The term gender preference is confusing because it has a number of at best tangentially related meanings. For example, the term gender preference or sexual preference is used to describe the desire of biological parents for either a male or female child and—in the extreme—use a range of odious methods (e.g., infanticide and sex-selective abortions) to achieve that result. In patrilineal societies, the necessity for a male birth is straightforward. Less-developed societies tend to favor males for immediate utilitarian reasons and, eventually, as a primitive social security system. No such clear-cut historical and/or cultural rationales fully explain this phenomenon’s occurrence in developed countries, where adoptive parents strongly prefer to adopt girls. Another use of the term gender preference is to describe explicit or implicit job discrimination by which women are perceived as unable to perform certain skills (e.g., tasks requiring heavy lifting and other such manual labor). Overall though, the most ubiquitous use of the terms gender preference and sexual preference is in reference to sexual orientation.

Prefer, meaning "to like better or best," is a transitive verb: It requires a direct object. Given this use of the word, sexual orientation is considered synonymous with gender preference, for most discussion of sexual orientation is about whether an individual can be labeled as homosexual, heterosexual, or bisexual—that is, whether the "direct object" is the opposite gender, the same gender, or both. Most research and theories focus on homosexuality, not heterosexuality or bisexuality. Indeed, at the heart of most explorations of sexual orientation is an attempt to determine whether homosexuality is an outcome of nature or nurture. In an effort to attain the worthwhile goal of de-stigmatizing homosexuality and having it successfully removed from official lists of pathologies, activists have tended to fixate on biological determinism.

Acknowledging the difficulty of parsing out the influences of nature and nurture, Mustanski, Chivers, and Bailey proposed a "thought experiment" (2002, p. 94) that would involve an ideal test of whether hormones influence sexual orientation by a prenatal, organizational action. This experiment would require sex reassignment of a random sample of newborn males reared by adoptive parents blinded to the child’s natal sex. This unethical "experiment" exemplifies the extremes required to sort out these factors. Mustanski and colleagues summarized the findings of the last decade in the neurohormonal areas, including psychoneuroendrocrinology, prenatal stress, cerebral asymmetry, neuroanatomy, anthropometrics, genetics, birth order, and developmental stability. They acknowledged some consistent findings, especially regarding genetics; however, their report concludes that it remains "puzzling … how and when these biological factors act and to what degree these factors influence sexual orientation" (p. 129). They also stated, "The term biological is frequently misunderstood and misused due to it being somewhat amorphous, given that all human behaviors are enacted by the brain and thus are in some sense biological" (p. 90). Thus, they speculated, "Rather than asking if sexual orientation is biological, we believe it is more fruitful to consider whether differences in sexual orientation primarily reflect differences in social experiences, differences in biologic factors unrelated to social experiences, or both. The ultimate goal of such research will be to understand the timing and mechanism of various etio-logical factors that influence sexual orientation" (p. 90).

In The Homosexual Matrix (1975), C. A. Tripp included a section titled "The Directional Controls of Sex." Tripp stated that sexual choices made and actions taken are learned behaviors influenced by an individual experience in the context of a particular society. These learning processes are "rooted in a biological groundwork of slowly accumulating changes … over eons of mammalian evolution." Tripp followed this path from sexual activity that is "rigorously regulated by specific physiologic controls" in lower mammals where "every movement is predetermined by key responses," through primates whose "sexual patterns are neither stereotyped nor guided by specific signals; they are almost entirely dependent on individual learning," culminating in humans with an enlarged cerebral cortex. Tripp described a "progressive relaxation of specific physiologic controls over sexuality" as the cerebral cortex assumes controls of voluntary behaviors such as sexuality. "Thus, human sexuality is exceedingly variable, deriving its directionality (especially its final targeting) from what is individually learned and experienced in personal and social settings" (pp. 12—15).

John Money created a list highlighting the endlessness of teasing out the antecedents for Tripp’s directionality and targeting. Describing what is required for what he labeled a lovemap, Money contended that "the variables will be genomic status; hormonal history (prenatal and postnatal); sexual brain cell functioning; history of toxic, infectious, or traumatic exposure; infantile pairbonding; juvenile troopbonding; juvenile sexual rehearsal play; sex education; adolescent sexual history; amative history in imagery, ideation, and practice; and so on" (2003, p. 238).

Ultimately, in reference to what or who leads to sex-uerotic arousal and attainment of orgasm, the terms sexual preference and gender preference are oxymorons because they imply that choice is at their core. Furthermore, such terms limit the "object" that stimulates the sexuerotic arousal and its sequela to gender-based categories. Such conceptualization marginalizes the entire phenomenon of paraphilias. Any review would be negligent if it focused on the power of the attraction of gender and ignored the same power that objects such as a shoe, a goat, or a child have on some individuals. Edward Albee’s realistic staging of "The Goat, or Who is Sylvia?" (2003) explores sexual orientation in a way that science has yet to attempt. Research into sexual preference needs to be broad enough to include such phenomena if it is to lead to an understanding of related conditions such as pedophilia. Use of gender preference as a synonym for sexual orientation limits such exploration.

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