Methods for prospectively incorporating gender into health sciences research
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Numerous studies have demonstrated that sex (a biological variable) and gender (a psychosocial construct) impact health and have discussed the mechanisms that may explain these relationships. Funding agencies have called for all health researchers to incorporate sex and gender into their studies; however, the way forward has been unclear to many, particularly due to the varied definition of gender. We argue that just as there is no standardized definition of gender, there can be no standardized measurement thereof. However, numerous measurable gender-related variables may influence individual or population-level health through various pathways. The initial question should guide the selection of specific gender-related variables based on their relevance to the study, to prospectively incorporate gender into research. We outline various methods to provide clarification on how to incorporate gender into the design of prospective clinical and epidemiological studies as well as methods for statistical analysis.
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Most gender-related variables are multi-categorical or continuous, despite ideological binary views.
“Ideologies that maintain dominating power structures often closely associate gender with sex and impose a binary view of gender, although empirical data show most gender-related variables to be either multi-categorical (for example, gender identities) or continuous (for example, masculinity and femininity)54–56.”
From Sex and gender in neurodevelopmental conditions (2023) · cites this paper as [55]
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Brede, J., Loomes, R., & Mandy, W. (2026) · Review Journal of Autism and Developmental Disorders · doi:10.1007/s40489-026-00562-0 · Cited by 3 · see citing works
Whitfield, M. M., Waite, J., Duhn, L., Ross‐White, A., Godfrey, C. M., & Plazas, P. C. (2022) · JBI Evidence Synthesis · doi:10.11124/jbies-21-00418 · Cited by 1 · see citing works
Gender-Related Factors Associated With Outcomes of Acute Coronary Syndrome in Young Female Patients
Fonseca, A. A., Peebles, A., & Pilote, L. (2023) · CJC Open · doi:10.1016/j.cjco.2023.11.019 · Cited by 1 · see citing works
Self-citationvan den Houdt, S. C. M., Mommersteeg, P. M. C., Widdershoven, J. W. M. G., & Kupper, N. H. M. (2024) · International Journal of Behavioral Medicine · doi:10.1007/s12529-024-10333-y · Cited by 1 · see citing works
Rocha, S. V., Cardoso, J. P., Correia, R. A., Silva, N. N., & de Araújo, T. M. (2024) · Revista Brasileira de Saúde Ocupacional · doi:10.1590/2317-6369/15122en2024v49e14
Cambia, J. M., Wannasri, A., Yang, C., Lee, C., & Tsai, M. (2025) · Journal of Adolescence · doi:10.1002/jad.70014
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Additional file 1 of Gender-related variables for health research
Nielsen, M. W., Stefanick, M. L., Peragine, D. E., Neilands, T. B., Ioannidis, J. P. A., Pilote, L., Prochaska, J. J., Cullen, M. R., Einstein, G., Klinge, I. I., et al. (2021) · Figshare · doi:10.6084/m9.figshare.14091096
Self-citationKern, M., Wischmann, H.-A., Müller, A., Kurth, T., & Theuring, S. (2026) · Biology of Sex Differences · doi:10.1186/s13293-026-00875-z
Decoding sex and gender effects on health: evidence from a nationwide cohort
Gebhard, C. E., Gysi, B., Gebert, P., Mikaïl, N., Liechti, L., Schmidlin, P. R., Vinzens, A., Haider, A., Bengs, S., Treyer, V., et al. (2026) · Biology of Sex Differences · doi:10.1186/s13293-026-00888-8
- Authors
- Tadiri, C. P., Raparelli, V., Abrahamowicz, M., Kautzy-Willer, A., Kublickiene, K., Herrero, M.-T., Norris, C. M., & Pilote, L.
- Affiliations
- McGill University Health Centre (CA)
- Sapienza University of Rome (IT)
- Karolinska Institutet (SE)
- Alberta Health Services (CA)
- Corresponding author
- Pilote, Louise
- Venue
- Journal of Clinical Epidemiology
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 129
- Pages
- 191-197
- ISSN
- 0895-4356 (ISSN-L)
- OpenAlex
- W3088540353
- Cited by
- 71
- References
- 31
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 19 · 2023: 15 · 2022: 16 · 2021: 6
- FWCI
- 6.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Hispana (publishedVersion, cc-by-nc-nd)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, other-oa)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion, cc-by-nc-nd)
- Funders
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Keywords
- gender, sex differences, prospective study design, gender measurement, clinical research design, epidemiological study design
- MeSH terms
- Health Equity, Gender Equity, Female, Humans, Male, Public Health, Quality of Health Care, Research Design, Sex Factors, Epidemiologic Studies, Sex Distribution, Needs Assessment
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