI). These types of work arrangement are more prevalent in the service sector industries, many of which have been hard-hit during this downturn. As of June, year-over-year (y/y) employment in part-time and temporary positions was down by 17% and 24%, respectively (Chart 1). For multiple job holders, employment fell by nearly 40%. By comparison, the 7% y/y decline in permanent positions seems relatively modest.
As dramatic as these declines are, they may still under-represent the pandemic’s toll on employment and incomes. Notably, overall hours worked fell more than employment during the months of lockdown and social distancing. This is especially true for non-standard workers who were more likely to work fewer hours than regular employees. For example, while self-employed workers saw only a 3% drop in employment since February, 43% of self-employed worked less than half of their usual hours in May (Chart 2). By comparison, among all employees, only 9% worked less than half of their usual hours. Moreover, self-employed people who were away from work were more hard-hit financially as they were far less likely to still be paid. Among incorporated self-employed workers with zero hours, less than 1 in 10 received pay compared to 1 in 4 for regular employees in the same situation.
As a result of the significant drop in hours worked, a far larger portion of the labor force was underutilized than suggested by the unemployment rate alone. While the official unemployment rate was 12.3% in June (equivalent to 2.45 million people), Statistics Canada noted that nearly 27% of the potential labour force was ‘underutilized’. The significant gap between the drop in the hours worked versus the more modest decline in employment helps to explain why 8.3 million of people have applied the Canada Emergency Response Benefit (CERB) (at any point during this crisis).
It is clear that self-employed and other non-standard workers were more impacted by the pandemic. Yet these workers usually have the least access to social safety nets, such as EI. Currently, EI unemployment benefits are mostly accessible to employees in the most traditional sense of the word: those that work full-time in a permanent positions for a single employer. By contrast, self-employed workers are not eligible for EIi, and, while those in temporary, contract and part-time positions are eligible, they might not have a chance to accumulate enough insurable hours to qualify because their work arrangements are less stable. Due to lack of EI coverage and significant loss of hours, nearly 40% of self-employed workers applied for CERB benefits, while only 12% and 5% of private and public employees did (Chart 3).
The reasons why some workers, such as those that are self-employed, are excluded are rooted in the design of the EI program. The program is based on insurance principles, with both employers and employees paying into it through mandatory contributions. The corollary is that those workers who have not paid in, as well as those who have left voluntarily without just cause, are disqualified. Contributions are also intended to make the program self-sufficient in the long-run as has been the case in Canada in recent years. In the case of self-employed workers, there’s also an issue of moral hazard when it comes to determining what represents a valid job separation (more on this in the section below: “What Complicates Offering EI Coverage For Non-Standard Workers”). For this and other reasons, many non-standard workers are currently ineligible for unemployment insurance.
These gaps in coverage have been growing as the job market has steadily tilted towards more non-standard work arrangements. In 2018, only 64% of unemployed Canadians had contributed to EI.ii Even among workers who have contributed, only 88% had accumulated enough insurable hours to qualify for benefits, which, depending on the regional level of unemployment, ranges between 420-700 hours in the 52-week period. The combined influence implies a relatively low EI coverage ratio for Canadian workers – out of 1.1 million Canadians who were unemployed in 2018, only 56% were eligible for EI.1 The share of unemployed workers who actually received EI benefits is even lower, averaging slightly above 40%.2 This is considerably below the median coverage among developed counties, which is around 60%.3
Due to data limitations and because non-standard workers include many different types of employment arrangements which may overlap, it is difficult to know with precision the prevalence of non-standard work in Canada. About 15% of Canadian workers are self-employed, while 17% work part-time. In 2016, Statistics Canada estimated that gig workers (self-employed freelancers, on-demand online workers and day labourers) accounted for roughly 8%-10% of Canadian workers. About half of those workers were relying exclusively on their gig income and had no other employment, making them ineligible for EI benefits.4
The low coverage rate and other limitations of the current EI system have been highlighted extensively in other research literature.5 For example, the fact that benefit eligibility and generosity varies geographically across Canada implies that there’s significant variability in coverage rates across provinces. EI coverage ratios are particularly low in Ontario, British Columbia and Alberta – all three provinces which also have above-national prevalence of self-employment (see Charts 4).6
In order to mitigate these shortcomings in the near term, the Canadian government rolled out the CERB program. Compared to EI, CERB qualification rules are very straightforward and were a quick means to provide financial assistance to an extremely broad and large number of applicants that included previously uninsured workers. CERB’s eligibility replaced the insurable hours threshold with a low and uniform income threshold, with anyone over the age of 15, having earned more than $5,000 in income in 2019 and who have lost their job or hours due to COVID-19. This had provided a helping hand to millions of non-standard workers in Canada. However, it has come with a steep price tag: in just three months since it was launched the government had already paid out $55 billions in benefits (as of July 5th) – nearly three times last year’s annual spending on EI and $28 billion more than it had predicted at the conception of the program.
CERB coverage was originally offered for 16 weeks, and was recently extended for an additional 8 weeks. However, it will start expiring in September for the earliest recipients, long before the labour market and certain industries are back to health. Unless adjustments are made to the EI program to accommodate non-standard workers, many of them may suddenly find themselves without unemployment assistance.
What Complicates Offering EI Coverage For Non-Standard Workers
Limited social protection for self-employed and other non-standard workers is not an issue unique to Canada. In most developed countries, non-standard workers have lower social protection compared to regular employees, with unemployment benefits being the least accessible benefit (Charts 5-8). Why is that and what makes implementation of unemployment insurance coverage for self-employed workers challenging for policymakers?
First of all, providing unemployment insurance for self-employed workers (and other non-standard workers) raises the issue of moral hazard. Put another way, presence of EI coverage may change behavior of self-employed workers making them less likely to take on work and more likely to remain unemployed. Non-standard workers tend to have more variable income, and they are far more likely to have lower future earnings than regular employees due, for example, to smaller assignments and contracts, or flexible pricing on various labor platforms (e.g. Uber). Lower expected future earnings could prompt them to quit in favor of EI benefits. More volatile earnings also make it more challenging to determine the appropriate income replacement rate. However, one solution to this could be to use income averaged over a period of time.
Secondly, for regular workers, reasons for leaving a job are transparent and can be verified with the employer. This is difficult to achieve in the case of non-standard workers. For example, if they avoid smaller assignments, then they will lose work but this will be impossible for government agencies to determine.
Some countries (e.g. Sweden, Austria, Slovakia, Spain) offer a voluntary option for self-employed workers to enroll into an employment insurance plan. However, a voluntary arrangement raises the issue of adverse selection. Workers with the highest risks or those that are most likely to make a claim have the greatest incentive to join, which limits the risk-sharing aspect of the program.
Adverse selection is something that Canada experienced first hand when it introduced the Special Benefits for Self-employed Workers (SBSE) in 2010 through the EI system, which allowed self employed workers to opt-in to gain access to maternity and parental benefits, sickness benefits and compassionate care and caregiver benefits. A 2016 program review study found that the characteristics, such as gender, age and income, of the self-employed workers who participated in the SBSE program were considerably different from the general sample of self-employed workers. In focus group studies, participants also indicated that the likelihood of making a claim was an important consideration for their decision to register for the benefits.7 Other issues with the voluntary scheme included a relatively low take-up rate, which in turn led to relatively high administration costs and required significant government subsidies to cover benefit payouts. Longer-run, low coverage is problematic for voluntary, contributions-financed, unemployment insurance schemes, as adverse selection could lead to a vicious cycle of rising insurance premiums and falling coverage. Meanwhile, achieving high coverage may require significant public subsidies because individual willingness to voluntarily pay for unemployment protection appears to be low.8 For those reasons, voluntary coverage schemes do not appear to work well in the case of non-standard workers.
Lastly, the current EI system is based on contributions from both employees and employers. In the case of the self-employed, it is not clear who will pick up the tab for the employer portion of the contribution. If the government subsidizes the employer portion, it could create adverse incentives for employers to hire a self-employed worker to reduce non-wage related labor costs. However, a lack of coverage for non-standard workers could also lead to this outcome, contributing to a rise in non-standard forms of employment. For example, in Italy, para-subordinate workers (self-employed but highly depended on one or very few clients) used to pay significantly lower pension contributions and were not eligible for unemployment and sickness benefits, resulting in significantly lower non-wage labor costs and a rising number of para-subordinated workers. In response to this Italy had gradually increased their contribution rates and expanded coverage. Levelling the playing field led to a significant decline in the prevalence of this type of employment. Austria had a similar experience with independent contractors.
Some Solutions Based on The International Experience
Despite the challenges in expanding unemployment insurance to non-standard workers, there is a growing understanding among many countries that the growing share of non-standard workers need social protection. As a result, more than two thirds of the OECD countries now offer at least partial unemployment benefits to self-employed workers. There’s a great variety of schemes, ranging from mandatory to partial and voluntary coverage, and no two are exactly alike. Still, their experience offers valuable lessons for Canada if it wishes to incorporate self-employed (and potentially other non-standard) workers into its EI system.
So what are some of the solutions of dealing with the higher moral hazard issue for non-standard workers? Lower level of EI benefits or a more restrictive access could be imposed in order to incentivize individuals to search for work or to keep their current job, and to offset higher level of moral hazard. In Sweden, for example, the moral hazard issue is mitigated through more restrictive access, allowing self-employed workers to claim benefits only after 5 years have passed since the previous claim. There is also a requirement that the firm has been shut down, which acts as an additional deterrent.
To mitigate adverse selection, upon starting a business, self-employed individuals in Austria have six months to decide whether they would like to participate in the voluntary unemployment insurance scheme, and that decision is binding for 8 years. In Canada, only half of startups survive to their eight-year anniversary, so there is a high likelihood EI could be used at least once by many self-employed business owners during this time period.10
Generally speaking, based on the OECD review,11 there appears to be a consensus that voluntary coverage schemes, particularly the ones with little or no commitment, such as Canada’s EI SBSE for the self-employed, are quite rare and do not work well to accommodate non-standard employment due to prevalent adverse selection, low participation and the significant public subsidies required to operate them.
On the other hand, mandatory EI contributions and coverage, like the one that currently exists for regular employees, would resolve the issue of adverse selection, hold more closely to the principle of risk sharing within their peer groups, and help to lower program costs. However, results from past surveys conducted in Canada found that there was little support among the self-employed for a mandatory contribution scheme.12 Due to the nature of their work, many self-employed workers indicated a preference to minimize their absence from work (to avoid the risk of losing clients etc.) suggesting that, unless their contribution rates are significantly lower, self-employed workers may get less “value-for-money” from EI programs, such as for example maternity/paternity leave, than traditional employees. The less predictable nature of their income means that they are likely more in need of an income protection program rather than employment insurance.
Indeed, based on surveys, their preferred financing option for temporary work/income disruptions was a tax-sheltered savings account.13 This is another viable alternative to contributions-funded EI, however, the downside is that individual contribution rates would need to be significantly higher in order to generate sufficient savings because there will be no splitting of contribution between employers and employees. There is also a risk that individuals, particularly those in part-time or low-income jobs, may not be able to accumulate sufficient savings to weather the unemployment or low-earnings spell.
For other non-standard workers, such as those with flexible hours or doing work for an online platform, one solution would be to introduce a wage premium for employees doing flexible work. This would compensate workers for the added income uncertainty. In Australia, for example, casual workers are entitled to a wage premium or have a minimum hours guarantee.
Lastly, if the goal is to make social protection more universal and harmonized across all forms of employment, a means-tested social protection system financed through general taxation, similar to that of Australia and New Zealand, could be adopted. However, moving to these systems would require a complete overhaul of Canada’s current contribution-based EI.
The labor market recovery is likely to be uneven and protracted. Even those workers that were able to return to work could remain underutilized and continue to face lower earnings due to social distancing restrictions and weaker consumer demand for a considerable period of time. This is especially true for self-employed and other non-standard workers, since their hours and incomes are more volatile and less protected. The rollout of CERB during the pandemic has been very helpful to address gaps in coverage within the current EI system. However, looking ahead, a more sustainable and permanent solution is required for workers outside the EI system. Having a more inclusive system with a broader contribution base, which accommodates non-standard workers but also includes a larger number of regular employees through more inclusive qualification criteria would help strengthen the recovery and maintain economic gains that were so far accomplished through CERB.
The traditional EI system is based on a binary choice of whether or not someone has a job. It is clear that with non-standard forms of employment becoming more prevalent, fewer people fit into that box. These workers need some form of insurance against joblessness as well as income volatility both during the current economic recovery and in the future to address the changing nature of employment relationships. Many OECD countries now offer various options for non-standard workers to participate in unemployment insurance systems, and their experience offers valuable lessons if Canada decides to follow suit.
Since 2010 self-employed workers can voluntarily participate in EI Special Benefit for Self-Employed Workers (SBSE) to gain access to many life event-type benefits accessible to regular employees, such as maternity and paternity leave programs, leave due to sickness or to care for an sick family member. In addition to this, current EI system allows certain exceptions for some non-standard workers. For example some individuals who work independently as barbers, hairdressers, taxi drivers, drivers of other passenger vehicles are eligible to receive benefits through the regular EI program. Fishermen are also included as insured persons under the EI Fishing Regulations. In the case of the self- employed fishermen, EI qualification is tied to income. In order to qualify for up to 26 weeks of benefit, they need to have earned between $2,500 to $4,200 in the last 31 weeks.
The two main reasons for not contributing to the EI program were not having worked in the previous 12 months, and non-insurable employment (which includes self-employment).
Gender identity is one's personal experience of one's own gender. Gender identity can correlate with assigned sex at birth, or can differ from it. All societies have a set of gender categories that can serve as the basis of the formation of a person's social identity in relation to other members of society. In most societies, there is a basic division between gender attributes assigned to males and females, a gender binary to which most people adhere and which includes expectations of masculinity and femininity in all aspects of sex and gender: biological sex, gender identity, and gender expression. In all societies, some individuals do not identify with some (or all) of the aspects of gender that are assigned to their biological sex; some of those individuals are transgender, genderqueer or non-binary. There are some societies that have third gender categories. Core gender identity is usually formed by age three. After age three, it is extremely difficult to change, and attempts to reassign it can result in gender dysphoria. Both biological and social factors have been suggested to influence its formation. Age of formation There are several theories about how and when gender identity forms, and studying the subject is difficult because children's lack of language requires researchers to make assumptions from indirect evidence. John Money suggested children might have awareness of, and attach some significance to gender, as early as 18 months to two years; Lawrence Kohlberg argues that gender identity does not form until age three. It is widely agreed that core gender identity is firmly formed by age three. At this point, children can make firm statements about their gender and tend to choose activities and toys which are considered appropriate for their gender (such as dolls and painting for girls, and tools and rough-housing for boys), although they do not yet fully understand the implications of gender. After age three, core gender identity is extremely difficult to change, and attempts to reassign it can result in gender dysphoria. Gender identity refinement extends into the fourth to sixth years of age, and continues into young adulthood. Martin and Ruble conceptualize this process of development as three stages: (1) as toddlers and preschoolers, children learn about defined characteristics, which are socialized aspects of gender; (2) around the ages of 5–7 years, identity is consolidated and becomes rigid; (3) after this "peak of rigidity," fluidity returns and socially defined gender roles relax somewhat. Barbara Newmann breaks it down into four parts: (1) understanding the concept of gender, (2) learning gender role standards and stereotypes, (3) identifying with parents, and (4) forming gender preference. According to UN agencies, discussions relating to comprehensive sexuality education raise awareness of topics, such as gender and gender identity.  Factors influencing formation Nature vs. nurture Main article: Nature versus nurture Although the formation of gender identity is not completely understood, many factors have been suggested as influencing its development. In particular, the extent to which it is determined by socialization (environmental factors) versus innate (biological) factors is an ongoing debate in psychology, known as "nature versus nurture". Both factors are thought to play a role. Biological factors that influence gender identity include pre- and post-natal hormone levels. While genetic makeup also influences gender identity, it does not inflexibly determine it. Social factors which may influence gender identity include ideas regarding gender roles conveyed by family, authority figures, mass media, and other influential people in a child's life. When children are raised by individuals who adhere to stringent gender roles, they are more likely to behave in the same way, matching their gender identity with the corresponding stereotypical gender patterns. Language also plays a role: children, while learning a language, learn to separate masculine and feminine characteristics and unconsciously adjust their own behavior to these predetermined roles. The social learning theory posits that children furthermore develop their gender identity through observing and imitating gender-linked behaviors, and then being rewarded or punished for behaving that way, thus being shaped by the people surrounding them through trying to imitate and follow them. A well-known example in the nature versus nurture debate is the case of David Reimer, otherwise known as "John/Joan". As a baby, Reimer went through a faulty circumcision, losing his male genitalia. Psychologist John Money convinced Reimer’s parents to raise him as a girl. Reimer grew up as a girl, dressing in girl clothes and surrounded by girl toys, but did not feel like a girl. After he tried to commit suicide at age 13, he was told that he had been born with male genitalia, which he underwent surgery to reconstruct. This went against Money’s hypothesis that biology had nothing to do with gender identity or human sexual orientation. Biological factors Several prenatal, biological factors, including genes and hormones, may affect gender identity. The biochemical theory of gender identity suggests that people acquire gender identities through such factors rather than socialization. Hormonal influences are also complex; sex-determining hormones are produced at an early stage of foetal development, and if prenatal hormone levels are altered, phenotype progression may be altered as well, and the natural predisposition of the brain toward one sex may not match the genetic make-up of the fetus or its external sexual organs. Hormones may affect differences between males' and females' verbal and spatial abilities, memory, and aggression; prenatal hormone exposure affects how the hypothalamus regulates hormone secretion later in life, with "women's sex hormones usually follow[ing] a monthly cycle [while] men’s sex hormones do not follow such a pattern." Intersex people Main article: Intersex A survey of the research literature from 1955–2000 suggests that more than one in every hundred individuals may have some intersex characteristic. An intersex human or other animal is one possessing any of several variations in sex characteristics including chromosomes, gonads, sex hormones, or genitals that, according to the UN Office of the High Commissioner for Human Rights, "do not fit typical binary notions of male or female bodies". An intersex variation may complicate initial sex assignment and that assignment may not be consistent with the child's future gender identity. Reinforcing sex assignments through surgical and hormonal means may violate the individual's rights. A 2012 clinical review paper found that between 8.5% and 20% of people with intersex variations experienced gender dysphoria. Sociological research in Australia, a country with a third 'X' sex classification, shows that 19% of people born with atypical sex characteristics selected an "X" or "other" option, while 52% are women, 23% men, and 6% unsure. At birth, 52% of persons in the study were assigned female, and 41% were assigned male. A study by Reiner & Gearhart provides some insight into what can happen when genetically male children with cloacal exstrophy are sexually assigned female and raised as girls, according to an 'optimal gender policy' developed by John Money: in a sample of 14 children, follow-up between the ages of 5 to 12 showed that 8 of them identified as boys, and all of the subjects had at least moderately male-typical attitudes and interests, providing support for the argument that genetic variables affect gender identity and behavior independent of socialization. Biological causes of transgender and transsexuality See also: Causes of transsexualism Some studies have investigated whether or not there is a link between biological variables and transgender or transsexual identity. Several studies have shown that sexually dimorphic brain structures in transsexuals are shifted away from what is associated with their birth sex and towards what is associated with their preferred sex. In particular, the bed nucleus of a stria terminalis or BSTc (a constituent of the basal ganglia of the brain which is affected by prenatal androgens) of trans women is similar to cisgender women's and unlike men's. Similar brain structure differences have been noted between gay and heterosexual men, and between lesbian and heterosexual women. Another study suggests that transsexuality may have a genetic component. Research suggests that the same hormones that promote differentiation of sex organs in utero also elicit puberty and influence the development of gender identity. Different amounts of these male or female sex hormones within a person can result in behavior and external genitalia that do not match up with the norm of their sex assigned at birth, and in a person acting and looking like their identified gender. Social and environmental factors In 1955, John Money proposed that gender identity was malleable and determined by whether a child was raised as male or female in early childhood. Money's hypothesis has since been discredited, but scholars have continued to study the effect of social factors on gender identity formation. In the 1960s and 1970s, factors such as the absence of a father, a mother's wish for a daughter, or parental reinforcement patterns were suggested as influences; more recent theories suggesting that parental psychopathology might partly influence gender identity formation have received only minimal empirical evidence, with a 2004 article noting that "solid evidence for the importance of postnatal social factors is lacking." A 2008 study found that the parents of gender-dysphoric children showed no signs of psychopathological issues aside from mild depression in the mothers. It has been suggested that the attitudes of the child's parents may affect the child's gender identity, although evidence is minimal. Parental establishment of gender roles Parents who do not support gender nonconformity are more likely to have children with firmer and stricter views on gender identity and gender roles. Recent literature suggests a trend towards less well-defined gender roles and identities, as studies of parental coding of toys as masculine, feminine, or neutral indicate that parents increasingly code kitchens and in some cases dolls as neutral rather than exclusively feminine. However, Emily Kane found that many parents still showed negative responses to items, activities, or attributes that were considered feminine, such as domestic skills, nurturance, and empathy. Research has indicated that many parents attempt to define gender for their sons in a manner that distances the sons from femininity, with Kane stating that “the parental boundary maintenance work evident for sons represents a crucial obstacle limiting boys options, separating boys from girls, devaluing activities marked as feminine for both boys and girls, and thus bolstering gender inequality and heteronormativity.” Many parents form gendered expectations for their child before it is even born, after determining the child's sex through technology such as ultrasound. The child thus arrives to a gender-specific name, games, and even ambitions. Once the child's sex is determined, most children are raised in accordance with it to be a man or a woman, fitting a male or female gender role defined partly by the parents. When considering the parents' social class, lower-class families typically hold traditional gender roles, where the father works and the mother, who may only work out of financial necessity, still takes care of the household. However, middle-class "professional" couples typically negotiate the division of labor and hold an egalitarian ideology. These different views on gender from a child's parents can shape the child's understanding of gender as well as the child's development of gender. Within a study conducted by Hillary Halpern it was hypothesized, and proven, that parent behaviors, rather than parent beliefs, regarding gender are better predictors for a child’s attitude on gender. It was concluded that a mother’s behavior was especially influential on a child’s assumptions of the child’s own gender. For example, mothers who practiced more traditional behaviors around their children resulted in the son displaying fewer stereotypes of male roles while the daughter displayed more stereotypes of female roles. No correlation was found between a father’s behavior and his children’s knowledge of stereotypes of their own gender. It was concluded, however, that fathers who held the belief of equality between the sexes had children, especially sons, who displayed fewer preconceptions of their opposite gender. Gender variance and non-conformance Main articles: Gender variance, Transgender, Transsexual, and Genderqueer See also: Cisgender Gender identity can lead to security issues among individuals that do not fit on a binary scale. In some cases, a person's gender identity is inconsistent with their biological sex characteristics (genitals and secondary sex characteristics), resulting in individuals dressing and/or behaving in a way which is perceived by others as outside cultural gender norms. These gender expressions may be described as gender variant, transgender, or genderqueer (there is an emerging vocabulary for those who defy traditional gender identity), and people who have such expressions may experience gender dysphoria (traditionally called Gender Identity Disorder or GID). Transgender individuals are greatly affected by language and gender pronouns before, during, and after their transition. In recent decades it has become possible to reassign sex surgically. Some people who experience gender dysphoria seek such medical intervention to have their physiological sex match their gender identity; others retain the genitalia they were born with (see transsexual for some of the possible reasons) but adopt a gender role that is consistent with their gender identity. History and definitions Definitions The terms gender identity and core gender identity were first used with their current meaning — one's personal experience of one's own gender — sometime in the 1960s. To this day they are usually used in that sense, though a few scholars additionally use the term to refer to the sexual orientation and sexual identity categories gay, lesbian and bisexual. Early medical literature In late-19th-century medical literature, women who chose not to conform to their expected gender roles were called "inverts", and they were portrayed as having an interest in knowledge and learning, and a "dislike and sometimes incapacity for needlework". During the mid 1900s, doctors pushed for corrective therapy on such women and children, which meant that gender behaviors that were not part of the norm would be punished and changed. The aim of this therapy was to push children back to their "correct" gender roles and thereby limit the number of children who became transgender. Freud and Jung's views In 1905, Sigmund Freud presented his theory of psychosexual development in Three Essays on the Theory of Sexuality, giving evidence that in the pregenital phase children do not distinguish between sexes, but assume both parents have the same genitalia and reproductive powers. On this basis, he argued that bisexuality was the original sexual orientation and that heterosexuality was resultant of repression during the phallic stage, at which point gender identity became ascertainable. According to Freud, during this stage, children developed an Oedipus complex where they had sexual fantasies for the parent ascribed the opposite gender and hatred for the parent ascribed the same gender, and this hatred transformed into (unconscious) transference and (conscious) identification with the hated parent who both exemplified a model to appease sexual impulses and threatened to castrate the child's power to appease sexual impulses. In 1913, Carl Jung proposed the Electra complex as he both believed that bisexuality did not lie at the origin of psychic life, and that Freud did not give adequate description to the female child (Freud rejected this suggestion). 1950s and 1960s During the 1950s and '60s, psychologists began studying gender development in young children, partially in an effort to understand the origins of homosexuality (which was viewed as a mental disorder at the time). In 1958, the Gender Identity Research Project was established at the UCLA Medical Center for the study of intersex and transsexual individuals. Psychoanalyst Robert Stoller generalized many of the findings of the project in his book Sex and Gender: On the Development of Masculinity and Femininity (1968). He is also credited with introducing the term gender identity to the International Psychoanalytic Congress in Stockholm, Sweden in 1963. Behavioral psychologist John Money was also instrumental in the development of early theories of gender identity. His work at Johns Hopkins Medical School's Gender Identity Clinic (established in 1965) popularized an interactionist theory of gender identity, suggesting that, up to a certain age, gender identity is relatively fluid and subject to constant negotiation. His book Man and Woman, Boy and Girl (1972) became widely used as a college textbook, although many of Money's ideas have since been challenged. Butler's views In the late 1980s, Judith Butler began lecturing regularly on the topic of gender identity, and in 1990, she published Gender Trouble: Feminism and the Subversion of Identity, introducing the concept of gender performativity and arguing that both sex and gender are constructed. Present views Medical field As of 2014, there is some changing of views and new discrepancies about the best way to deal with gender nonconformity. Some members of the medical field, as well as an increasing number of parents, no longer believe in the idea of conversion therapy. On the other hand, there are still a large number of clinicians who believe that there should be interventions for gender nonconforming children. They believe that stereotypical gender-specific toys and games will encourage children to behave in their traditional gender roles. Transsexual self-identified people sometimes wish to undergo physical surgery to refashion their primary sexual characteristics, secondary characteristics, or both, because they feel they will be more comfortable with different genitalia. This may involve removal of penis, testicles or breasts, or the fashioning of a penis, vagina or breasts. In the past, sex assignment surgery has been performed on infants who are born with ambiguous genitalia. However, current medical opinion is strongly against this procedure, since many adults have regretted that these decisions were made for them at birth. Today, sex reassignment surgery is performed on people who choose to have this change so that their anatomical sex will match their gender identity. In the United States, it was decided under the Affordable Care Act that health insurance exchanges would have the ability to collect demographic information on gender identity and sexual identity through optional questions, to help policymakers better recognize the needs of the LGBT community. Gender dysphoria and gender identity disorder Gender dysphoria (previously called "gender identity disorder" or GID in the DSM) is the formal diagnosis of people who experience significant dysphoria (discontent) with the sex they were assigned at birth and/or the gender roles associated with that sex: "In gender identity disorder, there is discordance between the natal sex of one's external genitalia and the brain coding of one's gender as masculine or feminine." The Diagnostic and Statistical Manual of Mental Disorders (302.85) has five criteria that must be met before a diagnosis of gender identity disorder can be made, and the disorder is further subdivided into specific diagnoses based on age, for example gender identity disorder in children (for children who experience gender dysphoria). The concept of gender identity appeared in the Diagnostic and Statistical Manual of Mental Disorders in its third edition, DSM-III (1980), in the form of two psychiatric diagnoses of gender dysphoria: gender identity disorder of childhood (GIDC), and transsexualism (for adolescents and adults). The 1987 revision of the manual, the DSM-III-R, added a third diagnosis: gender identity disorder of adolescence and adulthood, nontranssexual type. This latter diagnosis was removed in the subsequent revision, DSM-IV (1994), which also collapsed GIDC and transsexualism into a new diagnosis of gender identity disorder. In 2013, the DSM-5 renamed the diagnosis gender dysphoria and revised its definition. The authors of a 2005 academic paper questioned the classification of gender identity problems as a mental disorder, speculating that certain DSM revisions may have been made on a tit-for-tat basis when certain groups were pushing for the removal of homosexuality as a disorder. This remains controversial, although the vast majority of today's mental health professionals follow and agree with the current DSM classifications. International human rights law The Yogyakarta Principles, a document on the application of international human rights law, provide in the preamble a definition of gender identity as each person's deeply felt internal and individual experience of gender, which may or may not correspond with the sex assigned at birth, including the person's sense of the body (which may involve, if freely chosen, modification of bodily appearance or function by medical, surgical or other means) and other experience of gender, including dress, speech and mannerism. Principle 3 states that "Each person’s self-defined [...] gender identity is integral to their personality and is one of the most basic aspects of self-determination, dignity and freedom. No one shall be forced to undergo medical procedures, including sex reassignment surgery, sterilisation or hormonal therapy, as a requirement for legal recognition of their gender identity." and Principle 18 states that "Notwithstanding any classifications to the contrary, a person's sexual orientation and gender identity are not, in and of themselves, medical conditions and are not to be treated, cured or suppressed." Relating to this principle, the "Jurisprudential Annotations to the Yogyakarta Principles" observed that "Gender identity differing from that assigned at birth, or socially rejected gender expression, have been treated as a form of mental illness. The pathologization of difference has led to gender-transgressive children and adolescents being confined in psychiatric institutions, and subjected to aversion techniques — including electroshock therapy — as a 'cure'." The "Yogyakarta Principles in Action" says "it is important to note that while 'sexual orientation' has been declassified as a mental illness in many countries, 'gender identity' or 'gender identity disorder' often remains in consideration." These Principles influenced the UN declaration on sexual orientation and gender identity In 2015, gender identity was part of a Supreme Court case in the United States called Obergefell v Hodges in which marriage was no longer restricted between man and woman. Non-binary gender identities See also: Third gender and Genderqueer Fa'afafine Main article: Fa'afafine In some Polynesian societies, fa'afafine are considered to be a "third gender" alongside male and female. They are anatomically male, but dress and behave in a manner considered typically female. According to Tamasailau Sua'ali'i (see references), fa'afafine in Samoa at least are often physiologically unable to reproduce. Fa'afafine are accepted as a natural gender, and neither looked down upon nor discriminated against. Fa'afafine also reinforce their femininity with the fact that they are only attracted to and receive sexual attention from straight masculine men. They have been and generally still are initially identified in terms of labour preferences, as they perform typically feminine household tasks. The Samoan Prime Minister is patron of the Samoa Fa'afafine Association. Translated literally, fa'afafine means "in the manner of a woman." Hijras Main article: Hijra (South Asia) In some cultures of Asia, a hijra is usually considered to be neither a man nor a woman. Most are anatomically male or intersex, but some are anatomically female. The hijra form a third gender role, although they do not enjoy the same acceptance and respect as males and females in their cultures. They can run their own households, and their occupations are singing and dancing, working as cooks or servants, sometimes prostitutes, or long-term sexual partners with men. Hijras can be compared to transvestites or drag queens of contemporary western culture. Khanith Main article: Khanith The khanith form an accepted third gender in Oman. The khanith are male homosexual prostitutes whose dressing is male, featuring pastel colors (rather than white, worn by men), but their mannerisms female. Khanith can mingle with women, and they often do at weddings or other formal events. Khaniths have their own households, performing all tasks (both male and female). However, similarly to men in their society, khaniths can marry women, proving their masculinity by consummating the marriage. Should a divorce or death take place, these men can revert to their status as khaniths at the next wedding. Two-spirit identities Main article: Two-Spirit Many indigenous North American Nations had more than two gender roles. Those who belong to the additional gender categories, beyond cisgender man and woman, are now often collectively termed "two-spirit" or "two-spirited." There are parts of the community that take "two-spirit" as a category over an identity itself, preferring to identify with culture or Nation-specific gender terms.
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