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Sex and gender: modifiers of health, disease, and medicine
Open accessAbstract
Clinicians can encounter sex and gender disparities in diagnostic and therapeutic responses. These disparities are noted in epidemiology, pathophysiology, clinical manifestations, disease progression, and response to treatment. This Review discusses the fundamental influences of sex and gender as modifiers of the major causes of death and morbidity. We articulate how the genetic, epigenetic, and hormonal influences of biological sex influence physiology and disease, and how the social constructs of gender affect the behaviour of the community, clinicians, and patients in the health-care system and interact with pathobiology. We aim to guide clinicians and researchers to consider sex and gender in their approach to diagnosis, prevention, and treatment of diseases as a necessary and fundamental step towards precision medicine, which will benefit men's and women's health.
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“Remarkably, achievement of MASH resolution requires moderate body weight reduction for men, whereas much greater weight loss is required for resolution in pre-menopausal women [30].”
From Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease? (2024) · cites this paper as [30]
Experimental — accuracy not yet measuredIn the citing paper
“Sex and gender are important determinants of health outcomes.58”
From Global health 2050: the path to halving premature death by mid-century (2024) · cites this paper as [58]
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“Sex-related and gender-related attributes separately and jointly act as moderators of many human health outcomes7,52.”
From Sex and gender in neurodevelopmental conditions (2023) · cites this paper as [7]
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“It is not known whether these newer diabetes medications are equally beneficial in women [12,13].”
From Real-world sex differences in type 2 diabetes patients treated with GLP-1 receptor agonists (2024) · cites this paper as [12]
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Metadata
- Authors
- Mauvais-Jarvis, F., Bairey Merz, N., Barnes, P. J., Brinton, R. D., Carrero, J.-J., DeMeo, D. L., De Vries, G. J., Epperson, C. N., Govindan, R., Klein, S. L., Lonardo, A., Maki, P. M., McCullough, L. D., Regitz-Zagrosek, V., Regensteiner, J. G., Rubin, J. B., Sandberg, K., & Suzuki, A.
- Affiliations
- Imperial College London (GB)
- University of Arizona (US)
- Brigham and Women's Hospital (US)
- University of Colorado Anschutz (US)
- Washington University in St. Louis (US)
- Johns Hopkins University (US)
- University of Modena and Reggio Emilia (IT)
- University of Illinois Chicago (US)
- The University of Texas Health Science Center at Houston (US)
- Georgetown University (US)
- Duke Medical Center (US)
- ORCID
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 396
- Issue
- 10250
- Pages
- 565-582
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC7440877
- OpenAlex
- W3057302762
- Cited by
- 2,001
- References
- 203
- Citations by year
- 2026: 262 · 2025: 346 · 2024: 436 · 2023: 324 · 2022: 311 · 2021: 282 · 2020: 38
- FWCI
- 39.98
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-09-05)
- Open access
- bronze
- doi.org
- Locations
- The Lancet (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Universität Zürich
- National Institutes of Health (HL105339, HD057022, DK074970, DK107444, AG059093, HL132825, AG060730, AG057931, AG062333, AG026572, CA174737, NS08779, AG053589, HL114501, HL119380, NS096493)
- U.S. Department of Veterans Affairs (BX003725, CX001532)
- VetenskapsrÃ¥det (2019–01059)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
- Social Sciences › Gender Studies › Diversity and Career in Medicine
- Social Sciences › Sociology and Political Science › Gender, Health, and Social Inequality
- Keywords
- sex differences, gender differences, sex as a biological variable, sex hormones, epigenetics, biological sex, gender construction, precision medicine, women's health, men's health, disease susceptibility, treatment response
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Acute Disease, Cause of Death, Chronic Disease, Female, Health Status, Humans, Male, Pneumonia, Viral, Sex Characteristics, Sex Factors, Sex Distribution, Coronavirus Infections, Precision Medicine, Pandemics
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