Gender and Cardiovascular Disease Risk: Beyond the Binary

Sex trouble: Sex/gender slippage, sex confusion, and sex obsession in machine learning using electronic health records

“…Components of sex/gender and how a person interacts and is treated in a social world have significant impacts on their health and wellbeing. 38 , 39 , 40 , 41 Additionally, although a full treatment is outside the scope of this work, gender is also entwined with race, with race mediating how people experience their own genders and how others gender them. 42 , 43 , 44 , 45 The interaction of race and gender means that gendered understandings within the United States reflect the same types of white supremacist biases that all other institutions do, and although we do not have the expertise to fully unpack how sex and gender identity data gathering is mediated by race, we hope that others are able to build on this work to do so.…”

“…However, similarities and differences between transgender and cisgender people are not always well understood in the medical literature or by individual providers. 40 , 53 …”

“…However, similarities and differences between transgender and cisgender people are not always well understood in the medical literature or by individual providers. 40,53 Sex/gender slippage, sex confusion, and sex obsession Despite the complexities of sex and gender, the false assumptions of binary, static, and concordant sex/gender are deeply ingrained in our medical system. 23,33,54,55 This negatively impacts not just transgender and intersex people but also fails to serve anyone who doesn't exactly fit the average.…”

Sex Trouble: Common pitfalls in incorporating sex/gender in medical machine learning and how to avoid them

“…We will frequently use the term sex/gender to refer to the entwinement of these phenomena. Components of sex/gender and how a person interacts and is treated in a social world have deep impacts on their health and wellbeing (Stardust et al, 2017;Tadiri et al, 2021;Knight, 2021;Connelly et al, 2021). Additionally, although a full treatment is outside the scope of this work, gender is also deeply entwined with race, with race mediating how people experience their own genders and how others gender them (Ziyad, 2017;Jones and Shorter-Gooden, 2009).…”

“…However, with their emphasis specifically on "women," "female health" and "sex differences", these interventions actually reinforce a binary, static, and concordant framing of sex/gender, often excluding intersex, transgender, and non-binary people. A lack of consideration of differences in sex/gender leads to lack of knowledge about the experiences of and appropriate treatment for sex/gender minorities, and incorrect, denied, or delayed treatment (Knight, 2021;Stroumsa et al, 2019;Spade, 2003;Today, 2019;Rosendale et al, 2018;Goldstein et al, 2017;Mays et al, 2018).…”