Sex and gender in health research: Intersectionality matters

Subramaniapillai, Sivaniya; Galea, Liisa A.M.; Einstein, Gillian; de Lange, Ann-Marie G.

doi:10.1016/j.yfrne.2023.101104

Cited by 8 publications

(5 citation statements)

References 79 publications

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“…Finally, the contribution of sex and gender to individual and global health is crucial, but it is mandatory to consider them in a broader dimension, which includes intertwined factors, such as ethnicity, religion, educational level, and socio-economic status. Intersectionality represents a multidimensional approach useful to understand how these interlaced elements interact to shape our identity, behaviors, and complex interpersonal relationships [68]. An intersectional analysis is progressively taking hold also in clinical research, particularly tackling areas such as addictions [69], neurological disorders [70], or infectious diseases [71].…”

Section: Discussionmentioning

confidence: 99%

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Perna,

Raparelli,

Tordo Caprioli

et al. 2024

Microorganisms

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Sex and gender are fundamental health determinants and their role as modifiers of treatment response is increasingly recognized. Norepinephrine is a cornerstone of septic shock management and its use is based on the highest level of evidence compared to dopamine. The related 2021 Surviving Sepsis Campaign (SCC) recommendation is presumably applicable to both females and males; however, a sex- and gender-based analysis is lacking, thus not allowing generalizable conclusions. This paper was aimed at exploring whether sex- and gender-disaggregated data are available in the evidence supporting this recommendation. For all the studies underpinning it, four pairs of authors, including a woman and a man, extracted data concerning sex and gender, according to the Sex and Gender Equity in Research guidelines. Nine manuscripts were included with an overall population of 2126 patients, of which 43.2% were females. No sex analysis was performed and gender was never reported. In conclusion, the present manuscript highlighted that the clinical studies underlying the SCC recommendation of NE administration in septic shock have neglected the likely role of sex and gender as modifiers of treatment response, thus missing the opportunity of sex- and gender-specific guidelines.

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Section: Discussionmentioning

confidence: 99%

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Perna,

Raparelli,

Tordo Caprioli

et al. 2024

Microorganisms

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Section: Future Directionsmentioning

confidence: 99%

“…Future research initiatives should focus on sex-specific responses, hormonal influences, interactions with concurrent medications, and their effects on fertility, sexual health, survivorship, and overall outcomes [95,107]. These initiatives should also explore the interactions between immunotherapy and other medications commonly used by women, including hormone replacement therapies or contraceptives [108]. It is also imperative to scrutinize intersectionality; studying the diverse intersections of factors such as race, socio-economic status, and other determinants of health will shed light on disparities that affect the diagnosis, treatment, and outcomes in women with lung cancer [9,108].…”

Section: Future Directionsmentioning

confidence: 99%

“…Telemedicine initiatives can also enhance awareness and accessibility, particularly for those in remote or underserved areas, thereby enabling broader inclusion in clinical care and trials [9]. also imperative to scrutinize intersectionality; studying the diverse intersections of factors such as race, socio-economic status, and other determinants of health will shed light on disparities that affect the diagnosis, treatment, and outcomes in women with lung cancer [9,108]. A comprehensive approach involving healthcare providers, researchers, pharmaceutical companies, institutions, and governing bodies is also needed to promote a more unified understanding of clinical outcomes in women with lung cancer and enhance patient awareness and accessibility.…”

Section: Future Directionsmentioning

confidence: 99%

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Precision Immuno-Oncology in NSCLC through Gender Equity Lenses

Marks,

Sridhar,

et al. 2024

Cancers

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Precision immuno-oncology involves the development of personalized cancer treatments that are influenced by the unique nature of an individual’s DNA, immune cells, and their tumor’s molecular characterization. Biological sex influences immunity; females typically mount stronger innate and adaptive immune responses than males. Though more research is warranted, we continue to observe an enhanced benefit for females with lung cancer when treated with combination chemoimmunotherapy in contrast to the preferred approach of utilizing immunotherapy alone in men. Despite the observed sex differences in response to treatments, women remain underrepresented in oncology clinical trials, largely as a result of gender-biased misconceptions. Such exclusion has resulted in the development of less efficacious treatment guidelines and clinical recommendations and has created a knowledge gap in regard to immunotherapy-related survivorship issues such as fertility. To develop a more precise approach to care and overcome the exclusion of women from clinical trials, flexible trial schedules, multilingual communication strategies, financial, and transportation assistance for participants should be adopted. The impact of intersectionality and other determinants of health that affect the diagnosis, treatment, and outcomes in women must also be considered in order to develop a comprehensive understanding of the unique impact of immunotherapy in all women with lung cancer.

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“… 22 The proneness of gender to hierarchical pressures exemplifies a mechanism via which gender may intersect with other social determinants, such as socioeconomic status and class, affecting health outcomes. 23 This indicates that gender is seldom a stand-alone factor when affecting patients’ illness trajectories, but rather should be considered in its context of other social factors.…”

Section: Sex Gender and Healthmentioning

confidence: 99%

Gender scores in epidemiological research: methods, advantages and implications

Ballering,

Olde Hartman,

Rosmalen

2024

The Lancet Regional Health - Europe

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Sex and gender in health research: Intersectionality matters

Cited by 8 publications

References 79 publications

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Sex- and Gender-Based Analysis on Norepinephrine Use in Septic Shock: Why Is It Still a Male World?

Precision Immuno-Oncology in NSCLC through Gender Equity Lenses

Gender scores in epidemiological research: methods, advantages and implications

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