A roadmap for sex- and gender-disaggregated health research

Abstract

Sex and gender are fundamental aspects of health and wellbeing. Yet many research studies fail to consider sex or gender differences, and even when they do this is often limited to merely cataloguing such differences in the makeup of study populations. The evidence on sex and gender differences is thus incomplete in most areas of medicine. This article presents a roadmap for the systematic conduct of sex- and gender-disaggregated health research. We distinguish three phases: the exploration of sex and gender differences in disease risk, presentation, diagnosis, treatment, and outcomes; explaining any found differences by revealing the underlying mechanisms; and translation of the implications of such differences to policy and practice. For each phase, we provide critical methodological considerations and practical examples are provided, taken primarily from the field of cardiovascular disease. We also discuss key overarching themes and terminology that are at the essence of any study evaluating the relevance of sex and gender in health. Here, we limit ourselves to binary sex and gender in order to produce a coherent, succinct narrative. Further disaggregation by sex and gender separately and which recognises intersex, non-binary, and gender-diverse identities, as well as other aspects of intersectionality, can build on this basic minimum level of disaggregation. We envision that uptake of this roadmap, together with wider policy and educational activities, will aid researchers to systematically explore and explain relevant sex and gender differences in health and will aid educators, clinicians, and policymakers to translate the outcomes of research in the most effective and meaningful way, for the benefit of all.

Psychosocial distress and health status as risk factors for ten-year major adverse cardiac events and mortality in patients with non-obstructive coronary artery disease

“…Sensitivity analyses were done stratified by sex, as well as the interaction of sex-by-psychosocial factor adjusted for age 20 . The Type D personality continuous score was explored, by adding the quadratic negative affectivity and social inhibition terms 21 .…”

Differences across the lifespan between females and males in the top 20 causes of disease burden globally: a systematic analysis of the Global Burden of Disease Study 2021

“…Although disaggregating data by sex and gender identity is crucial, it constitutes only the initial step in unravelling the roots of health disparities between men, women, and gender-diverse individuals. 49 To effectively tailor responses that accommodate the life experiences and health challenges of all and promote changes, it is imperative to continue innovating in the analysis of secondary health data from a gender perspective. 8 , 50 This involves acknowledging gender as a social construct and focusing on the power dynamics and societal norms, which are key drivers of health disparities.…”