It has been identified as "sexist" in guidance issued to schools in the United Kingdom and described as "just as unacceptable as racist and homophobic language." The terms gender creative, pink boy, and tomgirl have been suggested as polite alternatives. The term sissy has historically been used among school children as a "relentlessly negative" insult implying immaturity and gender or sexual deviance.
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It can also be applied to girls as a term of affection from friends who are not family members. Sissy (or sis) can also be a relationship nickname formed from sister, given to girls to indicate their role in the family, especially the oldest female sibling. Research published in 2015 suggests that the terms are asymmetrical in their power to stigmatize: sissy is almost always pejorative and conveys greater severity, while tomboy rarely causes as much concern but also elicits pressure to conform to social expectations. "Sissy" is, approximately, the male converse of tomboy (a girl with masculine traits or interests), but carries more strongly negative connotations. Similar in meaning to pansy, or to nancyboy or poofter outside the United States. A man might also be considered a sissy for being interested in traditionally feminine hobbies or employment (e.g., being fond of fashion), displaying effeminate behavior (e.g., using hair products or displaying limp wrists), being unathletic, or being homosexual.
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Generally, sissy implies a lack of courage, strength, athleticism, coordination, testosterone, male libido, and stoic calm, all of which have traditionally been associated with masculinity and considered important to the male role in Western society. Sissy (derived from sister), also sissy baby, sissy boy, sissy man, sissy pants, etc., is a pejorative term for a boy or man who is not traditionally masculine, and shows possible signs of fragility.