Women and men fare differently regarding organ donation and transplantation. This chapter explores these differences and offers a feminist critique of the complex relationships that pertain among sex, gender, organ donation and transplantation. The first part of the chapter examines these differences, some of which are due to biological features such as effects of sex hormones while others are due to social norms including gender-related discrimination. The second part looks beyond current arrangements to analyze organ donation and transplantation as practices located within social systems and structures that differentially affect women and men in ways that are inflected by power relations. This feminist approach casts new light on ethical issues and offers conceptual tools for addressing transplant inequities.