USPSTF Approach to Addressing Sex and Gender When Making Recommendations for Clinical Preventive Services

Abstract

Clinical preventive service recommendations from the US Preventive Services Task Force (USPSTF) are based on transparent, systematic, and rigorous methods that consider the certainty of the evidence and magnitude of net benefit. These guidelines aim to address the needs of diverse populations. Biological sex and gender identity are sources of diversity that are not often considered in studies of clinical preventive services that inform the recommendations, resulting in challenges when evaluating the evidence and communicating recommendations for persons in specific gender identification categories (man/woman/gender nonbinary/gender nonconforming/transgender). To advance its methods, the USPSTF reviewed its past recommendations that included the use of sex and gender terms, reviewed the approaches of other guideline-making bodies, and pilot tested strategies to address sex and gender diversity. Based on the findings, the USPSTF intends to use an inclusive approach to identify issues related to sex and gender at the start of the guideline development process; assess the applicability, variability, and quality of evidence as a function of sex and gender; ensure clarity in the use of language regarding sex and gender; and identify evidence gaps related to sex and gender. Evidence reviews will identify the limitations of applying findings to diverse groups from underlying studies that used unclear terminology regarding sex and gender. The USPSTF will use gender-neutral language when appropriate to communicate that recommendations are inclusive of people of any gender and will clearly state when recommendations apply to individuals with specific anatomy associated with biological sex (male/female) or to specific categories of gender identity. The USPSTF recognizes limited evidence to inform the preventive care of populations based on gender identity.

Sex differences in COVID-19 symptoms and outcomes in people with kidney failure treated with dialysis: a prospective cohort study

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Transgender Individuals Deserve Compassionate, Personalized Care: A Transgender Patient Perspective

“…Use clear and consistent language in sex-specific care/treatment recommendations 5 Involve qualified transgender individuals in research planning that may affect transgender people 4,5 A: Transitioning has me feel happy to be me. I feel more emotionally intune with myself as well as others, and the physical changes my body has undergone make me elated to see the reflection that looks back at me.…”

Operationalizing the Journal of Human Lactation’s Gendered Language Policy

“…The United States Preventive Services Task Force (USPATF), recognized as setting the standards for healthcare delivery in the United States, recently issued its approach for the better review of scientific evidence for recommendations about sex and gendered clinical preventive services (Caughey et al, 2021). Their new policy is designed to:…”

“…The United States Preventive Services Task Force (USPATF), recognized as setting the standards for healthcare delivery in the United States, recently issued its approach for the better review of scientific evidence for recommendations about sex and gendered clinical preventive services (Caughey et al, 2021). Their new policy is designed to:Clarify the populations for which the recommendations should apply and also to present a proposed approach to making recommendations that are respectful of gender diversity and that identify when biological sex assigned at birth has limitations as a factor for whom should receive recommended services (p. E1).…”